Improving Community Approaches For Common Childhood Conditions.
Funder
National Health and Medical Research Council
Funding Amount
$478,602.00
Summary
Melissa’s end goal is community-based strategies that effectively prevent or manage common childhood conditions, which she addresses via four distinct yet unified programs of research (language-literacy, hearing loss, obesity, and early mental health-behaviour). All four programs are guided by long-term strategic plans that include advocacy and translation as central tenets. A further focus is research capacity-building in these areas via her substantial doctoral-postdoctoral programs.
ProbioticTreatment Of Diarrhoeal Disease And Malnutrition In Top End Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$332,036.00
Summary
Aboriginal children in the Top End of Australia have high rates of hospital admission for diarrhoea and malnutrition. We have discovered that underlying small intestinal damage in these children is an important contributor to the high complication rates and longer lengths of stay in hospital compared to non-Aboriginal children. This research proposes to continue our work on small intestinal damage by using two non-invasive tests of gut function, namely a sugar absorption test and novel breath te ....Aboriginal children in the Top End of Australia have high rates of hospital admission for diarrhoea and malnutrition. We have discovered that underlying small intestinal damage in these children is an important contributor to the high complication rates and longer lengths of stay in hospital compared to non-Aboriginal children. This research proposes to continue our work on small intestinal damage by using two non-invasive tests of gut function, namely a sugar absorption test and novel breath test. The sugar permeability test involves the children drinking a solution of the two sugars lactulose and rhamnose, and measuring their absorption into the blood 90 minutes later using a sophisticated measuring instrument called HPLC, which can measure minuscule amounts of sugars and is set up at Royal Darwin Hospital. The breath test involves children drinking another sugar solution with a special non-radioactive marker called a stable isotope of carbon, and measuring changes in the amount of this marker in carbon dioxide from the breath at timed periods after drinking the sugar solution. The breath is analysed in Adelaide using another sophisticated instrument. These tests are being used to measure abnormal sugar absorption due to intestinal damage, which is particularly common in Aboriginal children during the weaning period of 4-18 months. Our hypothesis is that treatment with 'healthy germs' (probiotics) like those in certain yoghourts will colonise the gut, stimulate immunity and reduce the presence of 'nasty germs' (pathogenic bacteria) in the intestines of Aboriginal children which contribute to the need for their hospitalisation with diarrhoea and malnutrition. If this hypothesis is correct, then this research will provide the best kind of evidence for reducing the need for hospital treatment by treating all cases of diarrhoea with these probiotics and possibly even decreasing the gut damage of children in the weaning period by including probiotics in their dietsRead moreRead less
Postnatal Dexamethasone In Tiny Babies: Does It Do More Good Than Harm?
Funder
National Health and Medical Research Council
Funding Amount
$394,688.00
Summary
The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shorte ....The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shortening the time that the babies need help with breathing. However, corticosteroids have the potential to cause long-term harm to the developing baby's brain, and may cause lifelong problems with thinking, walking, talking, seeing or hearing. We want to test in a clinical trial if corticosteroids, specifically dexamethasone, can reduce the need for help with breathing and the rate of chronic lung disease without causing long-term problems to the developing baby's brain. Babies who are very tiny (born weighing less than 1000 g), or born very early (born before 28 weeks of pregnancy, or more than 12 weeks premature) will be eligible for this study if they still need help with their breathing after one week of age from a machine called a respirator, and their doctor considers that corticosteroids might be helpful to the baby's breathing. Some babies will receive dexamethasone and other babies will be treated with a harmless placebo - chance will decide which treatment the baby receives. All other aspects of the babies' care will continue as normally. Children who survive to 2 years of age will be assessed fully to determine if they have any problems with their health, including problems with their thinking, walking, talking, seeing or hearing. We will determine if dexamethasone is helpful or not for very tiny or very premature babies who have breathing problems after the first week of life. We will also measure the economic impact of dexamethasone treatment in these babies.Read moreRead less
Rapid Ferric Carboxymaltose Infusion (Ferinject) For Iron Deficiency Anaemia In Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,236,421.00
Summary
The “Rapid Iron Infusion Project” will assess whether an intravenous infusion of ferric carboxymaltose (Ferinject) given over 15 minutes in children prior to their discharge from hospital will reduce the risk of ongoing anaemia. The potential benefits of iron infusion include higher haemoglobin levels, fewer painful iron injections over the next 6-9 months, better adherence to recommended treatment, and less use of primary health care resources.
