STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less
Role Of Placental Retroviral Protein Syncytin Carried On Exosomes In Mediating Vulnerability Of Pregnant Women To Influenza
Funder
National Health and Medical Research Council
Funding Amount
$645,145.00
Summary
50% of the women who died due to swine flu were pregnant. This project will examine if factors produced by the placenta make the pregnant woman more susceptible to influenza.
Tracking The Impact Of Drug Regulatory Actions: Consumer Health Outcomes, Risk-benefit Issues And Policy Framework.
Funder
National Health and Medical Research Council
Funding Amount
$439,324.00
Summary
This study will explore what happens in the community when a medicine is withdrawn from the market or discredited due to safety concerns. It will examine the impacts of two recent cases of medicine withdrawal or serious long-term safety concern, on a large cohort of women with high utilisation rates who were monitored during the time the medicines were discredited. The study will be an important guide to future regulatory, media and provider responses when medicines are discredited.
Non-invasive Detection Of Hypoglycaemia In People With Diabetes Using Brain Wave Activity
Funder
National Health and Medical Research Council
Funding Amount
$330,447.00
Summary
Hypoglycaemia remains a major cause of morbidity and mortality in people with both type 1 diabetes and type 2 diabetes who require insulin therapy. Current treatments for nocturnal hypoglycaemia are usually ineffective. Combining brain wave recording and artificial intelligence, we will identify the changes that precipitate an episode of hypoglycaemia allowing the development of a non-invasive device to prevent or alleviate these fearful and potentially life-threatening events.
How The Placental Protein Syncytin Impairs Maternal Immune Responses To Influenza
Funder
National Health and Medical Research Council
Funding Amount
$609,862.00
Summary
Pregnant women are known to be highly susceptible to certain viral infections, especially influenza, which results in severe illness and even death. The reason for this transitory susceptibility are unknown. We have found that a protein, Syncytin, has the ability to impair maternal immune responses to influenza We now will determine how it does this and discover potential interventions to reverse these effects.
Title: ‘Indigenous Counselling And Nicotine (ICAN) QUIT In Pregnancy’ - A Cluster Randomised Trial To Implement Culturally Competent Evidence-based Smoking Cessation For Pregnant Aboriginal And Torres Strait Islander Smokers
Funder
National Health and Medical Research Council
Funding Amount
$2,259,016.00
Summary
‘ICAN QUIT in Pregnancy’ tackles smoking through training health providers caring for expectant mothers of Indigenous babies in real-world primary care settings. The intervention was co-developed with Aboriginal communities. We will assess how many Indigenous women, cared for by the trained services, quit smoking, compared to the women that receive usual care. We anticipate that babies born to mothers in the intervention group will have less respiratory illness in their first six months.
Translating Evidence Based Smoking Cessation Care For Pregnant Indigenous Smokers
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
Smoking is a major cause of poor health in mothers and babies, yet smoking rates remain high in Indigenous pregnant women. This fellowship supports a trial of a culturally competent targeted intervention for Indigenous pregnant women who smoke. The intervention provides webinar training of health providers in participating Aboriginal Medical Services. A control group will use their standard care practices. Smoking rates of the women cared for by health providers in each group will be compared.
Disrupted Neurosteroid Synthesis Mediates The Adverse Effects Of Prenatal Stress
Funder
National Health and Medical Research Council
Funding Amount
$695,973.00
Summary
Maternal anxiety and related stress in pregnancy influences the fetus causing developmental changes that adversely affect the offspring leading to behavioural problems in childhood. However, mechanisms which transfer maternal changes to the fetus are unclear. We propose that disruption of the fetal-placental neurosteroid system is a major link. We will identify the deficits in this system caused by maternal stress and then examine therapies to reverse these disruptions.
Unraveling Mechanisms Of Liver Transplant Tolerance
Funder
National Health and Medical Research Council
Funding Amount
$694,822.00
Summary
Liver transplants are unique amongst solid organs as they are spontaneously accepted across different individuals and induce acceptance of other organs from the same donor co-transplanted at the same time. Using a new mouse liver transplantation model, this proposal will elucidate how the liver tissue performs this function and identify new markers associated with tolerance in the blood of mice. This knowledge will be used to identify liver transplant patients with reduced rejection risk.
Epigenetic Regulation Of Inflammatory Genes In The Fetal Membranes: Role In Term And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$468,534.00
Summary
Preterm birth is the leading cause of death among newborns and the biggest contributor to disability among infants. Here we propose research to define the mechanism that controls the length of pregnancy and is disrupted in preterm birth. Specifically, we will determine what causes the repression of the labour-promoting inflammatory genes in the uterus during pregnancy and what activates them at labour. We will identify new targets for interventions to block or prevent preterm birth.