Understanding and preventing disease
Understanding and preventing disease
Research underpins our knowledge of disease. Understanding history, sociology, ethics, biology, chemistry and physics is critical to the management and prevention of disease.
La Trobe researchers work in partnership with bioscience institutes, health providers, industry and government to make discoveries in fundamental sciences that improve diagnostics, therapeutics and clinical outcomes across a range of diseases.
La Trobe's research into Understanding and Preventing Disease contributes to the following United Nations Sustainable Development Goals (SDGs)
Selected impact stories
Many patients face long waiting times for outpatient and community health care. Waiting for services can result in physical deterioration and reduced engagement in services, and has also been associated with anxiety and decreased levels of community participation. The model developed by the La Trobe team, known as “Specific Timely Appointments for Triage” or STAT, targets clinics providing outpatient services over multiple appointments in community settings. STAT has been successfully implemented by service providers across states in Australia and New Zealand, and has consistently reduced waiting time by 20-40%, with some services reporting to have eliminated waiting lists.
Over the last 2 years (2021-2023) the Victorian Department of Health commissioned a review of the Demand Management Framework for Community Health. The old framework, which relied heavily on an outdated emphasis on triage tools, has been replaced by a new Demand Management Toolkit which draws on the principles of the STAT model and advocates its use as a way to manage demand for these services. Following receipt of a $200,000 by the Department of Health Victoria to support the implementation of the new Toolkit, the La Trobe University / Eastern Health team are conducting a series of workshops throughout 2024 for community health providers across Victoria, supported by a suite of resources, and an online community of practice for clinicians to work together to reduce health service waiting times. PhD student Kate Noeske will run a program of research alongside this implementation project, investigating how the model works when implemented at scale.
Leading team: Professor Warwick Grant
In 2017, the Global Burden of Disease Study estimated that at least 220 million people had onchocerciasis - known as ‘River blindness’ - with more than 99% of those effected living in sub-Saharan Africa. 5-10% of those infected go blind and the majority also develop severe disfiguring skin disease – both irreversible conditions. The primary tool for onchocerciasis control is mass drug administration with ivermectin, but the symptoms of onchocerciasis take over a year to appear after infection, whilst the recommended treatment span for ivermectin is 10-15 years (the life span of adult worms). Attempting to achieve disease elimination by directing treatment based on the prevalence of symptoms and the distribution of drugs will therefore never catch up with disease transmission, and onchocerciasis remains endemic in 23 countries of Sub-Saharan Africa.
Professor Grant’s lab at La Trobe has developed a set of tools based around landscape genetics - synthesising spatial information, environmental data, population genetics and prevalence data - to assist decision making for onchocerciasis elimination. Through longstanding collaborative research projects supported by the WHO, the Bill and Melinda Gates foundation, the NIH and the END fund – worth over $4 million - Grant has worked with collaborators in sub-Saharan Africa to develop and embed these tools. Within Grant’s lab at La Trobe, nine PhD graduates from countries where the disease is endemic – Ethiopia, Ghana, Nigeria, Tanzania – have been trained in molecular biology and other techniques. Grant also serves as a technical advisor to the Ethiopia Onchocerciasis Elimination Expert Advisory Committee (EOEEAC). The recommendations of that committee are used to inform and determine policy, and include elements directly devolved from La Trobe research.
Leading team: Professor Meg Morris
Falls are a major global public health problem and leading cause of accidental or unintentional injury and prolonged hospitalisation. Falls incident rates in hospitals vary from 3-17 falls per 1000 patient bed days. Between 30-40% of falls in hospital result in physical injury. A public-private partnership was initiated which aims to reduce hospital falls to improve the patient experience and patient outcomes. Evidence-based approaches were applied to improve hospital falls risk assessment, prevention and management. To implement effective methods in preventing hospital falls, systematic reviews of international literature on risk assessments and prevention were performed, clinician training and patient self-management programs were introduced, and a “Falls Cluster” community of practice was created across hospitals, supported by educational resources, policies and procedures, to facilitate best practice and behaviour change. This unique partnership focuses on optimising health service procedures and uniquely forges linkages between the private and public sectors. Wider benefits include discovery and innovation through nurturing a research culture within hospitals, and translation of new evidence regarding falls prevention, quality and safety into hospitals Australia-wide. The multi-university team conducted several major randomised trials and published them in leading international journals. This work and the newly generated knowledge were co-designed, co-produced and co-implemented with consumers (patients and industry partners) to positively impact patient outcomes, and have been incorporated into world guidelines on falls prevention released in 2022.
