51 results match your criteria: "Melbourne Children's Trials Centre[Affiliation]"
BMJ Open
December 2024
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Introduction: Infants born very preterm (VPT, <32 weeks' gestation) are at increased risk for neurodevelopmental impairments including motor, cognitive and behavioural delay. Parents of infants born VPT also have poorer mental health outcomes compared with parents of infants born at term.We have developed an intervention programme called TEDI-Prem (Telehealth for Early Developmental Intervention in babies born very preterm) based on previous research.
View Article and Find Full Text PDFPLoS One
December 2024
Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, Australia.
In children with cancer, febrile neutropenia (FN) is one of the most common complications of treatment, a leading cause of unplanned and prolonged hospital admission and is the key driver of antibiotic exposure. Co-designed with key stakeholders, 'Early versus Late Stopping of Antibiotics in high-risk FN' (ELSA-FN) is a randomised controlled, non-inferiority trial that compares stopping antibiotics in clinically stable patients after 48 hours with the current standard of care, continuing antibiotics until absolute neutrophil recovery. As an Australian first, we will exploit the potential of electronic medical record (EMR) systems, embedding all key aspects of the trial including screening, consent, randomisation and data collection into standard clinical and EMR workflows.
View Article and Find Full Text PDFAnesthesiology
October 2024
Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia. Email:
Background: Postoperative nausea and vomiting (PONV) is common after general anesthesia, with consequences for patient outcomes, satisfaction with care and healthcare costs. Our aim was to compare a new treatment, chewing gum, with a widely-used intravenous agent, ondansetron, to treat PONV in female patients in the post anesthesia care unit (PACU).
Methods: We conducted a multicenter, randomized, controlled non-inferiority trial in 17 hospitals in Australia and New Zealand.
Background: Following reduction of public health and social measures concurrent with SARS-CoV-2 Omicron emergence in late 2021 in Australia, COVID-19 case notification rates rose rapidly. As rates of direct viral testing and reporting dropped, true infection rates were most likely to be underestimated.
Objective: To better understand infection rates and immunity in this population, we aimed to estimate SARS-CoV-2 seroprevalence in Australians aged 0-19 years.
Anesthesiology
December 2024
The Children's Hospital at Westmead, Sydney, New South Wales, Australia; and University of Sydney, Sydney, New South Wales, Australia.
Background: The Trial Remifentanil DEXmedetomidine (TREX) trial aimed to determine whether, in children less than 2 yr old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard-dose sevoflurane anesthesia in terms of global cognitive function at 3 yr of age. The aim of the current secondary analyses was to compare incidence of intraoperative hypotension and bradycardia, postoperative pain, time to recovery, need for treatment of intraoperative hypotension and bradycardia, incidence of light anesthesia and need for treatment, need for postoperative pain medications, and morbidity and mortality outcomes at 5 days between the two arms.
Methods: This phase III randomized active controlled, parallel group, assessor blinded, multicenter, superiority trial was performed in 20 centers in Australia, Italy, and the United States.
Emerg Med Australas
February 2025
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Objective: Intranasal (IN) fentanyl and nitrous oxide (NO) can be combined to provide procedural sedation and analgesia to children. This combination is advantageous because of rapid onset of action and non-parenteral administration, but is associated with increased vomiting. We sought to describe the associations of demographic and procedural factors with early vomiting when using this combination in children.
View Article and Find Full Text PDFPaediatr Anaesth
June 2024
Department of Anesthesia, Royal Children's Hospital, Melbourne, Victoria, Australia.
Arch Dis Child
October 2023
Centre for Community Child Health, The Royal Children's Hospital, Parkville, Vic, Australia.
Objective: Nurse home visiting (NHV) is designed to redress child and maternal health inequities. Of the previous trials to investigate NHV benefits beyond preschool, none were designed for populations with universal healthcare. To address this evidence gap, we investigated whether the Australian 'right@home' NHV programme improved child and maternal outcomes when children turned 6 and started school.
View Article and Find Full Text PDFAust N Z J Psychiatry
August 2023
Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
Objective: The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD.
Methods: Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework.
Anesthesiology
June 2023
Department of Anaesthesia, Royal Children's Hospital Melbourne; Departments of Paediatrics, and Critical Care, University of Melbourne; and Anaesthesia Research and Melbourne Children's Trials Centre, Murdoch Children's Research Institute, Melbourne, Australia.
