Systematic Expansion Of The Clinical Evidence Base In Opioid Prescribing For Refractory Dyspnoea At The End Of Life
Funder
National Health and Medical Research Council
Funding Amount
$414,535.00
Summary
Morphine can relieve breathlessness in the palliative setting. But many important questions remain. What is the best dose, should the dose change over time, do different medications provide the same relief, and how common is dyspnoea in the general population? This three part project will extend our knowledge to answer these questions. Population data will provide critical background to plan best care for future palliative patients distressed by breathlessness.
A Multi-site Randomised Controlled Trial Comparing The Severity Of Constipation Symptoms Experienced By Palliative Care Patients Receiving Usual Care Compared To Those Diagnosed And Managed According To The Underlying Pathophysiology.
Funder
National Health and Medical Research Council
Funding Amount
$498,795.00
Summary
This research aims to consider whether the problems of constipation in palliative care are less severe when the physical changes that underlie the problem are explored.
A Sequential Multiple Assignment Randomised Trial (SMART) Of Nursing Interventions To Reduce Pain Associated With Chemotherapy Induced Peripheral Neuropathy
Funder
National Health and Medical Research Council
Funding Amount
$713,418.00
Summary
Modern chemotherapy treatments can result in damage to the peripheral nerves, resulting in a condition called peripheral neuropathy. This condition is characterised by a range of sensory and functional changes that can cause pain and reduced ability to perform daily activities. This project will test various non-pharmacological pain management measures to determine if they are effective in improving the quality of life of patients who experience this problem.
SCALE-C: Strategies For Hepatitis C Testing And Treatment In Aboriginal Communities That Lead To Elimination
Funder
National Health and Medical Research Council
Funding Amount
$2,175,170.00
Summary
Prevalence of hepatitis C infection within the Aboriginal population is among the highest of any identifiable population in Australia. Highly effective, direct-acting antiviral (DAA) therapy, and their listing on the PBS in 2016 has revolutionised HCV clinical management in Australia. The SCALE-C study will evaluate an established test and treat model to rapidly scale-up DAA within four Aboriginal communities to determine both impact on community prevalence and ongoing transmission.
Randomised Double-blind Controlled Trial Of Oxygen Versus Air To Palliate Intractable End-of-life Dyspnoea When Pa02 >55
Funder
National Health and Medical Research Council
Funding Amount
$463,318.00
Summary
Shortness of breath at the end-of-life is one of the most feared symptoms. Unlike most other symptoms, it worsens as death approaches. Despite the fact that more than 50,000 Australian will die an expected death in the next year, of whom the majority will have breathlessness toward the end-of-life, we know little about how best to treat this symptom. Oxygen is frequently introduced but we have not identified whether it is more effective than medical air, and, if it is more effective, which patie ....Shortness of breath at the end-of-life is one of the most feared symptoms. Unlike most other symptoms, it worsens as death approaches. Despite the fact that more than 50,000 Australian will die an expected death in the next year, of whom the majority will have breathlessness toward the end-of-life, we know little about how best to treat this symptom. Oxygen is frequently introduced but we have not identified whether it is more effective than medical air, and, if it is more effective, which patients would most benefit from it. Because of this lack of evidence, oxygen is only funded in Australia in community settings for people who have severely low oxygen levels in their blood. Palliative oxygen is provided on a compassionate basis at times but this is on an ad hoc basis and does not ensure equitable access for people at the end of life who experience shortness of breath. This multi-centre study will compare oxygen and air, with neither the participant nor caring clinicians knowing which treatment they will receive. After careful explanation, volunteers who agree to participate will be asked to use the oxygen machine for at least 15 hours each day for 7 days and fill out a diary twice each day. Five centres across Australia are planning to enroll 240 participants in this study. Outcomes will include whether the sensation of breathlessness has improved, the overall quality of life while being treated, the ability to perform activities of daily living and any side effects experienced. This study is eagerly awaited by clinicians and health planners not only in Australia but in North America and Europe. This study will provide data in a long-standing international debate about the role of oxygen in people with relatively normal levels of oxygen in their blood who suffer from shortness of breath at the end-of-life.Read moreRead less
Novel Interventions To Address Methamphetamines In Aboriginal Communities, Including A Randomised Trial Of A Web Based Therapeutic Tool Used To Treat Dependence In Clinical Settings.
Funder
National Health and Medical Research Council
Funding Amount
$2,177,908.00
Summary
Methamphetamine use in Aboriginal communities has gained much media attention, despite limited research studies to ascertain the full extent of its use and its impact. We propose a randomised trial of a web based therapeutic tool for use in Aboriginal Medical Services to treat clients using methamphetamines. In addition we will characterise the health and well-being of Aboriginal people who use methamphetamines and trial unique Aboriginal community led interventions to address methamphetamines.
