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
Equitable Access To Stuttering Treatments: Developing Distance And Self Managed Treatment Models
Funder
National Health and Medical Research Council
Funding Amount
$4,321,062.00
Summary
The development of normal verbal communication is of the utmost importance to human health. Stuttering is a prevalent disorder that severely interferes with communication. It can be disfiguring and typically causes speech related social anxiety. Social phobia is present in around half of adults affected. It prevents attainment of occupational potential and children who stutter are typically teased and bullied at school. For the past decade NHMRC Project funding has enabled the present team to co ....The development of normal verbal communication is of the utmost importance to human health. Stuttering is a prevalent disorder that severely interferes with communication. It can be disfiguring and typically causes speech related social anxiety. Social phobia is present in around half of adults affected. It prevents attainment of occupational potential and children who stutter are typically teased and bullied at school. For the past decade NHMRC Project funding has enabled the present team to conduct world class basic research and clinical trials in stuttering. Significant gains have resulted from that research, in particular the development of treatments across the age groups that have a significant evidence base. However, it is becoming increasingly clear that there are serious barriers to the implementation of these evidence based treatments, and innovative treatment developments are needed to address this. In particular, speech pathology services for rural and remotely located patients and their families are incompletely funded, and even in urban settings workplace restrictions have resulted in speech pathologists delivering incomplete and piecemeal treatments. The program of research will develop the following innovative treatment models to solve this problem: �Distance intervention models for the delivery of speech pathology services to rural patients and their families and others who are isolated from treatment services. �Self-managed treatment models for children and adults who stutter, including procedures to minimise the ubiquitous problem of relapse in adults. It is widely understood that social anxiety is a significant problem for many stutterers and research is urgently needed to establish the extent of social anxiety in stutterers across the age groups and its negative effects on treatment effectiveness. Thus, a further aim of this program of research is to: �Identify those patients for whom social anxiety is likely to constitute a barrier to successful treatment. �Develop supplementary interventions to meet the needs of those socially anxious patients. The cause of stuttering is unknown. Understanding the mechanisms underpinning effective behavioural treatments would contribute to understanding causal factors in stuttering. Thus, this program of research also aims to: �Establish why behavioural treatments work, thereby generating new knowledge about causal factors.Read moreRead less
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
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
Antibodies are made by B-cells and are essential for a functional immune system. B cells circulate in the body, and, when they encounter an invader, they mature into antibody-producing cells (ASC). A small proportion of the cells become “memory” cells with the potential to become ASC should the same infection occur in the future. This is the basis of vaccination. This program aims to understand how a B cell changes into an ASC. We aim eventually to be able to improve vaccines and understand dise ....Antibodies are made by B-cells and are essential for a functional immune system. B cells circulate in the body, and, when they encounter an invader, they mature into antibody-producing cells (ASC). A small proportion of the cells become “memory” cells with the potential to become ASC should the same infection occur in the future. This is the basis of vaccination. This program aims to understand how a B cell changes into an ASC. We aim eventually to be able to improve vaccines and understand diseases such as allergy, lupus, arthritis and leukaemia to develop novel therapies.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