Should Very Premature Babies Receive A Placental Transfusion At Birth? A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,875,774.00
Summary
Premature babies under 30 weeks gestation are up to a hundred times more likely than full term babies to die or survive with major disability, often from brain damage due to poor blood flow after birth. This randomised study will find out if giving them more placental blood at birth, by means of a delay in clamping the umbilical cord, then milking it, reduces anemia, blood transfusions, brain damage, infection, death and disability. The results may benefit millions of premature babies worldwide.
Child Health At Two Years Corrected Age After Antenatal Exposure To Dexamethasone Or Betamethasone; A Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,777,593.00
Summary
Both dexamethasone or betamethasone, given to women at risk of preterm birth substantially improve neonatal and child health. There are conflicting reports as to whether dexamethasone is better than betamethasone? This randomised trial will assess this. If dexamethasone is more beneficial, there will be fewer deaths and fewer disabled children. This will be of great importance for the care of women at risk of preterm birth, their children and health services in Australia and internationally.
Does Antenatal Magnesium Sulphate Given To Women At Risk Of Preterm Birth Between 30 And 34 Weeks' Gestation Reduce The Risk Of Death Or Cerebral Palsy In Their Children? - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,978,760.00
Summary
Antenatal magnesium sulphate is recommended prior to preterm birth at less than 30 weeks’ gestation. Whether there are benefits at later gestations is uncertain. This study is assessing whether magnesium sulphate given to women at risk of very preterm birth between 30 to 34 weeks’ gestation increases the chance of their baby surviving without cerebral palsy.
Vaginal Progesterone For The Prevention Of Neonatal Respiratory Distress Syndrome - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$935,107.00
Summary
Respiratory distress syndrome is a significant problem for babies born preterm. For these babies, a significant number will require support for their breathing. These babies are also at increased risk of dying, and in survivors, there is a risk of long-term disability. It is uncertain if giving vaginal progesterone therapy during pregnancy to women who have had a previous preterm birth can reduce these risks.
Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$718,055.00
Summary
Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of pre ....Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of prenatal corticosteroids is beneficial or harmful. In this clinical trial we will test what effect, if any, repeat doses of corticosteroids given to women who remain at risk of pretermbirth, have on children at the age of two years Women are eligible for the trial if at of less than 32 weeks of pregnancy, they have received corticosteroids seven or more days ago, and they are considered to be at continued risk of preterm birth. Women are randomised to one of the two treatment groups. Half the women will receive a weekly intramuscular injection of corticosteroids up to the time of birth or 32 weeks gestation, whichever is earlier, whilst the risk of very preterm birth remains. The other half of the women will receive a saline placebo injection. Chance will decide which treatment the women receives. In this study all children who survive to 2 years corrected age will be assessed to see if they have any problems with their health, growth and development. In particular we will assess how well they can walk, talk, understand, see and hear. The trial will be able to assess whether repeat doses of prenatal corticosteroids are helpful or not for infants at risk of being born very preterm by comparing the short term effects on infant health after birth and whilst in hospital with the effects on the child's later health, growth and development. An economic assessment of repeat doses of prenatal corticosteroids will be made in these children.Read moreRead less
Vaginal Progesterone For The Prevention Of Neonatal Respiratory Distress Syndrome - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,243,111.00
Summary
Respiratory Distress Syndrome is a significant problem for babies born very preterm (at less than 34 weeks of pregnancy). For these babies, over 90% will require support for their breathing. These babies are also at increased risk of dying, and in survivors, there is a risk of long-term disability. It is uncertain if giving vaginal progesterone therapy during pregnancy to women who have had a previous preterm birth can reduce these risks. This randomised controlled trial will assess the use of v ....Respiratory Distress Syndrome is a significant problem for babies born very preterm (at less than 34 weeks of pregnancy). For these babies, over 90% will require support for their breathing. These babies are also at increased risk of dying, and in survivors, there is a risk of long-term disability. It is uncertain if giving vaginal progesterone therapy during pregnancy to women who have had a previous preterm birth can reduce these risks. This randomised controlled trial will assess the use of vaginal progesterone therapy for women at risk of preterm birth as a means of reducing the risk of neonatal Respiratory Distress Syndrome and improving the outcomes of their babies.Read moreRead less