We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other co ....We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other countries (in North and South America, Asia, and Europe). This study will provide the first nationally-representative information on the burden of chronic obstructive pulmonary disease (COPD) and the opportunities for health gain by improving the management of this illness. In Australia, COPD is a relatively silent and under-recognised disease but nevertheless is the third most important contributor to the burden of disease and the third leading cause of hospital admission as well as being the underlying cause of 4.2% of all deaths. The information we will collect is needed to form a basis for prevention and disease management interventions to reduce the burden of COPD, particularly among population sub-groups who are disproportionately affected, either due to greater exposure to risk factors (mainly tobacco smoking and occupation), greater susceptibility, under-recognition and under-diagnosis, or inadequate disease management. Importantly, the study will serve to raise awareness about the hazards of smoking for all Australians. By identifying target groups, prevalent exposures and management deficiencies, it will lead the way towards policy-relevant randomised controlled trials testing community-based interventions to prevent COPD and-or manage it more effectively. The information collected will help advance knowledge of the prevalence, burden and treatment of COPD that will be relevant to communities throughout the world.Read moreRead less
An Integrated Health-sector Strategy To Combat COPD And Asthma In Vietnam: A Pragmatic Stepped Intervention Cluster Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,894,349.00
Summary
Chronic lung diseases are a major challenge for resource limited settings. In Vietnam, where smoking rates in males are around 50%, there is an urgent need for better strategies to prevent and treat chronic obstructive pulmonary disease (COPD) and asthma. We will perform a study of a low-cost integrated intervention including a health-system based smoking cessation program and the targeted use of proven therapy for COPD and asthma - inhaled corticosteroids - to reduce the burden of lung disease.
Translating Respiratory And Environmental Epidemiology Into Improved Lung Health
Funder
National Health and Medical Research Council
Funding Amount
$319,714.00
Summary
Chronic respiratory disease, tuberculosis and the effects of air pollution are important health problems globally. Evaluating current approaches to dealing with these problems and developing new approaches requires good data. Over the next five years I will lead a number of studies addressing these issues, in Australia and internationally, in order to provided the strongest possible evidence to underpin policy.
Lung disease is a major cause of death and disability world-wide. Tuberculosis was responsible for 1.4 million deaths in 2011. Asthma and chronic obstructive pulmonary disease (COPD) have been high priority diseases in Australia for many years. It was estimated that there were over 3 million deaths attributable to particulate air pollution in 2010. In this Fellowship I will undertake a series of projects designed to improve our understanding of these diseases and their causes.
National Clinical Centre Of Research Excellence In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$2,597,952.00
Summary
Severe Asthma remains a large burden for the Australian community. It does not respond to current management approaches. We will develop and implement a targetted therapy approach to severe asthma that will involve assessment of needs of people with severe asthma, community burden form severe asthma, biomarkers and linked treatment strategies, as well as knowledge transfer tools and training of the health and medical workforce.
Targeting Neutrophil Extracellular Traps To Reduce Inflammation In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$585,240.00
Summary
People with severe asthma, a chronic disease of the lungs, often have many inflammatory cells in the airways called neutrophils. Neutrophils release a meshwork of fibers in a web like trap called NETs, which are made of the cells DNA and other proteins that fight infection. These NETs can promote inflammation in the persons airways. Current asthma treatments have no effect on NETs. This project will measure NETs in the airways and test a new treatment to reduce NETs, and relieve asthma symptoms.
Studies On The Effects Of Endogenous And Exogenous Opioids In Modulating Exercise-induced Dyspnoea In People With Moderate / Severe Chronic Obstructive Pulmonary Disease (COPD). Two Double-blind Randomised, Placebo Controlled Trials.
Funder
National Health and Medical Research Council
Funding Amount
$197,086.00
Summary
There is evidence that morphine-like chemicals made by the body itself help reduce breathlessness. It is not clear whether this response is because of the effects of these morphine-like chemicals on the brain, in the lung or both. This study will help understand where these chemicals act to reduce breathlessness in people with emphysema during exercise. Subsequently, it will also help to understand whether small, regular doses of morphine safely further reduce breathlessness during exercise.
The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue ....The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue the Childhood Asthma Prevention Study (CAPS) which has been underway since mid-1997. CAPS is a randomised controlled trial in which 616 infants at high risk of developing asthma because of a family history have been enrolled. The interventions include allergen reduction and dietary supplementation with omega-3 fatty acids. The interventions are designed to have maximum effect but be simple to implement by parents. Several measures of compliance are being collected and regular contact is maintained though telephone calls and frequent home visits. Objective and subjective measurements of exposures, atopy, diet and asthmatic symptoms are being collected at 3 month intervals and at medical assessments when the children are 18 months, 3 and 5 years old. It is essential that we continue the study until all children are aged 5 and we will be able to test conclusively whether the interventions have had a positive effect. If so, CAPS will form the basis for a nationwide public health campaign which will have the potential to reduce the incidence of childhood asthma in Australia.Read moreRead less
Understanding How Azithromycin Prevents Exacerbations In Severe Asthma
Funder
National Health and Medical Research Council
Funding Amount
$697,273.00
Summary
In some people with severe asthma, conventional inhaler treatments are not able to control the disease so there is a need for new treatment options. We have recently completed a large clinical trial which showed that very low doses of a common antibiotic help prevent asthma attacks in this situation. However, not much is known about how the antibiotic is working. This study will help us understand how the antibiotic is working and which people respond best.
Exploring The Role Of Respiratory Virus Infections In Childhood Asthma Exacerbations
Funder
National Health and Medical Research Council
Funding Amount
$596,649.00
Summary
The PEAK study will explore the reasons children get worse asthma symptoms when they get colds. These reasons examined include the asthma medications taken (or not taken), allergies and exposure to allergens and the type of virus involved. The study follows the children over the whole school term and uses a new way to sample virus by collecting it in the breath, this is more comfortable than old methods and can be done at home.