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A New Model For The Pathogenesis Of Rheumatic Fever: Superantigen Priming Of The Immune Response To Group A Streptococci
Funder
National Health and Medical Research Council
Funding Amount
$248,820.00
Summary
Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, c ....Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, control of this ARF will partly depend on new and better treatment and prevention strategies. To achieve these goals a deeper understanding of the immune mechanisms underlying this disease is urgently needed. It is known that ARF is caused by an abnormal immune response following streptococcal infection. This leads to the production of cells called T cells that attack the body s own tissues rather than the bacteria itself. This autoimmune disease is responsible for the heart damage that underlies ARF. It is believed that this proces only occurs when susceptible individuals are infected with specific rheumatogenic strains of streptococci. However there are a number of deficiencies in this model and it is proposed that there is an additional factor responsible for the abnormal immune response in ARF. This project will explore the possibility that bacterial toxins called superantigens are the critical missing factor , by studying the immune response in ARF. Superantigens are produced by certain streptococci and staphylococci, and are potent in minute quantities causing widespread activation of the immune system. They have been found to play an important role in a number of autoimmune diseases and the type of immune response found in ARF fits well with that expected if superantigens were involved. If superantigens play an important role in causing the abnormal immune response in ARF then a number of new avenues would open for the treatment and prevention of this disease.Read moreRead less
Innovative Health Programs To Reduce Inequality In Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$876,005.00
Summary
As part of his Senior NHMRC Fellowship, Prof Simon Stewart, a world-renowned health services researcher, will lead an internationally linked team of researchers from a broad range of health disciplines to undertake a program of research designed to improve the lives of those most vulnerable to heart disease and poor health outcomes. His program of research will focus on Indigenous Australians, patients with complex forms of heart disease and urban African communities in economic transition.
Remote Aboriginal families and carers of children with disabilities. The project intends to explore the challenges that Aboriginal families who have children with disabilities experience when living in remote communities. Living in a community with family supports is important for the wellbeing, health and spirituality of Aboriginal people in the Ngaanyatjarra Pitjantjara Yankunytjatjara (NPY) lands. However, the NPY Women’s Council are concerned that this is a significant challenge for families ....Remote Aboriginal families and carers of children with disabilities. The project intends to explore the challenges that Aboriginal families who have children with disabilities experience when living in remote communities. Living in a community with family supports is important for the wellbeing, health and spirituality of Aboriginal people in the Ngaanyatjarra Pitjantjara Yankunytjatjara (NPY) lands. However, the NPY Women’s Council are concerned that this is a significant challenge for families and carers of children with disabilities. Project results will be used to propose models for supporting children with disabilities and their families and caregivers to live good lives in their communities. The outcomes are expected to inform service redesign to allow Aboriginal people to fully benefit from the National Disability Insurance Scheme.Read moreRead less
Special Research Initiatives - Grant ID: SR120100005
Funder
Australian Research Council
Funding Amount
$3,198,392.00
Summary
National Indigenous Research and Knowledges Network. The National Indigenous Research and Knowledges Network will capacity build and increase Indigenous higher degree, early and mid career researchers to develop new approaches to undertaking research and producing outcomes. NIRAKN's members include a number of universities, AIATSIS, and partner organisations.
The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the co ....The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the country. The project aims to inform consumers, health practitioners, health service planners and policy-makers about the impact of FIFO, as well as to contribute to the development of strategies designed to stabilise the remote health workforce.Read moreRead less
Improving Delivery Of Secondary Prophylaxis For Rheumatic Heart Disease: A Stepped-wedge, Community-randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,913,074.00
Summary
Rheumatic heart disease (RHD) is a major health problem in Indigenous communities. Continued progress in controlling RHD requires an understanding of how to improve delivery of regular injections of penicillin - secondary prophylaxis (SP). We will evaluate a systems-based approach to improving delivery of SP, using a stepped-wedge trial in 12 communities in NT and Qld. If successful, this model will provide a practical and transferable model.
Fostering Aboriginal sexual well-being by building on strengths. This project aims to use a strengths-based approach to examine how Aboriginal young people draw on social, cultural and personal resources to build their sexual well-being. Many Aboriginal Australians see strengths approaches as essential to addressing disadvantage. However, to date they have not been widely used to address the significant sexual health inequalities experienced by Aboriginal young people. The project will create ne ....Fostering Aboriginal sexual well-being by building on strengths. This project aims to use a strengths-based approach to examine how Aboriginal young people draw on social, cultural and personal resources to build their sexual well-being. Many Aboriginal Australians see strengths approaches as essential to addressing disadvantage. However, to date they have not been widely used to address the significant sexual health inequalities experienced by Aboriginal young people. The project will create new knowledge about ‘what works’ in supporting the sexual well-being of Aboriginal young people, that has relevance to a broad range of disciplines beyond the area of health and well-being.Read moreRead less
Closing the gap on Indigenous birth registration. This project investigates the nature and extent of problems faced by Indigenous Australians trying to access the birth registration systems within Australia. Following extensive consultation with Indigenous communities and other key stakeholders, this project will identify the causes of the problem and recommend appropriate solutions.
Investigating social, built and physical environment factors for remote Indigenous communities, and their relationships with cardiometabolic outcomes. This study with 74 remote Indigenous communities will be the first to evaluate features of their social, built and physical environments in relation to cardiometabolic risks and diseases. Policy-relevant results will identify features of environments to be targeted to assist reducing chronic diseases for Indigenous peoples in remote communities.
Re-integrating Central Australian community cultural collections. This project aims to apply current research on archiving and community access to find practical solutions to managing the large amounts of recorded cultural material of interest to the Central Land Council, the peak Indigenous representative body covering the southern half of the Northern Territory. The project aims to identify and integrate information in a common database, work with community members to create a prioritised list ....Re-integrating Central Australian community cultural collections. This project aims to apply current research on archiving and community access to find practical solutions to managing the large amounts of recorded cultural material of interest to the Central Land Council, the peak Indigenous representative body covering the southern half of the Northern Territory. The project aims to identify and integrate information in a common database, work with community members to create a prioritised list of any at-risk materials and apply locally meaningful categories for managing the archival materials relevant to their community, and deliver appropriate documentation of process, permissions and reports to support ongoing sustainability of the collections.Read moreRead less