Health Services Research: A Randomised Controlled Trial To Evaluate A Model Of Comprehensive Stroke Care
Funder
National Health and Medical Research Council
Funding Amount
$519,150.00
Summary
This study compares the length of stay and patient outcomes between two stroke care models - co-located acute-rehabilitation and dislocated acute-rehabilitation stroke care. In participating hospitals, acute stroke patients admitted to the emergency department will be randomly allocated to either model of care. Length of hospital stay and clinical outcomes will be examined 90 days post-stroke. Study results will provide high level of evidence for future stroke care model development.
Evaluating The Effectiveness Of Comprehensive Primary Health Care In Local Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,635,268.00
Summary
This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depr ....This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depressionRead moreRead less
Evaluation Of Enhanced Models Of Primary Care In The Management Of Stroke And Other Chronic Diseases
Funder
National Health and Medical Research Council
Funding Amount
$556,184.00
Summary
Chronic diseases are the leading cause of death and disability in Australia. Since 1999, patients in Australia have been able to access a variety of comprehensive disease management programs subsidised through Medicare. We will use comprehensive linked data from survivors of stroke registered in the Australian Stroke Clinical Registry to provide the first robust evaluation of the effectiveness of these enhanced models of primary care in patients with chronic diseases using stroke as an example.
IMPROVING STROKE OUTCOMES: NEW TARGETS AND THERAPIES
Funder
National Health and Medical Research Council
Funding Amount
$7,212,064.00
Summary
Previously we established a unique collaboration of researchers from the basic and clinical sciences.. The main aim of this ' vertically integrated ' model was to develop new therapies to improve stroke outcomes. We developed a system to identify ' off-the-shelf ' compounds which protect the brain after stroke onset. This involves data assimilation (meta-analysis) in a unique way, an approach which has attracted attention internationally. We are also completing an important clinical trial using ....Previously we established a unique collaboration of researchers from the basic and clinical sciences.. The main aim of this ' vertically integrated ' model was to develop new therapies to improve stroke outcomes. We developed a system to identify ' off-the-shelf ' compounds which protect the brain after stroke onset. This involves data assimilation (meta-analysis) in a unique way, an approach which has attracted attention internationally. We are also completing an important clinical trial using the clot dissolving agent tPA to extend the time during which the drug may be effective beyond the three-hours currently used. In the next phase of our program we plan to expand the basic science component to identify parts of brain cells (axons and dendrites) which may yield important information about new drugs to protect the brain. We will use our novel summary data technique to test drugs in animal models more appropriate to the human stroke paradigm than have been used in the past In clinical studies we will follow our theme of identifying new targets for therapy using sophisticated PET and MRI imaging techniques, both in patients who are at great risk of stroke recurrence after a minor warning stroke and those with stroke caused by bleeding within the brain. These studies will provide information about predictors of recurrent and worsening stroke which may be modified by new therapies. The final stage in identifying new therapies is the Phase III clinical trial. We will complete one of these in which the most appropriate drug preventing further strokes in a major new stroke subtype will be identified. Toward the end of the program, we will commence phase 3 studies of drugs we have selected as being most likely to protect the brain based on our animal experiments. The main benefit of this unique collaborative research model is to efficiently identify new therapies to reduce the burden of stroke, currently the second most common cause of death globally.Read moreRead less
Translating Science Into Treatment For Ischemic Stroke
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
My team has pioneered research in Australia that has advanced knowledge in the delivery of safer and more effective stroke therapies. I have developed software for the automated processing of multimodal CT imaging to better select patients for stroke therapies. In order to move this cutting-edge imaging technology into routine clinical practice several processes will occur: Implementation, validation and demonstration of patient benefits, and cost effectiveness of CT imaging selection in routine
Stroke Induced Disturbances In Glymphatic Clearance: Implications For Brain Repair?
Funder
National Health and Medical Research Council
Funding Amount
$491,688.00
Summary
We have made a remarkable discovery that the ability of the brain to clear waste proteins is significantly impaired after stroke. This may have important implications for development of dementia and milder changes in thinking late after stroke. We already have some clues regarding potential mechanisms. In this project we will further investigate these mechanisms and their effects on the brain and develop our understanding of potential ways to reverse the clearance problem to develop treatments.
A New Understanding Of Stroke Pathophysiology: Late Infarct Expansion May Be Under-recognised And Easily Preventable.
Funder
National Health and Medical Research Council
Funding Amount
$411,496.00
Summary
Stroke caused by a blood clot blocking a brain artery is one of the leading causes of death and disability. We recently discovered that pressure in the skull rises 24 h after stroke. Increasing evidence suggests that this causes growth of the stroke through its effects on brain blood flow. We will measure the blood flow reduction caused by the pressure rise and how frequent it is, then determine how much brain is saved and disability prevented by blocking it.
Implementation Of Quality Use Of Advanced CT Imaging In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,128,594.00
Summary
Many centres now use advanced CT scanning techniques to assess stroke patient suitability for clot-dissolving treatment. However, there is major variation across Australia in the clinical application of advanced CT scanning techniques, which is a barrier to the delivery of this treatment. This project addresses the variation in CT imaging techniques by developing, piloting and evaluating the implementation of a standardised advanced CT scanning strategy for acute stroke patients.
Microglial Paralysis In Post-stroke Neurodegeneration: Help Or Hindrance?
Funder
National Health and Medical Research Council
Funding Amount
$512,351.00
Summary
Dementia and cognitive decline may occur months or years after a stroke, associated with delayed loss of brain cells in different brain regions. We recently discovered that the cells responsible for protection and repair of brain, called microglia, become paralysed in these regions. We will use a live-imaging microscope to determine whether the microglial paralysis causes brain cell death. We will also determine if a commonly used stroke prevention drug can worsen the microglial paralysis.