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
Practical Tools For Robust Analysis Of Large Epidemiological Studies With Incomplete Data
Funder
National Health and Medical Research Council
Funding Amount
$358,492.00
Summary
Studies of the causes and consequences of health outcomes follow large cohorts of individuals for long time periods. A major challenge in analysing data from these studies is that information is often incomplete. Participants rarely complete all waves of data collection, or provide all requested information. Statistical research has led to increased use of a statistical method (multiple imputation) that recovers information from incomplete cases. This project will develop and improve this method
A Life Course Approach To Understanding Oral Health Inequalities
Funder
National Health and Medical Research Council
Funding Amount
$269,025.00
Summary
Preadolescent children in Australia have lower rates of dental decay than children in almost all other economically developed countries. This is not the case for Australian adults. In fact, Australian adults aged 35-44 years have higher rates of dental decay than adults of similar age in most other economically developed countries. Not only do Australian adults have comparatively poor oral health in the lead-up to midlife, but also socioeconomic inequalities in dental decay are more pronounced a ....Preadolescent children in Australia have lower rates of dental decay than children in almost all other economically developed countries. This is not the case for Australian adults. In fact, Australian adults aged 35-44 years have higher rates of dental decay than adults of similar age in most other economically developed countries. Not only do Australian adults have comparatively poor oral health in the lead-up to midlife, but also socioeconomic inequalities in dental decay are more pronounced at this stage of life than at any other stage before or after. This study proposes to look at how oral health in young adults in shaped by their experiences across childhood, adolescence and early adulthood. This approach is based on recent evidence that points to the importance to adult health of the early years of life. In this life course perspective, the poorer health of disadvantaged individuals is seen to result from ongoing and cumulative exposure to difficult and disadvantaged circumstances across their life course. This study will trace and follow up a cohort of almost 10, 000 South Australians for whom social, familial, economic and dental behavioural information was collected in 1991-92 when these individuals were aged from five to 15 years. Now aged from 19 to 29 years, these individuals will be invited to attend a dental examination and complete a survey that will provide information on health behaviours and life circumstances shown to be important determinants of general and oral health status. One purpose will be to explore reasons for the comparatively poorer oral health status of Australian adults. A second purpose will be to investigate the magnitude of socioeconomic inequalities in oral disease at different life stages. The findings will add to the knowledge of the etiology of oral disease and open up opportunities to develop new methods of oral health promotion based on the understanding of accumulated risk across the life course.Read moreRead less
DOES TREATMENT REVERSE THE NEUROCOGNITIVE AND CARDIOVASCULAR SEQUELAE OF SLEEP DISORDERED BREATHING IN CHILDREN?
Funder
National Health and Medical Research Council
Funding Amount
$519,826.00
Summary
Studies in children have shown that disruption to normal sleep patterns resulting from sleep disordered breathing (SDB) has severe consequences for both the cardiovascular system and neurocognition. To date there have been no studies in children to investigate whether treatment of SDB with adenotonsillectomy, which has been shown to reduce sleep fragmentation and neurocognition, also reduces blood pressure.
Ascending Control Of Behavioural State And Cognition - Role Of Nucleus Incertus And Relaxin-3 Transmission
Funder
National Health and Medical Research Council
Funding Amount
$540,356.00
Summary
Mental illness and dementia are significant social and economic burdens worldwide and knowledge of their underlying causes and more effective therapies are required. Our research aims to use pre-clinical models to characterize a little studied neuronal network implicated in control of brain theta rhythm activity, which could lead to improved treatment of neuropsychiatric diseases such as anxiety and depression, and degenerative cognitive decline.
Differentiation Of Respiratory Behaviour In The Mammalian Fetus
Funder
National Health and Medical Research Council
Funding Amount
$434,839.00
Summary
Mammalian fetuses are highly active from early in gestation, manifesting patterns of activity that are gradually transformed throughout fetal life, ultimately producing a repertoire of behaviours essential for postnatal survival. These behaviours are of fundamental importance to animals, and none more so than breathing which must perform effectively from the moment of birth. We plan to examine neural control mechanisms that transform a primitive pattern of breathing in the early gestation fetus ....Mammalian fetuses are highly active from early in gestation, manifesting patterns of activity that are gradually transformed throughout fetal life, ultimately producing a repertoire of behaviours essential for postnatal survival. These behaviours are of fundamental importance to animals, and none more so than breathing which must perform effectively from the moment of birth. We plan to examine neural control mechanisms that transform a primitive pattern of breathing in the early gestation fetus into the functional form that effectively ventilates the lungs after birth. In addition to examining the prenatal development of breathing, our program will focus on the developmental fate of a transient behaviour restricted to early development. This early behaviour plays a fundamental role in the development of the motor system before being extinguished under the influence of supraspinal inputs. This program will therefore provide a basis for understanding the mechanisms by which the brain establishes control of the motor circuits of the spinal cord during development. Further, the program is designed to provide a basis for understanding the respiratory problems so common in the preterm human infant.Read moreRead less