PhD projects

Why are babies in SCNs/NICUs at higher risk of permanent hearing loss?

Project description:

This PhD offers potential for practice changes that could improve lifelong hearing for infants admitted to SCNs/NICUs. Supervised by leading researchers in children’s hearing loss, epidemiology, paediatrics and audiology, it offers immense opportunities to establish a career and leadership in transformative newborn and child hearing loss research within the GenV initiative and beyond. 

Around one in five liveborn babies require admission to a special care nursery (SCN) or neonatal care unit (NICU). Admission to SCN/NICU is a known risk factor for permanent hearing loss. Compared to healthy babies, those admitted to NICUs are at 8 times the risk of hearing loss, with many hypothesized and interacting causal factors including immaturity, anaemia, infection/inflammation, ototoxic drugs, environmental noise, jaundice, intracranial haemorrhage/encephalopathy, hypoxia and genetic susceptibility. Large sample sizes and variations in care that equate to natural experiments are needed to clarify causal pathways and thence effective prevention and treatment. 

This PhD project will be conducted within the ‘Generation Victoria’ cohort, the only mega-birth cohort now recruiting internationally, targeting all 150,000 Victorian births over two years from 2021 and encompassing Victoria’s 5 NICUs and 40 SCNs. You will help set up a new statewide SCN data registry within GenV within which you will study critical SCN/NICU causal to hearing loss, including objective measurement of noise in each SCN/NICU. 

Supervisors: A/Prof Valerie Sung, Dr Jing Wang, Dr Peter Carew, Prof Melissa Wake 

Use and impact of psychotropic medication in pregnancy

Project description: Up to 20% of women suffer from mood or anxiety disorders during pregnancy, whose impacts on adverse pregnancy and child outcomes could be mitigated by antenatal psychotropic medications (such as antidepressants, antipsychotics, sedative-hypnotics and other sleep medications). While these medications appear safe in pregnancy, the knowledge base is incomplete, so some mothers choose against needed medication due to fear it may affect their unborn baby. This PhD student will work within the landmark ‘Generation Victoria’ (GenV) cohort, targeting all 150,000 babies born over two years (Oct 2021-Oct 2023) and their mothers at all 58 birthing hospitals in the state of Victoria, comprising consent, biosamples, and wide-ranging exposures and outcomes including administrative and clinical data. The student will contribute to creating a unique whole-state prescribing dataset within GenV by linkage/access to both primary care/outpatient medicines (Pharmaceutical Benefits Scheme (PBS)) and birthing hospitals prescribing data during pregnancy and the perinatal period. They will map ante/perinatal psychotropic medication use in the GenV cohort and then use causal techniques (including consideration of regional variations in medication use) to assess impacts on perinatal and infant/toddler outcomes such as language development, fine motor skills, and body composition. 

Supervisors: Prof Melissa Wake, Dr Jessika Hu, Prof Peter Coghill

Do we have sufficient safe medicine use information for pregnant women and their offspring?

Project description: Most women are prescribed at least one medicine during pregnancy. However, data are scant regarding the safety of medicines exposures for infants, as >98% of medicines do not have evidence regarding teratogenic risks and 73% of them have no human data. This PhD student will work within the landmark ‘Generation Victoria’ (GenV) cohort, targeting all 150,000 babies born over two years (Oct 2021-Oct 2023) and their mothers at all 58 birthing hospitals in the state of Victoria, and comprising consent, biosamples, and wide-ranging exposure and outcomes. The student will contribute to creating a unique whole-state prescribing dataset within GenV by linkage/access to both primary care/outpatient medicines (Pharmaceutical Benefits Scheme (PBS)) and birthing hospitals prescribing data during pregnancy and the perinatal period. Exploring the  expected systematic variation in prescribing patterns by hospital region, size and sector, they will investigate pathways from prescribing policies to variations in medication use and thence pregnancy and newborn outcomes, seeking causal insights into medicine benefits and safety. The landmark GenV platform thus offers immense opportunities to establish a career with leadership in pregnancy pharmacovigilance and child health research.    

Supervisors: Prof Melissa Wake, Dr Jessika Hu

Utilising GenV’s mega-cohort: Embedding early childhood trials for high-burden global issues

Project description: help children flourish, prevent illness and effectively manage the problems of the 21st century such as autism, obesity and depression. Yet children are underserved in interventional research and especially in large trials aligned with children’s highest-burden problems. Conversely, children are well-represented in large cohorts that capture today’s complex, interconnected challenges and outcomes, but these cohorts are not driving solutions at the scale needed.

Generation Victoria (GenV) is recruiting large, parallel whole-of-state cohorts of children born 2021-2023 and their parents to help find solutions to complex problems facing children and adults today. Alone among mega-cohorts internationally, GenV is now planning its Intervention Hub. The Hub will utilise the power of GenV to develop an intervention pipeline that can improve the health and wellbeing of our children and our nation. This will support many trials and trial designs, to show which policies, services and discoveries can really change outcomes at scale.

Expressions of interest are sought from prospective PhD students who wish to develop and conduct an embedded trial in GenV’s early childhood window. Interventions must be feasible to implement at a population level (whether targeted or universal) and align with a high-burden issue of global importance, such as mental health, climate and environment, cognition, development and educational outcomes, or health issues such as obesity, allergies and infections.

This PhD is not specific to any discipline and may appeal equally to clinician-scientists or research-only pathways. A commitment to rigorous evidence is essential.

Supervisors: Prof Melissa Wake, Dr Suzanne Long

Preconception and pregnancy exposures to neighbourhood environments and adverse birth outcomes

The environments that we live, work and play in impact our health. It is also likely that the neighbourhood environments that parents are exposed during preconception and pregnancy have lifelong health impacts. Studies have shown that exposure to air pollution in pregnancy is linked to a range of negative health effects at birth and in later life. Yet we don’t yet know: 1) whether preconception exposures to neighbourhood environments are linked to health; 2) how parental exposures to other aspects of the neighbourhood environment such as greenspace, noise and access to services influence health; or 3) how different aspects of the neighbourhood interact , for example, does living in a greener neighbourhood offset the negative effects of air pollution?

This PhD project will address these knowledge gaps by investigating the relationship between different aspects of the neighbourhood that parents were exposed to prior to birth and adverse birth outcomes. The project will use data from the Generation Victoria (GenV) cohort, which has collected parents residential address data and has information on birth outcomes. Multiple measures of the neighbourhood  will be developed using geospatial data and methods (e.g., geographic information systems and remote sensing). These measures will be linked to GenV participant addresses,  and statistical analyses will be used to investigate the relationship between exposures in preconception and adverse birth outcomes (e.g., low birth weight, preterm birth). Findings from the PhD will inform environmental interventions via urban planning and design. This project will suit a researcher with strong quantitative skills, an interest in geography and neighbourhood environments, and a willingness to learn geospatial skills.

Supervisors: Dr Suzanne Mavoa, Prof Melissa Wake