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Summer Edition - December 2019
Summer Edition - December 2019
In this edition:
Celebrating a stellar year
Each year, MCRI is privileged to welcome supporters to our Annual Showcase to hear from our researchers and see some of our amazing work. Catch up on the presentations from the night.
When does childhood end?
Adolescents are the largest global youth population in history: 1.8 billion people. When they go to a doctor, should they see a paediatrician or a GP?
“The World Health Organization defines adolescents as aged 10 to 19 years, however there’s been little research into the age of patients that paediatricians actually treat and how this varies across the world” says Adolescent Health Professor Susan Sawyer, from MCRI and the University of Melbourne.
It’s important to ask the question because previous research has found that global health systems are failing our young people by not meeting their needs. As a result, the world’s 1.8 billion adolescents are facing major health challenges:
- One in five (324 million) adolescents was overweight or obese in 2016 – that's 13 times the population of Australia
- One in four (430 million) was anaemic – that's 86 times the population of Australia
- More than half of all adolescent health problems are due to noncommunicable diseases (including mental health conditions).
The other challenge is that there are major differences in the way countries define the age limit for paediatric care. Susan’s research found that South Africa had the lowest upper age at 11.5 years, indicating that paediatrics there is yet to embrace adolescence. The USA had the highest upper age, with 19.5 years.
Despite similar health care systems, Australia’s mean upper age of paediatric care was 17.8 years while New Zealand’s was 15.6 years.
“Paediatrics has historically focused on very young children, largely neglecting adolescents, but the pattern of disease across childhood and adolescence is changing. Public health interventions and medical advances have seen the mortality rate of young children fall dramatically.
“This is not mirrored in adolescents, whose more complex disease burden remains relatively unchanged. The World Health Organization estimates that more than one million adolescents die every year.
“Young people face childhood and adult health conditions, including chronic physical conditions like diabetes and asthma, mental health conditions, anaemia, rising levels of obesity, interpersonal violence, diarrheal and bronchial illnesses, drug and alcohol abuse, sexually transmitted disease and road trauma” says Susan.
Co-author Professor Jonathan Klein from the University of Illinois and Coordinator of the International Pediatric Association Executive Committee said not many nations included adolescent health as part of their paediatric training.
“The evidence is clear. Our health care systems need to be more attuned to the needs of adolescents and young adults,” he says. “Improving adolescent care is a critical step if we hope to reach the United Nations’ Every Woman, Every Child, Every Adolescent promises, and achieve the 2030 UN Sustainable Developmental Goals.”
MCRI researchers have discovered three factors that can predict whether childhood weight problems will either start or be resolved by adolescence.
Currently, clinicians have no way of knowing whether an overweight seven year-old will become an obese 14 year-old. That means that they have no way of knowing whether targeting care to that child is the most efficient use of resources.
Most of the world’s population lives in countries where overweight and obesity kill more people than underweight. Obesity in childhood is associated with a higher risk of obesity, premature death and disability in adulthood.
The World Health Organization has identified obesity as a risk factor for non-communicable disease. These are non-infectious conditions – such as obesity, allergy and mental illness – that are associated with major disease burden for a community.
For clinicians who are considering whether to offer families resources to address their child’s weight, the three predictive factors for obesity in adolescence are:
- child’s Body Mass Index (BMI)
- mother’s BMI
- mother’s education level
When a child is just six or seven, these are the three factors that indicate whether that child will become an adolescent with weight problems, or whether it’s likely that any issues will resolve. With that knowledge, clinicians will be better equipped to target care to the young children who are at the greatest risk of adolescent obesity.
MCRI’s Dr Kate Lycett, study author, said until now most studies have overlooked the important questions around which children are likely to become overweight/obese and how it could be resolved. But knowing these three factors may help clinicians predict, with about 70 per cent accuracy, which children will develop and resolve excess weight.
“Because clinicians haven’t been able to tell which children will grow up to become teens with excess weight, it’s been hard to target interventions for those most at risk,” she said.
“The consequences of this are dire, with childhood obesity predicting premature death and implicated in cardiovascular disease, diabetes and cancer.”
Watch an interview with researcher Dr Kate Lycett here
A young mum gets her research wings
A key component of establishing a career in research is travelling to conferences overseas. What are the options if you have a young child at home?
MCRI early career researcher, Ms Simran Kaur, has been awarded a Franklin Women travel scholarship allowing her to attend the annual American Society of Human Genetics meeting in Houston, USA.
The Franklin Women Carer’s Travel scholarship assists researchers who have primary carer responsibilities by funding the costs of additional care while they present their research at an academic conference. The funding will allow Simran’s husband to take time off work to look after their young son.
While she’s in the USA, Simran will also visit collaborators at the University of Michigan and the University of Washington, to bring vital skills and techniques back to her laboratory, supervised by Professor John Christodoulou.
