Enterovirus 71 In The Asia-Pacific Region: Reverse Genetic Approaches To Virus Surveillance And Vaccine Development.
Funder
National Health and Medical Research Council
Funding Amount
$690,833.00
Summary
In this research the team will use advanced biotechnological techniques to study the distribution and virulence markers of an important emerging infectious disease, enterovirus 71 encephalitis, in the Asia-Pacific region. The knowledge and technical advances derived from this study will be shared with neighbouring countries in order to conduct sensitive surveillance for this infection throughout the region. The study's other major aim is to use cutting-edge biotechnological techniques to develop ....In this research the team will use advanced biotechnological techniques to study the distribution and virulence markers of an important emerging infectious disease, enterovirus 71 encephalitis, in the Asia-Pacific region. The knowledge and technical advances derived from this study will be shared with neighbouring countries in order to conduct sensitive surveillance for this infection throughout the region. The study's other major aim is to use cutting-edge biotechnological techniques to develop a genetically defined, live attenuated vaccine strain. Candidate vaccine strains will be tested for their effectiveness in both cell culture-based and animal models.Read moreRead less
Molecular Epidemiology Of Infection In Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$149,103.00
Summary
Destructive diseases of the gum tissue are known to be profoundly affected by modifying factors including systemic diseases such as diabetes, socio-economic conditions and the lack of effective control of microbial accumulation at the gum margin. This investigation will examine the hypothesis that a limited number of pathogenic bacterial strains, defined by quantitative molecular probe analysis, persist in or re-infect individuals to maintain a high disease burden in the presence of adverse modi ....Destructive diseases of the gum tissue are known to be profoundly affected by modifying factors including systemic diseases such as diabetes, socio-economic conditions and the lack of effective control of microbial accumulation at the gum margin. This investigation will examine the hypothesis that a limited number of pathogenic bacterial strains, defined by quantitative molecular probe analysis, persist in or re-infect individuals to maintain a high disease burden in the presence of adverse modifying factors that prevail in isolated, disadvantaged Aboriginal communities.Read moreRead less
Injecting Drug Users: Social Networks And Molecular Epidemiology Of The Hepatitis C Virus
Funder
National Health and Medical Research Council
Funding Amount
$543,868.00
Summary
The hepatitis C virus (HCV) continues to spread among injecting drug users (IDUs) in Australia at a very high rate, despite success in preventing the spread of HIV in the same groups; the complete reasons for this remain unclear. There is an urgent need for the HCV epidemic among IDUs to be contained. To do so, we must better understand the ways in which it is spreading among IDUs. Much is known about risk behaviours of individual IDUs and how they contribute to HCV transmission; much less is kn ....The hepatitis C virus (HCV) continues to spread among injecting drug users (IDUs) in Australia at a very high rate, despite success in preventing the spread of HIV in the same groups; the complete reasons for this remain unclear. There is an urgent need for the HCV epidemic among IDUs to be contained. To do so, we must better understand the ways in which it is spreading among IDUs. Much is known about risk behaviours of individual IDUs and how they contribute to HCV transmission; much less is known about how these behaviours are modified by the influence of the IDUs peer group, especially their immediate and intimate social networks. Despite its importance in influencing attitudes and behaviours, and therefore HCV transmission, this has never been studied in Australia, nor, in relation to HCV, in the world. We hope that by studying social and risk networks of IDUs we shall discover new ways in which control of the HCV epidemic can be achieved in Australia. We intend to do this among two groups of young IDUs, one of Vietnamese ethnicity, located in the one suburb of Melbourne. By using field techniques for gathering information (ethnography), and sophisticated analytic techniques to understand how these networks are formed and influence behaviours, we hope to be able to identify interventions which work at the level of the social group rather than the individual in bringing about the behaviour change necessary to prevent HCV transmission. To ensure that the risk networks we describe are as influential as they appear, and to discover more about the variability of HCV, we will also be investigating the relationship between the various strains of HCV in members of the IDU networks, particularly as another measure of the connectedness of networks and network members. This will be done using sophisticated genetic analysis of the HCV obtained from network members by blood test.Read moreRead less
Confirming The Burden Of Disease Associated With Dementia Using New Empirically Driven Australian Based Disability Rati
Funder
National Health and Medical Research Council
Funding Amount
$138,084.00
Summary
