New Methods Of Pain Assessment In Demented Older Persons
Funder
National Health and Medical Research Council
Funding Amount
$306,000.00
Summary
There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing ....There are substantial risks of inadequate pain assessment and management in persons with cognitive impairment and particularly in those with communication problems. Undetected or under-treated pain can have serious adverse effects on frail older adults including poorer cognitive performance, increased levels of depression, anxiety and disruptive behaviours, a reduced quality of life and higher levels of functional disability. These adverse effects contribute to greater demands for daily nursing care and a corresponding increase in health care costs. The present proposal aims to develop more sensitive, reliable and valid questionnaire and non-verbal measures of pain in older adults with cognitive impairment and particularly in those with verbal communication problems. By completion, the present studies should provide much needed information on the reliability and validity of several different types of verbal and non-verbal indicators of possible pain. This research should lead to improved pain assessment and management for the growing segment of the population who suffer from pain and impaired cognitive function.Read moreRead less
Episodic Memory Dysfunction As A Basis For Auditory Hallucinations In Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$278,517.00
Summary
Auditory hallucinations (AHs) occur frequently in people who suffer from schizophrenia. This symptom usually involves hearing voices that the hallucinator firmly believes originate from other people. The voices are often intrusive, abusive and persecutory. They are a source of significant stress and may result in self harm or harm to others. Our investigations will attempt to provide experimental support for the theory that AHs represent a misremembering of voices which were heard in the past. W ....Auditory hallucinations (AHs) occur frequently in people who suffer from schizophrenia. This symptom usually involves hearing voices that the hallucinator firmly believes originate from other people. The voices are often intrusive, abusive and persecutory. They are a source of significant stress and may result in self harm or harm to others. Our investigations will attempt to provide experimental support for the theory that AHs represent a misremembering of voices which were heard in the past. We will do this by attempting to characterise specific problems that hallucinators have in identifying when they heard verbal fragments and who said them. We plan to conduct our investigations at five levels. First, we will determine how accurate hallucinators' memories are for context by the use of special neuropsychological tests. Second, we will find out if hallucinators form more false memories than comparison subjects using a test in which such incorrect recollections occur commonly. Third, we will determine if hallucinators have a tendency to reconstruct the characteristics of false verbal memories in the same way that they reconstruct the characteristics of their hallucinations. Fourth, we will attempt to suppress these false verbal memories and finally, we will characterise those brain regions which are activated during true and false memory formation by using blood flow analysis technology in order to identify networks of brain activity which preferentially malfunction in hallucinating patients. This study provides the prospect of adding substantially to our understanding of the mechanisms underlying auditory hallucinations and to lead to the development of new cognitively-based treatments for the symptom.Read moreRead less
How well people perform in everyday situations is often determined by memory function. When required to perform under stress memory performance is often affected. The effect of a psychological stress test on memory function in healthy volunteers and the ability of a dietary supplement, tyrosine, to prevent the effects will be studied. The data may suggest that depletion amino acids is responsible for the decrements in performance that are evident after an acute stressor.
