A Record Linkage Study Of The Relationship Between Intra-uterine Growth, Birth Weight And Childhood Acute Leukaemia
Funder
National Health and Medical Research Council
Funding Amount
$126,000.00
Summary
Little is known about the causes of childhood leukaemia and cancer, and this has been the subject of intense study over many years. Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) are the most common types of childhood cancers. The early age of onset of diagnosis of cancer-leukaemia in childhood has focused attention on factors related to pregnancy. Many studies have investigated the relationship between birth weight and risk of leukaemia. Some studies have reported finding ....Little is known about the causes of childhood leukaemia and cancer, and this has been the subject of intense study over many years. Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) are the most common types of childhood cancers. The early age of onset of diagnosis of cancer-leukaemia in childhood has focused attention on factors related to pregnancy. Many studies have investigated the relationship between birth weight and risk of leukaemia. Some studies have reported finding an increasing risk of Acute Lymphoblastic Leukaemia with increasing birth weight, but not all studies have reported this relationship. The relationship between birth weight and Acute Myeloid Leukaemia has been even less well described. Many previous studies have not taken account of important factors when analysing the results. This study will use an existing pool of routinely recorded health information, thus ensuring accurate information on birth weight and factors such as maternal height and age and the length of the pregnancy. We will also have complete and accurate information on childhood cancer in Western Australia. Our results will contribute to knowledge about the causes of childhood leukaemia and the biological pathways involved in its development. If growth-related factors do prove to be integrally involved in the aetiology of childhood leukaemia, then the rapidly increasing prevalence of juvenile diabetes, overweight and obesity in Australia and other developed countries could have even more serious implications for the health of our children. It is important that we investigate this question as soon as possible.Read moreRead less
Socioeconomic Variation In Community Risk Profiles Associated With Health And Behaviour Problems In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$459,700.00
Summary
Until recently, emotional and behavioural problems of adolescence have tended to be dismissed as part of the normal turbulence of adolescent development; however, attitudes to adolescent health and health promotion have changed quickly. Downward age-trends in tobacco, alcohol and illicit drug use have made adolescents a major target for health promotion. The practical potential for adolescent mental health promotion has gained considerable ground and knowledge of the modifiable determinants of y ....Until recently, emotional and behavioural problems of adolescence have tended to be dismissed as part of the normal turbulence of adolescent development; however, attitudes to adolescent health and health promotion have changed quickly. Downward age-trends in tobacco, alcohol and illicit drug use have made adolescents a major target for health promotion. The practical potential for adolescent mental health promotion has gained considerable ground and knowledge of the modifiable determinants of youth mental health problems has been progressed by a growing number of studies examining distal and proximal predictors in community samples. The project plans to comprehensively assess locally elevated risk factors and depressed protective factors predictive of a range of adolescent health and behaviour problems including substance abuse, obesity and depression in 30 communities across three Australian States. These communities will be selected from the entire socioeconomic spectrum to determine how the social context of our neighbourhoods may influence the health and behaviour of adolescents . Surveys of students in grade 6 and year 8 will be conducted. Each participating student will be weighed and measured and asked to complete a questionnaire that assesses a comprehensive range of community risk and protective factors.Read moreRead less
Prenatal Repeat Corticosteroids In Women At Risk Of Preterm Birth For Improving Neonatal Health - An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$461,063.00
Summary
Giving repeat doses of prenatal corticosteroids to women at high risk of preterm birth reduces the risk of their babies having serivous health problems in the early weeks of life. It is unclear what dose, number of doses and interval between doses of corticosteroids is optimal. This review will determine if and how individual women should be treated with repeat corticosteroids to improve the health of their baby born too soon.
