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The aim of our study is to investigate the effects of a novel intervention - high-intensity aerobic interval training - on aerobic fitness, heart volumes and function, metabolic control, substrate utilization, nerve function and cardiovascular risk factors among women with previous gestational diabetes mellitus (pGDM). Women with pGDM have an exceptionally high (at least a 7-fold higher risk) risk of developing type 2 diabetes mellitus compared with women without pGDM. Previous GDM is associated with subclinical atherosclerosis prior to the development of the metabolic syndrome or T2D. There may also be subclinical heart dysfunction, however this has rarely been examined and responses to exercise training have not been investigated. It has been demonstrated recently that peripheral nerve dysfunction precedes the development of neuropathy in T2D and given that pGDM is associated with subclinical atherosclerosis prior to the development of the metabolic syndrome or T2D, nerve dysfunction may also be evident among women with pGDM, however, this has not been examined. There is an inverse relationship between physical activity and risk of type 2 diabetes mellitus (T2D) among women with pGDM. In fact, achieving the minimum recommended exercise targets (150 min of moderate-intensity exercise per week) halved the risk of developing T2D among women with pGDM. No studies have examined effects of high-intensity exercise training among women with pGDM.

The aim of our study is to investigate the effects of a novel intervention - high-intensity aerobic interval training - on aerobic fitness, heart volumes and function, metabolic control, substrate utilization and cardiovascular risk factors among patients with early-onset type 2 diabetes. Diabetes prevalence in Australia is amongst the highest in the developed world and increasingly affects younger people. Early-onset type 2 diabetes mellitus (EOT2D) is a very aggressive form of diabetes - evidenced by poor metabolic control, the appearance of severe cardiovascular disease about three decades earlier than in later-onset type 2 diabetes and early mortality – primarily from cardiovascular causes. Multiple stressors, including management of aggressive diabetes and the burden of obesity and other co-morbidities contribute to impaired quality of life among people with EOT2D. Among adults with later-onset type 2 diabetes, exercise training improves physical fitness, metabolic control, cardiovascular risk factors and quality of life and may reduce early mortality. The gold standard for assessing whole body (aerobic) fitness is peak oxygen uptake (VO2peak) which has both central (heart) and peripheral (skeletal muscle) components. There is a very robust inverse relationship between whole body fitness and mortality: the higher the fitness, the lower the risk of early mortality. The only intervention (other than blood doping which is inherently dangerous) that increases VO2peak is regular aerobic exercise training. However, the only previous study to examine the effects of exercise training in EOT2D found no significant change in whole body fitness or metabolic control after three months of traditional moderate-intensity aerobic exercise training. In contrast to the group with EOT2D, the obese control group without diabetes experienced substantial improvement in whole body fitness. This raises the question of whether a different training strategy would be effective in improving whole body fitness in EOT2D. Randomized controlled trials in older patients groups with cardiovascular disease, e.g. heart failure, demonstrated that an exercise strategy that is novel among people with chronic disease - high intensity aerobic interval training - was safe and was more effective in improving aerobic fitness, heart volumes and function and skeletal muscle capacity than traditional moderate-intensity continuous exercise. Aerobic interval training requires less time than traditional continuous exercise, and thus time-efficiency may render this form of exercise more sustainable for people with chronic disease who are required to cope with many stressors. The proposed study will provide the first evidence of the effects of high intensity aerobic interval training on fitness, metabolic control, heart volumes and function, nerve function and cardiovascular risk among people with early-onset type 2 diabetes.

