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A primary treatment goal of intensive insulin therapy for type 1 diabetes (T1D) is to minimise excessive glucose excursions (hyper- and hypoglycaemia), which exacerbate the risk of chronic vascular complications, disability and premature death. Even with benefits from new technologies such as insulin pumps, achieving optimal glycaemic control in T1D remains a challenge. Those on intensive insulin therapy have several fold higher risk for developing cardiovascular disease compared to those without diabetes. Effective lifestyle-based approaches to improve blood glucose control could further assist in preventing or delaying the onset of the serious vascular complications of T1D. Exercise recommendations for those with T1D have largely been based on studies showing benefits for those with and without type 2 diabetes (T2D). This is because exercise training studies in those with T1D have largely failed to demonstrate improved glycaemic control (HbA1c). Fear of exercise-related hypoglycaemia has been identified as the strongest barrier to exercise in adults with T1D, and epidemiological evidence suggests that those with T1D are just as inactive as their counterparts in the general population. There is now the need to identify practical and feasible lifestyle strategies that can help to optimise glycaemia and reduce the risk of diabetic complications. There are emerging alternatives to the conventional notion of health-enhancing bouts of exercise. Reducing and breaking up sitting time shows promise. Prolonged unbroken sitting time is detrimentally associated with cardiometabolic risk biomarkers, T2D, cardiovascular disease and all-cause mortality. Recent experimental studies, have also shown that prolonged sitting is associated with acute elevations in postprandial glucose and insulin responses, and these adverse effects are attenuated with frequent breaks in sitting. However, these studies have focussed on those who are healthy or overweight without diabetes, or on those with T2D. Although T1D and T2D are distinct conditions, chronic sustained hyperglycaemia is unequivocally associated with increased risk of vascular disease in both forms of diabetes. Consequently, there is a need to evaluate the effect of reducing prolonged sitting on glycaemia and vascular risk factors in T1D, and the associated potential to minimise risk of serious diabetes complications. In a randomised cross-over trial for adults with T1D, we will compare the acute cardiometabolic effects of three controlled experimental conditions: • prolonged uninterrupted sitting • prolonged sitting interrupted with regular short bouts of simple resistance activities Findings from this trial will help to identify new options for the lifestyle management of T1D, which can be examined in more depth in subsequent studies.

The aim of this study is to see whether fructose elevates triglyceride acutely and whether this gets worse after a month of consumption of fructose muffins. Overweight or obese volunteers underwent 2 acute fat tests over 3 hours with 2 muffins sweetened with sucrose or fructose. This was repeated after a month of consumption of 2 low fat muffins/day sweetened with either sucrose or fructose. Endpoints were area under the curve for triglyceride and glucose and weight

Mental illness accounts for significant childhood morbidity and mortality and is an area of national and global importance. Mental health problems are the dominant cause of childhood disability and contribute to 45% of the global disease burden in young people (10-24 years). • The recent Five-Year Youth Mental Health Report reveals alarming figures of one in four young people meeting diagnostic criteria for probable serious mental illness. This has increased from 18.7% (2012) to 22.8% (2016). • Half of all lifetime mental illnesses emerge by age 14, and 75% by age 24. • The negative long-term consequences of childhood mental illness include lower educational attainment, unemployment, substance use and addiction, crime and incarceration, self-harm and suicide. • Suicide is the leading cause of deaths in young people aged 15-24. Key policy recommendations from the report include support for the development of technology that provides an alternative to face-to-face health provider consultations. The prevention, identification and treatment of mental illness is a priority area for national and global health programs. Diagnostic and Management Need: Clinicians have not been able to achieve more than modest agreement in diagnosing mental illness, and the lack of objective measures for evaluating treatment has left long treatment titration cycles and suboptimal management. Indeed, the treatment of adolescent depression remains complicated and controversial because there are no objective measures of treatment effectiveness. New Research and The AutoMHaN Project: Research undertaken in Western Australia (WA) showed that there is a relationship between psychiatric status and 24-hour or ‘circadian’ heart rate (CHR). Broadly, different mental illnesses, such as Generalised Anxiety Disorder and Depression, are associated with distinctly different changes in CHR and this relationship is state-dependent: a change in clinical status is associated with a change in CHR. The autonomic nervous system (ANS) plays a key role in regulating basic body rhythms and activities including heart rate. Under these circumstances, evidence of distinct differences in CHR in different forms of mental illness, especially during sleep when environmental influences on heart rate are minimal, are an objective indication of basic differences between disorders. This suggests that an analysis of CHR can add an objective dimension to diagnostic assessment and the evaluation of treatment. The aim of this study is to see whether similar results can be obtained in children and adolescents. This pilot study will compare CHR from healthy children with CHR from children with different mental health and neurodevelopmental disorders including depression, anxiety, ADHD and autism. The aim is to see whether an analysis of CHR can provide objective indications of these conditions, differentiate between them and provide objective indications of their response to treatment.