The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden e ....The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden estimates. First, the dementia calculations currently use a “disability weight” metric derived from a Dutch study. This is problematic in that the weights do not reflect an Australian experience of dementia, nor do they reflect the preferences of people closely affected by the disease (e.g. carers). Second, the dementia estimates do not include cases of mild cognitive impairment (considered a precursor state of dementia). Hence the dementia estimates may not estimate the full impact of dementia in Australia. Finally, there is no evidence that the method used by the Burden of Disease study to account for the impact of disease comorbidity adequately deals with the comorbidity associated with dementia. Consequently, there is need to develop a new and comprehensive set of disability weights for dementia that are Australian-based, include all stages of dementia severity and account for comorbidity. The proposed project aims to develop a new set of empirically derived Australian-based disability weights for dementia. The project will entail three studies. The first study will generate empirically based case vignettes that describe a range of dementia case scenarios. These descriptions will then be used in rating exercises (Study 2) to develop new disability weights. The second study involves Australian health practitioners, carers and lay persons reading case vignettes and completing health valuation rating exercises to generate new disability weights for dementia. The third study uses the new disability weights to re-calculate the burden of disease estimates for dementia. The new estimates will be compared to those reported by the 2007 Australian Burden of Disease project. In knowing the accuracy of the estimates, policy makers can use the burden data for dementia with confidence when engaging in service planning for the future.Read moreRead less
Identifying EHealth Literacy And Readability Issues For Palliative Care Consumers
Funder
National Health and Medical Research Council
Funding Amount
$29,375.00
Summary
Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individ ....Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individual skills and experiences and how information is presented and made available. eHealth literacy is a measure of the mix of skills required by consumers to successfully access and understand palliative care information. Readability is one aspect of eHealth literacy and readability scales can be used to identify how effective websites are in providing appropriate written information for palliative care consumers. This research will help assess eHealth literacy levels and hence potential intervention needs of palliative care patients and carers as well as determining whether the readability requirement of palliative care websites and information is too high.Read moreRead less
An Investigation Of Care Planning Decisions In Advanced Pulmonary And Cardiac Illness In The Bayside Health Care Region
Funder
National Health and Medical Research Council
Funding Amount
$47,726.00
Summary
There has been little Australian research to develop interventions that facilitate end of life decision making. This project will provide a framework for understanding the issues in the planning of end of life care for people with chronic and life limiting illness and the relationship of this planning to organizational policy. The care decisions in hospital records of people with advanced lung and heart disease will be reviewed and people with those diseases interviewed about the issues they exp ....There has been little Australian research to develop interventions that facilitate end of life decision making. This project will provide a framework for understanding the issues in the planning of end of life care for people with chronic and life limiting illness and the relationship of this planning to organizational policy. The care decisions in hospital records of people with advanced lung and heart disease will be reviewed and people with those diseases interviewed about the issues they experience in planning their future care. Professionals from a range of health organisations will be interviewed about their experiences of care planning for people with life limiting lung and heart disease. As a pilot, this project will be used to contribute to the development of a model for a coordinated multidisciplinary process that brings together the health care services in a region and contributes to the systematic, ongoing development of infrastructure to improve end of life care.Read moreRead less
Avian Influenza - National Perception Of Risks To Paramedics And Innovative Ambulance Service Population-based Models Of
Funder
National Health and Medical Research Council
Funding Amount
$297,909.00
Summary
This research addresses the important public health role of prehospital Emergency Medical Services (EMS) in containing and managing contagion should an influenza pandemic evolve in Australia. Paramedics are front line health staff and in the event of a pandemic will be among the first members of the community to face exposure to infection. This research will explore the attitudes and perceptions of paramedics and their families to working in epidemic conditions, provide prediction of behavioural ....This research addresses the important public health role of prehospital Emergency Medical Services (EMS) in containing and managing contagion should an influenza pandemic evolve in Australia. Paramedics are front line health staff and in the event of a pandemic will be among the first members of the community to face exposure to infection. This research will explore the attitudes and perceptions of paramedics and their families to working in epidemic conditions, provide prediction of behavioural responses to highly infectious environments, and a clear understanding of attitudes to infection control and use of Personal Protective Equipment (PPE). Knowledge of how to manage and support the