Integration Of Risk Evaluation In Cardiovascular Disease Management Programs.
Funder
National Health and Medical Research Council
Funding Amount
$5,162,176.00
Summary
This study will determine the feasibility of a coordinated health care team approach to the treatment of cardiovascular disorders. It will examine a range of issues – who would most benefit from this approach, its value for money, the relative importance of health care services to consumers, and where to invest additional health funds. Built on strong collaborations between expert researchers in advanced diagnostic techniques, coordinated health care, community health care and health economics, ....This study will determine the feasibility of a coordinated health care team approach to the treatment of cardiovascular disorders. It will examine a range of issues – who would most benefit from this approach, its value for money, the relative importance of health care services to consumers, and where to invest additional health funds. Built on strong collaborations between expert researchers in advanced diagnostic techniques, coordinated health care, community health care and health economics, this provides a unique opportunity to benefit millions of Australians.Read moreRead less
New Evidence To Guide Decisions About The Prevention And Treatment Of Common Cardiovascular Diseases.
Funder
National Health and Medical Research Council
Funding Amount
$7,309,675.00
Summary
The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large ....The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large numbers of premature deaths and serious disabling outcomes. This Program of research seeks to provide new information that will give patients, doctors and policy makers innovative options for the treatment and prevention of heart attack and stroke. The Program will incorporate two main elements: observational studies and randomised controlled trials. The observational studies will establish the precise importance of each of the main causes of cardiovascular diseases (such as diabetes, blood pressure, smoking and cholesterol) at different ages, in different ethnic groups and in different geographic regions. Furthermore, these studies will also define the relative importance of established and novel risk factors for cardiovascular disease, providing important new information about how resources for prevention should be directed. The large-scale trials will provide evidence about the effectiveness and safety of a range of new cardiovascular disease prevention and treatment strategies. The work will build on the team�s very successful approach of evaluating the effects of established interventions in high-risk groups for whom those particular treatments are not currently indicated.The Program will also include studies that address the critical issue of translating health research findings into practice _ in terms of health policy, clinical practice and consumer behaviour. A particular focus involves the application and evaluation of novel Internet technologies for promoting best practice. The methodologies used by the team will ensure that the evidence generated by the Program is as precise and reliable as possible, in order to provide a sound base to guide decisions about changes in health care policy and practice. The research findings will have direct relevance to the healthcare needs of millions of Australians within the next five years, and the impact of the work will be assured by the development of implementation and dissemination plans for each major component of the Program.Read moreRead less
Novel Strategies For Improving Respiratory Support And Outcomes For Very Preterm Babies
Funder
National Health and Medical Research Council
Funding Amount
$8,381,820.00
Summary
Very premature birth is the commonest cause of illness and death in newborn babies, making it one of the most serious and costly issues in perinatal medicine. The major problem suffered by very premature babies is lung immaturity and its associated harmful effects on brain development. Most very premature babies require resuscitation followed by ventilatory support,often for several weeks. This is extremely expensive and places an enormous financial burden on health care systems. Furthermore, it ....Very premature birth is the commonest cause of illness and death in newborn babies, making it one of the most serious and costly issues in perinatal medicine. The major problem suffered by very premature babies is lung immaturity and its associated harmful effects on brain development. Most very premature babies require resuscitation followed by ventilatory support,often for several weeks. This is extremely expensive and places an enormous financial burden on health care systems. Furthermore, it increases the risks of respiratory illnesses, including bronchopulmonary dysplasia and chronic lung disease which can impair breathing and increase susceptibility to respiratory disease such as asthma later in life. The overall aim of this program is to improve outcomes for very premature babies, including less lung injury, better