Expectations And Barriers In The Ambulance Service And Palliative Care Interface
Funder
National Health and Medical Research Council
Funding Amount
$49,916.00
Summary
There are over 6000 paramedics in Australia. The ambulance service is faced with palliative care on a daily basis throughout the country. Their involvement in palliative care is diverse and may include response to end of life calls, response to aid home care, response to manage acute events, providing health transport and collaborating with other care givers. The nature of this involvement, and the broader policy, operational, clinical and social implications has not been researched in Australia ....There are over 6000 paramedics in Australia. The ambulance service is faced with palliative care on a daily basis throughout the country. Their involvement in palliative care is diverse and may include response to end of life calls, response to aid home care, response to manage acute events, providing health transport and collaborating with other care givers. The nature of this involvement, and the broader policy, operational, clinical and social implications has not been researched in Australia. This study will survey paramedics across two states to describe their involvement in palliative care, and the issues and challenges associated with provision of this service.Read moreRead less
Oxygen To Relieve Dyspnoea In Non-hypoxaemic Patients With End-stage Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$445,658.00
Summary
Chronic heart failure is a cause of suffering and a major cause of death in the Australian community. Patients who have chronic heart failure suffer from a range of symptoms that severely impacts every aspect of their life. One of the most common and distressing symptoms is breathlessness. As people with heart failure near death, their breathlessness may worsen not only in terms of its frequency, but also in its intensity. This worsening of symptoms is a source of great distress, both to patient ....Chronic heart failure is a cause of suffering and a major cause of death in the Australian community. Patients who have chronic heart failure suffer from a range of symptoms that severely impacts every aspect of their life. One of the most common and distressing symptoms is breathlessness. As people with heart failure near death, their breathlessness may worsen not only in terms of its frequency, but also in its intensity. This worsening of symptoms is a source of great distress, both to patients as well as their carers and family. Breathlessness is also the most common cause of admission to hospital for patients. A key strategy for managing this distressing symptom in the home is the supply of oxygen. However, due to a lack of scientific evidence for the benefit of home oxygen for people with heart failure, who do not necessarily have low levels of oxygen, it is very difficult for clinicians to access this therapy for their patients. This study seeks to assess if a specific breathlessness action plan alone or if the addition of either oxygen or air can relieve this distressing symptom. The scientific evaluation of these strategies will assist in improving the palliative care of people with chronic heart failure.Read moreRead less
Transforming Growth Factor Beta Signalling In Malignant Mesothelioma Growth And Collagen Production
Funder
National Health and Medical Research Council
Funding Amount
$509,917.00
Summary
Many cancers contain abundant connective tissue molecules called extracellular matrix (ECM) and data show that interaction of ECM with cells are important in the growth of cancers (1). Changes in expression of ECM and their receptors (integrins) have been associated with malignant changes in cells, enhanced tumour growth and resistance to chemotherapy (2,3). We have recently shown that inhibition of collagen, the most abundant ECM molecule produced by malignant mesothelioma (MM) cells, reduced M ....Many cancers contain abundant connective tissue molecules called extracellular matrix (ECM) and data show that interaction of ECM with cells are important in the growth of cancers (1). Changes in expression of ECM and their receptors (integrins) have been associated with malignant changes in cells, enhanced tumour growth and resistance to chemotherapy (2,3). We have recently shown that inhibition of collagen, the most abundant ECM molecule produced by malignant mesothelioma (MM) cells, reduced MM growth. How cancer cells regulate ECM production and control their growth is unclear but strong evidence suggests the growth factor transforming growth factor-beta (TGFB) plays an important role. We and others showed that MM cells secrete all forms (1-3) of TGFB, and TGFB1,2-like activity has been reported in pleural effusions from MM (4,5). All TGFB forms stimulate MM cells to grow and make ECM (6,7). We showed that high levels of collagen produced by MM are enhanced by TGFB. Small molecules called antisense oligonucleotides (AO) which blocked production of TGFB2 by cells, reduced MM cell growth in soft agar, a characteristic of cancer, and partially blocked MM growth in animal models (4,6). This was supported by studies using soluble TGFB type II receptors, which blocks TGFB1,3 (8), and our studies using TGFB2 specific antibodies, as both studies reduced tumour growth. These findings support a role for TGFB in MM growth. However, all TGFB forms can promote cell grow and collagen synthesis and therefore ways to block all TGFB forms are required to ensure maximal effect. This study will examine the effect of blocking common downstream signalling pathways of all three TGFB isoforms on MM collagen production and tumour growth. These pathways are activated when TGFB binds to its receptors sending messages to the nucleus of the cell to make collagen or grow. By identifying which TGFB signalling pathway is important, we may be able to design novel therapeutic approaches to help treat patients with this disease.Read moreRead less
Burden Of Disease&cost Effectiveness Of Intervention Options:informing Policy Choices & Health System Reform In Thailand
Funder
National Health and Medical Research Council
Funding Amount
$787,978.00
Summary
This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much d ....This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much disease and injury in Thailand is being caused by major risk factors, such as tobacco and unsafe sex. Using this information the team will evaluate the effectiveness of the major interventions to reduces diseases and injuries from risk factors that are affordable and applicable in the Thai context.Read moreRead less
Phosphoproteomics: Metabolic And Exercise Signalling Markers For Sedentary And Trained Individuals
Funder
National Health and Medical Research Council
Funding Amount
$1,222,500.00
Summary
It is widely recognized that diet and exercise have a major influence on the health and fitness. Sedentary lifestyles predispose people to obesity and the early development of age onset diseases. In the past decade we have gained considerable insight into the regulatory links between exercise and metabolism particularly involving the AMPK signalling pathway. This project is concerned with the phosphoproteome of trained and untrained skeletal muscle, fat and erythrocytes as a marker of fitness.