Adolescents

Parental refusal of treatment for leukaemia – When courts decide

Olivia is a 14-year-old girl from rural NSW who was diagnosed with Pre B Acute Lymphoblastic Leukemia (ALL).  The treatment is long and arduous, but if treated immediately has a 90 percent survival rate. Without treatment she will die within four weeks. Olivia has other conditions including epileptic encephalopathy (DEE), a severe intellectual disability, global developmental delay, communication difficulties, drug-resistant seizures and behavioural difficulties. The cancer therapy would require Olivia to have over 50 general anaesthetics as she won’t accept treatment without being restrained.  

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Aboriginal child health and Out of Home Care in Victoria

The Royal Children’s Hospital had over 7000 interactions with Aboriginal children and families last year.  Wadja Aboriginal Family Place Case Managers provide culturally sensitive support and care coordination to Aboriginal and Torres Strait families attending the hospital, either as inpatients or outpatients. 

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The revolution in the treatment of genetic skeletal disorders: precision therapy in practice

Over the past 15 years, the treatment of genetic skeletal disorders has evolved from purely symptomatic, to the emergence of several precision therapies that promise to change the health outcomes of children affected by these conditions. We have led this knowledge transformation, enabled and fueled by the genomics revolution. This Grand Round will update the progress on the precision treatment of genetic skeletal disorders that sets a template for the better treatment of many other rare genetic conditions.

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The Centre for Adolescent Health: Supporting the healthy development of young people

Spanning the three campus partners, the Centre for the Adolescent Health has driven actions for adolescent health over more than 3 decades, with the aim of understanding and promoting the healthy development of young people, locally and globally. Newly appointed as a Professor of Adolescent Health, Professor Peter Azzopardi will share his personal journey in adolescent health, and in doing so will celebrate the legacy of the late Professor George Patton. 

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We need to talk about sepsis!

In the emergency setting, sepsis is the primary or differential diagnosis for a substantial proportion of febrile or unwell children. In this Grand Round, we will discuss challenges with early recognition and initial management of sepsis in children. We will discuss RCH efforts to improve the care of children with sepsis, including local, national, and international collaborations.

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Children having tests, treatments, examinations and interventions; proposing an approach to minimise anxiety, distress, restraint and harm

This Grand Round will provide a critical overview of what we know about holding children for clinical procedures, considering the child, parent, health professional and system factors which can influence procedural practice. Lucy will discuss an approach to challenge accepted narratives within practice and adopt a more child-centred rights-based approach to reduce harm and the use of restrictive practice during procedures.

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100 years of insulin at The Royal Children’s Hospital – pigs, pumps and pluripotent potential

One hundred years ago the first insulin injection was given at RCH. Overnight, type 1 diabetes went from a fatal to a ‘manageable’ condition. Since that time, diabetes management has developed and evolved to a point where in the near future it is hoped that exogenous insulin will represent a treatment failure rather than a therapeutic mainstay. This Grand Round will trace the history of insulin therapy and diabetes management at RCH, and discuss the likely direction of new therapies in the upcoming decades.

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Exploring the role of rehabilitation services in the management of Functional Neurological Disorders

The approach and attitude towards Functional Neurological Disorders (FND) has changed over the last decade and anecdotally at least, we seem to be seeing more cases in our day-to-day practice.  Patients with functional symptoms present to many disciplines and functional symptoms can co-exist with organic pathology. There is now evidence to show earlier diagnosis and treatment can lead to more positive outcomes.   

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