Infantile reflux is the most common problematic early childhood condition encountered by doctors. Symptoms of infant reflux are diverse and could be due to a variety of other causes, making it difficult to diagnose and leading to inappropriate and often unnecessary therapies. We will assess the effectiveness of therapies known to reduce reflux acidity or volume by using novel diagnostic systems to determine if symptoms are reflux related and if so, whether symptoms are due to acid or volume reflux.

Surgery and anaesthesia can be stressful for children. This stress may be demonstrated as anxiety or post-operative behaviour disturbance (POBD). Using a premedication, such as midazolam, usually reduces pre-operative anxiety, but it does not always work. The use of another medication, pregabalin has been promoted in adults both for its anxiolytic and analgesic properties. The aim of this project is to determine if pregabalin is superior to midazolam at reducing POBD, anxiety and post-operative pain in children having day surgery.

Infantile eczema is a common condition, and infants with eczema often develop asthma. Damaged skin caused by eczema probably leads to sensitisation to inhaled allergens and subsequently asthma. Both eczema and asthma may be prevented by improving the infants' skin-barrier-function in early life. Unlike topical steroids, a new ceramide-based cream has been shown to improve skin barrier function. We will conduct a randomised-controlled-study of a ceramide cream for the prevention of eczema in infants, and eventually childhood asthma.

We do not understand why childhood diabetes is increasing rapidly among Australian children. The increase is likely to be due to environment. This project aims to investigate the role of the modern child's early life environment so that possible adverse risk factors for T1DM (e.g. sun avoidance, adequate exposure to minor infections, diet and child obesity) can be identified and then better advice can be provided to new parents on the optimal child environment required to reduce the risk of type 1 diabetes.

Aboriginal Australians have 2 to 10 times the rate of chronic kidney disease and premature death from cardiovascular disease compared with non-Aboriginal Australians. Our 6 year follow-up of Aboriginal children from diverse NSW areas has shown no increase in risk for these diseases when compared with non-Aboriginal children. The Aboriginal Health Worker for whom funding is requested will work with the ARDAC Second Phase Study and follow the participants for another 6 years to determine whether these health disparities start to manifest in young Aboriginal adults.

Retinal vessel calibre can be viewed non-invasively in children, and has been linked to heart disease in adulthood. There is new evidence that genetic factors may influence retinal calibre. This study will examine retinal vessel calibre in a population of twin children and compare the correlation of the retinal calibre between identical and non-identical twins. Findings from the study will provide important insights into the genetic determinants of retinal vessel calibre and the development of vascular diseases in early life.

This work builds on our report in the British Medical Journal in 2010 that mothers who experienced lower sunlight levels during early pregnancy were more likely to have offspring who later developed multiple sclerosis (MS). We now are investigating if children who develop MS have either lower vitamin D levels at birth and/or lower sun exposure during early postnatal life. The study design is a case control study where children with early onset MS are compared to healthy controls.

Young people with developmental problems suffer from significantly high levels of behaviour and emotional problems. Difficulties present from an early age, persisting over time. To understand how these problems begin and develop treatments, we need to examine these difficulties in young children with developmental delay. This study aims to evaluate a measure to assess behaviour problems in young children with developmental delay, determine how many young children have behaviour problems, and how this impacts their families.

A new vaccine that targets the most common infection (NTHi) in the lungs of children with bronchiectasis is now available. We will assess if this vaccine is effective in reducing NTHi airway infection in children who have been immunised with this new vaccine. If effective, all children at risk of the airway infection would likely benefit from the use of this vaccine. We will also study the immune response of children who have and have not received this vaccine.

Attention deficit hyperactivity disorder (ADHD) affects up to 7.5% of Australian children. Between 50 and 70% of parents also report that their ADHD child has a sleep problem. Sleep problems are associated with poorer child behaviour, concentration, and school attendance. We want to know if managing sleep problems in ADHD children can improve these outcomes. This pilot will determine the best way to manage sleep problems in ADHD children and results will inform a larger effectiveness trial of this approach.

