Improving The Design Of Pragmatic Clinical Trials In Children
Funder
National Health and Medical Research Council
Funding Amount
$128,224.00
Summary
Whilst clinical research is designed to investigate interventions that improve patient health, to date, patients (including children) and their families have had no say in deciding what health outcomes matter most to them. The voices of patients and their families must be heard and used to inform how studies are designed if we are to achieve an improved model of health care and health service delivery. We propose to investigate and provide recommendations as to how this is best achieved.
The Epidemiology Of Post Thrombotic Syndrome Following The Use Of Central Venous Lines In Paediatrics
Funder
National Health and Medical Research Council
Funding Amount
$130,203.00
Summary
The association between central venous lines (CVL) and blood clots in children is well known. Possible consequences of CVL-related blood clots are line blockage, pulmonary embolism (blood clots in the lungs) and post-thrombotic syndrome (PTS). PTS symptoms can be physically limiting, painful and disfiguring. Yet as the incidence of PTS is unknown, the importance of treating CVL-related blood clots is unclear. This study will assess the incidence of PTS and the associated risk factors in children ....The association between central venous lines (CVL) and blood clots in children is well known. Possible consequences of CVL-related blood clots are line blockage, pulmonary embolism (blood clots in the lungs) and post-thrombotic syndrome (PTS). PTS symptoms can be physically limiting, painful and disfiguring. Yet as the incidence of PTS is unknown, the importance of treating CVL-related blood clots is unclear. This study will assess the incidence of PTS and the associated risk factors in children.Read moreRead less
A Randomized Controlled Trial Of Effects Of Early Life Exposure To General Anaesthesia On Neurobehavioural Outcomes In Children With Cystic Fibrosis (CF)
Funder
National Health and Medical Research Council
Funding Amount
$587,240.00
Summary
Anaesthesia permits surgeries and other interventional procedures that benefit the health of children to be performed painlessly and non-traumatically. This study will provide critical information about whether the drugs used commonly for general anaesthesia represents a risk to very young children in terms of their neurobehavioural development.
Invasive Staphylococcus Aureus Disease In Children; Epidemiology, Treatment And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$124,676.00
Summary
This project will involve a systematic review of randomised controlled trials (RCT) on the treatment Staphylococcus aureus bacteraemia (SAB) as well as a local WA retrospective review to quantify disease burden, trends and outcome. A prospective 2-year multicentre Australian review will then identify variables that can predict complicated and uncomplicated SAB. This information will then be used to design a RCT protocol on risk-stratified treatment approaches for SAB in paediatrics.
School-Age Outcomes Of Very Preterm Infants And Antenatal Magnesium Sulphate Therapy - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$675,050.00
Summary
Despite recent major advances in care around the time of birth that have led to large increases in the survival rates for very preterm babies, the rate of adverse long-term health problems has not diminished in survivors, and remains too high compared with children not born very preterm. In particular they have higher rates of substantial problems with the way their brain works, particularly affecting their movement, vision, hearing, thinking and talking. We have just concluded a large clinical ....Despite recent major advances in care around the time of birth that have led to large increases in the survival rates for very preterm babies, the rate of adverse long-term health problems has not diminished in survivors, and remains too high compared with children not born very preterm. In particular they have higher rates of substantial problems with the way their brain works, particularly affecting their movement, vision, hearing, thinking and talking. We have just concluded a large clinical trial in Australia and New Zealand of magnesium sulphate which was given to mothers who were likely to deliver their baby too early (before 30 weeks of pregnancy). We have been able to show, for the first time, that magnesium sulphate was able to halve the rate of substantial problems with movement in 2 year old survivors, from 6% to 3%. However, we are not sure if this potentially important improvement will translate into better outcomes for the children as they grow older and reach school-age. As there are many examples of treatments given around the time of birth that have been shown to have some short-term benefits, but substantial long-term harms, we must be as certain as we can be that any advance in one small area of health is not counterbalanced by disadvantages in other health areas. We plan to assess the 1061 survivors from our earlier clinical trial of magnesium sulphate therapy at ages from 7-8 years, when they are at school. We will assess their movement and other important areas of their brain function, as well as their school progress and general health and growth. If we find important improvements in health at school-age of these children caused by magnesium sulphate therapy, without any substantial counterbalancing side-effects, magnesium sulphate will probably become standard therapy in mothers who are likely to deliver their baby very early. This will lead to a reduction in the burden of illness in the community caused by being born too early.Read moreRead less
SCHOOL-AGE OUTCOME FOR VERY TINY/PRETERM CHILDREN BORN IN VICTORIA IN 1991-92
Funder
National Health and Medical Research Council
Funding Amount
$252,956.00
Summary
The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (bo ....The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (born before 28 weeks of pregnancy, or more than 12 weeks premature) will be assessed long term (to 8-9 years of age), as broadly as possible, and in comparison with normal birthweight (NBW, birthweight >2499 g) children. Outcomes will encompass academic progress and behaviour, brain function, general health, growth, and respiratory health. We will compare the outcomes for very tiny-preterm children who were treated with several of these new therapies with those who were not so treated. We will assess whether alternative measures of long term outcome that assess the quality of life are applicable to very tiny-preterm children. If so, these measures could be used much more widely, since they are cheaper and less time-consuming.Read moreRead less
Evaluating Neonatal Intensive Care For Tiny Babies In The 2000s - Is It Still Effective, Efficient And Available?
Funder
National Health and Medical Research Council
Funding Amount
$246,333.00
Summary
Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively ....Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively high and stable over time, comparing favorably with many other health care programmes, both intensive and non-intensive. It has been increasingly available, with fewer than 10% of ELBW infants born outside major hospitals with intensive care nurseries, and more tiny babies offered intensive care. We now need to know if these benefits have been maintained for tiny babies born in the 2000s. Hence we need to assess the long-term health of tiny babies born in Victoria in 2005.Read moreRead less