Adolescent Assessment Of The Perth Infant Respiratory Cohort
Funder
National Health and Medical Research Council
Funding Amount
$412,327.00
Summary
In spite of extensive research over several years, we still don t know why some people get asthma while others do not or at what age the disease begins. We also don t know why in some people, asthma resolves during the teenage years while in other people the disease persists through adolescence. The Perth respiratory cohort has been studied on repeated occasions (at recruitment prior to birth, 1, 6 and 12 months, 6 and 11 years of age) and is unique in having measured airway responsiveness (AR) ....In spite of extensive research over several years, we still don t know why some people get asthma while others do not or at what age the disease begins. We also don t know why in some people, asthma resolves during the teenage years while in other people the disease persists through adolescence. The Perth respiratory cohort has been studied on repeated occasions (at recruitment prior to birth, 1, 6 and 12 months, 6 and 11 years of age) and is unique in having measured airway responsiveness (AR) soon after birth and at each subsequent assessment. Our previous data have established the importance of an individual s airway status in infancy in determining respiratory health in mid-childhood. Since the last assessment at 11 years, most children in this cohort will have passed through puberty. Lung growth will have been maximal, but there will be differences in the rate of growth between boys and girls. Body size will also have increased during this period and the body mass index may start to exert a major influence on measured respiratory function and the development or persistence of asthma. The aim of this research (assessing the Perth respiratory cohort at 16 years of age) is to look at the effect of gender, puberty and obesity on the previously identified early life risk factors to see how they determine respiratory health in 16 year olds. We expect that airway status in early life will continue to predict respiratory health at 16 years of age and that respiratory health will be modified by gender, puberty and the development of obesity. In addition we expect that genetic variations will show age-specificity in their associations with disease outcomes ie. particular variations will be associated with disease at different ages. This study will answer fundamental questions on airway function and physiology through childhood and adolescence.Read moreRead less
Multi-centre RDBC Trial Of Oxygen Vs Air For Relief Of Breathlessness In Terminally-ill Patients With Intractable Dyspno
Funder
National Health and Medical Research Council
Funding Amount
$149,701.00
Summary
This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects exp ....This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects experienced.Read moreRead less
Examining The Early Origins Of Asthma And Chronic Respiratory Disease
Funder
National Health and Medical Research Council
Funding Amount
$384,768.00
Summary
Asthma is the most common chronic lung disease of childhood. Birth cohort studies show that early life environmental stressors may increase asthma risk. This study will examine the impact of multiple early-life stressors using a novel ‘exposome’ model in international birth cohort studies, to identify the most significant factors. This will allow for interventions in a planned Australian birth cohort study, leading to improved health for Australians.
Occupational And Environmental Exposures Associated With Idiopathic Pulmonary Fibrosis In Australia
Funder
National Health and Medical Research Council
Funding Amount
$287,388.00
Summary
Idiopathic pulmonary fibrosis (IPF) is a progressive scarring lung disease of unknown cause with little effective treatment from which most patients die within 2-3 years. Although relatively rare, the public health impact is similar to many cancers. We will undertake a nationwide case-control study to identify jobs and exposures associated with the development of IPF. The results will influence policy to control exposures and over time reduce the occurrence of this devastating lung disease.
Health Impacts Of Sleep Apnea In Australian Men- A Longitudinal Population Study.
Funder
National Health and Medical Research Council
Funding Amount
$312,056.00
Summary
Obstructive sleep apnea (OSA) is very common, seen in 60-70% of men over 40 years old. OSA is linked to a number of serious conditions, e.g. heart disease and diabetes. However, we don't know which men are at risk of long term complications from OSA. Our aim is to follow-up men from a community sample of 1000 men who had sleep studies in 2010 to help identify who is at risk of poor health from OSA.
Asthma is a National Health Priority in Australia. This project follows the major international study of asthma and allergic diseases in adults. We will re-examine people who have taken part in previous studies in Melbourne. The project also surveys people of the same age currently living in the same area. Participants complete a short postal questionnaire. In the follow-up group, responders complete a more extensive questionnaire and come to our laboratory for clinical assessments.
A Multi-centre, Randomised, Controlled Trial Of BAL Directed Therapy In Young Children With Cystic Fibrosis.
