Investing in stem cell medicine

Mental health program expands

More than ever, building resilience in children and supporting young people’s mental health is vital.

One in four children will have a mental health disorder at some point, with puberty a key developmental stage when mental health issues emerge. The Mental Health in Primary Schools Pilot, developed by Murdoch Children’s with the University of Melbourne and the Victorian Department of Education and Training, has now expanded into more schools. First started as a pilot program in 10 schools in 2020, the program received Victorian Government and Ian Potter Foundation funding in 2021 to expand to 100 schools by early 2022. The program embeds a child mental health and wellbeing co-ordinator in schools to help identify and manage emerging mental health issues in students and connect education, social and health services. Early evaluation showed that it significantly increased teachers’ confidence in addressing students’ mental health issues.

A beneficial form of screen time

A new digital eHub will better connect children and families with available mental health support. The planned online Child and Family eHub is designed to improve access and engagement with social and mental health services to enable early intervention, especially for disadvantaged families. Murdoch Children’s Professor Sharon Goldfeld, Director of the Centre for Community Child Health, secured a National Health and Medical Research Council (NHMRC) Partnership Projects grant to design and build the eHub. Her team and Melbourne Children’s Campus collaborators will co-develop and test the eHub in three communities experiencing significant vulnerability. The free online resource provides easily accessible local information and connections to health and social care systems. “In Australia, 14 per cent of children have a mental health disorder,” Professor Goldfeld said. “We urgently need effective prevention and early intervention strategies to mitigate the huge rise in child and family mental health issues.”

Healthy minds

Parents and carers can use a new app to distinguish between normal childhood ups and downs and emerging mental health problems. The Raising Children Network’s Raising Healthy Minds wellbeing app helps families tell whether the behaviour of children aged up to 12 needs further investigation. The free app is tailored to a child’s needs and circumstances, including their reaction to the pandemic. It supports parents, carers and professionals to address wellbeing, behaviour and emotions, providing the latest evidence-based information on self and family care. Murdoch Children’s Professor Frank Oberklaid and Raising Children Network Director Derek McCormack developed the app with parents and health professionals.

Raising Children Network

The Raising Children Network is supported by the Australian Government to provide families with free, reliable and up-to-date evidence-based information on all aspects of raising children. It also conducts research and works with other groups. Member organisations are the Parenting Research Centre, Murdoch Children’s and the RCH Centre for Community Child Health.

Ready, set, play!

Yard size does not affect children’s physical activity levels, suggesting that children’s exercise might not be affected by denser cities and shrinking backyards. A 2021 Institute-led study found no association between yard space and greenness and physical activity, highlighting a child’s capacity for outside play regardless of the size of their yard. The study recorded the physical activity of 5,276 Melburnian six-year-olds over eight days. On average, they met physical activity guidelines of at least 60 minutes a day of moderate to vigorous physical activity. Murdoch Children’s and University of Melbourne researcher Dr Suzanne Mavoa said it is still important to identify ways to promote children’s activity levels and access to play spaces as a public health priority. “As cities become increasingly densified, urban design, shared indoor and outdoor spaces and schools will need to play a greater role in supporting young children’s physical activity and active play,” she said.

Helping vulnerable infants thrive

Treatment and technology advances are helping more vulnerable newborns to survive and, in many cases, thrive. But we can still do better.

When Joanna Bezette’s daughter Milly, now 2, was born at just 25 weeks, she had to be intubated and spent five months in neonatal intensive care. Joanna said new technology being tested by Murdoch Children’s researchers could help others avoid the family’s trauma when it took a month to discover how underdeveloped Milly’s lungs were. “Having issues identified earlier would be very reassuring for a lot of parents with very sick babies, because it’s terrifying when you don’t have any idea what’s going on and what the future might look like,” Joanna said. For the first time, Murdoch Children’s researchers have captured detailed images of newborns’ lungs as they took their crucial first breaths, which is set to improve diagnosis and treatment of babies like Milly. About 10 per cent of newborns, and almost all preterm infants, need resuscitation when their lungs don’t properly fill with air at birth. In the trial, researchers used non-invasive electrical impedance tomography (EIT) technology. A small silk belt was placed around the chest of full-term babies born at the Royal Women’s Hospital to facilitate high-resolution images of the lungs. The images showed how air moved through the lungs for each breath, and the breaths turned out to be far more complicated than previously thought. Murdoch Children’s neonatal and respiratory leader Associate Professor David Tingay said the new technology did not require radiation or interrupt life-saving care. He hoped the knowledge gained could also help doctors predict when a baby’s lungs might fail at birth. “This study showed that babies’ lungs are far more complicated than traditional monitoring methods had previously suggested,” he said. “Improving interventions in the delivery room first requires understanding the processes that define success and failure of breathing at birth.”

Preventing bleeding in babies

Melbourne Children’s Campus researchers hope to prevent bleeding in babies who need heart bypass support. The National Blood Authority-funded project investigated new treatments for babies born with heart disease who experience significant bleeding at the end of corrective surgery. Surgery usually involves a cardiopulmonary bypass, where a machine acts as the heart and lungs. Significant bleeding occurs in more than 10 per cent of child patients; 70 per cent of them aged under two. The study analysed blood samples from babies who had the surgery to understand what causes the bleeding. “Bleeding can lead to adverse outcomes such as a prolonged stay in the operating theatre, the need for life support and even death,” Project lead Professor Paul Monagle said. “The aim is to provide evidence for the use of new targeted treatments for babies undergoing cardiopulmonary bypass which will lead to less bleeding and better outcomes.” Improving birth weights and reducing complications in newborns is the goal of a new Murdoch Children’s project commissioned by North Western Melbourne Primary Health Network. It is implementing and evaluating new approaches to support pregnant women and families in Melton South. Murdoch Children’s Dr Elisha Riggs said a ‘whole of service’ approach involved a midwife and child health nurse supporting service providers to promote equity-oriented healthcare. “The project will work with local communities to ensure services are well set up to meet the needs of culturally diverse families, including families of refugee background,” she said. The project is in partnership with Djerriwarrh Health Services, Melton City Council’s maternal child health services, VICSEG New Futures and Foundation House.