Cerebral palsy describes a number of debilitating conditions involving impaired movement due to brain damage early in life. Although cerebral palsy mostly originates before birth, diagnosis often has to wait until the second year of life. We propose that 'gene switches' known to be influenced by the environment in the womb can be used to identify which babies will develop cerebral palsy, enabling immediate intervention to help lessen the symptoms of this condition.

Significant changes occur in body composition, sensitivity to insulin, lipoprotein levels, blood pressure and hormones during pregnancy. We aim to determine the effect of the transition through puberty on vascular structure and function. We aim to examine which factors of pubertal development influence cardiovascular health. This project will provide information that will better inform prevention programs that target adolescents and aim to reduce the burden of future cardiovascular disease.

Excess weight gain during pregnancy is associated with an increased risk of childhood obesity and subsequent elevated risk for developing cardiovascular disease later in life. While lifestyle programs are recommended during pregnancy to limit excess weight gain, there is no research assessing their effect on childhood cardiovascular disease risk. This project will assess the effect of an antenatal lifestyle intervention designed to limit excess weight gain in overweight and obese pregnant women on infant obesity and cardiovascular risk.

Despite the increasing amount of research into childhood obesity, there is no co-ordinated approach to research in this area, either nationally of internationally. The Australian Child and Adolescent Obesity Research Network (ACAORN) aims to address this problem with an innovative proposal to set up databases of (1) Australian paediatric longitudinal studies related to obesity, (2) treatment trials in childhood obesity for a prospective meta-analysis and (3) measurement tools for diet, physical activity, sedentary behaviour, and measures related to community-based interventions.

Sudden unexplained death in children is a tragic event that can cause further devastating consequences to living family and friends of the deceased child. This proposed Australia-wide research initiative will shed light on the genetic cardiac causes of sudden unexplained death in children, enable clinical screening of at-risk family relatives, and allow the initiation of appropriate therapeutic and preventative strategies, with the primary goal to reduce the incidence of sudden death amongst children in Australia.

Bronchiolitis is the most common severe respiratory tract illness in infants and remains a major cause of hospitalisation. Apart from supportive intervention, there is no treatment. We have found that during bronchiolitis immune cells damage the lung, increasing disease severity and leading to asthma/wheeze in approximately 50% of patients. Recently our lab demonstrated the ability of a protein, feG, to treat such lung damage. We aim to test the therapeutic potential of feG in decreasing lung damage caused by bronchiolitis.

This study aims to develop a quality of life questionnaire for adolescents with cerebral palsy. This questionnaire is essential to evaluate the effectiveness of a range of interventions and to aid in service planning and delivery. This questionnaire is based on our recently developed cerebral palsy quality of life questionnaire for children (CP QOL-Child), which has been extremely successful and is currently being translated into five different languages and used in several clinical trials.

Our PREV-IX_COMBO trial of PREVenar13 and SynflorIX10 aims to determine whether a schedule of both vaccines, potentially maximising protection from all vaccine components, may be most beneficial for high risk children. Immune correlates are globally recognised as the most cost effective way to evaluate expanded conjugate vaccines and different schedules. At the same time, important inconsistencies have emerged. Linking this FFC project with data from the PREV-IX_COMBO trial will support evidence based decisions for PCVs in high risk children

Mitochondrial diseases are the most common inherited metabolic diseases of childhood. They usually affect brain, heart or muscle but currently lack any effective treatments. We have generated two mouse models of Complex I deficiency, the most common mitochondrial disease, one with heart disease and the other neurological disease. We will determine whether bezafibrate can prevent or retard progression of symptoms in these mice. We anticipate that this will provide strong justification for human treatment trials to improve wellbeing of patients.

This study aims to determine whether there are early markers of developmental outcomes (eg learning and language skills) in primary school children with autism.

To answer this question, we will follow-up the development of young children from early childhood to late primary school. Understanding of these markers of child outcomes will lead to an improved understanding of the pathways to successful development and adjustment. This will facilitate the identification of specific early interventions to aid in improving outcomes for children.

We will determine whether maternal obesity during pregnancy is associated with differences in the structure of the newborn's blood vessels, consistent with a heightened risk of developing heart disease later in life. If so, this will change the perception of obesity, from a problem affecting an individual's health to one that affects the health of others.