Diet influences the selective advantage of mitochondrial DNA mutations. This project aims to examine critical mechanisms that affect mitochondrial DNA variation within species. It aims to test the hypothesis that mitochondrial DNA haplotypes have the potential to be under nutritionally induced balancing selection as a consequence of cellular signalling and/or Adenosine triphosphate (ATP) production by mitochondria. Diet can vary both seasonally and geographically and is a key environmental param ....Diet influences the selective advantage of mitochondrial DNA mutations. This project aims to examine critical mechanisms that affect mitochondrial DNA variation within species. It aims to test the hypothesis that mitochondrial DNA haplotypes have the potential to be under nutritionally induced balancing selection as a consequence of cellular signalling and/or Adenosine triphosphate (ATP) production by mitochondria. Diet can vary both seasonally and geographically and is a key environmental parameter that influences the ability of a species to colonise new habitats. The project plans to characterise the functional links between specific mitochondrial DNA haplotypes, mitochondrial functions and organismal traits. The expected outcome is a more precise grasp of the processes influencing genetic variation within and among species, which would inform current issues in ecology and genetics.Read moreRead less
Why do only some exotics become invasive? Combining ecological and genomic approaches to address alternative hypotheses in a recent Australian weed. This project will specifically test alternative hypotheses about how weeds become invasive. As invasive weeds affect both agricultural and native ecosystems equally, research on understanding the mechanisms of weed invasion is critical. Outcomes will benefit Australia by allowing better prioritisation of management against exotic plants already i ....Why do only some exotics become invasive? Combining ecological and genomic approaches to address alternative hypotheses in a recent Australian weed. This project will specifically test alternative hypotheses about how weeds become invasive. As invasive weeds affect both agricultural and native ecosystems equally, research on understanding the mechanisms of weed invasion is critical. Outcomes will benefit Australia by allowing better prioritisation of management against exotic plants already in the country by providing predictive tools to estimate likelihood of spread. For formal Pest Risk Analysis by regulators (eg Biosecurity Australia), our project will provide genomic tools by which the potential weediness of a regulated plant can be assessed through genetic screening, and forms part of an international effort to identify 'weedy genes'. Read moreRead less
China’s changing internal migration: patterns, causes, policy implications. China’s massive internal migration is no longer simply rural–urban and circular but highly diversified. The project aims to unravel that transition: its patterns, causes, and effects. Using 2020 census data and major longitudinal datasets, a China variant of Zelinsky’s classic mobility transition theory will be developed and deployed to identify underlying mechanisms. Among expected outcomes are powerful methods for asse ....China’s changing internal migration: patterns, causes, policy implications. China’s massive internal migration is no longer simply rural–urban and circular but highly diversified. The project aims to unravel that transition: its patterns, causes, and effects. Using 2020 census data and major longitudinal datasets, a China variant of Zelinsky’s classic mobility transition theory will be developed and deployed to identify underlying mechanisms. Among expected outcomes are powerful methods for assessing spatio-temporal migration patterns and causes, applicable to many economies especially in the Asia–Pacific. Benefits should include a new evidence base for migration and related urban–rural policy in China; and for Australia, policy inputs to improve prosperity through better relations with our biggest trading partner.Read moreRead less
The biology and epidemiology of the grapevine canker fungi, Botryosphaeria sp. Decline and dieback of grapevines is becoming an increasing problem for the viticulture industry in NSW. Recently, species of the fungus Botryosphaeria, were isolated from grapevines exhibiting these symptoms. In order to understand the biology and epidemiology of the causal organisms, we aim to; (i) determine species of Botryosphaeria present in NSW vineyards; (ii) determine which species are pathogenic on grapevines ....The biology and epidemiology of the grapevine canker fungi, Botryosphaeria sp. Decline and dieback of grapevines is becoming an increasing problem for the viticulture industry in NSW. Recently, species of the fungus Botryosphaeria, were isolated from grapevines exhibiting these symptoms. In order to understand the biology and epidemiology of the causal organisms, we aim to; (i) determine species of Botryosphaeria present in NSW vineyards; (ii) determine which species are pathogenic on grapevines; (iii) characterise the genetic diversity of strains and; (iv) screen fungicides for the control of these fungi. Information on the species, their biology and pathogenicity on grapevines, will enable the development of appropriate management strategies for its control and may lead to the development of molecular tools to identify species of Botryosphaeria.Read moreRead less