Genetic Dissection Of The Biogenesis And Function Of Type IV Fimbriae Of Pseudomonas Aeruginosa
Funder
National Health and Medical Research Council
Funding Amount
$407,545.00
Summary
Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. This pathogen, and a number of other important infectious bacteria use surface filaments, called fimbriae, like grappling hooks to attach to the cells of the body and to move across host tissues. These fimbriae are produced in response to environmental conditions, and are assembled by a pro ....Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. This pathogen, and a number of other important infectious bacteria use surface filaments, called fimbriae, like grappling hooks to attach to the cells of the body and to move across host tissues. These fimbriae are produced in response to environmental conditions, and are assembled by a process that is also used in the export of toxins and other pathogenic molecules. This project will characterise genes which specify and control this system, as a means to design better treatments against such bacteria, many of which are resistant to antibiotic treatment.Read moreRead less
The Out-and-About Trial: Improving Quality Of Life By Increasing Outdoor Journeys After Stroke
Funder
National Health and Medical Research Council
Funding Amount
$586,009.00
Summary
Many stroke patients cannot walk well when they leave hospital nor use public transport. Escorted outdoor journeys with a rehabilitation therapist can improve outcomes and quality of life after stroke. Yet not many stroke patients do not receive this type of community rehabilitation. This project aims to evaluate an implementation program to change therapists' practice and increase outdoor journeys after stroke. Benefits include improved quality of life and well being for peope with stroke.
Reducing Cancer Patients Psychosocial Needs. A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$452,025.00
Summary
With 345,000 cases of cancer diagnosed each year, cancer is one of the nation's health priority areas. Although significant improvements in the early detection and treatment of cancer have increased survival, these advancements may have added to the psychological, physical and resource burdens placed on patients by increasing the time between diagnosis and definitive outcome. Addressing the physical and psychological needs of cancer patients throughout the course of their illness has become an i ....With 345,000 cases of cancer diagnosed each year, cancer is one of the nation's health priority areas. Although significant improvements in the early detection and treatment of cancer have increased survival, these advancements may have added to the psychological, physical and resource burdens placed on patients by increasing the time between diagnosis and definitive outcome. Addressing the physical and psychological needs of cancer patients throughout the course of their illness has become an important component care. A potential mechanism for reducing the psychological morbidity associated with cancer is to intervene to reduce a patient's level of unmet needs. This proposal intends to test the cost-effectiveness of an innovative intervention to reduce the level of unmet needs among colorectal patients. The study involves recruiting patients diagnosed with colorectal cancer within the past 3 months through the cancer registry and assessing their level of unmet needs at four points-at entry into the study: 6-, 12- and 18- months post diagnosis. Experimental subjects will be assigned a specially trained volunteer worker attached to the cancer council to aid the patient in identifying resources to address their unmet needs. The volunteer will act as an information resource and emotional support person. The volunteer will access information about the patients unmet needs from study questionnaires, and work with patients to devise a plan for addressing their unmet needs. The study will determine whether the level of unmet needs among cancer patients can be reduced in this manner and whether this strategy also reduces psychological distress. The proposed research is unique as it could highlight mechanisms that could be utilised by all cancer councils in Australia. The intervention has the additional benefit of being able to reach all cancer patients in a particular state regardless of their geographic location or where they receive treatment.Read moreRead less
DCIS Management Since Publication Of Clinical Practice Recommendations: Surgeons' Practices And Women's Experiences
Funder
National Health and Medical Research Council
Funding Amount
$360,783.00
Summary
Ductal Carcinoma in Situ of the breast (DCIS) now represents 15% of all new cases of breast cancer. Although a benign disease, its diagnosis increases a woman's risk of developing invasive breast cancer and the goal of treatment is prevention of invasive disease. However the characteristics that predict this progression have not been clearly identified. Consequently women are confused about their diagnosis and both clinicians and women are faced with complex treatment decisions. The National Bre ....Ductal Carcinoma in Situ of the breast (DCIS) now represents 15% of all new cases of breast cancer. Although a benign disease, its diagnosis increases a woman's risk of developing invasive breast cancer and the goal of treatment is prevention of invasive disease. However the characteristics that predict this progression have not been clearly identified. Consequently women are confused about their diagnosis and both clinicians and women are faced with complex treatment decisions. The National Breast Cancer Centre (NBCC) published a set of eight clinical practice recommendations for the management of DCIS in September 2003 and a guide for consumers in 2004. Currently there is no information regarding how the treatment recommendations have been received by surgeons, the extent management of DCIS now follows these recommendations or the impact of the treatment recommendations on the medical experiences of women with DCIS. This project will fill this gap. The project aims to: 1. Examine the impact of clinical practice recommendations for the management of Ductal Carcinoma in Situ (DCIS) of the breast on clinical practice 2. Determine awareness of and attitudes towards the recommendations among surgeons treating DCIS and to examine the relationship between these attitudes and clinical practice 3. Examine women's experience of a DCIS diagnosis, their understanding of its prognosis and involvement in treatment decisions after release of a consumer guide in 2004 This research will determine whether the publication of the treatment recommendations in 2003 influenced the medical care women with DCIS recieve and identify the factors associated with surgeons and women that facilitate or prevent the uptake of these recommendations. This information will be used to develop strategies increase surgeons' adoption of the treatment recommendations in order to ensure that all women with DCIS have access to the best care possible.Read moreRead less
