Depression, Anxiety And Somatic Distress: Syndromal Structure And Relationship To Onset Of Clinical Disorder
Funder
National Health and Medical Research Council
Funding Amount
$224,085.00
Summary
The project aims to identify the principal dimensions or syndromes underlying symptoms of psychological distress (negative emotional states such as depression, anxiety, stress and fatigue). We plan to use an intensive longitudinal design to examine how these syndromes develop into episodes of clinical disorder. We expect that episodes of disorder will be predicted not only by closely related syndromes, but also by other causally related syndromes - for example, a period of increased anxiety and ....The project aims to identify the principal dimensions or syndromes underlying symptoms of psychological distress (negative emotional states such as depression, anxiety, stress and fatigue). We plan to use an intensive longitudinal design to examine how these syndromes develop into episodes of clinical disorder. We expect that episodes of disorder will be predicted not only by closely related syndromes, but also by other causally related syndromes - for example, a period of increased anxiety and stress may precipitate a depressive disorder. This information is important for understanding the aetiology of clinical disorders, for refining diagnostic criteria, and for the prediction and prevention of disorder. We also plan to collect information about the degree of disability that people suffer and the type of health services they access at various levels of severity of each syndrome. We expect that subclinical levels of some syndromes will be associated with substantial impairment and service usage, but that for other syndromes impairment will be minimal until clinical levels of severity are reached. This information will give a more complete picture of the community-wide burden of emotional distress, and will be directly relevant to health planning and policy.Read moreRead less
The Role Of Dendritic Cells In Graft-versus-host Disease After Allogeneic Stem Cell Transplantation.
Funder
National Health and Medical Research Council
Funding Amount
$317,633.00
Summary
Allogeneic bone marrow transplantation (BMT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. Graft-versus-Host Disease (GVHD) ocurrs when the newly transplanted bone marrow (which includes the immune system) recognises the transplant recipient as foreign and mounts an immune attack against patient tissues. GVHD is the major complication of BMT and is responsible for the death of up to half of the patients who receive this proced ....Allogeneic bone marrow transplantation (BMT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. Graft-versus-Host Disease (GVHD) ocurrs when the newly transplanted bone marrow (which includes the immune system) recognises the transplant recipient as foreign and mounts an immune attack against patient tissues. GVHD is the major complication of BMT and is responsible for the death of up to half of the patients who receive this procedure. Research to date by Dr Hill and colleages has provided substantial detail on how and why this process occurs. This information has led to a number of advances in the field which are already improving patient survival after BMT. This includes a new type of bone marrow transplantation that uses a naturally ocurring growth factor (called a cytokine) to allow the collection of immature bone marrow cells from the blood of transplant donors. The transplantation of these cells rather than bone marrow appears to reduce the chance of dying during BMT and also improves the cure rates from the underlying leukemia. In addition, Dr Hill has developed a novel method for preventing GVHD using different types of naturally ocurring growth factors called cytokine shields that help protect patient tissue from attack by the immune system. It has recently become clear that the immune system is directed by a subtype of white cells called dendritic cells and Professor Hart at the Mater Medical Research Institute has been a pioneer in this field. As initiators of the immune system it is likely that dendritic cells play a pivotal role in GVHD and Dr Hill and Prof Hart at the Mater Medical Research Institute will study DC within the context of Dr Hills newly developed therapies with the aim of further understanding the processes of GVHD. This work will allow manipulation of these cells during BMT in order to improve patient survival.Read moreRead less
Allogeneic stem cell transplantation (SCT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. The ability to cure leukemia by this procedure relates to a process known as Graft-versus-Leukaemia effects (GVL) which ocurrs when the newly transplanted stem cells (which includes the immune system) recognises the leukemia as foreign and mounts an immune attack against it. These studies will focus on the effect of a cellular pathway invi ....Allogeneic stem cell transplantation (SCT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. The ability to cure leukemia by this procedure relates to a process known as Graft-versus-Leukaemia effects (GVL) which ocurrs when the newly transplanted stem cells (which includes the immune system) recognises the leukemia as foreign and mounts an immune attack against it. These studies will focus on the effect of a cellular pathway invilving NKT cells that preliminary data suggests is critical to the development of GVL. Methods to augment this activation pathway will be studied in preclinical models that may then be studied in clinical trials with the aim of improving the outcome of patients transplanted for leukemias.Read moreRead less
New Methods Of Pain Assessment In Demented Older Persons
Funder
National Health and Medical Research Council
Funding Amount
$306,000.00
Summary
There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing ....There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing care and a corresponding increase in health care costs. The present proposal aims to develop more sensitive, reliable and valid questionnaire and non-verbal measures of pain in older adults with cognitive impairment and particularly in those with verbal communication problems. By completion, the present studies should provide much needed information on the reliability and validity of several different types of verbal and non-verbal indicators of possible pain. This research should lead to improved pain assessment and management for the growing segment of the population who suffer from pain and impaired cognitive function.Read moreRead less
Bone marrow transplantation (BMT) is the most effect treatment for a number of conditions, especially leukemia. Graft versus host disease (GVHD) is a complication of BMT and results in the death of up to 50% of transplant recipients. GVHD occurs when the newly transplanted immune system recognizes the recipient as foreign and mounts and immune reponse against the patients tissues. These studies will focus on identifying and understanding the function of the immune cells which drive GVHD.
