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The research design to be employed is a cluster randomized controlled trial of a multi-component intervention designed to improve the experience of Residential Respite Care (RRC) for people with dementia and their carers. Clustering will occur at the facility level with randomisation by necessity occurring at this level in order to prevent contamination of results due to changed processes during RRC admission required by the intervention. Thus, two facilities will be allocated as the intervention facilities and two as control facilities. Random allocation will occur via a random number generator. The program will provide support and communication before, during and after residential respite admission in order to facilitate the transition to respite care. Participants with dementia (PWD) and their carers will be interviewed face – to –face and also complete self –report instruments 2 weeks prior to moving into RRC. Allocation of residents will occur to either intervention or control group and all will be assessed during RRC admission. PWD and their carers will be interviewed face to face and asked to complete self report measures when transiting back to home care. PWD and their carers will be interviewed via telephone and asked to complete self report measures three months following return to home care.

The PROTECT-ICD study is a multi-centre randomised controlled trial targeting prevention of sudden cardiac death in patients who have reduced cardiac function following a myocardial infarct. The primary objective of the trial is to assess whether electrophysiologic study to guide prophylactic implantation of an implantable cardioverter-defibrillator early following MI (first 40 days) will lead to a significant reduction in sudden cardiac death. The secondary objective is to assess the utility of cardiac magnetic resonance imaging in assessing early myocardial viability, and its predictive value for both inducible and spontaneous ventricular tachyarrhythmias post-myocardial infarction.

Breast reduction surgery improves the quality of life of women with large breasts, with regard to both physical and psychosocial symptoms. At present two very different techniques predominate, with no consensus on whether the choice of operative technique affects patient satisfaction/quality of life (QOL). We aim to perform a prospective randomised cohort study to compare patient satisfaction/QOL following breast reduction using either the inferior pedicle Wise pattern or superomedial pedicle Hall-Findlay technique.

Many babies arrive naturally in a timely manner, however, sometimes we need to assist (or ‘induce’) a pregnancy if there are any complications, or if the pregnancy goes well beyond the due date. It is estimated that one in four women have an induced labour. The induction of labour is commonly commenced by placing some hormone gel (called Prostaglandin) in the vagina to make the cervix (the opening of the womb into the vagina) softer and allow it to open. Induction of labour can also be commenced using a small tube with a balloon on the end, inserted through the cervix and then inflated to mechanically stretch the cervix. In Australia, both methods are commonly used to prepare the cervix for labour. Following either method, when the cervix is more open, contractions are brought on by breaking the waters around the baby (called artificial rupture of membranes or ARM) and administering a hormone fluid (called Syntocinon) intravenously (IV; or into a vein). Sometimes, the induction process may be prolonged and it can take many hours, even days, before the cervix is more open. Prostaglandin hormone gel, in particular, can induce contractions. It is common practice that women undergoing induction remain an inpatient over this time. Balloon catheter induction is however very unlikely to induce contractions and there is even some published studies suggesting balloon catheter inductions may be associated with less chance of distress to babies. As such, for some women undergoing induction of labour with a low-risk, uncomplicated pregnancy, it would seem reasonable to go home after placement of the balloon catheter. The primary aim of the study is to demonstrate that going home after commencing an induction of labour using a balloon catheter is just as safe as having prostaglandin gel induction and remaining as an inpatient. We are additionally interested in the duration of labour, mode of birth, length of hospital stay, overall healthcare costs for women undergoing both induction policies, and which method is perceived by women to be more satisfactory.