Genetic Polymorphisms In Genes Controlling Innate Immunity As Risk Factors For Childhood Acute Lymphoblastic Leukaemia
Funder
National Health and Medical Research Council
Funding Amount
$241,500.00
Summary
For some time now, researchers have speculated that the development of childhood leukaemia is related to exposure to an infectious agent. However, a causal pathogen is yet to be identified. Recent studies have shown that the initial recognition of microbes as they enter the human body is determined by a group of receptors, toll-like receptors (TLRs), which selectively bind to essential components of these pathogens. This process allows the body to respond immediately to microbial invasion; a pro ....For some time now, researchers have speculated that the development of childhood leukaemia is related to exposure to an infectious agent. However, a causal pathogen is yet to be identified. Recent studies have shown that the initial recognition of microbes as they enter the human body is determined by a group of receptors, toll-like receptors (TLRs), which selectively bind to essential components of these pathogens. This process allows the body to respond immediately to microbial invasion; a process which is vital during early childhood, when clonal expansion of antibodies and other host defences is inadequate. It is becoming increasingly apparent that this innate immune response is not just the first line of defence but a necessary event for the development of an adaptive immune response. We propose that the innate immune system of children carrying TLR gene variants may be less effective at detecting the presence of microbial pathogens in the environment. We hypothesize that by dampening the stimulation of innate immunity in early childhood, TLR gene variants may indirectly cause a dysfunction in the maturation of a child's immune system and increase the chance of a pre-leukaemic clone emerging, leading to the development of childhood leukaemia.Read moreRead less
Maternal Health Study (phase 2): Longitudinal 4-year Follow-up Of A Prospective Nulliparous Pregnancy Cohort
Funder
National Health and Medical Research Council
Funding Amount
$660,402.00
Summary
The burden of disease among women after childbirth is substantial, under-recognised by health professionals, and symptoms do not necessarily resolve within the first 12 months. Common health problems after childbirth include: chronic exhaustion, back pain, urinary and faecal incontinence, perineal pain, sexual health issues and intimate partner violence. This study will extend follow-up of over 1500 women taking part in a longitudinal study investigating the physical and psychological health of ....The burden of disease among women after childbirth is substantial, under-recognised by health professionals, and symptoms do not necessarily resolve within the first 12 months. Common health problems after childbirth include: chronic exhaustion, back pain, urinary and faecal incontinence, perineal pain, sexual health issues and intimate partner violence. This study will extend follow-up of over 1500 women taking part in a longitudinal study investigating the physical and psychological health of women during pregnancy and the first 18 months after the birth of their first child. In phase 2 of the study, women will be followed up 6 and 12 months after second and subsequent births, and 4 years after the birth of their first child. A major aim of phase 2 of the study is to assess the prevalence, incidence, onset, severity, duration, recurrence and chronicity of maternal health problems (including urinary and faecal incontinence, perineal pain, sexual health issues, depression and intimate partner violence) after second and subsequent births, and 4 years after giving birth to a first child. The study will also determine the extent to which the method of birth in the first birth influences longer-term maternal health outcomes including urinary and faecal incontinence, and investigate the implications of chronic and recurring physical health problems for women's psychological health and well-being. Information on the incidence and natural history of maternal health problems after caesarean and operative vaginal births will make a major international contribution to more informed debate among clinicians, and to informing women, about the risks and benefits of increasing caesarean births. The study findings will be used to inform clinical midwifery, obstetric and primary care practice, and assist in the design of new early intervention and primary care strategies for supporting women in the early years of parenting.Read moreRead less
MULTICENTRE BRONCHIECTASIS STUDY: A Collaborative And International Study Of Bronchiectasis In Indigenous Children.
Funder
National Health and Medical Research Council
Funding Amount
$1,496,414.00
Summary
Aboriginal children have repeated pneumonia episodes; some get better while others develop bronchiectasis (a chronic lung disease). The risk factors associated with progression to bronchiectasis, and the natural history of bronchiectasis in this population is little known. Given the similarities of these diseases among indigenous populations of affluent countries and to increase study size, a collaborative and international study of Indigenous children (Aboriginal and Torres Strait Islander, New ....Aboriginal children have repeated pneumonia episodes; some get better while others develop bronchiectasis (a chronic lung disease). The risk factors associated with progression to bronchiectasis, and the natural history of bronchiectasis in this population is little known. Given the similarities of these diseases among indigenous populations of affluent countries and to increase study size, a collaborative and international study of Indigenous children (Aboriginal and Torres Strait Islander, New Zealand Maori or Pacific Islander and Alaskan Native) has been initiated. In Indigenous children, we aim to define the natural history of chronic moist cough (those at risk of developing bronchiectasis) and bronchiectasis, identify the risk factors associated with progression from early-mild disease (chronic moist cough) to bronchiectasis and to define the role of continuous antibiotic treatment in the prevention of recurrent pulmonary infections that are very common in these children. We plan to follow up Aboriginal children aged 12 months to 8 years diagnosed with bronchiectasis or chronic moist cough. For those diagnosed with bronchiectasis, after fully informed consent is obtained from the parent(s), the child will be allocated by chance to one of the 2 treatment regimes: (1) Azithromycin once-week or (2) placebo once-week. Children will receive the medication or the placebo for a period of 24 months. All these children will be clinically seen 2x-year by the study's paediatrician and 2x-year by the research nurse for the duration of the study. By documenting, for the first time, the epidemiology and natural history of children with chronic moist cough and bronchiectasis, the study will provide a much-needed rationale for their management. If we can scientifically show that this is true, that Azithromycin is effective in reducing the number of respiratory infections, this would be an achievable advance in the treatment in the field for these children.Read moreRead less
A National Case-Control Study Of The Causes Of Childhood Brain Tumours
Funder
National Health and Medical Research Council
Funding Amount
$1,159,259.00
Summary