respiratory health and shorter stays in hospitals. In order to reduce the health burden caused by very premature birth on the community we need to know more about how it alters the normal development of the lungs in the newborn period and into later life. In particular, we need to understand the cellular and molecular processes involved in lung development so that we can identify gene networks and developmental processes that are disrupted by severe premature birth. Such knowledge is necessary to provide a more rational, scientific basis for managing and treating the alterations in lung structure and function caused by premature birth. We also need to develop better ways of resuscitating and ventilating these infants so that lung injury is minimized.The research team is led by two neonatologists and three biomedical research scientists with a proven record of effective collaboration. This team is internationally unique in that it includes practicing neonatologists, respiratory physiologists and molecular biologists who have collaborated together productively and are regarded as world leaders in their respective fields. New talents have been brought into the team to provide expertise in pulmonary stem cell biology, the design of novel steroid drugs, and clinical follow-up. Together, this team has the potential (a) to greatly enhance the understanding of the impact of very premature birth on the developing lung, (b) to improve resuscitation and ventilation techniques, and (c) to translate the new knowledge into clinical practice to improve the outcome for prematurely born babies. Using well characterized animal models we will determine gene networks involved in fetal lung development and how these are altered by premature birth. The successful transition from fetal to postnatal life is critical for survival at birth but more information is needed. Using newborn lambs and rabbits, we will trial novel strategies for enhancing the transformation of the immaturelung into an effective gas exchange organ at birth. New data on lung aeratioRead moreRead less
Molecular Determinants Of Risk, Progression And Treatment Response In Melanoma
Funder
National Health and Medical Research Council
Funding Amount
$8,381,820.00
Summary
Melanoma is a major Australian health problem. NSW figures for 2002 show it to be the second most common cancer in men and women. It has a disproportionately heavy impact on productive years of the life of young Australians because it is the commonest cancer in those aged 15-45 years. The investigators are all associated with the Sydney Melanoma Unit (SMU), the world�s largest clinical service dedicated to the treatment of melanoma, treating >1200 new melanoma patients annually. We have also ....Melanoma is a major Australian health problem. NSW figures for 2002 show it to be the second most common cancer in men and women. It has a disproportionately heavy impact on productive years of the life of young Australians because it is the commonest cancer in those aged 15-45 years. The investigators are all associated with the Sydney Melanoma Unit (SMU), the world�s largest clinical service dedicated to the treatment of melanoma, treating >1200 new melanoma patients annually. We have also recruited large cohorts of individuals with high susceptibility to melanoma, both familial and population-based, throughout southeastern Australia. We aim to utilise these unique, internationally-recognised resources to develop a scientific basis for 1) improved management of individuals at high risk for development and progression of melanoma, and 2) improved treatment of patients with early and disseminated melanoma. We will base this on consolidation of existing collaborative research into molecular predictors of risk, progression and treatment response in melanoma.Read moreRead less
Advances In Clinical Trials Research And Evidence Based Decision Making
Funder
National Health and Medical Research Council
Funding Amount
$6,712,859.00
Summary
The NHMRC Clinical Trials Centre at the University of Sydney aims to use clinical trials and methodological research in trials to improve health in Australia and internationally It is a member of many international collaborative trials groups, especially in heart disease and cancer. A particular area of interest is patient preferences and decision making, particularly in cancer. The Clinical Trial Centre is active in using data from its own and other clinical trials in combined analyses to arriv ....The NHMRC Clinical Trials Centre at the University of Sydney aims to use clinical trials and methodological research in trials to improve health in Australia and internationally It is a member of many international collaborative trials groups, especially in heart disease and cancer. A particular area of interest is patient preferences and decision making, particularly in cancer. The Clinical Trial Centre is active in using data from its own and other clinical trials in combined analyses to arrive at better evidence.Read moreRead less
Generating The Evidence For New Strategies To Combat Cardiovascular Diseases.
