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Research

Neonatology and the Grace Centre for Newborn Care Research Unit

Contact Information


Name: Nadia Badawi Kaye Spence AM
Title: Neonatologist Clinical Nurse Consultant
Email: nadiab@chw.edu.au kaye@chw.edu.au
Telephone: 9845 2715 9845 2720
Fax: 9845 2251 9845 2251
Location: Grace Centre for Newborn Care Grace Centre for Newborn Care

Neonatal intensive care is a rapidly developing area of medicine and our unit specifically cares for newborn babies with cardiac and surgical problems or complex medical conditions. While the mortality rate has been declining steadily, surprisingly little is known about the long term outcomes of babies who undergo such care. The research in our unit focuses on evaluating the best methods of treatment as well as assessing long term outcomes that are important to babies and their parents.

We are interested in supporting novice researchers as evidenced by the establishment of the Clinical Neonatal Nursing Research Fellowship in 2003 and the increasing numbers of staff embarking on postgraduate research degrees. One of our greatest strengths is our multidisciplinary research team which includes medical, nursing and other allied health professionals, all of whom bring their own perspective to our research program.

Current Research

While our research projects may seem diverse, the theme of improving the care we provide to babies and their families runs throughout. Kaye Spence continues her research into the assessment and management of pain in the newborn and has tested The Pain Assessment Tool (PAT) for its reliability and validity. Her expertise in this area has now resulted in a national project on the use of sucrose for as pain relief in neonates. This project is funded through the National Institute of Clinical Studies and the CPHSR.

Major surgery, including cardiac surgery, is being undertaken at earlier ages and at smaller birth weights and this has prompted Nadia Badawi, Karen Walker and Sharon Laing to enrol these neonates in long term follow-up studies in collaboration with the Departments of Surgery, Cardiology and Cardiac Surgery. Many of these parents tell us that, in addition to behavioural and developmental concerns, their babies often experience feeding and sleeping difficulties when they take them home. These concerns are now the focus of an additional study which is being undertaken in collaboration with the Royal Children's Hospital in Melbourne and the University of Melbourne.

Despite improving perinatal and neonatal care, some babies are either stillborn or die in the neonatal period. While this is an area that many medical practitioners choose to ignore, Peter Barr's research focuses on the relationship of personality predisposition to negative emotions to parental grief and Neonatologists' fear of death to their ethical behaviour. As part of his PhD studies, Peter enrolled families who had experienced a perinatal death and continues to follow them up to assess the relationship between grief and subsequent pregnancy status 13 months after perinatal bereavement (in press) and the relationship between parental grief after the death of a child to personality traits as well as fear of death. The latter is an international study which is in progress.

Alison Loughran-Fowlds brings a basic science flavour to the unit and has been researching the role of Clara Cell Secretory Protein (CCSP), an inflammatory protein in newborn lung protection in the premature babies, the hypothesis being that they do not have enough of it. By studying the behaviour of CCSP in newborn infants Alison and her co-investigators hope to contribute to future prevention of neonatal lung disease. This study has been conducted in conjunction with the Royal Hospital for Women, Randwick and University of NSW, and is supported by grants from the Leslie Stevens Fund for Newborn Care, Sydney Children's Hospital Foundation and the Roth Foundation, Sydney, Australia.

Nadia Badawi has been carrying out population-based research into the risk factors and outcomes of newborn encephalopathy and cerebral palsy for over 10 years. This year she and her co-investigators have reported on the incidence of cerebral palsy and autism following newborn encephalopathy among survivors after the age of five years . These studies have been achieved in collaboration with the Telethon Institute for Child Health Research in Western Australia as well as the National Perinatal Epidemiology Unit in Oxford.

The outcomes of newborn intensive care are strongly influenced by workforce issues which have led Kaye Spence to examine the organisational culture and decision making in collaboration with the Clinical Governance Unit at the University of New South Wales looking into positive learning within the NICU as well as nursing knowledge and decision making. A collaborative project with the Clinical Nurse Consultants from the 9 NICUs and NETS in NSW. The study is partially funded by the Leslie Stevens Fund from SCH.

