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ROYAL CHILDREN'S HOSPITAL RESEARCH INSTITUTE I

Contents Department Reports 18

Allergy Anaesthesia

Biochemistry

Cardiac Surgery

Cardiology

Centre for Adolescent Health

Centre for Community Child Health

Centre for Hormone Research, Incorporating Endocrinology and Diabetes

Board of Research

Child Development and Rehabilitation

33 37

Management Report

Clinical Epidemiology and Biostatistics

Dentistry

The RCH Research Institute Chairman's Report

Research Committees

Gastroenterology and Clinical Nutrition

Research Advisory Committee

General Paediatrics

Career Grant Sub-Committee

Haematology and Oncology

Trainee Research Scholarship Sub-Committee

Immunology

Medical Imaging

Microbiology and Infectious Diseases Neonatology

57 59

Nephrology

Staff

Neurology

Administration

Occupational Therapy

Research and Support

Orthopaedics and The Hugh Williamson Gait Laboratory

Orthopaedic Molecular Biology Research Unit

Fellows and Scholars

Otolaryngology

Physiotherapy

RCH Ethics Committees RCH Ethics in Human Research Committee

RCH Animal Experimentation Ethics Committee

Stevenson Professor of Paediatrics, Professor Peter Smith

Plastic and Maxillofacial Surgery and The Melbourne Craniofacial Unit

The Research Association

Psychology

Research Institute Seminars

Respiratory Medicine

Social Work

Speech Pathology

Surgical Research Unit, F Douglas Stephens Laboratory

Publications

Donations

RCH Research Institute Grants

Project Grants

99 99 99

Equipment Grants

100

Minor Grants

100

Travel Grants

100

External Grants

102

Financial Statements

108

Part-time Career Grants Program Grants

RCH Research Institute 1998 1

Management Report Scientific Director

Secretary

Graeme Barnes, MD FRACP

Jenny Cope (to February)

General Manager

Julia Malone (from February)

Jane Glatz, PhD Human Resources and Grants Officer

Rochelle Moran

Research Support Officer

I'^j

Adam Chapman

) Jane Glatz, Julia Malone, Graeme Barnes, Rochelle Moran, Adam Chapman

A major new activity during 1998 was the

Prof John Funder. In August 1998, a workshop

researchers, rewards for excellence, and

RCHRI is pleased that the initial support given

This has allowed several high quality research

for our team, but we are continually rewarded

process of a Strategic Review of the Institute.

was held for 65 RCH health professionals and

exploration of ways to develop a

to Trainee Research Scholars often enables

projects to be funded in 1999 which otherwise

by the positive feedback from the research

researchers, again led by Dr Norman Swan.

meaningful career structure within the

them to obtain external funding for the

would have missed out.

community and the support offered by the

constraints of research funding.

remainder of the scholarship.

The RCH Research Institute, known as the Research Foundation when it was founded

Several key issues were identified as the

in 1960, has grown from a small enterprise

basis for the philosophy of the Institute.

supporting a few clinical researchers, to

academic and clinical activities, and

management of the Women's and Children's The RCHRI has taken a lead in campus-wide

• The physical co-location of researchers, The RCHRI continues to contribute at

discussions regarding redevelopment of

The main objective is to benefit child and

support services is to be addressed, plus

a national and state level to the development

laboratories, used for research, training and

a $9 million per year company. The Institute

adolescent health, i.e. outcomes are

complex and routine diagnostic tests.

employs 180 staff, provides a variety of

the implied capital funding issues.

of Australian health and medical research, by involvement with the Australian Association

If scientific research at the RCH is to maintain

services for its own researchers, hospital

important and should be measured.

Several steps were taken during 1998. They

of Medical Research Institutes (AAMRI) and

a leading edge, it is inevitable that improved

health professionals and the University of

Research and clinical care must be

Melbourne Department of Paediatrics and

Integrated.

collaborates with the Murdoch Institute.

Excellence is always a goal.

During this period of growth, several

Training and nurturing young researchers

"Centres" have developed, (Adolescent Health, Community Child Health, Hormone

is a high priority. Research seed funding must be provided.

Research), some hospital departments have

Opportunities should be available across

developed strong research programs, the

the breadth of child and adolescent health.

University of Melbourne Department of

Collaborations and theme research are to

Paediatrics research programs have

be encouraged.

increased and in 1986 the RCH Research Foundation Genetics Research Unit became the independent Murdoch Institute. The Research Foundation became the Research Institute in November 1997. The increasing size of the RCHRI and differing opinions about its functions, stimulated a decision of the Board to review its philosophy and goals, taking into account the complex interrelationships on campus between clinical care, research, education and teaching.

These issues will be addressed in several ways • Implementation of much of the philosophy will fall to the Research Advisory Committee, including assessing standards of research, seed funding, the range of research supported and encouragement of themes and collaborations. • Encouragement of public health research, and emphasis on potential health benefits will be objectives. • Appointment of a full-time Director

In May 1998, an RCHRI Board workshop was

• Staff welfare and support will need

held, facilitated by Dr Norman Swan, and with

attention, including development of a

external advice from Prof Fiona Stanley and

mentor program, appointments for honorary

4 RCH Research Institute 1998

Healthcare Network. Dur aims for the coming year are to consolidate the progress achieved through the Strategic Review, and to further develop mechanisms by which research outcomes are translated into improved health for children and adolescents.

included formation of a Board Sub-Committee

submissions to the Commonwealth

laboratory facilities will be required within

to oversee the search for a Director, a review

Government Health and Medical Research

the next 5 years. The RCHRI has worked

Graeme Barnes

by the Research Advisory Committee of

Strategic Review (Wills Committee). This

extensively with the RCH engineering

Jane Glatz

research standards on campus, discussions

activity is particularly important for

department to begin a redevelopment master

about developing theme research and

appropriate recognition of child and

plan that will serve the RCH research,

establishment of an appointments working

adolescent health research, which is

teaching and education community.

group. There are several more important

sometimes overlooked by policy-making

issues to address in 1999.

bodies.

In January, we appointed Adam Chapman to the newly created position of Research

A number of senior clinical researchers were

The Victorian Government Department of

Support Officer, with primary responsibilities

welcomed to the campus: Professor Colin

Human Services is conducting a review of

for administration of the RCH Human and

Morley, Dr Ruth Morley, Dr Nigel Curtis,

infrastructure funding of state-based medical

Animal Ethics Committees. This full time

Dr Noel Cranswick and Dr Paul Monagle.

research institutes, from which the RCHRI has

position serves all researchers on campus,

Professor George Patton was appointed

historically been excluded. A detailed

and also those from other organisations

Director of the Centre for Adolescent Health.

breakdown of RCHRI infrastructure was

engaged in collaborative research involving

Professor Geoff Tregear again chaired a very

prepared, including the indirect infrastructure

RCH patients. The RCHRI commitment to

hard working Research Advisory Committee.

support provided by the RCH, without which

funding this position reflects the importance

We are extremely fortunate to have six highly

the RCHRI would not survive. It is hoped that

of maintaining the highest ethical standards in

skilled and busy external people, prepared to

some infrastructure support will flow into the

research and also the significant increase in

devote so much time to this committee. Their

RCHRI in the near future.

research activity at the RCH. Julia Malone

task was especially difficult in 1998 with

also joined us as our secretary during 1998,

a record high standard required for NHMRC

Thanks go to Brian Mallon and staff of the

project grant success. The medical and

RCH Foundation. Research has a high profile

biomedical postgraduate scholars are to be

in their fundraising efforts, and the RCHRI was

congratulated for their success in being

delighted to receive $200,000 more than

The task of serving all the research needs of

awarded NHMRC or PHRDC scholarships.

anticipated from the 1998 Good Friday Appeal.

the RCH campus is certainly a demanding one

and Rochelle Moran continued as our Human Resources and Grants Officer.

RCH Research Institute 1998 5

Research Committees

RCH Ethics Committees

The Research Advisory Committee (RAC) assesses applications for research funding across the

The Research Institute continues to provide full management and administration of the Hospital

diverse range of research activities on campus. The voting members of the Committee are external

Ethics Committees, on behalf of the Women's and Children's Healthcare Network. The

to the campus and are expert in their respective fields, to ensure rigorous and independent

administrative load of these Committees is considerable as they serve all groups on campus,

assessment of research projects.

including the Royal Children's Hospital clinical departments, the University of Melbourne

A large number of applications for research funding were received again in 1998. 45 project grants,

RCH Research Institute.

Department of Paediatrics, the Murdoch Institute, Victorian Clinical Genetics Service and the 3 part-time career grants, 1 post-doctoral fellow, 16 trainee research scholarships, and 5 trainee research scholarship renewal applications. The outstanding effort of the RAC in assessing and ranking applications cannot be overstated. Unfortunately many worthy grants were still not able to be funded due to limited resources. The RAC is committed to regular review of assessment procedures, and endeavours to provide a system by which both new and established fields of research are supported. The details of grants awarded are provided under 'Research Institute Grants' at the end of the Annual Report.

RCH Ethics in Human Research Committee

Janet McEwan, RN, Nurse

The Career Grant Sub-Committee is convened

Trainee Research Scholarship Sub-Committee

Geoff Tregear, BSc PhD ERACCI

just prior to the RAC to assess applications for

The Trainee Research Scholarship Sub

The RCH Ethics in Human Research

of Directors

Howard Elorey Institute

part-time support for senior clinical

committee is specially convened to consider

Committee is constituted and operates

researchers at the RCH.

applications from young professionals wishing

according to the guidelines of the National

to pursue a higher degree in research, either

Health and Medical Research Council,

MDorPhD.

Australian Health Ethics Committee.

Research Advisory Committee

Career Grant Sub-Committee

Chairman

Members Shaun Brennecke, MBBS BmedSci(Hons) BA

Chairman

Dphil(Oxon) ERACOG, Department of Perinatal

Geoff Tregear, Chairman of RAC

Medicine Royal Women's Hospital

Members

Christina A Mitchell, MB BS PhD FRACP

Shaun Brennecke, Member of RAC

FRCPA, Department of Medicine Monash

Henry Ekert, Nominated Director of a RCH

University Box Hill Campus

Clinical Division (resigned June)

Kerin O'Dea, BSc PhD, Centre of Nutrition

Peter McDougall, Nominated Director

and Population Health Monash University

of a RCH Clinical Division (from June)

Arthur Shulkes, BSc PhD DSc, Department

Don Roberton, MBChB FRACP MD FRCPA,

Chairman Peter Moss, Nominee of the Board

Department of Psychology, University of Melbourne Attendees (Non voting) Graeme Barnes, Scientific Director RCHRI Glenn Bowes, Nominee of the RCH Andrew Kemp, Nominee of the RCH Medical Staff Association Margot Prior, Department of Psychology RCH Peter Smith, Head of University of Melbourne

Gordon Clunie, Nominee of the Board

Clinical Division (resigned June)

Peter Smith, Head of University of Melbourne

Panel

Panel, (resigned October)

Members Attendees

Andrew Kemp, Director of Physician Training

Executive Office

Christine Minogue, Nominee of Nursing

Terry Nolan, Head of Clinical Epidemiology

Justice Linda Dessau, Nominee of the

Research Management Group

Robert Williamson, Director Murdoch Institute

and Biostatlstics Unit

Board of Directors

Attendees (Non voting)

Margot Prior, Senior RCH non-medical

George Grant, Minister of Religion

Terry Nolan, Nominee of the RCH Research Association

researcher

Jane Glatz, General Manager RCHRI

Peter Smith, Head of University of Melbourne

John Hutson, Category B - Researcher Members Roger Lavelle, Category A - Veterinarian

Glenn Bowes, Nominee of the Chief

Graeme Barnes, Scientific Director RCHRI

Chairman

Elizabeth Northern, Psychosocial Technical

Jill Sewell, Biomedical Technical Panel

Peter Smith, Head University of Melbourne SEK Hulme, QC, Lawyer Pat Kee, Laywoman not associated with

Department of Paediatrics

Viginia Studdert, Category A - Veterinarian Robert Eyres, Category B - Researcher Anne Cronin, Category B - Research Manager Phillip Robinson, Category B - Researcher Robyn Sullivan, Category C - Animal Welfare representative Wendy van Dok, Category C - Animal Welfare representative (resigned April) Patsy Littlejohn, Category D - Independent

Noel Cranswick, Clinical Pharmacologist

person

Jane Glatz, General Manager RCHRI

Attendees

the RCH

Geoff Tregear, Chairman RAC

Rod Lamborn, Layman not associated with

Attendees (Non voting)

the RCH

Adam Chapman, Research Support Officer

Ross Linsley, Health professional neither

RCH Animal Experimentation Ethics Committee

Jane Glatz, General Manager RCHRI Kerry Fowler, Supervisor, Mouse House

Graeme Barnes, Scientific Director RCHRI

a medical graduate or a nurse, (resigned

Jane Glatz, General Manager RCHRI

March) Brian Lilley, Head, Pharmacy, Health

Robert Williamson, Director Murdoch Institute ■

6 RCH Research Institute 1998

Number of applications processed = 53

of Directors (from April)

Peter McDougall, Nominated Director

Department of Paediatrics

Jane Glatz, General Manager RCHRI

Bill White, Member of the Women's and

Charles O'Sullivan, Clinical Trial Technical

Henry Ekert, Nominated Director of a RCH

of a RCH Clinical Division (from June)

Department of Paediatrics

and New Zealand.

of Directors (resigned April)

Members

Christina A Mitchell, Member of RAC

John Trinder, B Psych(Hons) MA PhD,

Resource Management Council of Australia

research experience

Technical Panel Convenors

Women's and Children's Hospital Adelaide

Commonwealth Scientific and Industrial Research Organisation, and the Agricultural

Number of applications processed = 203

Chairman

and Medical Research Council, the

Colin Robertson, Medical graduate with

Children's Healthcare Network Board

of Surgery Austin and Repatriation Medical Centre

Ian McKenzie, Nominee of the Board

purposes, prepared by the National Health

The RCH Animal Experimentation Ethics

Magdy Sourial, Supervisor, Animal House Adam Chapman, Research Support Officer

Committee is constituted and operates

professional neither a medical graduate

according to the Australian code of practice

or a nurse, (from March)

for the care and use of animals for scientific

RCH Research Institute 1998 7

staff The research staff employed by the Royal Children's Hospital Research Institute during 1998 are listed below. Many additional staff on the RCH campus contributed to the research outcomes

Karen Campbell

Kate Hogg

Linh Quach

Darryl Carrington

Matthew Hughes

Susan Quinn

Rosemary Carzino

Anita Imberger

Christopher Riffkin

Cathy Catroppa

Rani Jacobs

Jeanette Ripper

Louisa Ceccato

Sophie Jerrim

Julie-Anne Ross

Patty Chondros

Kerrie Jones

David Rowe

Annette Clancy

Frances Justice

Vincenzo Russo

Jacinta Clifford

Efthimia Keramidaris

Charan Sandhu

Kathleen Cole

Jane King

Deborah Saunders

Noreen Condon

Soula Krejany

Louise Scaffidi

Meaghan Crawford

Trina Laffy

Bernadette Schwindt

Marita Dalton

Kathleen Lanigan

Heather Siddons

Gillian Deeble

Renee Lawson

Anita Skok

Susanna Del Brocco

Primrose Letcher

Felicity Sloman

Susan Dickie

Ingrid Liepe

Diana Smart

Chandra Diwarkarla

Paul Logan

Judith Spotswood

Nicole Dowling

Tracey Lomas

Kelly Steeper

Catherine Economou

Helen Maclean

Janet Strachan

Stephanie Edmondson

Clara Mbwili-Muleya

Kellie Tainton

Helmut Ehall

Justine McCourt

Heidi Terry

Sarah Emselle

Mary McCrohan

Marian Ussher

Sharon Evans

Elizabeth McGrath

Daryl Venables

Rhys Fogarty

Sandra McKean

Suzanna Vidmar

Jennifer Foord

Kathryn Meldrum

Marianne Vitellone

Josephine Forbes

Paula Mitchell

Suchindra Vivekanandan

Danielle Forer

Monika Narula

Janet Walstab

Rosie Gehrig-Mills

Stuart Nicol

Patrick Western

Deborah Gercovich

Craig Dlsson

Joanne White

Timothy Godber

Frances Dppedisano

Georgina Wilby

Celia Godfrey

Melissa O’Shea

Michelle Wills

Rebbeca Gorrell

Cathryn Pappas

Jacquie Wrennall

Travis Grant

Linda Pentland

Technical Officers

John Hargreaves

Vikki Pliatsios

Flora Haritou

Valintina Porublev

Leah Heffernan

Zeffie Poulakis

Kylie Hesketh

Susan Proctor

described in this report. These researchers are listed in the relevant department reports.

■••'1

Administration

Research Fellow Sam Menahem

Scientific Director Graeme Barnes

Senior Research Officers Elizabeth Algar

General Manager Jane Glatz Human Resources and Grants Officer Rochelle Moran Research Support Officer Adam Chapman Secretary Jennifer Cope (to February) Julia Malone (from February)

Leone Piggford Elizabeth Smibert Mimi Tang Lyndal Thomas

Mary-Anne Darcy Claire Wainwright Heather Gilbertson Paul White Julie Green Richard Williams Winita Hardikar Rory Wolfe Suzanne Hasthorpe Stephen Wood Paul Johnson Suzie Ymer Enzo Palombo Baiyun Zhou Research Officers

Research and Support Staff employed by RCHRI for all, or part, of 1998

Anne Altmann

Research Assistants Louise Adams

David Ashley Violet Albert Julie Bines

Senior Principal Research Fellows

Dianne Anderson

John Hutson

Carolyn Coffey

Principal Research Fellows

Vikki Dakin

Peter Anderson Robert Berkowitz

Emma Ball Andrew Davis Sabrina Barbie

John Carlin

Jamie Fitzgerald

Michael Carr-Gregg

Karen Greenland

John Connelly Russell Taylor Senior Research Fellows

Melinda Barker Shane Barwood Michelle Haby de Sosa Beth Bolger Serena Haywood Mary Bosco Patricia Hengel Samantha Brickell

Anthony Catto-Smith Colin Jones Peter Dargaville

Ruby Brouwer Andrew McFarlane

Christopher Wraight

8 RCH Research Institute 1998

Helen Bugg

Naomi Baker Sophie Gazeas Technical Assistants Robyn Breslyn John Elliot

RCH Research Institute 1998 9

Fellows and Scholars Jodi Ladhams Anick Sylvain Melinda Tursky Laboratory Assistants Nada Bogdanovich-Sakran

Research Nurses

Project Officers

Jennifer Clemo

Helen Butler

Caroline Collis Margaret Flood Janine Furmedge

Ian Burns

Frances Hammer

Slav Itkne

Catherine Hazard

Helen Reilly

Jennifer Hurley

Milka Sekulovski

Roslyn Nankervis

Annette Westley

Gabrielle Neave

Medical Dfficers

Sally Palmer

Leo Acevedo Dianne Browne Belinda Came Andrea Cretney Leonard Hartman Vanessa Johnston

Senior Nurse and Co-ordinator Jennifer Lund

of and immunity to infections with

Respiratory Medicine

Haemophilus influenzae.

Cytokine imbalance in childhood atopic

Department Funded Trainee Research Scholars

Karen Lee

intracellular cytokine.

Patrick Western

Immunology Lynn Williams Australian Kidney Foundation Scholar

David Ashley

Madalena Liu

Marita Baum

Glioma immunotherapy using cytokine

Anatomical and functional anomalies

Angelina Bowden

modified tumour cells expressing the

in urinary tract development.

Novo Nordisk Scholars

Endocrinology & Diabetes

Joseph Pua

varian EGFR.

NHMRC Public Health Fellowship

Travis Grant

Jane Burns

Characterisation of clinical isolates of Yersinia

The epidemiology of depression and

enterocolitica lacking known virulence

the scope for preventative intervention.

determinants.

Elissa O'Malley

Centre for Adolescent Health

Microbiology & Infectious Diseases

Lucy O'Malley

NHMRC Public Health Post Graduate Scholars

Harriet Hiscock

Margaret Johnson Fiona Tremaine Pathology Collectors

Christine Thompson Physiotherapist Fiona Smithson Medical Technician Ruth Clark

Dependant Sex Determination. Endocrinology & Diabetes

The bone mineral density of hypogonadal

Clinical Haematology & Oncology Research Institute Trainee Research Scholars

Suzanne Tansey

Lorraine Kelpie

Evolution of Sex Determination: Identification of conserved genes in Temperature

NHMRC Neil Hamilton Fairley Fellow Administration Assistants

Alisa Hawley

Karen Brooker

Microbiology & Infectious Diseases

disease as determined by the T-cell

Moira Stewart

Helen Flannery

Joanne Smart

The role of type 4 fimbriae in the pathogenesis

Patricia Keen

Melissa Hasty

Shane O'Dea

Derreck Sim

Pathophysiology of chronic pulmonary aspiration of non-acidic fluids.

Joanne Smart

Mamie Jenkin

Susan Smith

Ronda El Sheikh

Audrey Penington

Michael Starr

Departmental Secretaries

Olivia Gleeson

Claire Mauer

Kim Olinsky

Anna Fairclough

Colin Sherrington

men on subcutaneous testosterone implants. Retrospective study of patients with congenital anorchia. Endocrinology & Diabetes Preeti Dabadghoa IGF-1 Receptor Polymorphisms in Type

Christina Smart Rosemary Smart Melissa Stoddart

Sharon Goldfeld Health care utilisation patterns in the first

Nyree Walls

1 Diabetes. Endocrinology & Diabetes

interventions improve maternal well being? Centre for Community Child Health

12 months of life. Centre for Community Child Health

Michelle Toomey

Postnatal depression: Can infant sleep

Mary-Ann Hope Victorian Registered Nurses and the provision

Rachel Skinner Effective immunisation in adolescents.

of health care services to adolescents. Centre for Adolescent Health

Centre for Adolescent Health Johnny Millar NHMRC Medical Post Graduate Scholars Yvonne Bonomo Transition to drug and alcohol dependency

Capillary leak and lung function in children following cardiac surgery. Intensive Care Unit

in young people. A representative longitudinal study.

Huseyin Mustafa

Centre for Adolescent Health

Genetic and antigenic characterisation of Astroviruses causing acute gastroenteritis

Dianne Campbell Cell mediated immunity to Staph.aureus,

in children. Gastroenterology and Clinical Nutrition

staphylococcal superantigens in atopic dermatitis.

Christine DIesch

Immunology

Oxygen consumption in cerebral palsy after multilevel surgery.

Katie Heathershaw

Child Development and Rehabilitation

The school age child - Is hearing still an issue?

Jenny Royle

Centre for Community Child Health

Topical analgesia, general anaesthesia and immunisation: facilitating pain free immunisation. General Paediatrics

10 RCH Research Institute 1998

RCH Research Institute 1998 11

Stevenson Professor of Paediatrics, Professor Peter Smith

The Research Association The Research Association has been involved with many issues in 1998 and these are discussed as part of the Research Institute report. The end of 1998 brings to a conclusion the terms of executive

Department of Paediatrics, University of Melbourne During 1998 the Department of Paediatrics, University of Melbourne has continued to foster

members: John Carlin and Larrisa Nicholls. I would like to thank them for their input and assistance in running this organisation. The newly elected Research Association executive now comprises: Chariman: John Bateman, Deputy Chairman: Andrew Sinclair, Treasurer: Stephanie Edmondson,

its strong partnership with the Royal Children's Hospital Research Institute in encouraging and

Secretary: Sue Hasthorpe, Committee members: Lyndai Bond, Daphne Glaun, Angela Joe, Paul

developing research on the RCH campus. The success of the partnership is measured by the

Thomas and Linda Johnston as an ex-officio member.

Department's strong performance when benchmarked against other Departments in the Faculty of Medicine, Dentistry and Health Sciences and against Departments of Paediatrics at interstate

In 1998, the Research Institute continued the process of evaluating its goals, strategies, and

Medical Schools in terms of outcome measures such as higher research degree students and

organisational structure. This offers a unique opportunity to reassess the future strategic direction

research publications.

for research on this site. As part of this process the Research Association has worked closely with the Institute to maintain and strengthen the Royal Children's Hospital as an environment of academic

The Department currently has 90 research higher degree students enrolled. Several students

1. The identity and structure of the RCH Research Institute, 2. Professor/Director, 3. Increasing the

Fellowship to undertake postdoctoral studies in USA.

financial resource base, 4. The consolidation of research groups and laboratories to allow for

Associate Professor Terry Nolan achieved promotion to Professor in the 1998 Professorial Promotion round and we were fortunate to have Dr Nigel Curtis join the Department during 1998 as a Senior Lecturer and Consultant in Infectious Diseases. During 1998 Dr Kim Mulholland currently working at WHD in Geneva was awarded one of the prestigious Vic Health Senior

centralisation of infrastructure and promote interactions between otherwise widely separated research groups, 5, Career structures for researchers. Further consultation and involvement of researchers in such forums builds understanding and support which is necessary if we are to move forward.

Fellowships under the Sponsorship of the Department of Paediatrics. Dr Mulholland's major

The Research Association plays a vital positive role in stimulating, communicating and representing

interest is Vaccine Development and trials in developing countries.

researchers and their interests at every level in this hospital. The close consultative relationship

The continued development of research and education with a Public Health strand and international dimension will continue to be an important theme developing within the Department of Paediatrics and the RCH Research Institute over the next few years.

12 RCH Research Institute 1998

and research excellence. In August an RCHRI workshop was held to discuss issues such as:

have won prestigious awards including Dr Sharon Goldfield who has been awarded a Harkness

between the Research Institute and the Research Association has been successful in finding solutions to issues which arise in an ever changing environment. The challenge for the future is to attract and retain outstanding people and as a consequence position the RCH Research Institute as an international centre of research excellence.

RCH Research Institute 1998 13

Research Institute Seminars We wish to thank the organisers, Rachel Skinner and Travis Grant, and all the speakers as listed below, making the Seminar Program a success once again in 1998.

Nate Myers

Paul Thomas

George Chalkiadis

General Surgery

Murdoch Institute

Anaesthetics

Clinical Research in oesophageal atresia.

The genetic basis of de Morsier's Syndrome.

Enzo Palombo

Mary-Ann Hope

Gastroenterology

Centre for Adolescent Health

Stephanie Dowden

Genetic Diversity of Human Rotavirus.

Interviews with nurses who work with

Centre for Adolescent Health

Nigel Parker Oncology Research

Abigail Salyers Department of Microbiology,

Murdoch Institute Ethical Issues in Clinical Trial Design. Ruth Morley Clinical Epidemiology & Biostatistics Unit Randomised trial of early diet and outcome Mike Starr

Orthopaedic Surgery, Allergan Inc,

Microbiology

Clinical Epidemiology and Biostatistics,

USA (Aoki)

Clinical predictors of radiological pneumonia.

Department of Paediatrics

Kerr Graham, Roslyn Boyd, Roger Aoki

Introduction and background to the development of Botulinum toxin A (BXTA) in children with cerebral palsy. Update on recent work with BXTA and Biomechanical transformation of the gastroseoleus muscle

Geoff Davidson Director of Gastroenterology, Adelaide

diseases. Paul Johnston, and Tim Stinnear, Epidemiology of Mycobacterium Ulcerans.

Use of Victorian Children and Young People.

University of Melbourne School of Dental

Paediatric Cardiologist, Royal Brompton

Dermal Therapeutic Research

Endocrinology Department Christie Hospital UK.

Huseyin Mustafa Gastroenterology Epidemiology and characterisation of human astroviruses.

Development and validation of an asthmaspecific quality of life questionnaire for adolescents.

General Paediatrics

Senior Lecturer, Department of Preventive and

Guidelines attached to hospital name badges improves antibiotic use.

of inherited enamel defects.

Measuring physical and psychosocial wellbeing of primary school children with learning difficulties.

Lyndal Bond Centre for Adolescent Health Immunisation in childcare.

Social Medicine, University of Otago Medical School, Dunedin NZ Conduct Disorder - Some recent findings from the Dunedin Longitudinal Study.

Kari Storhaug Head, Resource Centre for Oral Health in Rare Medical Conditions Dento-Facial morphology in children with Prader-Willi Syndrome.

Martin Delatycki Murdoch Institute Friedrech Ataxia: the patient and the fibroblast. Phillip Ragg

Neuropsychological outcome in children with

David Armstrong

bacterial meningitis. A prospective study.

Respiratory Medicine

Anaesthetics

Lower airways infection mucoid Pseudomonal

A comparison of paracetamol and Painstop

Aeruginosa in young children with cystic

for day surgical anasethesia.

Inotropic stimulation in the developing

Dianne Campbell

cardiovascular system.

Department of Immunology The role of Staph Aureus in childhood atopic dermatitis.

Network Library Services Manager RCH Library

Craig Ollson

Searching data bases for journal articles:

Centre for Adolescent Health

howto improve your technique.

Chronic Illness Peer Support Project-assisting young people with chronic illness.

intervention for general practitioners in adolescent health.

Topical gene therapy for psoriasis.

Rob McGee

Centre for Community Child Health

Hospital UK

Judy Stoelwinder

Christopher Wraight

Recent endocrine observations in the child

Clinical and molecular genetic studies

Mental Health Services

Designing and evaluating an educational

treated for cancer.

Mary-Ann Lobo

Peter Anderson

Centre for Adolescent Health

Microbial ecology of the gut.

Jenny Royle

Science

Prevalence of Rheumatic Heart Disease

Dan Penny

short bowel syndrome in a preclinical model.

Lena Sanci

Centre for Adolescent Health

Steven Shalet

of very high risk young people.

University of Illinois

Christophe Rutishauser

Mechanisms, modulation and management of

Hepatitis B vaccination uptake and rates of hepatitis B and hepatitis C in a group

The unchartered world within us:

effect of sensation seeking and depression

Passive protection against diarrhoeal.

Michael Aldred

in Samoan Children.

Social and emotional factors modifying the

Clinical Nutrition

Measuring Health Concerns and Service

Clinical Epidemiology and Biostatistics

Centre for Adolescent Health

in early adolescent substance abuse.

Centre for Community Child Health

Andrew Steer

John Toumbourou

Julie Bines

RCH and Monash University Elizabeth Waters

its incorporation in statistical models.

in pre-term infants.

Women's & Children's Hospital

by injection of BXTA and casting in ambulant children with cerebral palsy.

Measurement error in medical data:

adolescents: a qualitative study.

STIM 1, a novel growth suppressor gene. Julian Savelescu

Rory Wolfe

Plasma levels after rectal administration of paracetamol in children.

fibrosis. John Massey Respiratory Medicine Newborn screening for Cystic Fibrosis: more or less? Robert Klupacs

Gordon Baikie

Director of Intellectual Property, AMRAD

Child Development and Rehabilitation

Corporation

Aspiration in Cerebral Palsy.

Intellectual property and patents in medical research.

14 RCH Research Institute 1998

RCH Research Institute 1998 15

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Department Reports

Allergy

Anaesthesia

Director

Dr David Hill, FRACP

Dr Kester Brown, MBChB MD FANZCA FRCA

Staff

Deputy Directors

Jenny Brown, RM

Dr Rod Westhorpe, MBBS FANZCA FRCA

Leone Thiele, BA RM

Dr Rob Eyres, MBBS FANZCA FRCA

Dr Cliff Hosking, FRACP

Staff Coroner

Dr Ian Humphrey, MBBS FRACP

Dr Chris Bolton

Dr Mimi Tang, MBBS PhD FRACP

Katrina Brereton, RN

FRCPA(lmmunol)

Dr George Chalkiadis

Dr Saowopark Chumpathong Dr Geoff Frawley Dr Jeanette Low Dr Ian McKenzie Dr Philip Ragg

Danielle Mitrou, RN

Invited International Presentations by Dr David Hill

Main Research Interests and Directions Recent research has focused on accidental ingestion of known allergens, and the appropriate

ALLSA Scientific Congress, Johannesburg,

labeling of packaged foodstuffs. The incidence of accurately labeled manufactured foodstuffs was

South Africa, The Melbourne Atopy Cohort

analysed according to specific food proteins. A genotype study has been researching the gene

Study: the role of diet in infancy.

responsible for eczema, which affects approximately 15% of infants. The benefits of house dust mite desensitisation are also being examined. The long-term study of 600 children at risk of

ILSI conference: Kuala Lumpur, Malaysia,

developing atopic diseases is now in its ninth year.

Asian Conference on Early and Childhood Nutrition: Growth Health and Economics -

The Centre continues to examine the causes and treatments of allergies, and has established

Food allergy and immunity-evaluating the

an international reputation based on its studies of infants and children.

risks and enhancing immunity in emerging disease profiles of food allergy in infants and young children.

