A New Model For The Pathogenesis Of Rheumatic Fever: Superantigen Priming Of The Immune Response To Group A Streptococci
Funder
National Health and Medical Research Council
Funding Amount
$248,820.00
Summary
Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, c ....Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, control of this ARF will partly depend on new and better treatment and prevention strategies. To achieve these goals a deeper understanding of the immune mechanisms underlying this disease is urgently needed. It is known that ARF is caused by an abnormal immune response following streptococcal infection. This leads to the production of cells called T cells that attack the body s own tissues rather than the bacteria itself. This autoimmune disease is responsible for the heart damage that underlies ARF. It is believed that this proces only occurs when susceptible individuals are infected with specific rheumatogenic strains of streptococci. However there are a number of deficiencies in this model and it is proposed that there is an additional factor responsible for the abnormal immune response in ARF. This project will explore the possibility that bacterial toxins called superantigens are the critical missing factor , by studying the immune response in ARF. Superantigens are produced by certain streptococci and staphylococci, and are potent in minute quantities causing widespread activation of the immune system. They have been found to play an important role in a number of autoimmune diseases and the type of immune response found in ARF fits well with that expected if superantigens were involved. If superantigens play an important role in causing the abnormal immune response in ARF then a number of new avenues would open for the treatment and prevention of this disease.Read moreRead less
Special Research Initiatives - Grant ID: SR120100005
Funder
Australian Research Council
Funding Amount
$3,198,392.00
Summary
National Indigenous Research and Knowledges Network. The National Indigenous Research and Knowledges Network will capacity build and increase Indigenous higher degree, early and mid career researchers to develop new approaches to undertaking research and producing outcomes. NIRAKN's members include a number of universities, AIATSIS, and partner organisations.
Re-integrating Central Australian community cultural collections. This project aims to apply current research on archiving and community access to find practical solutions to managing the large amounts of recorded cultural material of interest to the Central Land Council, the peak Indigenous representative body covering the southern half of the Northern Territory. The project aims to identify and integrate information in a common database, work with community members to create a prioritised list ....Re-integrating Central Australian community cultural collections. This project aims to apply current research on archiving and community access to find practical solutions to managing the large amounts of recorded cultural material of interest to the Central Land Council, the peak Indigenous representative body covering the southern half of the Northern Territory. The project aims to identify and integrate information in a common database, work with community members to create a prioritised list of any at-risk materials and apply locally meaningful categories for managing the archival materials relevant to their community, and deliver appropriate documentation of process, permissions and reports to support ongoing sustainability of the collections.Read moreRead less
Aboriginal place names and ethnobiology: enhancing interpretation of Indigenous culture and heritage. This project looks at how Indigenous people’s knowledge of place names and bush tucker can create opportunities for Indigenous communities in areas such as tourism. The project aims to do this by harnessing new advances in digital media which offer new ways of passing on this knowledge to both Indigenous and intercultural audiences.
Remote Aboriginal families and carers of children with disabilities. The project intends to explore the challenges that Aboriginal families who have children with disabilities experience when living in remote communities. Living in a community with family supports is important for the wellbeing, health and spirituality of Aboriginal people in the Ngaanyatjarra Pitjantjara Yankunytjatjara (NPY) lands. However, the NPY Women’s Council are concerned that this is a significant challenge for families ....Remote Aboriginal families and carers of children with disabilities. The project intends to explore the challenges that Aboriginal families who have children with disabilities experience when living in remote communities. Living in a community with family supports is important for the wellbeing, health and spirituality of Aboriginal people in the Ngaanyatjarra Pitjantjara Yankunytjatjara (NPY) lands. However, the NPY Women’s Council are concerned that this is a significant challenge for families and carers of children with disabilities. Project results will be used to propose models for supporting children with disabilities and their families and caregivers to live good lives in their communities. The outcomes are expected to inform service redesign to allow Aboriginal people to fully benefit from the National Disability Insurance Scheme.Read moreRead less
Improving Delivery Of Secondary Prophylaxis For Rheumatic Heart Disease: A Stepped-wedge, Community-randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,913,074.00
Summary
Rheumatic heart disease (RHD) is a major health problem in Indigenous communities. Continued progress in controlling RHD requires an understanding of how to improve delivery of regular injections of penicillin - secondary prophylaxis (SP). We will evaluate a systems-based approach to improving delivery of SP, using a stepped-wedge trial in 12 communities in NT and Qld. If successful, this model will provide a practical and transferable model.
National research study of the civil and family law needs of Indigenous people. This research will benefit Indigenous communities by improving access and equity in legal services. By identifying and addressing the civil and family law needs of Indigenous people, the research will make a key contribution to improving legal and social justice outcomes. Partner organisations in the research will actively implement the findings to the national benefit, creating more appropriate, accessible and bette ....National research study of the civil and family law needs of Indigenous people. This research will benefit Indigenous communities by improving access and equity in legal services. By identifying and addressing the civil and family law needs of Indigenous people, the research will make a key contribution to improving legal and social justice outcomes. Partner organisations in the research will actively implement the findings to the national benefit, creating more appropriate, accessible and better targeted legal services aimed at meeting identified needs. The research will make an important contribution to the Commonwealth's welfare reform and participation agendas, particularly its Access to Justice Framework as better access to legal services can play an important role in alleviating economic and social disadvantage.Read moreRead less
Fostering Aboriginal sexual well-being by building on strengths. This project aims to use a strengths-based approach to examine how Aboriginal young people draw on social, cultural and personal resources to build their sexual well-being. Many Aboriginal Australians see strengths approaches as essential to addressing disadvantage. However, to date they have not been widely used to address the significant sexual health inequalities experienced by Aboriginal young people. The project will create ne ....Fostering Aboriginal sexual well-being by building on strengths. This project aims to use a strengths-based approach to examine how Aboriginal young people draw on social, cultural and personal resources to build their sexual well-being. Many Aboriginal Australians see strengths approaches as essential to addressing disadvantage. However, to date they have not been widely used to address the significant sexual health inequalities experienced by Aboriginal young people. The project will create new knowledge about ‘what works’ in supporting the sexual well-being of Aboriginal young people, that has relevance to a broad range of disciplines beyond the area of health and well-being.Read moreRead less
The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the co ....The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the country. The project aims to inform consumers, health practitioners, health service planners and policy-makers about the impact of FIFO, as well as to contribute to the development of strategies designed to stabilise the remote health workforce.Read moreRead less
Immunising Aboriginal Mothers With Pneumococcal Polysaccharide Vaccine To Prevent Infant Ear Disease And Carriage
Funder
National Health and Medical Research Council
Funding Amount
$1,131,530.00
Summary
Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are nee ....Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are needed to eliminate, or at least delay, this early-onset pneumococcal colonisation. One such strategy is the administration to the mother of pneumococcal vaccine, which may protect the newborn infant by leading to higher titres of transplacental or breast milk pneumococcal antibodies and-or by reducing carriage (and transmission to the infant) of maternal pneumococci. Previous small studies using this strategy have been encouraging, but there have been no studies properly evaluating carriage or disease endpoints in infants. The polysaccharide pneumococcal vaccine is currently recommended for all Aboriginal and Torres Islander persons aged 15 years or more in the Northern Territory but uptake of the vaccine has been poor. We propose to conduct a pilot study to determine if maternal immunisation with this vaccine, either in the third trimester of pregancy of immediately following delivery, can reduce pneumococcal carriage and the prevalence of middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women who have uncomplicated pregnancies from Darwin and remote communities in the Top End of the Northern Territory. Each subject and their infant offspring will be followed-up after vaccination and at birth, one , two and seven months after birth.Read moreRead less