Wesley Research Institute

03/02/2023

Respiratory treatment for children in FNQ set to improve

Cairns Local News

NEW research findings are set to improve childhood respiratory treatment and reduce unnecessary medical transfers across 18 rural and remote health centres throughout North and Far North Queensland. Acute respiratory illnesses, e.g. bronchiolitis, asthma and pneumonia, are the most frequent cause of hospitalisation in children and 28 per cent of intensive care admissions. Even more concerning, mortality rates from Acute Respiratory Failure can be up to 20 per cent in under-resourced communities three to four times higher for Indigenous than non-Indigenous Australians. In FNQ, 30 to 50 per cent of children with acute respiratory failure are transferred to hospitals in Cairns or Townsville, and 9-12 per cent are transferred to Southeast Qld. 'PARIS on Country' is a new study being launched by Queensland's world-leading Paediatric Acute Respiratory Intervention Studies (PARIS) program. It is led by Chief Investigator Dr Donna Franklin, a researcher at Gold Coast University Hospital, Menzies Health Institute, Griffith University and James Cook University; she is also a member of the Paediatric Research in Emergency Departments International Collaborative (PREDICT). The program aims to cut the number of children being transferred away to city hospitals by up to 50 per cent. "Based on the evidence from two world-first clinical trials PARIS I and II we now understand when it is best to place an infant or child on nasal high-flow therapy and when to use standard oxygen as a first-line oxygen therapy," Dr Franklin said. High-flow oxygen therapy, which provides increased oxygen to patients via a nasal cannula, is rarely available in remote areas, and up to 50 per cent of all patients are transferred to city hospitals for a higher level of care than they may actually need. "This causes emotional stress for children and families, unnecessary load on emergency departments, and huge transfer costs for the State," Dr Franklin said. "PARIS on Country will develop and implement a respiratory care training package to help rural and remote clinicians decide when to escalate treatment and seek specialist advice via telehealth. "By providing local clinicians with the tools, education and information they need, we hope to see a positive change for these sick children." The resource and training pack is based on evidence from the world's first PARIS trials, which were led by Dr Andreas Schibler, a researcher at Queensland's Wesley Research Institute and a world leader in paediatric acute respiratory medicine and intensive care. A pilot study is currently running successfully in three remote Queensland hospitals, including Weipa, Thursday Island and Cooktown, under PhD Candidate and Lead Investigator Sally West from James Cook University, with the educational materials we have used in all PARIS studies. "This is a service parents in remote communities are desperate to see introduced. Having a child with breathing difficulties is stressful, but needing to transfer them away from country can be devastating, particularly for Indigenous families," Ms West said. The pilot study is now being expanded to 18 rural and remote hospitals across the Torres and Cape, Townsville, North West, and Cairns and Hinterland Hospital and Health Services. Caption Text: 7-month old Jenovia and her mum Lily have already been transferred from Napranum to Cairns Hospital four times with acute respiratory problems

25/01/2023

Pediatric Respiratory Failure No Better Off With Early High-Flow Oxygen

MedPage Today

Randomized trial only applies to toddlers without COVID-19, though SAN FRANCISCO -- Starting high-flow oxygen right away for young children with acute hypoxemic respiratory failure didn't help them leave the hospital sooner than standard oxygen...

24/01/2023

Australia and New Zealand have delivered the first academic evidence proving thousands of children can be safely treated

TVNZ 1 Wellington NZ

Australia and New Zealand have delivered the first academic evidence proving thousands of children can be safely treated in their local hospitals without the need to be moved to a lager one. Lily York's baby Jenovia has been transferred to Cairns four times in seven months because high-flow oxygen is rarely available in remote areas like hers in Napranum in Far North Queensland. York is part of a world-first study which is set to change global medical practices for millions of children with respiratory disease.

24/01/2023

KEEPING KIDS AT HOME

Cape York Weekly

A pilot program in Cape York is helping parents with sick kids stay closer to home. Dr Donna Franklin, pictured with Napranum mum Lily York and her daughter Jenovia York-Charger, says the results are already overwhelmingly positive. Seven-month-old Jenovia has already been transferred to Cairns Hospital four times with respiratory problems in her short life. Dr Franklin hones to reduce the amount of similar trips for other parents.