Analysis Of A Chemosensory Complex That Controls Twitching Motility And Virulence In Pseudomonas Aeruginosa
Funder
National Health and Medical Research Council
Funding Amount
$346,250.00
Summary
Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. Infection by this pathogen requires the controlled expression of a large number of virulence factors including extracellular enzyme, toxins and structures for the attachment and colonisation of host tissues. We have identified a complex multicomponent regulatory system which coordinates the ....Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. Infection by this pathogen requires the controlled expression of a large number of virulence factors including extracellular enzyme, toxins and structures for the attachment and colonisation of host tissues. We have identified a complex multicomponent regulatory system which coordinates the expression of many of the virulence determinants of this pathogen. This project aims to dissect the intermolecular interactions and signalling events which input into, occur within, and output from this regulatory system. This knowledge will provide a platform for developing rational strategies for the production of new antimicrobials for fighting infections by this and related pathogens.Read moreRead less
Protecting Hyposplenic Children And Adults: Identifying Optimal Immunisation Regimens
Funder
National Health and Medical Research Council
Funding Amount
$472,044.00
Summary
Children and adults without normal spleen function are at massively increased risk of overwhelming infection with the pneumococcus bacteria, with 200 times the risk of death from sepsis compared with the normal community. Poor spleen function can be due to an absent spleen (eg after surgery following a car accident) or an underlying medical condition (eg thalassaemia or cancer therapy). Thousands of Australians are affected by this condition and need extra protection from daily antibiotics and a ....Children and adults without normal spleen function are at massively increased risk of overwhelming infection with the pneumococcus bacteria, with 200 times the risk of death from sepsis compared with the normal community. Poor spleen function can be due to an absent spleen (eg after surgery following a car accident) or an underlying medical condition (eg thalassaemia or cancer therapy). Thousands of Australians are affected by this condition and need extra protection from daily antibiotics and additional immunsiations against pneumococcus. A new vaccine against pneumococcus was introduced for Australian infants routinely in 2005 and has prevented many from developing pneumococcal meningitis, sepsis and pneumonia. We wish to see whether this new vaccine, when used with the older existing pneumococcal vaccine, will better protect older children and adults with poor spleen function from the devastating effects of pneumococcus. We will compare different ways of using these vaccines to try to identify the most protective vaccination plan for this vulnerable group of Australians.Read moreRead less
Certain Death In Uncertain Time: A Qualitative Study Of The Experience Of Advanced Ovarian Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$221,755.00
Summary
Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful termi ....Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful terminology to describe it. The absence of discussion exacerbates patients' social isolation. Also, the quality of their remaining life, and the quality of the care they get, depends heavily on the quality of understanding and communication within the social systems that support them. A growing proportion of patients in developed countries fall into this category, including the 1200 Australian women who are diagnosed each year with advanced ovarian cancer. This study aims to increase our understanding of the experience of certain death in uncertain time by recruiting a group of 20 women with advanced ovarian cancer, and interviewing them every few months over three years. The study will explore all aspects of the experience of having advanced ovarian cancer, and generate a terminology for it - one that grows out of the women's own language. The study will inform the organisation and delivery of clinical care and services to women with ovarian cancer. It will also inform patient education programs, and help to tune medical education to the particular needs and perceptions of patients who are experiencing the certainty of death in uncertain time. Finally, the researchers will also explore the implications of the findings for medical ethics and health law, and for communication, information and decision-making in cancer medicine.Read moreRead less
Understanding Burn Injuries In Aboriginal And Torres Strait Islander Children: Treatment, Access To Services And Outcomes.
Funder
National Health and Medical Research Council
Funding Amount
$911,798.00
Summary
This is the first large scale study to systematically examine the burden of burn injury in Aboriginal and Torres Strait Islander children, including care and cost of treatment, and relationship between access to treatment and functional outcomes. With a team comprising epidemiologists, burns clinicans and Aboriginal health researchers, this study will generate important new research evidence to improve care in this over-represented and vulnerable population.