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Paediatric Research

Research is necessary for improving the health and healthcare of children and young people. It is important that children and young people are given the opportunity to take part in research that may benefit them, or those that follow them. We are proud of our department’s involvement in research studies, some of which are led by us in Norwich, and others where we contribute to national projects

The areas of research we specialise in include diabetes, rheumatological disorders (bones and joints), chest and respiratory problems, accidental injury, safeguarding children, epilepsy, nutrition and the gut, paediatric surgery and childhood cancer. Our department also has an active neonatal research programme.

All of our research is reviewed by ethics committees and follows guidance for good research practice. Most of our research projects are endorsed by a body called the National Institute of Health Research. http://www.crncc.nihr.ac.uk/ This is an organisation which provides funding for, and leads on NHS research. We hope that parents and carers, children and young people will be happy to be asked to take part in these research studies.

Jenny Lind Research Team

The team is led by Drs Richard Reading and Paul Clarke.

The team includes consultants in acute, neonatal, community and surgical paediatrics, dedicated paediatric research nurses and midwives, research administrative support, and pharmacists.

We work closely with researchers in the University of East Anglia. These include not only clinical researchers such as academic doctors and nurses but also health economists, psychologists and psychosocial scientists, medical geographers, environmental scientists, statisticians, academic social workers, educationalists, and biologists! We are fortunate to be able to work with such a wide range of researchers, which is important for investigating children’s health and wellbeing.


Links with researchers elsewhere

Clinical research depends on cooperation and cross-fertilisation of ideas between specialists in different centres. We have links with the following teams.

  • Diabetes: with teams in Cambridge University (Prof David Dunger) and University of Newcastle upon Tyne (Prof Allan Colver)
  • Neonatology: Teams in Bristol University and Guy’s Hospital
  • Accidental Injury: Universities of Nottingham, West England (Bristol), Newcastle upon Tyne, and Leicester (Prof Denise Kendrick)
  • Safeguarding; Institute of Child Health, London (Prof Ruth Gilbert)
  • Rare Diseases: British Paediatric Surveillance Unit http://www.rcpch.ac.uk/bpsu
  • Rheumatology: Teams in Great Ormond Street Hospital (Prof Lucy Wedderburn), Alder Hey Children’s Hospital (Prof Michael Beresford), Birmingham Children’s Hospital (Prof Tauny Southwood)
  • Mucosal immunity and bowel inflammation: Institute of Food Research, Norwich
  • Child psychiatric disorders: teams in Imperial College (Dr Cornelius Anu) and the Royal College of Psychiatrists (Prof Tamsin Ford)

Some important studies in the department

Our Paediatric Research Team is involved in commercial (industry-sponsored) and non-commercial clinical research studies. The best and most important studies get adopted onto the National Institute for Health Research portfolio.  We currently have over 25 active studies, which cover many specialities including Diabetes, Respiratory, Renal, Rheumatology, Community Paediatrics, Gastroenterology and Surgical studies.

Some examples of our active studies include;

TrialNet – Natural History Study of the Development of Type 1 Diabetes:

This study is helping to find out more about how Type 1 Diabetes develops and ways to delay and prevent it.  TrialNet screens relatives of people with Type 1 Diabetes.  We can screen you if you are;

3 to 45 years old and have a brother, sister, child or parent with Type 1 Diabetes OR

if you are 3 to 20 years old and have a cousin, aunt, uncle, niece, nephew, half-brother, half-sister or grandparent with Type 1 Diabetes.

https://www.diabetestrialnet-org

SPARKS CHARMS (Childhood Arthritis Response to Medication Study)

CHARMS recruits children with Juvenile Idiopathic Arthritis (JIA) who have either been on, or are currently starting on Methotrexate.  The goal of CHARMS is to understand the differences between those that ‘respond’ to therapy, compared to ‘non-responders’, by analysing immunological, genetic and psychological data from a large cohort of patients.

https://www.sparks.org.uk/our-research/research-highlight-sparks-childhood-arthritis-research/

PREDNOS 2

This study is looking to see whether a short course of daily Prednisalone (steroid therapy) at the time of an Upper Respiratory Tract Infection (URTI)  is effective in reducing relapse in children with Steroid Sensitive Nephrotic Syndrome.

http://www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/renal/prednos2/index.aspx

TORPEDO

Torpedo is a multi-centere, randomised controlled trial comparing fourteen days of intravenous therapy to three months of oral therapy in children with Cystic Fibrosis who have isolated Pseudomonas and fulfill the inclusion criteria.

http://www.torpedo-cf.org.uk

MICHAEL METHODS

This is a study exploring how the developing gut learns to live with the all of the germs in the bowel and how the breakdown in this tolerance is important in gastroenterological diseases.