Potential underlying mechanisms will also be determined, including the health of the placenta and blood cholesterol levels, to assist in designing future intervention studies.

This project involves the development and piloting of the eADVICE-incontinence© program. This program, which is supervised by GPs, mimics multiple visits to a specialist paediatric continence service. It combines assessment, diagnosis, tailored treatment advice, monitoring and feedback and well as education of the GP and families. Parents can also input further information about their child's progress, with modification of the ongoing treatment advice. The program will then be piloted on 50 children with urinary incontinence.

A mother's health during pregnancy can have lasting effects on her child's health. Adequate vitamin D is essential for healthy bones, but it may also influence child development or the risk of allergic diseases like asthma or eczema. We will measure vitamin D levels of 1,500 newborn infants from 4 Australian states, then study whether vitamin D status affects childhood growth, development and allergy. This project will help define vitamin D levels needed for optimal health of Australian children.

We will evaluate the role and function of an Indigenous Reference Group (IRG) as a model for conducting research in Indigenous communities. The evaluation will incorporate: direct observation of IRG meetings; semi-structured focus group discussions and interviews involving community representatives and other stakeholders, study participants, IRG members and researchers. Thematic analysis will be used to analyse the qualitative data.

Food allergy affects ~10% of children and rates are rising. The greatest rise has occurred in children under the age of 5yr. Currently, there is no cure for food allergy. Management relies on food avoidance, which is difficult to achieve. Recent deaths in children from food allergy highlight the need for an effective treatment. This clinical trial will test a novel treatment for peanut allergy. If effective we will have a proof of principle for treatment of all food allergy.

Friedreichs Ataxia is an inherited disorder that results in progressive degeneration of the nervous system and the heart. The onset age of symptoms is during childhood and their quality of life is severely hampered. We will use stem cells derived from Friedreichs Ataxia patients to generate the specific nerve cell types affected in this disease. These studies are very important for developing cellular models of this disease to aid the progression of drug discoveries and well as cell replacement therapies.

This project will describe what health and wellbeing means for Aboriginal children from their point of view, hearing their voices, and working with them to develop solutions to challenges they see as priority health and wellbeing concerns. It has been developed in partnership with Aboriginal community members with whom the project team already has strong relationships. It makes an important contribution to closing the gap in outcomes for Aboriginal children and to developing solutions more clearly targeted to their needs.

Such studies are needed if EV vaccines and antivirals currently being trialled are to be used in the primary prevention of diabetes.

The proposed studies will address some of the major unanswered questions regarding the molecular characteristics of EVs associated with T1DM development. Our studies will also provide important information regarding the molecular characteristics of diabetes-inducing EVs, and may lead to potential identification of putative 'diabetogenic' EVs. Because EVs are ubiquitous viruses, the effects of EVs isolated from children with pre-diabetes or diabetes on ß-cell function must be compared with non-diabetogenic EVs. We are the only group in Australia researching the link between EV infection and the prevention of type 1 diabetes. We have internationally recognised research expertise in T1DM, virology and cell biology, and have preliminary results suggesting enterovirus-induced diabetes is strain-dependent (5), as outlined in the research plan below.

This interdisciplinary project aims to investigate the impact of parental work patterns on child mental health and to shed new light on the social and economic causes of the high prevalence of mental health problems in children. The future of society and economic prosperity rests in having all children equipped not only physically but also mentally for their participation in society. The goal is to inform policies and innovative interventions to improve the mental health and wellbeing of future generations.

The Children with Hearing Impairment in Victoria Outcome Study (CHIVOS) has followed 88 children since diagnosis of congenital hearing loss, supported by the Foundation for Children. After assessments at 7-8 and at 12-13 years, we can now determine what early factors most affect outcomes on the cusp of adulthood (17-18 years): quality of life, language, academic skills, physical and mental health and life views. The longest population study of congenital hearing loss, CHIVOS has important implications for deaf children born today.