Significant Achievements

Main Research Interests and Direction

The department is proud of the fact that in

The Department of Anaesthesia at the Royal Children's Hospital once again supported an active

recognition of his outstanding achievements

research program in 1998. Research activities centred on the assessment and critical appraisal

and contributions to teaching and research in

of anaesthetic agents (both new agents and those in current use) and techniques used for

anaesthesia and related areas. Dr Kester

anaesthesia and for post-operative pain relief. These were compared to drugs and techniques

Brown was awarded a Member of the Order

currently in use both in this institution and in other institutions around the world. All projects

of Australia. He also received an honorary

are undertaken in order to further our knowledge and understanding of the complex field of

membership to the German Society of

paediatric anaesthesia. Such research ensures that we continue to achieve excellence In

Anaesthetists.

the field of patient care as well as making significant contributions to the world literature on paediatric anaesthesia. The department was once again well represented internationally with Drs Brown, Westhorpe, Eyres, Ragg, Frawley and Chalkiadis all travelling extensively. They undertook a variety of teaching assignments and featured in many meetings as guest speakers around the world.

Finnish Medical Association Turku, Finland, The clinical spectrum of food allergy in childhood. ILSI conference: Washington, USA, Classification of Gl Diseases of Infants and Children Due to Adverse Immunologic Reactions to Foods - The role of food protein intolerance In colic. UCB Pharma conference: Bali, Indonesia, The World of Allergy: Leading the Way The prevalence of food allergy In Australia and Asia.

18 RCH Research Institute 1998

RCH Research Institute 1998 19

Biochemistry Director

Arthur BW Yong, BAppSc MRACI

Professor Edward Janus, MD PhD FRACP

Russell Hawkins, Bsc (MLT) AIMLS

FRCPA Ronda Greave, BSc MAppSc DipEd MAACB

Professor E. Janus, 1st Congress of the Asian Pacific Society of Atherosclerosis and

Staff Dr John Connelly, MD BS MAACB

Invited International Presentations

Mary Eggington, BEc BSc

Vascular Diseases, Taipei, Taiwan, March 1998. Apolipoprotein (a) - a new risk factor -

Dr Joseph Montalto, PhD BAppSc Dip Biochem Peter Vervaart, BAppSc MAACB FAACB MAIMS James Pitt, BSc(Hons)

Genetic and environmental influences on phenotypic expression. Professor E. Janus, American Heart Association Scientific Sessions, Dallas, Texas, USA, November 1998. Traditional risk factors and changing incidence of cardiovascular disease.

Main Research Interests and Direction Significant Achievements

Dptimal health status in children and probably life time health status is affected by factors prior to birth, for example smoking and toxaemia, both of which are common. Accordingly the

Professor E.D. Janus was awarded a 1998

Biochemistry group participates in research on smoking cessation in pregnancy. Specifically

Research Excellence Prize by the University

urinary cotinine assays and reference intervals have been set up to detect women wbo relapse

of Hong Kong, his employer until 1997, for his

after ceasing smoking in pregnancy. This work has been done by Professor Janus and Rhonda

work on genetic and environmental factors

Greave in collaboration with Professor S. Brennecke, Sue Bishop and Lisa Trotter (Perinatal Unit

influencing apolipoprotein (a) expression.

RWH and QUIT). This work has major public health implications.

Peter Veraart was the 1998 Australian

Work at a preliminary stage (Professor E. Janus and Dr. A. Nankervis with Colleagues in Perth)

National Winner of the 2nd International

involves the study of newly recognised factors potentially predisposing to preeclampsia (PET)

Federation of Clincal Chemistry-AVL award.

in pregnancy in women with gestational diabetes. Specifically lipid and lipoprotein abnormalities,

He will be one of 10 National winners to

homocysteine, apolipoprotein(a), and factors predisposing to thrombosis (factor V Leiden and

participate in tbe IFCC-AVL Award Symposium

protein S deficiency) are being investigated. It appears that atherothrombosis and PET may share

on Advances in Critical Care Testing in

common pathophysiological pathways.

Florence in June 1999. Dr. John Connelly, with Professor E.D. Janus, Dr. Glynis Price (Endocrinology) and Assoc. Professor T. Nolan are analysing the long term follow up of over 300 children with Congenital Hypothyroidism to determine their long term intellectual performance and specifically those factors at birth and the precise mode of treatment which determine the best outcome. As 1 child in 3,000 worldwide is born with this deficit this is an important issue. Only a few other centres in the world have long term follow-up data, but in smaller numbers of children, and there is still considerable debate on tbe correct treatment regimes in early infancy. Peter Vervaart is undertaking collaborative studies for his PhD with Drs. G. Rice and P. Henschke of the Perinatal Research Centre on oxidative stress and respiratory disease in a rabbit model. This work has implications for the management of neonatal respiratory disease. James Pitt is continuing his PhD studies on glycoprotein structure using mass spectrometry. The objective is to apply this knowledge when Tandem Mass Spectrometry is introduced shortly to investigate Inborn Errors of Metabolism (overnight neonatal screening and also the investigation of rare and recently recognised disorders). Joe Montalto and Arthur Yong have continued to support the research done in Endocrinology particularly in intersex states and adrenal disease.

20 RCH Research Institute 1998

Cardiac Surgery Director Dr Tom R Karl

Invited International Presentations Attended

Deputy Director

Cochrane AD. Invited speaker: International

Dr Christian PR Brizard

Society for Heart Research, Australasian section, August 22-23, Sydney, Australia.

Staff

Current challenges in paediatric cardiac

Andrew Cochrane, FRACS FRCS CTh

surgery. Brizard CP. 4th International Congress of Cardiology and Cardiac Surgery. Kaslik, Lebanon, October 1998. Aortic valve surgery

Awards and Prizes

Main Research Interests and Directions

in children.

Clarke A. Thuys (perfusionist) was the winner

In 1998 the general purpose of the research activities of the Cardiac Surgery Unit at the Royal

Karl TR. Paediatric Cardiac Society Meeting.

of the Bard Award for Meritorious

Children’s Hospital was to evaluate the long term effect of the surgery we perform and to try

University of Amsterdam, Academic Medical

Presentation by an ASCVP member.

to diminish the side effects of the operations.

Australasian Society of Cardiovascular Perfusionists 15th Annual Scientific Meeting, October 17, Melbourne. Title: Bypass for Hepatic Tumour Resection

Centre, Amsterdam, September 1998. Surgery for truncus arteriosus. Extended indications

Understanding of the long-term outcome and complications is essential to allow improvement of the surgical strategies for repair, and therefore patients require long term follow-up after their operation. Recently we have focused on a sub-group of tetralogy of Fallot patients and also on a particular coronary artery abnormality. Prospective, randomized studies of different forms of therapy also signify a new era of cardiac surgery, and although these studies are time consuming

for the arterial switch operation. Cardiopulmonary bypass in neonates. Coronary anomalies in children, LVAD and ECMO in children. Tetralogy of Fallot: surgical update.

Karl TR. XXVIII Annual Congress of the Italian

Thuys CA. Australasian Society of

Society of Pediatric Cardiology, Bergamo,

Cardiovascular Perfusionists 15th Annual

October 1998. ALCAPA: Indications and

Scientific Meeting, October, 1998. Bypass

results, A V septal defect: Surgical strategies.

for hepatic tumor resection.

Coronary anomalies in tetralogy of Fallot, Surgery for UVH:The Melbourne experience. Karl TR. Grand Rounds, San Camillo Ospedale, Roma, October, 1998. Surgery for coronary heart disease in adults. Tetralogy of Fallot: Strategy for simple and complex cases. Karl TR Argentine Cardiac Society, Buenos Aires, October, 1998, Truncus arteriosus: Melbourne strategy, Cardiopulmonary bypass and perioperative support for the arterial switch operation, Univentricular heart: Surgical strategy and results. Coronary anomalies in coronary heart disease. Pulmonary atresia with intraventricular septum: Melbourne strategy, Extracorporeal support in children.

and expensive, the knowledge generated is more reliable that retrospective studies. Three examples of these types of research are 1. Dr. Tom Karl is heading a project investigating the intellectual and neurologic development at a long interval after complex neonatal cardiac surgery. Our unit operates heart/lung machines differently to many other cardiac surgery units worldwide. We want to demonstrate that this has been beneficial on long-term neurologic development. 2. An international study has been organized and commenced, in order to assess the benefit of anticoagulation with Warfarin versus treatment with Aspirin after the Fontan operation. The Australian arm is conducted by Andrew Cochrane. This study aims to resolve one of the long term controversies in paediatric cardilogy and cardiac surgery, as to whether anticoagulation is necessary after this procedure. 3. A project directed by Dr Christian Brizard is currently investigating the possibility of reducing the adverse reactions resulting from the use of the heart/lung machine in very young babies, and different methods of preventing these responses.

22 RCH Research Institute 1998 .i

RCH Research Institute 1998 23

Cardiology Dr Brian David Edis, FRACP Dr Robert Gideon Weintraub, MBBS(Hons) FRACP

Director Dr James L Wilkinson, MBChB FRCP FRACP FRCPCH FACC

Dr Massamichi Tamura

Dr J.L Wilkinson, Interventional Procedures in

Mr Richard Jonas, M.D., Ladd Professor

Paediatric Cardiology. Hong Kong Paediatric

of Surgery, Harvard Medical School,

Society, November 1998.

Cardiovascular Surgeon in Chief, Children’s

Dr Najib Advani,

Dr Andrew Mark Davis, MBBS MD FRACP

DrSuwan Danworapong,

Senior Clinical Research Fellow

Dr Mok Toi Meng,

DCH FRACP Research Fellow

Deputy Director

Dr Carlos Mas

Dr Lance Vivian Fong, FRACP

Dr David Michael Coleman, MBChB DipObst

Prominent Visitors to the Department

Invited International Presentations

Cardiology Fellows

Hospital, Boston, Massachusetts, USA. - The

Dr J.L. Wilkinson, Controversies in the

Dr Masahiro Kamada,

Boston Children's Experience with ECMO and

Management of aortic stenosis, coarctation

Ventricular Assist Devices - 12th March, 1998

of the aorta and interrupted aortic arch - 3rd

Professor Norman Silverman, Professor and

National Symposium on Paediatric Cardiology, Dr Liu Xiao-Quin,

Dr Michael Cheung, BSc(Hons) MRCP

Dr Tiow Hoe Goh, MBBS FRACP FACC DDU

Director of Paediatric Cardiology, University

Jakarta, Indonesia, November 1998,

of California, San Francisco - Foetal

Dr J.L. Wilkinson, Congenitally Corrected

Echocardiography - 7th September, 1998.

Transposition of The Great Arteries - Meeting Staff Cardiologists

Dr Selwyn Milner, Johannesburg, H.I.V.

on Nomenclature of Congenital Heart Defects

Prof Samuel Menahem Cardiologist, MD BS

and surgical procedures - Society of Thoracic

in Children with cardiac problems in

Surgeons, Chicago, 1998.

Johannesburg. 30th November, 1998.

MEdMPM FRACP FACC

Significant Achievements

Main Research Interests and Direction

The Department has been successful in

We have continued the program of non-surgical closure of Atrial Septal Defects, which was

gaining substantial funding from the Health

initiated in 1996. Approximately 70 patients have now had device closure of atrial septal defects

Department for the programme of device

at Royal Children's Hospital, with a gratifyingly high success rate and minimal associated morbidity

closure of atrial septal defects. Dr Wilkinson

/complications. Almost all these patients have had complete closure of their defects and have thus

and Dr Goh have been actively involved in

avoided the need for open-heart surgery. Detailed follow up of these patients is continuing. Prior

assisting cardiologists in other States

assessment and procedure techniques are being refined to improve success rates further.

(Western Australia, South Australia and New South Wales) with the initiation of similar programmes for device closure of septal defects in adult patients.

A new non-invasive ultrasound technique called "Doppler Tissue Imaging" has been investigated for the assessment of heart muscle movement. Studies of a cohort of normal children and groups of patients with cardiac problems including atrial septal defects and cardiac transplant recipients are underway. Subtle abnormalities of the heart's electrical activity, which can be tracked on the EGG (T Wave Alternans) are being assessed to obtain normal data and to examine groups of children at risk from potentially life-threatening abnormalities of heart rhythm. Abnormal heart function, which results in many patients after repair of a common heart defect called 'Tetralogy of Fallot’, is a frequent phenomenon. The relationship of different abnormalities of function to increasing symptoms (effort intolerance) and to the risk of abnormalities of rhythm is being explored using a number of different techniques including magnetic resonance imaging and T Wave Alternans. The cardiomyopathies are a group of heart muscle diseases for which the natural history in childhood has not been clearly documented. A nationwide study has been established, based at the Royal Children's Hospital, involving collaboration from all the paediatric cardiology centres in Australia. This research is collecting data concerning the incidence, natural history and outcome for different types of cardiomyopathy in children. Another important study is in progress to review the psychological and emotional sequelae for

children and their families following heart surgery in childhood.

24 RCH Research Institute 1998

» »

Centre for Adolescent Health

Promotion of mental health and emotional well-being through research Many of the common mental health problems of adulthood emerge for the first time during the

.1'

Project Officers Catherine Ashton-Smith, B AppSc (Health Prom)

Director

Deputy Director Susan Sawyer, MBBS MD FRACP Staff Professorial Fellow-Dept of Paediatrics Glenn Bowes, MBBS PhD FRACP Senior Lecturers in Adolescent Health Friederike Veit, MBBS FRACP John Toumbourou, BA(Hons) MA PhD MAPS Senior Research Fellow

Gayle DiPietro, MedStBed DipDomArts TSTC Sara Glover, CertEd BEd (PhD in progress) Senior Epidemiologist

Yvonne Bonomo, MBBS

disorders. Furthermore it has become increasingly clear that emotional well-being in adolescents

Bernadette Walsh, BSW

emotional and mental health, the Centre for Adolescent Health has devoted much effort to clarifying

Elizabeth Gregg, BA(Hons)

PhD Students

its determinants and developing ways of promoting emotional well being.

Cathy Bauld, BA GDipChildAdolPsychol

The Victorian Adolescent Health Cohort study is now in its seventh year and has had depression

a state-wide survey of fifteen thousand young

Jennifer Sharpies, BBSci MPsychol

and anxiety as a primary focus of attention. The study has outlined risks associated with puberty,

Victorians with a view to providing a profile

Helen Butler, BA(Hons) Dip.Ed.GDip(AdolHlth) Julie Webb-Pullman, M PubHealth(Uni of

growing international recognition and acclaim. Major research projects undertaken for the Department of Human Services include

delineated the early course of depressive episodes and clarified ways of best identifying early

Otago), DipComHealth (Uni of Otago), BA

of the social environment and health of young

Lena Sanci, MBBS DipRACDG FRACGP

disorder in young people. Current data analyses are examining the relationship of depression to

people allowing services and health

Lyndal Thomas, BSc(Hons)

Mary-Ann Hope, RN RM BAppSci(AdNur)

risk factors such as childhood temperament, family history of depression, coping style, perceptions

promotion responses to target need in local

Research Assistants

MAppSci

of childhood parenting and the experience of recent life events.

Celia Godfrey, BA(Hons)

Melissa O'Shea, BA(Hons)

Delia O'Donoghue, MSW

Rachel Skinner, MBBS

The descriptive epidemiology of the Adolescent Health Cohort Study is complemented by the Gatehouse Project funded by the Queen's Trust, VicHealth and NH&MRC. In this project the research team of educationalists and health researchers has developed a school-based approach

Georgina Wilby, BA(Hons)

Robyn Davies, BA(Hons)

Heidi Terry, BMus BSc(Hons)

Yvonne Bonomo, MBBS

John Hargreaves, BA

Masters Student

a whole-school approach that measures and addresses those aspects of school life which affect

Lucy O'Malley

Judy Davey, RN RM

emotional health and well-being. This includes a focus on policies and procedures for dealing with

Melissa Hasty

Kay Mills, BappSc(OccTher)

victimisation, bullying and alienation or disengagement from school. In addition the project includes

GDipHlthEd& Prom

a classroom-based program which assists young people to explore common scenarios from

Meagan Crawford, BPubHealth Melissa O'Shea, BA(Hons)

to mental health promotion. The study is being conducted in 26 Victorian secondary schools over a five-year period with ongoing surveys of students, review and evaluation of curriculum development, school-based work and professional development of teachers. The project adopts

a range of perspectives and develop a repertoire of skills for dealing with common stressful and

B Med Sci Students

challenging situations young people might face.

Darren Lee

Sarah Croucher

Kerryn Rubin

Fellows

Merryn Redenbach

Epidemiologist Christoph Rutishauser, MD Post-Doctoral Research Fellow Jane Burns, BA(Hons) PhD

research which leads the Australian research endeavour in this area and which is receiving

is strongly related to future physical health. Reflecting the importance of promoting adolescent

Lyndal Bond, BA(Hons) MA(Appl Psych)

Carolyn Coffey, BSc GDip Soc GDip Epi

to mount innovative, multidisciplinary

Community Research

Michael Carr-Gregg, BA(Hons) MA PhD MAPS Lecturers

of disease in adulthood associated with problems such as depression, anxiety and psychotic

The Centre for Adolescent Health continues

Craig Olsson, BSc(Hons)

George Patton, MBBS MD FRANZCP MRCPsych

teens. Recent work from the World Health Organisation has attested to the subsequent burden

Vikki Dakin, MBBS(Hons)

Significant Achievements

Peter Azzopardi Jenny Proimos, MBBS MPH FRACP Lena Sanci, MBBS DipRACDG FRACGP

Promotion of emotional and social well-being has been a primary focus of work in the Centre's

■

mental health problems commonly affecting young people. Research staff derive from a broad range of disciplines: medicine, social work, education, nursing, epidemiology, biostatistics and psychology, reflecting the multidisciplinary approach of the Centre to adolescent health. The

Dr Jane Burns has commenced this year as a post-doctoral research fellow funded through NH&MRC. A further area of achievement has been the success of collaborations with departments around Australia. The Centre for Adolescent Health has established strong working relationships with the National Centre for Epidemiology and Population Health (NCEPH), National Drug and Alcohol Research Centre (NDARC) and the Department of Public Health at the Queensland University of Technology

leadership and peer support to deal with the difficulties posed by the experience of chronic illness.

(QUT). In addition a strong research link has

Outcomes of the program have been evaluated with support from VicHealth and the Australian

developed with the Social Development

Rotary Health Research Fund. This program is now being disseminated around the state in

Research Group at the University of

a program funded by VicHealth with a strong quality assurance component. It has been the model

Washington in the USA. These build on earlier

for the evaluation of other programs including CHAT (peer support for socially isolated young

collaborations to place the Centre for

people) and PATS (peer support for children with a parent with psychiatric disorder).

Adolescent Health in a leadership role

being. Risk factors such as low family cohesion, poor parenting and family conflict are well

Research at the Centre for Adolescent Health covers the spectrum of physical, behavioural and

support from NH&MRC scholarships.

Community Resources Unit. The CHIPS program has been developed to use strategies of peer

It is clear that families and parents have a crucial influence on the development of emotional well

Main Research Interests and Direction

areas. The number of doctoral research students continues to grow with strong

established. A range of interventions have demonstrated effectiveness in reducing these familial risk factors, however dissemination and training in these programs has to date been limited.

in this area of research in Australia.

Awards and Prizes Dr Sanci was recently named Young

In conjunction with Jesuit Social Services, the Centre for Adolescent Health is evaluating

Investigator of the Year by the American

a Commonwealth funded program delivering a multifaceted program for families experiencing

Society of Adolescent Medicine, the first

these problems.

Australian to win this award.

research program ranges across studies in general population settings, work with young people

Most young people with an emotional problem will be cared for by a general practitioner whose

at high risk of future health problems and the needs of those presenting to clinical services.

skills in engaging with an adolescent and knowing what treatment approaches are available is

In each of these settings the focus of research work includes a focus on better understanding

of central importance. Earlier work by Dr Lena Sanci and Dr Friederika Veit delineated the need

the causes and course of adolescent health problems, assessing the level of health need in young

for systematic approaches to the training of GP's around the care of young people. Dr Sanci has

people, design of preventive and treatment interventions and evaluating how effective these might

continued this research theme in a randomised controlled trial of education of GP's using

be. In all of this work the research program operates in close liaison with the provision of

a package designed according to the best principles of clinician education. This demonstrated

adolescent medicine services, health promotion and education and training.

dramatic gains in the knowledge, skills and attitudes of GP's, gains that persisted twelve montjts later.

26 RCH Research Institute 1998

RCH Research Institute 1998 27

The Centre for Adolescent Health has continued to work collaboratively with the Centre for Young People’s Mental Health around studies of young people at very high risk of future psychosis. These collaborative studies are providing invaluable data on the early natural history of psychotic illness, the determinants of transition to psychosis and the scope for preventive intervention.

Invited International Presentations Dr Susan Sawyer, International Respiratory Forum. Madrid, Spain, March 27,1998.

Promotion of physical health through research

Why asthma in children and adolescents

Many health risk and health promoting determinants of later physical health emerge during the

is different to adults

adolescent years. These aspects of the lifestyles adopted by young Australians have been a further core aspect of the Centre's research program.

Dr Susan Sawyer, International Association of Adults with Cystic Fibrosis, Berlin,

There is no more important threat to later adult physical health than that arising from adolescent

Germany, June 14,1998. Sexuality and cystic

use of tobacco. The early course of tobacco use and its determinants were explored in the

fibrosis. Not a sexy subject

Victorian Adolescent Health Cohort Study. The findings indicated the importance of both smoking friends and emotional well-being in predicting the onset of tobacco use but parental smoking emerge as the most important predictor of continued use of tobacco at the end of secondary school.

Prominent Visitors to the Centre Professor Anthony Mann, Professor

Tobacco smoking is a health risk behaviour that is particularly damaging for young people with

of Epidemiological Psychiatry, Institute

diabetes and asthma. In a collaborative study with the Department of Diabetes and Endocrinology,

of Psychiatry, London

the centre has determined the prevalence of active and passive smoking in adolescents with diabetes mellitus and asthma, its relationship to illness control and complications. It also aims to identify the reasons why adolescents with diabetes and asthma start smoking. This study is

Professor Bob Douglas, National Centre for Epidemiology and Population Health, Canberra

supported by the AZA Australasian Paediatric Endocrine Group Research Award and will lead to the development of health educational tools for paediatricians, adolescent physicians and GPs,

Professor Heinz Hafner, Zentralinstitutfur Seelische Gesundheit, Mannheim, Germany

Alcohol and illicit drug use are further important causes of physical health problems in adolescence and young adulthood through their direct effects and indirectly in the case of illicit drug use through

Professor Richard Catalano, University

blood borne diseases. These themes are a growing focus for the Centre with two PhD students

of Washington

commencing studies in adolescent alcohol abuse and the establishment of a formal collaboration

Professor Wayne Hall, National Drug and

with the National Drug and Alcohol Research Centre (NDARC).

Alcohol Research Centre, University of NSW,

Immunisation in adolescence is a growing area for health research given the introduction of new

Sydney

vaccines relevant to this age group. Immunising adolescents is not a straightforward process

Dr. Harvey Whiteford, Department of Human

however and surveys on adolescent immunisation worldwide indicate poor uptake. Hepatitis B

& Family Services, Mental Health, Canberra

and MMR (measles, mumps, rubella) immunisation uptake rates of adolescents in one council region of Melbourne in 1996 indicated less than satisfactory uptake levels. This study has identified

Dr. Jan Nicholson, Queensland University

factors that influence the outcome of adolescent immunisation, developed a model of immunisation

of Technology

delivery that maximises vaccine uptake in this age group and evaluated the model with a view

Dr. Michael Lynskey, National Drug and

to informing dissemination on a wide scale.

Alcohol Research Centre, University of NSW,

Asthma is the most common chronic illness In young people and has been the focus of clinically

Sydney

based research projects at the Centre. One has seen the development and validation of an

Assoc. Prof. Michael Sawyer,

instrument for measuring the Quality of Life in adolescents with asthma. A second qualitative study

Women's & Children's Hospital, Adelaide

funded by NH&MRC funded study, has been undertaken in collaboration with the Victorian College of Pharmacy and Monash and La Trobe University. It has identified barriers to adherence to asthma care in adolescents with asthma by interviewing young people with asthma and their parents.

Dr. Paul Surtees, Institute of Public Health, Cambridge, UK Dr. Richard Eckersley, National Centre for Epidemiology and Population Health, Canberra Dr. Rob McGee, Dunedin Study, NZ Prof. Sue Spence, University of Queensland

The Gatehouse Project: Classroom strategies for promoting emotional well-being 28 RCH Research Institute 1998 J

Ik 1

Centre for Community Child Health

# concerns. These results raise public health policy issues with regard to appropriate and effective preventive health strategies in schools and by health services, and prompted the development

Research Scholars and Public Health Trainees

of a policy entitled 'Improving the health of school aged children' for the Public Health Association.

Kerry Haynes, CertAppSci(MedLabSci)

Director Frank Oberklaid, MBBS MD FRACP DCH Deputy Director Jillian Sewell, MBBS FRACP StaH Colin Feekery, MBBS FRACP Frederick C Jarman, MBBS FRACP

Jodie Doyle, RN MHProm Sharon Goldfeld, MBBS FRACP Katie Heathershaw, MBBS Harriet Hiscock, MBBS Research Officers and Assistants

AssocDipOHS BAppScilHealth Promotion)

Sophie Jerrims, BA Clara Mbwili-Muleya, MBBS(Romania) MPH Zeffie Poulakis, BBSc(Hons) Kate Reid, BA(Hons) Kerry Phelan, RN

Implicit in research aiming to improve children's health are the tools to assess child health status

was awarded the 0AM (Medallion of the

and the outcomes of health interventions. Development, assessment and promotion of such tools are key components of our research strategy. The HOYV study also provided normative information

Order of Australia).

for an important new child health status measure, the Child Health Questionnaire. Results provided

Sharon Goldfeld was awarded the prestigious

initial confirmation of its structural integrity for Australian use, and its ability to discriminate healthy

Harkness Fellowship to undertake

children from those with health concerns and those with frequent use of health services. It has

a comparative study in Boston, US, in 1999

since offered important insights into the emotional, physical and family functioning of children with

("Investigating how research findings and

a range of clinical conditions attending the Royal Children's Hospital. In turn, this is now leading

program analysis informs public policy for

to the Centre assisting clinical departments to themselves adopt ongoing functional outcomes

services to children aged 0-3 years") and

measurement for children with appropriate conditions. Preliminary work is now also being

an NHMRC Public Health Travelling

undertaken in the development of an infant health status measure.

Fellowship.

It is becoming clear from the work of Sharon Goldfeld that parents of young children often seek

Elizabeth Waters was awarded an NHMRC

health care extraordinarily frequently. Despite this, children and their parents are known to suffer

Public Health Travelling Fellowship and the

Karen Campbell, BSc GradDipDiet GradDipHealth Promotion MPH

Melissa Wake, MBChB FRACP DipObst DCH

Louisa Salmon, BA(Hons)

Elizabeth Waters, RN GradDipBusInfoSyst

Kylie Hesketh, BBSc(Hons)

Melinda Barker, BSc GradDipEdPsych

Kerryn Saunders, MBBS MD

GradDipEpi

Members of the Centre received major awards in 1998. Professor Frank Oberklaid

Ying Chen, BA MPH(Master of Public Health) MHIthSci(Public Health Practice) candidate

Awards and Prizes

from a range of high-prevalence problems which frequently remain undetected by primary care

Royal Children's Hospital Uncle Bob's

health professionals and for which secondary referral services are limited. In two community based

Travelling Scholarship to undertake her DPhil

studies (the Parent Education and Support project and the Infant Sleep Study), we are trialing

at the University of Oxford in the field of child

the systematic use of simple, validated parent reports to elicit problems such as sleep difficulties,

health status measurement and its application

Julie Green, RN Grad Dip HealthEd MPH

developmental concerns, postnatal depression and behavioural problems in the first two years

to child public health.

Michelle Haby de Sosa, BAppSc MAppSc PhD

of life, which are then backed up by simple interventions which can be delivered by nurses or family doctors. We hope that this approach will prove both acceptable and sustainable to families,

The Centre contributed two of the six finalist

Mary-Ann Darcy, RN BEd GradDipSociol Deidre Gartland, BSc(Hons)

MPH DPhil (candidate) Martin Wright, MBBS MD MPH FRACP

professionals and health care funders alike.

Main Research Interests and Direction

best paper in Community Child Health at the

The Centre continues the theme of evidence-based child health, collaborating in a much-publicised

Australian College of Paediatrics Annual

Cochrane Systematic Review of outcomes of smoking cessation programs for pregnant women.

Scientific Meeting.

in collaboration with Professor Judith Lumley and Dr Sandy Oliver, which has received wide

Working with populations and with individual children and their famiiies, dealing with conditions

recognition in Australian and British health policy strategies regarding the provision of universal

of widely varying severity, in the hospital and in the community - the Centre's diverse research

smoking cessation programs in maternity hospitals. Additional reviews in the area of asthma

activities are linked by common themes and common goals. Fundamental to our research is the

education, prevention of obesity, smoking cessation programs for families and carers, injury

aim of improving the health of all children in our community, through a mix of clinical,

prevention, developmental screening and outcomes of therapy for otitis media with effusion are

epidemiological, information and policy research activities.

papers competing for the Rue Wright prize for

VicHealth in September awarded the "Research to Practice Award" to Dr Rick Jarman for the Infant Hearing Screening Program.

in process. As a result of these reviews which predominantly focus on public health and health promotion interventions, Elizabeth Waters was invited to contribute on Systematic Reviews for

Our hearing impairment research illustrates a Centre theme which draws together population-

Public Health and Health Promotion at the Menzies Foundation/NHMRC closed conference

based and clinical research. The Victorian Infant Hearing Screening Program has enabled Victoria

on Evidence-based Health Advice in November.

to lead Australia in the early detection of sensorineural hearing loss. In 1998 the Centre was awarded VicHealth funding for evaluation of the developmental outcomes arising from earlier detection due to the program, and a second project is assessing the impact of the program

The year has been a very successful one for Geographic Information Systems (GIS) in Health, — L

a collaborative cross-sectoral public health research partnership with the Department of

on both hearing and hearing-impaired children. A major breakthrough in collaboration with the

Geomatics at the University of Melbourne. Collectively the partnership has been awarded three

Murdoch Institute was Kerryn Saunders' work in description of the phenotype associated with

ARC grants and a General Practice Evaluation Project Grant, and is a partner in the short-listed

connexin deficiency, now believed to be responsible for most autosomal-recessive deafness.

submission for a Cooperative Research Centre for The Atmospheric Environment and its Impact,

At the other end of the deafness spectrum, conductive hearing loss is mild but affects an enormous

the outcome of which will be known in late March 1999. Research in the area of GIS and pertussis,

number of children, and Katie Heathershaw has continued her research into optimising

in collaboration with the Department of Human Services, has highlighted the spatial and information

identification of otitis media with effusion and assessing its impact in the school entry population. The Health of Young Victorians (HOYV) study yielded valuable information about the health and well-being of 5,414 5-18 years olds across Victoria, and showed conclusively that Victorian primary

requirements for sophisticated infectious diseases surveillance systems. Qualitative and quantitative evaluations of the usefulness of GIS for Divisions of General Practice aim to help in the process of developing public health directions for these organisations.

school children are now significantly more obese than in 1985. Health worries reported by adolescents were of particular concern because, despite their prevalence (especially feelings of depression, worries about weight, and worries about self confidence), few of any age reported seeking help outside their immediate circle of parents and friends, especially for emotional health

30 RCH Research Institute 1998

RCH Research Institute 1998 31

r Invited International Presentations

speaker at two one-day conferences, "Early

Dr Paul Glasziou, University of Queensland,

detection of problems in young children (birth

and members of the Australasian Cochrane

- 6 years)" and "Promoting healthy outcomes

Centre provided the key presentations for the

Professor Frank Oberklaid, Cottrell Visiting

for primary school aged children". Professor

Child Health Systematic Review course.

Professor (under the auspices of RACP), New

Dworkin's visit gave a boost to discussions

Zealand, June 1998.

witbin the Centre regarding our research

Professor Frank Oberklaid, 12th International

strategy in prevention and early detection.

Congress of Paediatrics, Amsterdam, The

Dr Charlie Homer, Director, Clinical

Centre for Hormone Research Incorporating Endocrinology and Diabetes Associate in Clinical Biochemistry

Netherlands, August 1998. "The changing

Effectiveness Programs at the Children's

nature of paediatric services - the emergence

Hospital in Boston, provided presentations

of community child health."

on health outcomes and patient satisfaction

Professor Frank Oberklaid, Keynote Speaker,

to senior RCH staff in November and was

Christchurch, New Zealand, October 1998.

an invited tutor in the CCCH/CEBU Evidence-

"Consensus conference on research agenda

based Child Health Course.

