Find out about some of the Department of Paediatrics student experiences and pathways from their profiles below.
Project: Long-term consequences of respiratory instability on neurodevelopment and cardiovascular outcomes in preterm infants.
Experience in the Department: I completed my undergraduate studies and honours in Monash University Malaysia and am currently on an international scholarship to further my studies in the Department of Paediatrics. I chose paediatrics because I would like to know more about babies and their development. Since they have a long way ahead of them, understanding their development can help improve their quality of life, for them to live their lives to the fullest.
Preterm infants are born with immature cardio-respiratory control, which often manifests as pauses of breathing in the form of short central apnoeas and periodic breathing (a cyclical pattern of short repetitive central apnoeas). These breathing patterns occur during sleep are currently undetected in the nursery because they are deemed to be not life threatening. Recently, these short apnoeas and periodic breathing have been associated with hypoxia and reduced cerebral oxygenation in preterm infants after hospital discharge. This suggests that apnoea and periodic breathing may influence long-term cognitive and cardiovascular control in preterm infants. My research follows preterm infants before and after hospital discharge to explore the relationship between apnoea and periodic breathing on neurodevelopmental outcomes and cardiovascular control. We hope to determine a threshold that is related to neurodevelopmental impairment, which aid to clinical treatment decisions in the future.
Project: Investigating the extra- and intracellular signalling mechanisms of interleukin 37 and 38.
Experience in the Department: Interleukin 37 is a potent anti-inflammatory cytokine and part of the interleukin 1 family which governs principal pathways during inflammation but also homeostasis. My PhD will contribute to research investigating mechanism of regulation and action of interleukin 37. For example, how IL-37 imparts a strong inhibition on the production of pro-inflammatory cytokines and protects against a wide spectrum of inflammatory assaults.
With my PhD I hope to contribute to a better understanding of the mechanisms by which anti-inflammatory cytokines suppress inflammation and harness their therapeutic potential for clinical use in the future.
Project: Neo ICog: Understanding the gears that drive neonatal immunity.
Experience in the Department: My research centres around the Neo-ICog study, a multi-centre observational study of neonatal immune and coagulation systems in infants born less than 29 weeks gestation. Currently, little is known about the effects of being born so early on the development of these intrinsic systems. Infants born less than 29 weeks gestation are susceptible to a number of diseases as a result of their extreme prematurity, such as bronchopulmonary dysplasia (BPD). BPD is a chronic neonatal inflammatory lung disease with an incidence as high as 61 per cent. Despite substantial morbidity and mortality associated, there is no effective treatment available. This represents an urgent unmet medical need. This narrative is also seen for other diseases of prematurity, where our lack of understanding of the mechanistic processes that underpin these diseases may be limiting our ability to develop more effective treatments. A better understanding of how these systems develop, may help us to overcome these challenges.
My research in the Neo-ICog study will enhance our understanding of the immune and coagulation systems in infants born less than 29 weeks. This may have important implications on the potential pathways for better treatments through improved knowledge of the mechanisms involved.
Project: Investigating umbilical cord blood derived stem cells for therapeutic use in preterm brain injury.
Experience in the Department: I am a neonatologist at Monash Newborn, undertaking a translational PhD project with the Department of Paediatrics and the Miller-Allison lab group at the Ritchie Centre: investigating umbilical cord blood-derived cell therapy for preterm brain injury.
Every year in Australia more than 1000 infants are born extremely prematurely; this comes with risks such intraventricular haemorrhage and inflammatory brain injury, leading to long term developmental disabilities such as cerebral palsy. There are no known treatments or cures for these conditions. As such, my PhD project is focusing on investigating the use of umbilical cord blood-derived stem cells as a treatment for preterm babies at risk of brain injury, building upon previous pre-clinical evidence produced by the Miller-Allison group in animal models.
