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
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.
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.Read moreRead less
Does Gastrostomy Improve The Lives Of Children With Severe Disability And Their Families?
Funder
National Health and Medical Research Council
Funding Amount
$645,101.00
Summary
Around 750 Australian children are born each year with severe intellectual disability. Problems may include feeding difficulties and frequent hospitalisations. Feeding via a gastrostomy tube into the stomach can be used. We will conduct a data linkage study in NSW and WA, and collect additional data in WA to investigate patterns of gastrostomy use and its safety, effectiveness and costs. Our findings will help the management of poor feeding in intellectual disability.
Rapid Ferric Carboxymaltose Infusion (Ferinject) For Iron Deficiency Anaemia In Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,236,421.00
Summary
The “Rapid Iron Infusion Project” will assess whether an intravenous infusion of ferric carboxymaltose (Ferinject) given over 15 minutes in children prior to their discharge from hospital will reduce the risk of ongoing anaemia. The potential benefits of iron infusion include higher haemoglobin levels, fewer painful iron injections over the next 6-9 months, better adherence to recommended treatment, and less use of primary health care resources.
Child Health At Two Years Corrected Age After Antenatal Exposure To Dexamethasone Or Betamethasone; A Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,777,593.00
Summary
Both dexamethasone or betamethasone, given to women at risk of preterm birth substantially improve neonatal and child health. There are conflicting reports as to whether dexamethasone is better than betamethasone? This randomised trial will assess this. If dexamethasone is more beneficial, there will be fewer deaths and fewer disabled children. This will be of great importance for the care of women at risk of preterm birth, their children and health services in Australia and internationally.
I am a general paediatrician involved in national epidemiological and clinical research about a range of childhood conditions in Australia. I also have expetise in research translation into the