Depressive Illness And The Heart: Identifying The Relation Between Affective Disorders And Coronary Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$503,625.00
Summary
Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial inf ....Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial infarction (MI), which materially increases mortality. The mechanism of increased cardiac risk attributable to depressive illness is at present uncertain but activation of the sympathetic nervous system, exaggerated platelet reactivity and-or altered baroreflex function are likely to be of prime importance. Preliminary data from our laboratory indicates that whole body and cardiac sympathetic nervous activity and cardiac baroreflex sensitivity are modified following antidepressant therapy. Identifying the underlying neurochemical mechanisms responsible for alterations in affective behaviour, and quantifying cardiac and whole body sympathetic activity directly and indirectly, and testing whether therapeutic and behavioural interventions can influence brain neurotransmitter turnover and modify cardiac sympathetic tone, platelet reactivity, and baroreflex function in a fashion likely to reduce cardiac risk, will be an important step forward in alleviating the burden of depressive illness on the community.Read moreRead less
Early Parenteral Nutrition Vs. Standard Care In The Critically Ill Patient: A Level I Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,852,333.00
Summary
Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no ge ....Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no general agreement as to when intravenous artificial nutrition should be begun if a patient cannot tolerate a feeding tube. A recent systematic review of all available clinical trials suggests that if a critically ill patient cannot be fed by a stomach tube for at least 24 hours, they may benefit from intravenous artificial nutrition. This is not what currently happens under standard care. The purpose of this multi-centre randomised controlled trial is to determine if early intravenous nutrition saves lives. Because of the cost, and possible risk of increased infections, a study of this type is required before early intravenous nutrition could become a routine therapy in Australia. Informed consent to participate in the study will be obtained from next of kin, or directly from the patient themselves. The study will be managed at the Royal North Shore Hospital, University of Sydney and will include 26 collaborating ANZ hospitals over 18 months.Read moreRead less
Improving Risk Assessment For Recycled Water: Domestic Laundries And Recreational Parks
Funder
National Health and Medical Research Council
Funding Amount
$81,250.00
Summary
Recent droughts in Australia have meant that recycled water is becoming increasingly important to ensure the sustainability of our water resources. There are four different classes of recycled water (Class A, B, C and D), depending on the level of microbiological contamination. The potential level of exposure of the population to recycled water determines the class of water suitable for various reuse purposes. The need to address water recycling issues in Australia has resulted in increasing num ....Recent droughts in Australia have meant that recycled water is becoming increasingly important to ensure the sustainability of our water resources. There are four different classes of recycled water (Class A, B, C and D), depending on the level of microbiological contamination. The potential level of exposure of the population to recycled water determines the class of water suitable for various reuse purposes. The need to address water recycling issues in Australia has resulted in increasing numbers of innovative recycling schemes such as dual reticulation systems which supply two qualities of water to households, one of high quality for drinking and a second piped system delivering treated recycled water for non-potable (non-drinking) use. In this project, we will investigate the safety of using recycled water in different situations by using water with different known concentrations of micro-organisms to simulate recycled waters of different classes. Most state health authorities in Australia do not approve the use of recycled water for machine washing because of a lack of safety data, but its use in laundries could significantly reduce the need for high quality drinking water. We will perform experiments to help determine the safety of using recycled water for rinsing clothes during a washing machine cycle. Another use of recycled water is for irrigation of recreational parks. Because of safety concerns, when recycled water of Class B or C is used, some states advocate that the public must wait at least 4 hours after watering before they can gain access. This time period may be unnecessary. We will perform experiments to assess the potential exposure to micro-organisms in grass for park users at different time periods following irrigation with water of various classes. The information obtained from this project will help in the decision-making of health and water regulatory agencies.Read moreRead less
Droperidol And Olanzapine As Adjuncts To Midazolam For The Acutely Agitated Patient: A Randomised Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$187,872.00
Summary
Management of the acutely agitated patient, whether due to severe psychiatric illness or drug intoxication, results in a disproportionate use of Emergency Department resources. Drug sedation is frequently employed when an individual is at risk of harming themselves or others. This study will determine if antipsychotic drugs (droperidol and olanzapine), when added to midazolam (a commonly used sedative), is safer and more efficacious than sedation with midazolam alone.
Selective Estrogen Receptor Modulators (SERMs) - A Potential New Treatment For Women Of Child-bearing Age With Psychotic Symptoms Of Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$210,480.00
Summary
Schizophrenia is a devastating illness urgently requiring a new treatment approach. We have discovered that estrogen is an effective treatment for women with schizophrenia and are currently trialling a safer Selective Estrogen Receptor Modulator (SERM) known as brain estrogen� in postmenopausal women with schizophrenia. Regulatory permission is now available to trial the SERM in younger women, and we seek to extend our current SERM study into child bearing age women with schizophrenia.
A Randomised Controlled Trial Of Normoglycaemia Versus Conventional Glycaemic Control In Intensive Care Unit Patients.
Funder
National Health and Medical Research Council
Funding Amount
$1,773,507.00
Summary
The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are u ....The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are unsure if the treatment would work in their patients because of differences in the types of patients found in intensive care units in Australia, and because of other treatment given to the patients in the Belgian study. In particular the doctors in the Belgian unit studied only patients who had had operations and gave large amounts of intravenous sugar to their patients. This is not normally done in Australian Intensive Care Units and the safety of giving high dose insulin to patients not receiving large amounts of intravenous sugar is not known. This is of particular interest as reducing blood glucose to abnormally low levels can cause serious side effects and even result in permanent brain damage. The Australian and New Zealand Intensive Care Society proposes to conduct a new study involving 4,000 patients from intensive care units in Australia and New Zealand and will study all patients regardless of whether or not they have had an operation. These patients will be randomly assigned to receive insulin to control blood sugar levels to normal or to slightly above normal levels as has been tradition in intensive care units around the world. Outcome and serious side effects will be closely monitored. The results will be available within three years of starting the study, and these are likely to influence the treatment of the majority of patients admitted to intensive care units both in Australia and worldwide.Read moreRead less
Genetic And Physiological Mechanisms Of Executive Control
Funder
National Health and Medical Research Council
Funding Amount
$577,226.00
Summary
The question of how genetic variation contributes to individual differences in cognitive ability has fascinated scientists for decades. Arguably, executive control processes mediated by the frontal cortex are critical to our uniquely human ability for voluntary action, decision and will. Using a variety of novel innovations, this project will provide fundamental knowledge by developing a unique link between genetic, behavioural and neural indices of executive control.