The TEAMSnet study is a research project which aims to improve diabetes and cardiovascular healthcare in Aboriginal and Torres Strait Islander communities. The project is developing and testing the use of internet and mobile technologies to provide diabetic retinopathy screening and coordinated diabetes and CVD care in three Aboriginal communities in remote and very remote parts of the Northern Territory. The primary hypothesis is that participation in a culturally appropriate retinal imaging programme that includes education, care coordination and management will improve clinical outcomes, adherence to eye care and clinical visits, reduce hospitalizations and patient stress in dealing with self-management and that additional analyses of the retinal images will add value in indicating potential care plans that may impact on decreasing the risk for diabetic retinopathy progression. Thus, in collaboration with Northern Territory Indigenous communities and their health care providers, we propose the overall goal of implementing and evaluating a telemedicine-supported diabetes and CVD assessment and care program to facilitate optimal healthcare delivery for Indigenous Australians. The project plans to implement an established primary care-based teleretinal eye assessment programme that acquires digital images of the retina, assesses visual acuity, and transmits, via secure telecommunication links, the data to a grading centre (at the Centre for Eye Research Australia [CERA]) for assessment of clinical retinopathy. The project will also implement a telecommunications infrastructure that supports health information exchange between participating sites, CERA retinal grading centre and investigators. This includes a web-based telehealth Chronic Disease Management Program (CDMP), a clinical data repository that incorporates eye diagnoses and management recommendations, and a telehealth program for diabetes and CVD prevention and management. The potential benefits include increased rates of timely eye screening for diabetic eye disease, the development an eye screening software technology that integrates within the primary care environment through integration with software based electronic decision support for facilitating optimal diabetes, cardiovascular disease and lifestyle management with the ultimate improvement in clinical outcomes such as blood glucose control (Haemoglobin A1c), lipid levels and blood pressure.

This study aims to develop and assess the effectiveness of an individual based intervention for sleep problems in shift workers, and will be conducted in operational settings (i.e., Austin Hospital and Flinders Medical Centre). The targeted sleep problems include poor shift work responsiveness, insomnia and obstructive sleep apnoea/sleep disordered breathing. The effectiveness of the treatment will be based on whether or not shift work responsiveness, insomnia, obstructive sleep apnoea, sick and carers leave, RiskMan data (e.g., staff and patient related incidents), symptoms of mental health problems (depression and anxiety), sleepiness and functionality decrease from before the treatment to after the treatment. The project will also determine whether or not those who have been randomly assigned to the intervention group (labeled program 1) have lower levels of the aforementioned than those randomly assigned to the control group (labeled program 2). The labels “program 1” and “program 2” will be used to help blind the participants to the intervention and control group. While laboratory and clinical studies demonstrate benefits from the proposed interventions, research has yet to assess the impact of comprehensive sleep health management for shift workers in an operational setting. Developing an individual-level treatment method to improve sleep health and to identify and manage sleep problems in hospital staff will lead to better health outcomes for staff, improved alertness and patient outcomes, and in turn reduced costs of days lost (e.g., from sick leave) within the workplace. Participants will be allocated to Program 1 or Program 2. Both groups will receive an educational presentation; the talk for Program 1 will focus on sleep health, circadian rhythms and scheduling, whereas the talk for program 2 will be designed to seemingly but not actually assist in improving sleep or scheduling. From here, both groups will be given a questionnaire that will take approximately 30 minutes. For those in the intervention group, the answers to the questionnaire will then be used to identify those who are at risk for poor shift work responsiveness, insomnia and obstructive sleep apnoea. Those who are identified with a potential sleep problem will then receive further treatment. Follow-up questionnaires that are identical to those answered originally will then be completed directly after the treatment procedures end for those in the intervention group. Sick leave data will be collected at the end of each financial year with help from the Austin Hospital and Flinders Medical Centre.

