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Improving The Communication Of People With Severe Traumatic Brain Injury: A Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$448,293.00
Summary
Traumatic brain injury is the leading cause of disability in young Australians, and is particularly prevalent in young men. The condition disturbs thinking and problem solving. Ultimately, these problems manifest in impaired verbal communication. Communication problems following traumatic brain injury can make critical relationships-such as father, husband, and employee-impossible to sustain. Those affected are socially inappropriate and uncomfortable to be around, which causes a lifetime of los ....Traumatic brain injury is the leading cause of disability in young Australians, and is particularly prevalent in young men. The condition disturbs thinking and problem solving. Ultimately, these problems manifest in impaired verbal communication. Communication problems following traumatic brain injury can make critical relationships-such as father, husband, and employee-impossible to sustain. Those affected are socially inappropriate and uncomfortable to be around, which causes a lifetime of lost friendships, unemployability, and social isolation. Minimisation of these lifelong effects is of the utmost importance to the health of those affected, and is critical to reducing the economic burden of the condition. Two approaches have been shown to improve the communication of those with traumatic brain injury. Training in social skills is helpful, as is training partners to deal with difficult communication behaviours. However, to date, no research has concurrently studied these two approaches to rehabilitation. Consequently, it is unknown whether best results are achieved with either one of the two methods, or both. The present project uses a clinical trials approach in an innovative evaluation of three methods of treating those with traumatic brain injury compared with a control group. The trial involves the conceptual advances of including cost effectiveness of treatment as an outcome measure, and inclusion of advanced methods to measure the intricacies of verbal communication. The multidisciplinary team of Chief Investigators has international track records in the requisite disciplines for the study of traumatic brain injury and its rehabilitation.Read moreRead less
10-year Outcome After Stroke: Final Follow-up For Survival, Stroke Recurrence, Functional Ability And Costs
Funder
National Health and Medical Research Council
Funding Amount
$51,475.00
Summary
Stroke is common, occurring in approximately 50,000 Australians each year. About a third of people with stroke die within the first 12 months but we do not know how many survive or how well they manage in the longer term. We aim to interview 10-year survivors of stroke to assess how much help they need to undertake everyday activities, and how much the stroke is costing the Australian community. This information will help us in planning the health care needs for stroke patients in future years.
Improving Outcome After Stroke: A Large, Multicentre, Randomised Controlled Trial Of Very Early Mobilisation (AVERT)
Funder
National Health and Medical Research Council
Funding Amount
$2,915,758.00
Summary
In Australia, stroke accounts for 25% of all chronic disability. The personal and community burden of stroke-related disability is likely to increase considerably over the next 20 years, as the population ages. Without effective prevention and treatment strategies, stroke-related disability and its associated costs will increase. For treatments to have any major impact on death or dependency, they must be widely accessible, cost-effective, appropriate, safe and effective in the vast majority of ....In Australia, stroke accounts for 25% of all chronic disability. The personal and community burden of stroke-related disability is likely to increase considerably over the next 20 years, as the population ages. Without effective prevention and treatment strategies, stroke-related disability and its associated costs will increase. For treatments to have any major impact on death or dependency, they must be widely accessible, cost-effective, appropriate, safe and effective in the vast majority of patients. There is preliminary evidence from Norway that patients who start mobilising (i.e. sitting out of bed, standing and walking) within 24 hours of stroke are more likely to be discharged home (rather than require long term nursing home care), have a shorter stay in hospital, and improved outcome compared to patients who receive general medical ward care. This intervention is simple and more widely applicable than many other acute interventions, but it requires testing. We will conduct the first randomised controlled trial of very early mobilisation after stroke to determine the cost and benefits of the intervention. Patients will be randomised to receive either standard care or standard care in addition to very early and frequent mobilisation. At 3 months post stroke, we will identify the number of patients dead and disabled in each group to determine the effect of intervention on outcome. We will also determine care costs and quality of life in the longer term. The trial design enables comparisons to other standard interventions to improve stroke outcome to be made. We have already recruited two sites and randomised 46 patients to the pilot study. No safety or feasibility concerns have been raised. If positive, this study has the potential to lead to significant changes in clinical practice that may serve to reduce the burden of stroke to both individuals and the broader community.Read moreRead less
Long-term Outcome After Stroke: Survival, Stroke Recurrence, Functional Ability And Costs.
