ANTIPODES The Australian National Trial Investigating Post-Operative Deficit, Early Extubation And Survival
Funder
National Health and Medical Research Council
Funding Amount
$370,509.00
Summary
Brain damage following cardiac surgery is an unfortunate but common complication occuring variously in 30-80% of patients. Although severe strokes are uncommon (<1%), more subtle effects such as forgetfulness or behaviour changes may persist and make daily living difficult. Many attempts have been made to identify the exact cause of the brain damage, but no answer has been forthcoming. Recently, the introduction of modern anaesthetic techniques, which allow patients to wake up quickly after t ....Brain damage following cardiac surgery is an unfortunate but common complication occuring variously in 30-80% of patients. Although severe strokes are uncommon (<1%), more subtle effects such as forgetfulness or behaviour changes may persist and make daily living difficult. Many attempts have been made to identify the exact cause of the brain damage, but no answer has been forthcoming. Recently, the introduction of modern anaesthetic techniques, which allow patients to wake up quickly after the operation, have given strong indications that they may also cause less brain damage. We plan to test this aspect of modern anaesthesia, by comparing the results of tests for brain damage after anaesthesia that has been given by traditional methods and the recent method which allows patients to wake up quickly.Read moreRead less
Does Increased Non-Linear Behavior Caused By Dynamic Variables Increase Ventilatory-Induced Lung Injury (VILI)?
Funder
National Health and Medical Research Council
Funding Amount
$109,625.00
Summary
Acute lung injury (ALI) is precipitated by a variety of different insults, either directly to the lung or elsewhere to the body. Approximately 50% of the patients die. ALI is characterized by an increase in the leakiness of the barrier that normally separates the blood from the airspaces. The fluid which consequently floods the airspaces not only makes it difficult for patients to adequately obtain oxygen, but also dramatically increases the work of breathing by changing the surface forces withi ....Acute lung injury (ALI) is precipitated by a variety of different insults, either directly to the lung or elsewhere to the body. Approximately 50% of the patients die. ALI is characterized by an increase in the leakiness of the barrier that normally separates the blood from the airspaces. The fluid which consequently floods the airspaces not only makes it difficult for patients to adequately obtain oxygen, but also dramatically increases the work of breathing by changing the surface forces within the lungs. As a result, the patients must be mechanically ventilated. However, the very act of using a positive pressure to inflate the lungs often creates further damage, either through repeated opening and closing of collapse tissue or through its over distension. Ventilatory-induced lung injury (VILI), in itself is estimated to contribute to ~30% of the mortality. The best way shown to minimize VILI is through the use of small programmed breaths so as not to overinflate the lungs while still allowing adequate gas exchanges, superimposed upon a background pressure, in order to pre-inflate the lungs and prevent them from repeatedly collapsing. A remaining problem is that just as a rubber band changes its elasticity as it is stretched, so too the lung changes its mechanical properties during distension. Moreover, the lung is considerably more complex since different regions have different elasticities, which change differentially as air flows in and out of them. Airflow in turn depends on regional differences in the location, size, and number of conducting airways. Indeed, we have recently shown for the first time that dynamic changes in lung mechanics may contribute to VILI in patients, despite the use of safe ventilation modalities. This application proposes to examine the extent to which dynamic changes in lung mechanic contribute to VILI in an animal model, as a prelude to more costly, large scale clinical trials aimed at improving mortality.Read moreRead less
Early Detection Of Infants And Young Children With Autism
Funder
National Health and Medical Research Council
Funding Amount
$268,250.00
Summary
Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. ....Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. Therefore it is not possible to undertake such assessments with all children who have developmental problems. This project therefore proposes to evaluate a method for screening large populations of children for autism, thus enabling timely and more appropriate referral to assessment services. Previous work by the investigators has developed a potential screening tool (DBC Early Screen) for autism in young children under 4 years with developmental delay that has high levels of accuracy in identifying those infants and children who are at risk of autism and require specialist assessment. This project proposes to undertake a community field trial to assess the accuracy and reliability of this early screen and to establish its suitability for wide use as a population screening tool. The preliminary testing of DBC Early Screen demonstrated that a community field trial was feasible. The results of this study will facilitate the referral of infants and young children to specialist autism assessment services, thus enabling the commencement of appropriate early intervention for children and their families from an early age.Read moreRead less
Long-term Efficacy Of An Oral Health Promotion Program In The Prevention Of Early Childhood Caries.
