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One third of all heart attacks are repeat events. It is unknown whether the risk of having another cardiac event can be reduced by simply sitting less. We will assess sitting time, physical activity and the ‘active couch potato’ phenomenon in those with heart disease attending cardiac rehabilitation (CR) over 12 months. We will assess the potential independent impact of these behaviours on the CR participants’ cardio-metabolic health, health-related quality of life, exercise capacity, anxiety and depression, both locally and internationally. Outcomes will inform CR research, policy and practice and lead to better health outcomes for those with heart disease.

The private automobile is the preferred and most utilised transport option for older people in Australia. Longitudinal studies of ageing in Australia have examined driving patterns and transport use of older people and have found that people are continuing to drive well into later life, to a much greater extent than previous generations. While people 65 years or older represent 13% of the total Australian population in 2004, this is expected to double to 26% by 2051. Although a large proportion of older adults are safe drivers, studies indicate that older drivers are overrepresented in crashes per distance travelled, particularly with regard to serious injuries or death as a consequence of crash involvement. Our research and that of others indicate that older adults with cognitive, sensory and physical functional decline are more likely to be unsafe drivers, and our recent has successfully developed and validated off-road assessment tools for accurate identification of at-risk older drivers. Here, we propose to develop and trial a training program to improve the driving skills of older adults. Such a program will increase road safety, while maintaining mobility and independence for older drivers and promote healthy, productive ageing.

Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is incompletely reversible by short acting bronchodilators, which causes typical symptoms of breathelessness on exertion, cough, sputum production and sometimes wheeze. Nocturnal symptoms can also occur, which may be related directly to the severity of airflow obstruction but there may be other factors that affect sleep quality such as upper airway obstruction, obesity, medications, genetic variability and systemic inflammation. There has been little published work on sleep abnormalities in COPD, but sleep related symptoms in COPD appear to be common. Research questions and hypotheses In this project, we address the questions of how prevalent and what is the nature of sleep disturbance in COPD? We also propose the answer the question of how the sleep disturbances relate to changes in lung function, systemic and airway inflammation, genetic variations, activity levels and day-to-day variations in spirometry. Hypotheses Sleep disturbance in COPD is due to overnight changes in lung function, and associated with subjective overnight and early morning symptoms and worse quality of life. Our secondary hypotheses are that overnight changes in lung function are related to airway and systemic inflammation, and variations in genes that influence circadian variation. The significance of the findings will be increased understanding of the prevalence and mechanisms of sleep disturbance and symptoms in COPD. This may influence management of COPD in terms of physical and pharmacological treatment.

There is an urgent need for the development of novel approaches to the treatment of Alzheimer’s disease (AD). AD is characterised by progressive decline in cognitive functioning in most areas, including in memory, attention, visuospatial ability, language and executive function. Although there are medications that can slow the progression of symptoms somewhat, there are currently no effective treatments for these hallmark symptoms of AD. Recent research has indicated that the progressive cognitive decline seen in AD may be a result of decreased functional connectivity throughout what is known as the default mode network (DMN), a brain network whose anatomy closely mirrors the pattern of cortical atrophy seen in AD patients (i.e. prefrontal, posterior parietal, and medial temporal). An approach that is able to specifically target this network in order to enhance connectivity, and thus functioning, could result in a highly effective therapy for the cognitive impairments in AD. Non-invasive brain stimulation (NIBS) techniques have considerable promise in this regard. NIBS has been shown to modulate activation throughout large scale cortical networks, such as the one implicated in cognitive impairment in AD, to enhance cognition in a number of disorders and to produce long lasting behavioural effects. In particular, Theta Burst Stimulation (TBS) is a highly effective form of NIBS and allows for multi-site stimulation within a single treatment session. The use of TBS for the treatment of cognitive impairment in AD is an area of significant potential, and one that has yet to be adequately explored. We propose to conduct a double-blind placebo-controlled randomised pilot study comparing a treatment course of active TBS to sham TBS (i.e. 21 daily treatment sessions over six weeks). In each treatment sessions TBS will be sequentially provided to four brain regions, the left and right dorsolateral prefrontal cortex (lDLPFC, rDLPFC) and the left and right posterior parietal cortex (lPPC, rPPC).