Bronchiolitis is the most common cause of hospitalisation in infants, particularly Indigenous infants. Furthermore these infants are at greater risk of developing longer term respiratory problems. This study aims to:

1. Assess the ability of azithromycin to improve the immediate and longer term health of babies admitted to hospital with bronchiolitis, and
2. to determine which respiratory bacteria and viruses are a risk to children and how they affect the ability of our children to fight infection.

Annually, 8% of all babies in Australia are born premature (preterm). Being born preterm places infants at an increased risk of death and disability. Infection and fetal inflammation are common causes of preterm birth. We suggest that fetal skin may play an important role in the development of fetal inflammation and preterm birth. By studying fetal skin inflammation, we hope to better understand the causes of preterm birth and develop treatments to reduce the consequences of prematurity and fetal inflammation.

The Australian Temperament Project is one of Australia's most mature longitudinal studies of health and wellbeing. The study has captured unique information from parents and children over a 28-year period. The ATP children have now grown up and are having children of their own. This gives us an exceedingly rare opportunity to understand how patterns of health and wellbeing are handed down across the generations - from grandparents to parents to children - to inform new directions in preventive intervention.

Thirty children aged 2.5 - 15 years with upper limb impairment from cerebral palsy or an acquired brain injury will be administered the Melbourne Assessment on three occasions. Twenty of these children will be receiving intervention to their upper limb and ten children will be in the first six months of recovering from an acquired brain injury. Analysis of assessment scores across the three time points will determine if the scale is sensitive to detecting changes in upper limb abilities.

Protection from infection during early life is based on placental transfer of IgG (passive immunity). It is reported that many Australian indigenous infants succumb to ear infections caused by S. Pneumoniae in the first 6 weeks of life. Why does maternal transfer of IgG not protect these infants?

We aim to investigate passive immunity in this group and an indigenous group with similar socio-economic conditions but with no associated problems of ear infection.

Overweight/obesity affects around 25% of Australian children. New research suggests that shorter sleep duration in early childhood predicts later overweight/obesity. We have shown that a brief intervention suitable for public health uptake improves infant sleep problems. This follow-up study will determine whether it also reduces body mass index (BMI) and waist girth at age 6. Findings will be available by late 2010. If positive, the study will have immediate policy implications for preventing childhood obesity, as well as future research.

Information about the health needs of refugee children after settlement is scarce and existing research has tended to focus exclusively on either physical health or psychological wellbeing, mostly shortly after arrival. This study involves prospectively following a cohort of newly arrived refugee children for 2 years. The study will assess the physical health and psychological wellbeing of refugee children at regular intervals and will explore pre arrival and post arrival factors that contribute to favourable physical and psychological health outcomes at 2 years.

The aim of the Loozit study is to determine the effect of extended contact with a group leader over a 2 year period in overweight and obese adolescents attending a community-based weight management group program. We propose that extended contact with a group leader, by phone coaching and a combination of SMS text messages and/or email, will help obese adolescents to achieve and maintain the goals they set and will improve the outcomes of a high quality group weight management program.

The aim of the Loozit- study is to determine the effect of extended therapeutic contact over a 2 year period in overweight and obese adolescents attending a community-based weight management group program. We propose that extended therapeutic contact, by phone coaching and a combination of SMS text messages and/or email, will help obese adolescents to achieve and maintain the goals they set and will improve the outcomes of a high quality group weight management program.

Otitis media is the most prevalent paediatric disease presenting to general practitioners and often requires repeated antibiotic treatment. This project unifies clinical expertise in the treatment of otitis media, molecular virology and microbiology with immunology research expertise and equipment. Using state of the art detection methods, examination of bacterial and viral carriage and immune response within children with otitis media will address fundamental gaps in knowledge that will facilitate development of more effective treatment regimes and prevention strategies.

Preterm birth is the leading cause of neonatal death and disease in Australia. Although infection and inflammation are established as the primary causes of early preterm birth, we do not understand how they impact the fetus early in pregnancy.

Our new second trimester sheep model will allow us to study infection and inflammation in early pregnancy. This study will help us understand how early preterm birth occurs and help develop treatments to improve the health of babies and their mothers.

