Statistical Methods To Assist The Control Of Communicable Diseases, And Their Application
Funder
National Health and Medical Research Council
Funding Amount
$211,527.00
Summary
A range of programs, such as vaccination schedules and intervention in outbreaks, is in place to reduce our burden of illness from infectious diseases. This project aims to develop new methods, based on models and associated statistical analyses, to help ensure that our control programs are based on the best available evidence. There are five specific themes: 1. Developed methods for predicting major outbreaks of diseases and appy them to Australian data on measles, pertussis and Ross River viru ....A range of programs, such as vaccination schedules and intervention in outbreaks, is in place to reduce our burden of illness from infectious diseases. This project aims to develop new methods, based on models and associated statistical analyses, to help ensure that our control programs are based on the best available evidence. There are five specific themes: 1. Developed methods for predicting major outbreaks of diseases and appy them to Australian data on measles, pertussis and Ross River virus. The new methods will enable timely intervention to reduce the population risk from these diseases, and to guide the proposed elimination of measles from Australia. 2. The current concept of vaccine efficacy, which is central to the epidemiological assessment of vaccines, performs poorly when the vaccine provides only partial protection, when immunity wanes over time and when infected vaccinees have a lower infectivity. A concept of vaccine efficacy will be developed that overcomes these weaknesses. This concept will find widespread use in epidemiology. 3. Data available from 80 outbreak investigations of transmissible diseases will be analysed to assess the relative effectiveness of various intervention steps. 4. A comprehensive model, and associated computer software, will be developed as a tool for assessing the relative merits of different vaccination schedules. It will be applied to address Australian policy issues for vaccination against pertussis, chickenpox and rubella. 5. The method of backprojection for estimating trends in HIV infection and predicting AIDS incidence will be enhanced to incorporate newly available data in which HIV and AIDS diagnoses are linked. This will enable a precise assessment of infection incidence among heterosexuals and other exposure categories with relatively few cases, to ensure that HIV does not spread more widely.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
The Use Of Gene Expression Profiles To Predict The Response To Chemoradiotherapy In Patients With Oesophageal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$384,600.00
Summary
One of the most difficult and clinically important questions facing clinicians treating advanced cancer is deciding which patients will, and who will not, benefit from chemotherapy and-or radiotherapy. This is particularly true for clinicians treating locally advanced oesophageal cancer. Oesophageal cancer is a particularly aggressive tumour with a poor prognosis; the majority of patients die within 1 year of diagnosis with only 10% surviving to 5 years. In an attempt to improve outcomes, the us ....One of the most difficult and clinically important questions facing clinicians treating advanced cancer is deciding which patients will, and who will not, benefit from chemotherapy and-or radiotherapy. This is particularly true for clinicians treating locally advanced oesophageal cancer. Oesophageal cancer is a particularly aggressive tumour with a poor prognosis; the majority of patients die within 1 year of diagnosis with only 10% surviving to 5 years. In an attempt to improve outcomes, the use of preoperative (neoadjuvant) combined chemotherapy and radiotherapy as an adjunct to surgery has become common practice. Neoadjuvant therapy has been reported to induce complete regression of the tumour and increased survival times in 20-30% of patients. However, the lack of any apparent clinical benefit for those patients who are poor or non-responders to chemoradiation implies that a large proportion of patients are being exposed to significant toxicity and potential complication for no obvious advantage. In the project outlined in this application, we propose to use cDNA microarrays, a technology that allows the simultaneous assessment of the level of expression of thousands of genes at once, to profile the gene expression patterns of oesophageal tumours. These profiles will then correlated to the patients response to treatment to determine if the gene expression patterns can be used to predict the clinical response to chemoradiotherapy. Success will open the path to the development of a clinically important test that would significantly improve the management of advanced cancer patients by enabling personalised therapy for individual patients. Not only will this allow the selection of the most effective therapy for each patient but it will also free patients from suffering the nasty side effects of treatments that turn out to be of little benefit.Read moreRead less
Predicting Response To Chemoradiotherapy In Patients With Advanced Rectal Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$461,605.00
Summary
Many cancer patients receive expensive and unpleasant therapies that actually do not benefit them. This project will use a new technology that can simultaneously assess the level of expression of thousands of genes. We will test if the pattern of gene expression in tumours can predict the patients' response to therapy. Success will significantly improve the clinical management of advanced cancer patients and provide a rational basis upon which to tailor individualized treatment regimes.
Predictors Of The Outcomes For Joint Inflammation And Damage In Recent Onset Rheumatoid Arthritis Patients
Funder
National Health and Medical Research Council
Funding Amount
$255,750.00
Summary
Currently, it is difficult to predict what will happen to an individual patient who presents with newly diagnosed rheumatoid arthritis, either as a result of the natural history of the disease or as a result of drug treatment. It is also difficult to decide which drug treatment to offer a patient and when to decide to change the treatment to obtain a better clinical response. This study will investigate whether it is possible to predict the outcomes for a particular patient with rheumatoid arthr ....Currently, it is difficult to predict what will happen to an individual patient who presents with newly diagnosed rheumatoid arthritis, either as a result of the natural history of the disease or as a result of drug treatment. It is also difficult to decide which drug treatment to offer a patient and when to decide to change the treatment to obtain a better clinical response. This study will investigate whether it is possible to predict the outcomes for a particular patient with rheumatoid arthritis for joint inflammation and joint destruction, based on the findings in the joint lining tissue. This study will also investigate whether it is possible to make decisions on the likely success of drug treatment given to a patient with rheumatoid arthritis based on the initial or subsequent joint lining tissue biopsies. If successful, this study will lead to a greater ability to advise patients about likely outcomes from their condition, either with or without treatment and also to predict whether a treatment is likely to work at an early stage. In addition, this study may identify future potential treatments for rheumatoid arthritis.Read moreRead less
Trials To Prevent The Transmission And Complications Of Sexually Transmitted Infections, Including HIV
Funder
National Health and Medical Research Council
Funding Amount
$306,123.00
Summary
Sexually transmitted infections (STIs) are important causes of illness in some sectors of the community. Even though they can be effectively prevented and treated, many health services do not give them priority. This research project will study ways in which general practitioners can better diagnose and treat STIs. We will carry out trials that compare new approaches to supporting doctors in this area, that involve a mixture of training, reminders and technical support as needed.
Defining The Changes In Cell Biology Caused By PRESENILIN Truncations Associated With Different Diseases
Funder
National Health and Medical Research Council
Funding Amount
$622,886.00
Summary
Truncations of the PRESENILIN genes in humans can cause two very different diseases: inherited, early onset Alzheimer’s disease (familial Alzheimer's disease) and a skin disease named inherited Acne Inversa. One truncation is also involved in the non-inherited, late onset form of Alzheimer’s disease. Why do these different truncations produce different diseases? Investigating this question will teach us more about the molecular bases of these different diseases. This understanding will be requir ....Truncations of the PRESENILIN genes in humans can cause two very different diseases: inherited, early onset Alzheimer’s disease (familial Alzheimer's disease) and a skin disease named inherited Acne Inversa. One truncation is also involved in the non-inherited, late onset form of Alzheimer’s disease. Why do these different truncations produce different diseases? Investigating this question will teach us more about the molecular bases of these different diseases. This understanding will be required for the development of treatments.Read moreRead less