Generation Victoria (GenV) Solving complex issues affecting children and adults – a whole-of-state cohort with whole-of-campus implications

GenV’s vision is to help solve complex issues affecting today’s children and adults through an entire Australian state becoming a single platform that enhances research speed, capacity and translation. Led from the Melbourne Children’s Campus, the GenV Cohort will be open to the families of all 170,000 Victorian newborns over 2021-2. At its foundation are consent; existing geospatial, clinical and administrative data; biosamples; GenV-specific data; and melding observational and intervention design

Global health, the Australian government aid program and the triple transition

Widening health inequities, emerging disease threats, and shortfalls in financing for health are challenging the gains made in global health over the past 20 years.  Many countries face a ‘triple transition’: Epidemiologically –  from infectious to chronic diseases; Financially – from donor to domestic financing of health, and Structurally – as health systems reorganise to achieve universal health coverage.  Dr Stephanie Williams will provide an overview of Australia’s global health contribution with practical examples of how the aid program is adapting to these changes.

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.

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?