Grants and Other Financial Assistance

  • NHMRC Career Development Award 2003 - 2007: Nadia Badawi
  • Corporate support for the Clinical Neonatal Nursing Research Fellowship
  • Leslie Stevens Fund from Sydney Children's Hospital

Our Research Team

  • Peter Barr, Neonatologist
  • Nadia Badawi, Neonatologist
  • Robert Halliday, Neonatologist
  • Alison Loughran-Fowlds, Neonatologist
  • Kathryn Carmo, Neonatologist
  • Jenny Elliot, NUM
  • Kaye Spence, Clinical Nurse Consultant
  • Karen Walker, Audit Officer
  • Sharon Laing, Research Officer

Collaborations

We work in collaboration with the other neonatal units throughout Australia and New Zealand (NICUS) (ANZNN), the Centre for Perinatal Health Services Research (CPHSR) University of Melbourne, Macquarie University, University of New South Wales, University of Sydney, the Telethon Institute for Child Health Research in WA, and the National Perinatal Epidemiology Unit at the University of Oxford.

Recent Publications

2005

Allgood C, Abdel-Latif M, Oei J, Bajuk B, Lui K, for the NICUS Group Department of Newborn Care RHfWBSRN2NICUNDCNCfPHSR. Has the outcome of extremely preterm outborn infants changed over time in NSW & ACT? 2005 Mar 13; Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide, South Australia; 2005.

Badawi N, Spence K. Consultant and contributor to neonatology section of Mosby's dictionary. Mosby's dictionary of medicine, nursing and health professions - Australian and New Zealand edition. Elsevier; 2005.

Badawi N, Felix JF, Kurinczuk JJ, Dixon G, Watson L, Keogh JM, et al. Cerebral palsy following term newborn encephalopathy: a population-based study. Developmental Medicine & Child Neurology 2005 2005;47:293-8.

Badawi N, Batey M, Morris J, Nicholl M, Badawi N. Specific obstetric emergencies. In: Finn M, Bowyer L, Carr S, O'Connor V, Vollenhoven B, editors. Women's health: a core curriculum.Sydney: Elsevier; 2005. p. 163-75.

Barr P. Relationship of grief, anxiety and depression to pregnancy status 13 Months after a perinatal death. 2005 Mar 13; Perinatal Society of Australia and New Zealand, 9th Annual Congress, Adelaide South Australia; 2005.

Barr P. The history of perinatal grief research in Australia. 2005 May 7; Australian Birth Defects Society Symposium, Sydney, Australia 2005.

Barr P. Grief, anxiety and depression in the pregnancy after loss. 2005 May 26; MISS Foundation Passages 2005 Parental Bereavement Conference, Phoenix, AZ, USA 2005.

Barr P. Understanding grief emotions. 2005 May 26; MISS Foundation Passages 2005 Parental Bereavement Conference, Phoenix, AZ, USA 2005.

Barr P. Some babies die: psychosocial intervention. 2005 May 26; MISS Foundation Passages 2005 Parental Bereavement Conference, Phoenix, AZ, USA 2005.

Barr P. Perinatal death an ultimate concern. 2005 Sep 14; Department of Neonatology, Loyola Medical Centre, Chicago, IL, USA 2005.

Barr P. An existential view of perinatal death. 2005 Sep 14; Department of Neonatology, Loyola Medical Centre, Chicago, IL, USA 2005.

Barr P. Grief specific to perinatal death. 2005 Sep 15; First Candle/SIDS Alliance/International Stillbirth Alliance 2005 Conference, Together:Making a World of Difference 2005.

Barr P. The couple after stillbirth. 2005 Sep 15; First Candle/SIDS Alliance/International Stillbirth Alliance 2005 Conference, Together:Making a World of Difference 2005.

Barr P. Perinatal death: nature of the dialogue with parents. 2005 Sep 20; Phoenix Children's Hospital, Phoenix, AZ, USA 2005.

Barr P. Existential emotion and parental grief. 2005 Sep 20; Department of Human Services, Arizona State University, Phoenix, AZ, USA 2005.

