THE DETECTION AND MANAGEMENT OF DEMENTIA IN GENERAL PRACTICE.
Funder
National Health and Medical Research Council
Funding Amount
$499,977.00
Summary
This research aims to examine a new method and practice guidelines for detection of early dementia. General practitioners will be screened on their ability to diagnose and manage dementia and to distinguish it from other diseases. Patient outcomes - including quality of life, depression, and satisfaction with care and referral indicators - will be examined.
Cognitive Outcome And Therapeutic Interventions For Coronary Artery Disease.
Funder
National Health and Medical Research Council
Funding Amount
$392,104.00
Summary
Dementia is recognized as an increasingly important factor affecting quality of life as people age. Deaths from heart disease are declining, in part due to improved surgical techniques and to the use of less invasive methods to keep arteries open such as coronary stenting. It is now well known that 20 to 60% of patients experience some degree of impairment in thinking ability (cognitive impairment) after cardiac surgery, that this will persist in some of these individuals for years and may incre ....Dementia is recognized as an increasingly important factor affecting quality of life as people age. Deaths from heart disease are declining, in part due to improved surgical techniques and to the use of less invasive methods to keep arteries open such as coronary stenting. It is now well known that 20 to 60% of patients experience some degree of impairment in thinking ability (cognitive impairment) after cardiac surgery, that this will persist in some of these individuals for years and may increase the risk of long-term problems. Cognitive impairment affects people in many ways. While it is not yet known whether the occurrence of cognitive impairment predisposes to dementia, it is thought that Mild Cognitive Impairment (MCI) may do so. We propose to explore the link between MCI and Post Procedural Cognitive Deficit (PPCD) in patients with coronary disease from before the first point of objective diagnosis, i.e. prior to the coronary angiogram, and over a 12-month period, through and subsequent to further treatment interventions such as stenting or cardiac surgery. Our Pilot data suggest that PPCD does indeed occur after angiography, and we propose to identify how long this lasts, whether MCI predisposes to it and whether it is better to wait until it resolves before further interventions are undertaken. In this way we hope to identify the safest treatment strategy for patients with coronary disease that will minimize the occurrence of Cognitive Deficit and possibly longer-term cognitive changes after investigation and treatment for their symptoms.Read moreRead less
Roles Of Enzymes Of The Dipeptidyl Peptidase Gene Family In Human Liver
Funder
National Health and Medical Research Council
Funding Amount
$79,750.00
Summary
Chronic liver diseases, particularly those caused by autoimmune disease, alcohol and Hepatitis B and C virus infection, are major causes of morbidity and mortality in our community. They are characterised by progressive scarring of the liver which finally leads to liver failure and the need in many cases for organ transplantation. Each year 15,000 Australians become infected, probably for life, with hepatitis C virus. Unless more effective treatments are developed approximately 20% of these infe ....Chronic liver diseases, particularly those caused by autoimmune disease, alcohol and Hepatitis B and C virus infection, are major causes of morbidity and mortality in our community. They are characterised by progressive scarring of the liver which finally leads to liver failure and the need in many cases for organ transplantation. Each year 15,000 Australians become infected, probably for life, with hepatitis C virus. Unless more effective treatments are developed approximately 20% of these infections will progress to liver failure or liver cancer within 30 years. Diabetes afflicts 150 million people, and 90% have Type 2 diabetes. We request funding of our research on a family of enzymes highly prospective as targets for novel therapies for these diseases. We are internationally recognised experts on this enzyme family and on liver disease. The prototype member of this enzyme family, dipeptidyl peptidase (DP) IV, is being targeted by novel drugs that are in phase III clinical trials for Type 2 diabetes. Family member fibroblast activation protein (FAP) is targeted by novel anti-cancer drugs We were first to clone and lodge patent applications for two new enzymes of this family, DP8 and DP9. Our research proposal would lead to determination of whether FAP, DP8 and-or DP9 are valuable targets for novel liver disease therapeutics and facilitate generating the development of such therapeutics by a more thorough understanding of the activities and roles of these enzymes Completion of this project will greatly increase our understanding of these enzymes and their roles in chronic liver injury. This work can potentially lead to the development of specific inhibitors of enzyme function designed to relieve liver damage.Read moreRead less
Gene Based Treatment Strategies For Diabetic Retinopathy
Funder
National Health and Medical Research Council
Funding Amount
$2,630,000.00
Summary
Diabetic retinopathy is the leading cause of blindness in the working population of developed countries and it is an increasing problem in the developing world. Present therapy involves extensive laser destruction of the light-detecting part of he retina. In addition, it is not only effective when administered at an appropriate stage in the disease process. Consequently, there is an urgent need for the development of better, prophylactic, easily administrable and cheaper therapies. This project ....Diabetic retinopathy is the leading cause of blindness in the working population of developed countries and it is an increasing problem in the developing world. Present therapy involves extensive laser destruction of the light-detecting part of he retina. In addition, it is not only effective when administered at an appropriate stage in the disease process. Consequently, there is an urgent need for the development of better, prophylactic, easily administrable and cheaper therapies. This project aims to develop a potentially permanent solution to alleviate diabetes-related blindness in the world. The project combines several very recent scientific advances into one strategy to combat diabetic retinopathy at a molecular level. Vision is our most important sensory organ that cannot be replaced. Thus, human trials can only be conducted following extensive animal safety and efficacy trials. To