Funder
National Health and Medical Research Council
Funding Amount
$571,750.00
Summary
The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated ....The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated with a decline in pulmonary function and an increase in morbidity and mortality. Many CF centres internationally now treat young children with CF using aggressive antibiotic protocols in an attempt to eradicate infection. Most centres use oropharyngeal specimens to diagnose LRTI with a sensitivity of around 45% and specificity of around 90%. Thus many children miss out on treatment or are exposed unnecessarily to antibiotics. The use of antibiotics themselves may increase the risk of infection with resistant organisms thus complicating the design of drug trials in young children as monitoring for the emergence of resistant new organisms requires BAL. It is thus of key importance that the safety and value of FB and BAL is examined and long term outcomes are obtained. The financial costs of managing patients with CF in Australia may be estimated at more than $85 million-annum. Early intervention strategies may reduce health costs because of improved morbidity or may increase costs due to the intervention. This will be the first time an economic evaluation of early management and the cost effectiveness of an intervention in children with CF has been undertaken which will enable responsible health care planning for this important group of patients. This trial provides a unique opportunity to study the relationship between LRTI and inflammation and long term outcomes such as lung function and radiological scores and will provide key evidence for designing future trials.Read moreRead less
An Education Intervention For Childhood Asthma By Local Aboriginal And Torres Strait Islander Health Workers
Funder
National Health and Medical Research Council
Funding Amount
$97,500.00
Summary
There are only a few studies on asthma in Aboriginal and Torres Strait Islander children, and those are restricted to prevalence and hospitalisation data. We have previously shown that the prevalence of childhood asthma in the Torres is similar to that of mainstream Australia and that children of this region generally have more severe asthma than children seen in urban areas. Using a model of care appropriate for Aboriginal and Torres Strait Islander people, with the involvement of local Indigen ....There are only a few studies on asthma in Aboriginal and Torres Strait Islander children, and those are restricted to prevalence and hospitalisation data. We have previously shown that the prevalence of childhood asthma in the Torres is similar to that of mainstream Australia and that children of this region generally have more severe asthma than children seen in urban areas. Using a model of care appropriate for Aboriginal and Torres Strait Islander people, with the involvement of local Indigenous health care workers, we have adapted an asthma information package. With Study 1, we will examine the effect of local health care workers using this education package to educate children about their asthma. Our hypotheses is that children who receive additional asthma education by health worker have better asthma control. So we propose a randomized controlled trial of a culturally appropriate education intervention with children diagnosed with asthma. Enrolled children will be allocated by chance to one of the two regimes: (1) additional asthma education intervention: children will receive a personalised booklet (containing individual data eg. growth, photo of the child, health worker visits etc) that will be used during the medical consultation. They will also have 3 visits from the health worker for their asthma. (2) no additional intervention (they will receive usual information about asthma at the consultation and no health worker visit). With Study 2 we will examine the natural history of children with asthma and asthma-like symptoms and with symptoms suggestive of sleep breathing problems. Two groups of children previously seen by this team (5 years ago) will be clinically reassessed. Our hypothesis is that short to medium term history of asthma in Indigenous children in the Torres Strait is similar to non-Indigenous Australian children where there is a general improvement with age.Read moreRead less
The Interactions Between Sleep Disordered Breathing, Metabolic Syndrome And Vascular Risk.
Funder
National Health and Medical Research Council
Funding Amount
$361,030.00
Summary
We will look at two common diseases in the Australian community, the metabolic syndrome and obstructive sleep apnoea (OSA), and explore the common links they have to the risk of disease of the heart and blood vessels. We will then take a group of patients who have both diseases, treat the OSA, and assess the impact of this treatment on their cardiovascular health. Metabolic syndrome is a term given to patients who have high blood sugar, obesity, high lipid levels and raised blood pressure. The A ....We will look at two common diseases in the Australian community, the metabolic syndrome and obstructive sleep apnoea (OSA), and explore the common links they have to the risk of disease of the heart and blood vessels. We will then take a group of patients who have both diseases, treat the OSA, and assess the impact of this treatment on their cardiovascular health. Metabolic syndrome is a term given to patients who have high blood sugar, obesity, high lipid levels and raised blood pressure. The Australian Bureau of Statistics estimates that half the Australian population is overweight, and US studies suggest that nearly of the adult population has metabolic syndrome. This is strongly linked to diseases of the heart and blood vessels, eg heart attacks and stroke. Patients with OSA stop breathing during the night when their throat closes over. The blood oxygen falls, which causes the patient to wake momentarily, then start breathing again. This cycle repeats itself throughout the night. The usual treatment is an air pump (CPAP) connected to a nose mask, which blows air into the throat and prevents closure. This disease is strongly linked to high blood pressure, raised blood sugar levels and heart and blood vessel disease. Patients with the metabolic syndrome will have an overnight sleep study to diagnose OSA, giving the likelihood of having OSA in this group of patients. They will then have extensive investigations of the health of their heart and blood vessels. From these, we will determine which aspects of OSA are more likely to result in cardiovascular disease. Those patients diagnosed with OSA will be treated with CPAP for 3 months. Half the patients will receive normal CPAP; the other half will receive ineffective CPAP. They will then be re-tested and we will compare the results before and after treatment. Thus we will measure likelihood of OSA in this large group of patients, and the health benefits they may gain from treatment of their OSA.Read moreRead less