Read more about Milly’s story

Improving birth weights

From blood to brain, cancer under the microscope

High-tech tools

A smartphone app is helping children move on from cancer. The Murdoch Children’s-led project is developing a post-cancer app and digital tool for children, adolescents, and their families. The project was funded by the Cancer Council Victoria. Murdoch Children’s Associate Professor Maria McCarthy, of the Institute’s Take a Breath research program and the RCH Cancer Centre, is developing a smartphone app and online platform to help children and young people move on from cancer treatment. “Five-year survival rates in paediatric cancer now exceed 80 per cent,” Associate Professor McCarthy said. “Despite improved survival outcomes, children and adolescents treated for cancer are at risk of developing long-term physical and psychological difficulties related to their disease or treatment.” These ‘late effects’ may emerge over months and years after treatment ends. Until now young people and their families received little information or guidance. The Digital Survivorship Companion (DiSC) app will provide information including treatment history and health-related treatment impacts. It will also enable care and help recruit patients for appropriate trials.

‘Virtual’ radiotherapy

Virtual reality helped children calmly receive radiotherapy treatment and could alleviate the need for general anaesthetic. A Murdoch Children’s and Peter MacCallum Cancer Centre trial gave 30 participants aged 6-18 virtual reality (VR) goggles to simulate cancer treatment before it began. Following the VR experience, the children and their parents reported reduced anxiety and improved understanding of the radiotherapy process. Associate Professor McCarthy said researchers tested a range of physical measures including nausea and anxiety and mood markers to get a genuine sense of whether it could impact quality of life. Young children often need a general anaesthetic to ensure they can have radiotherapy, meaning repeated anaesthetics over their radiotherapy cycle. The study showed 29 out of the 30 children did not need a general anaesthetic for their radiotherapy, indicating VR can help avoid its use. “Like most people, I was very aware of VR and its use in gaming and entertainment, but unaware of its potential utility in a clinical setting,” Associate Professor McCarthy said. “A lot of our inpatients can experience isolation, loneliness and boredom at times, so I can definitely see a place for an immersive experience like VR.”

At the heart of the problem

Using funding from the Australian Government and the Heart Foundation, a national network of specialist hubs are investigating how cancer treatments can cause heart damage. Associate Professor Rachel Conyers leads the project to establish three cardio-oncology hubs looking at how chemotherapy and other cardio-toxic cancer treatments damage the heart and arteries and cause strokes. “The aim is to improve the cardiovascular outcomes of Australian cancer survivors through a national network of multidisciplinary cardio-oncology hubs that combine research with clinical services,” she said.

Children and cancer

Each year, almost 1,000 children are diagnosed with cancer across Australia. The new Victorian Paediatric Cancer Consortium (VPCC) will see Murdoch Children’s and the Hudson Institute of Medical Research co-lead a collaboration of Victorian hospitals and research institutes to improve childhood cancer survival rates and quality of life. The Consortium’s research will focus on finding new therapies for cancers with the greatest unmet medical need, including brain, bone and soft tissue cancers – all with low survival rates. The Federal Government’s Medical Research Future Fund (MRFF), supported by the Children’s Cancer Foundation, established the new collaboration with $9.6 million over three years. The VPCC is co-led by Hudson Institute’s Professor Ron Firestein and Murdoch Children’s Neuro-Oncology Group Leader Professor David Eisenstat, who is also Head of The Royal Children’s Hospital Cancer Centre. Researchers and clinicians across Melbourne’s Monash and Parkville medical precincts will explore nextgeneration precision oncology, new tumour immunotherapy developments and the role of epigenomics. A state-wide registry of childhood cancer survivors will be expanded to follow up, and later transition children to adult services.

Keeping hearts healthy

James Bloor beat cancer when he was five, but it left him with a damaged heart. James had Burkitt’s lymphoma and developed heart damage from his anthracycline chemotherapy drug.

Five years after James’ cancer was treated, he was diagnosed with cardiomyopathy – damaged heart muscle. “He went from being a little boy who ran and played all day, to a child who can’t do basic things without having to stop for a rest,” his mother Toni said. “He struggles to keep up with us, even when walking, and has to remind us to slow down.” James is part of a Murdoch Children’s study that aims to identify those at risk of heart damage following cancer treatment. “We hope that one day a prevention or cure for heart damage from cancer treatment can be found so that other children can have better outcomes,” Toni said. “We want James to beat this one too.” Murdoch Children’s is recruiting across 12 hospitals for the national Australian Cardio Oncology Registry (ACOR)/Bio-bank study, the largest of its kind in the world. Among a growing number of Murdoch Children’s cancer projects, the registry is seeking patients of all ages exposed to therapies that can damage heart tissue, like chemotherapy, radiotherapy and immunotherapy. The study is investigating biological clues using genetics and heart imaging studies to reveal who are the 15 per cent of children vulnerable to heart damage if treated with cancer drugs.