24/01/2023

Nasal High-Flow Oxygen for Respiratory Failure No Benefit Over Standard Therapy in Children Aged 1 to 4 Years: Presented at SCCM

FirstWord Pharma

By Nancy Melville SAN FRANCISCO -- January 23, 2023 -- Children aged between 1 and 4 years with acute hypoxemic respiratory failure did significantly benefit from the early use of nasal high-flow oxygen therapy compared with standard oxygen therapy, and had higher rates of intensive care unit (ICU) admission, according to a study presented at the 2023 Critical Care Congress, the Annual Meeting of the Society of Critical Care Medicine (SCCM). “We found that nasal high-flow did not reduce the length of stay in the hospital, and we couldn’t identify a subgroup that would benefit from early nasal high flow therapy,” said Andreas Schibler, MD, St. Andrew’s War Memorial Hospital, Brisbane, Australia. Nasal high-flow oxygen therapy has gained interest and shown benefit in infants with acute hypoxic respiratory failure by reducing the requirement to escalate care. However, the effects of the therapy in children aged 1 to 4 years have not been explored. To investigate, Dr. Schibler and colleagues conducted the Pediatric Acute Respiratory Studies 2 (PARIS 2), a clinical trial involving 1,567 children aged 1 to 4 years at 14 centres in Australia and New Zealand who required hospital admission for mild to moderate acute hypoxemic respiratory failure. Patients were randomised 1:1 to treatment either with high-flow oxygen therapy (n = 753) or standard oxygen therapy (n = 764). Of 1,517 included in the primary analysis, the median age was 1.9 years and 46.7% were female. About 75% presented with a wheeze, with obstructive breathing. For the primary outcome of length of hospital stay, those in the high-flow oxygen group had a significantly longer stay of 1.77 days compared with 1.50 days for the standard care group (adjusted hazard ratio [aHR] = 0.83; P < .001). The differences between the groups were consistent, regardless of wheezing status. In terms of secondary outcomes, the high-flow oxygen group had a higher median length of oxygen therapy (1.07 days vs 0.75 days; aHR = 0.78). In addition, in the high-flow oxygen group, there were 94 (12.5%) admissions to the ICU compared with 53 (6.9%) in the standard oxygen group. A lack of tolerance was a key factor among children who did switch from high-flow oxygen to the standard therapy group.

21/01/2023

Study in NZ set to change treatment of children with acute respiratory problems

BioSpectrum Asia

A world-first Australian and New Zealand (NZ) study is set to change how clinicians treat children with acute respiratory problems, improving best care and potentially saving millions of healthcare dollars, particularly in remote, rural and indigenous communities. The PARI programme is led by Dr Andreas Schibler, a researcher at Queensland’s Wesley Research Institute and a member of the leading Paediatric Research in Emergency Departments International Collaborative (PREDICT) group. PARIS II is the world’s first large-scale clinical trial in children aged under five years presenting to hospital emergency departments with a respiratory illness requiring oxygen. It compared standard oxygen therapy with nasal high-flow therapy, which is a simple method of providing increased oxygen via nasal cannula, but one that is rarely available in smaller hospitals. The results, based on 1500 children aged from one to five years presenting to 14 emergency departments across Australia and New Zealand, clearly identify the children who can be treated with standard oxygen and those who need additional respiratory support with nasal high-flow oxygen therapy. Further, the results demonstrate that the combination of these two oxygen methods can be safely used in general wards of smaller and regional hospitals that do not have children’s intensive care services. The study also demonstrated that oxygen therapies work differently for children than for infants and adults. “The team is now about to embark on an analysis of more than 6,000 patients to better understand the best respiratory care for these children. It's the first study that's ever been done of this magnitude”, said Dr Andreas Schibler.

21/01/2023

University Of Auckland Study Aims To Reduce Transfers Of Children With Respiratory Illnesses