Funder
National Health and Medical Research Council
Funding Amount
$12,809,917.00
Summary
The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour combating heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and the world. While there are many established treatment and prevention strategies there remains great potential for further advances to avert large numbers of deaths and serious disabling outcomes. This Program will provide new information that will give patien ....The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour combating heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and the world. While there are many established treatment and prevention strategies there remains great potential for further advances to avert large numbers of deaths and serious disabling outcomes. This Program will provide new information that will give patients, doctors, consumers and policy makers new options for disease prevention.Read moreRead less
Insult, Injury And Recovery In Brain Disease: From Molecules To Therapeutic Outcome
Funder
National Health and Medical Research Council
Funding Amount
$8,215,611.00
Summary
When nerve cells are damaged, destroyed or injured, through disease or trauma, common pathological processes are set in train. Even though there are many factors that might trigger disease, these inevitably lead to common processes that end in cell death or initiate protective processes. One theme involves the factors that surround these responses to nerve injury and stress, and the consequent protective and regenerative responses that ensue. Another theme, closely integrates with the first, is ....When nerve cells are damaged, destroyed or injured, through disease or trauma, common pathological processes are set in train. Even though there are many factors that might trigger disease, these inevitably lead to common processes that end in cell death or initiate protective processes. One theme involves the factors that surround these responses to nerve injury and stress, and the consequent protective and regenerative responses that ensue. Another theme, closely integrates with the first, is to exploit basic biological mechanisms with the aim of identifying and developing therapeutic targets for the management of a wider range of neurological conditions.Read moreRead less
MOLECULAR AND CELLULAR PATHOGENESIS OF HUMAN LIVER DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$4,928,323.00
Summary
n humans, chronic liver diseases cause cirrhosis of the liver in some but not all individuals. This leads to protracted ill-health, complications (fluid retention in the abdomen, confusion, bloodstream infections, kidney failure, liver cancer) resulting in hospitalisation, liver transplantation and premature death. In Australia, cirrhosis is an important cause of death and of years of potential life lost, while liver cancer has recently doubled and is predicted to treble by 2020. The common caus ....n humans, chronic liver diseases cause cirrhosis of the liver in some but not all individuals. This leads to protracted ill-health, complications (fluid retention in the abdomen, confusion, bloodstream infections, kidney failure, liver cancer) resulting in hospitalisation, liver transplantation and premature death. In Australia, cirrhosis is an important cause of death and of years of potential life lost, while liver cancer has recently doubled and is predicted to treble by 2020. The common causes are hepatitis C, fatty liver disorders, alcohol and hepatitis B; when 2 of these are present together, there is a higher risk of cirrhosis. This program aims to unravel the pathological processes which cause cirrhosis at the molecular and cellular levels, in order to understand why some people are at higher risk. These processes could result from genetic predisposition, other constitutional factors (age, gender) or from lifestyle factors (overnutrition, inactivity, alcohol). The 3 chief investigators from Westmead s Millennium Institute and the Centenary Institute of Royal Prince Alfred Hospital are international experts in hepatitis C, non-alcoholic steatohepatitis (NASH) and other fatty liver disorders, autoimmune hepatitis, liver transplantation, and scarring processes that lead to cirrhosis of the liver. The new knowledge that will result from these studies will be used to help prevent people developing severe forms of chronic liver disease, and for treating cirrhosis if it has already occurred.Read moreRead less
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
Developmental Aspects Of Respiratory Inflammation, Allergy And Asthma
Funder
National Health and Medical Research Council
Funding Amount
$7,169,609.00
Summary
Asthma develops as a complex series of interactions between genetic susceptibility and environmental exposures occurring in early life. While many children grow out of asthma others do not and develop the chronic form of the disease that persists into adult life. Our research involves understanding why some susceptible children develop asthma and why this becomes chronic in some. We will undertake studies in children to find out how and why this occurs. A major part of our studies involve longit ....Asthma develops as a complex series of interactions between genetic susceptibility and environmental exposures occurring in early life. While many children grow out of asthma others do not and develop the chronic form of the disease that persists into adult life. Our research involves understanding why some susceptible children develop asthma and why this becomes chronic in some. We will undertake studies in children to find out how and why this occurs. A major part of our studies involve longitudinal studies in cohorts of children recruited before birth. Having the ability to study children as they grow and develop conditions such as allergies and asthma allows us to understand why these conditions occur and allow us to predict which children are likely to develop them. Our research Program also has a solid focus on Translational Research, in which we will use the findings from our basic science studies to develop and test new methods of preventing and of treating asthma. These studies will include new methods for preventing the development of allergies, preventing the damage done to the lungs by severe viral respiratory infections in early life and better methods of treating established allergic asthma by improving immunotherapy techniques. By its very nature, primary prevention of disease in young children is controversial and raises some interesting questions. As part of this Program we intend to initiate consultation and debate in public, academic, regulatory and industry circles. An important role for our Program is shifting the current emphasis away from treatment of established disease towards preventing disease occurring. This is the best way to decrease the health, social and economic burden of chronic diseases such as asthma.Read moreRead less