My PhD project has clinical and laboratory components. The clinical study is a phase 1 trial of autologous cord blood-derived stem cell administration in extremely preterm infants, and is actively recruiting. The lab components of his project are investigating the characteristics of extremely preterm cord blood cells, expansion of these cells, and the neuroprotective effects of expanded cord blood stem cells on a fetal sheep model of preterm brain injury.
Degree: BMedSc Honours
Project: Are Oxygen saturation targets achieved for preterm infants at risk of retinopathy of prematurity?
Experience in the Department: My study is a quality assurance project in the Monash Newborn. I am prospectively looking at the oxygen saturations of infants born <28 weeks’ gestation and whether or not these are being kept within the target levels of 91-95%. This work is largely desk-based and primarily involves data collection from a computer. We are going to analyse our findings in the context of infants who develop a range of neonatal conditions including retinopathy of prematurity, chronic lung disease of prematurity, necrotising enterocolitis and also infant mortality.
I chose to do my project with the Paediatrics department as I am extremely interested in paediatrics and think it would be a great career path! Specifically, I chose Monash Children’s because it is extremely well organised and linked to the school of clinical sciences (who provide weekly lectures and great support for students). There are lots of research students in the Paediatrics department so we all feel like we are in our own little team!
Next year, I’m really excited to go back to clinical rotations and complete my 5th and final year of medicine.
Degree: BMedSc Honours
Project: Comparison of management and outcomes in extremely preterm infants between the Monash Children's Hospital NICU (Melbourne Australia) and the John Radcliffe Hospital NICU (Oxford UK).
Supervisors: A/Prof Kenneth Tan and Prof Charles Roehr
Experience in the Department: The survival of extremely premature newborns (<28 weeks) varies significantly within countries and across the world. My project investigates the differences between two neonatal intensive care units (NICUs): one at Monash Children’s Hospital and the other at John Radcliffe Hospital in Oxford, UK. These two NICUs have a significant difference in their mortality rates and we do not yet know why. Specifically, we are looking at the practices surrounding withholding or withdrawal of life support in these infants. This is usually done when the risk of pain and suffering or poor outcome outweighs the potential benefit of treatment. We hope to identify if withholding and withdrawal of life support contributes to differences in mortality.
I chose to do my BMedSc Honours at the Department of Paediatrics for two reasons. Firstly, I am interested in paediatrics as a career and wanted the opportunity to explore this further. I have been able to meet and chat to many of paediatricians connected to the department about clinical work and research. I also chose the Department of Paediatrics because I knew that they have a very strong focus on research and have many fantastic supervisors. We have great facilities and everyone is very friendly. It is a fabulous environment in which to do an Honours year!
Next year, I will be completing my fifth and final year of medicine. I am very excited to return to clinical studies, but I will certainly be looking to do more research in the future.
Degree: BMedSc Honours
Project: Hypothermia in low birth weight babies: strategies to improve outcomes.
Experience in the Department: I am currently completing a BMedSc(Hons) year. My project is a randomised controlled trial aiming to improve outcomes for small babies who we know are at an increased risk of hypothermia. We are trialling a continuous temperature monitoring device on these babies to see whether it leads to benefits during their first month of life. The project is based on the postnatal wards of Monash Medical Centre, where eligible newborn babies are recruited and then subsequently randomised.
I chose to undertake my project with the Paediatrics department as I have a keen interest in pursuing paediatrics as a career path later on and also heard great things about the department from numerous previous students. Once I finish this year, I’m planning to either complete my final year of medicine or potentially continue on to a PhD, eventually working as a junior doctor before hopefully getting onto the paediatrics t raining program.
Degree: BMedSc Honours
Project: Measuring blood flow in children with a novel device
Supervisors: A/Prof Roderic Phillips and Prof Tony Penington
Experience in the Department. I am currently undertaking a BMedSc Honours project with the Department of Paediatric Plastics and Oral and Maxillofacial surgery using a video microscope camera to analyse microcirculatory blood flow under various scenarios, including maxillary orthognathic surgery and in vascular anomalies including infantile haemangiomas. The camera has not been widely used and I believe this offers the opportunity to investigate and develop new protocols for use in the clinical sphere.
