Minimising Disability And Falls In Older People Through A Post-hospital Individualised Exercise Program.
Funder
National Health and Medical Research Council
Funding Amount
$536,435.00
Summary
This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of ....This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of and adherence to the exercise program and the cost effectiveness of the program will be established. We will recruit 350 older people in the first six months after an in-patient stay in aged care and rehabilitation wards at one of two large teaching hospitals. Participants randomised to the intervention group will be asked to complete an individualised home exercise program three times a week. In addition, they will be offered a choice between receiving monthly physiotherapy home visits or attending exercise classes. These weekly exercise classes will be conducted by physiotherapists and will be made up of 6-8 people. The control group will receive an education booklet about falls prevention and will be given the opportunity to join the program on a self-funding basis after their one-year control period is complete. Post-intervention between-group comparisons will be made using appropriate statistical techniques including regression models. Additional analyses will establish predictors for program adoption and adherence and cost-effectiveness (the incremental cost per fall prevented in the exercise group compared with the control group). This study addresses an increasingly important health care problem in a systematic manner and thus has the potential to substantially enhance the health of older people in Australia and internationally.Read moreRead less
An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
Clinical Impact Of Clonal Pseudomonas Aeruginosa In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$547,238.00
Summary
In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on ....In patients with cystic fibrosis (CF), the normal defence mechanisms are compromised by an inherent genetic fault which results in an extremely sticky and dehydrated mucus. The respiratory system is unable to eradicate microbes (infection) from the lungs of patients with CF which begin to multiply and cause infection and inflammation. Recurring infections are treated with multiple courses of antibiotics and frequent hospitalisation and eventually result in premature death. This study focuses on the major bacterial problem, Pseudomonas aeruginosa. Several studies from Australia and the UK, including our own have shown that about 30% to 45% of patients share the same strain of Pseudomonas aeruginosa within a centre. We know that two dominant strains of Pseudomonas aeruginosa are found in CF centres on the eastern board of Australia. This is unexpected as this bacterium is usually acquired from the environment. The emergence of these clonal strains is causing increasing anxiety in the CF community. This study is designed to provide vitally needed information on the clinical implications of being infected by an clonal strain of Pseudomonas aeruginosa and the risk factors for the acquisition of an clonal strain. This new information will provide a rationale basis for the need for changes to infection control policies (including patient segregation), better outcome predictors for patients infected with clonal strain of Pseudomonas aeruginosa.Read moreRead less
Improving Sexual Health In Men With Prostate Cancer: Randomised Controlled Trial Of Exercise And Psychosexual Therapies
Funder
National Health and Medical Research Council
Funding Amount
$583,416.00
Summary
Sexual dysfunction is one of the most common and distressing side effects of prostate cancer. Despite being a critical survivorship care issue, there is a clear gap in knowledge surrounding the optimal treatment of sexual dysfunction in men with prostate cancer. This project examines whether exercise aids in the management of sexual dysfunction and explores if an integrated treatment model incorporating pharmacological, exercise and psychosexual therapies maximises improvement in sexual health.
Precision Nanomedicine-based Diagnostics And Therapeutics For Refractory Malignancies
Funder
National Health and Medical Research Council
Funding Amount
$7,329,484.00
Summary
The vast majority of cancer patients die of their disease due to the emergence of drug resistant cancer cells or metastatic disease that is diagnosed at late stages. Our program aims to develop new types of therapy to specifically target aggressive cancers. To detect cancer early and evaluate the effectiveness of cancer therapy, we will develop sensitive diagnostic tools and devices. This research has application to both childhood and adult cancers.
Real-time Optical Window Imaging Of AKT-FRET Biosensor Mice To Maximise PI3K/AKT Drug Targeting Within The Hypoxic Microenvironment Of Pancreatic Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$683,447.00
Summary
Inefficient drug response in solid tumour tissue is often a limiting factor in the clinical effectiveness of cancer therapies. Using cutting-edge imaging technology and 3D models that mimic the disease, we have mapped areas of poor drug response within distinct regions of tumours with low oxygen levels known as hypoxia. Here, we will specifically target factors limiting efficient drug targeting in these areas to improve the encouraging anti-cancer profile of AKT inhibitors in pancreatic cancer.
New Treatments For Epitheliod Inflammatory Myofibroblastic Sarcoma
Funder
National Health and Medical Research Council
Funding Amount
$647,267.00
Summary
Epithelioid Inflammatory myofibroblastic sarcoma (eIMS) is a rare aggressive cancer, most common in of childhood and young adults. This cancer has been scarcely studied due to its rarity and is not cured by standard chemotherapeutic regimes. Our investigations will extensively characterise eIMS samples from recently diagnosed patients, and apply a new laboratory model to discover more effective drugs and improve treatment outcomes.
Molecular Markers Of Phenotype, Therapeutic Responsiveness And Prognosis In Human Cancers.
Funder
National Health and Medical Research Council
Funding Amount
$11,762,117.00
Summary
This proposal aims to identify molecular markers that can be used to classify subtypes of particular cancers according to their prognosis and response to therapy. This will optimise selection of patients for the most appropriate treatment and lead to the development of new therapeutic strategies.
mTOR signalling in serous ovarian cancer. Serous ovarian cancer is the most aggressive and lethal gynaecological cancer in Australian women. Activation of Mammalian Target of Rapamycin (mTOR) is frequently observed and associated with poor prognosis in ovarian cancer patients. However, the mechanisms dysregulating mTOR in the pathogenesis of ovarian cancer are unknown. In preliminary studies, deletion of genes regulating mTOR signalling in up to 60 per cent of human serous ovarian cancer patien ....mTOR signalling in serous ovarian cancer. Serous ovarian cancer is the most aggressive and lethal gynaecological cancer in Australian women. Activation of Mammalian Target of Rapamycin (mTOR) is frequently observed and associated with poor prognosis in ovarian cancer patients. However, the mechanisms dysregulating mTOR in the pathogenesis of ovarian cancer are unknown. In preliminary studies, deletion of genes regulating mTOR signalling in up to 60 per cent of human serous ovarian cancer patients was observed. This project will provide mechanistic details of involvement of mTOR signalling in pathogenesis of the serous ovarian carcinoma, and develop a rationale for targeting mTOR pathway in these patients. Read moreRead less
Infectious And Lifestyle Determinants Of Non-melanoma Skin Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$983,711.00
Summary
Basal and squamous cell skin cancers are the leading cancers in Australia, with about 2% of the population developing them each year. As well as sun exposure, a number of other factors have been thought to effect these cancers. This study will examine if factors such as smoking, alcohol consumption and infection with certain skin related human papillomaviruses also increase their risk. Even a small effect may make a big difference when it comes to preventing these common cancers.