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To compare fibroptic guided intubation through two supraglottic devices. This is helpful in the management of patients with difficult airways where conventional intubation is unable to be achieved

This study aims to determine how many people who are unsuitable for screening with the faecal occult blood test (FOBT) will take up bowel cancer screening with the new blood test instead. Who is it for? You may be eligible to join this study if you are aged between 50 and 74 years (inclusive), are at higher risk of developing bowel cancer and are unwilling or unable to participate in faecal screening tests for bowel cancer due to either personal or medical reasons. Study details: Bowel cancer screening is typically achieved with a FOBT which detects small amounts of blood in faeces. While this form of screening has been shown to be effective at detecting cancer at an early and more treatable stage, there are many people in the community who are unable to complete the screening test. This can be due to a dislike of sampling from faeces, or due to a condition that causes bleeding from the bowel (such as haemorrhoids) which would interfere with the results of the FOBT. We have recently developed a new form of screening for bowel cancer with a blood test which could provide an appropriate means of testing for these individuals. In our study we will determine how many people who are unsuitable for FOBT testing will take up bowel cancer screening with the new blood test instead. We will also determine what factors may influence their decision on whether to complete a screening test. As part of the study we will provide the participants (and their GPs) with their test result, and advice on further medical investigations should they test positive. A better understanding of how to provide better screening options for people at higher risk for bowel cancer is important and could have significant implications for public health practice.

Residents in aged care facilities are often the frailest in our society. They regularly have issues with cognition which can hinder their decision making capacity and which deteriorates over time. Residents or substitute medical decision-makers (Persons Responsible) often complete advance care plans to help inform future medical decisions in case of clinical deterioration. The residential aged care facility “Goals of Patient Care” form is a medical treatment order based on the patients advance care plan or wishes. This serves as a communication tool for staff in the aged care facility, visiting doctors (regular or locum GPs), ambulance staff and emergency department staff. The form helps guide healthcare decisions made on behalf of the resident in both planned and emergency situations. The form is filled in with the resident, or substitute medical decision maker, if the patient is unable due to presence of dementia. Residents’ GPs will be invited to be involved in the process also. We intend to implement the form in 3-4 pairs of residential aged care facilities. In each pair will be one facility using the intervention and one not using it. We will compare outcomes in both the intervention facilities (using the medical treatment order) and the control facilities (not using the medical treatment order). This comparison will look at residents’ usage of hospital services, including emergency reviews, emergency admissions, length of stay and outpatient reviews, to see the effect “Goals of Patient Care” has on these. We will also gather baseline characteristics on all residents involved including their previous 12 month hospital usage. We will investigate the uptake of the “Goals of Patient Care” form, ability of the residents to make healthcare decisions, presence of dementia without diagnosis in the residents, and death and place of death of residents. Our qualitative outcomes will include improvements in communication, ease of medical decision making and effect on conflict. We will gather data up to 12 months after the implementation of the form. We will survey the healthcare workers prior to implementation, and organise focus groups and brief interviews to investigate our qualitative outcomes with the healthcare providers involved at 6 and 12 months.

Diet and lifestyle change are key elements of the management of blood sugar levels and blood pressure in those with type 2 diabetes. There is growing evidence that foods containing lupin could make a positive contribution to management of diabetes. Lupin can be used as a novel food ingredient. It is rich in protein and fibre and contains negligible sugar and starch (glycaemic carbohydrate). It can be incorporated into foods such as bread to reduce the glycaemic (blood sugar raising) carbohydrate. We will conduct an intervention study in type 2 diabetic subjects to investigate the effects of regular consumption of lupin-containing foods on short-term control of blood sugar levels, blood pressure and attention and memory.

This study will examine the role of exercise in optimising asthma management. We will compare and contrast the effects of two exercise intensities: a single exercise session at a moderate-intensity (i.e. exercising at the level of a brisk walk or dancing) versus a single exercise session at a vigorous-intensity (more exhaustive, i.e. at the level of running or playing soccer). We will also compare these two exercise types with no exercise (control condition). We anticipate that while moderate-intensity exercise will be beneficial to asthma, the effects of vigorous-intensity exercise are unknown. We will collect sputum samples from 60 adults with asthma, both before and 4 hours following their exercise or rest session, and blood samples before, and 2 and 4 hours following the exercise or rest session. These samples will provide a direct measure of inflammation and antioxidants, both in the airways and bloodstream, thus enabling us to quantify the benefit or consequence of each type of exercise on inflammation in adults with asthma.

