Unraveling Mechanisms Of Liver Transplant Tolerance
Funder
National Health and Medical Research Council
Funding Amount
$694,822.00
Summary
Liver transplants are unique amongst solid organs as they are spontaneously accepted across different individuals and induce acceptance of other organs from the same donor co-transplanted at the same time. Using a new mouse liver transplantation model, this proposal will elucidate how the liver tissue performs this function and identify new markers associated with tolerance in the blood of mice. This knowledge will be used to identify liver transplant patients with reduced rejection risk.
Creating A Culture Of Safety And Respect: A Controlled, Mixed Methods Study Of The Effectiveness Of A Behavioural Accountability Intervention To Reduce Unprofessional Behaviours
Funder
National Health and Medical Research Council
Funding Amount
$875,978.00
Summary
Unprofessional behaviours among health professionals are common and are associated with increased patient dissatisfaction and medicolegal risk. Addressing these behaviours is a national issue. Ethos is a structured accountability system involving a process of early, non-punitive and tiered intervention and will be introduced across four Australian hospitals. This research will be the first controlled study to assess the effectiveness of the Ethos program to improve patient safety in Australia.
STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less
Computational haemodynamics system for prediction of risk of rupture of cerebral aneurysms. Every year about 2000 Australians suffer a ruptured aneurysm in the brain and some 750 of these die within 4 weeks. Since there is an increase in the detection of unruptured aneurysms, especially in healthy young people, there is an urgent need to be able to decide which lead to rupture and to provide suitable treatment options. This project, which will provide markedly improved means of patient-specific ....Computational haemodynamics system for prediction of risk of rupture of cerebral aneurysms. Every year about 2000 Australians suffer a ruptured aneurysm in the brain and some 750 of these die within 4 weeks. Since there is an increase in the detection of unruptured aneurysms, especially in healthy young people, there is an urgent need to be able to decide which lead to rupture and to provide suitable treatment options. This project, which will provide markedly improved means of patient-specific risk determination for aneurysm rupture, will have significant impact in reducing associated costs on the national health burden due to cerebral hemorrhage and stroke, on community productivity and disability and on more efficient targeting of expensive and dangerous brain surgery.Read moreRead less
Systemic Safety: the meanings of behaviour in contexts of surgical care. This collaborative project aims to improve our understanding of interacting systems of communication, as exemplified by the context of surgery. Increasingly, adverse events in operative care are considered systemic rather than a product of system breakdown. Existing systems, and how they lead to adverse events, need to be made more explicit. We will describe surgical practice as a system of meaning-bearing systems, integra ....Systemic Safety: the meanings of behaviour in contexts of surgical care. This collaborative project aims to improve our understanding of interacting systems of communication, as exemplified by the context of surgery. Increasingly, adverse events in operative care are considered systemic rather than a product of system breakdown. Existing systems, and how they lead to adverse events, need to be made more explicit. We will describe surgical practice as a system of meaning-bearing systems, integrated from context to content to expression, and incorporating language and other symbolic systems. We will display the ensemble effects of choices in these systems and how they predispose towards or inhibit adverse outcomes through systemic networks.Read moreRead less