I chose this project as it offers me the opportunity to maintain clinical skills, as I am undertaking research in the clinical environment, while also enhancing my research capabilities. Next year I will be completing my final year of medical training and hope to complete my internship at a Melbourne hospital. In the future, I aspire to train as a surgeon.
Project: Ventilatory control instability and paediatric sleep disordered breathing: Novel insights from assessment across infancy and childhood.
Supervisor: Prof Rosemary Horne and A/Prof Bradley Edwards
Experience in the Department: As a medical student, I had developed a strong interest in paediatrics. This led me to complete a BMedSc (Honours) in 2018. Having had the opportunity to work with and learn from leading experts in the field of Paediatric Respiratory and Sleep Medicine, I was inspired to continue my research and undertake the MD/PhD pathway offered by Monash University.
Infants and children spend the majority of their time asleep as they undergo rapid growth and development. Common sleep disorders such as sleep disordered breathing can negatively impact the developing brain and other body systems and as such requires timely detection and management. Currently, the management of sleep disordered breathing in children focuses only on the compromised upper airway anatomy, which while effective, does not always lead to cure. My research explores other potential contributory mechanisms to sleep disordered breathing in children, particularly unstable ventilatory control. We are also interested in gaining a better understanding of the early postnatal development of ventilatory control and how this might relate to unstable breathing patterns commonly seen in infants. Through this work, we are ultimately aiming to improve detection of potentially dangerous breathing patterns in infants and to develop more targeted, individualised treatment options for children with sleep disordered breathing.
Where am I now? Having completed my PhD I have returned to 5th year medicine. My experience as a MD/PhD student at the Department of Paediatrics and The Ritchie Centre has been incredibly positive. There are many opportunities to collaborate and learn from world-renowned researchers and clinician-scientists. The strong focus on translational research means that you get to work closely with clinicians and get to see the real world applications of your research.
Dr Lauren Nisbet
Project: Sound asleep: Cardiovascular implications of sleep disordered breathing in preschool children.
Experience in the Department: I completed my PhD in 2013 and was the third student to take part in the MBBS/PhD initiative at Monash University, which offers medical students the skills to become clinician-scientists. During my PhD candidature I had the opportunity to present my research nationally and internationally and to visit a number research laboratories in the USA and present my data to the top experts in the field of paediatric sleep disordered breathing. One highlight of my candidature was an invitation to spend 10 weeks at the University of Michigan investigating sleep apnoea in children with Down syndrome. Two first author publications were produced from this experience. My research won several awards including the New Investigator Award at the Australasian Sleep Association Annual Scientific Meeting, the Heart Foundation of Australia Travel Award and the American Thoracic Society International Trainee Travel Award. In 2015 I won the World Association of Sleep Medicine Elio Lugaresi Award for Education at the World Congress of Sleep Medicine in Seoul, Korea. This award is given to an early career researcher for the best original young investigator paper published in Sleep Medicine.
Where am I now? Since graduating I have published in multiple highly-regarded journals including Archives of Disease in Childhood, whilst working in clinical medicine. I am currently dual training to be a general paediatrician and sleep physician and plan to combine both research and clinical practice in my future career.
Project: Anti-inflammatory strategies towards necrotising enterocolitis.
Experience in the Department: I completed my PhD in 2017, focusing on novel anti-inflammatory strategies for a rare but often deadly neonatal gut disease named necrotising enterocolitis. From formula feeding mice pups by hand to processing human blood samples, my research allowed for me to see several different aspects of where science might take you….even when that might be processing frozen baby stools to study the changes to microbial species in the gut!