Burn injuries and treatment often cause excruciating pain for patients. Hypnosis has demonstrated benefits in treating pain in addition to pharmacological pain management. However, psychological pain management techniques are not currently used in standard pain management protocols on burns units. Audio recordings could be an efficient way for patients to access these treatments, and nurses may be well-positioned to assist patients to use them, as they spend more time with the patient than other clinicians and are usually present during wound dressing changes. The aims of this project are: 1. To explore the feasibility of using audio recordings of hypnosis as an adjunct to pharmacological treatment of burn pain. 2. To explore the feasibility of nurses assisting with the administration of hypnosis recordings. Adults over 18 years of age who are admitted to the burns unit with an injury that requires surgery will be screened and those who are eligible will be invited to participate in the study. Pain, anxiety and relaxation will be measured for all participants during a dressing change to give baseline information. Then patients in an experimental group will be asked to listen to a 25 minute recording of hypnosis 5 times to practice before using the recording in a further dressing change. Those in a control group will receive standard care during their dressing changes. After dressing changes patients will be asked to rate their pain, anxiety and relaxation experience. Nurses will administer the recordings. The experiment will follow a repeated-measures between groups design, which means that pain, anxiety and relaxation ratings and personality measures can be compared between the groups before and after treatment. Results will provide information about the benefits of hypnosis and mindfulness audio recordings for patients on the burns unit, and the feasibility of using nurses to administer these. They will also provide valuable information about personality variables that influence how well someone will benefit from either treatment, which will assist with treatment planning.

The aim of this randomised controlled trial is to develop, implement and evaluate a community-based intervention to promote physical activity among adults diagnosed with Type 2 Diabetes, at high risk of Type 2 Diabetes or overweight /obese. The 20-week intervention will include five sessions with a qualified personal trainer and a smartphone App. Aerobic fitness, muscular strength, physical activity, functional mobility, BMI, waist circumference, blood pressure, and cognitive variables will be assessed. Assessment will be conducted at baseline, 10-weeks and 20-weeks.

This study aims to determine whether acupressure therapy will be able to improve sleep quality in patients receiving haemodialysis (HD) or haemodiafiltration (HDF) for treatment of end stage kidney disease (ESKD). Other outcomes include change in quality of life, adverse reaction at the site of acupressure application and patient acceptability.

The ingestion of excess energy, particularly fat, is largely responsible for the current epidemic of lifestyle-related diseases such as obesity, diabetes and sarcopenia (the progressive loss of muscle mass with increasing age). The development of sarcopenia is exacerbated by low levels of physical activity and also in overweight or obese individuals through an increase in body fat and concomitant decrease in muscle mass. However, performing resistance and aerobic exercise in combination with the ingestion of high-quality protein sources (e.g., dairy-based protein) has been shown to enhance and/or maintain muscle mass. This has important health implications for reducing the risk of developing sarcopenia, obesity or other debilitating health conditions such as diabetes. Accordingly, the aim of this research is to investigate whether high fat levels decreases the muscle growth response following resistance and endurance exercise and protein ingestion.

The purpose of this study is to assess if the drug, PAX-1, can reduce cancer pain when used in addition to usual pain medication. It will also assess the side effects it may cause. Who is it for? You may be eligible to join this study if you are aged 18 years or above and are experiencing moderate or severe, persistent cancer-related pain are in the palliative setting. Study details: Participants in this study will be randomly (by chance) allocated to one of four groups. Participants in three of the groups will receive the study drug, PAX-1, at a dose of either 7.5mg, 10mg, or 12.5mg . Participants in the fourth group will receive a placebo (inactive) tablet. The tablets are taken orally 3 times a day for 28 days. All participants will continue to take their usual pain medication in addition to the study medication. They will not know to which group they have been allocated until after the study. Participants will be asked to record their daily pain intensity on a numerical rating scale. They will also be asked to complete questionnaires on appetite, sleep quality, functional status, and quality of life and will undergo safety and tolerability evaluations involving blood tests, ECGs and monitoring of adverse events. This will enable us to determine the clinical benefit of PAX-1 for cancer patients in the palliative setting.

Fixed airway narrowing is a common complication of long standing asthma. It occurs despite good treatment with puffers that are effective in controlling inflammation. It causes symptoms such as wheeze, cough, shortness of breath and there is no known treatment for asthma related fixed airway narrowing because the mechanisms and causes are poorly understood. It is more common in older patients who have had asthma for many years, in whom there are also greater symptoms. Airway inflammation due to neutrophils is more common in older people with asthma who have fixed airway narrowing. Neutrophils are a type of cell that are part of the body's immune system which causes inflammation. Neutrophilic airway inflammation can cause damage to the airways and lung tissue. The aim of this research is to determine how neutrophils affect the function of the smaller airways in older people with asthma. We will also determine how neutrophils cause airway and lung damage, which can lead to fixed airway narrowing. We will recruit people with asthma who are >40 years of age, are non smokers and have no other significant lung or heart problems. Participants will undergo breathing tests and a bronchoscopy, using a small camera on the end of a flexible tube, to obtain samples from their lungs. The significance of this study will be the discovery of the mechanisms that underlies this major complication of asthma. It will assist in overcoming the major barrier halting progress to an effective treatment strategy for which the mechanisms are unknown.