Funder
National Health and Medical Research Council
Funding Amount
$649,971.00
Summary
Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is no information on outco ....Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is no information on outcome beyond 5 years. It is thought that at 10 years after stroke about 70% of patients will have died, and a further 5-10% will have had another nonfatal stroke. The aim of this study is to assess the long-term outcome of patients with stroke. These will include measures of survival, stroke recurrence, and ability to perform usual daily activities. The use of health care and community resources and the associated costs of this will also be assessed. Information on survival patterns, stroke recurrence, disability and costs will be of great value for health service planning. Such information will also be useful to patients, their families, and medical staff who treat these patients.Read moreRead less
Neurocognitive Studies Of Brain Plasticity Associated With Surgical Treatment Of Arteriovenous Malformations
Funder
National Health and Medical Research Council
Funding Amount
$701,922.00
Summary
We will use state-of-the-art brain imaging methods to test whether specific brain areas which have been chronically starved of adequate blood supply can regenerate, informing debate about limits on brain plasticity. Arteriovenous malformations (AVMs) are longstanding defects which can cause thinking skills to 'migrate' to other brain regions in childhood without noticeable impact. Surgical correction allows a test of what happens to the previously inactive area: Does the area 'start to think'?
Gastrointestinal Sensory Function In Normal And Diseased States
Funder
National Health and Medical Research Council
Funding Amount
$691,026.00
Summary
Chronic pain and discomfort from the digestive system is a major health care issue world-wide. There is currently no effective treatment for these problems, which often have no apparent organic cause. Lack of treatment is due to a lack of understanding about how sensations are transmitted from the digestive system to the brain. Our research group has unique and powerful techniques that allow us to probe the basic mechanisms of sensory function, and make rapid progress towards finding drugs that ....Chronic pain and discomfort from the digestive system is a major health care issue world-wide. There is currently no effective treatment for these problems, which often have no apparent organic cause. Lack of treatment is due to a lack of understanding about how sensations are transmitted from the digestive system to the brain. Our research group has unique and powerful techniques that allow us to probe the basic mechanisms of sensory function, and make rapid progress towards finding drugs that reduce specific types of sensory signals from the gut. We shall investigate sensory mechanisms in the upper and lower regions of the gut, where symptoms are most prevalent in diseases such as non-cardiac chest pain, functional dyspepsia and irritable bowel syndrome. Six aspects of sensory nerve endings in the gut are to be investigated: 1. The grouping of endings into functional classes (similar to touch or pressure receptors in skin) 2. How endings respond to chemicals and hormones found in the gut 3. How currently available drugs may be useful in reducing sensitivity 4. The mechanisms by which inflammation affects sensitivity 5. How nerve growth factors may trigger changes in sensitivity 6. How pores or channels in nerve endings determine their functionRead moreRead less
Functional Evaluation Of BRCA1 & BRCA2 Unclassified Sequence Variants And Identification Of Critical Pathogenic Domains.
Funder
National Health and Medical Research Council
Funding Amount
$331,312.00
Summary
The major genes that predispose to hereditary breast cancer are called BRCA1 and BRCA2. Most mutations in these genes cause the protein product to be truncated and inactive. However there are many families in which such truncating mutations are not found, but instead there are sequence changes that slightly alter the protein product. It is often difficult to predict whether these sequence variants are likely to cause hereditary breast cancer simply by looking at the position and nature of the se ....The major genes that predispose to hereditary breast cancer are called BRCA1 and BRCA2. Most mutations in these genes cause the protein product to be truncated and inactive. However there are many families in which such truncating mutations are not found, but instead there are sequence changes that slightly alter the protein product. It is often difficult to predict whether these sequence variants are likely to cause hereditary breast cancer simply by looking at the position and nature of the sequence change. Consequently, it is not possible to offer informative genetic counselling to these women or their at-risk family members. Assessment of the potential pathogenicity and functional significance of these unclassified sequence variants will be directly useful with regard to the clinical management of these women and their families, and will develop our current understanding of how different domains of these genes contribute to their role as cancer susceptibility genes.Read moreRead less
What Drives Abnormal Cerebral Activity In Secondary Generalised Epilepsy
Funder
National Health and Medical Research Council
Funding Amount
$565,809.00
Summary
Secondary Generalised epilepsy (2GE) is a severe, disabling epilepsy syndrome characterised by childhood onset frequent, treatment resistant seizures and developmental delay. Although one of the four major categories of epilepsy, it is poorly understood. This project uses combined EEG (brainwave testing) and MRI to reveal which brain areas are involved in the epileptic activity of 2GE. Advanced analysis techniques will explore which brain regions initiate 2GE epileptic activity.