Improving Quality Of Care For People With Dementia In The Acute Care Setting
Funder
National Health and Medical Research Council
Funding Amount
$1,859,855.00
Summary
People with dementia are often undetected in hospital. This can result in problems which impact their long-term health and wellbeing. An electronic nursing assessment system for people admitted to hospital which reduces nursing admission documentation time, increases identification of patients with cognitive impairment and risk of delirium on admission, supports care planning and increases time for direct clinical care will improve the quality of care for patients with dementia in hospital.
Can Skin Infection With Group A Streptococcus Cause Acute Rheumatic Fever?
Funder
National Health and Medical Research Council
Funding Amount
$459,450.00
Summary
It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of ....It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of the cause of ARF, and have important implications for prevention of ARF around the world. Presently, these approaches focus on diagnosing and treating sore throat, but no country has proven that such a program can be successful in substantially reducing new cases of ARF. If it was known that skin infection could lead to ARF, then countries (including Australia) could emphasise the importance of skin health programs. A further benefit of this knowledge would be to influence GAS vaccine development, which presently is largely focused on the prevention of sore throat. A different possibility has recently been raised - that the cause of ARF may not always be GAS, but instead that the related bacteria GCS and GGS may have the potential to cause this disease. Proof of this hypothesis would even more dramatically alter our understanding of disease causation, prevention, and vaccine development. We propose to determine the cause of ARF in Aboriginal communities by regularly swabbing families of people with a history of ARF, and using genetic fingerprinting of the bacteria from the skin and throat swabs. When cases of ARF occur, we will be able to determine the site and type of infection that precipitated the attack. We will conduct a related study in more communities, in which we will swab family members of people with ARF and of control families (without ARF) to determine the bacteria most commonly isolated from ARF families.Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less
Do marine heat waves cause pathogen outbreaks in Australian coastal waters? This project aims to identify links between increasingly frequent Marine Heat Wave (MHW) events and outbreaks of microbes that cause disease in marine animals, reduced aquaculture yields and human health hazards. Pathogenic bacteria from the Vibrio genus exhibit a preference for elevated seawater temperature and this project will test the hypothesis that episodic MHWs will trigger blooms of dangerous species. Using innov ....Do marine heat waves cause pathogen outbreaks in Australian coastal waters? This project aims to identify links between increasingly frequent Marine Heat Wave (MHW) events and outbreaks of microbes that cause disease in marine animals, reduced aquaculture yields and human health hazards. Pathogenic bacteria from the Vibrio genus exhibit a preference for elevated seawater temperature and this project will test the hypothesis that episodic MHWs will trigger blooms of dangerous species. Using innovative ecogenomic tools, this project will track the impact of MHWs on the dynamics of pathogenic Vibrio within coastal habitats, oyster farming facilities and coral reefs. The benefit of this project will be essential new knowledge on an emerging threat to Australia’s valuable marine estate, food security and public health.Read moreRead less
Australian savannah landscapes: past, present and future. Australian savannahs are productive and culturally and biologically significant landscapes but are vulnerable to climate change. The project will determine savannah function (carbon and water balance) for the present and assess how sensitive they have been to past climate variability. The project will then address how they may respond to future climate change.
Vulnerability of Australian savannas to climate change and variability. Australian savannas are productive and are culturally and biologically significant landscapes, but they are vulnerable to climate change. This project will determine savanna function (carbon and water balance) for the present and assess how sensitive they have been to past climate variability. The project will then address how they may respond to future climate change.
Are evolutionary refugia traps for endemic species? This project aims to determine whether species that have small geographic ranges and which live in historically stable refugia have evolved narrow climatic tolerances. The project will compare such species with more widespread, related species living in the same areas and combine field- and lab-based estimates of physiological tolerances with genomic estimates of population history and diversity. The expected outcome is to test the prediction f ....Are evolutionary refugia traps for endemic species? This project aims to determine whether species that have small geographic ranges and which live in historically stable refugia have evolved narrow climatic tolerances. The project will compare such species with more widespread, related species living in the same areas and combine field- and lab-based estimates of physiological tolerances with genomic estimates of population history and diversity. The expected outcome is to test the prediction from evolutionary theory that small-range, refugial species are intrinsically more sensitive to climatic change. The project expects to provide improved guidance for ecological management of biodiversity hotspots.Read moreRead less
Immunising Aboriginal Mothers With Pneumococcal Polysaccharide Vaccine To Prevent Infant Ear Disease And Carriage
Funder
National Health and Medical Research Council
Funding Amount
$1,131,530.00
Summary
Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are nee ....Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are needed to eliminate, or at least delay, this early-onset pneumococcal colonisation. One such strategy is the administration to the mother of pneumococcal vaccine, which may protect the newborn infant by leading to higher titres of transplacental or breast milk pneumococcal antibodies and-or by reducing carriage (and transmission to the infant) of maternal pneumococci. Previous small studies using this strategy have been encouraging, but there have been no studies properly evaluating carriage or disease endpoints in infants. The polysaccharide pneumococcal vaccine is currently recommended for all Aboriginal and Torres Islander persons aged 15 years or more in the Northern Territory but uptake of the vaccine has been poor. We propose to conduct a pilot study to determine if maternal immunisation with this vaccine, either in the third trimester of pregancy of immediately following delivery, can reduce pneumococcal carriage and the prevalence of middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women who have uncomplicated pregnancies from Darwin and remote communities in the Top End of the Northern Territory. Each subject and their infant offspring will be followed-up after vaccination and at birth, one , two and seven months after birth.Read moreRead less
Either side of the Big Wet: the future resilience of south-eastern Australia's biota. Australia must develop strategies for managing its biodiversity under climate changes expected to occur under projected Intergovernmental Panel on Climate Change (IPCC) emission scenarios. The project will furnish comprehensive data on the response of plants and animals to the break in the Big Dry (1997-2009) in 2010-11 and evaluate how predict biotic components will cope with future climates.
Linkage Infrastructure, Equipment And Facilities - Grant ID: LE110100144
Funder
Australian Research Council
Funding Amount
$150,000.00
Summary
Mobile isotope monitoring for environmental studies. This facility will enable a quantum leap in Australia's capacity to undertake real-time, field based studies of environmental processes using the natural isotope tracers of carbon, oxygen and hydrogen. It will enable the researchers to address a range of fundamental research questions in climate change, water resources, ecology and human impact in tropical Australia.