The transmission and acquisition of health care associated microorganisms by hospitalised patients is associated with serious morbidity. Critically ill patients are particularly susceptible to serious infections with these organisms due to the nature of their illness and the numerous vascular and intra-cavity devices they have. It is known that persistence of these organisms within the healthcare environment is a major source of these transmissions. Environmental cleaning is important in the control of these organisms and traditionally relies on wet cleaning methods of the patient environment with detergents and disinfectants. This process of cleaning is time consuming, requiring significant resources and personnel. In addition, much of the environment is not easily amenable to these cleaning methods (e.g under surfaces, monitoring devices). Increasing bed occupancy and bed turnover creates added pressure to the effectiveness of these traditional cleaning methods. Hydrogen peroxide vapour (HPV) is an attractive alternative to these traditional cleaning strategies. This is due to being less personnel dependent, the vapour will effectively reach more difficult areas, simplifies complex cleaning process for numerous types of surfaces and recent evidence suggests that it is more effective in eliminating environmental organisms than traditional disinfection treatments. This study aims at assessing the effectiveness and practicality of using HPV compared to traditional cleaning methods in the routine ICU patient discharge cleaning process. Specifically we are looking at the control of the acquisition of hospital acquired organisms by patients in a busy general intensive care unit. Null Hypothesis: “ That Hydrogen Peroxide Vapour is no better than standard double cleaning (viraclean and detergent, no bleach) procedures in regards to acquisition of hospital acquired Clostridium difficile and multiresistant organisms during the course of an ICU admission. “ The Multi Resistant Organism (MROs) acquisitions to be measured include: - Multi Resistant Gram Negative bacteria (MRGN), - Methicillin Resistant Staphylococcus aureus (MRSA), - Vancomycin Resistant enterococci (VRE) and Clostridium Difficile cultures will only be collected if they are clinically indicated. Clostridium Difficile will not be included on routine admission and discharge swabs to Intensive Care. There will be a planned interim analysis at 4 months to re-calculate the sample size required.

Reading is a significant part of our everyday lives. Reading is needed for work, for home life, e.g. reading bills and for pleasure, e.g. reading a novel or reading aloud to grandchildren. The loss of the ability to read as a result of a stroke can therefore have a devastating impact on people’s lives. There is therefore a significant need to find reading therapy approaches that are effective. This project will determine the effectiveness of reading therapy delivered at Curtin University Reading Clinic (CURC) for people who have mild-moderate reading difficulties after stroke. Fifteen participants will be recruited to take part in the study. Assessments will be conducted pre and post therapy in order to determine effectiveness. Gains will be measured in terms of reading accuracy, reading comprehension, reading speed, verbal language, reading confidence and emotions associated with reading. Additional qualitative data regarding identity as ‘a reader’ and participation in reading related activities will also be collected via a post-therapy interview. Therapy will focus on functional reading and use materials selected by the participants e.g. a novel they wish to read. The therapy approach will be individualised depending on the participant’s own goals and the profile of their reading difficulties. We hypothesise that the reading therapy delivered by CURC will result in similar gains to those found with the participants in Cocks et al., 2013 and Cocks et al., 2010. These include significant, positive improvements in: reading comprehension, reading accuracy, reading speed, improved verbal language, pleasure in reading, confidence with reading and participation in reading related activities.

Mental health (MH) problems are a major public health concern. Because the prevalence of MH issues is higher in the Emergency Department (ED) than the general population norm, the ED is a potentially effective (but neglected) setting to target these issues. Detection of mental health problems before they become severe will enable intervention and support to be provided at an early stage, which may improve health and prevent further deterioration. The proposed study focuses primarily on participants with mild and moderate levels of psychological distress as identified by the Kessler Psychological Distress Scales and will exclude those with severe levels of psychological distress as this may indicate an existing mental disorder. The primary hypothesis to be tested is that, compared to patients who receive standard care i.e. no BI, patients who receive early BI (MI and MI follow-up) will report: 1) reduced levels of depression, anxiety and stress; 2) higher levels of motivation to self-manage health needs; 3) increased (appropriate) healthcare-seeking behaviours; and 4) improved quality of life.

