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After lung transplantation patients are prescribed drugs, called immunosuppression medication, to control the immune system to stop them from rejecting the new lung(s). Managing immunosuppression medication is lifelong post-transplant, and the Lung Transplant Physicians take many factors into consideration when dosing medications. The purpose of this project is to determine if the blood tests, QuantiFERON-Monitor (QFM), which measures immunity and QuantiFERON-CMV (QFN-CMV), which measures immunity to a virus, could provide extra information for the Lung Transplant Physicians to help in their decisions about immunosuppression medications. The aim of this study is to observe if there is any relationship between both the QFM and QFN-CMV Test results and immunosuppression drug levels and doses, and any occurrence of rejection and infection after transplantation. This study will be observational, immunosupression drug managment will be managed by the Lung Transplant Physicians as per standard practice. The QFN-Monitor and QFN-CMV tests will be collected for comparsion at the end of the study, but will not alter patient care.

To investigate the impact of a pre-discharge medication review by a hospital clinical pharmacist on 'at-risk' patients' health and quality of life.

The study is investigating the capacity of tDCS to alter ‘emotional processing bias’. Emotional processing bias refers to the interaction of cognitive and emotional processing that result in unconscious preferential processing of emotional stimuli of a certain valence (e.g. unconscious preference for positive or negative stimuli and information). We all have unconscious biases in our emotional processing. A positive emotional processing bias has been linked to aspects of mental health and maladaptive biases are a key component of many mental illnesses, such as depression. Very few studies have investigated whether tDCS can alter emotional processing bias, and due to methodological limitations the findings of those small number that have are inconclusive. Also, no studies to date have investigated the patterns of brain activity associated with tDCS and bias modification.

This study aims to describe the effect of limb compression on lymphoedema in terms of fluid distribution and soft tissue structure changes using MRI. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have a clinically detectable unilateral secondary upper limb lymphoedema arising from treatment of breast cancer. This diagnosis must be made using accepted diagnostic thresholds for bioimpedance spectroscopy (BIS) or volume measurements. You must also currently use a compression garment for management of your lymphoedema. All participants enrolled in this study will have at least one MRI scan while wearing the upper limb compression garment. Depending on participant availability, a second MRI scan on a separate visit may also be performed where participants do not wear the compression garment for that day. It is hoped that this study will contribute to a better understanding of how different levels of compression can be used in control of the lymphoedema.

Cortisol is a steroid hormone produced by the adrenal gland that is critical for life. Cortisol controls many body functions including appetite, glucose metabolism, blood pressure and immune function. Cortisol secretion varies widely among healthy individuals. Recent studies have shown that higher cortisol secretion, even within the normal range, is associated with an increase in blood glucose and risk of heart disease. How variability in cortisol secretion contributes to increased risk of diabetes and heart disease is unclear. In this study, we will investigate whether variability in cortisol production causes insulin resistance and reduces blood vessel dilation. This could be a mechanism that explains a link between heart disease and diabetes.

The rate of peripheral intravenous catheter failure at the RBWH is high (around 40%). When a catheter fails, before treatment has been completed, a new catheter is generally required, causing discomfort to the patient and considerable cost to the organisation. There are a number of reasons for catheter failure, some of which may be preventable with appropriate intervention. At present we do not have a clear idea of the causes of catheter failure at the RBWH. The proposed study will follow a cohort of patients from admission to discharge and closely monitor any IV access events associated with their stay. Patients with catheter failure will be compared to a group who do not have catheter failure, to identify opportunities for intervention.

Body Dysmorphic Disorder (BDD) affects approximately 2% of the population and involves constant worry and distress about how someone thinks and feels that they look. About 40% of people with BDD do not respond to currently available treatments. In BDD, there appear to be abnormalities in the activity of some areas of the brain, including areas responsible for visual processing. To date there have been no studies evaluating whether transcranial stimulation (TMS) is helpful for people with ongoing and distressing symptoms of BDD, including those who have not responded to other treatments. Hence, the aim of this study is to determine whether TMS is helpful in the treatment of people experiencing BDD, aged 18-65 years, who have not responded to currently available treatments. TMS uses electric currents to generate magnetic fields which can be used to stimulate the brain. This technique is non-invasive (does not require surgery or the introduction of instruments into the body) and requires no anaesthesia or hospital stay/treatment. The TMS in the study will stimulate the areas of the brain responsible for visual processing, which may be functioning abnormally in BDD, over a 6 week period. Participation in the study does not require a change or stopping of usual treatment, which may include medication and/or psychological treatment, determined by participants' consultation with their treating psychiatrists.

Orientation interventions have been recommended as being important within cognitive rehabilitation (e.g. Corrigan et al, 1985) and researchers have also suggested that environmental stimuli which may aid in reorientation, such as familiar pictures or personal possessions (Watanabe et al, 1998). However critical evaluation of how effective these interventions are has been limited to date, with only controlled studies investigating the use of daily screening (Tate et al, 2000) and the use of calendars (Watanabe et al, 1998), and none of the studies have investigated this issue in acute care. This trial will test the efficacy of a standardised reorientation program that can be administered in acute care is developed to reduce the length of time a person remains in PTA after TBI

We have recently shown that increasing fitness improves arrhythmia outcomes in patients with atrial fibrillation, a common heart rhythm disorder. In this study, we intend to evaluate a goal-directed, lifestyle based physical activity intervention for the reduction of AF burden and symptom severity. We hypothesise that our physical activity intervention will lower arrhythmia burden and improve symptom severity when compared to standard medical care alone.

In 2008 local leaders in Fitzroy Valley identified prevention, diagnosis and management of Fetal Alcohol Spectrum Disorders (FASD) and early life trauma (ELT) as a community priority. This led to the development of the Marulu Strategy which aims to address FASD prevention, diagnosis and therapy. Following the results of a prevalence study, Aboriginal community leaders also identified an urgent need for a system-wide and sustainable response to high rates of FASD and neurodevelopmental impairment. This study will investigate the effectiveness of the Alert Program (registered trademark) at improving primary school aged children’s measures of self-regulation and executive function in the Fitzroy Valley region including those children with FASD. This study will introduce the Alert Program (registered trademark) to families and community members, into school programs and child health practices in the Fitzroy Valley. The project will document a sustainable and culturally appropriate method of implementing the program through the trial site schools. It is anticipated an approach to screening and therapy for impairments in self-regulation and executive functioning will be translated into other health and educational sites. Teacher and school support staff will deliver ten Alert Program (registered trademark) lessons in their classrooms over eight weeks using a curriculum and resources provided by the study team. These materials have been developed by adapting existing Alert Program (registered trademark) activities and resources to suit the Kimberley classroom environment. Three workshops will be developed for parents and caregivers so they too can learn about Alert Program(registered trademark) and implement the concepts, activities and vocabulary of the program at home. Furthermore, this study will contribute to an emerging evidence-base of a multidisciplinary and collaborative model for children in remote and regional areas with FASD, and the development of a sustainable model of health care in the remote Kimberley region. It is also hoped this research will lead to improving the efficiency of health service delivery through utilising telehealth.