India Education Diary

A world-first Australian and New Zealand study is set to change how clinicians treat children with acute respiratory problems, improving best care and potentially saving millions of healthcare dollars, particularly in remote, rural and Indigenous communities. Latest findings from the Paediatric Acute Respiratory Intervention Studies (PARIS) were published on 18 January 2023 in the pre-eminent peer-reviewed Journal of the American Medical Association (JAMA). The PARIS programme is led by Dr Andreas Schibler, a researcher at Queensland’s Wesley Research Institute and a member of the leading Paediatric Research in Emergency Departments International Collaborative (PREDICT) group. PARIS II is the world’s first large-scale clinical trial in children aged under five years presenting to hospital emergency departments with a respiratory illness requiring oxygen. It compared standard oxygen therapy with nasal high-flow therapy, which is a simple method of providing increased oxygen via nasal cannula, but one that is rarely available in smaller hospitals. The results, based on 1500 children aged from one to five years presenting to 14 emergency departments across Australia and New Zealand, clearly identify the children who can be treated with standard oxygen and those who need additional respiratory support with nasal high-flow oxygen therapy. Further, the results demonstrate that the combination of these two oxygen methods can be safely used in general wards of smaller and regional hospitals that do not have children’s intensive care services. The study also demonstrated that oxygen therapies work differently for children than for infants and adults. “It is about the right treatment at the right time for the right patient,” said Dr Schibler. “High-flow oxygen therapy is rarely available in rural and remote areas of Australia and many patients are transferred to city hospitals for a higher level of care than they may actually need. “This causes emotional stress for children and families, unnecessary load on emergency departments, and huge transfer costs for the State. “Until now there has been no scientific guidance so doctors have assumed high-flow therapy is the best treatment for young children because evidence has already shown it works for infants but the PARIS II study has demonstrated that is not necessarily the case. “After almost a decade of studying the application of high-flow therapy in children, we are able to translate this into further meaningful clinical practice in the rural and remote hospitals. “In collaboration with Dr Donna Franklin from the Gold Coast University Hospital, who is leading a new project PARIS on Country, we are aiming to promote health equity and reduce transfers of sick children with respiratory disease to city hospitals in 18 rural and remote hospitals. A child can receive the care in local hospitals, with their family and community support close, because clinicians will have clear clinical pathways to follow in the care and management of these patients.” Conducted in collaboration with PREDICT, PARIS II builds on 10 years of clinical research by Dr Schibler involving over 4500 children. It follows the successful PARIS I study, completed in 2016, and published in the prestigious New England Journal of Medicine. So significant are the PARIS II findings that Dr Schibler has been asked to present to more than 6000 clinicians at the esteemed Society of Critical Care Medicine Conference in San Francisco later this week (21 January). “It is a genuine honour to be asked to speak at this conference and explain our findings to medical professionals caring for young children throughout the world,” he said. “The team is now about to embark on an analysis of more than 6,000 patients to better understand the best respiratory care for these children. It’s the first study that’s ever been done of this magnitude.” PARIS II is funded by Australia’s National Health and Medical Research Council (NHMRC) with support from the Thrasher Research Fund (US), Emergency Medicine Foundation (Australia), Children’s Hospital Foundation (Australia) and Perth Children’s Hospital Foundation (Australia). Other contributors include Wesley Research Institute, PREDICT, Queensland Health, The University of Queensland, Bond University and Griffith University. Contributors from Waipapa Taumata Rau, University of Auckland were Professor Stuart Dalziel and Dr Jocelyn Neutze.

20/01/2023

Dr Donna Franklin interviewed on National TalkBlack radio

Bumma Bippera Media

So what we're saying here is virtually getting the children the patients are being serviced in their own community is what I'm picking up. Yeah. Correct.

20/01/2023

Respiratory treatment for kids in remote areas is set to improve thanks to a new research project.

Triple M Radio - syndicated across Townsville and Cairns stations

Respiratory treatment for kids in remote areas is set to improve thanks to a new research project. The Paris on Country programme aims to provide rural clinicians with better access to tools, education and information, cutting the need to transfer sick children to city hospitals in half. The Wesley Research Institutes, Dr Andrea Shibley says locally current transfer rates are too high Transfer rates that we currently observing up for North Queensland, there's 30 to 50% of these children get moved. When you compare this to south east Queensland, where we have as little as 9 to 12% of these children need a transfer to a dedicated children's hospital. The pilot study has been expanded to 18 regional hospitals, including here in Townsville.

19/01/2023

A Queensland researcher has found many of the children transferred to city intensive care units with respiratory issues could be treated in smaller rural hospitals Dr Andrea Kibler and his team compared ways of treating acute respiratory illness in 1500 children across Australia and New Zealand.

ABC Radio - Far North, North West, North Queensland, Western Queensland

Syndicated across seven ABC Radio regional stations. A Queensland researcher has found many of the children transferred to city intensive care units with respiratory issues could be treated in smaller rural hospitals Dr Andrea Kibler and his team compared ways of treating acute respiratory illness in 1500 children across Australia and New Zealand. He says part of the study focused on keeping children from remote parts of far north Queensland in their communities. And we know now that some form like the nasal high flow is completely safe to be used in these regional and metropolitan hospitals and it has improved in the sense that we have to transfer less of these patients to the big children's hospitals in the cities.