date the development of new therapies has been seriously hampered by the lack of appropriate, easy to reproduce animal models for different stages of diabetic retinopathy. In addition, it aims to identify new therapeutic agents from molecules that are naturally produced by the retina while fighting the disease. Finally, tested and evaluated in the animal models. The most successful therapeutic candidates will then be further developed for human trials.If successful, our approach will potentially have a major impact on the treatment of diabetic retinopathy and possibly on all diabetic vascular diseases. A single injection might only be necessary to prevent the development of diabetic retinopathy, which would represent a significant weapon in the management of patients. In addition, successful application of secretion gene therapy in the eye might open up the possibility to introduce the same concept for the treatment of larger organs undergoing microvascular changes as a result of diabetes.Read moreRead less
In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states ....In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.Read moreRead less
Needs Based Access To Specialist Palliative Care Services: Development And Evaluation Of A Consumer Toolkit
Funder
National Health and Medical Research Council
Funding Amount
$286,572.00
Summary
The study will test the cost-effectiveness of two models of supportive care coordination for advanced cancer against _usual care�: a Telephone Caseworker model and an Oncologist-GP model. Both models are aimed at improving patients� and their informal caregivers� health and psychosocial status; are patient-centred, evidence based and readily transferable across health care settings. The Telephone Caseworker model has the additional advantage of reaching people isolated through geography, physica ....The study will test the cost-effectiveness of two models of supportive care coordination for advanced cancer against _usual care�: a Telephone Caseworker model and an Oncologist-GP model. Both models are aimed at improving patients� and their informal caregivers� health and psychosocial status; are patient-centred, evidence based and readily transferable across health care settings. The Telephone Caseworker model has the additional advantage of reaching people isolated through geography, physical disability or age.Read moreRead less
A Comprehensive Regulatory Strategy For Obesity Prevention In Australia
Funder
National Health and Medical Research Council
Funding Amount
$810,696.00
Summary
This research aims to develop regulatory approaches to obesity prevention and the reduction of socio-economic inequalities in obesity prevalence. Laws related to the provision, marketing, and labelling of food, urban planning, transportation, taxes and subsidies and so on will be comprehensively analysed and prioritised, and options proposed for legislative reform. The evidence-base and the implementation pathways will be developed contemporaneously and will be widely promoted to governments. A ....This research aims to develop regulatory approaches to obesity prevention and the reduction of socio-economic inequalities in obesity prevalence. Laws related to the provision, marketing, and labelling of food, urban planning, transportation, taxes and subsidies and so on will be comprehensively analysed and prioritised, and options proposed for legislative reform. The evidence-base and the implementation pathways will be developed contemporaneously and will be widely promoted to governments. A significant portion of time will be devoted to working closely with those within the bureaucracy who administer the law and legislators who together make the relevant policy decisions so that they may gain an understanding of the rationale behind each recommendation.Read moreRead less
Preventing Obesity Among Socioeconomically Disadvantaged Women And Children
Funder
National Health and Medical Research Council
Funding Amount
$2,072,674.00
Summary
The research will investigate the causes of the increased risk of obesity among socioeconomically disadvantaged women and children. It will also focus on women and children who appear �resilient� to obesity and will explore the possibility of applying the lessons learned to other women and children, in order to help support them in adopting and maintaining obesity-protective behaviours. The research aims to provide evidence to inform policies and programs that should be put into place to prevent ....The research will investigate the causes of the increased risk of obesity among socioeconomically disadvantaged women and children. It will also focus on women and children who appear �resilient� to obesity and will explore the possibility of applying the lessons learned to other women and children, in order to help support them in adopting and maintaining obesity-protective behaviours. The research aims to provide evidence to inform policies and programs that should be put into place to prevent obesity among socioeconomically disadvantaged groups.Read moreRead less
Primary Care: What Is Their Approach To Patients With Advanced Cancer And Those Who Require Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
It is recommended that 50-60% of all cancer patients receive radiotherapy at some time in their disease. However, only 38% of all cancer patients receive radiotherapy in Australia. Advanced cancer patients may be missing out on radiotherapy because they are not referred for palliative radiotherapy. The specific aims of this study are to: Explore the primary care approach to patients with advanced cancer and particularly those who require radiotherapy; Define factors that influence how Australian ....It is recommended that 50-60% of all cancer patients receive radiotherapy at some time in their disease. However, only 38% of all cancer patients receive radiotherapy in Australia. Advanced cancer patients may be missing out on radiotherapy because they are not referred for palliative radiotherapy. The specific aims of this study are to: Explore the primary care approach to patients with advanced cancer and particularly those who require radiotherapy; Define factors that influence how Australian GPs respond to symptoms of advanced cancer; Map the patients’ perspective on current referral practice for palliative care. This project will be comprised of three stages: simulated consultations with GPs, survey of GPs and patient interviews. These methods will enable researchers to develop an understanding of the primary care approach to patients with advanced cancer and those who require radiotherapy and how patients with advanced disease are referred for treatment.Read moreRead less