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This study involves examining the persistence and immunogenicity of P. falciparum 7G8 blood stage parasites following commencement of anti-malarial treatment with doxycycline. Participants will receive a single inoculum of purified malaria parasites followed one hour later by commencement of doxycycline treatment. Following this, we will measure the level of parasites in the blood-stream of the participants. We will also be assessing the way the immune system responds to the inoculum and the safety and tolerability of the inoculum. Characterising the persistence, immunogenicity, safety and tolerability of the malaria parasite following commencement of doxycycline treatment is important as this data may contribute to the development of novel malaria vaccine strategies.

Assessing the feasibility of a trial of earplugs in patients admitted to the ICU is a critical step in a program of research ultimately designed to test the efficacy of a routine policy of ear plug placement to improve patient-centered outcomes in patients admitted to the ICU.

Purpose of study is to explore the effect of an early intensive arm movement program in patients who have suffered a stroke within the past four weeks, in order to see if greater neuroplastic changes are driven resulting in improved functional recovery. It is hypothesised that an increase in the amount of arm movement by patients in the intervention (early intensive arm movement) group will have greater arm functional recovery compared to patients in the control (usual care and routine therapy) group.

PURPOSE One of the methods of providing pain relief after a Caesarean Section involves the injection of local anaesthetic into the muscle layers to surround the nerves that supply pain sensation to the lower abdomen. These blocks are called Ilioinguinal / Iliohypogastric nerve blocks and Transversus Abdominis Plane (TAP) blocks and have been used for a range of surgeries. This helps to reduce pain over the surgical wound where the Caesarean Section is performed. The purpose of this study is to determine if combining these blocks in addition to opioid and anti-inflammatory pain management will improve pain relief in the first 24 hours for women who have an elective Caesarean Section. This block will be performed at the end of the Caesarean section before the spinal anaesthetic has worn off. HYPOTHESIS Our primary aim is to determine whether administering the modified Ilioinguinal-Transversus Abdominis Plane (iTAP) nerve block in addition to opioid plus NSAID analgesia is superior to opioid plus NSAID analgesia alone following caesarean section with a Pfannenstiel incision. STUDY DESIGN AND INTERVENTION Approximately 100 volunteers will participate in this study and the study will be conducted at the Lyell McEwin Hospital. You will be enrolled in this study on the day of your Caesarean Section and randomly allocated to one of two groups. One group will receive pain medication with the iTAP block in the Post Anaesthetic Recovery Unit (PARU) as well as opioid medication (Fentanyl) through a Patient Controlled Analgesia (PCA) device. The second group will receive pain medication with the PCA but will receive a placebo block. A placebo is a medication with no active ingredients or a procedure without any medical benefit. It will feel like the real thing but it is not. Your participation in the study will continue until 24 hours after the iTAP block / placebo block. OUTCOMES We will be measuring total pain medication usage (opioids) and pain levels (VAS) over a 24 hour period. We will also measure adverse side effects of pain medication and the block, as well as the satisfaction of our participants. Hopefully there will be less pain and pain medication usage in our interventional group.

The aim of this research is to see if a psychological treatment based on meditation principles called “Mindfulness Based Cognitive Therapy” (mindfulness) is an effective treatment for depression in Parkinson’s disease. The study will compare an 8-week group MBCT treatment to a placebo-control group of Supportive Psychotherapy. The aim is to determine whether the MBCT program effectively reduces anxiety, depression, and caregiver burden and increases in quality of life and motor symptoms. This study will also introduce a session to the MBCT program which is specifically for partners/carers. This session will aim to help carers of people with PD to understand the principles of mindfulness to encourage them to become involved in the mindfulness practice with their partner/loved one. The aim of this is to help improve the person with Parkinson’s disease use of mindfulness and also decrease stress for carers.

There is now a growing amount of research supporting the notion of communication between gut microbiota (microorganisms; e.g. ecoli, streptococcus) and the central nervous system (CNS) (known as the brain-gut axis). According to Cryan and Dinan (2012) communication between the gut and CNS may be occurring through neural, endocrine and immune pathways indicating the possibility of alterations to gut microbiota as a form of therapy for treatment of CNS related disorders. According to a review by Kidd (2000) integrative treatments such as correction of intestinal dysbiosis, nutritional supplementation and dietary modifications can be a successful way to help children with ADHD reduce symptoms and move towards a productive and normal life. A review by Stevens, Kuczek, Burgess, Hurt, and Arnold (2011) states that there are a number of studies that have found encouraging results in ADHD children following an elimination diet (Pelsser et al., 2011; Pelsser et al., 2009) and diets challenging with or removing any artificial food dyes (Bateman et al., 2004; McCann et al., 2007). This review supported the use of dietary interventions in at least subpopulations of ADHD children, concluding diets that removed artificial colours significantly improve symptoms that return when challenged (Stevens et al., 2011). These authors also concluded that elimination diets would be an appropriate intervention for children who have not responded satisfactorily to traditional treatment. Moreover, Villagomez and Ramtekkar (2014) concluded that the use of nutritional supplementation in children with ADHD may be a justified and importantly safe intervention, where a number of studies have observed improvements in ADHD related symptomatology following nutritional supplementation (Bilici et al., 2004; Harding, Judah,& Gant, 2003; Hawkey & Nigg, 2014; Huss, Volp, & StaussGrabo, 2010). Further, due to the understanding of the microbiome’s connection to neurodevelopment, it is compelling to consider the role it is likely to play in disorders such as ADHD (Theije et al., 2014). Unlike autism spectrum disorders (ASDs), there have been no studies investigating the microbial composition and status of ADHD children, which could help provide some important insights into the effects of food or food allergy on behaviour (Theije et al., 2014). Previously no study has investigated the effects of diet and nutrition upon psychological functioning (cognition, brain activity, and sleep), together with gut microbial composition in this population. This is important because investigations of gut composition have to date largely been ignored in children with ADHD (Theije et al., 2014) and this information could be used as an important indicator to guide clinical decisions on an individualised level. Although this study is applying a standardised protocol in the interests of experimental control, this information could still be important for future individualized treatments.