The study will investigate how to improve identification of patients with malignant pleural mesothelioma who will derive benefit from treatment with chemotherapy and/or investigational agents, and also identify any potential factors that may predict overall outcome of the patients including survival (prognostic factors) so that individualised therapy is possible for patients with malignant pleural mesotheliom. Who is it for? You may be eligible to join this study if you are aged over 18 years, have a pathological diagnosis of malignant pleural mesothelioma, and about to commence on chemotherapy of choice by the treating physician including first line, second line or experimental regimens. Trial details: Participants with malignant pleural mesothelioma in all stages of disease will be recruited. Participants will be treated with the current chemotherapy of choice by the treating physician, including first line, second line or experimental regimens. There is no study specific intervention. participants will be consented for collection of their tumour tissue, blood samples and answering some questionnaires at baseline and subsequent follow ups.

For many years the phenomenon of involuntary movements provoked by yawning, has been observed in stroke patients with paralysed limbs, particularly the arm. More than a hundred years ago, an analysis suggested that removal of inhibitory pathways, unmasked the associated movements of yawning and limb movements, which had an evolutionary link related back to the swim bladder and pectoral fins of fish. In healthy individuals, yawning is often accompanied by generalised stretching, which may include elevation of the arms, known as pandiculation. The paralysed arm of stroke patients can be seen to move during a yawn, often bringing the hand towards the mouth, before suddenly dropping again at the end of the yawn. Walusinski coined this, “parakinesia brachialis oscitans”. The observation appears to have been regarded as a curiosity, with some texts almost derisively regarding it as something that could potentially give false hope to stroke patients. There has been some investigation into the neural basis of yawning in healthy subjects, with interest in the possible involvement of the mirror neurone pathways, and other regions distant to the motor cortex, including the ventromedial posterior prefrontal cortex. Movement of the paralysed limb during yawning in patients with pyramidal tract lesions, has been suggested to provide evidence for an independent “emotional motor” system, separate to the corticospinal motor tracts. Recruitment of these areas and pathways might provide a potential mechanism for recovery of motor function after stroke, particularly in the arm. There may thus be some potential for somehow utilising arm movements associated with yawning to stimulate upper limb recovery. Another fascinating aspect of yawning, is the common observation that witnessing yawning in others may result in another individual yawning; so called “contagious” yawning. This does not appear to be related to hypoxia or hypercarbia8. Some 42-55% of humans witnessing images of subjects yawning, will yawn themselves and the act of thinking of yawning may provoke yawning. 33% of adult chimpanzees yawned in response to seeing videos of other chimps yawning, possibly inferring advanced self awareness and empathy in this species. It is possible, therefore that yawning could be “evoked”, and thus used as a potential means for stimulating upper limb movements in paralysed patients. The exciting potential could be that yawning could thus be utilised as a neurorehabilitation therapy The primary purpose of the study is determine the incidence of Yawning Induced Movements in stroke survivors. We hope to use this data to guide the development of future studies with the aim of determining if these movements can have an application in the rehabilitation of stroke survivors

AIM: The aim of this randomised controlled study is to investigate the impact, in older adults, of a novel aquatic exercise intervention which optimises the haemodynamic stimulus responsible for improvement in brain blood flow and function. HYPOTHESES: 1. A land-based walking program will improve brain blood flow and function in elderly subjects (>50yrs), relative to a matched but non-trained control group. 2. Water-based walking, involving elevated responses to the circulation when training in water will improve brain blood flow and function to a greater degree than land-walking. 3. Improvement in brain blood flow measures will be significantly related to changes in cognition, memory and clinical measures. RESEARCH DESIGN: The study is a randomised, single-blind controlled trial. METHODS: One hundred fifty healthy, insufficiently active individuals, aged 50 years and older, with subjective memory complaints will be recruited from the community. Participants will be randomised to either a land-based, water-based or non-exercise training group. The exercise groups will attend centre-based exercise sessions 3 times a week for 6 months. The control group will maintain their usual lifestyle and attend 4, one hour centre-based healthy ageing education sessions over the 6 months. Primary and secondary outcome measures will be assessed at baseline, 6 and 12 months. In addition the primary outcomes brain blood flow and peripheral vascular function will be assessed at week 12 during the 6-month exercise training period.