Joseph Montalto, BAppSci PhD

Centre for Hormone Research Executive

Christopher Wraight, BSc(Hons) PhD

Research Groups

George Werther, MD MSc(Oxon) FRACP

Androgen Research Unit Chief Investigators

(Chairman)

Garry Warne, MBBS FRACP

Jeffrey Zajac, MBBS FRACP PhD

Professor Gerald Rushton, University of Iowa,

Prominent Visitors to the Centre

was an invited international speaker to the

Andrew Sinclair, BSc(Hons) PhD Principal

Research Officers

CCCH/Department of Geomatics second

Research Scientist

Helen Maclean, BSc(Hons) PhD Karen Greenland, BSc(Hons) PhD

Systems (GIS) in Health, and presented a very

Endocrinology and Diabetes

successful seminar on developing a research

Director

agenda for GIS in health.

Garry Warne, MBBS FRACP

was a valued guest of the Centre for 3 days in August. During that time he was the keynote

Post-doctoral Research Fellow Paul White, BSc PhD (Pharm)

Rhys Fogarty, BBiotech (Hons) Ingrid Liepe, BSc Sandra McKean, BSc(Hons)

annual seminar on Geographic Information of Paediatrics at the University of Connecticut,

George Werther, MD MSc(Oxon) FRACP

Research Assistants

for neonatal follow-up and outcomes."

Professor Paul Dworkin, from the Department

Dermal Therapeutics Syndicate Chief Investigators

PhD Students Emma Ball, BSc(Hons)

Daryl Venables, BSc(Hons) Project Management Assistant Anna Fairclough, BSc

Georgia Giannakis, BSc(Hons) Deputy Director

George Werther, MD MSc(Oxon) FRACP Staff Endocrinologists Fergus Cameron, MD BMedSci FRACP

, Glynis Price, MBBCh FCP(SA) FRACP Margaret Zacharin, MBBS FRACP Fellows Preeti Dabadghao, MD

Georgia Rekaris, BSc(Hons)

Molecular Development Unit Chief Investigator

Research Assistant

Andrew Sinclair, BSc(Hons) PhD

Leah Heffernan, BSc(Hons)

(NH&MRC Senior Research Fellow)

Growth Research Unit Chief Investigator

Post-doctoral Research Fellows

George Werther, MD MSc(Oxon) FRACP

Michael O'Neill, BSc(Hons) PhD

Senior Research Scientist Christopher Wraight, BSc(Hons) PhD Senior Associate

Peter McClive, BSc(Hons) PhD

Matthijs Smith, BSc(Hons) PhD Craig Smith, BSc(Hons) PhD

Ahmed Massoud, MD MRCP

Leon Bach, MBBS PhD FRACP

Helen Wilmore, BSc(Hons) PhD

Joseph Pua, MD

CSL Research Fellow

PhD Students

Andrew McFarlane, PhD

Jane Andrews, BSc(Hons)

Research Officer

Patrick Western, BSc(Hons)

Research Nurses Debbie Boyce, BBSc RN Ann Reilly, RN Dietician Heather Gilbertson, APD BSc GradDipDiet

Suzie Ymer, BSc(Hons) PhD Katrina Bell, BSc(Hons) PhD Students Stephanie Edmondson, BSc(Hons)

GradDipDiabEd

Vince Russo, BSc(Hons)

Endocrine Social Worker

Research Assistant

Elizabeth Loughlin, MA

Janet Stevenson, CertAppISci

Research Psychologists

Technical Officer

Elisabeth Northam, MA PhD

Naomi Baker

Kirsty Reed, BSc(Hons)

Peter Anderson, BA(Hons)

Harriet Hiscock examines a baby in the Infant Sleep Study RCH Research Institute 1998 33

“II

Main Research Interests and Direction

Significant Achievements

The mission of the Centre for Hormone Research is to prevent the long-term consequences

The Dermal Therapeutics Syndicate,

of endocrine disease occurring in childhood and adolescence. Major diseases and health issues

developing a new topical gene therapy

in our society such as diabetes, osteoporosis and infertility, have their beginnings in early life.

for psoriasis, achieved "Proof of principle",

Similarly, normal growth and development of each specialised body organ is essential to adult

namely identifying a "lead compound"

health. The research in our Centre is focussed on these key areas of growth and its control by

antisense oligonucleotide shown to be active

growth factors, sexual development and its control by genes and hormones, diabetes and its

in reversing human psoriasis grafted onto

complications, and bone diseases such as osteoporosis. Our laboratory and clinical research

a "nude" mouse. Furthermore, broad patents

is closely linked to our patient population, so that our discoveries will have real immediate and

in the U.S, Australia and New Zealand were

future benefits to our children and their families, as well as to society in general.

granted for this exciting invention.

The Growth Research Group, headed by George Werther, is studying the "Insulin-like growth

The inaugural G4 Scientific Meeting of the

factors". IGFs are essential to normal development of each body organ, and play a key role in

Centre for Hormone Research was held from

several important diseases. The group's work, involving molecular and cell biology, is examining

October 22-24, at the Royal Children's

the way the IGFs regulate growth of individual cells, both healthy and diseased. Studies in the

Hospital, with a theme of "G4" - glucose,

brain have shown that the IGFs play critical roles in control of nerve cell survival, particularly

gonads, growth and genes. Some 75

following brain injury. Our work in the laboratory, in collaboration with colleagues in New Zealand,

delegates attended from around Australia,

offers potential new treatments for birth injury and stroke.

with four distinguished invited international

Our work in diabetes shows that the IGFs are involved in the devastating complications causing kidney failure, blindness and nerve damage. These findings may allow the manipulation of the effects of the IGFs in diabetes, and reduce the risks of these unacceptable complications. In the skin the IGFs are critical for normal development, and the group's studies examining the way they access skin cells has led to an exciting spin-off offering a new and effective topical gene therapy for the common skin disease psoriasis (see below).

speakers. We also organised and hosted the Biennial National IGF Meeting on October 25th at the Zoo, Andrew Sinclair's group was awarded US, European, and Australian patents for a novel sexing gene ASW, which will have many industrial and other applications.

The Dermal Therapeutics R & D Programme headed by Christopher Wraight and George Werther

mmm

is developing a new gene therapy for the common skin disease psoriasis. The technology at the

Awards and Prizes

core of the project is a new category of therapeutic molecule called antisense oligonucleotides

The Macquarie Bank Travelling Fellowship

(AON). We have developed an AON that blocks the IGF response system in psoriasis and this year

was awarded by Royal Australasian College

saw some exciting advances in the project. We demonstrated reversal of psoriasis in our animal

of Physicians to A/Prof George Werther

psoriasis model, which consists of biopsied human psoriasis lesions donated by patients, then

in support of a sabbatical at the University

grafted on "nude" mice. The second major advance was the granting of a broad US patent in

of Michigan in 1999.

November, protecting our ability to market the technology. The project now enters the critical formulation stage: our "lead compound" will be formulated into a cream in readiness for clinical trials on psoriasis sufferers. The Molecular Development Unit, headed by Andrew Sinclair, has isolated several novel genes by analysis of differential gene expression from the embryonic chick genital ridge and produced detailed expression profiles for several genes. The tissue and sex specific expression patterns suggest new roles of these genes in early gonadal development. They are examining other gene family members and isolating the human gene to establish their roles in gonad development and sex determination. They have continued to search for mutations in genes which control normal testis development, particularly in sex reversed patient groups. This mutation analysis has provided new insights into critical regions of these genes which are necessary for correct testis development. In their other major project they have identified several new human SOX genes which play important roles in development. The new SOX genes have been analysed in detail to determine where and when they are expressed in the developing embryo. These new SOX genes have been mapped to human chromosomes and these regions examined for known human disease syndromes. They are currently analysing patient groups for mutations in these SOX genes.

aiSfc

Aruirew Sinclair and Katrina Bell analysing the expression pattern of their newly discovered gene RCH Research Institute 1998 35

an enlargement of the human androgen receptor results in the development of a form of motor

Prominent Visitors to the Department

neurone disease (Kennedy's disease) in males. Questions that relate to this are; what are the genes

The Honorable Sir James Gobbo, Governor

Our Androgen Research Group, headed by Garry Warne and Jeffrey Zajac, is investigating how

that are stimulated by androgens in the nervous system? To which DNA sequences does the

child Development and Rehabilitation

of Victoria - Patron of the Centre

androgen receptor bind? Can we develop an animal model of Kennedy's disease that would make the condition easier to study in a living organism? We have examined ways in which the mutated androgen receptor alters gene transcription in cultured cells. We have used differential display

Professor Otto Mehls, Paediatric

Dr Chris Williams, Neuroscientist, University of Auckland

Kathleen Cole, BBSc

Paediatricians

Jane King, BSc(Hons) Janet Walstab, BSc

Director

androgen-responsive gene, ARC-2, that was discovered using whole genome PCR. We are making

Research Assistants

Lynn Robert

Enver Bajraszewski, MB BS FRACP

Nephrologist, University of Heidelberg

to identify androgen responsive genes in a neuroblastoma cell line. We are studying a unique

Medical Records Administrator

Dinah Reddihough, MB ChB BSc FRACP

Bronwyn Cathels, MB BS FRACP

Research Midwives

Kevin Dunne, B Med Sc MB BS FRACP

Caroline Collis

Catherine Marraffa, MB BS FRACP

Catherine Hazard, BN(Mid)

Doug Bryan, MB BS FRACP FAFRM

Margaret Rowell, MB BS FRACP

Moira Stewart

Staff Clinical Psychologist

Paediatric Neurologist

Speech Pathologists

University Wellcome CRC, lecture on germ

Kevin Collins, MB BS FRACP

Libby Ferguson, BAppSc

cell development.

Daphne Glaun, MA PhD

Physiotherapists

Hilary Johnson, DipSpTh MA(Ed)

of bone density in hypogonadal men treated with sub-cutaneous testosterone from mid

Dr Jean D Wilson, University of Texas

Fellows

Adrienne Fosang, BAppSc

adolescence; a study of vitamin D status in chronically ill, recurrently hospitalised children;

Southwestern Medical School: interested

Gordon Baikie, BMedSci MB BS FRACP MRCP

and a study of uterine growth in girls with Turner's syndrome on oestrogen treatment.

in androgen action, on sabbatical in Zoology

good progress towards the mouse model of Kennedy's disease (transgene construction is complete) and are collaborating with Associate Professor Joel Bornstein, a neurophysiologist,

FAFRM

Professor David Hill - Developmental Biologist

Deputy Director

- University of Ontario

on functional outcome studies.

Professor Anne McLaren, Cambridge Dr Margaret Zacharin is conducting the following studies: trials of disodium pamidronate in polyostotic fibrous dysplasia and osteogenesis imperfecta; a study of bone density and the effect of interventional treatment in children with chronic disease requiring long term steroids; a study

Pamela Thomason, BAppSc

Christine Olesch, MB BS

at Melbourne University Dr Fergus Cameron's research interests during 1998 included virilising adrenal tumors in childhood, congenital pituitary disorders, diabetes and bone and calcium metabolism. His efforts have largely focussed on the establishment of bone mineral densitometry at RCH within the context of a

Professor Roger Short, Royal Women's Hospital, lecture on reproductive biology

"Healthy Bones Unit". This unit will facilitate research into the paediatric precursors of

Dr Denis Lubahn, Columbia University,

osteoporosis. His diabetic research is looking at perceived health and lifestyle issues associated

Missouri, steroid hormone receptors. Lecture

Main Research Interests and Directions

with diabetes, prevention of diabetic nephropathy, assessing degree of dehydration in diabetic

at G4 Meeting on oestrogen receptors

The Department of Child Development and Rehabilitation is committed to the care of children with

Professor Louis Low, University of Hong Kong,

disabilities, particularly children with cerebral palsy, spina bifida, intellectual disability and multiple

ketoacidosis, and benefits of outreach programs to diabetics in remote areas. General endocrine research interests include predictive factors for thyroidectomy in Graves disease and metabolic consequences of premature pubarche.

disabilities. The research program has two important aims; firstly to learn more about the causes

Queen Mary Hospital, lecture on growth

of childhood disability; and secondly, to improve treatment methods to ensure the best possible

hormone therapy at G4 meeting

outcomes for children and their families. Professor Steven Shalet, Christie Hospital,

Invited International Presentations Garry Warne Lecture series. Department of Paediatrics, RIPAS Hospital, Brunei Department of Paediatrics, Kuala Beleit

Causes of childhood disability

George Werther

Manchester, APEG Guest Lecturer, lecture

April 1998: International Growth Symposium,

on the endocrine consequences of cancer

It is vital to learn more about the causes of childhood disability. In our efforts to initiate preventive

Lyon. France; IGFs in the brain

treatment

strategies, gathering new information about responsible factors is an important first step. Cerebral

May 1998: Children's Hospital Research

Dr Jeremy Allgrove, St Bartholomew's

this disorder, the cause is unknown. Dur research in this area approaches

palsy is the major cause of physical disability in childhood, and yet, in about half of all children with

Foundation, Cincinnati, Ohio. "GH usage

Hospital, London. Lecture on Bisphosphonate

in Australia"

treatment in children.

the problem in several different ways. A Cerebral Palsy Register has been established which is useful both for monitoring trends in frequency, and is also valuable for selecting specific groups

Hospital, Brunei "Non-insulin dependent

of patients for further study. In 1997, a National Health and Medical Research Grant was obtained

diabetes in childhood and adolescence"

to investigate antenatal, perinatal and neonatal antecedents of severe spastic cerebral palsy. This

Training Programme: National Institute

work continued in 1998 and will be completed in 1999. For this project, we sought the collaboration

for Paediatrics, Hanoi, Vietnam

of the three major maternity hospitals in Victoria, along with the Perinatal Data Collection Unit.

Consensus Meeting of Italian Paediatric Endocrinologists, Isola di Tessera, Venice "Intersex surgery in infancy: sometimes or never?" ESICDN: Annual Conference of the Endocrine Society of India, Banares Hindu University, Varanasi: "Gonads, genes and gender"

Dther research in this area has involved, firstly, a study of the MRI brain scans of children with cerebral palsy. Secondly, two mutations have been identified in recent years that predispose carriers to venous thrombosis (thromboembolism). One is a mutation localised to the factor V gene called the Factor V Leiden mutation. It is questioned whether the presence of this mutation may predispose children to cerebral palsy and this is being studied. Evaluation of outcomes to improve treatment methods The other major focus of our research program is an evaluation of treatment strategies so that the best interventions can be put in place for children and their families. During 1998, we completed

,51

our work evaluating programs based on Conductive Education for young children with cerebral palsy and published a randomised study which demonstrated the benefits of both this approach and more traditional methods.

36 RCH Research Institute 1998

RCH Research Institute 1998 37

':T

Clinical Epidemiology and Biostatistics

In collaboration with the Department of Orthopaedics, we have embarked on a number of studies. Firstly, Botulinum toxin A has recently been introduced for the treatment of spasticity in cerebral palsy. Benefits reported include reduction in muscle tone and increased range of motion at joints. However, the toxin is costly with an uncertain duration of action in young children and administration often requires an anaesthetic. We are evaluating the role of Botulinum toxin A

Justine McCourt, RN RM Dip App.Sc RM

Jenny Foord

GradDip(HealthProm)

Debbie Gercovich, SEN

therapy in the treatment of cerebral palsy to assess whether administration does improve functional outcome in young children. Secondly, single event multilevel surgery is being used for

Marg Flood, RN RM DipArts

Head

Anita Imberger, BSc(Hons)

consumption following this procedure. Finally, we are collaborating in an important multicentre

Associate Professor Terry Nolan, BMedSc

Kathleen Lanigan, SEN

project which aims to evaluate the use of a new brace, along with Botulinum toxin A injections,

MBBS PhD FRACP FAFPHM

for the treatment of hip problems in cerebral palsy.

Deputy Head

children with cerebral palsy, and a study is being undertaken to determine the changes in energy

Liz McGrath, BA DipEd Associate Professor John Carlin, BSc(Hons)

Respiratory illness is a major problem for some children with cerebral palsy. In conjunction with the Departments of Gastroenterology, Speech Pathology and Thoracic Medicine, we are continuing to study diagnostic methods that may help to provide better information as to which children are at risk for lung disease. We also hope to establish whether modified feeding regimes may be

PhD

Charan Sandhu, SEN

Staff Menzies Foundation Fellow

Debbie Saunders, SEN

Ruth Morley, BA MBBchir FRCPCH

beneficial for these children. Together with the Departments of Speech Pathology, Dentistry and Plastic Surgery, we are continuing our work to evaluate the optimal treatments for drooling in children with developmental disabilities. Our group demonstrated that dental caries may develop following surgical treatment if dental care is not maintained. We are attempting to establish which particular children are at risk

Susan Smith, RN RM

Research Officers

Trina Laffey, BHealthSc

Mary-Ann Darcy, RN DipAppSci Bed DipSoc

Rosie Gehrig-Mills, RN GrCertCCN

Rory Wolfe, BSc PhD

Gabrielle Neave, RN Dip CommHIth

Anne Altmann, MBBS(Hons) MPH FAFPHM

Anita Skok, BA Grad Dip Psych

for dental disease. In addition, a new oral appliance is being evaluated to ascertain if it can improve Research Assistants

saliva control, eating and speech in young people with cerebral palsy.

Susie Proctor, BSc DipEd

Michelle Wills, RN BN GradDipCommHIth

Patty Chondros, BSc(Hons) DipEpi & Bio Fiona Tremaine, RN

A multidisciplinary team including a psychologist and a neurologist has been studying the

Suzanna Vidmar, BSc(Hons)

differences between parents' and professionals' understanding of developmental disability.

Judith Spotswood, SEN Annette Clancy, RN RM

It is hoped that further knowledge in this area may assist in developing improved methods of

Noreen Condon, RN RM DipAppSc

intervention services. Two studies are currently being undertaken that aim to assist children with spina bifida. Firstly,

Derrick Sim, MBBS Dianne Brown, MBBS Shane O'Dea, MBBS Claire Mauer, MBBS Kim Olinsky, MBBS Len Hartman, MBBS Audrey Pennington, MBBS Vanessa Johnstone, MBBS(Hons) Andrea Cretney, MBBS(Hons) Leo Acevedo, MBBS Belinda Came, MBBS DRACOG FRACGP NHMRC PhD Scholars Priscilla Robinson, MPH BNurs RGN RDN RHV Rachel Skinner, MBBS Public Health Trainee

Jenny Hurley, RN RM Bed Dip OH&S

communicating information to families and may also have implications for families use of early

Research Medical Officers

Creina Mitchell, BAppSc(AdNg) GrDipComp

DipEdAdmin

Jenny Clemo, RN RM

Jacinta Clifford, BN GrDipMid

Sally Palmer, RN BN

Significant Achievements

Main Research Interests and Directions

Our work has been selected for presentation

Clinical Epidemiology and Biostatistics pursues research related to the prevention of child and

with the help of the Department of Allergy, all children with spina bifida are being screened for latex allergy. Secondly, the use of anal plugs for faecal incontinence is being investigated. Our research program relies heavily on our colleagues within other hospital departments, other hospitals and also the participation of community agencies such as the Yooralla Society of Victoria and the Spastic Society of Victoria. We are very grateful for their cooperation and support as we work together to learn more about how we can best understand and treat disability in children.

at a number of major international meetings

adolescent illness and injury, with a special focus on infectious diseases and their prevention

in the United States. Associate Professor

through the use of vaccines. We offer technical help and collaboration to a number of other

Nolan was invited by the Commonwealth

research teams at the Institute who have similar interests and goals. In addition, our research

Government to undertake a review of public

focuses on developing and applying new methods of analysis of long term follow-up studies

health research and training in Australia

in childhood and adolescence.

during 1998 (the Public Health & Research

Program, PHERP). Both he and Associate Professor Carlin have been invited by the World Health Organisation to contribute to research on child health in developing countries.

Vaccine Clinical Trials In collaboration with a number of Australian and International vaccine developers, we are conducting large scale community clinical trials of new vaccines including combinations of existing vaccines which are being developed to cope with the increasing introduction of highly effective new vaccines into Australian childhood immunisation schedules. We are now completing a program of several research studies extending over five years to evaluate a new pentavalent vaccine developed jointly by Australian and American manufacturers. Other studies have focused on similar combination vaccines developed in Europe, and new vaccines containing chicken pox vaccine. Evaluation of an exciting new intranasal spray influenza vaccine has also been under way. Recent studies from the United States suggest that this vaccine when introduced will have a major

38 RCH Research Institute 1998

RCH Research Institute 1998 39

media in children and their consequent antibiotic and health care usage.

Prominent Visitors to the Department

impact on reducing health care costs by preventing large numbers of febrile illnesses and otitis

Immunisation Programs

Professor James Hanley, Sabbatical from

Funded by the Victorian Health Promotion Foundation, and lead by NHMRC scholar Rachel Skinner,

McGill University, Department of Epidemiology

we have been conducting an evaluation of a newly developed promotional program which aims to

and Biostatistics, Montreal, Canada.

achieve high uptake of Hepatitis B immunisation in Victorian High School children. In a large scale community randomised trial conducted in over 160 high schools, this program has been delivered to many thousands of high school children.

Dr Peter Margolis, University of North Carolina, Chapel Hill. USA - collaborative work on prediction of infant death in developing

In other studies, we have examined the effectiveness of immunisation delivery by maternal and

countries (World Health Organisation project).

child health nurses in an inner Melbourne municipality, and surveyed large numbers of day care centres and family day care groups to investigate opportunities for improved immunisation uptake through day care.

Dr Kim Mulholland, Global Program on Vaccines, World Health Organisation, Geneva, Switzerland - prediction of infant

We are also conducting methodologic evaluation of new statistical methods for the analysis of

death in developing countries.

longitudinal data funded by NHMRC, and in collaboration with the Centre for Adolescent Health. Professor Michael Kramer, Professor of Paediatrics and of Epidemiology and Biostatistics, Montreal Children's Hospital

Ill

and McGill University, Montreal, Canada.

ect aims to increase Hepatitis B immunisation of vouno arlnlp<tppntc

40 RCH Research Institute 1998

..........

fe'l

Dentistry l Director

Senior Registrars

Dr Roger K Hall, DAM MDSc FRACDS FICD

Dr Sarah Hulland, BSc DDS DipPedoDent MSc

Deputy Director

Invited Presentations DrRK Had

FRCDS(C) (to March 1998)

International Association of Dentistry for the Handicapped

Visiting Professional Fellow (sponsored by Colgate)

Senior Orthodontist

Chair of main session - Surgical management

A. Prof. Dr Kari Storhaug, DDS, PhD.

Dr Peter Scott, BDS MS(III) FRACDS

of craniofacial disorders

Head, Resource Centre for Oral Health in

Yokohoma, Japan, September 1998

rare medical conditions. University of Oslo

Dr James 0 Lucas, BSc MDSc FRACDS FICD

Dr Soni Stephen, BDS (from March 1998)

Staff Consultant in Oral Medicine Prof Michael J Aldred, BDS PhD GradCertEd FDSRCS FRCPath FFOP(RCPA)

Main Research Interests and Direction The clinical focus of our research over the last 12 months has expanded significantly under the guidance of Dr Lucas. Several new projects have been initiated assessing the effect of intervention in a variety of conditions on clinical outcome. Evidence based dentistry is still in its infancy and the work being carried out in the unit is not only exciting but will also contribute significantly to future clinical care. Similarly the orthodontists. Dr's Peter Scott, John Robinson, Denise Lawry, Sue Needham and Neil Pinto are developing assessment criteria for craniofacial growth and development. Particular interest at present is centered around Binders Syndrome and the effect

Meeting of the French National Society for

lack of adequate IT within the department and the huge range of data requiring collation makes it difficult for the department to manage it's clinical research base. As Visiting Professor at the University Louis Pasteur in Strasbourg France over the past year. Dr Hall has continued his collaboration on developmental dentine defects found in Osteogenesis Imperfecta, with Dr Joseph Hemmerle and Dr Marie-Cecile Maniere, University of Strasbourg, with Dr Janna Waltimo of the University of Helsinki as consultant. The arrival of Dr Nicky Kilpatrick in March 1999 will, we hope, see expansion of the clinical

A.Professor Storhaug's particular interest

Oral soft tissue lesions in children

is the oral health of children with disability,

Strasbourg, France, June 1998

particularly those with oromotor problems.

Paediatric Dentistry. Congenital dental anomalies in children Some unusual orofacial lesions in children

She is the director of a large centre of excellence in this area in Norway. She is also the current president of the International Association of Dentistry for the Handicapped.

Paris, France, November 1998

Presentations by Dr Storhaug

Australian Dental Association (Tasmanian Branch)

Zealand Society for Paediatric Dentistry

Congenital dental anomalies in children Cleft lip and palate associated with

September 1998

Paediatric Dentistry.

Meeting of the French National Society for

of distraction osteogenesis in children with significant mandibular growth deficiency. Currently the

42 RCH Research Institute 1998

Prominent Visitors to the Department

National meeting of the Australian and New Caries trends and treatment needs in disabled children, Melbourne

syndromes; diagnosis and management.

Prader Willi syndrome and Oral Health

Hobart, Australia, September 1998

Lunchtime research seminar - RCH

Dr S Stephen

Oral functional problems in disabled children

National meeting of the Australian and New

and adolescents; a multiprofessional

Zealand Society for Paediatric Dentistry

treatment approach

Early childhood caries

Grand Rounds - RCH

Melbourne, September 1998 Dr J Lucas

research activities as well as continued collaboration with basic science. Her recent research

Malaysian Dental Association Conference

interests have involved laboratory and clinical work on the aetiology, assessment and management

Dental materials in paediatric dentistry

of dental erosion, the implications of PKU on oral health and health services research.

Kuala Lumpa, Malaysia, April 1998

RCH Research Institute 1998 43

Gastroenterology and Clinical Nutrition

Rotavirus The importance of rotavirus as a cause of severe diarrhoea was reinforced by a retrospective

Gastroenterologists

Director Tony Catto-Smith, MD FRACP MRCP DCH Deputy Director and Head of Hepatology

Nutrition Nurse Coordinator

Don Cameron, MB BS FRACP

Debbie Jessen, SRN

Mark Dliver, MD FRACP

Helen Shallen, SRN

Ralf Heine, MD FRACP

Fellows

Research Assistants

Susan Jimenez, MD (Philippines)

Helen Bugg, BSc

Tamanna Begum, MB BS (Bangladesh)

Sarah Emselle, BSc(Hons)

Katrina Allen, MB BS FRACP

Rebecca Gorrell, BSc(Hons)

Suporn Treepongkaruna, MD (Thailand)

Paul Masendycz, BAppSci

PhD Students

survey covering 13 years of data from hospitalised children (April 1980 to March 1993), and by

Professor Ruth Bishop was honoured during

an Australia-wide study of hospitalised children (1993-1996). Approximately 10,000 Australian

the year with the prestigious CVI Pasteur

children under 5 years of age need hospital inpatient treatment each year for severe rotavirus

Award for her contribution to Vaccine

diarrhoea, representing 50% of all hospital admissions for gastroenteritis. New molecular biological

Development. This was awarded by the

tests show that some children continue to be infected by rotavirus for up to 2 months after they

International Committee of Children's Vaccine

recover. This could be one of the main ways that rotaviruses survive for long periods in the

Initiative, Geneva. She also received the

community. Our 13 year study has made us aware that there is a need for further research

Clunies Ross National Science and

to detect the cause of severe gastroenteritis in many young children, particularly those less than 6 months old.

Technology Award. Dr Ralf Heine was awarded his MD by the

Arnold Smith, MB BS FRACP Staff Senior Gastroenterologist Graeme Barnes, MD FRACP Senior Principal Research Fellow NHMRC Ruth Bishop, AO PhD DSc FASM Senior Research Officers Enzo Palombo, BSc(Hons) PhD Winita Hardikar, MB BS FRACP PhD Senior Research Officer and Head of Clinical Nutrition Julie Bines, MB BS FRACP Research Officer Leone Piggford, MB BS FRACGP

Significant Achievements

The development of a vaccine to prevent rotavirus has been a major focus of our group for several

University of Melbourne for his thesis entitled

years. A 19 month long Phase IIA rotavirus vaccine trial has been completed and is still being analysed.

"Gastro-oesophageal reflux in chronic illness".

Colin Sherrington, MB BS FRACP

Research on the genetic and antigenic variation of rotavirus clinical isolates focused on investigation of temporal diversity in the major viral capsid protein, VP7. We have found that

University of New South Wales for his thesis

BSc Hons Students

discrete genetic lineages of this protein exist within the major virus serotype in Australia and that

mediated mast cell degranulation in the

Sachintha Jayasinghe, BSc

these lineages are antigenically distinct. We also found that the emergence of these lineages

Hooded Lister rat".

Helen Anthony, BSc(Hons) MHumNutr

Dr Mark Oliver was awarded his MD by the

Violet Albert, BSc Huseyin Mustafa, BSc(Hons) Fran Justice, BSc Chandra Diwarkala, BSc(Hons) Technical Assistant Ruth Clark, CertAppSci(MedLab) Technical Laboratory Assistants Nurse Coordinator and Reseach Assistant

Nada Bogdanovic-Sakran

Diane Simpson, SRN Research Nurse Jennifer Lund, SRN

fluctuates with time. Rare rotavirus serotypes have been identified in hospitalised children, some of which are new to Australia. These results have implications for the future design of rotavirus vaccines and vaccination strategies.

Slav Itkine Research Secretaries

entitled "Intestinal Motor Responses to IgE

Sachintha Jayasinghe completed his BSc(Hons) studies with a thesis entitled "Genetic and antigenic characterisation of

Surveillance in Melbourne has identified astrovirus as a cause of gastroenteritis in up to 4%

serotype G1 rotaviruses from clinical isolates

of children admitted to hospital. This has now become a new research focus for our group.

of major Australian urban centres, 1996.

Anne Peace Janine Furmedge, BSc SRN Jane Lee Gabrielle Neave, SRN

Gastroenterology

Dr Julie Bines continues as President

This group focuses on two main areas, epithelial barrier function and gastrointestinal dysmotility.

of AuSPEN and on the Executive Council,

We have identified abnormalities in the way rotavirus-infected gut cells handle large molecules.

International Confederation for Nutrition

This has implications for host defence and viral pathogenesis. Further research suggests that the

Support Organizations.

mechanisms responsible for diarrhoea during gastroenteritis may be much more complicated than previously thought, involving changes in the cytoskeleton of enterocytes.

Main Research Interests and Direction

A second focus has been on gastro-oesophageal reflux, which is an important cause of childhood

Research remains a major focus within the Department. One of our strengths has been the

illness. We are developing new methods of accurately diagnosing reflux and determining its effects, particularly on the lungs.

collaborations developed with other researchers both within and outside the hospital campus. These have included both clinical and basic science components. Each of the four major groups

Constipation and faecal incontinence are important causes of morbidity in childhood. Studies in

focus on a particular disease "theme".

collaboration with the Department of Surgery and with the University of Melbourne are helping

Nutrition Nutritional disturbances can have a profound effect on the progression and recovery of a range

to identify some of the basic mechanisms behind severe bowel dysfunction.

of diseases. This group has focused on strategies that may improve the nutritional outcome for children who have had extensive bowel resection. Characterisation of the process of intestinal adaptation will enable the development of clinical strategies to enhance and hasten the adaptation

Liver Clinical studies have focused on Hepatitis C and G infection in children. We have reported our experience with chronic Hepatitis C in this hospital and are currently examining the prevalence of Hepatitis G and seroconversion in a group of children at high risk of infection.

process. While this may be of direct benefit to children with short bowel syndrome the knowledge

i;'

may also give an important insight into the regulation of growth and differentiation in the intestinal mucosa. The development of a preclinical model has been developed to assess the Impact of specific nutritional and growth factor interventions. A further focus for this group has been the careful evaluation of existing methods of providing parenteral nutrition in order to optimise its effectiveness.

44 RCH Research Institute 1998

RCH Research Institute 1998 45

General Paediatrics Invited International Presentations

Prominent Visitors to the Department

Professor Bishop delivered an invited oration

Visitors during the year included Dr D Matson,

on Rotavirus at the 38th Annual ICAAC

Centre for Pediatric Research, Norfolk, USA.

Dr Michael Harari, FRACP

Jenny Royle, FRACP

Dr David James, FRACP

Dande Mularno, MD MMed

A/Prof Andrew Kemp, FRACP PhD

meeting of the American Society of

Postgraduate Research Fellows

Dr Peter Hewson, MD FRACP

Research Assistants Cathryn Goucher, RN

Microbiology, San Diego. Assoc Prof Graeme Barnes gave an invited

Director

review of rotavirus vaccines at the Asia Pan

A/Prof Mike South, MD DCFI MRCP FRACP

Pacific Society for Paediatric

Deputy Director

Gastroenterology and Nutrition meeting.