Background: Obesity is considered to be at epidemic proportions yet data is limited for the mechanisms of breastfeeding that reduce risk of obesity later in life. In particular the influence of breastmilk components on gastric emptying rate, appetite control and body composition in term infants is largely poorly understood. Furthermore an accurate non-invasive methodology to measure infant body composition is required to identify infants at risk of obesity. Aims: This study aims to investigate the relationship between infant gastric emptying rate and the composition of the consumed breastmilk, with the focus on milk proteins (whey and casein fractions), appetite hormones such as leptin and adiponectin and POPs. Further associations between breastmilk components and infant body composition will be investigated with the accent on longitudinal study. New methods of measuring infant body composition (ultrasound skinfolds) will be developed. Objectives: 1. To establish possible longitudinal associations between breastmilk macronutrients and components and both infant and maternal body composition. 2. To investigate and describe gastric emptying of term fully breastfed infants feeding on demand and establish possible associations with breastmilk composition. 3. To establish effect of milk intake and extracellular fluid reservoirs on bioimpedance in term breastfed infants I order to evaluate the possibility to use pre- and post-breastfeed measurements interchangeably. 4. To determine body composition (percent fat mass, %) of breastfed infants using bioimpedance spectroscopy and ultrasound skinfolds and to compare performance of these two methods in term breastfed infants. 5. To determine pesticide residues concentration in human milk during the first year of lactation and establish possible associations between pesticide residues in breastmilk and demographic factors of breastfeeding dyads.

The primary objective of this feasibility pilot study is to gather preliminary data on the use of gabapentin to reduce pain in children with dystonic CP to inform a future RCT including trialling the recruitment process and retention rate, the outcome measures, and to identify complications and side effects from the medication which could impact on the design of an RCT. The study will specifically examine the variability of results for different outcome measures to determine effect sizes that will be used to inform the planning of a future trial (choice of primary outcome measure, sample size planning).

Previous research has focused on guided self-help programs (GSH) - those that include scheduled contact with a mental health professional - or internet-based programs that differ from the 'app' platform in two ways. Firstly, with regard to GSH, 'app' based programs provide no additional contact point for users, and secondly internet-based programs were not readily convenient to users as access is restricted to a personal computer, whereas 'apps' can be used anywhere at the individual's convenience on their mobile phones. Additionally, the focus of past research has been on depression or anxiety in conjunction with another disorder such as panic disorder, which has lesser incidence compared to social anxiety. Therefore, the proposed study will focus on specifically on Social Anxiety Disorder (SAD) due to its higher prevalence and because of the nature of the disorder the lower likelihood of people with the disorder seeking professional treatment. The very nature of SAD makes it highly unlikely people will seek professional help as the treatment environment embodies the social situations they fear and research has shown that the majority of people who meet the diagnostic criteria for SAD fail to seek treatment or delay seeking treatment. This is where 'app' self-help programs become relevant as they provide a less stressful treatment option. During tertiary studies is a very stressful period for young adults. During this time, students are given new freedoms and exposed to things such as illicit substances and the responsibilities that come with becoming an adult. The current generation of university students have been exposed to technology in way never before seen, which has changed the way simple acts such as socialising are experienced. The nature of SAD means that people are likely to turn to alternate forms of communication where they feel less anxiety, such as the internet or mobile devices (Gary, 2008). The increased ownership and use of mobile devices and internet services has provided the current generation with unparalleled access to new forms of communication (ABS, 2015). This trend has decreased the need for face to face conversation and, therefore, also decreased the opportunity for young adults to develop social skills. Taking this into consideration it could be that the current generation of tertiary students may be experiencing higher levels of SAD as they encounter social situations they do not have the skills to cope with and learn. Primary Objective: To demonstrate the efficacy of a mobile based Cognitive Behavioural Therapy mobile ‘app’ versus a control group, as treatment for Social Anxiety Disorder. Secondary Objective: To demonstrate the efficacy of a mobile based Acceptance and Commitment Therapy ‘app’ as treatment for Social Anxiety Disorder.

We are undertaking research into the use of ultrasound to diagnose pneumonia in children. Currently, doctors may order a chest X-ray if they are concerned a child has pneumonia. Studies that have looked into this in children and adults suggest that ultrasound of the lungs may be as good as chest X-ray at identifying pneumonia and it has the added advantage of being at the patient’s bedside and not exposing the child to radiation. We aim to perform a lung ultrasound on children in the emergency department who have had a chest X-ray ordered by their treating doctor. We will then compare the results of the X-ray and the ultrasound to see whether the ultrasound has similar findings. Lastly, we will perform a follow-up phone interview 2-3 weeks after each child has been discharged from the emergency department to document if they improved, whether or not they needed antibiotics, or subsequently needed to consult another doctor. We hope our study will provide support to the growing idea that lung ultrasound may is useful for diagnosing pneumonia. In addition, we hope that we may begin to understand when it would be a good idea for the child to still have a chest X-ray and when the findings of a lung ultrasound are sufficient. This information may guide future research into using lung ultrasound to diagnose pneumonia.