Barr P. Perinatal death an ultimate concern. 2005 Sep 21; Department of Pediatrics, University of Arizona, Tuscon, AZ, USA 2005.

Browning Carmo K, Barr P. Drug treatment of neonatal seizures by neonatologists and paediatric neurologists. Journal of Paediatrics and Child Health 2005;41:313-6.

Craven P, Badawi N. The newborn. In: Bowyer L, editor. Women's health: a core curriculum.Sydney: Elsevier; 2005. p. 177-85.

Darlow B, Cust A, Donoghue D. Improved outcomes for very low birthweight infants: evidence from New Zealand national population based data. Archives of Disease in Childhood Fetal & Neonatal Edition 2005;88(1):23-8.

Darlow B, Hutchinson J, Simpson J, Henderson-Smart D, Donoghue D, Evans N. Variation in rates of severe retinopathy of prematurity among neonatal intensive care units in the Australian and New Zealand neonatal network. British Journal of Ophthalmology 2005;89(12):1592-6.

Darlow B, Hutchinson J, Henderson-Smart D, Donoghue D, Simpson J, Evans N, et al. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics 2005;115(4):990-6.

Dawson J, Nash J, Morritt ML, Bredemeyer S, Spence K, Kinross D, et al. Measuring quality use of medications in neonatal intensive care units. Neonatal, Paediatric and Child Health Nursing 2005 Nov;8(3):12-8.

Dawson J, Summan R, Badawi N. Push versus gravity for intermittent bolus gavage tube feeding of premature and low birth weight infants (Protocol). The Cochrane Library 2005 2005;(2).

Harrison D, Johnston L, Spence K, Gillies D, Nagy S. Salivary cortisol measurements in sick infants: A feasible and objective method of measuring stress? Journal of Neonatal Nursing 2005;11:10-7.

Lam J, Spence K, Halliday R. Parent's perception of nursing support. 2005 Mar 13; Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide, South Australia; 2005.

Loughran-Fowlds A, Badawi N, Christodoulou J, Wiley V, Wilcken B. Inborn errors of metabolism presenting in the newborn period to intensive care units in New South Wales between 1990 and 2001. 2005 Mar 13; Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide, South Australia; 2005.

Luig M, Lui K, and the NSW & ACT NICUS Group. Epidemiology of necrotizing enterocolitis - Part 1: Changing regional trends in extremely preterm infants over 14 years. Journal of Paediatrics and Child Health 2005 Apr;41(4):169-73.

Luig M, Lui K, and the NSW & ACT NICUS Group. Epidemiology of necrotizing enterocolitis - Part 11: Risks and susceptibility of premature infants during the surfactant era: A regional study. Journal of Paediatrics and Child Health 2005 Apr;41(4):174-9.

Shingde V, Halliday RftNGGCfNCTCHaWWNA. Surgical ligation of patent ductus arteriosus in preterm babies < 32 weeks in NSW and the ACT from 1992-2001. 2005 Mar 13; Perinatal Society of Australia and New Zealand, 9th Annual Congress, Adelaide, South Australia; 2005.

Spence K, Laing S, Smith J, Pong B, Badawi N. Parent satisfaction: a measurable clinical outcome of nursing care? 2005 Mar 13; Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide, South Australia 2005.

Spence K, Gillies D, Harrison D, Johnston L, Nagy S. A clinically reliable pain assessment tool for use in neonates. Journal of Obstetrics Gynecology and Neonatal Nursing 2005;34(1):80-6.

Spence K, Gillies D, Harrison D, Johnston L, Nagy S. A reliable pain assessment tool for clinical assessment in the neonatal intensive care unit. Journal of Obstetrics Gynecology and Neonatal Nursing 2005;33(5):80-6.

Walker K, Dimmick S, Badawi N, Nunn G, Halliday R, Cooper S, et al. A population-based study of outcomes following surgery for congenital heart disease in low birth weight infants. 2005 Mar 13; Perinatal Society of Australia and New Zealand, 9th Annual Congress, Adelaide, South Australia; 2005.

Walker K, Badawi N, Halliday RftNG. A decade of transposition of the great arteries in NSW and ACT. 2005 Mar 13; Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide South Australia; 2005.

