The Stunting Risk Assessment Tool: Identifying Infants At High Risk Of Impaired Growth And Development In Resource Poor Settings.
Funder
National Health and Medical Research Council
Funding Amount
$344,644.00
Summary
Stunting is a neglected global health crisis. After the age of 2, irreversible health, developmental and economic consequences occur that are perpetuated across generations. Early risk prediction is key to more effective interventions. By determining the contribution of risk factors in pregnancy and early infancy, I propose to develop a tool that can be used by health workers to identify infants at high risk of stunting in early life, so that early preventive measures can be introduced.
Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$265,900.00
Summary
Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of pre ....Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of prenatal corticosteroids is beneficial or harmful. In this clinical trial we will test what effect, if any, repeat doses of corticosteroids given to women who remain at risk of preterm birth, have on children at the age of two years Women are eligible for the trial if at of less than 32 weeks of pregnancy, they have received corticosteroids seven or more days ago, and they are considered to be at continued risk of preterm birth. Women are randomised to one of the two treatment groups. Half the women will receive a weekly intramuscular injection of corticosteroids up to the time of birth or 32 weeks gestation, whichever is earlier, whilst the risk of very preterm birth remains. The other half of the women will receive a saline placebo injection. Chance will decide which treatment the women receives. In this study all children who survive to 2 years corrected age will be assessed to see if they have any problems with their health, growth and development. In particular we will assess how well they can walk, talk, understand, see and hear. The trial will be able to assess whether repeat doses of prenatal corticosteroids are helpful or not for infants at risk of being born very preterm by comparing the short term effects on infant health after birth and whilst in hospital with the effects on the child's later health, growth and development. An economic assessment of repeat doses of prenatal corticosteroids will be made in these children.Read moreRead less
Being Born Small Is Not Good For The Heart:early Detection Of Cardiovascular Risk
Funder
National Health and Medical Research Council
Funding Amount
$486,757.00
Summary
Intra uterine growth restriction(IUGR) is linked to adult onset of cardiovascular disease. However, little is known about the mechanism(s) which underlie this link or which babies are most at risk. This study aims to assess cardiovascular function in infants and children who were growth restricted. Early identification of cardiovascular dysfunction may aid in new opportunities for monitoring and therapeutic targets to ultimately reduce later onset of cardiovascular morbidity in this population.
Early School-Age Outcomes After Exposure To Repeat Prenatal Corticosteroids - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,083,964.00
Summary
AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. However, we are not sure if this potentially important improvement will t ....AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. 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. This is particularly important to find out for repeat antenatal corticosteroids given the earlier conflicting reports from non-randomised studies. We plan to assess the 1085 survivors from our earlier clinical trial of repeat dose of prenatal corticosteroids when they are of early school age. We will assess their movement and other important areas of their brain function, as well as their school progress, blood pressure, lung function and general health and growth. EXPECTED OUTCOMES OF THE RESEARCH If we find important improvements in health outcomes at school-age in children exposed to repeat corticosteroids, without any substantial couterbalancing adverse effects, repeat steroids will be recommended standard therapy in women who are likely to give birth to their baby very early. This will lead to a reduction in the burden of ill health.Read moreRead less
Metformin In Gestational Diabetes: Follow-up Of Mothers And Offspring: Body Composition, Insulin Resistance, Development
Funder
National Health and Medical Research Council
Funding Amount
$630,142.00
Summary
Children born to women with gestational diabetes are at increased risk of later obesity and diabetes. This study will help to assess if giving such women during their pregnancy the cheap oral diabetes drug metformin rather than insulin injections can safely reduce this risk, measuring growth, fatness and blood glucose-insulin in the children at 2 and 5 years of age, as well as assessing the mothers. If so, such treatment might help to reduce the worldwide burden of disease related to obesity.