The Department of Gastroenterology and Hepatology at the Princess Alexandra Hospital has recently established an Integrated Care Clinic as a strategy to help meet the growing demands for Gastroenterology and Hepatology outpatient services, to reduce waiting times and minimise risks to patients resulting from delayed health care management. The Integrated Care Clinic provides a multi-disciplinary approach by providing outpatient services cooperatively by GPs/specialists and nurses and well as by allied health professionals including psychologists, dieticians and exercise physiologists to manage patients with highly prevalent, but chronic conditions including patients with functional gastrointestinal disorders such as irritable bowel syndrome (IBS) as well as hepatology conditions such as non-alcoholic fatty liver disease (NAFLD). This study aims to compare the effects of standard care and the Integrated Care Clinic on the health outcomes of 500 consecutive patients presenting to an outpatient department with Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis, stable Inflammatory Bowel Disease and Irritable Bowel Syndrome (IBS) in relation to psychological, dietary and activity outcome parameters.

This study will be a single-centre, double-blind, placebo-controlled, dose-escalation study to assess the safety, tolerability and PK of GMA301 (thereafter referred to as getagozumab), in healthy subjects. Four sequential dosing cohorts, each with 6 subjects receiving getagozumab and 2 subjects receiving placebo (total of 32 subjects), will be given increasing single doses of getagozumab. sentinel dosing is proposed for each group. Two sentinel subjects (1:1 active to placebo) will be dosed first and the remaining 6 subjects in the cohort will be dosed 7 days later, followed by at least 12 days prior to the next cohort dosing. After Screening (Screening Period of 28 days), eligible subjects who meet the inclusion criteria and none of the exclusion criteria will be randomized into the study. A computer-generated randomization schedule will be used. The treatment period will last up to 8 weeks, followed by a 2-week follow-up period.

Internationally, the evidence in support of arts programs for participants’ health and wellbeing is rapidly growing. The Mater Young Adults Health Centre (YAHC) arts in health program will offer participants four 6-session options: Vocal Group, Tuned In music program, Art Therapy group, and Podcast Making group. The aim of the project is to evaluate treatment as usual (TAU: individualised medical and allied health consultations) + arts health group; versus TAU; to evaluate the potential effect of the arts health groups on measures of participant wellbeing, identity, social connectedness, and engagement with the health service.

