There has in recent years been a rapid increase in the number and complexity of clinical trials and novel therapies for neurogenetic conditions. Many of these conditions are individually rare, but their impact upon affected children and their families may be very severe. While the increasing awareness and availability of new treatments brings great hope and excitement for all involved in care of these children, it also presents significant challenges for clinicians and for patients and their families.
Fortunately, COVID-19 in children is generally mild. However, the necessary public health mitigation measures to control community transmission have resulted in many unintended consequences for families and children.
How are Victorian children tracking during the pandemic? What can families do to help their children through these uncertain times? And how are young people with disabilities faring?
For several months, we have experienced significant restrictions on how we live and work. Whilst Victoria’s strict lockdown protocols are working to suppress the virus, for many of us, social isolation has taken a toll on mental health. Our new reality, and the social, mental and emotional deprivation that accompanies it, highlights that what we do in life and who we do it with, are critical to how we feel.
The COVID-19 pandemic is forcing us to re-organize and re-conceptualize many aspects of our lives. In this Grand Round, I will start with some general thoughts about these changes. Then, I will focus specifically on the challenges that the pandemic creates for the way that we oversee and regulate clinical research. I will speculate about whether some of these changes represent a better way of doing things and thus ought to change the way we practice after the pandemic.
Chimeric Antigen Receptor (CAR) T cells have revolutionised treatment for patients with acute lymphoblastic leukaemia (ALL) where standard therapies have failed. We reflect on our first 12 months as the first national paediatric referral centre providing CAR T cell treatment to children with relapsed or refractory ALL from Australia and New Zealand, and highlight the collective efforts and lessons for the hospital-wide CAR T cell team.
Currently in Australia, children as young as 10 years old can be arrested, held in police cells, taken before a magistrate and incarcerated in prison-like settings. Most children who are incarcerated are never convicted of a crime.
In the early decades of European settlement, Australia was free of some infectious diseases such as measles, scarlet fever and diphtheria which could not survive the long voyage to Australia. When these infections did arrive, as shipping times reduced, resistance was low and severe epidemics occurred, especially among children in the crowded slums of the cities, and among indigenous populations who were previously free of these infections.
Creating a preferred future implies vision, thoughtfulness and actions. It requires knowledge and skills that are developed over time. To craft a future for ourselves or to contribute to the crafting of another’s future, means we need to think and act creatively and thoughtfully.
It is well established that kids get less sick from COVID-19 than adults. However, what do we know about the extent infected children contribute to spreading the virus?
With some areas of Melbourne approaching their third week of lockdown and widespread community transmission, how do we make decisions about when it’s safe to reopen schools and what can we do to prevent kids from transmitting the virus? At Melbourne’s largest children’s hospital, we will hear what the commonest conditions are that are causing kids to get sick during the COVID-19 pandemic.
The effect of epidemics on pregnant women and newborns has often been neglected, so what do we know about the effects of COVID-19 in pregnancy and newborns?
As vaccines and other treatments are developed, should pregnant women also be included in clinical trials?
In low- and middle-income countries, disruption of essential maternity and newborn services may erode many of the gains made in maternal and child health over the past two decades.