A/Prof Samuel Menahem, MD FRACP FACC MEdMPM

Susan Zoliowski, RN

Dr Michael Marks, MD MPH FRACP Dr Margot Nash, MD FRACP

Dr Lionel Lubitz, MRCP FRACP DCH A/Prof Terry Nolan, BMedSc PhD FRACP

Dr Don Cameron was an invited speaker and

Staff

demonstrator at the Asian Pan-Pacific Society

Senior Medical Research Staff

of Paediatric Gastroenterology and Nutrition

Dr Roger Allen, FRACP

Dr Rod Phillips, BSc(Hons) FRACP PhD

Dr Doug Bryan, FRACP FAFRM

Dr Kathy Rowe, MD FRACP MPH DipEd

Dr Noel Cranswick, BMedSc FRACP

Dr Mike Starr, FRACP

FAFPHM

Endoscopy Workshop in Galle, Sri Lanka, Dr Winita Hardikar presented her work on ontogeny of the human basolateral bile acid transporter to the AASLD in Virginia.

Dr Nigel Curtis, PhD MRCP

Clinical Fellows Dr Giles Bates, FRACP

Dr Enzo Palombo was invited to give several presentations in the UK on the genetic

Dr Daryl Efron, MD FRACP Dr Susie Gibb, FRACP

diversity of rotaviruses and astroviruses.

Main Research Interests and Direction The research activities of the Department cover the broad nature of general Paediatric Medicine, and include behavioural studies, basic laboratory investigations, clinical observations, through to randomised controlled trials of therapeutic interventions. Much of the Department's research IS conducted in collaboration with others, both within and outside the hospital. Such collaboration has proven to be very beneficial. Influence of antibiotic guidelines on prescribing practices for childhood infections Despite the existence of institutional and state guidelines on appropriate use of antibiotics, repeated audit shows that inappropriate drugs are frequently prescribed for common childhood infections. This study assesses the impact of an ID badge-sized set of antibiotic guidelines on prescribing practices. The results suggest significant improvement and cost savings. Pain and immunisation Immunisation causes local pain through needle insertion; infiltration: immediate local irritation; and delayed local reaction to vaccine components. Vaccines containing acellular pertussis should reduce the delayed reaction of childhood immunisations and analgesic creams have the potential to eliminate the immediate pain. Childhood immunisation could become painless, which would increase its acceptability to children, and may influence vaccine uptake rates and needle phobia. Randomised controlled studies will primarily investigate the efficacy of analgesic creams and effects on vaccine immunogenicity in children and adults undergoing routine immunisation. Potential effects on uptake rate and needle phobia will also be studied. The use of portable ultrasound in suprapubic aspiration of urine from the bladder SPA is the best method of obtaining uncontaminated urine from the bladder in children suspected of having urinary tract infection. Unfortunately the success rate is only around 50% because the

Dr Roger Glass, Centres for Disease Control, Atlanta. Prof Ruth Bishop AO, Royal Children's Hospital Research Institute, Melbourne. Prof Sir Gustov Nossal AC, WHO Global Program for Vaccines and Immunization. Dr Albert Kapikian, National Institutes of Health, Bethesda.

bladder may be empty at the time of the procedure. This study has shown that the use of a simple volumetric bladder ultrasound device significantly improves the success rate.

Dr Glass and Prof Ruth Bishop receiving the Children's Vaccine Initiative Pasteur Award, in Geneva I

RCH Research Institute 1998 47

Haematology and Oncology

General Practitioner database In conjunction with the North, Northwestern and Melbourne Divisions of General Practice, a database of GPs interested in Paediatrics was established at the Royal Children's Hospital. It was intended that patients presenting to the Emergency Department without an identifiable GP would be

Research Officer Group leader

Project Nurse

Nigel Parker, BSc(Hons) PhD

Susan M Dickie, BNursing

Post Doctoral Fellow

Research Assistants

Richard Williams, MBBS BMedSci PhD

Renee L Lawson, BAppSc

referred using the database. The study has failed to significantly improve the rate of these patients obtaining GPs. Antibiotic related serum sickness in childhood

Clinical Research

Research Officer

Director

Sheenaz Manji, BSc(Hons) PhD

Peter J Smith, MD FRACP FRCPA

Senior Research Assistant

A retrospective review has been undertaken of 700 children presenting to the emergency department with an acute rash. About 40 cases of antibiotic related serum sickness have been identified. Using national prescribing data, we calculate that cefaclor is about 10 times more likely than amoxil to cause serum sickness.

Clinical Director Keith D Waters, MBBS FRACP

Tracey Lomas, BHealthSc Research Nurses Suzanne Tansey, RN Midwife

Manula Hancock, BSc(Hons) Frances Hammer, RN Midwife Research Assistants Darryl Carrington, BApplSc(Hons)

Roslyn Nankervis, RN BAppSc MEd

Henry Ekert, AM MD FRACP FRCPA

Samantha Brickell, BSc(Hons)

Tumour Immunology Laboratory

Head of Bone Marrow Transplantation

Gillian Deeble, BSc(Hons)

David M Ashley, MBBS PhD FRACP

Leoni Vanstekelenberg, BSc(Hons)

Post-doctoral fellow

Honours Students

Fiona Radcliff, BSc(Hons) Phd

Sally Dennis, BSc(Hons)

Senior Research Assistant

Senior Consultant Haematologist/Oncologist

Laboratory Head Karin Tiedemann, MBBS FRACP Consultant Haematologist/Oncologist Peter Downie, MBBS FRACP Consultant Haematologist/Oncologist David M Ashley, MBBS PhD FRACP

Samara Cairns, BSc(Hons)

Clinical Assistant

Stem Cell Biology Laboratory

Elizabeth Smibert, MBBS DCH

Laboratory Head

Deborah Scarcella, BSc(Hons) PostGrad Dip in Drug Eval Pharm

Simon J Bol, MSc-biol PhD-med

Research Assistants Chris Riffkin, BSc(Hons)

Senior Consultant Haematopathologist Paul Monagle, MBBS FRACP FRCPA Clinical Fellows Mathew Robson, MBBS

Senior Bone Marrow Transplant Scientist

Suchindra Vivekanandan, BSc(Hons)

Dianne P Tucker, BAppSc MSc

Alana Gardiner, BSc(Hons)

Bone Marrow Transplant Scientist

Rowan Foster, BSc(Hons)

Andrew Fryga, BAppSc Christopher Barnes, MBBS

Students Research Assistant

Anne Mitchell, MBBS

Kerrie Jones, BAppSc

Data Managers

PhD Students

Gemma Rigutto, BSc

Helen Law, BSc(Hons)

Jennifer Houlihan, MSC CRC

Georgia Polidoros, BSc(Hons)

Jenny Gason, BA

BMDI Cord Blood Bank

Leslie Chow, BA Shirleen Evans, RN

Esther't Hoen, BSc(Hons) Amy Gray, BMedSci PhD Students Kate Drummond, MBBS FRACS Agadha Wickremesekera, MBBS FRACS

Scientific Director

General Staff

Simon J Bol, MScbiol PhDmed

Senior Laboratory Assistant

Medical Director

Marie Edwards, RN

Karin Tiedemann, MBBS FRACP

Clinical Nurse Co-ordinators

Project Scientist

Sally Hanson, RN BN GradDipAdvNsg

Jeanette J Ripper, Dipl/CertAppSc

Helen M Reilly, BA Laboratory Assistant Ian Burns, DipMedLabTech

Natalie Grapsas, RN BN Laboratory Research Molecular Oncology Laboratory Laboratory Head Peter J Smith, MD FRACP FRCPA Senior Research Officer Group leader Elizabeth Algar, BSc(Hons) MSc PhD

RCH Research Institute 1998 49

Main Research Interests and Direction During 1998 the staff of Haematology & Oncology have pursued a variety of new endeavours in both clinical and basic research which aim to improve the outcome and wellbeing of children with haematological and malignant diseases. A major change in emphasis has been toward enhancing international collaborations. As well, links with the pharmaceutical industry and joint

Significant Achievements Clinical Research The most significant achievements of the department in clinical research through the period of 1998 has been the change in

ventures both in clinical and lab based research have been developed with major sponsorships

emphasis to make a greater contribution

from Searle, SmithKIine-Beecham, AMGEN and other pharmaceutical companies. The department

to the international paediatric haematology

once again takes great pleasure in acknowledging the ongoing support from LARCH, the RCHRI, the

and oncology research effort. International

Bluey Day Fund, CIKA, My Room and the Bone Marrow Donor Institute. Clinical Research Oncology Related Research

collaborative studies have been initiated with the Paediatric Oncology Group, SlOP, a Dutch Co-operative Group, the multi-institutional

Clinical haematology and oncology at the Royal Children’s Hospital is the largest member of the

thrombosis co-operative group and on an

Australian and New Zealand Children's Cancer Study Group (ANZCCSG). Two new Australia wide

institutional basis with St Jude Children's

studies have been developed for Hodgkin's disease by Professor Henry Ekert as principal

Research Hospital in Memphis and Baylor

investigator and the 7th Acute Lymphoblastic Leukaemia study by Dr Keith Waters as principal

University in Houston, Texas. All these

investigator. The ANZCCSG Ewing's Sarcoma study I is nearing completion and Dr Karin Tiedemann

iniatives have been developed in association

will open a second study early in the new year. The second Australia wide Infant Brain Tumour

with our new and improved operating systems

study has been developed by Dr David Ashley. In the last 12 months there has been a new focus

for clinically based research.

toward international studies and a formal affiliation has been made with the Paediatric Oncology Group in the USA through which nine new open clinical studies were commenced. The International Society of Paediatric Oncology Study for Liver Tumours (SIOPEL III) is now open. There are 3 industry based collaborative studies which are currently open. These include the AMGEN sponsored Vetopec for children with relapsed solid tumours, the Searle based MPO study of a novel growth factor for patients with solid tumours and a Smith Kline-Beecham sponsored study in collaboration with St Jude Children's Research Hospital in Memphis for patients with newly diagnosed brain tumours.

Laboratory Research Highlights of the lab based research programme include the growth of the tumour immunology programme with a successful international grant from the James S McDonnell Foundation based in the United States. The identification of new brain tumour genes will allow progress over the next year

Bone Marrow Transplant

toward human vaccine trials. Dr Elizabeth

A highlight of these increased clinical research endeavours within the department is bone marrow

Algar's group was awarded the Poster Prize

transplant. Data from transplants is reported to the Australian Bone Marrow Transplant Registry

at the 1998 Lome Cancer Conference for their

and the International Bone Marrow Transplant Registry. These data contribute to the analysis

ongoing investigations into Beckwith

of a variety of transplant variables. In 1998 the unit made a significant contribution to studies

Wiedemann syndrome. Dr Parker was

comparing the outcome of unrelated bone marrow and cord blood transplants. New studies in

successful in characterising a second human

brain tumours, relapsed solid tumours and Ewing's sarcoma involved the use of peripheral blood

gene now known as STIM 11. Importantly,

stem cells In which a patient's own blood is returned to them after chemotherapy has dramatically

a number of students have successfully

increased with. In 1997 the number of stem cell re-infusions was 16 and in 1998 a total number

completed honours, BMedSci and doctors

of re-infusions on clinical research protocols was 55. Neuro-oncology

of philosophy during the 1998 year through the department of paediatrics.

The neuro-oncology programme treating children with brain and spinal cord tumours has greatly expanded over the past year. New clinical research protocols include those in collaboration with St Jude, through the POG and being developed through the ANZCCSG. Joint efforts have been initiated in collaboration with the social work department examining the impact of brain tumours upon family life and with the neuro-psych department examining the neuro-psychological sequelae of treatment for brain tumours. Other research initiatives in the department during 1998 include a collaborative study with cardiology examining the use of echocardiography in order to predict long term side effects to the heart from chemotherapy in children who were previously treated for acute lymphoblastic leukaemia. A joint project between haematology and oncology at the Royal Children's Hospital and at the Monash Medical Centre was initiated and will examine familial causes of childhood cancer and is to be co-ordinated by Dr Libby Smibert and Dr Peter Downie.

RCH Research Institute 1998 51

Haematology Related Research

Bone Marrow Donor Institute Cord Blood Bank

A number of clinical research studies have been initiated in patients suffering from non-malignant

Umbilical cord blood is increasingly used instead of bone marrow as a source of blood-forming

haematologic conditions. Dr Paul Monagle returned this year from Canada and has been very busy

stem cells for transplantation. Worldwide trials have shown that transplantation of cord blood can

in starting a number of new projects. Through his efforts a number of new clinical trials related to

offer a chance of successful treatment to patients who cannot find a suitable bone marrow donor.

thromboemolic diseases in children have commenced. These include several international multi

Apart from the advantage that cord blood can be collected, processed and stored in a ready-to-use

centre clinical trials in patients having anti-coagulation after heart surgery, deep venous

form, cord blood transplants have shown to result in lower incidence and severity of Graft versus

Prominent Visitors to the Department Dr Vita Land POG Operations Manager Chicago Illinois USA

thrombosis, central venous line clots and those with acquired clotting disorders. Dr Monagle

Host Disease (GvHD) than bone marrow transplants. This allows a certain degree of mismatch in

is a member of the international steering committee for these trials and Australian coordinator.

tissue type between cord blood donor and patient, which considerably increases the chances of

Director Radiation Oncology

finding a suitable cord blood for transplantation. The study of the correlation between haplotype-

St Jude Children's Research Hospital

matching and transplant outcome is a new focus that can contribute to further improvement of

Memphis Ten, USA

A study in haemophiliac patients aimed to develop new methods of treating life threatening reactions to medical replacement of their deficient factors has been completed and reported

patient treatment. Experimentation to improve cord blood collection procedures and cell processing

at an international meeting by Prof. Henry Ekert.

is ongoing and translates to supplying the clinic with the highest quality cord blood cells possible.

Laboratory Research Molecular Oncology Laboratory Group Leader: Dr Elizabeth Algar Dr Algar's focus continues to involve the investigation of the genetic events associated with Wilms' tumour. The Beckwith Wiedemann syndrome is an inherited illness in which many children develop Wilms' tumour. By examining the abnormal genes in this syndrome Dr Algar's group hopes to

In particular, study of the effects of blood processing and cell manipulation techniques on different types of blood forming stem cells is of major importance to develop procedures that will produce a product of the highest effectiveness.

Dr Larry Kun

Dr Stephen Shalet Department of Endocrinology Manchester Children’s Hospital UK Dr David Walker Director of Dncology Nottingham UK

understand the basis of Wilms' tumour and other diseases such as childhood leukaemia. Through

Dr Anna Meadows

understanding the mechanisms which contribute to this malignant disease it is hoped that new

Children's Hospital of Philadelphia

approaches may be developed to treating cancer using gene targeted strategies.

USA

Group leader: Dr Nigel Parker

Dr Maureen Andrew

further work has continued during 1998 studying the novel gene STIM 1. This gene is located

Director International Childhood Thrombophila

on chromosome 11 in an area that is abnormal in many childhood cancers. The gene appears to

Programme

control rates of cell growth in tumour cells and may have important implications in future therapies.

Canada

A second human gene termed STIM II has also been identified by Dr Parker and appears to have

Dr Mark Crowther

a very similar function to STIM I.

Haematologist

Tumour Immunology Laboratory

McMaster University

Work in this laboratory has continued on developing vaccines as a method of treatment for human

Canada

brain and solid tumours. During 1998 work has focussed on identifying a series of genes that are made by brain tumours but not normal brain. These genes are in the GAGE and MAGE family. In work partly supported by CIKA the group has demonstrated that these genes are highly

Invited International Presentations

represented in brain tumours and may be potential targets for future immunotherapy and diagnostic

Dr David M. Ashley

purposes. Work has also focussed on further exploration of the way brain tumour cells can be

Preuss Foundation Seminar for Vaccines

made to die using acellular switch known as FAS. Work this year has shown that the FAS receptor

in Human Brain Tumours

is expressed on many paediatric brain tumours and appears to be abnormal in it's function.

Salk Institute San Diego CA USA

This work has important implications as further insights into FAS and its abnormal behaviour may allow future therapeutic strategies to be designed.

Dr David M. Ashley Invited Seminar St. Jude Childrens Research

Stem Cell Biology Laboratory

Hospital,

New initiatives for the stem cell biology group during 1998 included a study aimed to understand

Memphis Ten, USA

the growth and maturation of blood forming cells from human umbilical cord blood. Through 1998 Dr Helen Law successfully completed her PhD study on platelet numbers after transplantation procedures and the these studies may form the basis for helping to identify the types of cells which will improve platelet numbers after transplantation. i

52 RCH Research Institute 1998

RCH Research Institute 1998 53

;

Immunology Director

Melbourne University Postgraduate Scholar

and/or cytokines that regulate the development of allergic inflammation in the airway. This will then

Professor Andrew Kemp, MB BS PhD FRACP

Travis Gooding, BSc(Hons)(Joint supervision

identify potential targets for novel therapies that selectively inhibit allergic inflammation in the

with Department of Microbiology)

airway. These studies will also provide important insights into the basic adhesive interractions

Staff Consultant Immunologist Dr Mimi Tang, MB BS PhD FRACP FRCPA

Research Assistant

Dianne Campbell was awarded the Ackman

mediating lymphocyte recirculation and migration to the lung, an area that currently remains poorly

Australasian College of Physicians, and an

efficacy of anti-cytokine therapy for asthma. A genetic approach is used to target key cytokines Scientist

Australian College of Paediatrics travelling

previously identified as playing critical roles in the development of allergic airway inflammation

Anne Balloch, BAppSci MSc

grant to enable her to continue research in

in asthma. Thus the unifying aim of these studies is to develop new improved treatments for

George Georgiou, BSc(Flons)

asthma. The strategy is to identify important immunologic factors in the development of allergic

NHMRC Postgraduate Scholar

inflammation that may then be used as targets in novel therapies that selectively inhibit airway

the Department of Immunology at Stanford University USA. Mimi Tang received the Clinical Investigator Award from the

inflammation in asthma.

Dr Joanne Smart, MB BS BSc

scholarship from Melbourne University, a travelling scholarship from the Royal

understood. A second area of work funded by the NHMRC is focused on examining the potential

Efthimna Keramidaris, BSc(Hons) MSc

Significant Achievements

Australian Society of Clinical Immunology and Allergy.

Another aspect of research into the immune response in allergic disease has been the study by G, Georgiou of antigen binding molecules which are derived from T-cells. A monoclonal antibody

Invited International Presentations

has been produced to these antigens which has enabled purification of the antigen binding molecules and study of the role of these molecules in cytokine generation. This is the first time

Main Research Interests and Direction

that a monoclonal antibody has been produced to these molecules.

The research in the Department of Immunology has focused on further understanding of allergic

Andrew Kemp was an invited lecturer to the Paediatric Society of New Zealand Annual

In combination with microbiology the immune response to Mycobacterium ulcerans, a bacteria

disease in childhood. Allergic diseases such as asthma and eczema are increasing rapidly in

Meeting, Palmerston North, New Zealand.

which produces chronic skin ulcers, is being investigated. For the first time it has been

Western societies and the incidence of these diseases has doubled over the last twenty years.

demonstrated that there is a major depression of the T cell response to the organism which may

The Department of Immunology has research programs directed at further understanding the

explain why this organism causes severe long standing skin ulcers

inflammation which leads to the common skin disease eczema or atopic dermatitis and the respiratory disease of asthma. The research in eczema by Dr Smart and Prof Kemp is directed to identifying and understanding cytokine imbalances which may lead to the development of the disease. The Department has shown that there is a reduced amount of the cytokine gamma-interferon inside cells from eczema patients and that this lack of cytokine is due both to a decreased number of cells and a decreased amount of interferon per cell. It has been previously shown in the Department that this defect in cytokine production is actually present before the development of eczema and it appears to be one of the basic immune defects which causes the immune system to respond to environmental allergens in a way which leads to the development of allergic disease. An important trigger of eczema has been infection due to staphylococcal bacteria which secrete a potent inflammatory substance called superantigen. Studies in the Department have characterised for the first time the nature of the immune response to this superantigen both with regard to cellular and antibody mediated immunity. An increased understanding of the role of Staphylococcus aureus in the provocation of information in eczema has the potential to lead to better treatment methods. Other studies have looked at receptors called CLA on circulating T-cells which may be involved in the migration of T-cells into eczema skin. Another theme of research in our department is directed by Dr Mimi Tang and focuses on investigating the immunopathogenesis of airway inflammation in asthma with the ultimate aim of developing novel more effective therapies for this common disorder. There is a major emphasis on translation of basic immunological discoveries into new and improved treatments for this condition. Asthma is the most common chronic disorder of childhood and is a significant cause of morbidity and mortality in our community. The major abnormality in asthma is inflammation

of the airway lining. Unfortunately, current therapy relies primarily upon the use of nonspecific - tAKECARE -

antiinflammatory agents, corticosteroids, which are only partially effective in severe disease and cause serious side effects at higher doses. Novel therapies that can selectively inhibit allergic

inflammation in the airway are required to more effectively control airway inflammation while avoiding unwanted side effects. One aspect of Dr Tang's research funded by the RCHRI and Rammaciotti Foundation focuses on examining the roles of adhesion molecules and cytokines in the development of airway inflammation in asthma. The aim is to identify key adhesion molecules

Mimi Tang and Ross McKenzie work on developing a novel anti-cytokine therapy for asthma 54 RCH Research Institute 1998

Mi'-"

Medical Imaging

Microbiology and Infectious Diseases

Director

Emeritus Radiologist

Dr David Cook, MBBS FRACP MD

DrDWBoldtMBChBFRACR

Deputy Director

Fellows

Research Scientists

PhD Students

Dr Michael Ditchfield, MBBS FRACR

Dr M Fitzgerald, MB BCh BAD FFRRCSI FRCR

Louise Adams, BSc(Hons)

Andrea Bigham, BSc(Hons)

Staff Consultant Radiologists

DrAMoon,MBChBBHBFRACR

Vicki Bennett-Wood, BSc(Hons)

Travis Gooding, BSc(Flons)

Dr L Coleman, BSc MBCHB FRACR

Anne-Marie Bordun, BSc(Hons)

Travis Grant, BSc(Hons)

M Kean, DipARPSc GradDipEd

Dr Elizabeth Hartland, BSc(Hons) PhD

Larissa Nicholls, BA BSc(Hons)

Medical Imaging Technologists Head of Network Department

Dr M A Fink, BSc MB BChir MRCP(UK)

Associate Professor Suzanne M Garland,

FRCR FRACR

MBBS FRCPAFACSHP

Dr Angela Joe, BSc(Hons) PhD

Michael Starr, MB BS FRACP

Dr Stephen Fasulakis, BSc MBCHB

Director of Microbiological Research

Frances Oppedisano, BAppSci

Marija Tauschek, BSc(Hons)

(Cape Town) FCRAD(D)SA

Professor Roy M Robins-Browne, MB BCh

Jacinta Russell, BAppSci MSc

Louise Taylor, BA BSc(Hons)

FASM

Janet Strachan, BAppSci MTH

MSc Students

Staff Clinical Infectious Diseases Fellow

Hospital Scientists

Nuclear Medicine Physician DrS Mair, MBBS FRACP

PhD DTM&H FCPath(SAfr) FRCPath FRCPA

Dr Teresa Lazzaro, MB BS FRACP Registrar in Pathology

Main Research Interests and Direction

Dr David Siebert, MB BS FRCPA

Consultant staff have been involved with supervision of various retrospective reviews by fellows

Senior Research Officer (part time)

of existing departmental data which reflect the unique nature of the clinical material available to us

Dr Paul D Johnson, MB BS PhD FRACP

Soula Krejany, BSc

Samantha Alabaster, BSc

Rebecca D'Brien, BSc(Hons)

Kerrie Stevens, BAppSci GradDipMedSci

BSc (Hons) Student Richard Howard, BSc

Anastasia Stylianopoulos, BSc BMedSc Student Peter Ward, BAppSci PhD

Jason Harney

and have co-operated with many research projects undertaken by other members of hospital staff. The on-going prospective studies in MRI and various retrospective studies have included collaborative work with neurologists, neurosurgeons and orthopaedic surgeons in particular. Improved funding for MRI has enabled us to set aside a specific proportion of each week for

Main Research Interests and Direction

designated research projects and agreements have been reached with Neurology and the Baker

Research undertaken in the Department covers basic and applied areas of microbiology and

Institute for project time during 1999.

infectious diseases. The main theme of basic research is bacterial infections, with a particular emphasis on the mechanisms by which bacteria cause disease and the means by which they

Studies of aspiration in children with severe cerebral palsy, in association with Thoracic Medicine,

discovering novel means to detect and characterise infectious agents in patients' specimens and

respiratory insufficiency in this condition. The results of this study were presented at two national

to restrict the spread of these agents between patients. Another important area involving applied

meetings during 1998. This data is currently being prepared for publication.

research is the rapid detection of infectious agents in patients' specimens and their

Radionuclide intestinal transit studies were investigated, as part of a continuing study, in children with constipation in association with the Department of Gastroenterology and Paediatric Surgery. The results of the late follow-up of children presenting with UTI and having abnormal initial DMSA renal scans have been prepared for publication in association with the Department of Nephrology.

spread from the environment to their hosts and between hosts. This research is directed towards

were completed in Nuclear Medicine in an effort to better understand its role in the genesis of

characterisation in terms of disease-causing capacity. The results of this research have led to a number of improvements in the laboratory diagnosis of infectious diseases in children. Some of the major advances in our research effort during the past year included the discovery of novel virulence determinants in Escherichia coli. Yersinia enterocolitica and Haemophilus influenzae. Amongst these were the discovery of a protein which appears to assist £ co//strains

The coming year will see an improvement in Medical Imaging staffing levels from 3 radiologists

that cause the haemolytic uraemic syndrome (also known as "hamburger disease") to colonise

and one NM physician, to a full staff complement of 5 radiologists during March.

the intestinal tract of humans and animals. We also identified a distinct pathogenic category of Y, enterocolitica vjh\ch evidently causes disease by a novel mechanism and characterised

The improved staff situation in Medical Imaging during 1999, will permit renewed systematic

a possible novel colonisation factor of H. Influenzae. We also showed that f. coll can cause

research activity in the department after a break of two years, which all members of staff

the haemolytic uraemic syndrome even when the primary site of infection is outside the intestinal

are anticipating with enthusiasm.

tract and demonstrated that the ability of Streptococcus pyogenesto cause severe invasive disease does not correlate with the ability of the bacteria to invade epithelial cells in vitro. Another significant achievement during the year was the confirmation of the sensitivity and specificity of the method developed in our laboratory for the rapid diagnosis of infections with Mycobacterium ulcerans.

56 RCH Research Institute 1998

RCH Research Institute 1998 57

Neonatology During the past year, we also expanded our ability to identify viruses in tissue samples, including those which have been processed for histological examination and stored for prolonged periods. These techniques will allow us to search for viruses in suspected infections, such as myocarditis and encephalitis, where no cause was found using traditional diagnostic methods. We have also used molecular techniques, including DNA fingerprinting, to identify the source and route of spread of several infectious agents. In one such instance, we used DNA fingerprinting to trace an outbreak of infection with Pseudomonas aeruginosa to a toy box containing water-retaining toys. This finding led to changes in hospital practice regarding the use and sterilisation of such toys.

Professor of Neonatology

Fellows

Professor Colin Morley

Dr Douglas Hacking

with the organisation and running of a highly

Director

Dr Marina Hughes

successful international Mycobacterium

Dr Neil Campbell

Significant Achievements Several members of the Department assisted

ulcerans conference in Melbourne, during

Dr John Mills

Deputy Director

which the World Health Drganisation

Dr Peter McDougall

announced that they had chosen Melbourne Staff Consultant Staff Neonatologists

as the site for one of only three M, ulcerans reference laboratories worldwide.

Dr Peter Dargaville, MDBS FRACP

Awards and Prizes

Dr Paul Ekert, MBBS FRACP

Dr Elizabeth Hartland was awarded

Invited International Conferences

a Howard Florey Fellowship (one of only four

Roy Robins-Browne was invited to attend

Institute of Medical Research

in Australia) to undertake research at the

an international conference on intestinal

Imperial College in London for two years.

microflora in Japan.

PhD student Walter and Eliza Hall

Dr Peter Loughnan, MBBS FRACP Dr Michael Stewart, MBBS FRACP

Dr Paul Johnson received the highly prestigious international Glaxo Wellcome Agents for Change Award in recognition of his research into Mycobacterium ulcerans. Larissa Nicholls was awarded the Becton Dickinson Prize for the best presentation by a student based in Victoria at the Australian Society for Microbiology Annual Scientific Meeting.

Awards and Prizes

Main Research Interests and Directions

Dr. Peter Dargaviile awarded best basic

Lung disease of both premature and mature newborns remains a principal clinical task and focus

science paper at the Australian and New

of research within the department of Neonatology. Newer technologies introduced into the

Zealand Intensive Care Society meeting 1998.

neonatal unit for the treatment of lung disease include high frequency ventilation. The department has developed substantial clinical expertise in the use of such technology. A principal focus

Louise Taylor was awarded a Postgraduate

of research is the correct application of high frequency ventilation, including jet ventilation and

Overseas Research Experience Award from

development of new treatment protocols such as surfactant lavage in babies affected by meconium

the University of Melbourne to undertake

aspiration syndrome. The research incudes both laboratory and clinical programs. Congenital

research at the University of Maryland

diaphragmatic hernia is a condition where a large clinical experience has accumulated across

in the USA.

the departments of Surgery, Intensive care and Neonatology. There is ongoing follow up of infants affected by this condition. The department has active involvement in basic science research. Understanding the mechanism of the molecular response to disease states may be key to the development of future therapeutic directions for many diseases affecting newborn infants. Asphyxial brain injury is a major clinical problem faced in the Neonatology unit. Research into the molecular mechanism underlying the death of cells in response to birth asphyxia will contribute to the development of therapeutic strategies for the future. Vitamin K is routinely administered to all newborn infants. Important questions regarding the efficacy of oral administration of Vitamin Kto prevent the serious condition of haemorrhagic disease of the newborn is a particular research interest within the department.

58 RCH Research Institute 1998

RCH Research Institute 1998 59

Nephrology Director

Nephrology Fellow

Colin Jones, FRACP PhD

Stephen McTaggart, MBBS

Senior Nephrologist

Research Scientists

Harley Powell, FRACP

Josephine Forbes, BSc

Director Dialysis and Transplantation

Kristen Kelynack, BSc

Rowan G. Walker, MD FRACP

Clinical Nurse Specialist

Staff Nephrologists

Maree Ross-Smith, SRN Michelle Rose, SRN

David A McCredie, MD FRACP Lilian M Johnstone, FRACP Amanda M Walker, MD FRACP

Prominent Visitors to the Department

Main Research Interests and Direction

Dr Otto Mehls, from Heidelberg visited the

components of the renal interstitium were the main research interests. This work involved

Nephrology Unit to speak on Growth Hormone

continuing collaboration between members of the Department and the Department of Nephrology

underthe Florence-May McCredie Fellowship

at the Royal Melbourne Hospital. The Department attracted new funding from NH&MRC enabling

Dr Sharon Addler, from California visited underthe Priscilla-Kincaid-Smith Visiting Professor Grant

Basic research regarding the regulation of extra-cellular matrix in the kidney and the cellular

work to continue on the project biology and significance of the renal interstitial myofibroblast. Strategies are being implemented to decrease the production of matrix by the renal Interstitial myofibroblast. Ms Kristen Kelynack's research into the genetics of myofibroblast movement has been rewarded with good publications. Ms Josephine Forbes' work with endothelin receptor

Professor Ichikawa spoke to the Nephrology

antagonists in acute renal ischaemic injury has been extended into chronic ischaemic injury.

Unit in relation to renal developmental

She was able to show decreased matrix production following injury using agents that are presently

physiology at a presentation to the Royal

being trialed for use in the human.

Children’s Hospital. The department is undertaking widespread clinical studies. The multi-centre. Eastern State, collaborative study examining the effects of placebo or antibiotic prophylaxis of antenatal detected hydronephrosis has ended recruitment. The multi-centre international paediatric study examining the use of Mycophenolate mofetil in children who have renal transplants has also ended recruitment. The Department has been involved extensively with both of these studies. Dngoing study of the cardiovascular complications of renal failure have been performed by Lilian Johnstone. David McCredie has been continuing the studies of renal disease in Aboriginal children with John Matthews and Wendy Hoy from the Menzie’s School of Health Research in Darwin. In collaboration with the department of Radiology and General Paediatrics data showing the absence of new renal scars after urinary infection is being collated and submitted for publication.

RCH Research Institute 1998 61 •..M 3

Neurology

; !t. !

Director

Honorary neurologist

A new study evaluating gene replacement therapy in an animal model of muscular dystrophy

Dr Lloyd Shield, BSc (Med) MBBS FRACP

Prof Sam Berkovic, BMedSci MD FRACP

is being planned.

Deputy director

Trainee research fellow

Dr Simon Harvey, MD FRACP

Dr Serena Haywood, BSc MBBS MRCP(UK)

Staff Senior neurologist

Research assistants

Technology in Paediatric Neurology. Vlllth

Val Porublev, BAppISci

International Child Neurology Congress.