Each year, approximately 24,000 infants are born prematurely in Australia, with approximately 3,500 of these infants residing in regional and remote locations. Research has identified that infants born prematurely are more likely to experience developmental delay and disability compared to their term born peers. The evidence for early intervention to improve motor and cognitive outcomes for preterm infants prior to preschool age is growing, however more research is needed to understand the most effective dosage, timing and content of such therapy. Even less understood is the impact of early intervention for preterm infants on their participation. The aim of the new PreEMPT Physiotherapy Program is to enhance Standard Physiotherapy Care in the first four months post term corrected age via 3 key aspects: - Participation-focused: PreEMPT has been designed to put the focus on participation of the infant within the context of their family. Life situations important to the family will be identified by the family at the start of each PreEMPT session, and will be used as a starting point to drill down to the sensorimotor capabilities needed to participate in these identified life situations. - Enablement-model - PreEMPT focuses on an enablement model with parents/care-givers to facilitate goal-setting and take a solution-focused approach to supporting their infant’s development in the context of their unique family circumstances. - Mix service delivery model of face to face and telehealth: Telehealth has been used across a variety of adult and paediatric populations to support the health and rehabilitation of those who reside in regional and remote areas, however there are no current studies published that incorporate telehealth-based physiotherapy services for preterm infants. Telehealth will be used to provide more regular opportunities for checking development, for progressing intervention, and for supporting parent enablement in the first 4 months post term age. 20 infants will be recruited. Following consent and baseline assessment at term corrected age, infants will be randomised to either Standard Physiotherapy Care (SPC) (n=10) or PreEMPT Physiotherapy (n=10). Infants randomised to SPC will receive 3 physiotherapy sessions consisting of general information regarding physical develop as is the current practice at Toowoomba Hospital. Infants randomised to the PreEMPT arm will receive alternating face to face (total = 7) and telehealth (total=7) weekly from 2 -15 weeks corrected age. The primary aim is to evaluate the feasibility and efficacy in improving motor performance of infants at 4 months corrected age. Secondary aims include exploring the relationship between motor performance and participation, evaluating the effectiveness of PreEMPT on an infant’s General Movements, and on an infant’s language, motor, and cognitive development and finally to evaluate the impact of PreEMPT on parental mental well-being and satisfaction.

The aim of this research is to evaluate the feasibility (e.g. acceptability, usage and ability to recruit and retain) of a brief (single use) online nutrition intervention for young adult (17-35 years) university students, and to estimate its preliminary efficacy in changing eating behaviours compared with control. Participants will be randomly allocated to the intervention (EATS: Eating Advice To Students) or attention control (Thrive online alcohol intervention) group. Participants in both groups will be asked to complete online questionnaires prior to completing the intervention or control program (baseline) and 3 months later (follow-up). Participants in the intervention group will also be asked to complete an additional online survey to assess the acceptability of EATS. Participant’s usage of the EATS website will also be tracked.

Background: Sepsis is one of the leading causes of death in hospital patients. The early administration of broad spectrum antimicrobials improves survival in sepsis. However, the use of these antimicrobials must be balanced with their unintended consequences, such as the development of antimicrobial resistance and adverse effects. Many patients receive prolonged courses of inappropriate antimicrobials in suspected sepsis. The established antimicrobial stewardship (AMS) team currently do a post-­prescription review of restricted antimicrobials and positive blood cultures. They do not routinely review treatment in sepsis, however they may have a role to promote the optimal use of antimicrobials in this setting. Aim: To determine the impact of AMS intervention in patients with medical emergency team (MET) calls for suspected sepsis Hypothesis: AMS intervention will improve appropriateness of antimicrobial therapy in suspected sepsis Participants: Patients with MET calls for suspected sepsis Method: Randomised controlled trial Control: Standard care (antimicrobials managed by the home team) Intervention: Standard care PLUS AMS review 48 hours post MET call Outcomes: Appropriateness of antimicrobial therapy at 72 hours post MET call

This study will will address the gaps in the literature by exploring the underlying neural correlates of an acute dose of caffeine using both an attentional network task and a flanker Go/NoGo task. Specifically, caffeine is expected to improve the alerting and executive control networks of attention, but not the orienting network. For the attentional network task, it is hypothesised there will be a reduction in reaction time and an increase brain activity (N1 amplitude) following alerting (central) but not orienting (spatial) cues after caffeine ingestion in comparison to placebo. For the flanker go/nogo task, it is hypothesised that Reaction Time and brain activity (N2 amplitude) will be greater for incongruent relative to congruent trials, and that this flanker interference effect would be reduced from pre- to post-ingestion for caffeine relative to placebo.