Healthy bacteria in the intestinal tract regulate metabolism and enable the absorption of nutrients. However, it has been estimated that 50% of adults do not have the right balance of gut bacteria. In 2019, the Franks/Wood Lab for Applied and Environmental Microbiology isolated and tested a microbe called Bacillus subtilis BG01-4, which is found in utero and in breast milk and contributes to gut health in newborns. This has now been developed by VERNX into a peribiotic, or innovative form of dietary supplement that improves holistic digestive health. In 2021, Vernx was awarded a commonwealth Commercial Acceleration grant of $1.4m to develop and commercialise the supplement, which was followed by an additional $1.3m in international investment. Vernx are now expanding their range of supplements on the basis of this success.
Leading team: Professor David Winkler
Surface chemistry, topography, and mechanical properties are important in medical devices as they influence the biological response to materials. For example, hydrophilic or hydrophobic surfaces can promote tissue and bone regeneration or prevent attachment of pathogens to medical devices. Professor Winkler collaborated with researchers at the University of Nottingham on a Next Generation Biomaterials project funded by the Engineering and Physical Sciences Research Council (EPSRC) for 5 years (~$12M). This project developed high throughput methods of assessing the interaction of materials with biology and modelled these data by machine learning. Their aim was to develop and translate materials for indwelling and implantable medical devices, advancing earlier work which had already received registration for clinical use. The EPSRC grant has been renewed for another 4 years (~$10M) to target the effect of artificial surface micro topographies (shapes) to cell responses relevant to wound care and surgical meshes, requiring better ways of encoding surface chemistries and topographies using deep learning methods, and improved interpretation of models for mechanistic insight to provide design rules to guide chemists to synthesise better materials.
Antimicrobial Resistance is a major global health problem with over 700k people currently dying each year – which is projected to increase to over 10 million per year by 2050 without new antibiotics. More than 1.5 million infections are hospital-acquired resulting in almost 100k deaths annually. An estimated 20–40% of nosocomial infections are contributed to cross-contamination from healthcare staff working with patients. Moreover, there is a growing body of evidence that current disinfection solutions may be ineffective at reducing hard surface contamination and nosocomial infection in healthcare environments. In partnership with Wintermute Biomedical, La Trobe University researchers have collaborated on developing new antimicrobials (by creating soluble forms of fatty acids) – an example is the surface disinfectant Doxall that is now a commercial product. Novel antibiotics are crucial to sustain health, agriculture, and the environment as we enter the post-conventional antibiotics era.
Leading team: Dr Brooke Patterson
In all contact sports, women have up to double the risk of serious head and knee injury, and in the AFL, women have five times greater risk of ACL (anterior cruciate ligament) injury compared to men. The “Prep to Play” warm-up and strength program was developed during a collaboration project between the AFL and LTU to reduce injury risk and enhance the performance of community women football players. The trial trained 60 physiotherapists to deliver Prep to Play workshops to teams and provide support at their training. More than 3000 people (coaches, players, parents, staff) have participated in the program. The next phase will evaluate the reduction in injuries, the increased confidence, skills and knowledge of players, coaches, and physiotherapists, and examine avenues to increase program uptake.
Leading team: Professor Hylton Menz
Falls in older people result from a complex interaction between intrinsic risk factors (e.g., muscle weakness, impaired vision, and slow reaction time) and extrinsic risk factors (e.g., home hazards and cracked footpaths). Foot problems were found to be an independent risk factor, allowing novel avenues for intervention to be explored. Professor Menz’s world-first randomised trial demonstrated that a multifaceted podiatry intervention reduced the incidence of falls by 36%. This work led to several biomechanical studies that identified specific footwear design features that could be manipulated to optimise balance and mobility in this population. As a result, specific footwear designs and orthotic interventions to prevent falls have been manufactured to be commercially available in 2023 following successful trials of the prototypes.
NanoMslide is a fast, accurate, label-free diagnostic platform that could revolutionise the way we detect cancer.
In 2022, the technology won both the Eureka Prize for the innovative use of technology and the Victoria Prize for Science & Innovation. A recent study featured in Nature showcased the NanoMslide's remarkable ability to instantaneously differentiate cancer cells from healthy cells within breast tissue, utilizing nothing more than a conventional optical microscope. Breast cancer is the first or second leading cause of female cancer deaths in 95% of the countries worldwide. Early detection and intervention play a pivotal role in ensuring long-term patient survival and carry substantial implications for health economics and societal impacts for Australia. Through a simple colour change under the microscope, the NanoMslide makes it easier to detect small numbers of cancer cells within tissue samples. Whilst this research has only been conducted in breast cancer, the scope for NanoMslide extends far beyond this, with applications currently being researched in a range of other cancers and diseases as well.