Modern Chemical Exposures In Utero And In Infancy, And Their Impact Upon Early Neurodevelopmental Outcomes In The Barwon Infant Study, An Unselected Birth Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$138,353.00
Summary
I am a paediatric doctor interested in the effects of modern industrial chemicals on children’s development. Even in the womb babies are exposed to industrial chemicals and we know some, like lead, are harmful to developing brains. I am interested in other chemicals that are now suspected to affect development, including the polybrominated diphenyl esters (PBDEs), and I intend to investigate this as part of the Barwon Infant Study, which follows 1250 children from before birth to 3 years.
Investigating Autism Spectrum Disorder: Causes And Efficacious Interventions
Funder
National Health and Medical Research Council
Funding Amount
$705,501.00
Summary
Autism Spectrum Disorder (ASD) is a growing public health concern, but we know little about the causes nor treatments for the condition. During the period of this Fellowship I will seek to make significant inroads into these unknowns, by performing large-scale international research into the genetic, biochemical and neurological causes of ASD, and conducting a series of clinical treatment trials in collaboration with research groups from across the world.
The Cherbourg Project: Building Capacity For FASD Screening And Diagnosis
Funder
National Health and Medical Research Council
Funding Amount
$717,501.00
Summary
The House of Representatives 2012 Inquiry into Fetal Alcohol Spectrum Disorders (FASD) noted the particular need for research, training and capacity-building relating to FASD in ATSI communities.This project, in collaboration with Cherbourge community in Queensland and the WHO, addresses several Inquiry recommendations by providing: training to increase local capacity to screen/diagnose FASD; community education; diagnostic service for FASD; FASD prevalence data; and data to inform service provi ....The House of Representatives 2012 Inquiry into Fetal Alcohol Spectrum Disorders (FASD) noted the particular need for research, training and capacity-building relating to FASD in ATSI communities.This project, in collaboration with Cherbourge community in Queensland and the WHO, addresses several Inquiry recommendations by providing: training to increase local capacity to screen/diagnose FASD; community education; diagnostic service for FASD; FASD prevalence data; and data to inform service provision and prevention programs.Read moreRead less
Cumulative Harm: Reducing child abuse through improved decision-making. In 2005/06 56,000 cases of child abuse were substantiated in Australia, and this figure is rising exponentially. Disillusionment is growing with an incident based approach to children's safety which fails to either acknowledge or intervene effectively in the cumulative effects of harm to the child's development and well-being. This project uses the leverage of new legislation to re-focus on an earlier intervention with vulne ....Cumulative Harm: Reducing child abuse through improved decision-making. In 2005/06 56,000 cases of child abuse were substantiated in Australia, and this figure is rising exponentially. Disillusionment is growing with an incident based approach to children's safety which fails to either acknowledge or intervene effectively in the cumulative effects of harm to the child's development and well-being. This project uses the leverage of new legislation to re-focus on an earlier intervention with vulnerable children at risk of cumulative harm within a hospital setting. An interdisciplinary lens is bought to the development of new knowledge to provide a better and healthier start to life for this group of children.Read moreRead less
The Centre will enhance Australian clinical immunisation research and training, focussing upon clinical questions with translatable outcomes not easily addressed by industry. Optimal immunisation and interventions to maximise uptake of existing and new vaccines in high risk patient groups, such as children with cancer, immigrants, children with chronic diseases and adolescents will be studied. New vaccine trials, innovative use of existing vaccines, systematic collection of vaccine failure data, ....The Centre will enhance Australian clinical immunisation research and training, focussing upon clinical questions with translatable outcomes not easily addressed by industry. Optimal immunisation and interventions to maximise uptake of existing and new vaccines in high risk patient groups, such as children with cancer, immigrants, children with chronic diseases and adolescents will be studied. New vaccine trials, innovative use of existing vaccines, systematic collection of vaccine failure data, and targeted epidemiology and disease modelling vaccine preventable disease will also allow a broad program of research, enabling training and mentoring of young clinical nurse and physician researchers. Collaborations with existing national immunisation, infectious diseases and research institutions will allow maximal effectiveness of clinical studies.Read moreRead less