Dr Ian Hopkins, MD FRACP

Kelly Steeper, BSc(Hons)

Neurologists

Invited international presentation

Other research activities have included clinical reviews of acute myelitis, acute demyelinating

Lloyd Shield: Chairman and speaker,

encephalomyelitis and Guillain Barre syndrome.

Symposium on the Use of Information

Ljubljana, Slovenia. September 1998.

Dr Sari Hayllar, MBBS

Dr Kevin Collins, MBBS FRACP Drug Trial Coordinator Dr Andrew Kornberg, MBBS FRACP

Maree Brick, RN

Dr Peter Rowe, MBBS FRACP Dr Ingrid Scheffer, MBBS FRACP Dr Lindsay Smith, MBBS FRACP

Main Research Interests and Direction Departmental research crosses a number of clinical and basic neuroscience areas of paediatric neurological disease. The aims of these research endeavours is to better understand the causes, the natural history and the treatments of specific conditions affecting the brain, nerves and muscles of children. Epilepsy and intellectual disability are the focus of several research projects in the department. Neurological assessment, magnetic resonance brain imaging (MRI) and neuropsychological testing are being employed in separate studies examining the causes and consequences of epilepsy and brain malformations. Departmental members have participated in research primarily undertaken at the Austin and Repatriation Medical Centre to discover genes causing specific epilepsy syndromes in childhood. The department participates in clinical drug trials of new antiepileptic medications and closely follows the progress of children with refractory epilepsy who undergo surgical treatment. An ongoing focus of epilepsy research is the application of new brain imaging techniques to the investigation of children with uncontrolled epilepsy. Such techniques promise more accurate characterisation and better treatment of children's epilepsy. The Paediatric Neuromuscular Research Laboratory at the Royal Children’s Hospital is actively involved in neuromuscular (nerve and muscle) disease research, particularly with disorders of the immune system and muscular dystrophy. Autoimmune disorders are conditions where the body's immune system "fights itself" and damages target tissues such as nerves or muscles. Antibodies may be formed as part of this immune process. Current projects include studying antibodies against nerve tissues in autoimmune disorders including neuropathies and inflammatory myopathies. We are trying to understand how these antibodies cause disease, how the antibodies can be used to help diagnose and follow these disorders and how specific therapies may be devised. Muscular dystrophy research is carried out in collaboration with the Melbourne Neuromuscular

I'i r

Research Centre. The muscular dystrophies are a group of inherited disorders of muscle characterized by weakness presenting from birth to late adulthood and as a group are the

commonest serious muscle diseases. No curative treatments are available. A number of growth factors have been shown to stimulate the growth of muscles, and it is possible that treatment with growth factors may show benefit, as we have found in animal models of muscular dystrophy. A number of projects involving the study of these growth factors are currently underway.

Andrew Kornberg testing muscle strength in a child with Duchenne Muscular Dystrophy 62 RCH Research Institute 1998

i:!

Occupational Therapy

Orthopaedics and The Hugh Williamson Gait Laboratory

Chief Occupational Therapist Barbara Scoullar, DipOT Deputy Chief Josie Duncan, BAppSc(OccT) Staff

Registrars

Research Fellows

Dale Carroll, BAppSc(OccT)

Dr Anita Boecksteiner

Shane Barwood, MBBS FRCS(Part 1)

Dr Gerard Bourke

Richard Dallalana, MBBS

Dr Christopher Pullen

Stephania Fatone, CPO PhD student

Jane Galvin, BAppSc(OccT)

Director Professor H Kerr Graham, MD FRCS(Ed)

Lindy Johnson, BAppSc(OccT)

FRACS

Melinda Randall, BAppSc(OccT)

Deputy Director

Main Research Interests and Direction

Dr Lu Ton

Mr Ian P Torode, FRACS

Dr Adrian Trivett

Staff List Consultant Orthopaedic Surgeons

Dr Shay Zayontz

Mr Roy Carey, FRACS

School of Human Biosciences, La Trobe Raphael Hau, MBBS Research Fellow Nigel W. Keenan, MB BCH BAD FRCS(Ed)

Gait Laboratory Staff

Christine Olesch, MBBS

Roslyn Boyd, BSc(Anatomy) BAppSc

Vicki Pliatsios, MBBS FRACS (Part 1)

Mr D Robert V Dickens, FRACS

(Physiotherapy) PGDip(Biomechanics)

Pgrad Dip(Biost& Epidemiology)

Miss Susan Liew, FRACS

Elise Cullis, BEng(Electronics)

Justin Wong, Enrolled in BMedSc

Mr Gary R Nattrass, MD FRCSC FRACS

Adrienne Harvey, BAppSc(Physiotherapy)

(University of Melbourne)

The investigation of the score - rescore reliability has been completed showing a very high level of intra and inter-rater repeatability for all test items. The test-retest reliability also showed high

BMedSc(Alberta)

MPhysio (Paeds)

Visiting Dverseas Fellows

repeatability for the total scores.

Mr Mark O'Sullivan, FRACS

Jill Rodda, BAppSc(Physiotherapy)

There have already been many state, interstate and international enquiries regarding the

Mr Ton Tran, FRACS

Fiona Smithson, BAppSc(Physiotherapy)

The Melbourne Assessment of Unilateral Upper Limb Function has neared completion. The assessment has been designed to be a simple quantitative test of unilateral upper limb function in children with neurological conditions (e.g. cerebral palsy and acquired brain injury).

assessment, particularly by Occupational Therapists conducting research projects requiring pre and post-intervention measurements.

PGDipHIthResMeth

Todd Simmons, MD Chicago Memorial Children's Hospital David Borton, MD Central Remedial Clinic, Dublin

Roland Starr, BA(MathsHons) MS(Maths)

Research Interests and Direction The Department of Orthopaedic Surgery and The Hugh Williamson Gait Laboratory have a combined comprehensive program of outcome studies in the field of motor disorders, mainly cerebral palsy and spina bifida. We are actively involved in elucidating mechanisms of understanding deformity progression, means of prevention and methods of correction. This involves longitudinal assessments using instrumented measures in children with cerebral palsy and spina bifida. These are correlated with previous animal work carried out by our group and we also propose to carry out animal work in the future. We are the leading group internationally in the evaluation of Botulinum toxin A as a tool for spasticity management, particularly in children with cerebral palsy but also in traumatic brain injury and other conditions. Our recent activities in this area include the potential of Botulinum toxin as an analgesic agent in the management of pain associated with spasticity. In this area we have completed a randomised controlled trial which is now in press. In the Gait Laboratory we have used a coordinated approach to evaluate the effects of Botulinum toxin in large skeletal muscle groups identifying improvements in kinematics, kinetics and energy consumption following protocols established by our group.

64 RCH Research Institute 1998

RCH Research Institute 1998 65

We are involved in expanding our spasticity management options by the introduction of intrathecal Baclofen and selective dorsal rhizotomy in association with Associate Professor Jeff Rosenfeld and

Prominent Visitors to the Department

Orthopaedic Molecular Biology Research Unit

the Department of Neurosurgery. These new invasive measures will require careful monitoring and Associate Professor Goran Hansson,

Head

Research Assistants

Department of Orthopaedics, Central Hospital,

Associate Professor John Bateman,

Susanna Freddi, BSc(Hons)

We are conducting a series of outcome studies into the surgical management of cerebral palsy

Halmestad, Sweden (4th November - 21st

BSc(Hons) PhD

and spina bifida using a variety of objective and subjective measures including the energy cost

December). Sabbatical

(NH&MRC Principal Research Fellow)

Professor Charles Galasko, Professor of

Deputy Head

assessment using Gait Laboratory technology for their introduction.

of walking and the use of validated questionnaires. In this area we will be working in close cooperation with Professor Frank Oberklaid and associates who are developing a network-wide group of outcome measures.

Orthopaedics, Manchester Children's Hospital (26th - 30th October). Sir Arthur Sims Commonwealth Fellow 1998

Significant Achievements The Gait Laboratory hosted the first Australasian Clinical Gait Analysis Course in February assisted by three eminent North American visitors (see below). Sixty-five visitors attended from all over Australia and New Zealand. For the second year in succession Roslyn Boyd and Shane Barwood have had papers shortlisted for the Richmond prize for best

Kerr Graham and Roslyn Boyd continue to

Professor Bob Gillespie, Buffalo, New York.

Dr Amanda Fosang, BSc(Hons) PhD (NH&MRC Research Fellow) Staff Senior Research Officer

Sue Golub, BSc(Hons) Karena Last, BSc Carly Selan, BSc(Hons) Heather Stanton, BSc(Hons) Postgraduate Students Kylie Patterson, BSc(Hons)

Dr Shireen Lamande, BSc(Hons) PhD

be the chair and adviser to the Worldwide

Keynote presenter at the Australian

Advisory Board and US Research panel on

Paediatric Orthopaedic Seminar. (14th - 15th

Research Officers

the use of Botulinum toxin A in the

February)

Dr Jamie Fitzgerald, BSc(Hons) PhD

Francesca Mercuri, BSc(Hons)

Professor Ivan Krajbich, Shriners Hospital,

Dr Richard Wilson, BSc PhD

Emmanouil Sigalas, BSc(Hons)

management of Juvenile Cerebral palsy.

Invited International Presentations

Chrishan Samuel, BSc(Hons)

Portland, Oregon. Keynote presenter at the

BSc(Hons) Student

Australian Paediatric Orthopaedic Seminar.

Kate Shields, BSc

(14th - 15th February)

H K Graham, R N Boyd, Clinical Gait Analysis Course, Starship Children's Hospital Auckland, New Zealand. June 24th - 26th

paper at American Academy of Cerebral Palsy

The following three visitors conducted The North American Clinical Gait Analysis Course assisted by the Gait Laboratory team

(AACPDM) in San Antonio. These papers

RN Boyd, XXII International Congress of

drew correlations between clinical measures

Paediatrics, Amsterdam, 9th - 14th August

developed in our laboratory and their use in

Invited Satellite symposium "Botulinum toxin

predicting response to Botulinum Toxin A in

of Orthopaedics, Clinical Director Gait

A in the management of children with

children with cerebral palsy and in describing

Laboratory. Gillette Children's Hospital,

Cerebral Palsy"

Minesotta

(11th - 13th February) Professor James R Gage, Professor

the means of ambulation of children with low

Main Research Interests and Directions The extracellular matrix of connective tissues, such as skin, cartilage, bone, tendon, and muscle, is an intricate network of macromolecules which provides both structural scaffolding and regulatory signals for cellular growth and tissue development. Our research is directed at understanding the biosynthesis, regulation, structure and function of these complex matrices in health and disease. Our approach involves the characterisation of mutations causing inherited

Visiting Professor, HK Graham to The

Dr Roy Davis PhD, Bioengineer and Director

diseases of connective tissues and detailed biochemical analysis of the effect of these mutations,

Children's Memorial Medical Centre, Gait

of the Connecticutt Children's Medical Centre

and those produced by molecular biology techniques, in cell culture experimental systems.

In total the Royal Children's Hospital had 18%

Analysis Laboratory, Chicago USA.Mth - 15th

Gait Laboratory

of the total program at this meeting to present

September. Presentations included:-" Why do

lumbar and sacral level spina bifida.

Our studies on the collagen I, II and III mutations in inherited connective tissue diseases continues.

a range of papers looking at outcomes of

we need clinical gait analysis in paediatric

Sylvia Ouunpuu MSc, Connecticutt Children's

surgery, validation of clinical measures of

orthopaedic surgery?, "Practical energy

Medical Centre Gait Laboratory

spasticity and new surgical procedures in

measurements in motor disordered

children with cerebral palsy, as well as hip

children";"Botulinum toxin in the

displacement in children with hemiplegia, gait

management of juvenile cerebral

studies in children with spina bifida. Kerr

palsy";"Single event multilevel surgery in

Graham and Roslyn Boyd presented a seminar

children with cerebral palsy: planning,

on an evidence based medicine approach to management of equinus with colleagues from the Texas Scottish Rite Hospital, Dallas and University of Freiberg, Germany. This was the first workshop to be presented at the Academy by a Non North American team.

conduct and outcomes"

We have defined many mutations leading to brittle bone disease (01), Lax tissue diseases (Ehler'sDanlos syndrome) and cartilage disease (Chondrodysplasias). Many of our studies now explore the biochemical basis of how the mutations disturb collagen structure and lead to tissue malfunction. During 1998 we have continued to develop and expand the use of a new molecular diagnostic approach for premature termination (nonsense) mutations called the protein truncation test (PTT), which facilitates the rapid scanning of patients and family members. We originally applied this test to diagnosis of osteogenesis imperfecta, and in collaboration with Dr Ravi Savarirayan (Murdoch Institute) we have now expanded its use to diagnosis of the inherited cartilage disease. Stickler

RN Boyd, Texas Scottish Rite Hospital,

syndrome. We have applied for patent protection for our method which involves significant

Dallas,'USA. September 15-16th "Botulinum

modifications to the published procedure, that will greatly improve its application to the diagnosis

Toxin A in the Management of Cerebral

of other inherited diseases. Studies with Dr. Susan Forrest and Steven Nasioulas (Murdoch

Palsy"

Institute) have already demonstrated that this modified PTT will improve mutation detection in colon cancer. Recent studies on cartilage-specific type X collagen have identified mutations which prevent protein assembly and have, for the first time, provided information at the protein level on the molecular basis of a group of chondrodysplasias. Further studies will include the generation of specific type X collagen mutations in transgenic mice in collaboration with Prof. Kathryn Cheah (University of Hong Kong).

66 RCH Research Institute 1998

!|/

RCH Research Institute 1998 67

Mutations in collagen VI have very recently been shown to cause a muscle disorder called Bethlem myopathy. In collaboration with Dr Henrik Dahl and Dr Mac Gardner (Murdoch Institute) and Dr. Andrew Kornberg (Neurology, RCH) we have characterised mutations in three families with Bethlem myopathy, and were the first to perform detailed protein studies on these patients to determine the effect of the mutations on collagen VI structure and function. In other studies we are determining the role of collagen VI in muscle cell differentiation. Site-directed mutagenesis is being used to introduce specific mutations in collagen gene domains

Significant Achievements Following examination by the US Patent and Trademark Office our patent describing monoclonal antibody AF-28 (Diagnostic methods and compositions relating to the proteoglycan proteins of cartilage breakdown) has been allowed (PCT/AU95/00395)

postulated to be important structurally and functionally. The mutant genes are introduced into cell type I collagen C-propeptide has defined protein sequences critical for folding, assembly and

Invited International Presentations

extracellular processing, and we are also studying the protein domains important in assembly

Assoc. Prof. John F. Bateman, British

of collagens VI and X.

Connective Tissue Society Meeting, University

cultures and analysed biochemically to assess the affect of the mutations. Detailed analysis of the

A second major research effort is aimed at elucidating the pathways of cartilage destruction in arthritis. The major goal of these studies is to gain a better understanding of the complex

of Wales, Cardiff, U.K. March 30-31,1998. "The Molecular Pathology of Collagens"

biochemical processes that lead to joint pathology by identifying the enzymes involved in tissue

Assoc. Prof. John F. Bateman, 4th CCGH

damage, detailing their catabolic activities and unravelling the mechanisms that control their

Symposium, Frontiers of Matrix Biology,

expression. A number of metalloproteinases are involved in cartilage degradation, but little is

Hiroshima, Japan, June 20-22,1998.

known of their mechanism of action or the regulatory factors controlling them. Using a variety

"Metaphyseal Chondrodysplasia"

of biochemical, biomolecular and tissue culture approaches to tackle these problems we have identified a novel control mechanism involving metalloproteinase binding to one of its products. These results provide new targets for the design of inhibitors of cartilage destruction. Fragments of fibronectin (Fn-f) in arthritic joints are known to promote the breakdown of cartilage

Dr Shireen R. Lamande, IX International Congress on Neuromuscular Disorders, Adelaide, Australia, August 30-September 4, 1998, "Bethlem myopathy"

aggrecan, but the precise mechanism is not clear. Our attention has focussed on the metalloproteinases -13 and -14 and their regulation by Fn-f, as well as the pattern of aggrecan fragments generated following Fn-f stimulation of cartilage in explant culture. Our data shows the direct involvement of at least two distinct families of metalloproteinases. In other studies with clinical and industry collaborators, we are looking for correlations between specific markers of cartilage destruction and disease severity. These studies are aimed at the development of diagnostic methods for (i) determining the levels and progression of arthritic disease, (ii) assessing the efficacy of therapeutic regimes and (iii) predicting clinical outcomes, in children with juvenile chronic arthritis and haemophilia, and patients with osteoarthritis.

Jamie Fitzgerald analysing research results 68 RCH Research Institute 1998

Otolaryngology

Physiotherapy

Director

Cathy Abery, BAppSc(Phty)

Dr Robert Berkowitz, MD FRACS

Anne McCoy, MSc BAppSc(Phty)

GradDipPhysio

Deputy Director Dr John Vorrath, FRACS Staff List Dr Warner Mooney, FRACS Dr Michael Silverstein, FRACS

GradOipRehabSt Director of Research Associate Professor Mary Galea, PhD BAppSc(Phty) BA GradDipNeuro GradDipPhysio

Sharon Vladusic, B(Phyt) Bev Eldridge, BAppSc(Phyt) Jill Rodda, BAppSc(Phyt) Pam Thomason, B(Phyt)

Staff

Dr Elizabeth Rose, FRACS

Adrienne Flarvey, BAppSc(Phty) MPhysio

Dr Robert Webb, FRACS

Elizabeth Williams, Dip(Phty) Adrienne Fosang, BAppSc(Phty) Brenda Button, DipPhysio

Main Research Interests and Directions Laryngeal Motor Neurons

The Department has continued to study the motor neurons responsible for control of laryngeal muscles and the neurotransmitters which modulate the activity of these motor neurons. This

Main Research Interests and Direction

collaborative study with the Department of Neurosurgery, Royal North Shore Flospital, Sydney

This year has seen the consolidation of our research ethos. Six staff have commenced

is part of an ongoing program which is attempting to identify the factors responsible for

or are completing higher degrees, and ten physiotherapists are involved in collaborative projects

maintenance of coordinated laryngeal activity with respiration. This knowledge is essential for

conducted through Centres within Royal Children's Hospital namely the Hugh Williamson Gait

planning strategies for pharmacologic intervention of laryngeal disorders, particularly congenital

Laboratory; the Department of Child Development and Rehabilitation; the Spina Bifida Physiotherapy

bilateral vocal cord paralysis.

Assessment Centre and the Department of Respiratory Medicine. Although collaborative research will always remain a significant objective, the importance of taking a leadership role in defining and guiding our own research endeavours plays a complementary and significant role. To promote this development. Associate Professor Mary Galea has been appointed as Director of Research, a joint appointment with the School of Physiotherapy, the University of Melbourne, Mary's knowledge and skills will be invaluable in consolidating our post-graduate and research programmes. Although physiotherapists have a number of validated tools to assess adults with a motor disability, the reliability and validity of these tools for use in a paediatric population remains unknown. In completing her Masters degree, Adrienne Harvey has investigated whether the Clinical Test for Sensory Interaction in Balance (CTSIB), using one-legged stance, which has been found to be a reliable assessment tool to evaluate balance in the adult population, is also an appropriate assessment tool for children. Adrienne's research study has shown that children whose vision is still developing, are more dependent on this sense for balance, up to 11 years of age. Consequently, the CTSIB test itself was not sensitive enough to be a discriminatory tool when assessing balance, in a paediatric population. However it can be used as a re-assessment tool, in conjunction with other balance tests. Similarly, Liz Williams is currently evaluating the "Timed Up and Go Test" which has been shown to be a reliable and valid tool in a geriatric population. Children in the 4,6 and 8 years age group are being assessed over time. Dependent on the results, Liz is hoping to develop a simple outcome tool to measure motor function in children with disabilities. The International Myelodysplasia Data Base established in the late 1970's has been revitalised. Its new name, the Spina Bifida Physiotherapy Assessment Centre, signifies a change in direction. One of the Centre's main objectives will be the integration of research and clinical responsibilities

70 RCH Research Institute 1998

RCH Research Institute 1998 71

to enhance patient management. Elizabeth Williams, Cathy Abery and Sharon Vladusic have been involved in refocussing the Centre's role that will include the development of clinical research

studies to improve the management of children and adolescents with spina-bifida. Evaluating the effect of Botulinum Toxin A on the physical function of children with Cerebral Palsy, is part of a larger research project conducted through the auspices of the Department of Child

Plastic and Maxillofacial Surgery, and The Melbourne Craniofacial

Development & Rehabilitation. Pam Thomason and Adrienne Fosang are investigating whether following such an intervention, changes in a child's physical function, correlate with parents perception of change in their child. Results to date have shown a significant correlation between tbe two measurement tools employed in the study. These findings were presented at the international meeting of the American Academy of Cerebral Palsy and Developmental Medicine held in San Antonio USA in September 1998.

Head

Consultant Maxillofacial Surgeons

Anthony D Holmes, FRACS

Andrew Reggie, MBBS FACOMS FRACDS

Staff List Deputy Director

Stephen Gibbons, FRACDS

Keith L Mutimer, FRACS Brenda Button, who currently resides in Washington retains a honorary appointment within

Consultant Plastic Surgeons

the hospital. Brenda is completing her PhD detailing the relationship between the use of postural

Douglas S McManamny, FRACS

drainage and gastro-oesophageal reflux in children with cystic fibrosis.

Bruce R Johnstone, FRACS In health care, there has been a shift in thinking about the role of the consumer as patient. Patient KirstyAMacGill, FRACS

surveys can indicate consumer satisfaction with health care delivery and give significant feedback when changes in work practices or service delivery occur. A consumer satisfaction survey has

Timothy Probert, FRACDS Research Fellows Glenn Bartlett, FRACS Registrars David McCombe Christopher Moss

Heather Cleeland, FRACS

been developed in Physiotherapy and then administered across five other Allied Health

Christopher J Coombs, FRACS

Departments within the hospital. It is hoped that this survey will serve as a benchmarking tool to identify best practice across the participating departments at Royal Children's Hospital and later

Alan F Breidahl, MS DipAnat FRACS

in Allied Health Departments in tertiary paediatric hospitals in Australia.

Anthony J Pennington, FRACS

Main Research Interests and Direction The research interests of the Plastic & Maxillofacial Unit is driven by the "laboratory bench to the bedside" philosophy. Unsolved problems in health care delivery in childhood dysmorphology, growth and development are identified, laboratory investigations designed and performed and the results translated back into clinical management of the patients. 1998 was an exciting and fruitful time in this regard. The clinical problem of reconstructing large bony defects had previously been developed involving the the microsurgical transfer of vascularised free fibula bone. This has the advantage of adequate length for most circumstances, but the disadvantage of inadequate thickness, requiring several years to develop the thickness and strength required for full weight bearing. Distraction osteogenesis had also been developed to lengthen bones, involving cutting the bone and utilizing an external fixation device to increase its length. This technology was applied by our research fellow, Glenn Bartlett to instead increase the width of the pig fibula, and demonstrate suitability for microvascular free tissue transfer of the wider, stronger fibula.

Similar research directions were undertaken in the Faciomaxillary section of the department. Distraction osteogenesis has previously been described for lengthening of the mandible, but was applied to the clinical problem of increasing the width of the mandible in the rabbit animal model. Future research directions for 1999 including our research fellow from Boston, Adam Kolkar, being involved in collaborative studies with the Surgical Research Unit investigating the anatomy of limb anomalies in VATER mice, and the establishment of tissue culture for haemangioma by another American fellow, John Meara, in the search for a protein "switch" to induce spontaneous remission of this disfiguring condition of childhood.

RCH Research Institute 1998 73

Psychology Co-ordinator of Clinical Neuropsychology

Mr Matthew Hughes, Bbus GradDipAppPsych

Services Ms Jacquie Wrennall, BSc(Hons) MSc (Clin Neuropsych) MAPsS CCN

Professor Margot Prior, B Mus BA MSc PhD FAPS FASSA

Ms Melinda Gladman, BA GradDipAppChild

Dr Vicki Anderson, BA(Hons) MA(Hons) PhD

Psych MEd Psych MAPsS Clinical Psychologists

Research Assistants

Ms Lesley Bretherton, BSc MSc BA(Hons)

Ms Cathy Catroppa, BBSc DipEdPsych MEd

MA(Clin Psychol) MAPS

Dr Anne Rickards, BA(Hons), MA (Hons), Ms Joanna Elliot, BPsych MPsych MAPsS

Staff

Mr Peter Anderson, BA GradDipAppPsych

Clinical Neuropsychologists

Co-ordinator of Clinical Psychology Services

MAPsS

Dr Elisabeth Northam, BA MA PhD

CCN

University of Oslo, Norway

Lyn Barnett, Chief Psychotherapist Exeter Health Authority, U.K.

Annual Meeting, Budapest, July 1998

On study leave with the Australian

Neuropsychological changes in children with

Temperament Project

Presentations at the Royal Children's Hospital and various conferences and professional meetings

Presentations in Psychology Department, Royal Children's Hospital and University of Melbourne

keynote speaker

Dr Rob McGee

The Neuropsychology of Autism

University of Otago, New Zealand On study leave with the Australian

PhD ABPA MAPsS

Temperament Project

Ms Linda Pentland, BA(Hons) MA(Clin Neuropsych) Ms Rani Jacobs, Bsc GradDip

International Neuropsychological Society

Professor Margot Prior

Ms Diana Smart, BA(Hons) DipEd MA MAPsS

CCN

Dr Elisabeth Northam, BA MA PhD MAPsS

Dr Kristin Matthieson

National Autistic Society, U.K., London:

Psych MAPsS

Dr Elisabeth Northam, BA MA PhD MAPsS

Dr. Elisabeth Northam

IDDM six years after disease onset

Dr Daphne Glaun, BA(Hons) MA PhD MAPs Deputy Director

Prominent Visitors to the Department

'Children and war' Ms Primrose Letcher, BA(Hons)

Honorary Research Associates

MAPsS CCN CEDP Director

Dr Stephen Wood, MA(Hons)(Cantab) PhD

Invited International Presentations

Presentations at the Royal Children's Hospital and various conferences

MAPsS CCN Ms Robyn Stargatt, BSc (Hons) MSc (Clin Neuropsych) MAPS CCN CEDP

(Child & Adolescent Psych)

Main Research Interests and Direction 1998 saw the creation of an Academic & Research Unit in the Mental Health Service. An audit of research and academic endeavours highlighted the dominant contribution of the Psychology Department in research in mental health and paediatric illness and handicap. The co-ordinator of this Unit is Peter Anderson. The large and productive Neuropsychology research group continues to be successful with

research grants and publications. Studies currently in progress are examing the neuropsychological and psychosocial correlates of bacterial meningitis, PKU, insulin dependent diabetes, head injury, temporae lobe epilepsy, hydrocephalus, neuronal migration disorders and brain tumors. Functional MRI imaging is being used to study language in normal children. The Australian Temperament Project, now in its 16th year, is extending its longitudinal research into mid to late adolescence through its latest grants. It attracts considerable international attention with presentations in many countries. The Autism Team which includes four psychologists in its multidisciplinary group has recently set up some research into movement characteristics of autistic and ADHD children, in collaboration with the Psychology Department, University of Melbourne.

74 RCH Research Institute 1998

RCH Research Institute 1998 75

Respiratory Medicine Research Fellows

Research Scientist

Work performed in the department was presented at the Australasian, European and American

Dr Gillian Nixon, MB ChB FRACP

Richard GD Roberts, BSc(Hons) MScDipEd

Thoracic Societies as well as conferences of the Australian Paediatric Societies and the European

from Feburary

PhD

and North American Cystic Fibrosis annual meetings. Dr Colin Robertson also presented work

Dr Jackson Wong, MBBS MRCP(UK),

Research Assistants

at the world asthma meeting in Barcelona Spain.

MRCPCH DCH FHKAM(Paed) MhkCPaed

Marita Dalton, AssocDip MRA GradDip

from September

Epidem

Director

Dr Jeurg Barben, MD from July

Mary Bosco, MSc

Dr Anthony Olinsky, MB Bch Dip Paed FCPSA

Dr Julian Vyas, MBBS MRCP(UK) MRCPCH

Mary McCrohan, BAppISci

FRACP

from December

John Elliott

Deputy Director

Colin Sherrington, BMedSci MBBS FRACP

Rosemary Carzino, BSc(Hons)

Colin F Robertson, MBBS MSci (Epi) FRACP Staff Thoracic Physicians Philip J Robinson, BMedSci MD FRACP Susan M Sawyer, MD FRACP

John Massie, MBBS DCH PhD FRACP

Laboratory Assistant

Cystic Fibrosis Clinic Co-ordinator and Counsellor

Irish Lyell, BApplSci(Biophysics)

Judith Glazner, RN BBSc(Hons) MA (Clinical Psych)

David S Armstrong, MBChB FRACP

Main Research Interests and Direction The Thoracic Medicine department continued its long term studies into airway inflammation and early lung disease in infants with cystic fibrosis. Dr John Massie continued the investigations into lower airway infection in infants with cystic fibrosis utilizing the bronchial lavage route. Dr Gillian Nixon joined us from New Zealand and has continued the department's work into the relationship between infection and inflammation in the lungs as determined from bronchoalveolar lavage (BAL) and an objective measure of pulmonary function. Lung function testing using the "raised volume rapid thoraco-abdominal compression technique" (RVRTC) is performed under standardised general anaesthesia at the same time as bronchoscopy and BAL is performed. Measurements are taken at diagnosis, 12 months and two years and during intercurrent respiratory exacerbations as clinically indicated. These studies have recently shown that patients with early infection in their lungs have reduced lung function later in childhood. Further areas of continued research included Dr Robinson's work into lung abnormalities in the sudden infant death syndrome and the effects of passive cigarette smoking on lung development. These studies have shown that infants whose mothers smoke during and after pregnancy have altered structure to their airways. Dr Robinson's studies have further shown that in patients who died from SIDS there is a structural abnormality in the amount of smooth muscle within the small airways. Several studies into new therapies in asthma were conducted. These included a new oral once a day tablet for childhood asthma, as well as an epidemiological study conducted by Dr Jeurg Barben from Switzerland, on a new challenge test as a screening tool for asthma, using inhaled dry powder mannitol. Dr Julian Vyas and Dr Jackson Wong both joined the department from Leicester UK. Dr Vyas is investigating lung function measurements in infants in intensive care who have bronchiolitis while Dr Wong is refining his technique of measuring breath sounds and using this information to determine alterations in intra thoracic airway calibre. Dr Colin Sherrington completed his work on aspiration lung disease in patients with cerebral palsy.

■:i

Exercise testing in the Respiratory Laboratory 76 RCH Research Institute 1998

T,':;

I 1'

Social Work

Speech Pathology

Head of Department

Social Workers

Chief Speech Pathologist

Jane Miller, BADipSocStuds

Helen Goodman, MSW, BA DipSocStuds

Bronwyn Parry-Fielder, BAppSci(SpeechPath)

Director of Research Unit

Nadine Cameron, BA BSW(Hons)

Professor Alun Jackson, PhD MSc BA DipSocStuds Director, Royal Children's Hospital/University

GradDip(CommDis) MEdSt GradDip(Health) Serv Managmt

Belinda Johnson, BA BSW(Hons) Deputy Menka Tsantevski, BA BSW(Hons) J Fisher, MA(AppLinguistics) DipSpeech Therapy TPTC

of Melbourne, Social Work Practice Research Unit

Speech Pathologists E Ferguson, BAppSci(SpeechPath) GradDip

Staff Senior Academic Associate

(CommDis)

Margaret Dietz Domanski, PhD ACSW

F Haritou, BAppSci(SpeechPath) S Morse, BAppSci(SpeechPath)

Significant Achievements

Main Research Interests and Direction

This newly established research unit is still

The Department aims to improve health outcomes for children, adolescents and their families and

in the setting up and consolidation phase.

improve the knowledge base of the Social Work profession by carrying out a range of research

The most important achievement in 1998 was

and evaluation projects which predominantly arise from the practice of the social workers

the winning of sufficient tenders and to

in the hospital.

Main Research Interests and Direction The Speech Pathology Department is involved in several collaborative clinical research projects which involve children with swallowing problems and /or communication problems. Some of these

ensure ongoing work for a stable group of social work researchers to enable the unit to build up a quantum of experience.

head injury in early childhood" which is being conducted in collaboration with the Department of • Integration of research, advocacy and education with clinical care

Prominent visitors to the Department

• Fostering of a culture of inquiry among the professional social workers in the

Professor Gail Auslander of the Paul

• Development of links and partnerships with other departments, disciplines and organisations

Baerwald School of Social Work, Hebrew

Smith of the Hospital Support Unit ran

Psychology at Melbourne University and the Neuroscience Centre. This project is now in its sixth year and is following the development of young head injured children. A subsequent study is looking at the outcomes for this group of children five years after their head injury.