Where am I now? Having completed my PhD, my exposure to other projects in my lab involving big data led me to pursue further training in data science and experience data science consulting work. These experiences and the knowledge I gained from my PhD leveraged my next position as an Assistant Professor at Hokkaido University in Japan where I worked on bioinformatics analyses of cancer datasets as well as the more recent big data arising from COVID-19 research. Currently I am applying my skillset towards new challenges, to deepen our understanding of the links between immature immunity and neonatal disease.
Degree: BMedSc Honours
Project: The utility of ultrasound scans for the diagnostic evaluation of acute appendicitis in children.
Supervisors: Dr Maurizio Pacilli and A/Prof Ram Nataraja.
Experience in the Department: I had the privilege of undertaking my BMedSc Honours year in 2020 with the Department of Paediatric Surgery at Monash Children’s Hospital. Thanks to the incredible support and guidance of my supervisors, I was able to be involved in a number of projects in differing capacities. For example, we set up a prospective pilot study about How Intraoperative pain Predicts Post-operative Outcomes (HIPPO study), by using heart rate variability as a marker of parasympathetic nervous system tone. Unfortunately due to COVID this project was suspended, so instead we retrospectively studied the utility of ultrasound scan for the diagnostic evaluation of acute appendicitis in children.
An honours year is a fantastic opportunity to explore the world of research, have your own project, and learn an abundance of essential skills which provide a strong foundation for the future. I chose to do a project in the Department of Paediatrics as I have a keen interest in the field and knew it provided a supportive environment.
Where am I now? I have returned to 5th year medicine and we are currently in the process of finalising manuscripts for publication and presentations at international conferences, and I would love to continue contributing to the department!
Degree: BMedSc Honours
Project: Effects of a Preoperative Carbohydrate Drink on Postoperative Recovery after Day Surgery in Children: A Randomised Double-Blind, Placebo-Controlled Trial (The Sweet Dreams Trial).
Experience in the Department: I completed my BMedSc Honours in 2019. My trial involved giving children a carbohydrate loaded drink (or a placebo) 2 hours before surgery and assessing the effect it had postoperatively. We particularly focussed on if it would improve their metabolic state, and reduce nausea, vomiting, pain, or length of hospital stay. I coordinated the trial and was involved in all stages including ethics, recruitment, data collection and analysis, presenting at conferences, and writing the manuscript.
I thoroughly enjoyed my honours year. I was given a huge responsibility to recruit 120 children and was able to work in such an incredible team that played a significant part in allowing me to reach our goal. My experience allowed me to learn new many skills, whilst also building on my knowledge of paediatric health.
Where am I now? I chose to do my honours project in the Department of Paediatrics as I hope to pursue a career in Paediatric Health. Children are such joyous, brave and resilient beings, and I love working with them both clinically and non-clinically. This year, I am currently working as an Intern at Monash Health and will be looking to apply to the Paediatric Training Program in the near future.
Sara di Simone
Degree: BSc Honours
Project: Culturing the Respiratory Bacteria Isolated from Intubated Neonates
Experience in the Department: In 2020 my honours project was centred around the ‘GLAM & I’ clinical study. ‘GLAM & I’ aims to investigate what microbes colonise the gut and lung and examine the interplay between our microbiome and immune system. During my honour’s year, ‘GLAM & I’ was in its pilot phase and my project aimed to optimise the culturing conditions required to grow the respiratory bacteria. During my honour’s year, I was blessed with to have the opportunity to obtain precious samples from neonatal ICU at Monash Children’s Hospital.
Where am I now? I was so excited and motivated by my project during honours that I chose to continue this project and complete my PhD in 2021. Taking the ‘GLAM & I’ study to full scale, my project longitudinally obtains time-matched respiratory, gut, breastmilk and blood samples from neonatal and paediatric ICU patients to investigate host microbe interactions between the lung and gut microbiomes and the immune system. My hope for my project is to unlock microbiome-based medicines to target and treat disease in these young patients.