N Engl J Med
April 2023
From the Infectious Diseases Group (L.F.P., N.L.M., V.A., R.B., K.G., G.G., S.G., C.G., A.G., T.J., E.M., S.P., J.W.T., P.V., N.C.), Melbourne Children's Trials Centre (F.O., C.L.M., K.J.L., K.P.P., A.D.), and the Clinical Epidemiology and Biostatistics Unit (F.O., C.L.M., K.J.L.), Murdoch Children's Research Institute, the Department of Paediatrics, University of Melbourne (L.F.P., N.L.M., A.G., K.J.L., K.P.P., P.V., N.C.), the Infectious Diseases Unit (L.F.P., A.G., P.V., N.C.), Research Operations (K.G.), and the Department of Allergy and Immunology (K.P.P.), Royal Children's Hospital Melbourne, and the Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity (S.N.), Parkville, VIC, Precision Medicine Theme, South Australian Health and Medical Research Institute (S.B., D.J.L.), the Department of Thoracic Medicine, Royal Adelaide Hospital (S.B.), and Adelaide Medical School and Robinson Research Institute, University of Adelaide (H.S.M.), Adelaide, SA, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute (T.R.K., L.M., P.C.R.), the Department of Immunology, PathWest, Queen Elizabeth II Medical Centre (M.L.), the Department of Immunology, Sir Charles Gairdner Hospital (M.L.), and the Department of Immunology and General Paediatrics, Perth Children's Hospital (M.L., P.C.R.), Nedlands, WA, the University of Western Australia Medical School, Perth (M.L., L.M., P.C.R.), Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA (D.J.L.), the Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch, WA (L.M.), the Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, North Adelaide, SA (H.S.M.), the Department of Endocrinology and Diabetes, Children's Hospital at Westmead (C.F.M.), Sydney Children's Hospitals Network (N.J.W.), and the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Disease (N.J.W.), Westmead, NSW, and the Faculty of Medicine and Health, University of Sydney, Sydney (C.F.M., N.J.W.) - all in Australia; the Infectious Diseases Unit, Department of Pediatrics, Gynecology, and Obstetrics, Faculty of Medicine, University of Geneva and University Hospitals of Geneva, Geneva (L.F.P.); the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (M.B., C.P.-A.); Exeter Collaboration for Academic Primary Care (J. Campbell) and Exeter Clinical Trials Unit (A.O.), University of Exeter Medical School, and the Medical Research Council Centre for Medical Mycology, University of Exeter (A.W.) - both in Exeter, United Kingdom; Fiocruz Mato Grosso do Sul, Fundação Oswaldo Cruz (J. Croda), and Universidade Federal de Mato Grosso do Sul (J. Croda, R.D.O., P.V.S.), Campo Grande, Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health (M.D., G.S.), Catholic University (M.D.), and Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (A.G.-S.), Rio de Janeiro, and the Institute of Clinical Research Carlos Borborema, Doctor Heitor Vieira Dourado Tropical Medicine Foundation (B.J., M.V.G.L.), and Instituto Leônidas and Maria Deane, Oswaldo Cruz Foundation Ministry of Health (M.V.G.L.), Manaus - all in Brazil; the Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT (J. Croda); University of Texas Medical Branch, Galveston (M.V.G.L.); and Institut d'Investigació Germans Trias i Pujol, Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Barcelona (C.P.-A.), the Division of Infectious Diseases and Microbiology, Hospital Universitario Virgen Macarena, and the Department of Medicine, University of Seville, Biomedicines Institute of Seville-Consejo Superior de Investigaciones Científicas, Seville (J.R.-B.), and CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid (J.R.-B.) - all in Spain.
Background: The bacille Calmette-Guérin (BCG) vaccine has immunomodulatory "off-target" effects that have been hypothesized to protect against coronavirus disease 2019 (Covid-19).
Methods: In this international, double-blind, placebo-controlled trial, we randomly assigned health care workers to receive the BCG-Denmark vaccine or saline placebo and followed them for 12 months. Symptomatic Covid-19 and severe Covid-19, the primary outcomes, were assessed at 6 months; the primary analyses involved the modified intention-to-treat population, which was restricted to participants with a negative test for severe acute respiratory syndrome coronavirus 2 at baseline.
BMJ Open
March 2023
Emergency Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Introduction: Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in emergency departments (EDs) in adults and young people. Despite the increasing number of presentations and significant associated risks to patients, families and caregivers, there is limited evidence to guide the most effective pharmacological management in children and adolescents. The aim of this study is to determine whether a single dose of oral olanzapine is more effective than a dose of oral diazepam at successfully sedating young people with ASBD.
View Article and Find Full Text PDFBMJ Open
March 2023
Emergency Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Introduction: Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in emergency departments (EDs) in adults and young people. Despite the increasing number of presentations and significant associated risks to patients, families and caregivers, there is limited evidence to guide the most effective pharmacological management in children and adolescents. The aim of this study is to determine whether a single dose of intramuscular olanzapine is more effective than intramuscular droperidol at successfully sedating young people with ASBD requiring intramuscular sedation.
View Article and Find Full Text PDFExpert Rev Anti Infect Ther
March 2023
Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia.