Royal Children's Hospital f f

!■(

• Offering consultation and professional development to all Royal Children's Hospital Social Workers

K I,

a workshop for Allied Health on Research related matters. Professor Irwin Esptein, School of Social

• Actively seek honours and post graduate students and distinguished international academics

current research.

We are also looking at whether early diagnosis of children with sensori-neural hearing loss

measures of speech and language outcomes. II

Invited International Presentations

1' :

The Royal Children s Hospital and La Trobe University have recently made a joint appointment of the first Professor of Paediatric Speech Pathology, to be employed in an Australian hospital. Professor Sheena Reilly will commence working in the Speech Pathology Department in April 1999. Sheena Reilly's previous research has been in the area of paediatric dysphagia and motor speech

directions of the unit and its various research projects and individual consultation on

funded by a grant from the Home Enteral Nutrition Research and Development Project.

at 150 children aged 6 - 7.5 years, using a range of standardized and descriptive assessment

York and Mt Sinai Medical Center, New York provide consultation regarding the future

take food by mouth after a lengthy period of tube feeding. The project is one of a group of projects

improves outcomes. The study, co-ordinated through the Centre of Community Child Health will look

• Placing a high priority on the growth of external research funding

Work, Hunter College, City University, New visited the research unit for a fortnight to

In collaboration with the Gastroenterology Department, the Nutrition - Food Services Department, and the Mental Health Service, we are also studying the factors influencing a child's capacity to

(statewide nationally and internationally)

University of Jerasulem visited the Research Unit, provided consultation and with Ms Gayle

projects are long term projects, such as the research project "Developmental patterns involving

The key strategies are:

2nd International Conference on Social Work

disorders, and she will continue work in this area, in addition to providing leadership for the general

in Health and Mental Health, Melbourne, 1998

research direction and research program within the department.

Jackson, AC, Johnson, B, and D'Toole, M,

'Discharge Planning in Complex Paediatric

Cases' Jackson, AC, 'Academic - Agency

rb i

Partnerships in Health Social Work'

L Li

! ‘

78 RCH Research Institute 1998 RCH Research Institute 1998 79

Surgical Research Unit F.Douglas Stephens Laboratory Director

Research Fellows

John M Hutson, BS MD(Monash) MD(Melb)

Zoltan Hrabovszky, MD

FRACS Deputy Director Sue Hasthorpe, BSc(Hons) PhD Postdoctoral Fellow Patricia Hengel, BSc(Hons) PhD Research Assistants Lisa M Watts, BAppSci Pamela J Farmer, BAppSci Baiyun Zhou, MD(Melb) Sabrina Barbie, BSc

Elizabeth Penington, MBBS FRACS (MD Student) Madalena Liu, MBBS (MD Student) Reisuke Imaji, MD

The cause of abnormal bowel function in children with intractable constipation More than 150 children have now been studied with severe chronic constipation and soiling. In the past, no diagnosis could be made, leading to extreme frustration and secondary

Invited International Presentations

psychological disturbance. With new tests developed in collaboration with Dr CW Chow from

John Hutson: British Council Course,

Anatomical Pathology, now we can identify a cause in about 2/3 of these children. We have

Manchester UK, July 16-18,1998

employed a new postdoctoral fellow. Dr Patricia Hengel, and are embarking on a major study

a) "Intersex" b) "Undescended Testes"

to unravel the histological and functional anomaly in these children.

John Hutson: Ninth Fukuoka International Symposium on Perinatal Medicine, Fukuoka Japan, Sept 5-6,1998 "Endocrinological development in neonatal urology"

Ahnkie Lee, MD Students Benjamin Cook, (BMedSci student) Peter Hsu, (Summer student) Sing-Jill Chow, (Summer student)

Kellie Tainton, BSc(Hons)

Significant Achievements

Main Research Interests and Direction

Our most significant advance this year has

These are four main themes in the surgical research laboratory

been the increasing recognition that we have identified the cause in children with intractable "slow-transit" constipation and soiling. A paper describing the first 100 patients produced widespread interest when it was presented at the American Academy of Pediatrics meeting in October.

Testicular descent and function perinatally The laboratory remains one of the world leaders in research on descent of the testis, and undescended testis, which is an extremely common surgical problem in children. We are continuing to explore the effects of various hormones and the genitofemoral nerve on the process. Our work on the development of neonatal germ cells (the precursors of sperm) also has expanded, and we have established some unique methods of both culturing and labelling germ cells at different stages. These studies are key to the understanding of infertility secondary to undescended testes. Hormonal control of inguinal hernia closure Inguinal hernia is the commonest surgical condition in childhood, but its cause has been unknown. Our work on testicular descent has led us to discover some of the controls for hernia closure, and these studies are extremely exciting, as they suggest that a nonsurgical treatment for hernias may be possible in the near future. The causes of abnormal development of the bowel and bladder Abnormal development of the bowel and bladder leads to serious surgical problems in babies. We have expanded our study of a new rodent model in which the fetuses develop a large number of abnormalities of the gullet, rectum and bladder.

80 RCH Research Institute 1998

Publications

* 't: .:. 'r,k',..

iHK..;.

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Publications 5110 Ahluwalia J, Loughnan P. (1998) Neonatal Pain. Manual of Acute Pain Management in Children. Eds. McKenzie, Graukroger, Ragg, Brown. Harcourt and Brace 5111 Alexi Meskishvili V, Dahnert I, Hetzer R, Lange PE, Karl TR. (1998) Origin of the circumflex coronary artery from the pulmonary artery in infants. Ann, Thorac. Surg. 66:1406-1409 5112 Amor DJ, Algar EM, Slater HR, Smith PJ (1998) High frequency of t(12;21) in childhood acute lymphoblastic leukaemia detected by RT-PCR. Pathology 30:381-385

5148 Borton D, Walker K, Nattrass G, Graham

5156 Buttery JP, Alabaster SJ, Heine RG, Scott

(1998) Chapter 9, The leg and foot. In:

HK. (1998) Calf lengthening in cerebral

SM, Crutchfield RA, Garland SM. (1998)

production of TGF b1 inhibits cerebral

Orthopaedic Management of Spina

emission computed tomography-EEG

palsy: risk factor outcome analysis.

Multiresistant Pseudomonas aeruginosa

edema, enhances TNF-induced

Bifida Cystica. Third Edition. Eds.

relations in temporal lobe epilepsy

Developmental Medicine & Child

outbreak in a pediatric oncology ward

apoptosis and improves survival

Broughton NS, Menelaus MB. Harcourt

[letter]. Neurology 51:645-646

Neurology. Supp 78, 40:19

related to bath toys.

in a murine glioma model.

Brace

Hale LP, Bigner DD. (1998) Local

J. Neurolmmunol 86:46-52

of executive function in children. Neuropsychological Rehabilitation 8:319-350 5114 Anderson V, Pentland V. (1998). Attention deficit following paediatric head injury.

Graham HK. (1998) Validity of a clinical

5157 Campbell DE, Hill D, Kemp A. (1998)

D, Haan E. (1998) A type III collagen

Enhanced IL4 but normal interferon

JFFasslerR. (1998) Collagen II

gly559 to arg helix mutation in Ehler's-

Opinion in Neurology 11:129-134

is essential for the removal of the

Danlos syndrome type IV. Human

notochord and formation of

Mutation. Supp11(6), S257-S259

5121 Aszodi A, Chan D, Hunziker E, Bateman

intervertebral discs. J. Cell Biol. 143:1399-1412 5122 Ball C, Westhorpe R. (1998) Cover Note: 26:3

26:347 5124 Ball C, Westhorpe R, (1998) Cover Note:

dietary intake and nutritional status

26:129 5126 Ball C, Westhorpe R. (1998) Cover Note: The small Inhaler. Ann. Intens. Care 26:479 5127 Ball C, Westhorpe R. (1998) Cover Note: The Tecota Inhaler. Ann. Intens. Care 26:617 5128 Barnes GL, Uren E, Stevens KB, Bishop

in infants with cystic fibrosis. Pediatr.

RF. (1998) Etiology of acute gastroenteritis in hospitalised children in Melbourne, Australia, from April 1980 to March 1993. J. Clin. Microbiol. 36:133-138

Pulmonol. 26:371-379 I

5129 Barwood SA, Duffy C, Rodda J, Starr R, 5118 Ashley DM. (1998) Laboratory Advances in Central Nervous System Tumours. Cancer Forum 22:(2):142-148 5119 Ashley DM, Kong FM, Bigner DD, Hale

and cellular specific induction of the

Nattrass G, Menelaus M, Graham HK. (1998) The means of progression of children with low lumbar and sacrallevel spina bifida. Developmental

LP. (1998) Endogenous expression of

Medicine & Child Neurology. Supp

transforming growth factor bl inhibits

78, August 40:23

injury. Molecular Brain Research 59:119-134

laryngoscopy. Annals of Otology Rhinology and Laryngology 107:75-80 5141 Berkowitz R G. (1998) Vocal cord paralysis. In: Practical Pediatric Otolaryngology. Eds. Cotton R T, Myer C M. Lippincott-Raven Philadelphia 613-624 5142 Bines JE. (1998) Future directions in Nutrition Support. Asia Pacific Journal of Nutrition 7:238-240 5143 Bines JE. (1998) Starvation and Fasting: Biochemical aspects. In: Encyclopedia

5134 Bennhagen RC, Menahem S. (1998) Holt-

London 1779-1786

Dram syndrome and multiple ventricular septal defects: an association suggesting a possible genetic marker? Cardiology in the Young 8:128-130 5135 Bennhagen RC, Weintraub RG, Lundstrom N-R, Svenningsen NW. (1998)

5144 Bines JE, Francis D, Hill D. (1998).

in cerebral blood flow velocity and alterations in cardiovascular function. Biology of the Human Neonate 73:275-286 5136 Bennett-Wood V, Carapetis J, RobinsBrowne RM. (1998) Ability of clinical isolates of Streptococcus pyogenes to adhere to and invade HEp-2 epithelial cells. J. Med. Microbiol. 47: 899-906 5137 Benzie I F F, Janus E D, Strain J J. (1998) Plasma ascorbate and vitamin E levels

Fas-mediated apoptosis in a murine high

52:447-451

gamma production in children with isolated IgE- mediated food

Neurology. Supp 78 40:7

hypersensitivity. Pediatric Allergy

5150 Boyd RN, Pliatsios V, Graham HK. (1998) Use of objective clinical measures in

Immunology 9:68-72 5158 Campbell DE, Kemp AS. (1998)

predicting response to Botulinum toxin A

Production of antibodies to

in children with cerebral palsy.

Staphylcoccal superantigens in atopic

Developmental Medicine & Child

dermatitis Arch. Dis. Child 79:400-404

Neurology. Supp 78 40:28 5151 Boyd RN, Pliatsios V, Starr R, Nattrass G, Graham HK. (1998) Biomechanical

5159 Carden SM, Colville DJ, Davidson AJ, McKenzie IM, Mackey DA, McKenzie J, Elder JE. (1998) Adjunctive intra

transformation of the Gastrosoleus

operative local anaesthesia in paediatric

Muscle injection of Botulinum toxin

strabismus surgery: A randomised,

A in ambulant children with cerebral

controlled trial. Aust. and NZ.

palsy. Gait and Posture 7 (2):166

J. of Ophthalmology 26:289-297

5152 Breidahl AF, Szwajkun P, Chen YR. (1997) Pneumosinus dilatans of the maxillary

Pediatric Gastroenterology and Nutrition 26:123-128 5145 Bines JE, Francis D, Hill D. (1998). Short

5160 Carlin J, Chondros P, Masendycz P, Bugg H, Bishop RF, Barnes GL. (1998).

sinus: a report of two cases. Br. J, Plas.

Rotavirus infection and rates of

Surg. 50:33-39

hospitalisation for acute gastroenteritis

Reducing the parenteral nutrition requirement in TPN dependent children

Hypoxic-ischaemic encephalopathy is associated with both regional changes

cerebral palsy in a randomized clinical trial. Developmental Medicine & Child

of Human Nutrition. Eds. Sandler MJ, Caballero B, Strain JJ. Academic Press,

in Hong Kong Chinese. Eur. J. Clin. Nutr.

58:302-309

of the neonatal upper airway by flexible

components of the IGF-I/IGFBP axis in the rat brain following hypoxic-ischemic

growth and tumorigenicity and enhances grade glioma model. Cancer Res.

5140 Berkowitz R G. (1998) Assessment

with short bowel syndrome. Journal of

Paediatrics and Child Health 34:170-174

(1998) Severe viral respiratory infections

5133 Beilharz EJ, Russo VC, Butler G, Baker

CE, Scheepens A. (1998) Co-ordinated

The Oxford Vaporizer. Ann. Intens. Care

Carzino R, Hull J, Glinsky A, Phelan PD

and Child Health 34:120-126

M, Werther GA, Gluckman PD, Williams

Paxton S. (1998) Relation between

5117 Armstrong DS, Grimwood K, Carlin JB,

cancer survival. Journal of Paediatrics

The EMO Vaporizer. Ann. Intens. Care

5125 Ball C, Westhorpe R. (1998) Cover Note:

fibrosis in Australia. Journal of

Psychosocial aspects of adolescent

NL, Connor B, Sirimanne ES, Dragunow

5115 Anthony HD, Bines JE, Phelan PD,

Paxton S. (1998) Current approaches to

5132 Bauld C, Anderson V, Arnold J. (1998)

5123 Ball C, Westhorpe R. (1998) Cover Note:

Intens. Care 26:239

the nutritional management of cystic

Pediatr. Infect. Dis. J 17:509-513

measure of spasticity in children with

8:283-300

5116 Anthony HD, Catto-Smith AG, Phelan P,

5149 Boyd RN, Barwood SA, Baillieu CE,

other epilepsy syndromes. Current

The Marrett Drawover Apparatus. Ann.

in Childhood 78:443-447

5139 Berkovic SF, Scheffer IE. (1998) Febrile seizures: genetics and relationship to

Neuropsychological Rehabilitation

in cystic fibrosis. Archives of Diseases

5130 Barwood SA, Graham HK, Menelaus MB.

5131 Bateman JF, Chiodo AA, Weng YM, Chan

Snow's Ether Inhaler. Ann. Intens. Care 5113 Anderson V. (1998) Assessment

5138 Berkovic SF, Newton MR, Harvey AS, Berlangieri SU. (1998) Single photon

5120 Ashley DM, Sampson JH, Archer GE,

5153 Brizard CP, Mas C, Sohn Y, Cochrane AD, Karl TR. (1998) Transatrialtranspulmonary tetralogy of Fallot repair

in young children, Australia, 1993-96. MJA 169:252-256 5161 Carlin J, Taylor P, Nolan TM. (1998)

is effective in the presence

School-based bicycle safety education

of anomalous coronary arteries.

and bicycle injuries in children: a case-

J. Thorac. Surg. 116:770-779

control study. Injury Prevention 4: 22-27

bowel syndrome, intestinal permeability and glutamine. Journal of Pediatric Gastroenterology and Nutrition 27:615-616 5146 Bond L, Nolan T, Lester R. (1998). Home

5154 Bryan D. (1998) The Adolescent. In Orthopaedic Management of Spina

5162 Catto-Smith AG. (1998) Paediatric gastrointestinal disorders. In:

Bifida Cystica. Third Edition. Eds.

Gastrointestinal Drug Guidelines, 2nd

Broughton NS, Menelaus MB. Harcourt

edition. Therapeutic Guidelines Ltd,

Brace 7-14

North Melbourne.

vaccination for children behind in their immunisation schedule: a randomised controlled trial. Medical Journal of Australia 168:487-490 5147 Bond L, Nolan T, Pattison P, Carlin J. (1998) Vaccine preventable diseases and immunisations: a qualitative study of mothers' perceptions of severity, susceptibility, benefits and barriers.

5155 Burns J, Patton GC, Coffey, C, (1998)

5163 Catto-Smith AG. (1998) Gastro-

A brief scale for the prediction of

oesophageal reflux in children with

suicidal behaviour in a representative

chronic disease. Hong Kong Journal

adolescent population. Australian

of Paediatrics 3:1-3

Journal of Psychology 50:75-76

5164 Catto-Smith AG, Coffey C, Nolan T. (1998) The clinical significance of anismus in encopresis. Gastroenterology and Hepatology 13:942-947 11' 1

Australian & New Zealand Journal of Public Health 22(3):441-446

84 RCH Research Institute 1998 ^1

RCH Research Institute 1998 85

5165 Chan A, Baranowski B, Berry L, Liu M,

5173 Clarnette TD, Lam SKL, Hutson JM.

5182 Deerojanawong J, Sawyer SM, Fink AM,

5190 Dohar JE, Alper CM, Rose EA, Doyle WJ,

Raffi B, Post M, OBrodovich H, Mitchell

(1998) Ventriculo-peritoneal shunts

Stokes KB, Robertson CF. (1998) Totally

Casselbrant ML, Kenna MA, Bluestone

Maternal cigarette smoking is

JL. (1998) Pulmonary valve annulus

L, Monagle P, Andrew M. (1998)

in children reveal the natural history

implantable venous access devices

CD. (1998) Treatment of chronic

associated with increased airway wall

grows after balloon dilatation of neonatal

Influence of mechanical stretch

of closure of the processus vaginalis.

in children with cystic fibrosis: incidence

suppurative otitis media with topical

thickness in children who die from

critical pulmonary valve stenosis.

on thrombin inhibition by mixed fetal

J. Pediatr. Surg. 33 (3):413-416

and type of complications. Thorax.

ciprofloxacin. Annals of Otology,

sudden infant death syndrome. Am. Rev.

American Heart Journal 136(2):276-280

53:285-289

Rhinology & Laryngology 107:865-871

Resp. Crit. Car. Med 158:802-806

lung cells. Am. J. Respir. Cell. Mol. Biol. 9(3):419-425

G, Stylianopoulos T, Gottlieb T. (1998)

5183 de Koning-Ward TF, Grant T, Oppedisano

5206 Giodano L, Moldwin RL, Downie PA,

5199 Elliott SJ, Srinivas S, Albert MJ, Alam K,

Goldberg A, Gupta R, Allen R, Aithal NH,

Harvey AS, Alvarez L, Dean P, Gilman J,

Robins-Browne RM, Gunzburg ST, Mee

Kim DH, Le Moine PJ, Smith SD. (1997)

F, Robins-Browne RM. (1988) Effect

and biochemical consequences

Staphylococcus aureus in Australia.

of bacterial invasion of macrophages

Yaylali I, Morrison G, Prats A, Altman N,

BJ, Chang BJ. (1998) Characterization

Growth inhibition of B-cell precursor

of collagen X mutations in mice and

Lancet 352:145 (letter)

on the outcome of assays to assess

Birchansky S, Bruce J. (1998) Epilepsy

of the roles of hemolysin and other

acute lymphobistic leukemia cell lines

bacterium-macrophage interactions.

surgery in the first three years of life.

toxins in enteropathy caused by alpha-

by monocytes: a role for prostaglandin

J. Immunol. Methods 215:39-44

Epilepsia 39:737-743

hemolytic Escherichia coli linked

E2. Leukemia Research 21(10):925

humans. Matrix Biology 17:169-184 5167 Chan D, Weng YM, Graham HK, Sillence

5175 Collins KJ. (1998) The child with a headache. In: Practical Paediatrics.

DO, Bateman JF. (1998) A nonsense

Eds. Robinson MJ and Roberton DM.

mutation I the carboxyl-terminal domain

Churcbill Livingstone 567-571

of type X collagen causes haploinsufficiency in schmid metaphyseal chondroplasla. Journal of Clinical Investigation 101(7):1490-1499 5168 Chang AB, Grimwood K, Harvey AS,

5176 Colman P, Caudwell J, Jankulowski C, Margetts H, McNair P, Oakley M, Schmidli R, Werther GA, Alford F, Ward G, Tait B, Honeyman MC, Harrison LC. (1998) The Melbourne Pre-diabetes

5184 deVeber G, Chan A, Monagle P,

5192 Duffy CM, Barwood SA, Graham HK.

Marzinotto V, Massicotte MP, Leaker M,

(1998) Chapters, Gait, In: Orthopaedic

Andrew M. (1998) Anticoagulation

Management of Spina Bifida Cystica.

therapy in pediatric patients with sinovenous thrombosis: a cohort study. Archives of Neurology 55(12):1533-1537 5185 deVeber G, Monagle P, Chan A,

to human diarrhea. Infect. Immun. 66:2040-2051

Third Edition. Eds. Broughton NS,

0. (1998) Membrane type I MMP (MMP-

assessment. Child: Care, Health and

Menelaus MB. Harcourt Brace

14) cleaves at three sites in the

Development 24:457-472

5193 Duke T, Butt W, South M, Karl T. (1998) Early markers of major adverse events

aggrecan interglobular domain. FEBS Lett. 430:186-190

MacGregor, Curtis R, Lee S, Vegh P,

in children after cardiac operations.

nervous system tuberculosis following

dependent diabetes. Medical Journal

Adams M, Marzinotto V, Leaker M,

J. Thorac. Cardiovasc. Surg.

Friedman AH, Cokgor I, Haglund MM,

resolution of miliary tuberculosis.

of Australia 169:81-84

Massicotte MP, Lillicrap D, Andrew M.

114:1042-1052

Ashley DM, Rich J, Dolan ME, Pegg AE,

5169 Chang AB, Grimwood K, Hutson JM, Jones CL. (1998) Renal tuberculosis in an Australian born child. J. Paediatr. Child. Health 34 (3):293-295

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analysis. Neuropsychological

(1998) Preschool behaviour problems

Rehabilitation 8:301-318

in a multicultural Australian urban area.

5308 Pestronk A, Choksi R, Yee W, Kornberg AJ, Lopate G, Trotter J. (1998) Serum antibodies to heparan sulfate

Journal of Paediatrics and Child Health 34:164-169 5317 Ragg P. (1998) MCQ's and OSCE’s for

glycoaminoglycans in Guillain Barre

the primary FRCA. Ann. Intens. Care

syndrome and other demyelinating

25(6):729

polyneuropathies. Journal of Neuroimmunology 91:204-209

5318 Ragg P. (1998) The Anaesthetic Viva Vol 2. Ann. Intens. Care 25(6):728

5309 Phillips RJ, Bonomo Y. (1998) Acne. Check Program of Seif Assessment. Ed. The Royal Australian College of General Practitioners 320:13-14

34: 346-348

90 RCH Research Institute 1998

RCH Research Institute 1998 91

5319 Ramachandran M, Gentsch JR, Parashar

5334 Sawyer SM, Collins N, Bryan D, Brown

5342 Skinner RS, Nolan T, Bowes G. (1998)

5352 Starr M, Barnett P, Carlin J, Fink M,

Desmarchelier P. (1998) Shiga toxin-

D, Hope MA, Bowes G. (1998) Young

Measles-mumps-rubella and hepatitis

Harrison S, Hogg G, South M. (1998)

Stanley C. (1997) Fasting hypoketotic

Bishop RF, Greenberg HB, Urasawa S,

producing Escherichia coli in Australia.

people with spina bifida: transfer from

B vaccination uptake in adolescents:

Is there a better way to make the

coma in a child with deficiency

Gerna G, Coulson BS, Taniguchi K,

Escherichia coli 0157:H7 and other Shiga

paediatric to adult health care. Journal

a survey in metropolitan Melbourne.

diagnosis of pneumonia in children?

of mitochondrial 3-hydroxy-3-

Bresee JS, Glass Rl, (1998) Detection

toxin-producing E. coli strains. Eds.

of Paediatrics and Child Health.

Medical Journal of Australia 168:546-549

Aust. NZ.J. Med. 28:108

methylglutaryl-CoA synthase. New

34:414-417

and characterization of novel rotavirus

Kaper JB, O’Brien AD. Washington, DC:

strains in the United States. J. Clin.

American Society for Microbiology

Microbiol. 36:3223-3229

66-72

5320 Reddihough DS, King J, Coleman GJ,

5327 Robinson PJ, Natoli G. (1998)

5343 Sohn YS, Brizard CP, Cochrane AD, 5335 Sawyer M, Patton GC. (1998) Unmet

Wilkinson JL, Mas C, Karl TR.(1998)

5353 Starr M, Bennett-Wood V, Bigham AK, De Koning-Ward TF, Bordun AM, Lighfoot

need in mental health service delivery:

Arterial switch in hearts with left

D, Bettelheim K, Jones C, Robins-Brown

children and adolescents. In: Unmet

ventricular outflow and pulmonary valve

RM, (1998) Hemolytic-Uremic Syndrome

5360 Thompson GN, By Hsu, Pitt JJ, Treacy E,

England Journal of Medicine 337(17):1203-1207 5361 Thompson NS, Baker RJ, Cosgrove AP, Corry IS, Graham HK. (1998)

Catanese AA. (1998) Efficacy

Comparative trial of a high dose

need in Psychiatry. Eds. Andrews G,

abnormalities. Annals of Thoracic

following urinary tract infection with

Musculoskeletal modelling in

of programs based on Conductive

pancreatic enzyme preparation with

Henderson S. London:Cambridge

Surgery 66(3):842-848

enterohemorrhagic Escherichia coli:

determining the effect of Botulinum toxin

Education for young children with

a standard dose pancreatic enzyme

University Press

Case report and review. Clinical

on the hamstrings of patients with

cerebral palsy. Developmental Medicine

preparation in patients with cystic

and Child Neurology. 40:763-770

fibrosis. Australian Jnl. Hosp. Pharm.

5344 Somers GR, Tesorriero AA, Hartland E, 5336 Sawyer SM, Tully MA, Dovey M, Colin

Robertson CF Robinson PJ, Venter DJ,

Infections Diseases 27:310-315

crouch gait. Developmental Medicine & Child Neurology 40(9):622-5

AA. (1998) Reproductive health in males

Cbow CW. (1998) Multiple

with cystic fibrosis: Knowledge,

leiomyosarcomas of both donor and

Wagner N, Tedder N. (1998) Efficient

5328 Rowe KS. (1998) The hyperactive infant

attitudes, and experiences of patients

recipient origin arising in a heart lung

lymphocyte migration across high

chronic illness. Behaviour Change

and child. In: Practical Paediatrics,

and their parents. Pediatric Pulmonology

transplant patient. Am, J. Surg.

endothelial venules of mouse peyer's

Karl TR. (1998) Centrifugal ventricular

15:151-159

4th ed. Eds. Robinson MJ and

25:226-230

Pathology 22(11):1423-1428

patches requires overlapping expression

assist in children under 6kg. Eur. J.

of L-selectin and Beta 7 integrin.

Cardio-Thorac. Surg. 13:130-134

5321 Redlich N, Prior M. (1998). Cognitivebehavioural interventions in paediatric

5322 Richardson S, Grimwood K, Gorrell R, Palombo E, Barnes G, Bishop R. (1998)

28(3)

Robertson DM. 5329 Rutishauser C, Sawyer SM. (1998)

5337 Scheffer IE, Phillips, HA, O'Brien CE,

in childcare settings. Childcare and Children's Health 1(2):3-4

Helping to clear the smoke - the doctor's

Mulley JC, Berkovic SF. (1998) Familial

severe diarrhoea in young children.

role in smoking prevention and cessation

partial epilepsy with variable foci: A new

Lancet 351:1844-1848

in adolescents. Australian Family

partial epilepsy syndrome with

Physician 27(12):1110-1113

suggestion of linkage to chromosome 2. Ann. Neurol. 44:890-899

Sawyer SM. (1998) Parents with mental

5330 Rutishauser C, Sawyer SM, Bowes G.

illness. Is there help for their adolescent

(1998) Quality of Life assessment

children? Australian Family Physician

in adolescents with asthma. European

Ritchie M, Bateman J, Cetta G, Valli M.

27:987-988

Respiratory Journal 12:486-494

(1998) Human cells unable to express

5324 Robertson CF, Dalton M, Peat, JK, Haby

5331 Samuel CS, Coghlan JP, Bateman JF.

MM, Bauman A, Kennedy JD, Landau LI.

(1998) The effects of relaxin, pregnancy

(1998) Asthma and other atopic diseases

and parturition on collagen metabolism

in Australian children. Australian arm

in the rat pubic symphysis. J. Endocrinol.

of the International Study of Asthma

159:117-125

and Allergy in Childhood. Med. J. Aust. 168:434-438 5325 Robertson CF, Norden MA, Fitzgerald DA,

5332 Sanson A, Prior M, Oberklaid F, Smart D. (1998) Temperamental influences on psychosocial adjustment: From infancy

Connor FL, Van Asperen PP, Cooper PJ,

to adolescence. Australian Educational

Francis P, Allen HDW, (1998) Treatment

and Developmental Psychologist. 15:7-38

of acute asthma: salbutamol via a jet nebuliser vs spacer and metered dose inhaler. J. Paediatr. Child. Health. 34:142-146

5333 Sawyer SM. (1998) Transition to adult health care. In: Diabetes and Adolescence. Eds. Werther G, Court J. Melbourne:Miranova Publications 255-268.

5345 South M. (1998) Febrile convulsions

Baling M, Wrennall J, Wallace RH,

Prolonged excretion of rotaviruses after

5323 Rimmington H, Olsson C, Walsh B,

5326 Robins-Browne RM, Elliott E,

UD, Jin S, Woods PA, Kirkwood CS,

5346 South M. (1998) Pediatric diagnosis: interpretation of symptoms and signs in children & adolescents - review. J. Paediatr. Child.Health

5338 Scott JE, Dyne K, Thomlinson AM,

decoron produced disorganized extracellular matrix lacking "Shape Modules" (Interfibrillar proteoglycan bridges). Exp. Cell Res. 243:59-66 5339 Shield LK. (1998) Neuromuscular Disease. In: Practical Paediatrics,

34(5), 486:1034-4810 5347 South M. (1998) Principles and practice of children's emergency care - review. Med. J. Aust. 168(10):514 5348 South M, McIntyre P, Roberts M. (1998) NHMRC guidelines: time to reflect? Meningitis Management 1998:1

5354 Steeber D, Tang M, Zhang X, Muller W,

Journal of Immunology, 161:6638-6647 5355 Tang M. (1998) Allergy testing for the

Envenomation by a juvenile Steatoda

Melbourne: Churchill Livingstone

spider treated with redback spider

546-554

antivenom. Med. J. Aust. 169(11):642

5340 Simmons T, Smithson F, Rodda J, Starr R,

5350 Sporik R, Hill D, Thompson P, Stewart G,

Boyd R, Graham HK. (1998) The high

Carlin J, Nolan T, Kemp A, Hosking C.

incidence and clinical significance of hip

(1998) The Melbourne house dust mite

dysplasia in Winters and Gage type

study: long term efficacy of house dust

4 hemiplegia. Developmental Medicine

mite reduction strategies, J. Allergy. Clin.

& Child Neurology. Supp 78,40

Immunol. 101:451-456

Determination. J. Exp. Zool. 281: 501-505

5351 Starr M, Alexander R. (1998) Rapid viral diagnosis. Contagion 3.1:1-2

5363 Tiedemann K, Tauro G. (1998) Anaemias of Childhood, part 13: Haematology and Oncology. In: Practical Paediatrics 4th

allergic disease in childhood. Qi Chin

Edition. Eds. Robinson MJ, Robertson

Med. Gazette 8(1):99-102

DM. 49:486-502

5356 Tang M, Steeber D, Zhou X, Tedder T. (1998) Intrinsic differences in L-selectin

5364 Ting S, Ziegenbein R, Gan E, Catalano J, Monagle P, Silvers J, Chambers F Ng S,

expression affect T and B lymphocyte

McGrath B. (1998) Dalteparin for deep

subset specific recirculation pathways.

venous thrombosis: a Hospital in the

Journal of Immunology 160:5113-5121 5357 Tang M, Williams L. (1998) Pneumatosis Intestinale in children with primary

Home Program. Medical Journal of Australia 168(6)272-276 5365 Torode I, Dickens DR. (1998) Chapter 12,

combined immunodeficiency. Journal

The Spine. In: Orthopaedic Management

of Pediatrics 132:546-549

of Spina Bifida Cystica. Third Edition.

5358 Thompson C J R, Berkowitz R G. (1998) Extradural frontal abscess complicating

Eds. Broughton NS, Menelaus MB. Harcourt Brace

nasal septal abscess in a child.

5366 Torode I, Donnan L. (1998) Posterior

International Journal of Pediatric

dislocation of the humeral head

Otorhinolaryngology 115:183-186

in association with obstetric paralysis.

5359 Thompson F, Catto-Smith A, Moore D, Davidson G, Cummins A. (1998). Epithelial growth and development of the small intestine in human infants. Journal of Paediatric Gastroenterology and

5341 Sinclair AH. (1998) Human Sex

O'Connor EB, Cochrane AD, Brizard CP,

diagnosis and management of paediatric

5349 South M, Wirth P, Winkel KD. (1998)

4th ed. Eds. Robinson MJ, Roberton DM.