Funder
National Health and Medical Research Council
Funding Amount
$165,664.00
Summary
The aim of the project is to test the long-term efficacy of oral health promotion program, the purpose of which is to lower the prevalence of tooth decay among young children. Tooth decay affects approximately 1 in 6 children by age of 3 years and 1 in 2 children by age of 5 years. The disease negatively influences all aspects of quality of life of child. Tooth decay is associated with infection, pain, and frequent hospitalisation. The proposed project is a follow-up of an randomised controlled ....The aim of the project is to test the long-term efficacy of oral health promotion program, the purpose of which is to lower the prevalence of tooth decay among young children. Tooth decay affects approximately 1 in 6 children by age of 3 years and 1 in 2 children by age of 5 years. The disease negatively influences all aspects of quality of life of child. Tooth decay is associated with infection, pain, and frequent hospitalisation. The proposed project is a follow-up of an randomised controlled trial (RCT), which started with enrolment of pregnant women. They were randomised into the test and control groups. Mothers in test group received 3 round of preventive oral health information in the form of anticipatory guidance, the first round at enrolment, the second and third at 6, 12 months of age of child respectively. The information was mailed to their home address. All children were examined at age of 20 months of age. The children in the test group had lower prevalence of tooth decay compared to children in control group, (test group 1,7%, control group 9.6%). While the oral health information was effective in preventing decay at 20 months, longer-term follow-up is highly desirable. Therefore, we plan to follow-up the oral health of the children at 5 - 6 years old. It is anticipated, that 75% mothers from the trial will be contactable and will continue with their participation in the study. A third comparative group of children at the same age will be drawn from database of the South Australian School Dental Services to check if the children in the trial are representative of all SA school children. All children will be examined by dentists or school dental therapists after they enter school. The prevalence of the tooth decay and its mangement will be examined and compared among children from test and control groups and children from community.Read moreRead less
Attracting, preparing, and sustaining quality teachers in early education. This project aims to address the chronic shortage of early childhood teachers in Australia, which is compromising quality and return on investment in early education. The project expects to generate new understandings about this specialist teacher workforce through an innovative, ecological, longitudinal design that will track early childhood teachers’ career trajectories and develop a world-first tool to assess early chi ....Attracting, preparing, and sustaining quality teachers in early education. This project aims to address the chronic shortage of early childhood teachers in Australia, which is compromising quality and return on investment in early education. The project expects to generate new understandings about this specialist teacher workforce through an innovative, ecological, longitudinal design that will track early childhood teachers’ career trajectories and develop a world-first tool to assess early childhood teacher quality. Findings are expected to inform policy— including the Australian Government-endorsed 10-year national Workforce Strategy and the Australian Government's Early Years Strategy— to support the future sustained supply of a quality early childhood teacher workforce and improve outcomes for young children.Read moreRead less
Identification Of The Molecular Hallmarks Of Naevi Progressing To Melanoma
Funder
National Health and Medical Research Council
Funding Amount
$314,644.00
Summary
Melanomas are amongst the most commonly occurring cancers in Australia with >136,000 people living with a previous melanoma diagnosis. One of the highest risk factors for developing melanoma is having a high number of moles (or naevi). It is therefore important to fully understand how and why naevi develop into melanoma. It is hoped that early detection markers will be identified which will help identify early melanomas and as such improve patient outcome.
Early Detection And Early Intervention For Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$2,088,220.00
Summary
Cerebral Palsy (CP) is Australia’s 5th expensive health condition. Early Detection and effective early interventions are vitally needed to improve long-term outcomes. This fellowship develops and tests novel interventions to optimise neuroplasticity by improving early detection and physical, cognitive, psychological and health outcomes in children with CP. Earlier accurate detection of CP will ensure effective treatments utilise critical periods of brain development.
Randomised Controlled Trial Of Therapeutic Pulmonary Lavage In Meconium Aspiration Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$182,550.00
Summary
Meconium aspiration syndrome (MAS) is a serious respiratory disease of full term infants, which can lead to very severe respiratory failure. It is caused by the inhalation of meconium, the secretion of the fetal intestine, into the lung at or prior to delivery. As a result, the airways and air sacs within the lung are damaged, leading to difficulty with breathing and poor oxygen levels. About one-third of all infants with MAS require mechanical ventilation in the first days of life, and are ofte ....Meconium aspiration syndrome (MAS) is a serious respiratory disease of full term infants, which can lead to very severe respiratory failure. It is caused by the inhalation of meconium, the secretion of the fetal intestine, into the lung at or prior to delivery. As a result, the airways and air sacs within the lung are damaged, leading to difficulty with breathing and poor oxygen levels. About one-third of all infants with MAS require mechanical ventilation in the first days of life, and are often extremely difficult to manage. At present, the main treatments given to a ventilated infant with severe MAS are supportive, rather than curative. Lung cleansing procedures are not part of routine care in this condition, even though removal of meconium from the lung may reduce the amount of damage that occurs. This project is a randomised controlled trial of a lung cleansing procedure called lung lavage in ventilated infants with severe MAS. During the lung lavage, a quantity of cleansing fluid containing a natural substance called surfactant is introduced into the lung, and then removed by suctioning. This procedure cleanses the lung of some of the meconium, and in preliminary testing, appears to be safe and well-tolerated even in the sickest infants. In the proposed trial, we will randomly allocate ventilated infants with severe MAS to receive either a lung lavage procedure, or routine care. This will take place within 24 hours of birth. We are looking to see whether the lavage procedure shortens the duration of ventilation, oxygen therapy or hospitalisation. Because there are only a small number of ventilated infants with MAS at any one centre per year, we will involve as many Australian neonatal intensive care units as we can in the study. We aim to enrol 66 infants in the trial, of whom half will receive lavage therapy.Read moreRead less
Enabling Personalised Risk Assessment For Colorectal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
Bowel cancer screening will be most effective in disease prevention if it is applied proportionately to individual person's risk. Risk-based screening requires a risk calculator to assess personal risk. By utilising existing large, international datasets, I will identify the risk factors specific for different bowel cancer types and incorporate them to upgrade the prediction model that I have developed. This will achieve more accurate risk prediction to enable personalised risk-based screening.
Peer Delivered Early Intervention For Infants At High Risk Of Cerebral Palsy In Indigenous Australia
Funder
National Health and Medical Research Council
Funding Amount
$286,891.00
Summary
This study explores the effectiveness of early detection and intervention for infants at risk of cerebral palsy in Indigenous Australia. Infants will be detected by 3 months, and randomly assigned to one of two intervention groups; home-based peer-delivered multi-domain intervention, or health advice. Infants receiving the novel intervention are expected to have improved developmental outcomes, and caregivers improved mental health.