Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$82,450.00
Summary
1 in 300 children suffer from chronic constipation that is not fixed by changing their diet or taking laxatives. They continue to suffer the problem into adulthood. They also have fecal incontinence or soiling that causes problems with socialising and schooling. We are testing a method of electrical stimulation through the skin on the belly to increase the movement of the bowel. Initial results are encouraging, showing that the rate of movement of the bowel is increased and soiling is decreased.
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$346,995.00
Summary
We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the ....We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the level of the belly button. The electrical stimulation is applied using a current (interferential current) that stimulates deep into the abdomen. We tested 8 children and had very encouraging results with improved constipatio in 5-8 and all with soiling stopped. Parents and children are keen to use this technique but first we need to establish that the results are reproducible in a larger group of 70 children. We also need to know if the effect was just a placebo response (due to time spent with the physiotherapists), and how long the effect lasts. We will also measure changes in soiling. Faecal soiling is smelly and antisocial. Relief of soiling has a big impact on a child's ability to fit in at school and to attend normal schooling. We will measure outcomes using daily diaries kept by children, questionnaires, how quickly food moves through the bowel and pressures within the bowel. We have a multidiciplinary team of experienced clinicians and scientists with expertise in these techniques and in constipation and incontinence in children (paediatric surgeon, gastroenterologist, manometry nurse, incontinence paediatrician and physiotherapist, expert in electrical stimulation and gut nervous system scientist). This technique could revolutionise treatment of chronic constipation. Most physiotherapists have TESIC machines, allowing delivery Australia wide. It is non-invasive and should also be able to be used by adults, including the elderly in nursing homes.Read moreRead less
Neuro-muscular Apparatus In Human Colon And In Children With Chronic Constipation
Funder
National Health and Medical Research Council
Funding Amount
$195,660.00
Summary
NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, ....NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, that send processes to the muscle and lining of the gut. There are sensory neurons, motor neurons and neurons that connect between the other neurons (interneurons). Nerves communicate between each other and cause muscles to contract by releasing chemicals (transmitters). In the last decade, we have discovered that communication between the nerve and muscle cells occurs through a third cell type- interstitial cells of Cajal. These cells also have a role as pacemaker cells for the muscle cells. In a small study, we have found that the muscle can contract in response to transmitters but that activation of the nerves does not result in muscle contraction in NIDKIDs. This result shows that transmission from neurons to muscle is not occuring in large bowel from NIDKIDs. In this study, we will examine a larger group of patients to determine if a functional defect in the muscle, a defect in the nerve chemical transmitters or a lack of the intermediate cells (the interstitial cells of Cajal) is causing the problem in the NIDKIDs. Further treatment of each patient will be easier if the defect causing his-her problem is known. We would then be able to target their problem with drugs that would work specifically at the point of breakdown in their individual gut.Read moreRead less
Developing A Psychological Model Of Care For Adolescents And Young Adults With Complex Congenital Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$86,117.00
Summary
Adolescents and young adults with complex congenital heart disease face many challenges including the need for lifelong cardiac surveillance, medication, and navigating normal transitions such as developing independence; factors which place the individual at risk of psychological morbidity. Determining risk factors contributing to loss to follow-up and psychological morbidity is needed to develop evidence-based psychological interventions, which are strongly recommended but currently lacking.
Improving Outcomes For Children With Chronic Illness Through Evidence-based Intervention, Improved Implementation And Enhanced Health Psychology Research
Funder
National Health and Medical Research Council
Funding Amount
$476,728.00
Summary
I lead Australasia's largest research group improving physical/mental health in families of children with cancer. With this CDF, I will broaden my work across child illnesses and internationally. I will introduce novel programs into the clinic/community, ensure technologies are delivered safely and improve health psychology research. I will increase collaboration across diseases and support emerging researchers. Evidence from this CDF will directly inform future child health services and policy.
Innovation To Improve The Experience And Outcomes Of Paediatric Central Venous Access Devices: The E-Vascular Access Passport
Funder
National Health and Medical Research Council
Funding Amount
$318,768.00
Summary
Children have central venous access devices (CVAD)– tubes inserted into great veins leading to the heart- to enable treatment of complex health conditions. But paediatric CVAD are problematic for clinicians, and stressful for children and families - many result in severe complication and stop working. The project aims to advance paediatric CVAD care by identifying paediatric CVAD burden, and developing an innovative, data and technology-based resource -the e-Vascular Access Passport.
A Multi-centre, Double-blind, Randomised Controlled Trial To Evaluate The Efficacy Of 10 Valent-pneumococcal-Protein D Conjugate Vaccine In Reducing Respiratory Exacerbations In Children Aged ? 18 Months With Suppurative Lung Disease
Funder
National Health and Medical Research Council
Funding Amount
$1,160,660.00
Summary
Chronic suppurative (ie infected) lung diseases in children are major causes of poor health and deaths worldwide. Repeated childhood infections contribute to poor lung health in adults. The most common organism causing infection is non-typeable Haemophilus influenzae (NTHi). This study aims to determine whether a vaccine against NTHi can reduce repeated respiratory infections in children. If so, vaccination may lead to substantial improvements in current/ future lung health, and considerable dir ....Chronic suppurative (ie infected) lung diseases in children are major causes of poor health and deaths worldwide. Repeated childhood infections contribute to poor lung health in adults. The most common organism causing infection is non-typeable Haemophilus influenzae (NTHi). This study aims to determine whether a vaccine against NTHi can reduce repeated respiratory infections in children. If so, vaccination may lead to substantial improvements in current/ future lung health, and considerable direct and indirect cost of disease savings.Read moreRead less
A Multi-site Randomised Controlled Trial Comparing The Severity Of Constipation Symptoms Experienced By Palliative Care Patients Receiving Usual Care Compared To Those Diagnosed And Managed According To The Underlying Pathophysiology.
Funder
National Health and Medical Research Council
Funding Amount
$498,795.00
Summary
This research aims to consider whether the problems of constipation in palliative care are less severe when the physical changes that underlie the problem are explored.
Advancing The Knowledge, Understanding And Management Of Respiratory Exacerbations In Children With Bronchiectasis
Funder
National Health and Medical Research Council
Funding Amount
$71,359.00
Summary
Bronchiectasis is a condition which causes significant morbidity, burden of disease and mortality in children as well as adults. Exacerbations in bronchiectasis influence the decline in lung function and quality of life for patients. Although the importance of treating exacerbations effectively is well accepted, there are no universally accepted guidelines for recognizing and managing an exacerbation of bronchiectasis in children. This study aims to fill this clinical and research gap.