Improving The Outcome Of Premature Infants- A Randomised Trial Of Preventive Care At Home
Funder
National Health and Medical Research Council
Funding Amount
$633,375.00
Summary
The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of e ....The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of early preventive care programs geared to changing the infant's environment (physical management, behavioural regulation, maternal factors). In the proposed study we aim to use a low cost preventive care program at home conducted by physiotherapists and psychologists that has been shown to have utility and efficacy in pilot work, with follow up until 2 years of age. In subsequent studies we would aim to follow this cohort to school age, to determine if there are any lasting benefits of early intervention accompanied by measures of brain growth and structural development using advanced imaging techniques. Any new health care program should result not only in improvements in health, but should be affordable to implement so an economic evaluation will also be undertaken. This study will also utilise novel and advanced MRI brain imaging techniques to understand the complex interaction between brain injury and altered brain development in these infants with the risk and the repsonse to this program of care. In this way the changes in brain connectivity, structure and biochemistry can be formally defined to undertsnad the pathway of any potential benefit from this program.Read moreRead less
Evaluating Neonatal Intensive Care For Tiny Babies In The 2000s - Is It Still Effective, Efficient And Available?
Funder
National Health and Medical Research Council
Funding Amount
$246,333.00
Summary
Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively ....Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively high and stable over time, comparing favorably with many other health care programmes, both intensive and non-intensive. It has been increasingly available, with fewer than 10% of ELBW infants born outside major hospitals with intensive care nurseries, and more tiny babies offered intensive care. We now need to know if these benefits have been maintained for tiny babies born in the 2000s. Hence we need to assess the long-term health of tiny babies born in Victoria in 2005.Read moreRead less
The Centre For Research In Childhood Early Respiratory Disease
Funder
National Health and Medical Research Council
Funding Amount
$2,621,023.00
Summary
The Centre for Research in Childhood Early Respiratory Disease is dedicated to the prevention of lung disease in young children with chronic respiratory disease. We aim to better understand the process of lung disease to identify predictors of disease and to treat it better. We will investigate the psychosocial effects of early interventions to better manage families. We will facilitate collaborations to provide best practice guidance and will train the next generation of doctors and researchers
Understanding The Mechanisms Of Bleeding And Clotting Complications For Children On Extracorporeal Circuits.
Funder
National Health and Medical Research Council
Funding Amount
$1,113,385.00
Summary
Extracorporeal Membrane Oxygenation (ECMO) is advanced life support, which can save critically ill children. Significant bleeding occurs in 39%; clotting in 31% of children on ECMO; stroke in 12%. The biggest barrier to reducing these complications is the lack of understanding of how the bleeding/clotting system works in ECMO. This unique proposal uses the largest paediatric ECMO population in Australia and a multidisplinary expert team to develop a mechanistic understanding of these issues.
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.
A Randomised Controlled Trial Of A Community-based Weight Management Intervention In Obese Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$79,534.00
Summary
This research will explore various aspects of managing overweight and obesity in adolescence, including a review of previous studies. The central focus will be participants' weight, health and behavioral outcomes in a randomised controlled trial of a community-based weight management program for 13-16 year olds. A focus group study will be conducted to increase understanding of parent-adolescent communication regarding overweight and the decision to seek treatment.
Nitric Oxide On Cardio Pulmonary Bypass In Congenital Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$1,878,889.00
Summary
Children undergoing open heart surgery on a heart lung machine can experience serious side effects from the exposure to the artificial circulation during surgery and may have either prolonged need for life support in intensive care or even may suffer from long term complications. In this study we investigate the use of a new approach using nitric oxide, a anti-inflammatory gas, during surgery to reduce these side effects.
Necrotising enterocolitis (NEC) is a devastating bowel condition afflicting almost 1 in 10 of very preterm babies. About a third of babies with NEC do not survive. Currently, there is no cure. We propose the use of stem-like cells from the human placenta as a targeted therapy for NEC, working by minimising gut damage and accelerating gut repair.
Nasal Highflow For Paediatric Acute Hypoxic Respiratory Failure
Funder
National Health and Medical Research Council
Funding Amount
$2,627,819.00
Summary
The burden of respiratory disease in children requiring intensive care admission is increasing despite better quality care in hospitals. This study investigates a new method, called nasal high flow, to support the breathing of children, that can be provided in regular children's wards in regional and metropolitan hospitals. The study anticipates to demonstrate that early intervention with nasal high flow reduces the need for intensive care admission.
Neuroprotective Role Of Sulphate Among Preterm Babies (SuPreme Study)
Funder
National Health and Medical Research Council
Funding Amount
$749,338.00
Summary
Magnesium sulphate administered to mothers shortly before preterm birth, reduces the risk of cerebral palsy. The mechanism of its neuroprotective effect is unknown, and our studies suggest sulphate is the protective element. Preterm babies rapidly become sulphate deficient, and magnesium sulphate mitigates this deficiency in most infants. In this study we will investigate whether low blood sulphate levels at 1 week of age correlate with cerebral palsy.