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
Mathematical Modelling Of Bacterial Carriage In Children
Funder
National Health and Medical Research Council
Funding Amount
$421,746.00
Summary
Children exposed to larger numbers of other children are at risk of persistent bacterial infections. Such circumstances explain the high rates of ear and chest infections, and skin sores seen in children in historical times. Changing social circumstances (smaller families, better housing, nutrition and hygiene), as well as the introduction of antibiotics, explain the decline of such infections in affluent communities since the early 20th century. However, even today, in affluent countries, child ....Children exposed to larger numbers of other children are at risk of persistent bacterial infections. Such circumstances explain the high rates of ear and chest infections, and skin sores seen in children in historical times. Changing social circumstances (smaller families, better housing, nutrition and hygiene), as well as the introduction of antibiotics, explain the decline of such infections in affluent communities since the early 20th century. However, even today, in affluent countries, children attending group child care are at high risk of ear infections. As many bacteria are resistant, antibiotics are now much less effective than when they were first introduced. Furthermore, there is a continuing load of infection for children in Aboriginal communities, in PNG and other developing countries, causing hearing loss, chronic respiratory problems, and heart disease and renal disease in later life. Using data previously collected from other studies in Indigenous communities and children in child care, mathematical models allow us to ask what if?, and answer important public health questions: 1. What environmental and public health measures can reduce the cycle of cross-infection in child-care and high-risk populations? 2. What coverage rates with pneumococcal vaccine will eliminate the vaccine-specific bacteria from child care centres, from the wider community, and from high risk populations? 3. Will infections with bacteria not covered by vaccine then increase? 4. Will the resistant bacteria tend to disappear if antibiotic use is restricted? 5. Under what circumstances will antibiotics help to control infection? The modelling will promote understanding of the social and health costs of bacterial infection in Aboriginal communities and child care and use educational scenarios to promote uptake of the most cost-effective and socially acceptable interventions.Read moreRead less
Evaluation Of The Effectiveness Of Mobile Preschool For Child Health And Development In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$456,369.00
Summary
This project is a retrospective study of the effectiveness of the NT Mobile Preschool Program using assessment data for children's emergent literacy, social and emotional competencies and health status. Effectiveness will be established by comparison with achievement and health status data for children not attending preschool and those in communities with no preschool service. The study will identify and describe the key factors influencing the health and learning outcomes of the three groups.
Yarning with our mob about human papillomavirus (HPV) vaccination uptake. This project aims to identify a range of modifiable factors that affect the participation of Indigenous adolescents in human papillomavirus (HPV) vaccination school programs. The project expects to generate new knowledge by combining Indigenous methodologies and a socioecological model to explore policy, community, interpersonal and intrapersonal factors impacting HPV vaccination uptake for this population. Expected outcom ....Yarning with our mob about human papillomavirus (HPV) vaccination uptake. This project aims to identify a range of modifiable factors that affect the participation of Indigenous adolescents in human papillomavirus (HPV) vaccination school programs. The project expects to generate new knowledge by combining Indigenous methodologies and a socioecological model to explore policy, community, interpersonal and intrapersonal factors impacting HPV vaccination uptake for this population. Expected outcomes include a more comprehensive understanding of the factors behind the low rates of HPV vaccination among Indigenous adolescents. This information should provide significant benefits including the identification of modifiable factors to increase HPV vaccination rates for Indigenous adolescents.Read moreRead less
Diseases caused by the pneumococcus represent the largest cause of vaccine preventable death in the world today, mainly pneumonia and meningitis. In 2011, 16 developing countries will introduce pneumococcal conjugate vaccines, none in east Asia. Lack of research has been a major barrier to their use in the region. We have established an international centre of excellence in the field and we seek support to extend the capacity of this group and to transfer the technology to Vietnam.
Telling it like it is: Aboriginal perspectives on Aborigines, Euro-Australians and race relations. This project will make an important contribution to reconciliation by identifying Aboriginal views on how to improve race relations in Australia. By challenging stereotypes and analysing Aboriginal perspectives, this project will provide a robust evidence base for effective service provision.