5362 Thuys CA, Mullaly RJ, Horton SB,

Nutrition 26: 506-512

Journal Pediatric Orthopedics 18(5):611-5 5367 Toumbourou J. (1998) Drug survival kit for the 21st Century. In-Psych 20(6):27 5368 Toumbourou J. (1998) Social development and youth substance abuse. Drug Ed. News. (June):6

92 RCH Research Institute 1998

RCH Research Institute 1998 93

5369 Toumbourou J, Hamilton M, Fallon B.

I'f

5379 Warne GL, Zajac JD. (1998) Disorders

5398 Yung AR, Phillips LJ, McGorry PD,

(1998) Treatment level progress and time

of Sexual Differentiation. In:

Australian Plants for Pain Relief and

McFarlane, CA, Francey S, Flarrigan S,

spent in treatment in the prediction

Endocrinology and Metabolism Clinics

Anaesthesia. Proceedings, The Fourth

Patton GC, Jackson HJ. (1998) The

of outcomes following drug-free

of North America. Eds. Burger FIG,

International Symposium on the History

prediction of psychosis: A step towards

therapeutic community treatment.

McLachlan R 45:945-967

of Anaesthesia. Eds. Am Esch JS &

indicated prevention of schizophrenia?

Goerig M. Drager Druck Lubeck

British Journal of Psychiatry

Addiction 93(71:1051-1064 5370 Uemura S, Hurley MR, Hutson JM, Chow

5380 Warne GL, Zajac JD, MacLean HE. (1998) Androgen insensitivity syndrome in the

5391 Wilkinson JL. (1998) Assessment of

172(33):14-20

era of Molecular Genetics and the

the infant and child with suspected heart

and VIP-immunoreactive nerve fibres

Internet. J. Pediatr. Endocrinol. Metab.

disease. In: Practical Paediatrics. Eds.

controlled trial of aminophylline

in the colonic circular muscle in

11:3-9

Robinson MJ, Roberton DM. 4th ed.

in children with severe acute asthma.

Melbourne: Churchill Livingstone.

Arch. Dis. Child 79(5):405-410

5371 Veit F. (1998) Behavioural Problems. Check Program of self-evaluation. Royal Australian College of General Practitioners 321:7-9 5372 Veit F. (1998) Young Offenders Health Issues. Australian Paediatric Review 8:6-7 5373 Wake M. (1998) Management of otitis

5381 Waters E, Oberklaid F. (1998) Community Child Health Data Collection. Ambulatory Child Health 3 (4):373-386 5382 Waters E, Wright M. (1998) Moving child health outcomes forward. Australian and New Zealand Journal of Public Health 22 (2): 686-90 5383 Waters K. (1998) Australian and New Zealand Trials in Acute Lymphoblastic

media with effusion (glue ear). Australian

Leukemia of Childhood. Inter. J.

Paediatric Review 8(1): 3-5

Pediatric. Hematology/Oncology.

5374 Walker K, Graham HK. (1998) The

5(2-4):187-197

'peroneus-brevis turn up’ procedure:

5384 Waters K, Smith PJ. (1998) Cancer

a new method for fixation for tendon

in childhood: molecular biology and

transfers in the foot. Developmental

clinical features. Practical Paediatrics

Medicine & Child Neurology. Supp 78,

4th Edition. Eds Robinson MJ, Roberton

40:3

DM51

5375 Wallace RH, Wang DW, Singh R,

5385 Werther GA. (1998) To Stretch or Not

Scheffer IE, George AL, Phillips HA, Saar

To Stretch (Commentary).Lancet

K, Reis A, Johnson EW, Sutherland GR,

351.309-310

Berkovic SF, Mulley JC. (1998) Febrile seizures and generalised epilepsy associated with a mutation in the Na+ channel Blsubunit gene SCN1B. Nature

5386 Werther GA. (1998) Thyroid disorders in childhood.Practical Paediatrics, 4th Edition. Eds Robinson MJ, Roberton DM. Churchill Livingston

Genetics 19:366-370 5387 Werther GA, Court JM. (Eds:) (1998) 5376 Wangprasartsuk P, Main BJ: (1998) Adverse local reactions to amethocaine

5377 Warne GL. (1998) Advances and Challenges with Intersex Disorders. Reproduction, Fertility and Development. 10:79-85 5378 Warne GL. (1998) The Child of Uncertain Sex. In: Practical Paediatrics. Fourth edition. Eds. D Roberton and M Robinson. Churchill Livingstone 624-630

94 RCH Research Institute 1998

5392 Wilkinson JL. (1998) Common heart defects and diseases in infancy and

mutant rat as a cryptorchid model

ed. Melbourne: Churchill Livingstone.

Br. J. Urol. 8:290-294

'Amplatzer Septal Occluder' device

in immature mice confirmed

for atrial septal defect. Cardiology in

by bromodeoxyuridine (BudR) labelling

the Young 8(3):295-302

in vitro. Br. J. Urol. 81:880-883

5394 Williams R, Elliott K, Sholler G, Royle J, Isaacs D, Nolan T, Allen R, McNeil R, Elliott E. (1998) Kawasaki disease in Australia, 1993-95. Archives of Disease in Childhood 78:33-39 5395 Woo J, Leung SSF, Ho SC, Lam TH, Janus ED. (1998) Dietary Intake and Practices in the Hong Kong Chinese population. J. Epidemiol. Community Health 52:631-637 5396 Woodrow N, Tran T, Umstad M, Graham HK, Robinson H, de Crespigny L. (1998) Mid-trimester ultrasound diagnosis of isolated talipes equinovarus accuracy & New Zealand of Obstetrics & Gynaecology 38 (3):301-5 5397 Wraight CJ, Liepe IJ, White PJ, Hibbs

factor system in the developing brain.

AR, Werther GA. (1998) Intranuclear

Hormone Research. Supp11,49:37-40.

localisation of insulin-like growth factor

5389 Werther GA, Russo V, Rekaris G, Baker N, Fosang AJ, Bach LA. (1998) Insulin like growth factors: Implications for the

PJ. (1998) Temperature sensitivity

clinical experience with use of the

and outcome for infants. Australian

(1998) The Role of the Insulin-like growth

Update Software. Updated quarterly.

5401 Zhou B, Hutson JM, Hasthorpe S, Farmer of primary spermatocyte DNA synthesis

Publishers 5388 Werther GA, Russo V, Baker N, Butler G.

Cochrane Library, Issue 2,1998. Oxford:

Efficacy of orchidopexy

by quantitative cytological analysis.

5393 Wilkinson JL, Goh TH. (1998) Early

cessation programs implemented during pregnancy. Cochrane Review. In The

on spermatogenesis in the immature

Eds. Robinson MJ, Roberton DM. 4th Chapter 48:470-484

Lumley J, Oliver S, Waters E. (1998) Smoking

5400 Zhou B, Hutson JM, Hasthorpe S. (1998)

childhood. In: Practical Paediatrics.

Diabetes and the Adolescent. Miranova

cream. An audit and case report. Ann. Intens. Care 26(3):312

Chapter 47:460-469

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5399 Yung M, South M. (1998) Randomised

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children. Pediatr. Surg. Int. 14(1-2): 66-70

5390 Westhorpe R. (1998) The Use of

binding protein-3 (IGFBP-3) during cell division in human keratinocytes. J. Invest. Dermatol. 111:239-242

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RCH Research Institute 1998 95

Donations

The Royal Children's Hospital Research Institute, with the financial assistance of the Victorian public and corporate sponsors who donate to the Good Friday Appeal, conducts research into child and adolescent health. Without public and corporate donations, research abilities of the RCHRI would be substantially limited. All donations to the Research Institute are tax exempt and are deductible for income tax purposes. Legacies are also exempt from probate and estate duties. The RCHRI extends a heartfelt thank you to all those who donated money this year.

Mowbray College

General Donations

m Lin^

■s I,:.

$50

Estate of N E Creaton

$98,818

V & E Tessari in memory of Norma Walker $40

Rio Tinto Services

$12,500

J Dare in memory of Norma Walker

$40

J B Were & Sons Charitable Fund

$10,000

J & A Willis in memory of Margaret Black $30

Bell Charitable Fund

$8,000

D P Cupples in memory of Norma Walker $25

Estate of E H Flack

$6,000

M Bloy in memory of Norma Walker

$25

Anonymous

$4,000

J B Willis in memory of Norma Walker

$25

$3,000

C Boyle, N Key & V McNiff in memory

;.'ij|

Anonymous

Danar Pty Ltd M Tuckey

; !;

$550

Holy Trinity Opportunity Shop

$500

Paediatric Society of Victoria

$398

Frankston Naval Memorial Fund

•1

$1,000

$300

I Donations & Grants 1

Cardiology W&WChong

$10,000

Centre for Adolescent Health Med-E-Services Pty Ltd

$750

Customer Focus Pty Ltd

$150

Centre for Community Child Health Reuters Australia

of Norma Walker

$25

R Umansky

$25

D Howard

$20

J Morgan

$20

$1,160

Centre for Hormone Research, Incorporating Endocrinology and Diabetes Rotary Riverdance Performance

$18,000

Rio Tinto

$12,500

Mary Schepisi

$5,667

Suisse

$5,000

Rockwell Australia Pty Ltd

$3,000

E P Dobson in memory of Matthew Barratt $20 P & K demons in memory

M Hall

$250

SBall

$250

Sir Don Trescothwick

$2,500

Blake Dawson Waldron (Staff)

$185

of Norma Walker

$20

Estate of G Reveleigh

$2,000

Residents of Raymond Court

$160

E Hurley in memory of Norma Walker

$20

Rotary Club of Dandenong

$2,000

J Sam

$100

G L Bracken in memory of Norma Walker $20

Palais Bingo Parlour

$1,500

N Kuklycz

$100

M Wuffin in memory of Norma Walker

$15

Lions Club of Woodend

$250

N & B Basseggio & M Kollosche

$100

M E Alfred in memory of S Lawerence

$10

S Thornton

$234

H C Fraser in memory of Norma Walker

$10

Renaissance Supermarket

$100

Hilda Burkin

$10

Bone Densitometer

J Escatt in memory of Norma Walker

$10

Lions Club of Castlemaine

$250

Lions Club of Forest Hill

$250

Donations for Specific Research Areas

Body Corporate Committee in memory of Norma Walker

$100

St James Church in memory of Norma Walker

$100

of Lorraine Kuklyeh

$20

W & Z Crowther in memory

D P Schwarzman in memory

N Basseggio in memory of Lorraine Kuklyeh

$50

S M Sims

$50

J Fraser in memory of Norma Walker

$50

of Norma Walker

$10

Diabetes Research

G Hale

$10

S Alberti

$25,000

KDahl

K Beaugelhall

$10,766

P Genovese

Cuppa for Kids

$1,006

RCH Research Institute 1998 97

$200

Sara Lee Bakery PhD Scholarship

$14,392

Hawthorn Auxiliary

Gastroenterology and Clinical Nutrition J & F Capes in memory of Emma Ritchie

$20

Nutritional Research

Anonymous in memory of Rebecca O’Brien $5

Neurology Elisa plate reader

$19,000

Inn Group

$6,050

Inn Group

$3,500

J Allen in memory of Raelene Allen

$50

$700

Haematology and Oncology

$50

of Kathryn Gooey Occupational Therapy

$1,304

Studfield Auskick

RCH Parkville Auxiliary

Carols by Lite back

$397

Tullamarine Primary School

$220

Asthma Research

K & B Hayes in memory of Sam Toovey

$100

Anonymous in memory

$10,000

Respiratory Medicine

of Rebecca O'Brien Hoppers Crossing Sports Club in memory

$97

R S & E Irving in memory of Rachael Dunn $50 D Lewis in memory of Rachael Dunn

$30

Anonymous in memory of Rachael Dunn

$30

of Rebecca O'Brien

of Rachael Dunn

$25

W Wright in memory of Sarah McKernan $25

O'Brien C Lyth in memory of Rebecca O’Brien

of Rebecca O'Brien

Estate of Lorna E County

$10,626

J B Were & Sons Charitable Fund

$10,000

Estate of G Eldridge in memory of Lydia Elbourne

$5,000

M Heinze

$150

Linfox

i i

L Youl in memory of Sarah McKernan

$40

Whitefriars College

$918

$20

P R Mullaly

$250

RJ&J Mullaly R C Mullaly

$75

The application of T-wave alternans as

$75

a marker of arrhythmia propensity in children.

David Winter Collectors Club

$750

u ll

$10

of Rebecca O'Brien

K J & J Davis

$100

K O'Brien in memory of Rebecca O'Brien $10

Lioness Club of Corryong

$35

Beryl & Lisa Jones in memory

Kids with Cancer Benefit

$10

$100

Rhabdoid sarcomas Research

98 RCH Research Institute 1998

S Harvey 0.5 FE

J M Hutson 0.5 FE Study of congenital anomalies in paediatric

of Irene Waite

of Rebecca O'Brien I

$20

Kaylene Lee in memory

Anonymous in memory

$20

Intractable partial epilepsy of childhood.

Anonymous in memory of Rebecca O’Brien

D Reddihough

research group.

Further development of the Victorian Cerebral Palsy Register.

J Bateman A M Davis 0.3 FE

J M Walker

$10

a marker of arrhythmia propensity in children. $10,000

to develop new initiatives within the

$10,000

Orthopaedic Research Unit $80,000

R Weintraub National Australian Childhood

R Bishop

Jeff Neal in memory of Rebecca O'Brien $10 $1,000

Surfactant therapy and modulation in infants

LTTwomey & E Mullaly

$20

The application of T-wave alternans as

funding. They provide budgetary flexibility

$100

Bone Marrow Donor Institute

G Squires

PDargavilleO.5 FE

A Mullaly & J Dunn

of Rebecca O’Brien

A Davis These grants are awarded on merit to larger

$120

$20

Anonymous in memory

Program Grants

with lung disease.

T P Mullaly & A M Brennan

intracellular cytokine response. $8,000

in obtaining significant external peer reviewed

K Smith in memory of Rebecca O'Brien

of Rebecca O’Brien

tissues.

Rotavirus infection and epithelial permeability.

G Mullaly

Jodie Heath in memory

Cytokine imbalance in childhood atopic disease as determined by the T-cell

$150

$100

A Kemp

factors in developing, damaged and diseased

research groups who have been successful

$20

Cord Blood Bank

Leukemia Research

Total: $323,456

of Rebecca O'Brien

Judith Flower in memory

$218,792

a commitment to research.

GWertherO.5 FE The role and actions of insulin-like growth

A Catto-Smith 0.2 FE

E P Blackburn in memory

of Rebecca O'Brien

$3,000

in clinical care of children, but who also make

$20

Brain tumour Research Fundraising Group

These grants provide part salary support for senior health professionals who are involved

$4,000

L Herring in memory of Rebecca O'Brien $20

Vermont Cancer Research

$30

Gotta Get a Life Foundation

Bone Marrow Research $371

Part-time Career Grants

Neuronal Intestinal Dysplasia Research

$20

St Thomas the Apostle Primary School

$50,000

M & R DeJong in memory

J Saunder in memory of Sarah McKernan $20 j

$45

E&LBrown in memory of Rebecca O'Brien

$20

Kaylee & Ashlee Palmer in memory of Rebecca O'Brien

of Ashley Haddad

The Frazer Family in memory of Rebecca

S D Minister in memory of Sarah McKernan

Diaphragmatic Hernia Research $50

The Mackie Family in memory

B M Matthews in memory

of Rebecca O'Brien

Surgical Research Unit $60

W F Russell in memory of Rachael Dunn $100 Dimboola-Pimpinio Primary School

Jess Scudamore in memory

Cystic Fibrosis Research

M & Z L Gooey in memory

Family of Nicholas Miles

RCH Research Institute Grants

Gastroenterology, Rotavirus Unit

Cardiomyopathy Study. $15,000

$60,000 J Toumbourou A Sinclair

Childhood Behaviour Problems in the

Molecular Development Unit

prediction of year 8 substance abuse.

$60,000

$20,000

Antigenic Target in Immune-Mediated

Project Grants

P Dewan

Neurologic.

These grants provide funding for salaries

surgery. A J Kornberg 0.5 FE

S Menahem 0.15 FE

for researchers and specific expenses related

Emotional and psychological sequelae

to the the research project.

of paediatric cardiac surgery.

E Palombo

ML Tang 0.7 FE

Sequence analysis of capsid protein genes

The role of L-selectin and ICAM-1

of human astroviruses causing gastroenteritis

in lymphocyte migration to sites of allergic

in children.

inflammation in the airway/lung.

$5,680

Urachal obstruction as the aetiology of vesicoureteric-reflux in the fetal pig model. $24,000 P Dargaville Comparison of dilute natural surfactant and a perfluorocarbon-saline emulsion for therapeutic lung lavage in the piglet model of meconium aspiration syndrome. $24,500

$8,978

RCH Research Institute 1998 99

S Harvey Functional magnetic resonance imaging of language cortex in normal children with brain lesions. Neuropsychological and psychosocial functioning in children with temporal lob

Continuing Project Grants E Algar

S Menahem

J Forbes

P Robinson

Computer

Cardiology

Nephrology

Thoracic Medicine

$2,407

Emotional and psychological sequelae

Australian and NZ Society of Nephrology,

European Respiratory Conference, September

of paediatric cardiac surgery.

March 9th - 12th 1998, Auckland, New

20 - 24th, Geneva Switzerland.

$4,989

Zealand.

Studies on the Wilms' tumour 1 gene (WT1) in Wilms' tumour and leukaemia.

Centre for Hormone Research / Endocrinology

$46,795

2 centrifuges, peristaltic pump $17,698

epilepsy.

V Anderson, C Catroppa, R Stargatt

$30,000

Attention skills following closed head injury

Gastroenterology & Clinical Nutrition

in children and V A Anderson, R Jacobs,

Sequencing apparatus, mini gel

S Harvey. Executive functions following

electrophoresis system, pH meter, finnpipettes

damage to the frontal lobes in childhood.

$6,660

A J Kornberg The relationship and significance of antiganglioside antibodies and Campylobacter

L Salmon

P Robinson

J Green

Centre for Community Child Health

Clinical Epidemiology and Biostatistics

Centre for Community Child Health

4th National Health Promoting Schools

Risk factors for meningococcal disease

Geographic Information Systems in Public

conference, November 15- 17th, Brisbane,

in Victoria.

Health Conference, August 19th - 21st 1998,

Queensland.

$4,980

San Diego, California.

F Smithson

$10,800

Microbiological Research Unit

Travel Grants

S Goldfeld Centre for Community Child Health

European Society of the Movement Analysis

pathogenicity of Guillain-Barre syndrome.

K Graham, R Boyd, G Nattrass, D Reddihough,

PCR machine, mini autoclave

Travel grants are awarded to assist with travel

30th Annual Conference of the Public Health

in Adults and Children, 7th Annual Meeting,

$30,000

A McCoy

$15,580

and accommodation expenses, enabling

Association of Australia, September 13-16th,

September 23 - 26th, Belfast, Northern Ireland.

researchers to attend conferences at which

Hobart, Tasmania.

jejuni infection in the association, severity and

The use of a variable hip abduction brace and V Anderson Executive dysfunction in children with frontal lobe lesions. $37,000 J E Bines Development and Characterisation of a large animal model for short bowel syndrome. $40,000

botulinum toxin A in the conservative management of hip dysplasia in children with

Orthopaedic Molecular Biology Research Unit

they have been accepted to give a research

Electo-elution and purification system,

presentation.

cerebral palsy.

2 electrophoresis tanks, 2 slab

$52,800

electrophoresis units, gamma monitor

Annual meeting - American Academy for Cerebral Palsy and developmental medicine,

$9,759

Association of Australia, September 13-16th,

September 16 - 19th, San Antonio, Texas.

80th Annual Meeting of the US Endocrine

Hobart, Tasmania and 4th National Health

Oxygen consumption in cerebral palsy after

Social Work Research Unit

Society, June 24th - 27th 1998, New Orleans,

Promoting Schools conference,

multilevel surgery.

Computer and printer

USA.

November 15-17th, Brisbane, Queensland.

$14,421

$5,152

M Dalton

S Lancaster

Surgical Research

Thoracic Medicine

Psychology

Suspended cell manual pressure device

American Thoracic Society International

14th International Congress of the

$3,355

Conference, April 24th - 29th 1998, Chicago,

International Association for Child and

Illinois.

Adolescent Psychiatry and Allied Professions,

S Emselle

August 2nd - 6th 1998, Stockholm, Sweden.

Gastroenterology and Clinical Nutrition

S McKean

C Olesch, D Reddihough, K Graham, A McCoy

and chromic cyclosporin a induced renal

These grants provide funding to purchase

failure.

equipment which is essential for ongoing

$40,500

research programs, or to assist in the

J Hutson

establishment of new research initiatives.

Third floor laboratories combined (Molecular Development, Orthopaedic Molecular Biology Research Unit, Surgical Research)

Intestinal Neuronal Dysplasia: clinical,

Much of the state-of-the art equipment

Video imaging system

anatomical and functional characterisation of

required by researchers to remain

patients with Substance P deficiency,

internationally competitive is becoming

$41,000

increasingly expensive. Many research

Minor Grants

groups rely on the Research Institute to provide equipment for their research.

Longitudinal pathways to adolescent antisocial behaviour, substance use and

All Laboratory Groups

anxiety/depression.

Contribution to confocal microscope.

$53,422

$62,276

D Ashley

Centre for Adolescent Health

A Novel Approach to the Treatment of

2 laptop computers, 6 headset telephones

Paediatric Malignant Giloma with Fas/APO-1

and accessories, 2 cameras and VCR

Gene Transfer and combined immunotherapy.

$9,930 Centre for Community Child Health

M Tang

3 computers, colour printer, contribution

The role of L-selection and ICAM-1

to photocopier

lymphocyte migration to sites of allergic

$24,578

inflammation in the airway/lung.

Physiotherapy

Centre for Community Child Health 30th Annual Conference of the Public Health

Equipment Grants

$55,489

P Thomason

K Hesketh

EBall

Endothelin Antagonism in acute ischaemic

A Sanson

Orthopaedics

Centre for Hormone Research

C LJones

I '

Child Development & Rehabilitation

Australian Society for Medical Research

Centre for Hormone Research

National Scientific Conference,

Endocrine Society of Australia Combined

November 22 - 25th, Hobart, Tasmania.

Scientific Meeting, August 23 - 28th, Perth.

These grants are seed funds of $1,000-$5,000

P Farmer

E Northam

for investigators who have not previously

Surgical Research

Psychology

received competitive research grants

Australian Institute of Medical Scientists 1998

International Neuropsychological Society

of $20,000 or more.

National Scientific Meeting,

Meeting, July 8th - 11th 1998, Budapest,

September 21 - 25th, Hobart, Tasmania.

Hungary.

$11,000

G Bartlett Plastic Surgery

J Fitzgerald

G Rekaris

Transverse distraction of the pig fibula.

Orthopaedic Research

Centre for Hormone Research

$1,410

Matrix Biology Society of Australia and New

80th Annual Meeting of the US Endocrine

Zealand National Conference, September 25 -

Society, June 24th - 27th 1998, New Orleans,

28th, Harndorf S.A., then Australian Society

USA.

L Johnston Centre for Community Child Health Promoting best practice in the management of peripheral intravascular devices in the hospitalised paediatric patient.

S Ymer Centre for Hormone Research Endocrine Society of Australia, September 29th - October 1st, Canberra.

for Biochemistry and Molecular Biology conference, September 28 - 1st October, Adelaide S.A.

$4,120

$56,868

100 RCH Research Institute 1998

RCH Research Institute 1998 101

External Grants The following grants were awarded to researchers on the Royal Children's Hospital campus.

E Waters

CSL Ltd

J Toumbourou, G Patton, and S Sawyer

The majority of these grants were awarded directly to the Royal Children's Hospital Research

An epidemiological study of geographic

T Nolan

Guidelines to inform planning and purchasing

Institute. Others were awarded via the RCH or the University of Melbourne.

variations in the wellbeing of children related

Pentavalent vaccine evaluation

of evidence based practice: interventions for

to socioeconomic differentials, service

$302,756

utilisation, and environmental conditions. $7,500

J E Bines. A G Catto-Smith, K Gibbons

MWake

Aviron Ltd (USA)

Health outcomes after gastrostomy.

The Child Health Questionnaire in clinical

T Nolan

$120,000

populations: Validation of parent and self-

Intranasal flu vaccine evaluation. $441,787 Bayer Corporation USA A Fosang Industry Grant Diagnostic assays for monitoring aggrecan degradation in arthritis patients. $28,122 American Society of Clinical Oncology

Apex Trust for Autism

F Cameron

D M Ashley

M Prior, D Marks

Establishment of the Healthy Bones Unit,

Young Investigator Award (ASCO)

For video film on Asperger Syndrome

Royal Children's Hospital, Melbourne.

$56,000

$10,000

$50,000

AMRAD

Arthritis Foundation of Australia

AusIndustry/AMRAD

D M Ashley

H Stanton

G L Barnes, R F Bishop

Postgraduate Fellowship

Degradation of cartilage proteoglycan:

$421,899

Cell Death Pathways in Malignant Glioma.

Do fibronectin fragments promote aggrecan

$20,000

degradation by the metalloproteinase family?

Anti-Cancer Council of Victoria P Smith. N Parker

$32,000 Asthma Foundation of Victoria

CJWraight,GAWerther

Bronchial responses during and after exercise

Australian Research Council

in asthmatic children.

V Anderson

$20,000

$46,000 A C Jackson,B Johnson Literature Review and Annotation: The Protection of High Risk Infants. $12,000

problems. $49,300 E Waters. Safety Centre and Dept of Paediatrics Guidelines to inform planning and purchasing of evidence-based practice: interventions to prevent childhood injury.

A C Jackson, S Thomas,

$49,936

H Goodman, N Cameron Evaluation of Family Choice Program. $80,000

E Waters The Child Health Questionnaire: Development and validation of parent and self-report short

amyotrophic lateral sclerosis.

forms for the Australian Population.

Theoretical Frameworks for Parenting

$35,500

Assessment and Parenting Skills: an Analysis. Clive and Vera Ramaciotti Foundations

$30,000

G Werther, F Cameron, G Price, C F Clarke, R Geben

Equipment grant for Confocal Microscope F Oberklaid

Diabetes in Youth- A Statewide Approach to

Parent Education and Support Program.

Effective Management and Outcome,

$100,000

$79,000

Teething: Illness perception in infants and

F Oberklaid

Diabetes Australia

young children.

The Victorian Infant Hearing

H Gilbertson

$7,000

Screening Program.

The use of the glycaemic index for dietary

$20,000

Neuropsychological outcome in children

$65,000

management of children with diabetes.

with early treated PKU.

Collier Charitable Fund

$7,500

F Cameron

G Patton, J Toumbourou, L Bond

Establishment of the Healthy Bones Unit,

Measurement of risk and protective factors

Royal Children's Hospital, Melbourne.

predictive of well-being outcomes in the

$25,000

Victorian Adolescent Population.

D Reddihough

$237,352

The Victorian Cerebral Palsy Register

Equipment grant for Leica MZ6 dissecting

Asthma Victoria - Anna Jane Trust

microscope and glass pipettes.

S M Sawyer

$6,600

A qualitative study of smoking in adolescents

M Prior, A Jorm, S Easteal

with asthma.

Genetics of Temperament

P Anderson

same day surgery.

children with physical and emotional

$56,000

MWake

$52,000

Improving patient and family outcomes after

report standard and short forms for Australian

A C Jackson, L Littlefield, A Reynolds

$700,000

Convoy for Kids Grant

A G Catto-Smith, K Lee

in acute and chronic motor syndromes and

Colgate Oral Care

R Roberts

Apex Foundation for Research into Intellectual Disability Ltd

Antiganglioside and sulfatide antibodies: their

therapy for proliferative skin diseases.

in childhood neoplasms.

J Hutson, S Hasthorpe

A J Kornberg

Dermal Therapeutics- R & D toward a topical

The role of mutagenesis and epimutagenesis

ANZ Trustees

Bethlehem Griffiths Research Foundation

significance, associations and pathogenicity

Ausindustry Research & Development Syndication Scheme

Department of Human Services, Victoria

promoting health in the adolescent population. $49,900

$15,000 Equity Trustees - The Lynne Quayle Charitable Trust Fund

$6,000

$44,000

Asthma Victoria - Helen Schutt Trust

A H Sinclair

Commonwealth Department of Health and Family Services

R Robins-Browne, P D Johnson

G Patton, J Burns

Infections caused by enterohaemorrhagic

M Zacharin

$10,000

Neuropsychological outcome in children

S M Sawyer

Evolution of sex determination: conserved

with early treated PKU.

Reliability of adolescent self-report of

genes in temperature-dependent sex.

$40,000

The effectiveness and cost effectiveness of

Eschericia coli in Victoria.

Acarbose in diabetes study

adherence with preventative asthma

$54,000

interventions that aim to reduce suicide,

$40,000

$5,000

R Robins-Browne, P D Johnson

Financial Markets Foundation for Children

A S Harvey, I E Scheffer, S F Berkovic,

medication A comparison with parental report

G D Jackson

and objective measurement.

Genetic and acquired factors in intellectual

$20,000

among young people

P Smith, N Parker

$14,555

Mechanisms of cell-cell signal transduction in haemopoiesis by the novel transmembrane

disability.

R Morley

protein STIM1.

$21,843

Equipment grant for Ultrasound machine

$15,000

usage.

J Toumbourou, G Patton f

Biology of Mycobacterium ulcerans.

D Reddihough, H K Graham, A McCoy,

$49,000

G Coleman

Evaluation of Program for Parents

Botulinum toxin A therapy in the management

$72,200

of children with cerebral palsy. $36,872

$10,000

j 102 RCH Research Institute 1998

iL..

RCH Research Institute 1998 103

The Garnett Passe and Rodney Williams Memorial Foundation

G Patton

J Bateman

N Parker, P Smith

J Toumbourou, A Sanson

Pharmacia and Upjohn

Support for Education Symposium on

Protein Engineering to study collagen

Haemopoetic, molecular and cellular analysis

Longitudinal pathways to adolescent

F Cameron

E Rose

Innovative Communities Caring for Health

structure, biosynthesis and function.

of human genes at 11p15 5.

adjustment and maladjustment: risk and

Career Development Award

Adjuvant therapy in the prevention of sensori

and Welfare of Adolescents.

$385,069

$52,084

resiliency.

$50,000

neural hearing loss in meningitis.

$2,500

J Bateman

G Patton, G Bowes, S Glover, J Toumbourou

Molecular Pathology of Human Collagen

A population based preventive intervention

A H Sinclair

$30,000 P Robinson

$76,892 Pfizer USA A Fosang

Ian Potter Foundation

Travel support to present research findings

Mutations.

for the antecedents of youth suicide.

The molecular biology of gonad development.

Industry Grant

A Fosang

to European Respiratory Society Scientific

$83,772

$30,042

$189,176

Monoclonal antibodies for monitoring

J Bateman, S Lamande

G Patton, J Carlin

AH Sinclair

Travel support to attend the American

Meeting.

Academy for Cerebral Palsy Developmental

$2,000

The pathobiology of Bethlem myopathy:

Statistical methods for the analysis

The SOX gene family: their role in

LEW Carty Foundation

defining a role of collagen VI in muscle.

of longitudinal data.

development and human genetic disease.

Queen's Trust

M Zacharin

$47,324

$47,513

$72,580

G Patton, G Bowes

R F Bishop, G L Barnes

G Patton, J Carlin, C Coffey

CSmith, AH Sinclair

Medicine Conference in San Antonio USA. $1,000 H Gleber

Bisphosphonate trials

Travel support to attend the Sixth International

$17,000

Immunology and epidemiology of rotavirus

Adolescent health risk behaviours and

Postdoctoral Fellowship

M Zacharin

infection.

psychopathology: continuities in adulthood.

The molecular genetics of gonad development.

Chronic disease/long term steroids

$220,632

$72,000

$61,713

R N Boyd, J Wong, J Wright,

D Reddihough, R Bell, N Beischer

GLWarne,JDZa|ac

G R Nattrass, H K Graham

Antenatal and perinatal antecedents

The androgen receptor: mechanism of action.

Conference of Telemedicine and Telecare. $1,500 S Goldfeld

$10,000

Travel support to attend the Boston Medical Centre and Cochrane Colloquium. $1,000 M Haby de Sosa

Mazda Foundation

A multicentre randomised controlled trial

of spastic cerebral palsy.

Learning Difficulties Centre

on the management of femoral fractures

$37,931

$6,500

in children.

M Prior, B Dodds

Travel support to attend the World Asthma Meeting. $1,000

Meat Research Council P Desmarchelier, R Johnson,

$28,000 A G Catto-Smith, R F Bishop

R Robins-Browne

Rotavirus infection and epithelial permeability.

D Nilsson

Significance of enterohaemorrhagic E coli

$46,152

Travel support to attend the Mount Sinai

in meat in Australia.

