Early Predictors And Body Composition Changes Associated With Adiposity Rebound
Funder
National Health and Medical Research Council
Funding Amount
$201,650.00
Summary
Overweight and obesity rates are increasing in children, and overweight children have higher risk of adult obesity and therefore diseases including heart attack, stroke and diabetes. The preschool years may offer opportunities to divert children from the path to obesity, before poor physical activity and nutritional habits become firmly established. Adiposity rebound is the time in a child's life (usually around 5 to 6 years of age) when body mass index (BMI) begins to increase after a steady de ....Overweight and obesity rates are increasing in children, and overweight children have higher risk of adult obesity and therefore diseases including heart attack, stroke and diabetes. The preschool years may offer opportunities to divert children from the path to obesity, before poor physical activity and nutritional habits become firmly established. Adiposity rebound is the time in a child's life (usually around 5 to 6 years of age) when body mass index (BMI) begins to increase after a steady decline in BMI in the preschool years. Early adiposity rebound is associated with increased BMI in later life. We don't yet know whether the early adiposity rebound causes the higher BMI, or whether it is simply an early sign of an already-established pathway of behavioural and environmental risk. We need a much better understanding of predictors of early adiposity rebound and the changes that occur to determine if age at adiposity rebound is a modifiable risk factor for adult obesity. This study will document the process and timing of adiposity rebound and the changes in percent body fat and lean body mass that occur during that time. We will also determine whether risk and protective factors for early adiposity rebound and overweight at age 6 years are the same or different. We will study over 400 children on whom extensive data have been collected since birth, including period of gestation, birth weight and length. At various stages during their first two years of life, height, weight, feeding patterns and development were recorded. We will measure BMI and perform bioimpedance analysis (BIA) on these children six times between 4 and 6 years of age. BIA provides a measure of body fat and lean mass that is well accepted by children. This will help determine the relationship between changing BMI at different ages and the fat-to-lean mass ratios associated with those changes. This study is the first to consider body composition changes during adiposity rebound.Read moreRead less
An Early Intervention To Prevent Muscle Weakness In Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$82,607.00
Summary
Patients commonly suffer from a debilitating and globally pronounced weakness post intensive care admission. The causes and ways to prevent this weakness are not fully understood. This study will investigate the benefits of early exercise involving electrical stimulation of the leg muscles during in-bed cycling and will compare changes in muscle size and strength compared to usual care. We will also examine why muscles become weak so quickly, to help target future treatments to prevent weakness.
Individual Patient Data Meta-analysis Of Randomised Control Trials In Fluid Resuscitation
Funder
National Health and Medical Research Council
Funding Amount
$85,027.00
Summary
I am a registered nurse focused in critical care research. I have an interest in the area of fluid resuscitation. My aim is to carry out an individual patient data meta-analysis (IPDMA) on randomised controlled trials (RCTs) in fluid resuscitation. The IPDMA will consist of two of the largest critical care trials; Saline Vs Albumin fluid Evaluation (SAFE) study and the Crystalloid Vs Starch (CHEST) study, to add further evidence to the currently limited fluid resuscitation literature.
Optimising Nutrient Delivery And Absorption In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$560,715.00
Summary
Patients surviving ICU are frequently discharged malnourished. Adequate nutrition is essential for optimal outcomes. It is considered best practice to administer nutrition as a liquid formula via a tube passed through the nose into the stomach, however this is frequently limited by impaired gastrointestinal function. We aim to develop more effective strategies for the provision of nutrition to improve nutritional and thereby clinical outcomes in critically ill patients.
The Generation Of High Quality Evidence In Critical Care Medicine Through Multicentre Randomized Controleld Trials And Its Translation Into Practice
Funder
National Health and Medical Research Council
Funding Amount
$240,121.00
Summary
This research program will establish new approaches to sepsis, traumatic brain injury, kidney protection, transfusion, post-operative care, sedation, antibiotics and mobilization of acutely ill patients. Experimental research will help understand why the kidney malfunctions during severe infection. Database investigations will identify of successful patterns of treatment and potential new fields of investigations. Informatics based studies will use electronic data to develop decision support sys ....This research program will establish new approaches to sepsis, traumatic brain injury, kidney protection, transfusion, post-operative care, sedation, antibiotics and mobilization of acutely ill patients. Experimental research will help understand why the kidney malfunctions during severe infection. Database investigations will identify of successful patterns of treatment and potential new fields of investigations. Informatics based studies will use electronic data to develop decision support systems to improve patient care.Read moreRead less
Early Parenteral Nutrition Vs. Standard Care In The Critically Ill Patient: A Level I Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,852,333.00
Summary
Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no ge ....Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no general agreement as to when intravenous artificial nutrition should be begun if a patient cannot tolerate a feeding tube. A recent systematic review of all available clinical trials suggests that if a critically ill patient cannot be fed by a stomach tube for at least 24 hours, they may benefit from intravenous artificial nutrition. This is not what currently happens under standard care. The purpose of this multi-centre randomised controlled trial is to determine if early intravenous nutrition saves lives. Because of the cost, and possible risk of increased infections, a study of this type is required before early intravenous nutrition could become a routine therapy in Australia. Informed consent to participate in the study will be obtained from next of kin, or directly from the patient themselves. The study will be managed at the Royal North Shore Hospital, University of Sydney and will include 26 collaborating ANZ hospitals over 18 months.Read moreRead less
Impact Of Gastrointestinal Dysmotility On Enteral Nutrition In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$533,792.00
Summary
Critically ill patients require nutrition for optimum recovery. Ideally, this is provided via the gut, but oesophageal reflux, slow gastric emptying and small intestinal dysfunction frequently prevent adequate delivery of nutrients to these patients, exposing them to complications such as pneumonia and gastrointestinal bleeding. The work performed by the applicants will improve the ability of doctors in the Intensive Care Unit to feed patients and prevent the development of such complications.
Upper Gastrointestinal Motor And Absorptive Function In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$260,760.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known abou ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known about the reasons underlying these dysfunctions. The applicants, with ongoing support from the NH and MRC have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of these conditions. These contributions have been underpinned by pioneering the development of new methodologies to examine gut function. In collaboration with the intensive care specialists in Adelaide, we now seek to apply this knowledge to evaluate gut function in patients in the Intensive Care Unit. The proposed studies will provide the most comprehensive studies to date of the gut function in critically ill patients and have important implications for treatment.Read moreRead less
Management Of Refeeding Syndrome In Critical Illness: An AuSPEN Endorsed Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,366,987.00
Summary
Critically ill hospitalised patients are frequently malnourished. When feeding is reestablished in malnourished patients, they often exhibit severe electrolyte imbalances and metabolic disturbances that can lead to slower recovery times, increased complications and even death. The purpose of this clinical trial is to investigate the benefits of a conservative approach of managing critically ill patients with refeeding syndrome.
Centre Of Research Excellence - REduce The Burden Of Antimicrobial ReSistance Through OPtimal, PersONalised Dosing (RESPOND)
Funder
National Health and Medical Research Council
Funding Amount
$2,500,000.00
Summary
Each year more than 17 million people die from infectious diseases. Many of these deaths are due to the poor use of antimicrobial drugs and an increase in infections caused by antimicrobial-resistant 'superbugs'. CRE RESPOND will enable an optimal treatment of infection by empowering clinicians with an evidence-based, patient-centred approach to guide antimicrobial dosing. We will generate new knowledge, educate healthcare workers, and build research capacity through our network of collaborators