Activated Dendritic Cell Monoclonal Antibodies As Therapeutics To Prevent Graft Versus Host Disease
Funder
National Health and Medical Research Council
Funding Amount
$432,750.00
Summary
A New Therapy to Prevent Graft versus Host Disease in Bone Marrow Transplantation Bone marrow transplants often fail due to the immune reaction of the grafted donor cells against the patient (graft versus host disease). Current treatments to prevent this do not always work and have serious side-effects or other disadvantages.The immune reaction is induced by activated dendritic cells which are the primary stimulators of the body's defences against foreign invaders. We have developed antibodies i ....A New Therapy to Prevent Graft versus Host Disease in Bone Marrow Transplantation Bone marrow transplants often fail due to the immune reaction of the grafted donor cells against the patient (graft versus host disease). Current treatments to prevent this do not always work and have serious side-effects or other disadvantages.The immune reaction is induced by activated dendritic cells which are the primary stimulators of the body's defences against foreign invaders. We have developed antibodies in mice that react with human activated dendritic cells and prevent them from inducing immune responses in the test-tube. These antibodies are also likely to be effective in patients, but cannot be used in their present form because mouse antibodies induce an undesirable immune response in humans. We therefore plan to convert them to resemble human antibodies (antibody engineering). Antibodies that react with other types of cell in the body are already used to treat or prevent a variety of conditions, including graft versus host disease, but no one has developed a therapeutic antibody against activated dendritic cells. We are applying to the NHMRC for funding to engineer our antibodies and to test them in test tube experiments and also in mouse models of graft versus host disease. We also plan to study the changes in blood levels of activated dendritic cells in bone marrow transplnt patients. This will provide information on the best time to use our new therapeutic antibodies to prevent graft versus host disease. The aim of this grant application will have been achieved if, after three years, we have a new antibody ready for testing in bone marrow transplant patients.Read moreRead less
Regulatory Dendritic Cells For The Prevention And Treatment Of Graft-versus-Host Disease.
Funder
National Health and Medical Research Council
Funding Amount
$165,250.00
Summary
Allogeneic bone marrow transplantation (BMT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. Graft-versus-Host Disease (GVHD) ocurrs when the newly transplanted bone marrow (which includes the immune system) recognises the transplant recipient as foreign and mounts an immune attack against patient tissues. GVHD is the major complication of BMT and is responsible for the death of up to half of the patients who receive this proced ....Allogeneic bone marrow transplantation (BMT) remains the most effect curative treatment for patients with a number of malignant conditions, especially leukemia. Graft-versus-Host Disease (GVHD) ocurrs when the newly transplanted bone marrow (which includes the immune system) recognises the transplant recipient as foreign and mounts an immune attack against patient tissues. GVHD is the major complication of BMT and is responsible for the death of up to half of the patients who receive this procedure. These studies will focus on the ability of a newly defined type of white blood called a regulatory dendritic cell to prevent this complication and avoid the requirement for BMT patients to take drugs that suppress their immune system.Read moreRead less