Chronic lung diseases, including chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), bronchiectasis and asthma, are characterised by breathlessness, reduced exercise tolerance and impaired quality of life. ‘Flareups’ of chronic lung disease are common in people with this condition and often lead to admission to hospital and decline in lung function, imposing considerable burden on patients and the healthcare system. Pulmonary rehabilitation is known to be effective at improving exercise tolerance and function, and helping to prevent ‘flareups’ particularly for people with COPD. However, it is often difficult for people to access these group exercise training programs due to issues surrounding transport and lack of access to programs, particularly in regional areas of Australia. Advances in internet technology and accessibility have made it possible for people to receive specialist medical care and rehabilitation therapy directly to their home. By using readily available equipment such as an exercise bike and iPad it is possible for people with chronic lung disease to undertake a supervised pulmonary rehabilitation program in their own home. However, whether this kind of training is as effective as hospital-based pulmonary rehabilitation is unknown. This project aims to determine whether pulmonary rehabilitation undertaken at home, using internet-based technology, is at least as effective as centre-based pulmonary rehabilitation in improving quality of life, breathlessness and exercise capacity in people with chronic lung disease. People who agree to take part in the study will be randomly allocated to undertake pulmonary rehabilitation at either a hospital-based group or in their home, with internet-based supervision. At the beginning and end of the 8 weeks of the intervention phase, and at 12months post completion of pulmonary rehabilitation, participants will undergo measurements of health status and exercise capacity. Hospital medical records and GP records will be reviewed to determine the frequency of acute chest infection and to identify hospital admissions and treatment of acute infections. This will be tracked for 12 months for all participants. It is hypothesized that: 1. Home-based telerehabilitation will provide clinically significant improvements in health-related quality of life, exercise capacity and symptoms which are equivalent to those seen in centre-based rehabilitation. 2. Telerehabilitation, delivered using our low cost model, will be more cost-effective from a societal perspective when compared to centre-based pulmonary rehabilitation for chronic respiratory disease.

Most colorectal surgery is now performed laparoscopically. Therefore most pain is deep inside the abdomen rather than the small incisions on the abdominal wall. This study would like to use a pain management technique that uses local anaesthetic infused via plastic catheters into the intraperitoneal space in the abdomen, close to the internal incisions. It is hoped that by doing this patients will need to use less opioid drugs and thereby avoid the side effects of these drugs and possibly recover more quickly from the surgical procedure with less pain. Currently there are many different pain management techniques used after surgery and include: -Intravenous pain medication with opioid drugs such as Morphine or Fentanyl. -Epidural (small plastic tube inserted near spinal cord where medication can be given) with a combination of local anaesthetic drugs +/- morphine-like drugs. -Local anaesthetic blocks via small plastic tubes placed between the abdominal muscles at the time of operation and allow for local anaesthetic to be given between these muscles. -Oral pain medication such as paracetamol and oxycodone. -A combination of any of the above techniques. These techniques can have side effects especially with the Morphine-like drugs that can be a problem in patients having surgery on the bowel and include: -Nausea and vomiting -Reduced bowel function (constipation or bowel temporarily stops working - ileus) -Drowsiness or sleepiness -Slowed respiratory rate and reduced cough -Reduced mobility leading to prolonged bedrest -Increased risk of blood clots due to immobility Because of these side effects the study is designed to see if the local anaesthetic infused intraperitoneally will result in improved pain relief, mobility, earlier return of gut function and less complications,