Introduction: Febrile neutropenia is a common complication experienced by children with cancer or those undergoing hematopoietic stem cell transplantation. Repeated episodes of febrile neutropenia result in cumulative exposure to broad-spectrum antibiotics with potential for a range of serious adverse effects. Short-course antibiotics, even in patients with high-risk febrile neutropenia, may offer a solution.
View Article and Find Full Text PDFInt J Antimicrob Agents
March 2023
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Background: Empiric vancomycin dosing regimens fail to achieve recommended target trough concentrations of 10-20 mg/L in the majority of infants. This study assessed the performance of a model-based dosing calculator (Vanc App) in achieving target vancomycin concentrations at first steady-state level.
Methods: This was a multicenter prospective study in four tertiary pediatric hospitals over an 18-month period.
PLoS One
November 2022
Ingham Institute, Western Sydney University, Penrith, NSW, Australia.
Objectives: Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program ("right@home") in promoting children's language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years.
View Article and Find Full Text PDFJ Paediatr Child Health
December 2022
Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
Aim: To determine the prevalence of high flow nasal cannula (HFNC) therapy in infants presenting to hospital in Australia and New Zealand with bronchiolitis over four bronchiolitis seasons. Secondary aims were to determine temporal trends in HFNC use, and associations between HFNC, hospital length of stay (LOS) and intensive care unit (ICU) admission.
Methods: A planned sub-study of a multi-centre international cluster randomised controlled trial investigating knowledge translation strategies for a bi-national bronchiolitis guideline.
BMC Health Serv Res
August 2022
Emergency Research, Murdoch Children's Research Institute, The Royal Children's Hospital, Level 4 West, 50 Flemington Road, Parkville, VIC, 3052, Australia.
Background: Understanding how and why de-implementation of low-value practices is sustained remains unclear. The Paediatric Research in Emergency Departments International CollaboraTive (PREDICT) Bronchiolitis Knowledge Translation (KT) Study was a cluster randomised controlled trial conducted in 26 Australian and New Zealand hospitals (May-November 2017). Results showed targeted, theory-informed interventions (clinical leads, stakeholder meetings, train-the-trainer workshop, targeted educational package, audit/feedback) were effective at reducing use of five low-value practices for bronchiolitis (salbutamol, glucocorticoids, antibiotics, adrenaline and chest x-ray) by 14.
View Article and Find Full Text PDFDisabil Rehabil
June 2023
Murdoch Children's Research Institute, Melbourne Children's Trials Centre, Parkville, Australia.
Purpose: To investigate the effects of providing rigid wrist-hand orthoses plus usual multidisciplinary care, on reducing hand impairments in children with cerebral palsy.
Methods: A pragmatic, multicentre, assessor-blinded randomised controlled trial aimed to enrol 194 children aged 5-15 years, with wrist flexor Modified Ashworth Scale score ≥1. Randomisation with concealed allocation was stratified by study site and passive wrist range.
Pediatrics
May 2022
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
BMJ Open
December 2021
School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia.
Objectives: To investigate the additional programme cost and cost-effectiveness of 'right@home' Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care.
Design: A cost-utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%.
J Paediatr Child Health
February 2022
Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
Aim: This study aimed to determine whether targeted interventions, proven to be effective at improving evidence-based bronchiolitis management, changed factors previously found to influence variation in bronchiolitis management.
Methods: This survey assessed change in factors influencing clinicians' (nurses and doctors) bronchiolitis management at baseline and post-intervention in a cluster randomised controlled trial of targeted, theory-informed interventions aiming to de-implement non-evidence-based bronchiolitis management (no use of chest X-ray, salbutamol, antibiotics, glucocorticoids and adrenaline). Survey questions addressed previously identified factors influencing bronchiolitis management from six Theoretical Domains Framework domains (knowledge; skills; beliefs about consequences; social/professional role and identity; environmental context and resources; social influences).
Dev Med Child Neurol
February 2022
Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia.
Aim: To determine whether a task-specific physiotherapist-led training approach is more effective than a non-specific parent-led home programme for attaining bicycle-riding goals in ambulant children with cerebral palsy (CP).
Method: Sixty-two ambulant children with CP aged 6 to 15 years (33 males, 29 females, mean age 9y 6mo) with bicycle-riding goals participated in this multi-centre, assessor-blind, parallel-group, superiority randomized controlled trial. Children in the task-specific group participated in a physiotherapist-led, group-based, intensive training programme.
BMJ Open
July 2021
Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
Introduction: Egg allergy is the most common food allergy in children but recent studies have shown persistence or delayed resolution into adolescence. As there is currently no effective long-term treatment, definitive treatments that improve quality of life and prevent fatalities for food allergies are required. We have previously shown that a novel treatment comprising a combination of the probiotic CGMCC 1.
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