Franklin Women is a social enterprise that focuses on retaining women in health sciences. The travel scholarship was launched to address the financial and logistical barriers that often prevent women attending academic conferences.
MCRI is also recognising the extra pressure on parents who are trying to establish a career in research. The Institute now offers two career-disruption fellowships to its staff to fund an ‘extra set of hands’ in the laboratory, or for carers to travel to conferences to help maintain their professional networks.
He loves coffee. And he needs your help.
According to Scott Reddiex, caffeine is now what mostly motivates him in life – but this wasn’t always the case. As a kid, it was his passion for discovery.
“I wanted to be a scientist when I was a child. I’ve always loved learning about how things work, new discoveries and solving problems.”
This passion followed Scott through school and lead to him enrolling into the Bachelor of Biomedical Science at the University of Melbourne, where he discovered immunology.
“In undergrad, I was fascinated by how science tackles infectious diseases. I decided then to pursue research in immunology and microbiology as a career.”
Scott is now working to tackle infectious diseases as a Research Assistant and Lab Manager in MCRI’s Cellular Immunology group. His group studies the roles played by the many different cell types in our immune systems and how they relate to infections, autoimmunity and cancer.
One particular project the team has been working on involves looking at how particular immune system cells can change following infection with tuberculosis and/or receiving the BCG vaccine (which protects us from Mycobacterium tuberculosis). As part of this research, Scott is looking for blood donors.
“Whether you have or haven’t received the BCG vaccine, we are always in need of anyone who can donate some blood to this work!”
If you’re keen to donate, you can find out more here about eligibility criteria and how to take part here.
To wind down outside the lab, Scott plays guitar and runs most days. He also loves watching both the English and Scottish Premier Leagues.
His love of science and learning remains.
“One of the highlights of this job is engaging the work we do with others, whether they are scientists or not. Interdisciplinary collaborations, science communication and education are increasingly important, and always really rewarding.”
Waking up baby: the factors behind severe sleep problems
One in five new mothers report that their baby has severe and persistent sleep problems in the first year. There are two factors that make this more likely for a new baby.
The study, led by MCRI’s Dr Fallon Cook, found that most parents of a new baby will experience difficulties with their baby’s sleep at some point in the first year; three out of five mothers report mild or fluctuating problems.
But for one in every five mothers those sleep problems are both persistent and severe.
Fallon says this is an important finding because parents of sleep-disturbed infants often feel severely fatigued, depressed and anxious, and worry they are doing something to cause their baby’s sleep problems.
“Our findings suggest some infants may be predisposed to have sleep problems, despite parent’s best efforts to help their infant sleep better,” she says.
Fallon’s study found that the mothers who reported significant sleep problems had two common factors. “These mothers were more likely to have poorer mental and physical health during pregnancy in comparison to mothers of infants with no sleep problems,” says Fallon.
The findings show that for some, infant sleep problems may have more to do with mother’s wellbeing during pregnancy than with parenting style.
Until now it was unclear whether it was possible to predict which infants will have sleep problems. The current findings, along with other emerging research, suggest that severe and persistent infant sleep problems are linked somehow to mothers’ wellbeing during pregnancy.
“Identifying and supporting mothers with poor mental and physical health during pregnancy is crucial. These mothers may benefit from more intensive support once the child is born.
“Parenting an infant who isn’t sleeping well is extremely hard. It’s important that parents seek help from their GP or child health nurse if feeling depressed, anxious or exhausted, and reach out to family, friends, and local parenting groups for additional support.”
If you would like support with your mental health when you have a new baby, contact PANDA panda.org.au
When the drugs don’t work
A lot of young people with autism are on an antidepressant to manage obsessive compulsive behaviours, but new research shows that the drug doesn’t always work.
About one in 70 Australians are diagnosed with autism spectrum disorder, with boys four times more likely to be diagnosed than girls.
“Restricted, repetitive and stereotypic behaviours frequently interfere with everyday functioning and include ritualistic behaviours, unusual sensory interests, and difficulty coping with change, which often manifests as anxiety, irritability, aggression and self-injury” says MCRI paediatrician Professor Dinah Reddihough.
Fluoxetine (also known as Prozac) is commonly prescribed to manage these sorts of behaviours.
However, new research has found that taking the drug for 16 weeks failed to significantly lower the frequency and severity of obsessive-compulsive behaviours in children with autism spectrum disorders including autism, Asperger's syndrome and pervasive developmental disorder (PDD).
Dinah says, “more than half of children and adolescents with autism spectrum disorders are prescribed medication, with up to one third receiving antidepressants - despite inconclusive evidence of their effectiveness.”
She says that initial results showed some behavioural improvements, but additional analyses revealed no significant difference between the groups in the study.
She says “while the evidence was not strong enough to recommend fluoxetine as a treatment we couldn’t exclude that it’s helpful for some children.
“If parents have any concerns about the use of fluoxetine they should speak with their health professional before changing any treatment plan,” she says.
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