The large number of patients require a central venous access device (CVAD) for the administration of intravenous fluids, medications, blood products and specialised treatments. These intravenous fluid lines will be accessed by nurses via a needleless connector (NC) multiple times every shift; however these connectors have also been linked with the development of CVAD associated bloodstream infection (CLABSI). The two most common causes of CLABSI are: the colonisation of the outer surface of the catheter during insertion from bacteria originating from the skin; and colonisation of the inner surface of the catheter through contamination of the hub or NC, often from poor non-touch technique practices from healthcare workers. These complications can be minimised, however while practice is variable, with little evidence to guide clinicians, research is required to reduce the gaps in this area. The importance of decontaminating the needleless connectors (NC) has been highlighted prior to accessing the central venous access device (CVAD) by many of the current CVAD guidelines. However, the standard for the scrub time and the decontamination solution is still lacking, with some studies showing the time required for decontamination to be from 10 to 30 seconds using friction and 70% isopropyl alcohol swab. The Centre for Disease Control and Prevention (CDC) guidelines for the prevention of intravascular catheter-related infections suggest decontamination with a chlorhexidine/alcohol preparation. However, they do not mention a specific time for this procedure, other than stating that using a 70% alcohol solution for 3 to 5 seconds is not adequate (O'Grady, 2011). The national evidence based guidelines for preventing healthcare associated infections in National Health Service hospitals in England (Epic3) recommend disinfecting the connector for a minimum of 15 seconds with chlorhexidine gluconate in 70% isopropyl alcohol, then allowing it to dry prior to accessing the system. The Queensland Health I-Care Guideline for Tunnelled Central Venous Catheters recommends a 5 second scrub with a 70% alcohol solution and allowing the connector to dry before accessing the CVAD system. With each guideline having differing recommendations, clinicians may have difficulty deciding which method will reduce the risk of CLABSI.

Injuries to the brain that occur after an accident, such as a car crash or after a fall, can be serious and have lasting negative consequences. Estimates suggest that at least 10 million people globally are affected by this type of brain injury every year, known as traumatic brain injury. Those that survive are often left with significant physical and or mental disabilities that are challenging to manage for the patients, their families and the health care system. Prevention of the accidents are important, but it is also important to find treatments that can help the recovery of patients affected by traumatic brain injury. At present there are a limited number of treatments that improve the recovery of these patients. One important area that has promising evidence is temperature control. Our group has contributed to evidence in this area of study. Preliminary evidence suggests that a raised temperature is a very common occurrence and that it may be harmful after traumatic brain injury. Yet, there still remains substantial uncertainty about this finding and whether reducing the patients temperature will help in their recovery. In clinical practice in Australia, cooling treatments are used with substantial variability by doctors, without certainty that the treatment will help the patient recover. Additionally, From our prior research, we know that often the temperature of patients still remains above the normal range, despite the use of cooling treatments. Therefore, we propose a study to work out if it is possible to maintain patient temperature in a targeted low normal range and avoid any elevation of temperature. From our prior work, maintaining temperature in a low normal range is an approach that is used in some centres in Australia. If we are able to maintain temperature in a low normal range successfully, then our plan is to apply for a larger grant to work out if this approach helps with the recovery after traumatic brain injury a study that would help inform the way patients are treated. This larger type of study would require about 1000 patients, but the study that we are seeking to do now only involves 50 patients and is designed to provide practical, preliminary information to enable us to proceed to the next stage.

The primary study hypothesis is that use of the Flinders chronic condition self-management program (FP) intervention will result in weight loss in patients with moderate to severe obstructive sleep apnoea (OSA) over a 6 month period compared to a cohort of historical patients matched for age, sex and baseline BMI with moderate-severe OSA. INTERVENTION: The Flinders Chronic Condition Management Program will be delivered to all participants. The Flinders Program was developed by the Flinders Human Behaviour & Health Research Unit (FHBHRU) and is used widely to enable patients to self-manage their chronic disease. Patients will also be offered a weight management Impromy program developed by Commonwealth Scientific and Industrial Research Organisation (CSIRO) at no cost in addition to intensive support using behavioural techniques. The pharmacy-supervised Impromy program uses nutritious and highly accepted meal replacements as a means to weight loss. DESIGN: A prospective cohort of 40 patients will be compared to a historical control cohort. DURATION: Participants will be followed-up over a 6 month period to assist them to achieve their goals.

This study aims to identify what the impact of young adults in their first year of university has on behaviours and choices made around diet and exercise, and how this may impact on nutritional intake, physical activity and anthropometric measures. This concept has been fuelled by longitudinal studies from the US which have consistently demonstrated an increase in weight during the first year of university with the rate of weight gain in university students determined to be 5.5 times greater than the general community. To date there has been no study in Australia documenting dietary and physical activity levels in first year undergraduate students and the impact on weight. As obesity is a growing health concern in young adults in Australia, it is important to identify how the influences involved in the transition period from high school to university, as well as observing changes in overall health and lifestyle patterns, may guide universities and health practitioners in providing advice and strategies on healthy and sustainable choices that can be made around diet and exercise to prevent further weight gain as a result of a new environment.