Precision medicine: Pharmacokinetic strategies to optimise transplant immune suppression (and other uses)

Kidney transplantation is the best treatment for children with end-stage kidney disease. However, the typical transplanted kidney fails substantially short of recipient life expectancy, due largely to chronic rejection. At the same time, the immunosuppressant drugs needed to prevent rejection sometimes cause morbidity and even mortality, from infection, cardiovascular disease and malignancy. Achieving the optimal balance between rejection risk and immunosuppressant toxicity is a critical challenge. Patients vary in how they respond to immunosuppressant drugs, so it’s very hard to get it right every time.

Neuro-Oncology: The past, the present and the future

Neuro-Oncology had stagnated for several decades with little to no improvement in patient outcomes despite marked improvements in other areas of paediatric oncology. With the advent of advanced genomics and epigenomics and an explosion in our understanding of disease, we are finally seeing improvements. Dr Hansford will discuss the advances in modern Paediatric Neuro-Oncology and highlight the opportunities, problems and challenges as we push for better cure rates and quality of survivorship into the future for children with brain tumours.

Digital Health on the Melbourne Children’s Campus: innovation, evidence and translation

Global demand for accessible, evidence-based and cost-effective healthcare is rising. Advances in technology together with its increasing use and declining costs have provided valuable opportunities for greater application of digital applications in healthcare. However, only a small percentage of digital apps have undergone clinical validation, and healthcare organisations are not traditionally equipped to innovate, evaluate and implement digital technology solutions.

The crying infant – diagnosis and management strategies

All babies cry. What is normal and what is abnormal? Is the crying excessive or is that mother’s perception. What causes the crying – hunger, over handling, “wind”, “colic”, “silent reflux”, allergy?

Patient Reported Outcomes in children’s health services: why should we use them and how can they be embedded in Epic?

Patient Reported Outcomes (PRO) have been used for decades in clinical trials, observational studies, population health surveys, and for estimates of quality of life in economic evaluations. However, the use of PROs as part of routine measurement in clinical settings is relatively new.  In this Grand Round, 3 speakers will discuss the use of PROs in the UK, in mental health at RCH and integrating PROs into the EMR.

Crowd-funding and other social media use by families

One of the growing worldwide challenges in paediatric health care is how to understand and respond to some of the many ways in which families of sick children use social media. This presentation draws together a number of strands of thought from my recent sabbatical in the UK, where the paediatric hospital staff are still experiencing the flow-on effects of the high-profile (and high-conflict) social media campaigns run by parents of Charlie Gard and Alfie Evans. I will present some data from two recent studies of how families in UK and Australia use social media, especially crowd-funding, and then raise for discussion some of the ethical and social challenges arising from social media use.

Influencing global immunisation policy through research in the Asia-Pacific region

Pneumonia is the commonest cause of childhood death throughout the world, especially in low and middle income countries. The pneumococcal conjugate vaccine (PCV) has been available for 19 years, but there are still many outstanding issues in its use: how do we measure the impact of this vaccine when the causes of pneumonia are many; how do we monitor serotype replacement in the post-PCV era; how do we measure herd protection; and how many doses of the vaccine are really needed for optimal protection?

RSV @ RCH (and elsewhere)

Respiratory syncytial virus (RSV) is a leading cause of severe acute respiratory infections (SARI) in children in countries throughout the world. The Royal Children’s Hospital (RCH) emergency department, wards and intensive care unit are full of patients with RSV infections (including bronchiolitis) from April to September, with a peak in June-July. The Melbourne Children’s campus has a long history of RSV associated research, including clinical trials encompassing preventative, supportive and therapeutic strategies.

Working effectively with gender and sexuality diverse children and young people in health care

Drawing on several recent and ongoing Australian research projects, funded by the Australian Research Council and the Collaborative Research Centre (CRC), ‘Young and Well’, this presentation focuses on how health care professionals can most effectively engage with sexuality and gender diverse children and young people to provide the most inclusive and affirmative care.