2004

Atherton N, Halliday R, Duncan G, Walker K, Berry A, Badawi N. Should we be transporting term babies with very low apgar scores? 2004 Mar 15; 2004.

Badawi N, Keogh JM. Neonatal encephalopathy. Evidence-based Pediatrics and Child Health. BMJ Books; 2004. p. 499-507.

Bajuk B, Vincent T, Oei J, Sutton L, Lui K. Urban or rural. What does it matter? 2004 Mar 15; 2004.

Bajuk B, Bolisetty S, Vincent T, Lui K. Perinatal characteristics and outcomes of very preterm multiples and singletons in NSW and ACT, 1992-2002. 2004 Mar 15; 2004.

Barr P. Guilt - and shame-proneness and the grief of perinatal bereavement. Psychology and Psychotherapy: Theory, Research and Practice (2004) [77], 493-510. 2004.
Ref Type: Magazine Article

Barr P. Perinatal grief - a dialogue with the family. 2006 Mar 15; 2004.

Barr P. Guilt, shame, and perinatal grief. 2004 Mar 15; 2004.

Dimmick S, Badawi N, Randell T. Thyroid hormone supplementation in infants undergoing cardiac surgery - a systematic review. 2004 Mar 15; 2004.

Dixon G, Badawi N, Felix J, Keogh JM, Dragovic S, Petterson B, et al. Autism following a history of newborn encephalopathy. 2004 Mar 15; 2004.

Felix J, Badawi N, Kurinczuk J, Dixon G, Watson L, Keogh J, et al. Cerebral palsy following term newborn encephalopathy. 2004 Mar 15; 2004.

Harrison D, Johnston L, Spence K, Nagy S, Gillies D. Salivary cortisol as a clinical measure of stress. 2004 May 13; 2004.

Henderson-Smart D, Hutchinson J, Simpson J, Donoghue D, Evans N, Broadbent R, et al. Size matters - prenatal risk factors for chronic lung disease. 2004 Mar 15; 2004.

Hill B, Spence K, Halliday R. Feeding patterns in newborn infants following cardiac surgery. 2004 Mar 15; 2004.

Levison J, Reid S, Beeby P. The incidence and outcome for severe meconium aspiration syndrome in NSW and the ACT, 1993-2002. Is mortality caused by aspiration of meconium? 2004 Mar 15; 2004.

Levison J, Donoghue D, Hutchinson J, Sokol J, Miller J, Tarnow-Mordi W, et al. Survival for infants with congenital diaphragmatic hernia in ANZNN. 2004 Mar 15; 2004.

Loughran-Fowlds A, Oei J, Wimalasunderera N, Xu H, Wang H, Egan C, et al. The influence of gestation and mechanical ventilation on serum pneumoproteins in preterm infants. 2004 Mar 15; 2004.

Loughran-Fowlds A, Oei J, Xu H, Wang H, Egan C, Henry R, et al. Early post-natal surge of serum clara cell secretory protein levels in newborn infants is related to maturity. 2004 Mar 15; 2004.

Loughran-Fowlds A, Oei J, Wimalasunderera N, Xu H, Wang H, Egan C, et al. Influence of gestation on lung production of clara cell secretory rotein in ventilated newborn infants. 2004 Mar 15; 2004.

Loughran-Fowlds A, Oei J, Wimalasunderera N, Wang H, Xu H, Egan C, et al. The influence of gestation and mechanical ventilation on serum clara cell protein in preterm infants. 2004 Mar 15; 2004.

Oei J, Bajuk B, Lui K. Maternal drugs of addiction in infants requiring neonatal intensive care in NSW and ACT. 2004 Mar 15; 2004.

Oei J, Kao Y, Wang H, Egan C, De Grave A, Loughran-Fowlds A, et al. The relationship between polymorphisms of the CCSP gene and neonatal lung disease - a pilot study. 2004 Mar 15; 2004.

Spence K, Lau C. Implementing practice change in the NICU: does nursing culture impact on success? 2004 May 13; 2004.

This document was reviewed on Thursday, 7 May 2009

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