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Background: Intravenous paracetamol is ubiquitously used in hospitals as an antipyretic and analgesic worldwide. It is administered to a wide array of patients including those undergoing major surgeries due to its minimal side effect profile. Previous studies have suggested that 4g/day paracetamol is safe in patients undergoing liver resection surgery, however other authorities recommend that administration be kept at a maximum of 2g/day in patients with hepatic impairment. There is now a growing body of evidence that supports the safety of paracetamol use even in patients with liver disease. However, there are no studies to date that have investigated the haemodynamic effects of paracetamol in patients with chronic liver disease. Recent studies have provided evidence that paracetamol may cause hypotension in critically ill patients, which may have important clinical implications for patients undergoing major surgery. The mechanism for this hypotension is unknown but may be attributable to one the stabilizing compounds found in the formulation, mannitol. Mannitol is a known diuretic and even in small quantities can cause episodes of transient hypotension. There is insufficient evidence evaluating the use of paracetamol in the setting of liver transplantation, and importantly there are no pharmacokinetic studies that evaluate safety and efficacy in this setting. Hypothesis: A single dose of paracetamol (1g IV) has adverse effects on blood pressure in patients with chronic liver disease undergoing liver transplantation surgery. Study aims: To determine whether paracetamol has any adverse haemodynamic effects in patients with chronic liver disease who are undegoing liver transplantation.

The aim of this project is to study whether the oral sensitivity to basic tastes (umami taste, Monosodium glutamate MSG and sweet taste; sucrose) would influence on human eating behavior which include total energy intake, sensitivity to satiety, appetite hormone profiles and salivary flow rate and hormone profiles. The purpose of this project is to improve the understanding of the correlation between taste perception and food eating behaviors.

The General practitioners Antimicrobial Stewardship Survey (GAPS) is a research project funded by the Department of Health which aims to decrease antibiotic resistance in Australia by reducing the antibiotic prescribing rates for Acute Respiratory Infections in primary care. Utilising the considerable expertise from several institutions in Queensland (The University of Queensland, Bond University and Queensland University of Technology) we propose to investigate innovative and cost effective interventions which will lead to a reduction in antibiotic prescribing in primary care. This is a diverse group of experts from clinical and academic fields who work together on research that will translate into a reduction of antibiotic resistance and improved strategies for the appropriate use of antibiotics at clinical and policy level.

Clinical experience and reports from families of children with type 1 diabetes has long suggested that meals high in protein and/or fat cause an increase in blood glucose levels after eating. Increased blood glucose levels, including after consumption of food, is well-known to add to long term health complications in type 1 diabetes. Current type 1 diabetes management guidelines recommend adjusting insulin doses for food based on the amount of carbohydrate to be eaten at each meal. However, there has been an increase in evidence, including that from a recent study by our study group, to suggest that other nutrients such as fat and protein should be considered when calculating pre meal insulin. High levels of protein and/or fat in a meal cause a larger than expected rise in blood glucose levels after eating and these high blood glucose levels persist, suggesting the need for extra insulin. This research project will compare the insulin required to maintain blood glucose levels at a constant level when consuming two meals, one high in protein and the other low in protein. This will be determined by looking at the difference in intra venous insulin requirements after both meals. IV insulin will be given to participants to maintain blood glucose levels at a constant level whilst they are eating the meal and in the 5 hours following. Fifteen participants will consume both a high protein and a low protein meal, at least one week apart. The different insulin amounts needed to maintain blood glucose levels after each test meal will provide accurate calculation of the expected increase in insulin requirements on consumption of a high protein meal. This study will provide important information in the management of type 1 diabetes in both adults and children. This information will be used immediately in our day to day management of patients and will guide the development of clinical guidelines to minimize the rise in blood glucose levels after eating.

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.