responses of frontline health workers to an infectious disease outbreak is critical to the emergency system response. This project aims to mitigate the effects of perceived risk of infection on attitudes and behaviour of paramedics, by informing health promotion and infection-prevention messages to paramedics and their families. This research will also explore the emerging role of ambulance services as a key component of a public health surveillance system to provide an early warning of pandemic disease outbreaks and facilitate implementation of effective disease control strategies. Current triage systems, used for allocation of patients to appropriate treatment and-or quarantine, are not designed for epidemic environments, and may inadvertently facilitate disease spread and delay identification of victims requiring immediate care and-or quarantine. This project will explore the utility of a population-based triage tool to control an infectious disease outbreak by reducing patient-to-patient disease transmission. The project will facilitate expansion of current public health disease surveillance strategies and triage mechanisms for use during an epidemic, to effectively manage increased workloads within a highly infectious environment, whilst maintaining usual emergency medical services.Read moreRead less
In type 1 diabetes the body becomes deficient in insulin production from pancreatic b cells because the immune system mistakenly attacks and destroys b cells as if they were an invading infection. Recurrence of autoimmune destruction of b cells also occurs following transplantation of whole pancreas or islet cells and may occur in the future when other engineered insulin producing cells are transplanted. The focus of this program is to better understand how b cells are killed by the immune syste ....In type 1 diabetes the body becomes deficient in insulin production from pancreatic b cells because the immune system mistakenly attacks and destroys b cells as if they were an invading infection. Recurrence of autoimmune destruction of b cells also occurs following transplantation of whole pancreas or islet cells and may occur in the future when other engineered insulin producing cells are transplanted. The focus of this program is to better understand how b cells are killed by the immune system and to test ways of protecting beta cells from these mechanisms. Because of the inaccessibility of the pancreas to study (particularly biopsy) in humans with diabetes, much of the proposed work will be carried out in b cells derived from non-obese diabetic (NOD) mice, the best available mouse model of type 1 diabetes. It is clear from the literature that a molecule called perforin found in cytoxic T lymphocytes (CTL) is a major, if not the major, mechanism the immune system uses against b cells. For this reason we will try to better understand the interaction between b cells and perforin and ultimately design ways of them from perforin-mediated cell death. It is equally clear that there are other mechanisms besides perforin that can cause b cell death and the program will also address discovery of these mechanisms and new ways to block them. Beta cells in NOD mice will be protected from perforin or other mechanisms by the addition of protective genes or removal of harmful genes using transgenic knockout technology. Addition or removal of genes involved in cell death can be done systematically and each protocol tested using NOD mouse model. The process of cell death that b cell undergo in type 1 diabetes is called apoptosis. Apoptosis is a general mechanism by which cells of all types die. Experts in the biology of apoptosis and perforin are important members of the program, providing the opportunity to translate the latest advances in cell death research to diabetes. This research addresses several of the specific research areas of interest to JDRF. It focuses on the prevention of b cell death in individuals with type 1 diabetes receiving islet transplants. It may be applicable in the future to protection of stem or precursor cells that have been differentiated into b cells or even to devising strategies to prevent the development of diabetes.Read moreRead less
Informing The Development Of A Model Of Care For Patients With End Stage COPD: What Are Their Needs And And They Being Met
Funder
National Health and Medical Research Council
Funding Amount
$49,425.00
Summary
Currently there is no specific model of care for people with end stage chronic obstructive pulmonary disease (COPD), despite growing evidence of the specific symptoms and issues of this patient group. Interviews with end stage COPD patients and their carers will be undertaken to explore the services currently being accessed, and how well patients’ needs are being met by these services. This project will conduct an audit of available services in South Australia and then examine how hospital, spec ....Currently there is no specific model of care for people with end stage chronic obstructive pulmonary disease (COPD), despite growing evidence of the specific symptoms and issues of this patient group. Interviews with end stage COPD patients and their carers will be undertaken to explore the services currently being accessed, and how well patients’ needs are being met by these services. This project will conduct an audit of available services in South Australia and then examine how hospital, specialist palliative care units and primary care services (including general practice) can interface to meet these identified patient and carer needs. The results from this study will be used to inform development of a distinct model (or models) of care that addresses the needs of patients with end stage COPD.Read moreRead less