A Randomised Control Trial Of Medical Treatment Versus The Placement Of The Lap Band In Severely Obese Adolescents.
Funder
National Health and Medical Research Council
Funding Amount
$481,905.00
Summary
There has been a substantial rise in the number of overweight and obese adolescents in our community. While prevention of obesity is the ultimate goal, effective stratagies for the management of obese adolescents must be sought. Unfortunately there are few studies that have focused on this problem in adolescents and success has been very limited. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in severely obese (body mass index > 35 kg-m2) adul ....There has been a substantial rise in the number of overweight and obese adolescents in our community. While prevention of obesity is the ultimate goal, effective stratagies for the management of obese adolescents must be sought. Unfortunately there are few studies that have focused on this problem in adolescents and success has been very limited. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in severely obese (body mass index > 35 kg-m2) adults and there are now several small studies that demonstrate its effectiveness in adolescents. Modern obesity surgery involving the keyhole placement of an adjustable band around the very upper part of the stomach has proven to be safe and effective and requires one 24 hr stay in hospital. In this collaborative study, involving the Monash University Centre for Obesity Research and Education and the Royal Children's Hospital, we propose to formally test, for the first time, the effectiveness of a weight loss program that includes adjustable band surgery, and compare this with a comprehensive best care behavioral program, over a period of 2-years in severely obese adolescents. We estimate that suitable subjects will come from the top 1% for body mass index in our community. After thorough assessment 50 suitable candidates with ages ranging from 14 to 18 years will be randomly allocated to one of the two treatment programs. The intensity of each program will be similar. A broad range of measues including: weight, health status, physical disability, psychological status, body image and quality of life, will be performed before and at completion of the 2-year programs. In addition we will compare the complications, compliance and cost of the two programs. This study will help us assess and compare the effectiveness of the 2 programs and provide vital information regarding the role of modern keyhole obesity surgery for the management of severely obese adolescents.Read moreRead less
Understanding The Factors Governing Susceptibility And Outcome In Childhood Infection
Funder
National Health and Medical Research Council
Funding Amount
$276,122.00
Summary
This research seeks to understand why a minority of children are prone to severe and often life-threatening infections and inflammation. It focusses on infections both in preterm infants and in later childhood, which may also be relevant to understanding atherosclerosis. I am also interested in improving the health of recently arrived refugees, by conducting research that allows the development of evidence-based health interventions and developing national policy on refugee health.
In Vitro And In Vivo Assessment Of The Funhaler -an Innovative Therapeutic Device For Children
Funder
National Health and Medical Research Council
Funding Amount
$472,750.00
Summary
Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler ....Aerosol therapy is the most effective form of treatment for children with respiratory diseases such as asthma. While optimising aerosol delivery systems has an important role in increasing the efficacy of asthma therapy, ensuring patient compliance is often the most difficult part of the clinician's role, particularly in the paediatric age group. An innovative small volume spacer device (Funhaler) developed by a West Australian company (InfaMed, Ltd) may help overcome this problem. The Funhaler incorporates a spinning toy attached to the outside of the spacer. The toy is activated when the patient breathes through the spacer. The device has been designed to encourage children to co-operate when their asthma therapy is being delivered. The Funhaler is currently in the late development stage. We propose, firstly, to carry out in vitro assessments of drug delivery from the Funhaler compared to the two most widely available small volume spacers: the Aerochamber Plus (Trudell, Canada) and the Breath-A-Tech (Scott-Dibben, Australia). These assessments will be carried out to meet the standards of regulatory bodies worldwide (including the FDA). Secondly, we propose to perform extensive in vivo studie: filter studies to assess drug delivery to the patient; deposition studies to measure drug deposition in the lungs; and a pilot clinical trial to assess the efficacy of the device during medium to long-term use in children aged 2-8 years.Read moreRead less
A Randomized Controlled Trial Of Effects Of Early Life Exposure To General Anaesthesia On Neurobehavioural Outcomes In Children With Cystic Fibrosis (CF)
Funder
National Health and Medical Research Council
Funding Amount
$587,240.00
Summary
Anaesthesia permits surgeries and other interventional procedures that benefit the health of children to be performed painlessly and non-traumatically. This study will provide critical information about whether the drugs used commonly for general anaesthesia represents a risk to very young children in terms of their neurobehavioural development.
Limiting Tuberculosis Transmission And Improving The Care Of Affected Children
Funder
National Health and Medical Research Council
Funding Amount
$412,419.00
Summary
Tuberculosis (TB) is the biggest infectious disease killer on the planet. Drug-resistant TB poses a particular challenge in the Asia-Pacific region. My research will assist Australia to progress towards domestic TB elimination. It will improve the management of “difficult to treat” cases and help to safeguard the public against ongoing TB transmission. Work in neighbouring countries will help to contain the spread of drug-resistant TB and protect vulnerable young children.
Invasive Staphylococcus Aureus Disease In Children; Epidemiology, Treatment And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$124,676.00
Summary
This project will involve a systematic review of randomised controlled trials (RCT) on the treatment Staphylococcus aureus bacteraemia (SAB) as well as a local WA retrospective review to quantify disease burden, trends and outcome. A prospective 2-year multicentre Australian review will then identify variables that can predict complicated and uncomplicated SAB. This information will then be used to design a RCT protocol on risk-stratified treatment approaches for SAB in paediatrics.
Bio-molecular Studies For Improved Diagnosis And Management Of Australian Children With Fish Allergy
Funder
National Health and Medical Research Council
Funding Amount
$496,602.00
Summary
Allergy to fish among children is often life-long and emerging as a significant healthcare issue worldwide, while management of fish allergy is challenging due to the lack of reliable diagnostic assays. This research grant will lead to the development of novel diagnostics for fish allergy in Australia, addressing aspects of the worldwide food allergy epidemic and forms the ideal platform for the study of fish specific allergens, generating novel knowledge for greatly improved patient management.
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.
Efficacy Of Interventions For Equinus Gait In Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
Muscle spasticity is a primary cause of disability in children with cerebral palsy; however their muscles also do not develop properly: they are weak and resistant to stretch. This study will examine the precise muscle adaptations that occur due to spasticity using innovative ultrasound techniques and motion analysis. The influence of BOTOX treatment and orthopaedic surgery on muscle structure and function will be evaluated. This research will translate into better intervention planning.
The Clinical Utility Of Small Airway Function Tests In Paediatric Respiratory Disease
Funder
National Health and Medical Research Council
Funding Amount
$64,631.00
Summary
Respiratory disease is an important child health issue with long term implications into adulthood. The evaluation of small airways involvement in disease processes, using an accurate sensitive measures of function, such as forced oscillation technique and multiple breath washout, potentially facilitates not only early detection of disease, but instigation of earlier treatment, better assessment of response to treatment, and ultimately better outcome.