We don't understand how chronic disease develops but evidence is mounting for an origin before birth. It's possible that that a fetus can be 'reprogrammed' in the womb by maternal diet, stress, etc, predisposing it to chronic disease later. A possible mechanism behind this is epigenetics, which involves molecules binding to our DNA and turning our genes on or off. Once identified, epigenetic marks can be changed by diet or drugs, opening up possible new avenues for prevention and therapy.

Our team wishes to test the effectiveness of an internet based multimodal therapy (MiTii: 'Move it To improve it') which combines upper limb training and physical activity in children's homes. The program combines visual perception and cognitive skills training, important aspects of activity engagement and participation in a virtual training environment. The feasibility of delivering MiTii has been confirmed in a pilot study of 19 children in Denmark achieving on average 35 minutes of training daily for 20 weeks with 96 percent compliance. Children made significant gains in motor and processing skills, self esteem, functional strength and visual perception. The program requires only three therapists (physiotherapist, occupational therapist and psychologist) to train 98 children. As current therapy programs are resource intensive and time consuming it is important to determine if gains from a minimally resourced remote, web based program such as MiTii are sustained over a 12 month period as this could offer a cost effective, timely model of care, particularly for rural, remote and isolated children with CP.

This project examines the efficacy of a novel treatment for children who suffer from highly debilitating obsessive-compulsive disorder (OCD), in order to improve access to treatment and child outcomes. The active novel treatment involves 2-sessions intensive exposure therapy, coupled with anti-tuberculosis drug d-Cycloserine (DCS), recently been shown to improve outcomes when given prior to exposure therapy, through enhancing learning processes. This study involves a randomized controlled trial and examines outcomes up to 6 months follow-up.

Australia is currently experiencing a pertussis (whooping cough) epidemic. Infants under 4 months old are too young to be protected by our current vaccine schedule and older children, aged 3- 5 years old have waning immunity from their last pertussis vaccine resulting in high rates of pertussis. The aim of this study is to see if 2 early pertussis vaccine doses, prior to 4 months old, and a later booster dose at 12 months gives the same immune responses after 2 doses and better responses following a later 3rd dose than the current standard schedule.

Emerging evidence suggests that compulsory sleep times in childcare may adversely affect child well-being and health. Most 4 year olds do not require day-time sleep, yet 50% of centres have compulsory sleep-times without alternative activities. Such practise is potentially stressful and disruptive for night sleep and attendant long-term health. This study compares a range of physiological and psychological child outcomes across centres with compulsory and child-centred sleep practices during the childÔøΩs final year of attendance and in the following year.

Children of preschool age and older show severe problems in many areas after a head injury. What effect a head injury has on young children (before 3 years) is currently unknown but is thought that these children have more problems than older children do. This study will look at how young children recover after a head injury and the findings will be used to form programs to help these children before they develop long-lasting social, behavioural and learning difficulties.

Use of UCB for transplantation is limited in older children, adolescents and adults because of the low engraftable stem cell dose and can result in high rejection rates, slow recovery of blood cells following transplantation potentially leading to increased rates of life threatening infections or bleeding. A potential solution to this is to develop a strategy to expand engraftable UCB cells prior to transplantation allowing for greater use of UCB for all kids in need of a life saving transplant.

Dental decay is one of the most common chronic diseases of childhood. To examine the bacterial, environmental and social factors involved in the development of tooth decay we have enrolled 450 children from disadvantaged families into the VicGen prospective birth cohort. Data has been collected at child age 1, 6, 12 and 18 months and we propose to extend the study to when the children are aged 2_ years; providing powerful prospective, longitudinal data during a critical developmental period.

Our previous studies lead to the first description of protracted bacterial bronchitis (PBB), an important and common cause of chronic cough in children. PBB has been incorporated into Australian and international cough guidelines.

We will study possible underlying mechanisms and clinical outcomes of PBB, a likely antecedent to chronic lung disease, if recurrent. We will undertake in-depth clinical and laboratory studies of blood and airway cells of children with and without recurrent PBB to evaluate several immunity types and function.

We propose to conduct a randomized controlled trial to compare a personalized alarm watch against a standard watch for enhancing timed voiding for treating daytime urinary incontinence in children. 360 children aged 5-13 years with daytime urinary incontinence will be randomized to timed voiding with either a personalized alarm watch or a standard watch for months. Primary outcome of interest will be incontinence cure rates for both watches at 3 months.