Social Work Leadership Enhancement

$45,000

Program. $2,000

104 RCH Research Institute 1998

G A Werther, CJWraight

$69,200

$114,823

$11,000

$2,000

R Robins-Browne, R Strugnell

IGFBP-3intheskin.

$37,000

Thoracic Society meeting, Chicago.

$88,861

Escherichia coli.

atrophy.

Hospital, Cleveland and attend the American

$94,700

directed mutagenesis and neo-epitope

Prevention of blindness in children.

R Massie

diseased brain.

Motor Neurone Disease Research Institute

in the pathogenesis of spinobulbar muscular

Travel support to visit the Rainbow Children's

with Y enterocolitica.

differentiation for the study of the Role of

D Mackey

in San Antonio USA.

cell death in the developing and

The role of IGF binding protein-3 in epidermal

$122,784

$2,000

Insulin-like growth factors and programmed

Pathogenesis of and immunity to infections

enteropathogenic and enterohaemorrhagic

technology.

Developmental Medicine Conference

R Robins-Browne

Mechanism of diarrhoea in infections with

G L Warne, J D Zajac

Academy for Cerebral Palsy

G A Werther

Analysis of aggrecan metabolism by site-

The role of androgen receptor abnormalities

Travel support to attend the American

$109,589

A Fosang

Jack Brockhoff Foundation

A Fosang, P Thomason

aggrecan degradation. $16,000

H K Graham, R N Boyd, D Reddihough, G R Nattrass A multicentre randomised trial of Botulinum

Muscular Dystrophy Association S Haywood, A J Kornberg Antiganglioside and sulfatide antibodies,

toxin A and bracing in the management of hip

P Robinson The effect of in-utero cigarette smoke exposure on post natal lung structure and function. $49,987

problems in cerebral palsy.

A Sanson, J Toumbourou, M Prior, F Dberklaid

$74,577

Australian Temperament Project

Campylobacter jejunii and their relationship

$76,892

National Heart Foundation

of anticoagulation after the Fontan operation. $27,062 Nestle DJHill

$20,000

Humoral regulation of inguinal hernia closure

G Shaw, M Renfree, JM Hutson

and mechanisms of tissue remodelling.

Hormonal control of inguinal closure.

$103,990

$46,400

Molecular mechanisms in Beckwith

T Nolan

K Stewart, R Aroni, S Sawyer, M Abramson

Diabetes register

Wiedemann Syndrome.

Longitudinal data analysis

Qualitative study of barriers to therapy

$10,000

$67,742

$48,369

V Anderson

E Northam, R Adler, P Anderson, G Werther

Development following head injury

Neuropsychological changes in children with

in preschool children.

IDDM 6 years after disease onset,

$60,000

$50,115

Queensland Institute of Medical Research C Robertson Genetic study of asthma in twins. $47,840 Reckitt and Coleman MWake Teething: Illness perception in infants and young children. $10,000 Roche C Robertson Pulmozyme Early Intervention Trial. $32,346 Rhone-Poulenc Rorer T Nolan

$30,000

The Australian arm of a randomized study

J M Hutson, S Hasthorpe

E Algar and P Smith

$75,000

Desmopressin in enuresis A D Cochrane, P Monagle, R G Weintraub

to Guillain Barre Syndrome.

NHMRC

Population based preventive intervention for the antecedents of youth suicide.

Melbourne Atopy Cohort Study $10,000 Novo Nordisk Regional Diabetes Scheme F Cameron

Ricegrowers Co-operative Limited

DJHill The role of maternal diet in colic in breastfed infants. $75,400 Royal Children's Hospital Foundation Special Events Committee F Cameron Establishment of the Healthy Bones Unit, Royal Children's Hospital, Melbourne. $50,000

adherence in adolescents with asthma. $87,500

M Zacharin Establishment of the Healthy Bones Unit, Royal Children's Hospital, Melbourne. $20,000

RCH Research Institute 1998 105

University of Melbourne

P Henschke, G Rice, P Vervaart

K Patterson

Gatehouse project: Developmental approach

Ontogeny of inflamation and oxidative stress

Postgraduate Scholarship

to emotional health in young people.

response in neonatal lung disease.

Molecular pathology of collagen VI assembly

$108,131

$60,000

and matrix deposition. $15,000

St Jude Medical/Getz Bros

An early intervention program for children

VicHealth Promotion Foundation

at risk for conduct disorde.r

Cardiothoracic Surgery Fellowship awarded

G Bowes

$10,000

by the Royal Australasian College of Surgeons.

Grant for Centre for Adolescent Flealth

$15,000

$500,000

Serono Australia Pty Ltd

D JHill

William Angliss Foundation F Cameron Establishment of the Healthy Bones Unit,

M Zacharin

The Prevention of Asthma - a study of

Royal Children's Hospital, Melbourne.

Turner's syndrome project

prolonged breastfeeding and allergen

$2,000

$4,000

avoidance in infancy and early childhood. $90,000

William Buckland Foundation F Cameron

T Nolan

D JHill

Establishment of the Healthy Bones Unit,

Studies on MMR-V and 6-valent combination

The benefit of House Dust Mite Avoidance

Royal Children's Hospital, Melbourne. $25,000

vaccine.

Measures in Children with Chronic Asthma.

$590,473

$60,000

UCB Faulding

T Nolan

R F Bishop

D J Hill

Adolescent hepatitis B vaccination promotion.

Collaborating centre for laboratory rotavirus

Melbourne Atopoy Cohort Study

$21,151

research.

$25,000

3 :|

j |i

M Prior

A D Cochrane

SmitbKIine Beecham

■

G Patton, G Bowes, S Glover, J Toumbourou

Royal Women's Hospital and 3AW

106 RCH Research Institute 1998

World Health Organisation

$16,583

Director's Report The directors have pleasure in submitting their report, together with the accounts of the Royal

Associate Professor T Nolan, BMedSc MB BS

Professor P J Smith, BSc MD BS FRACP

Professor R Williamson, PhD MSc BSc(Hons)

Children's Hospital Research Institute ("The Research Institute") and the consolidated accounts

PhD FRACP FAFPHM

FRCPA

FRCP FRCPATH

of the economic entity, being the company and its controlled entity, for the year ended 31 December

Associate Professor Nolan is Associate

Professor Smith is the Stevenson Professor

Professor Williamson was appointed Director

Professor of Paediatrics, University of

and Head of the Department of Paediatrics

of the Murdoch Institute in April 1995. He is

Melbourne, Head of the Clinical Epidemiology

at the University of Melbourne. He represents

also the Foundation Research Professor of

& Biostatistics Unit and a paediatrician

the University on the Board.

Medical Genetics at the University of

in the Department of General Paediatrics.

Director since 21/3/97.

Melbourne.

1998 and the auditor's report thereon.

He represents the Medical Staff Association on the Board. Director since 15/3/93.

Director since 20/3/95. Associate Professor G Werther, MD BS MSc FRACP Associate Professor Werther is Deputy Director of the Department of Endocrinology and Diabetes. He represents the Medical Staff Association on the Board. Director since 7/7/97. Resigned 1/12/98.

1. Directors The names and relevant details of the directors of the company in office at any time during or since the financial year are:

Mr R M Charlton, AM FTSE BE(Mining) MESc

Ms J Fenton, LLB(Hons) MPRIA

Mr Charlton holds a number of Board

Ms Fenton is Principal of Fenton

positions including Chairman, South East

Communications, a strategic communications

Water Ltd., Chairman, National Basketball

consultancy. President of Very Special Kids.

League, Director, Coles Myer Ltd, Director,

Director since 7/4/97.

Mr P C Barnett, FCPA

Hong Kong Bank of Australia Ltd, Director,

Mr Barnett was formerly Chief Executive of

Southern Health Care Network and is

Pasminco Limited. He is a Director of Ericsson

Chancellor of the University of Newcastle.

Australia Limited, Mayne Nickless Limited,

Director since 23/3/92.

Norwich Union Australia Group, Santos Limited and Australian Media and Communications Limited. Director since 23/3/92. Ms L Berry, BA LLB(Hons)

Meetings

Attended

Held

L Berry

Resigned 4/8/98.

L Cattermole

R M Charlton

Dr J de Campo

J K Dowling

Professor H Ekert

J Fenton

Johnson

Professor C I Johnston

Professor R G Larkins

J H Nickson

Associate Professor T Nolan

Director since 25/2/87.

Mrs Cattermole is the Chairperson of the

Director since 27/11/89.

Director since 1/8/95.

Meetings

Held*

Director since 26/11/91.

of the Royal Children's Hospital.

Ministerial Business Advisory Group.

Meetings

Attended

Director since 7/7/97.

Mrs L Cattermole, BSc

& Engineering Council and the Victorian

Meetings

Women's and Children's Healthcare Network.

He represents the University on the Board.

Committee, the Prime Minister's Science

No. of

P C Barnett

Repatriation Medical Centre.

including the Copyright Law Review

No. of

Hospital.

President of the Board of Management

Federal and State Government committees

No. of

Dr de Campo is the Chief Executive Officer,

Dowling & Co. Estate Agents, and a past

Ltd and is a past and present member of

No. of

of Management of the Royal Children's

University of Melbourne, Austin &

Managing Director of Aspect Computing Pty

Meetings

Dr J de Campo, MBBS FRACR MHA FRACMA

Board. He is the Managing Partner of K.L

Women's and Children's Health Care Network,

Finance Committee

Foundation and is a past member of the Board

Professor Johnston is Professor of Medicine,

Director since 26/8/98.

Directors' Meetings

Director

Governors of the Royal Children's Hospital

Mr Dowling is the current Chairman of the

and Children's Health Care Network.

the financial year are:

Mrs Johnson is a member of the Board of

Professor C I Johnston, AO MB BS FRACP

Ellison and is also a Director of the Women's

The number of directors' meetings and Sub-committee meetings and the number of meetings attended by each of the directors of the Company during

Mrs D Johnson, RN RM BA(Hons)

Mr J K Dowling, FREI FVLE(Val & Econ)

Ms Berry is a partner of the law firm Minter

Directors' Meetings

Professor R G Larkins, MD BS PhD FRACP Professor H Ekert, AM MD FRACP FRCPA

Professor Larkins is James Stewart Professor,

Professor Ekert is the senior consultant

Department of Medicine, University of

Haematologist/Oncologist and was previously

Melbourne, Royal Melbourne Hospital.

the Director of the Department of

Director since 25/2/87.

Haematology/Oncology and Director (Medical) Division of Medicine. He represents the Royal Children's Hospital Medical Staff Association. Director since 18/11/98.

Professor P Smith

Associate Professor G Werther

Professor R Williamson

Mr JH Nickson, BEc ACPA Mr Nickson is the Director of Corporate Services at J.B. Were & Son Stockbrokers,

* reflects the number of meetings held during the time the director held office during the year. ** Mrs D Johnson and Associate Professor G Werther resigned as directors in 1998.

Melbourne, which renders investment service to the Research Institute in the ordinary

2. The principal activities of the economic entity during the course of the last financial year were to promote and undertake medical research of any kind.

course of business. Director since 15/3/93.

108 RCH Research Institute 1998

3. The Research Institute is a company limited by guarantee. As such it has no share capital, and no dividends are paid.

RCH Research Institute 1998 109

KPMG Chartered Accountants 4. Review of operations

Independent Auditor's Report to the Members of the Royal Children's Hospital Research Institute

The consolidated net surplus of the economic entity for the last financial year was $902,003 (1997 $612,119). Of this amount $542,383 has Scope

been committed to research, funded from specific purpose funds, to be expended over the life of various projects. The majority of the surplus (after specific purpose fund transfers), is directed to research grants for 1999. No provision is required for taxation as the company is exempt

We have audited the financial report of Royal Children's Research Institute for the financial year ended 31 December 1998, consisting of the profit and

from income tax.

loss accounts, balance sheets, statements of cash flows, accompanying notes, and the directors' declaration set out on pages 112 to 124. The financial

The Research Institute supports research carried out at the Royal Children's Hospital by the award of its own research grants,

time to time during the financial year. The Company's directors are responsible for the financial report. We have conducted an independent audit of this

report includes the consolidated financial statements of the consolidated entity, comprising the Company and entity it controlled at the year's end or from the administration of external grants and donations, and the provision of the necessary infrastructure.

financial report in order to express an opinion on it to the members of the Company.

The staff of the Research Institute continue to be successful in gaining research grants from NHMRC, Victorian Health Promotion Foundation,

Our audit has been conducted in accordance with Australian Auditing Standards to provide reasonable assurance whether the financial report is free of

Industry and other outside funding agencies.

material misstatement. Our procedures included examination, on a test basis, of evidence supporting the amounts and other disclosures in the financial report, and the evaluation of accounting policies and significant accounting estimates. These procedures have been undertaken to form an opinion

5. There were no significant changes in the state of the economic entity's affairs during the financial year.

whether, in all material respects, the financial report is presented fairly in accordance with Accounting Standards and other mandatory professional reporting requirements and statutory requirements so as to present a view which is consistent with our understanding of the Company's and the

6. The Company has agreed to indemnify the following Directors of the Company, Mr P C Barnett, Ms L Berry, Mrs L Cattermole, Mr R M Charlton,

consolidated entity's financial position, and performance as represented by the results of their operations and their cash flows.

Dr J de Campo, Mr J K Dowling, Professor H Ekert, Ms J Fenton, Mrs D Johnson, Professor C I Johnston, Professor R G Larkins, Mr J H Nickson, Associate Professor T Nolan, Professor P Smith, Associate, Professor G Werther and Professor R Williamson, against all liabilities to another person

The audit opinion expressed in this report has been formed on the above basis.

(other than the Company or a related body corporate) that may arise from their positions as Directors of the Company and its controlled entities, except where the liability arises out of conduct involving a lack of good faith. The company has paid insurance premiums of $3,509 in respect of directors'

Audit Opinion

and officers liability.

In our opinion the financial report of the Royal Children's Hospital Research Institute is in accordance with:

7. Further information as to likely developments in the operations of the economic entity and the expected results of those operations in subsequent

(a) the Corporations Law, including:

financial years has not been included in this report because, to include such information would be likely to result in unreasonable prejudice (i) giving a true and fair view of the Company's and consolidated entity's financial position as at 31 December 1998

to the economic entity.

and of their performance forthe year ended on that date; and 8. No significant events have arisen subsequent to year end, that have significantly effected, or may significantly effect the entities operations (ii) complying with Australian Standards and the Corporations Regulations; and

in future financial years, or the results of those operations in future financial years, or the entities state of affairs, in future financial years.

(b) other mandatory profession reporting requirements.

By Drder of the Board

) KPMG

J.K. Dowling (Director)

Chartered Accountants

J. H. Nickson (Director) RJ Douglas Melbourne

Partner

9 February 1999 Melbourne 9 February 1999

no RCH Research Institute 1998

RCH Research Institute 1998 111

(

r Balance Sheets at 31 December 1998

Profit and Loss Accounts for Year Ended 31 December 1998

Company

Consolidated

Company

1998

1997

962,315

850,307

- Petty Cash

100

Prepaid Expenses

10,386

16,516

5,813,964

5,204,052

6,786,765

6,070,975

619,670

Consolidated Note I

Note

Operating Revenue

Company/

Consolidated

1998

1997

9,482,171

8,623,472

Current Assets Cash - Bank

Operating Surplus before Income Tax and transfer to Specific Purpose Funds Income Tax Attributable to Operating Surplus

902,003

Investments

612,119

I.Kal

Total Current Assets

Operating Surplus after Income Tax

902,003

612,119

Accumulated Funds at Beginning of the Financial Year

1,737,114

1,543,676

Total Available for Appropriation

2,639,117

2,155,795

Non-Current Assets Debtor - RCH

Transfer from/(to) Specific Purpose Funds

(542,383)

(418,681)

Loan to Controlled Entity

Accumulated Funds at End of the Financial Year

2,096,734

1,737,114

Investments

1,566,337

1,558,371

1,375,746

1,367,780

Plant and Equipment

1,085,103

944,950

Furniture and Fittings

55,359

42,968

Total Non-Current Assets

3,326,469

3,326,471

2,983,334

2,983,336

Total Assets

10,113,234

10,113,236

9,054,309

9,054,311

29,670

25,550

525,528

525,530

542,709

542,711

195,000

70,000

324,646

291,223

Revenue in Advance

41,468

75,290

Total Current Liabilities

1,116,312

1,116,314

1,004,772

1,004,774

232,048

186,666

Total Non-Current Liabilities

232,048

186,666

Net Assets

8,764,874

7,862,871

The profit and loss accounts are to be read in conjunction with the notes to and forming part

7,968

of the financial statements.

Current Liabilities Accrued Expenses Accounts Payable

Provision for Lab Development Provision for Employee Entitlements

if;

Non-Current Liabilities Provision for Employee Entitlements

Members' Funds Reserves

1,502,917

Specific Purpose Funds

5,165,223

4,622,840

Accumulated Funds

2,096,734

1,737,114

Total Member's Funds

8,764,874

7,862,871

The balance sheets are to be read in conjunction with the notes to and forming part of the financial statements.

RCH Research Institute 1998 113

112 RCH Research Institute 1998 1

Statements of Cash Flows for Year Ended 31 December 1998

Notes to the Statements of Cash Flows

Company/

Consolidated

For the purpose of the Statements of Cash Flows, cash includes cash at bank and shortterm deposits

1998

1997

at call. Cash as at the end of the financial year as shown in the Statement of Cash Flows is reconciled to the related items in the balance sheet as follows:

Specific Purpose Funds Income

9,018,164

8,237,827

Donations Received

101,834

64,528

Note

(i) Reconciliation of Cash

Cash Flows From Operating Activities

Payments to Suppliers and Employees Net Cash (Used in)/Provided by Operating Activities

(ii)

(8,108,340)

(7,657,152)

1,011,658

645,203

Company/

Consolidated

1998

1997

962,315

850,307

100

962,415

850,407

Surplus for the Year

902,003

612,119

Depreciation of Non-Current Assets

274,892

184,367

Interest Received

(262,310)

(273,154)

Dividends Received

(65,980)

(47,438)

(Decrease)/lncrease in Current Trade Creditors

(13,061)

(6,373)

(Decrease)/lncrease in Provisions

203,806

176,208

(Decrease)/lncrease in Revenue in Advance

(33,823)

(4,229)

Cash - Bank Cash - On Hand

Cash Flows From Investing Activities Interest Received

262,310

273,154

Dividends Received

65,980

47,438

Payment for Investments

(800,503)

(354,986)

Payment for Non-Current Assets

(427,437)

(323,163)

Net Cash (Used in)/Provided by Investing Activities

(899,650)

(357,557)

Net lncrease/(Decrease) In Cash Held Cash at Beginning of Financial Year Cash at End of Financial Year

(i)

112,008

287,646

850,407

562,761

962,415

850,407

(ii) Reconciliation of Net Cash (Used in)/Provided by Operating Activities to Operating Surplus

Decrease/dncrease) in Accrued Income

3,703

The statements of cash flows are to be read in conjunction with the notes to and forming part Decrease/(lncrease) in Prepaid Expenses

of the financial statements.

Net Cash (Used In)/ Provided by Operating Activities

6,131 1,011,658

645,203

1 ■

114 RCH Research Institute 1998 RCH Research Institute 1998 115

2. Operating Surplus

Notes to and Forming Part of the Accounts for Year Ended 31 December 1998

Operating surplus before income tax has been determined after: Company/

Company/

Consolidated

1998

1997

2,203,000

1,940,000

(a) Crediting as revenue

1. Statement of Significant Accounting Policies

1.4 Consolidation

1.7 Debtors

The consolidated accounts of the economic

Debtors are carried at amounts due.

entity include the financial statements of the

No interest is charged on outstanding

Grants Royal Children's Hospital Foundation

Research Institute being the chief entity and

amounts. The collectibility of debts is

Royal Children’s Hospital re Trainee Scholars

140,000 X

140,000

its controlled entity being Foundation Biotech

assessed at balance date, and specific

NHMRC

1,035,611

1,036,892

Pty Ltd.

provision is made for any doubtful accounts.

NHMRC via University of Melbourne (Paediatrics)

442,222 K"

398,324

classified by the Australian Taxation Office

The balances and effects of transactions

1.8 Accounts Payable

NHMRC via University of Melbourne (Psychology & Microbiology)

99,674 y

134,850

as a scientific institution and is exempt

between controlled entities included in the

Liabilities are recognised for amounts

NHMRC via University of Melbourne (Adolescent Health)

14,175 .<'

from income tax under Section 23(e)

consolidated accounts have been eliminated.

to be paid in the future, for goods or services

Commonwealth Government

received, whether or not billed to the

Victorian Department of Human Services

479.367

322,184

Victorian Health Promotion Foundation

88,110 ^

220,468

1.1 Basis of Preparation of the Financial Statements (a) The Royal Children's Hospital Research Institute ("The Research Institute") is

of the 1936 IncomeTax Assessment Act. 1.5 Employee Entitlements

Research Institute. Accounts payable,

(b) The financial statements have been

Salaries and Annual Leave

are normally settled within 30 days.

prepared in accordance with the historical

The provision for employee entitlements

cost accounting convention. Applicable

to salaries and annual leave represents the

1.9 Comparative Information

accounting standards and the disclosure

amount which the Research Institute has

Where necessary, comparative figures have

requirements of the Corporations Law have

a present obligation to pay resulting from

been adjusted to conform with changes in

been adopted as the basis for preparing

employees' services provided up to the

the presentation in the current year.

the financial statements. The accounting

balance date. The provision has been

policies have been consistently applied.

calculated at nominal amounts based on current wage and salary rates and

1.2 Investments

87,882

Medical Research Foundations and Trusts

545.367

377,966

Industry

2,485,783

2,601,494

Bone Marrow Donor Institute

218,792 A

138,153

Privately Funded Research

86,325 X

39,000

Australian Research Council via University of Melbourne

61,500

36,000

Other Research Grants via University of Melbourne

76,253

224,125

Other

172,249

36,477

Targeted Donations and Estates

899,706

507,830

General Donations and Estate Income

101,834

64,528

includes related on-costs.

Investments are stated at the lower of cost and net recoverable amount.

Donations Long Service Leave

The liability for employee entitlements to long 1.3 Plant and Equipment

service leave represents the present value

Items of plant and equipment are capitalised at historical cost and depreciated over their estimated useful life commencing from the time each item is ready for use.

of the estimated future cash outflows to

Interest and Dividends

be made by the employer resulting from

Interest Revenue

266,223

269,861

Dividend Revenue

65,980

47,438

9,482,171

8,623,472

Direct Research Costs - Salaries & Salary On costs

5,092,010

5,027,292

Direct Research Costs - Maintenance & Consumables

2,270,327^

2,013,234

375,860-^

370,606

employees' services provided up to the balance date.

The company depreciates plant and

Liabilities for employee entitlements which

equipment using the straight line method.

are not expected to be settled within twelve

(b) Charging as Research & Development Expense

The following indicates the useful lives of

months are discounted using the rates

non current assets on which the depreciation

attached to national government securities

charges are based;

at balance date, which most closely match

Staff Costs - Administration and Research Support

the terms of maturity of the related liabilities.

Laboratory Consumables Support

20,890 ^

17,891

Equipment under $2,000

13,386

6,827

Equipment Repairs and Maintenance

12,090

to future increases in wage and salary rates,

Depreciation - Plant and Equipment

2Um

184,367

and the Research Institute's experience with

Laboratory Development Costs

125,000

staff departures. Related on-costs have also

Trainee Research Scholarships

151,571 ^

101,174

Travel Grants and Expenses

19,240 ^

12,059

1.6 Research and Development Costs

Strategic Review

51,288

Research and development expenditure

Library and audiovisual

17,000 S

17,000

Auditors' Remuneration

10,700

6,800

Other Expenditure

145,914

Medical Equipment

7 years In determining the liability for employee

Non Medical Equipment

3 years

Computer Hardware

3 years

Scientific Equipment

10 years

entitlements, consideration has been given

been included in the liability. Audio Visual

3 years

Furniture 8i Fittings

13 years

is expensed as incurred.

15,290

113,813

Total Research & Development Expenditure

8,580,168

8,011,353

Operating SurplusADeficit)

902,003

612,119

I'I

116 RCH Research Institute 1998

RCH Research Institute 1998 117

F 5. Plant and Equipment

3. Auditors Remuneration Consolidated

Company

Consolidated

Company

Consolidated

Company

Consolidated

Company

1998

1997

1998

1997

Plant and Equipment

1,995,296

1,584,878

9,000

8,500

8,500 Less Accumulated Depreciation

910,193

639,928

1,085,103

944,950

Furniture and Fittings

71,006

53,987

Less Accumulated Depreciation

15,647

11,019

55,359

42,968

42.968

Amounts received or due and receivable by auditors for audit services

9,000

8,500

4. Investments Current

5,813,964

Commercial Bills

5,813,964

5,204,052

Non-Current Unsecured Notes (i)

219,796

179,796

6. Accounts Payable

Bonds (i)

30,800

Creditors - General

33,137

26,630

Shares - at cost (i)

807,773

657,182

Royal Children's Hospital

492,391

516,079

Shares - at directors valuation (i)

500,000

Inter-company Payable

Investment in R&D Syndicate (ii)

7,968

Shares in Controlled Entity

2 1,566,337

1,558,371

2 1,375,746

525,528

525,530

542,709

542,711

Annual Leave

321,432

290,787

Long Service Leave

235,262

187,102

556,694

477,889

Current

324,646

291,223

Non-Current

232,048

186,666

556,694

477,889

7. Provision For Employee Entitlements

1,367,780

(I) Market value of the listed investments is $2,840,705. The listed shares in other corporations, redeemable preference shares and convertible notes are readily traded on organised markets in standardised form. (ii) The Company has licenced certain technology to investors in the Dermal Therapeutic Research & Development Syndicate which has, overthe three years commencing July 1995, received $7,698,000 comprising: Licence fee Research Development price

4,950,000 2,748,000 7,698,000

The syndicate investors deposited this amount in a fixed interest bearing deposit account. The syndicate appointed the Royal Children's Hospital Research Institute to undertake further research and development of the core technology on Its behalf. Drawdowns by the Royal Children's Hospital Research Institute from the deposit account are fixed by the syndicate agreement. During the financial year the Royal Children's Hospital Research Institute received drawdowns of $617,000 (1997: $724,000). The joint venture funds can be drawn down as required. Usually this will be on a quarterly basis. In the financial records of the Company, research income is only brought to account as It is received. The licence is exclusive for a defined number of years with the intention of developing and distributing

the technology into a commercially available product.

118 RCH Research Institute 1998

RCH Research Institute 1998 119

I 8. Financial Instruments

10. Specific Purpose Funds

Financial assets of the Research Institute include cash, commercial bills and inter-company receivables.

Company/

Financial liabilities of the Research Institute include inter-company trade payables. Accounting policies

Consolidated

1998

1997

4,622,840

4,204,159

for financial assets and liabilities are set out in Note 1. (a) Interest rate risk Except as follows, all financial assets and financial liabilities are non interest bearing.

Balance at 1 January

Interest Risk Exposures

Income

The economic entity's exposure to interest rate risk and the effective weighted average interest rate

Grants

for classes of financial assets and financial liabilities is set out below:

Royal Children's Hospital Foundation

1,398,642

1,373,392

NHMRC

1,035,611

1,036,892

NHMRC via University of Melbourne (Paediatrics)

442,222

398,324

NHMRC via University of Melbourne (Psychology & Microbiology)

99,674

134,850

NHMRC via University of Melbourne (Adolescent Health)

14,175

Financial assets

Cash Investments

Weighted average interest rate

Company/

Consolidated

1998

1997

962,415

850,407

5,813,964

5,204,052

6,776,379

6,054,459

4.21%

4.33%

Commonwealth Government

87,882

Victorian Department of Human Services

479,367

322,184

Victorian Health Promotion Foundation

88,110

220,468

Medical Research Foundations and Trusts

545,367

377,966

Industry

2,385,783

2,501,494

Bone Marrow Donor Institute

218,792

138,153

Privately Funded Research

86,325

39,000

Australian Research Council via University of Melbourne

61,500

36,000

Other Research Grants via University of Melbourne

76,253

224,125

Other

172,249

36,477

899,706

507,830

160,950

181,012

8,164,726

7,616,049

Salary Costs

5,092,010

5,027,292

Maintenance and Consumables

2,270,327

2,013,234

Equipment Purchases

260,006

156,842

7,622,343

7,197,368

Transfer from Profit and Loss

542,383

418,681

Balance at 31 December

5,165,223

4,622,840

(b) Credit risk Credit risk represents the loss that would be recognised at the reporting date if couterparties failed completely to perform as contracted. The Research Institute does not have signficant exposure to any individual customer or counterparty. (c) Fair value The net fair value of non-current investments is shown in Note 4 to the financial statements. The net fair value of cash, trade payables and loans are not materially different from their carrying amounts.

9. Reserves Company/

Company/

Consolidated

Company

Consolidated

1998

1997

Capital Gifts - Equipment

15,895

Capital Gifts - General

987,022

Asset Revaluation

500,000

Total Reserves at 31 December

1,502,917

Donations Targeted Donations and Estates Interest and Dividends Interest and Dividends

Expenses

The above figures form part of the Revenue and Expenditure in note 2.

120 RCH Research Institute 1998

RCH Research Institute 1998 121

11. Related Parties Disclosure

12. Superannuation Fund

(a) Directors

The Research Institute contributes to the Unisuper Superannuation Fund

The names of each person who held the position of Director of the Company during the financial year are:

(Tertiary Education Superannuation Scheme).

P C Barnett, FCPA

Total contributions made during this year were $337,521 (1997: $299,292) of which $15,637 was accrued (1997: $19,830) at the end of the financial year.

L Berry, BA LLB Contributions to the fund are paid as follows: L Cattermole, BSc a) Basic benefit/TESS - 7% R M Charlton, BE(IVIining) MESc b) Contributory scheme - Employee 7% Dr J de Campo, MBBS FRACR MHA FRACMA - Employer 14% J K Dowling, FREI FVLE(Val & Econ)

13. Accumulated Funds

Professor H Ekert, AM MD FRACP FRCPA

The Research Institute has increased its accumulated funds by $359,620 (1997: $193,438), largely due J Fenton, LLB(Hons) MPRIA

to an additional $300,000 received from the Good Friday Appeal, above the budgeted expectation. The Research Institute will direct the majority of these funds to research grants in 1999.

D Johnson, RN RM BA(Hons) Professor C I Johnston, MB BS FRACP

14. Liability of Members In accordance with the Articles of Association, in the event of this Company being wound up, members

Professor R G Larkins, MD BS PhD FRACP

may be called upon to make a subscription not exceeding $10.00, As at 31 December 1998, the number J H Nickson, BEc ACPA

of members of the company is 14,

Associate Professor T Nolan, BMedSc MB BS PhD FRACP FAFPHM Professor P Smith, BSc MD BS FRACP FRCPA Associate Professor G Werther, MD MSc FRACP Professor R Williamson, PhD MSc BSc(Hons) FRCP FRC PATH Mrs D Johnson and Associate Professor G Werther resigned as Directors during the year.

A director of the Research Institute, Mr Nickson is the Director of Corporate Services at J.B. Were & Son Stockbrokers, Melbourne. This firm renders investment services to the Research Institute. All dealings with the firm are in the ordinary course of business and are on normal commercial terms and conditions. A director of the Research Institute, Ms Berry is a partner of Minter Ellison Lawyers, Melbourne. This firm had rendered specialist legal services to the Research Institute, in which Ms Berry has particular expertise. All dealings are in the ordinary course of business and are on commercial terms and conditions. (b) Remuneration of Directors Company/

Company/

Consolidated

1998

1997

Number of directors whose remuneration were within the following bands:

No.

Total income paid or payable, or otherwise made available to all directors from the Company or any other related party.

Sixteen directors noted above received no remuneration. The above values for the remuneration of directors include amounts paid to directors or superannuation funds in respect of the retirement of directors.

122 RCH Research Institute 1998

RCH Research Institute 1998 123

Directors' Declaration In the opinion of the directors of the Royal Children's Hospital Research Institute: (a) the financial statements and notes, set out on pages 112 to 123 are in accordance with the Corporations Law, including: (i) giving a true and fair view of the financial position of the Company and consolidated entity as at 31 December, 1998 and of their performance, as represented by the results of their operations and their cash flows, for the year ended on that date; and (ii) complying with Accounting Standards and the Corporations Regulations; and (b) there are reasonable grounds to believe that the Company will be able to pay its debts as and when they become due and payable. Signed in accordance with a resolution of the directors:

J.K. Dowling (Director)

/ J.H. Nickson (Director) Melbourne 9 February 1999

I) I)

Design and Photography

Text Input and Editing

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Jane Glatz

Bert Oi Paolo

Julia Malone

Educational Resource Centre,

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Women's and Children's Health Care Network

Adam Chapman

1999, Job no: 993106

Royal Children's Hospital Research Institute

Jane Glatz

] 124 RCH Research Institute 1998

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