 

PAST STUDIES

  • BENDY BENign joint hypermobility study. This is funded by ‘Research for Patient Benefit’ and is a randomised controlled study to determine whether interventions (such as Physiotherapy, occupational therapy, education) improve the outcome for children suffering with pain and/or disability because of being ‘overly stretchy’ (ligamentous laxity)
  • Keeping Children Safe. This is a series of studies investigating safety factors for common accidents to young children and ways of preventing accidents. We are recruiting children under five years in the Emergency departments of the NNUH and JPUH, through GP practices and in local Children’s Centres.
  • The WAIT study is an NIHR sponsored multi-centre randomised controlled clinical trial of the anti-leukotriene agent Montelukast as needed versus placebo, for viral wheeze. We aim to recruit 2-5 children per month between the ages of 10 months and 5 years, with at least 2 previous wheezing episodes with viruses but no interval symptoms. Children will be recruited from A&E, CAU, Buxton Ward and Jenny Lind outpatients.

Research grants

We receive income from a number of studies which enables us to support some smaller studies in the department. Below are a selection of the larger grants held by the department.

  • The Bendy study. Research for Patient Benefit NIHR grant reference no PB-PG-0407-13279 £188,430. Grant holder Prof Alex MacGregor
  • Keeping Children Safe at Home NIHR Programme grant ref: RP-PG-0407-10231 £240K 2009-2014. Grantholder: Prof D Kendrick Nottingham, local grantholder: R Reading.
  • National surveillance study of Gonorrhoea, Syphilis, Chlamydia and Trichomonas Infection WellChild research grant £48K 2010-2012 Grantholder: R Reading

Examples of recent publications from the department

  1. Thalange N, Deeb L, Iotova V, Kawamura T, Klingensmith G, Philotheou A, Silverstein J, Tumini S, Ocampo Francisco A-M, Kinduryte O, Danne T. “Insulin degludec in combination with bolus insulin aspart is safe and effective in children and adolescents with type 1 diabetes”.Pediatric Diabetes 2015: 16: 164–176. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413367/pdf/pedi0016-0164.pdf
  2. Wynn P, Stewart J, Kumar A, Clacy R, Coffey F, Cooper N, Coupland C, Deave T, Hayes M, McColl E, Reading R, Sutton A, Watson M, Kendrick D. “Keeping Children Safe at Home: Protocol for a case-control study of Modifiable Risk Factors for Scalds. Inj Prev 2014;20:5 e11 doi: 10.1136/injuryprev-2014-041255
  3. Armon K, “Musculoskeletal Pain and Hypermobility in Children and Young People: Is it benign joint Hypermobility Syndrome” . Invited Editorial for Archives of Diseases in Childhood. 2015;100(1):2-3
  4. Armon K, “Outcomes for Juvenille Idiopathic Arthritis”. Paediatrics and Child Health     2014;24(2)64-71
  5. Deave T, Towner E, McColl E, Reading R, Sutton A, Coupland C, Cooper N, Stewart J, Hayes M, Pitchforth E,Watson M, Kendrick D. Multicentre cluster randomised controlled trial evaluating implementation of a fire prevention Injury Prevention Briefing in children’s centres: study protocol. BMC Public Health 2014, 14:69 http://www.biomedcentral.com/1471-2458/14/69
  6. Chiewchengchol D, Murphy R, Morgan T, Edwards SW, Leone V, Friswell M, Pilkington C, Tullus K, Rangaraj S, McDonagh J, Gardner-Medwin J, Wilkinson N, Riley P, Tizard J, Armon K, Sinha MD, Ioannou Y, Mann R, Bailey K, Davidson J, Baildam EM, Pain CE, Cleary G, McCann LJ, Beresford MW. Mucocutaneous manifestations in a UK national cohort of juvenile-onset systemic lupus erythematosus patients. Rheumatology 2014, Online publication 03/2014; DOI:10.1093/rheumatology/keu137
  7. Ani C, Reading R, Lynn R, Forlee S, Garralda E. Incidence and 12-month outcome of non-transient childhood conversion disorder in the U.K. and Ireland. Br J Psychiatry. 2013;202:413-8. doi: 10.1192/bjp.bp.112.116707
  8. Kendrick D, Maula A, Stewart J, Clacy R, Coffey F, Cooper N, Coupland C, Hayes M, McColl E, Reading R, Sutton A, Towner EM, Watson MC; Keeping Children Safe Study Group. Keeping children safe at home: protocol for three matched case-control studies of modifiable risk factors for falls. Inj Prev. 2012 Jun;18(3):e3. doi: 10.1136/injuryprev-2012-040394
  9. Thalange N, Bereket A, Larsen J, Hiort LC, Peterkova V. Treatment with insulin detemir or NPH insulin in children aged 2-5 yr with type 1 diabetes mellitus. Pediatr Diabetes. 2011 Mar 21. doi: 10.1111/j.1399-5448.2010.00750.x

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