19/01/2023

Regional hospitals can safely treat acute child respiratory infections, study finds

ABC Online

A Queensland researcher says too many children with respiratory infections are automatically transferred to major hospitals, when they could receive the same treatment in their rural or regional centre. A paediatric intensive care specialist aims to halve the number of children in Far North Queensland transferred to city hospitals with the conditions His research found the same respiratory support can be delivered in general wards in regional hospitals However a study led by Dr Andreas Schibler, a paediatric intensive care specialist from Brisbane, has demonstrated that a common type of respiratory support, usually provided to children in city-based intensive care units, can also be delivered in general wards in regional hospitals.

18/01/2023

New research could mean children like Genovia can stay close to home.

National Nine News Darwin

But new research could mean children like Genovia can stay close to home. We've been able to demonstrate that these children can be safely treated in regional hospitals. The five year study compared oxygen methods. Finding less intensive treatments are equally effective. What we found was the children that had the shorter length of stay were the ones that were on standard oxygen, as opposed to those that were started on high flow therapy. And that actually surprised us.

18/01/2023

New research could mean children like Genovia can stay close to home.

National Nine News Brisbane

But new research could mean children like Genovia can stay close to home. We've been able to demonstrate that these children can be safely treated in regional hospitals. The five year study compared oxygen methods. Finding less intensive treatments are equally effective. What we found was the children that had the shorter length of stay were the ones that were on standard oxygen, as opposed to those that were started on high flow therapy. And that actually surprised us.

18/01/2023

New Australian and New Zealand research shows traumatic transfers to major city hospitals are both costly and unnecessary.

10 News First Adelaide

News She had tugged down here. I cried like, Oh, what's happening with my baby? Mum Lily lives in the small western Cape York community of neighbouring them, but there's been a regular passenger aboard flying doctor flights to Cairns after severe respiratory disease threatened her baby's life and bronchiolitis for the first time. Second time, third time and fourth time. When I flew out to Cairns but just released Australian and New Zealand, research now indicates these often traumatic transfers to major city hospitals are both costly and unnecessary. The majority of these children in the past having been transferred to one of the city hospitals, can actually be cared in the local community where treatment with oxygen can be easily administered. The aim is to keep these children on country, so keep them in their community where they've got the support of their loved ones, of their family, their friends, the host by doctors to transfer children under five from remote to larger medical centres may be influenced by some grim statistics. 25,000 Aussie children under five years old are hospitalised every year with pneumonia, asthma or bronchiolitis. 3000 of those needing intensive care. Alarmingly, Indigenous children are 11 times more likely to die from respiratory disease than the rest of the population. Numbers, it's hoped, will drop dramatically with a new approach to remote care. By reducing the amount of movement from community back to the social community that they know in the remote setting. We know that can make a real impact.

18/01/2023

More Australian children are hospitalised by acute respiratory disease than any other illness, which prompted researchers to take another look at how it is being treated.

10 News First Melbourne

More Australian children are hospitalised by acute respiratory disease than any other illness. That's prompted researchers to take another look how it's being treated. And it appears that for the majority of cases, doctors have been doing it all wrong. Seven months old, a picture of health and as cute as a button. But for the majority of little Geneva's short life, the simple act of breathing has been a challenge. She had watery eyes, cough. She had tugged down here. I cried like Oh, what's happening with my baby? Mum Lily lives in the small western Cape York community of neighbouring. But there's been a regular passenger aboard flying doctor flights to Cairns after severe respiratory disease threatened her baby's life and bronchiolitis for the first time. Second time, third time and fourth time. When I flew out to Cairns but just released Australian and New Zealand, research now indicates these often traumatic transfers to major city hospitals are both costly and unnecessary. The majority of these children in the past, having been transferred to one of the city hospitals, can actually be cared in the local community, where treatment with oxygen can be easily administered. The aim is to keep these children on country, so keep them in their community where they've got the support of their loved ones, of their family, their friends, the host by doctors to transfer children under five from remote to larger medical centres may be influenced by some grim statistics. 25,000 Aussie children under five years old are hospitalised every year with pneumonia, asthma or bronchiolitis. 3000 of those needing intensive care. Alarmingly, Indigenous children are 11 times more likely to die from respiratory disease than the rest of the population. Numbers, it's hoped, will drop dramatically with a new approach to remote care. By reducing the amount of movement from community back to the social community that they know in the remote setting, we know that can make a real impact.

