A Randomised Trial Of Constraint Induced Movement Therapy And Botulinum Toxin A In Children With Congenital Hemiplegia.
Funder
National Health and Medical Research Council
Funding Amount
$399,995.00
Summary
Congenital hemiplegia occurs in over 1 million children under 21 years of age in the industrialized world. It is the most common type of cerebral palsy, accounting for 36 percent of children diagnosed with this lifelong condition. We intend to determine if a promising new treatment approach is effective in providing a superior and lasting benefit, compared to conventional techniques. Children with hemiplegia usually have the intellectual capacity to attend normal school; however the impaired arm ....Congenital hemiplegia occurs in over 1 million children under 21 years of age in the industrialized world. It is the most common type of cerebral palsy, accounting for 36 percent of children diagnosed with this lifelong condition. We intend to determine if a promising new treatment approach is effective in providing a superior and lasting benefit, compared to conventional techniques. Children with hemiplegia usually have the intellectual capacity to attend normal school; however the impaired arm reduces independence in activities of daily living and can compromise their ability to participate in educational, leisure and vocational roles. Previously we have shown that a program of upper limb rehabilitation in children with spasticity was effective in improving participation and quality of life. We have also shown that rehabilitation combined with Botulinum toxin A (Botox) can further improve functional activity. We believe that a new method of therapy, that has been used effectively in Adults with stroke, called Constraint Induced Movement Therapy (CIMT) may also be beneficial in the treatment of children with congenital hemiplegia. In CIMT, the unimpaired arm is constrained in a glove to promote use of the impaired arm (hemiplegic arm). We predict that, combined with the Botox treatment, CIMT will provide a superior and longer lasting benefit compared to standard rehabilitation combined with Botox. The primary aim of our study is to test this hypothesis in a controlled trial. A secondary aim is to further our understanding of the central neurovascular mechanisms underlying changes in upper limb function. To achieve this, we will use Functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS) to measure central activation in the parts of the brain controlling movement. Improving our understanding of the mechanisms involved in this condition is an essential next step towards providing a more effective and long lasting treatment.Read moreRead less
Epithelial Drivers Of Neutrophil Plasticity In Early Cystic Fibrosis Lung Disease
Funder
National Health and Medical Research Council
Funding Amount
$849,462.00
Summary
Why airway inflammation becomes chronic so early in life for people with cystic fibrosis (CF) is unclear. This project will use the latest techniques to characterise immune cells found in airways of infants with CF and model in the laboratory how immune cells react to the CF airway. We will challenge CF airway cells with different bugs that can infect the lung, then see if the responses by CF airway cells can change the normal response of immune cells, triggering chronic disease.
The Identification Of Thoracic Targets For Prevention And Intervention In Bronchopulmonary Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
The persistence of breathing problems from infancy to later life is a complication of premature birth with lifelong consequences. Breathing problems often occur together with lung disease, but prematurity can also affect heart and blood vessel development, and weakness of the main breathing muscle. We will find out how much the heart, lungs and diaphragm contribute to breathing problems in babies; helping us to better predict, diagnose and treat severe breathing problems in babies born preterm.
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
Lung, Heart And Respiratory Muscle Disease After Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$1,328,858.00
Summary
Breathing problems persisting into infancy and later life is an important complication of premature birth with lifelong consequences. Breathing problems often occur together with lung disease, but prematurity can also affect heart and blood vessel development, and weakness of the main breathing muscle (the diaphragm). We will find out how much the heart and diaphragm contribute to breathing problems in babies, and will help us to better predict, diagnose and treat severe breathing problems.
Clinical Trial Of Minimally-invasive Surfactant Therapy
Funder
National Health and Medical Research Council
Funding Amount
$1,172,978.00
Summary
This proposal is for funding of a clinical trial investigating a new and less-invasive technique of giving surfactant to improve lung function in preterm babies born between 25 and 28 weeks gestation. The trial will examine whether giving surfactant using the less invasive method results in better outcomes, including a reduction in time on respiratory support, and higher survival without chronic oxygen dependency.
RCT Of Headbox Oxygen Vs CPAP For Neonatal Respiratory Distress In Non-tertiary Hospitals
Funder
National Health and Medical Research Council
Funding Amount
$225,500.00
Summary
Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safet ....Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safety. Currently, babies who need oxygen in a local hospital are placed in a crib with a clear plastic box around their head and oxygen is run into the box (headbox oxygen). There is an alternative method of providing oxygen called CPAP (Continuous Positive Airway Pressure). This involves giving the oxygen directly into the baby's nose via soft rubber prongs. CPAP has been used since the 1970's. It is the main form of respiratory support for infants in many NICUs in Australia and the world. There is some evidence that death and lung disease may be reduced. However, the babies in these studies are sicker and smaller than babies in local hospital nurseries. CPAP is used in some local nurseries in New Zealand, however no studies have been done to see if CPAP reduces the need for inter-hospital transfer. The study will involve hospitals that have been selected because of their level of on site medical and nursing staff. These hospitals will have support and advice from two NICUs that use CPAP as their main form of respiratory support. Babies who need oxygen will be randomly allocated to either have headbox oxygen or CPAP. If the baby becomes so unwell such that certain preset criteria are met, the baby will be transferred to a NICU in the usual way. If CPAP safely reduces the need for inter-hospital transfer, many parents will be saved the anxiety associated with transfer, and the separation it often causes.Read moreRead less
The Significance Of Human Metapneumovirus In The Australian Paediatric Population
Funder
National Health and Medical Research Council
Funding Amount
$457,625.00
Summary
A newly discovered paramyxovirus, human metapneumovirus (hMPV), shows clinical and virological charcteristics very similar to those of human respiratory syncytial virus (hRSV). Human RSV is the major cause of acute lower respiratory illness in infants and accounts for more than 1 million deaths world wide annually. Most infants are infected in their first year of life, and re-infection is common. Genetic variation of the virus is thought to play a critical role in its ability to escape the immun ....A newly discovered paramyxovirus, human metapneumovirus (hMPV), shows clinical and virological charcteristics very similar to those of human respiratory syncytial virus (hRSV). Human RSV is the major cause of acute lower respiratory illness in infants and accounts for more than 1 million deaths world wide annually. Most infants are infected in their first year of life, and re-infection is common. Genetic variation of the virus is thought to play a critical role in its ability to escape the immune response and establish multiple sequential infections in the same host. Currently, we have no knowledge of the extent that hMPV exists in the Australian population, nor do we know if hMPV is a significant respiratory pathogen in paediatric patients. This research aims to determine the importance of hMPV as a respiratory agent, and will establish the rate, age of exposure, and incidence of hMPV infection in Australian children. In addition, we will identify the hMPV strains (genotypes) that infect local children, and the difference, if any, between these and virus strains detected in children from other community groups, and from overseas. Such data is invaluable in devising a future vaccine strategy for hMPV, and the study of the genetic variability among Australian strains will have profound implications for public health. This research project is a preliminary study into the clinical and virological significance of hMPV, in children, and will form a basis for future research projects. Once this preliminary data is obtained, further studies are possible to determine the cellular immune response to hMPV infection and its role in long-term protection. Also,it is likely that hMPV, like hRSV, may prove to be an agent associated with long-term decreased pulmonary function and airflow limitation perhaps developing to asthma.Read moreRead less