A Prospective Single Arm Trial Of Involved-field Radiotherapy For Stage I-II Low Grade Nongastric Marginal Zone Lymphoma
Funder
National Health and Medical Research Council
Funding Amount
$363,869.00
Summary
This is an international, multicentre study that will, for the first time, prospectively measure the curative potential of radiotherapy in localised marginal zone lymphoma (MZL). Most MZL arises in mucosa-associated lymphoid tissue (MALT), either in the stomach or in a range of other organs such as salivary glands, the tissues around the eye or the thyroid. Many stomach MALT lymphomas are caused by infection with Helicobacter Pylori. This infection can also be associated with non-gastric MALT ly ....This is an international, multicentre study that will, for the first time, prospectively measure the curative potential of radiotherapy in localised marginal zone lymphoma (MZL). Most MZL arises in mucosa-associated lymphoid tissue (MALT), either in the stomach or in a range of other organs such as salivary glands, the tissues around the eye or the thyroid. Many stomach MALT lymphomas are caused by infection with Helicobacter Pylori. This infection can also be associated with non-gastric MALT lymphomas, but the association has never been prospectively studied. Chlamydia Psittaci infection can cause MALT lymphoma in the orbit. The management of localised MZL outside the stomach is controversial and there have been no large prospective studies of any of the commonly-used treatments (radiotherapy, chemotherapy, surgery). No prospective studies have looked at the role of infection with Helicobacter pylori or the role of autoantibodies in these diseases. Radiotherapy is the best-characterised therapy in the literature and appears to have a high cure rate with low toxicity. The disease seems exquisitely radiosensitive. Management of localised MZL in Australia can be ad hoc and we have often seen patients who have undergone unnecessary mutilating surgery or ineffective chemotherapy. It has been reported that localised non-gastric MZL (stage I and II) can be cured with radiotherapy in a high percentage of patients (usually >70%) in retrospective studies from large centres such as Princess Margaret Hospital in Toronto. Workers from that centre will participate in this study. This study will: Prospectively report efficacy and toxicity for radiotherapy in MZL for the first time Definitively document Helicobacter Pylori status in all cases and Chlamydia status in orbital cases Provide a gold standard against which to compare new therapies This study won the award for the most highly supported study in its year at the TROG annual scientific meeting.Read moreRead less
Epicardial Mapping Of Persistent Atrial Fibrillation. Identifying AF Mechanisms In Different Atrial Substrates.
Funder
National Health and Medical Research Council
Funding Amount
$654,341.00
Summary
Atrial fibrillation (AF) is a very common heart rhythm disturbance (arrhythmia) which carries with it an increased risk of having a stroke and a twofold risk of dying. At present, we still have only a limited understanding of the mechanism of AF when it becomes persistent. The aim of this study is to determine the critical mechanism of persistent AF in patients with different types of heart conditions. This knowledge is fundamental to the development of more successful curative approaches.
Adult non-Hodgkin?s lymphoma (NHL) is one of the most rapidly increasing cancers of recent times. The rise has occurred worldwide in men and women of all ages. The reason for most of the rise is unknown. It has recently been proposed that part of the upsurge may be due to increases in sun exposure which have occurred during the same period. There is some indirect evidence to support this hypothesis. For example, the rate of occurrence of NHL is higher closer to the equator in Australia than it i ....Adult non-Hodgkin?s lymphoma (NHL) is one of the most rapidly increasing cancers of recent times. The rise has occurred worldwide in men and women of all ages. The reason for most of the rise is unknown. It has recently been proposed that part of the upsurge may be due to increases in sun exposure which have occurred during the same period. There is some indirect evidence to support this hypothesis. For example, the rate of occurrence of NHL is higher closer to the equator in Australia than it is in England and Wales, and NHL is diagnosed more frequently among British migrants to Victoria than it is in their homeland. The sunlight hypothesis will be tested by comparing the pattern of sun exposure in Tasmanians diagnosed with NHL during the years 1998-2001 and in a sample of Tasmanians without the disease. tasmania has been chosen because levels of ultraviolet (UV) radiation are low there in all but the summer months, when it approaches the levels of Brisbane, Sydney and Melbourne. There is therefore a greater difference in UV exposure between the most exposed and the least exposed in Tasmania, making it an ideal location to test the hypothesis. The link between NHL and a measure of melanin pigmentation in the skin will also be studied. The incidence of NHL is higher in lighter-skinned ethnic groups than it is in darker-skinned people living at the same latitude, but it is not known whether risk varies within Caucasian populations. A new measure of melanin in the skin, developed at the Menzies Centre for Population Health Research in Hobart, will better allow the effects of skin colour to be studied.Read moreRead less
Non-alcoholic steato-hepatitis (NASH) is a common disease of liver inflammation and scarring, which may progress to cirrhosis or liver cancer. While type 2 diabetes causes a higher rate of NASH and more rapid NASH progression the reasons for this are not clear. We have developed a novel animal model of NASH with diabetes added to dietary induced obesity. We show that a growth factor is elevated in the affected livers. We plan to block the growth factor to see if we can prevent NASH worsening.