Growth-restricted babies are often born with brain damage, and then grow up with disabilities such as cerebral palsy and/or learning and behavioural problems. A major challenge for the obstetrician and scientist is to identify why poor fetal growth can lead to brain injury - in particular, to abnormal development of white matter. With this knowledge we will be able to design treatments that prevent this type of brain injury and improve childhood health.

This proposed study is embedded within an already funded multicentre randomised controlled trial. It provides an unique opportunity to study two additional novel components that has never been studied in people with bronchiectasis. The first component aims to determine if a blood marker can be used to predict a respiratory exacerbation. The second is an evaluation of the economic costs of bronchiectasis. The results of this will potentially alter clinical practice and inform public health policy.

Children with autism have difficulties in understanding the emotions of others, for example facial expressions. These difficulties contribute to the significant problems experienced by children with autism in their interactions with other children and adults. This study aims to test the effectiveness of a programme developed to improve the emotion recognition skills of young children with autism.

We aim to create an index of childhood health orientations, school performance, and educational engagement that will predict health behaviours in adulthood. We will use data already collected as part of the Childhood Determinants of Adult Health (CDAH) study. This study started in 1985 with 8,498 children who were followed-up in 2004-05 when aged 26-36 years. The project will involve new conceptual development, statistical analysis and modelling of this large and unique dataset.

Preschool children who fail to understand and regulate their emotions are at risk for mental health and antisocial behaviour problems throughout their lives. Parents play a central role in helping children develop these abilities. The Tuning in to Kids programme teaches parents' skills that help children learn about and regulate their emotions. The program has already been shown effective when delivered by a research team – the proposed study will evaluate whether Tuning in to Kids is effective in a real-world setting when delivered by staff from community agencies rather than the program developers.

Making the transition from fetus to neonate is one of the greatest physiological challenges; this is even more challenging for preterm babies. These babies need to cope with extreme changes to blood flow within the lung, heart and brain and subsequently this can result in brain injury and poor neurodevelopmental outcome. This application will focus on developing simple techniques at delivery, to prevent adverse outcomes related to poor circulation at preterm birth.

Today's challenge is to cure childhood leukaemia without compromising quality of life. We will perform an eighteen-month pilot study to investigate if measurement of chromosome (telomere) biology in leukaemia cells can predict what treatment a child should receive, the response to treatment and whether the child is likely to survive. These findings may allow us to better determine the intensity of therapy required for the treatment of childhood leukaemia, thereby improving patient survival and enhancing long-term quality of life.

Children with obstructive sleep apnoea (OSA) have increased surgical risk because they have abnormal breathing responses (VRs). We will test VRs under anaesthetic before surgery or during a sleep study. We will test the breathing responses of infants with cleft palate and older children with OSA. Both groups will be studied before and after their treatment for OSA. If we show that treating OSA corrects VRs we know we can reduce the risk of surgery for these infants and children.

Tooth decay is a major problem in the Australian community, leading to pain, disability and significant cost. Despite fluoride being present in the water supplies of many cities and considerable public education, the level of dental decay is actually increasing in Australian children. This projects research priorities are to collect samples of families oral bacteria, DNA and questionnaire information to explain how a persons genes and their environment can influence the colonisation and transmission of decay-forming bacteria.

Exclusion of disruptive students has increased significantly in recent years. Research suggests that the seeds to this problem are sown in the first few years of school and that many children referred to separate settings remain until they drop out or enter juvenile detention. This research will track 200 children through the early school years to understand how and why some students do not benefit from common behaviour management practices and what supports are needed to avert such negative trajectories.

The Wollongong Sport pilot study aims to evaluate the effects of a community-based after-school sports program designed for overweight, obese and at-risk of overweight children and delivered to boys and girls separately. We propose that participation in the gender-specific programs will improve children's weight status, blood profiles, physical activity participation, fitness, self-esteem and health-related quality of life, after treatment (30 weeks) and at follow-up (12 months), more than participation in a health education program.