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The primary objective of this study is to determine if nutritional supplementation improves exercise capacity in patients with Chronic Obstructive Pulmonary Disease (COPD) attending pulmonary rehabilitation. Secondary aims of this study are to evaluate if nutritional supplementation results in greater improvements in hand grip strength, body weight, body mass index (BMI), nutritional status (MNA), health related quality of life and lower limb strength in people with COPD participating in pulmonary rehabilitation. Participants will attend an 8 week (16 session) pulmonary exercise rehabilitation program which consists of two 1.5 hour exercise sessions per week. Participants that consent to take the nutritional supplement will be assigned to the intervention group and will be asked to take a nutritional supplement daily for the period of their 8-week exercise rehabilitation program. Participants who decline to take the nutritional supplement will be invited to also take part in the study and will be assigned to the Control Group (non-randomised) and asked to complete baseline and follow up outcome measures only. Overseas studies have shown that nutritonal supplements improve exercise outcomes for patients with COPD attending pulmonary rehabilitation and we aim to see if this can be replicated in the Australian population.

12 groups of 8-12 subjects will be chosen from 6 volunteer Western Sydney Medical Centres to attend 6 x fortnightly experiential learning sessions conducted as Programmed Shared Medical Appointments (pSMAs) in diabetes risk factor management. Participants will be selected from pre-diabetes and early diagnosed (3 years) Type 2 diabetes patients who are not on diabetic medications. The intervention will include a structured audio-visual presentation (12-15 minutes) before a discussion session with a trained facilitator (usually trained nurse or allied health professional), followed individual clinical consultations with a GP with all participants contributing. End-point outcomes (HbA1C, body weight) will be compared with standard treatment controls after 12 months. Patient and provider satisfaction with the process are secondary outcomes.

Exercise is undertaken as part of usual physiotherapy care following heart surgery. While it is considered safe, the exact effects of exercise which is commony prescribed following heart surgery by physiotherapists on heart function, breathing rates and oxygen levels are unknown. Establishing this information will further inform exercise prescription guidelines for physiotherapists who care for people following heart surgery. The aim of this study is to determine the relationship between heart rate, respiratory rate and oxygen saturation and measures of physical function and exercise intensity following heart surgery. People who have undergone heart surgery and require physiotherapy following surgery will be recruited for this study. During the usual physiotherapy tasks which involves exercise, and tests of balance and leg strength, measurements of heart function, breathing rate and oxygen levels will be extracted from the continuous monitoring system of which all people following cardiac surgery are connected to. Participants will be asked to rate their level of breathlessness and exertion following exercise. The relationship between exercise intensity and measures of heart function, breathing rate and oxygen saturations will be assessed.

Metformin is the first drug chosen to treat type 2 diabetes mellitus. However, the regulatory label warns against it use in people who also have chronic liver disease (CLD) but there is little published data to support this warning. Despite this, metformin is used in patients with CLD. This study will investigate the safety and pharmacokinetics of metformin in patients with CLD who are already prescribed metformin to treat their type II diabetes mellitus (T2DM) . We hypothesis that metformin, at doses adjusted based on renal function, can be safely administered to patients with CLD. Further, the pharmacokinetics of metformin in patients with CLD will be similar to those reported in patient with T2DM and no CLD.

This is a pharmacokinetic study of Lumacaftor/Ivacaftor (Orkambi) in children between 2 years and 18 years of age who are homozygous for Phe508del-CFTR with severe cystic fibrosis related liver disease, in comparison to those without severe liver disease.

Respiratory complications are reportedly very low (<2%) following open incision lower abdominal surgery and simple laparoscopic upper gastrointestinal surgery (e.g. lap choles). Due to a high cost to benefit ratio, prophylactic physiotherapy directed respiratory exercises and assisted early ambulation is not provided to these patients over and above standard ward care in a majority of hospitals in Australia or Europe. However as more complex procedures, such as bowel resections are increasingly being performed, the corresponding operation times are extending well past 3 hours. This may independently increase the risk of a respiratory complication. However, reports on respiratory complications in prolonged (>3r) laparoscopic and open lower abdominal is lacking. This trial aims to measure rates of respiratory complications in this population in the context of standard hospital ward care. Risk prediction modelling of those patients at highest risk will ensure that future prophylactic delivery of respiratory exercises and Physiotherapy is targeted to those patients that most require them.

Patients with AF frequently reports dyspnea upon exertion and exercise intolerance. However, the factors that contribute to these symptoms are not clear. In this study, we will objectively quantify exercise capacity, with the aim of assessing the impact of preselected clinical features on peak oxygen uptake and ventilatory efficiency.

This project investigates the effectiveness of a rhythm and movement intervention, delivered by early childhood teachers, to improve self-regulation for preschool-aged children living in disadvantaged communities. Coordinated rhythmic movement activities are proposed as an effective means to support the neurological bases of self-regulation and enhance motor, auditory, and self-regulatory functioning. Project outcomes will include resources designed for teachers on how to use rhythmic movement activities to improve young children’s skills to regulate attention and behavior. This will have significant benefits for positive school transition, and may help to address disparities in early learning and childhood wellbeing.

Pain and mental health conditions, especially posttraumatic stress disorder (PTSD), are common and disabling after injury. This study is evaluating an adaptation of the Trauma Survivor Outcome Support (TSOS) model that was developed in Seattle, USA. The intervention that we are evaluating will provide tailored psychological support and coordinated care through a case manager, and aims to reduce the prevalence and impact of persistent pain and symptoms of mental health conditions after major trauma. The control group receives enhanced usual care in which the participant's primary care provider receives a letter summarising the participants potential ongoing treatment needs when they enter the study. The study hypothesis is that the TSOS model of care will be acceptable to patients after major trauma, and that it will reduce the severity of pain and mental health symptoms compared with enhanced usual care.

An advanced hybrid closed-loop (A-HCL) insulin delivery system has shown safety and high time-in-range in a previous study. The use of a faster acting insulin aspart (FiASP) with a more rapid onset and shorter duration of insulin action compared to standard insulin aspart could improve the responsiveness of a HCL system. Limited data is available regarding the use of FiASP in HCL systems. The aim is to compare meal-time glucose control using A-HCL delivering FiASP vs. insulin aspart. All participants will undertake the study over a 22 week period, completing 2 study stages, each of 11 week duration 1) A-HCL with insulin aspart, 2) A-HCL with FiASP. Each stage will be identical with respect to meal challenges (2 per week of differing meal compositions). Outcome measures include CGM time-in-range and time in hyperglycaemic and hypoglycaemic ranges and system performance outcomes.