Testing for scale up: An Indigenous social and emotional learning program . This project takes key learnings from prior research that conceptualised, set up, and tested a social and emotional learning program, Skills for Life (SFL), with Aboriginal and Torres Strait Islander students in grades 7-9 in remote Northern Territory and Queensland schools. It aims to: establish the process and necessary conditions for scaling up SFL to diverse remote schools with Aboriginal and Torres Strait Islander s ....Testing for scale up: An Indigenous social and emotional learning program . This project takes key learnings from prior research that conceptualised, set up, and tested a social and emotional learning program, Skills for Life (SFL), with Aboriginal and Torres Strait Islander students in grades 7-9 in remote Northern Territory and Queensland schools. It aims to: establish the process and necessary conditions for scaling up SFL to diverse remote schools with Aboriginal and Torres Strait Islander students across Australia's top end. Further evidence for the program’s effectiveness will also be built by measuring students’ resilience, help seeking, and psychological distress; and teachers’ cultural awareness; quality of teacher-student relationships, and perceptions of students’ emotional and behavioural difficulties. Read moreRead less
Healing Country: integrating knowledge systems to meet climate challenges. Aboriginal and Torres Strait Islander communities are currently experiencing severe environmental challenges related to a changing climate. Led by Aboriginal communities, this project aims to integrate traditional knowledges and environmental and health data to create community story-data maps. These interactive, online maps will be a unique and powerful blend of information, providing a rich evidence base, decision-suppo ....Healing Country: integrating knowledge systems to meet climate challenges. Aboriginal and Torres Strait Islander communities are currently experiencing severe environmental challenges related to a changing climate. Led by Aboriginal communities, this project aims to integrate traditional knowledges and environmental and health data to create community story-data maps. These interactive, online maps will be a unique and powerful blend of information, providing a rich evidence base, decision-support and communication tool to inform the co-design of local climate change mitigation, adaptation and resilience plans. The project aims to give agency to Aboriginal communities in leading a systems change process to reduce environmental risks and strengthen health and wellbeing.Read moreRead less
Vitality and change in Warlpiri songs at Yuendumu. Vitality and change in Warlpiri songs at Yuendumu. This project aims to understand the reasons behind the reported decline in knowledge of songs amongst younger generations at Yuendumu in the past 40-50 years, using a Central Australian music archive. This project will analyse selected song repertories over time, with insights and advice from today's senior custodians; and design strategies for Warlpiri people to re-engage with this important bo ....Vitality and change in Warlpiri songs at Yuendumu. Vitality and change in Warlpiri songs at Yuendumu. This project aims to understand the reasons behind the reported decline in knowledge of songs amongst younger generations at Yuendumu in the past 40-50 years, using a Central Australian music archive. This project will analyse selected song repertories over time, with insights and advice from today's senior custodians; and design strategies for Warlpiri people to re-engage with this important body of Warlpiri-initiated research in their own country. This research is expected to reinvigorate inter-generational transfer of highly significant cultural knowledge and practices.Read moreRead less
Assessing supportive care needs of Indigenous cancer survivors' caregivers. This project aims to gather data about the needs of partners and caregivers of Aboriginal and Torres Strait Islander cancer survivors. The project will undertake a comprehensive exploration of the experiences of caregivers and develop a psychometrically tested tool to assist in identifying unmet needs. The project expects to provide new knowledge about the needs of this population and a validated tool to better assess th ....Assessing supportive care needs of Indigenous cancer survivors' caregivers. This project aims to gather data about the needs of partners and caregivers of Aboriginal and Torres Strait Islander cancer survivors. The project will undertake a comprehensive exploration of the experiences of caregivers and develop a psychometrically tested tool to assist in identifying unmet needs. The project expects to provide new knowledge about the needs of this population and a validated tool to better assess these needs. The project will result in improvements in the assessment of unmet supportive care needs in caregivers of Indigenous cancer survivors, leading to more timely interventions, and a better quality of life for patients and caregivers.Read moreRead less