Childhood brain tumours are the second most common childhood cancer (~20%) after leukaemia (~35%) and are the leading cause of cancer death among children. Children who survive a brain tumour are often left with physical and mental problems as a result of treatment. This can have a significant impact on the child, family and community. Greater understanding of the causes of childhood brain tumours may lead to preventative measures. Most children with brain tumours are very young, suggesting that ....Childhood brain tumours are the second most common childhood cancer (~20%) after leukaemia (~35%) and are the leading cause of cancer death among children. Children who survive a brain tumour are often left with physical and mental problems as a result of treatment. This can have a significant impact on the child, family and community. Greater understanding of the causes of childhood brain tumours may lead to preventative measures. Most children with brain tumours are very young, suggesting that factors to which parents are exposed may affect future children. For this reason, it is important to study the parents as well as the child. This study will investigate environmental exposures known to be harmful, such as parental cigarette smoking and exposure to pesticides and other chemicals. Such exposures are also thought to increase the risk of other childhood cancers like Acute Lymphoblastic Leukaemia. We will also investigate whether dietary factors - including vitamin supplements - in the parents or the child can reduce the risk of a child developing a brain tumour. This study also examines genetic factors which can influence the body's ability to deal with toxins. Some genetic variations, combined with diet and lifestyle factors, may alter the risk of developing some cancers. These interactions need to be examined in greater detail for childhood brain tumours. This national study will examine specific genes and analyse them in conjunction with rigorous assessment of exposures throught to be related to the development of childhood brain tumours. Results obtained from children with brain tumours and their parents will be compared with those from healthy 'control' children and their parents. This is the first study to assess gene-environment interactions in relation to the risk of childhood brain tumours.Read moreRead less
A Prospective Study Of The Effects Of Early Life Growth On Adult Mammographic Density
Funder
National Health and Medical Research Council
Funding Amount
$460,517.00
Summary
It is now well-known that a woman's breast density, as measured by a breast scan, is a predictor of her future risk of breast cancer. It is also known that women who are heavier as babies and grow rapidly before age 7 are more likely to develop breast cancer in adult life. The effects were strongest in women who had early puberty. It has been suggested that there are critical points in early life growth that contribute to higher breast density in middle-age. Population-based surveys with early l ....It is now well-known that a woman's breast density, as measured by a breast scan, is a predictor of her future risk of breast cancer. It is also known that women who are heavier as babies and grow rapidly before age 7 are more likely to develop breast cancer in adult life. The effects were strongest in women who had early puberty. It has been suggested that there are critical points in early life growth that contribute to higher breast density in middle-age. Population-based surveys with early life growth data on large numbers of women that span birth to adulthood are necessary to estimate accurately the association between early life growth and breast density in middle age. Few such studies exist; Tasmanian Asthma Study is one of them. In 1968, all 4,194 female Tasmanian school children born in 1961 were surveyed and height and weight measured. Subsequently, weight and height measurements were carried out on samples of this cohort. We are currently conducting the 37-year follow-up of the TAS and to date have traced 87% and achieved a response rate of 77% (2,850) for a postal survey. This included self-reported weight and height measurements and detailed information reproductive history and the use of hormones. Weight, height and waist to hip ratio are currently measured on 600 of these respondents. We have access to school medical records of the full cohort, which have weight and height data measured at school medical inspections throughout school years, and maternal records so far for half of the total cohort, which have information on birth weight and length, and period of gestation. Hence, TAS now provides an ideal opportunity, unique within Australia, to investigate prospectively the association between early life growth and mammographic density in middle-age women. We will measure breast density in these women now they are in their late 40s, using the Australian Mammographic Density Research Facility at The University of Melbourne.Read moreRead less
Early Life Stress, Adolescent Brain Development And Risk For Adverse Cognitive And Psychosocial Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$640,595.00
Summary
This project aims to study pre and postnatal childhood factors and examine their association with HPA-functioning, cognition, and mental health during adolescence in the Western Australian Pregnancy Cohort Study (Raine Study). Childhood exposures include not only trajectories of stressful life events, family functioning and mental health status during childhood, but also effects of intrauterine and postnatal growth patterns, and a comprehensive range of psychosocial, familial and environmental f ....This project aims to study pre and postnatal childhood factors and examine their association with HPA-functioning, cognition, and mental health during adolescence in the Western Australian Pregnancy Cohort Study (Raine Study). Childhood exposures include not only trajectories of stressful life events, family functioning and mental health status during childhood, but also effects of intrauterine and postnatal growth patterns, and a comprehensive range of psychosocial, familial and environmental factors. It is our objective to characterise functional polymorphisms for genes related to stress regulation and examine their interactions with early life exposures and their neurobiological consequences. We will also test 16 year old Raine subjects for cognitive ability, and in some we will image their brain activity while performing these tests. We anticipate to enhance the already comprehensive phenotypic Raine Study data base with neurobiological information for future neuroscience studies as the Raine cohort matures. We hypothesise that increased and sustained trajectories of early life stress, family dysfunction or poor mental health during childhood will increase the risk of Raine Study adolescents experiencing: (i) - increased stress sensitivity with higher baseline cortisol levels during adolescence; (ii) - increased adolescent stress sensitivity, if they are carriers of specific haplotypes of the glucocorticoid and mineralocorticoid receptor genes.;(iii) - depression during adolescence, if they are homozygous or heterozygous for the short allele of the serotonin transporter (5-HTT) gene; (iv) - poorer cognitive performance and increased atypical non-prefrontal cortex (PFC) brain activity during cognitive testing as measured by fMRI; and (v) -more mental health problems during adolescence.Read moreRead less