18/01/2023

A new project is aiming to improve childhood respiratory treatment for those living in remote and rural Qld

WIN News Queensland

A new project is aiming to improve childhood respiratory treatment for those living in remote and rural Queensland It's hoping to lead to a significant reduction in medical transfers to metropolitan and regional hospitals, allowing patients and their families to stay closer to their communities. Seven month old Genovia has been in and out of hospital for most of her short life, with bronchiolitis, a respiratory illness causing coughing and difficulty breathing. The first time I went with her, it, I cried like, Oh, what's happening with my baby? Why? She's like this. Living in remote far north Queensland, access to specialised care was far away, requiring Lily and her young daughter to fly to Cairns, over 800 kilometres from their home of Napa annum for treatment. The journey far from ideal. Lonely. Hopeless, helpless. A 2020 pilot study called Remote Paris found respiratory support methods like nasal high flow could be safely used in rural and remote areas. The Paris on Country project now aiming to implement these findings. We are going to teach the hospital staff how to look after these children, how to use nasal high flow in the far north, 30 to 50% of children with acute respiratory failure are transferred to hospitals in Cairns and Townsville. While that figure is lower at just 9 to 12% in south east Queensland, it's hoped the Paris on country team can reduce these transfers by half, significantly improving treatment access. So this has a huge impact on costs of transport and reduction of the load in emergency departments as well. In the city hospitals. The aim is to keep these children on country, so keep them in their community where they've got the support of their loved ones, of their family, their friends.

18/01/2023

News Headlines - Qld researchers have unveiled a new way to treat children living with respiratory ailments.

10 News First

Queensland researchers unveiled a groundbreaking new way to treat children living with serious respiratory ailments. More Australian children are hospitalised by acute respiratory disease than any other illness. That disturbing fact has caused researchers to take another look at how it's being treated and for a majority of cases, doctors have been doing it all wrong.

18/01/2023

World-first way for kids to breathe easy

The Australian

Fewer children with respiratory diseases such as asthma and chest infections will need to be transported long distances to large metropolitan children’s hospitals due to world-first Australian research that is set to lessen the massive burden on families and the healthcare system. Acute respiratory illnesses such as bronchiolitis, asthma and pneumonia are the biggest reason a child presents to hospital, with 20,000 to 25,000 children admitted in Australia each year. Three thousand of them are sent to ICUs. But a study by Queensland’s Wesley Research Institute, to be published in the Journal of the American Medical Association on Wednesday, found children requiring oxygen could be treated in general wards in smaller hospitals rather than being transferred to children’s ICUs in big cities.

18/01/2023

RURAL QUEENSLAND GAINS NEW CHILDHOOD RESPIRATORY TREATMENT

WIN News Cairns

It is hoping to lead to a significant reduction in medical transfers to metropolitan and regional hospitals, allowing patients and families to stay closer to their communities.

06/12/2021

At-risk mining towns 'falling through the gaps' for mental health care

The Courier Mail/The Daily Mercury

Mental health is still considered a taboo topic of discussion for Bowen Basin residents. But professionals are now on hand to help those struggling to access services in mining towns.

11/11/2021

ABC Tropical North Radio

Join us for Breakfast and get the essential start to your day. Local news, information, and events from the tropical north.

23/03/2022

Wesley Medical Research launches world-first trial to treat rare genetic disorder in children

The Courier Mail

A world-first clinical trial in Brisbane offers hope to children living with an incurable degenerative disease, which can leave sufferers in a wheelchair by 10, struggling to breathe by 15 and to likely die of cancer in their 20s. Queensland’s Wesley Medical Research has started the trial with 40 children from around Australia who have the rare genetic disorder Ataxia-Telangiectasia (A-T) — children like four-year-old Goldie Digby.

23/03/2022

Wesley Medical Research - Ten News First - 23 March 2022

Ten News First

Wesley Medical Researcher and lead investigator, Professor David Coman, explained that the symptoms of A-T are like “the worst parts of cerebral palsy, muscular dystrophy and cystic fibrosis combined, with children also at a higher risk of cancer and lung disease”.

10/11/2021

7News Mackay

A major resources company has partnered with researchers, to provide more mental health services to workers in coal country. 'Navicare' has launched in Moranbah, giving locals a pathway to treatment.