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Research Topic : Paediatric Palliative Care
Field of Research : Paediatrics
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  • Funded Activity

    Understanding The Mechanisms Of Bleeding And Clotting Complications For Children On Extracorporeal Circuits.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $1,113,385.00
    Summary
    Extracorporeal Membrane Oxygenation (ECMO) is advanced life support, which can save critically ill children. Significant bleeding occurs in 39%; clotting in 31% of children on ECMO; stroke in 12%. The biggest barrier to reducing these complications is the lack of understanding of how the bleeding/clotting system works in ECMO. This unique proposal uses the largest paediatric ECMO population in Australia and a multidisplinary expert team to develop a mechanistic understanding of these issues.
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    Funded Activity

    Strengthening Community Based Paliative Care Services: Towards A Better Understanding Of Medical Aspects Of Caring For C

    Funder
    National Health and Medical Research Council
    Funding Amount
    $68,892.00
    Summary
    Caring for children [and their families] in the palliative phase of an illness offers unique challenges. Community based palliative care programs provide a predominantly adult focused service, their experience with children being limited by smaller numbers. This study aims to better characterize the medical aspects of caring for terminally ill children in Australia, thru the use of a parental survey in a large representative cohort at the Royal Children's Hospital, Melbourne (RCH). The focus wil .... Caring for children [and their families] in the palliative phase of an illness offers unique challenges. Community based palliative care programs provide a predominantly adult focused service, their experience with children being limited by smaller numbers. This study aims to better characterize the medical aspects of caring for terminally ill children in Australia, thru the use of a parental survey in a large representative cohort at the Royal Children's Hospital, Melbourne (RCH). The focus will be to identify issues relating to symptom assessment and management, family and caregiver support and psychosocial-bereavement support. The knowledge gained will be used to redesign-strengthen links between paediatric hospitals and community based palliative care programs.
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    Funded Activity

    Improving Communication Processes And End Of Life Care In The Neonatal Period: Drawing On The Experiences Of Parents And Health Care Professionals

    Funder
    National Health and Medical Research Council
    Summary
    The parents of infants who have died in newborn intensive care, as well the professionals who care for these infants, will be invited to share their experiences of the conversations that took place around the time of the infant's death and how these contributed to the care provided. It is intended that the care of future infants who die under the care of the neonatal team will be improved through dissemination of this knowledge and associated improvements in training of professionals involved in .... The parents of infants who have died in newborn intensive care, as well the professionals who care for these infants, will be invited to share their experiences of the conversations that took place around the time of the infant's death and how these contributed to the care provided. It is intended that the care of future infants who die under the care of the neonatal team will be improved through dissemination of this knowledge and associated improvements in training of professionals involved in this field.
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    Funded Activity

    Evaluation Of The Incorporation Of WHO Guidelines Into Post-graduate Medical Curriculum; The Impact On Quality Of Care

    Funder
    National Health and Medical Research Council
    Funding Amount
    $130,704.00
    Summary
    There is abundant evidence that many patients do not receive medical treatments of proven effectiveness. This is even more apparent in developing countries. Strategies to improve use of proven treatments is needed. Our research aims to evaluate an educational program for doctors in Lao PDR, based on World Health Organisation guidelines for the care of sick children in hospitals, including the impact on the knowledge of doctors and on the quality of care in the hospitals in which they work.
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    Funded Activity

    Nitric Oxide On Cardio Pulmonary Bypass In Congenital Heart Disease

    Funder
    National Health and Medical Research Council
    Funding Amount
    $1,878,889.00
    Summary
    Children undergoing open heart surgery on a heart lung machine can experience serious side effects from the exposure to the artificial circulation during surgery and may have either prolonged need for life support in intensive care or even may suffer from long term complications. In this study we investigate the use of a new approach using nitric oxide, a anti-inflammatory gas, during surgery to reduce these side effects.
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    Funded Activity

    Neuroprotective Role Of Sulphate Among Preterm Babies (SuPreme Study)

    Funder
    National Health and Medical Research Council
    Funding Amount
    $749,338.00
    Summary
    Magnesium sulphate administered to mothers shortly before preterm birth, reduces the risk of cerebral palsy. The mechanism of its neuroprotective effect is unknown, and our studies suggest sulphate is the protective element. Preterm babies rapidly become sulphate deficient, and magnesium sulphate mitigates this deficiency in most infants. In this study we will investigate whether low blood sulphate levels at 1 week of age correlate with cerebral palsy.
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    Funded Activity

    A Randomised Controlled Trial Of A Fluid Containing 140mmol/L Of Sodium Compared To A Fluid Containing 77mmol/L Of Sodium For Maintenance Intravenous Fluid Therapy In Hospitalised Children.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $183,959.00
    Summary
    Intravenous fluid therapy is one of the most common and important treatments for children in hospital. In spite of this we know very little about what fluid should be used and there is now good evidence that children are experiencing adverse outcomes because of fluid treatment. The aim of this trial is to determine which intravenous fluid is best in children. It will be the largest and most relevant intravenous fluid trial performed in children. The results will have an immediate impact on treat .... Intravenous fluid therapy is one of the most common and important treatments for children in hospital. In spite of this we know very little about what fluid should be used and there is now good evidence that children are experiencing adverse outcomes because of fluid treatment. The aim of this trial is to determine which intravenous fluid is best in children. It will be the largest and most relevant intravenous fluid trial performed in children. The results will have an immediate impact on treating children worldwide.
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    Funded Activity

    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.
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    Funded Activity

    Understanding The Factors Governing Susceptibility And Outcome In Childhood Infection

    Funder
    National Health and Medical Research Council
    Funding Amount
    $276,122.00
    Summary
    This research seeks to understand why a minority of children are prone to severe and often life-threatening infections and inflammation. It focusses on infections both in preterm infants and in later childhood, which may also be relevant to understanding atherosclerosis. I am also interested in improving the health of recently arrived refugees, by conducting research that allows the development of evidence-based health interventions and developing national policy on refugee health.
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    Funded Activity

    In Vitro And In Vivo Assessment Of The Funhaler -an Innovative Therapeutic Device For Children

    Funder
    National Health and Medical Research Council
    Funding Amount
    $472,750.00
    Summary
    Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler .... Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler incorporates a spinning toy attached to the outside of the spacer. The toy is activated when the patient breathes through the spacer. The device has been designed to encourage children to co-operate when their asthma therapy is being delivered. The Funhaler is currently in the late development stage. We propose, firstly, to carry out in vitro assessments of drug delivery from the Funhaler compared to the two most widely available small volume spacers: the Aerochamber Plus (Trudell, Canada) and the Breath-A-Tech (Scott-Dibben, Australia). These assessments will be carried out to meet the standards of regulatory bodies worldwide (including the FDA). Secondly, we propose to perform extensive in vivo studie: filter studies to assess drug delivery to the patient; deposition studies to measure drug deposition in the lungs; and a pilot clinical trial to assess the efficacy of the device during medium to long-term use in children aged 2-8 years.
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