Diabetes results in an increase in the stickiness of platelets, which may result in blockage of arteries and other cardiovascular diseases. This is usually prevented with conventional cardiovascular medication (most commonly used Aspirin). Aspirin is a commonly used antiplatelet therapy (blood thinner) for patients with cardiovascular disease. However, it has greatly reduced efficacy in diabetes. This project is being conducted to evaluate an alternative to aspirin such as anthocyanin which is an antioxidant that has been shown to reduce narrowing of arteries. This study will compare the protective effects of aspirin with anthocyanin supplement, which is a rich natural antioxidant, on platelet (blood cells involved in clotting of blood and when not functioning normally can lead to risk of cardiovascular diseases such as stroke, heart attack or other heart diseases) function and activity as well as lipid (cholesterol and other fats) profile and inflammation. Any decrease in platelet activity and improvement in lipid profile and inflammation following the treatment will be suggestive of decreased thrombotic (narrowing and blocking of arteries responsible for heart attack and strokes) tendency and risk of heart disease in patients with diabetes. One hundred participants from 4 groups (normal healthy, diabetes with history of cardiovascular diasese, diabetes without cardiovascular disease and pre-diabetes populations) will consume either aspirin tablets 81 mg/day (1 tablet daily) or 320mg (4 tablets daily) anthocyanins (antioxidants from billberries and blackcurrant) for four weeks each as first treatment. they will then take second treatment after 4 weeks washout period. The fasting blood and urine sample will be collected at the baseline and post first treatment and again pre and post second treatment. Each blood sample will be tested for full blood examination, 3 different types of platelet function tests, coagulation profile, inflammation marker, HbA1c, lipid profile, uric acid and full blood + urine antioxidant levels and microalbumin. The data from this study will be used to guide management of antiplatelet and anticoagulant therapy more effectively in this population.

This study aims to investigate the side effects, safety, and effectiveness of combining dabrafenib and trametinib with radiotherapy in treatment of BRAF V600E/K mutation-positive melanoma. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have received dabrafenib and trametinib (for 2 weeks or more prior to enrolment) for treatment of BRAF V600E/K mutation-positive melanoma that is either Stage IIIC (unresectable) or Stage IV (metastatic). Study details: Melanoma that has spread to other parts of the body may benefit from radiotherapy to help reduce symptoms from melanoma. Previous studies have shown that melanoma may be sensitive to radiotherapy and that it can help to improve quality of life. All participants in this study will receive palliative radiotherapy concurrently with their dabrafenib and trametinib treatment. The radiotherapy dose, frequency and duration will be determined by your treating radiation oncologist and dependent on the location and size of your tumours. Up to 3 areas of disease can be irradiated at the same time. Regular follow up visits will be performed up to 12 months to monitor patient response and any toxicities experienced. CT scans will also be performed every 8 weeks to monitor response to treatment.

Menopause is a natural transition in every woman’s life, marking the end of fertility. Some women transit with little or no symptoms, while others suffer from the mood swings, hot flushes, insomnia and ‘brain fog’, which can last for many years. Eventually, these menopausal symptoms will disappear or lessen in intensity post-menopausally but there is nothing to celebrate. This is because women will no longer have the heart protective benefits of estrogen (a hormone that regulates menstruation). Reduced production of estrogen increases a woman’s risk of osteoporosis, heart disease, high blood pressure, stroke and dementia. These disease conditions are closely related to poor blood circulation; estrogen targets the blood vessels to promote blood flow to tissues and organs like our heart, lungs and brain. Our brains require the effects of estrogen to increase blood flow to specific regions responsible for memory and learning. When circulating estrogen levels fluctuate they alter blood flow to the brain, triggering mood swings, irritability and poor mental performance (brain fog). It is believed that a persistent decrease in blood flow to the brain marks the start of brain function decline. Hormone replacement therapy (HRT), or estrogen therapy, is effective in reducing menopausal symptoms; some post-menopausal women continue HRT indefinitely. Estrogen can positively affect mental abilities such as concentration, memory, reasoning and reaction time. Resveratrol is an ingredient found in grapes and berries that has multiple benefits for heart health. It can work through multiple mechanisms including mimicking the action of estrogen on blood vessels to improve circulatory function, thereby having the potential to increase blood flow in the brain and enhance mental abilities and mood. We aim to determine if regular resveratrol supplementation can enhance blood flow response to cognitive demands in specific regions of the brain and thereby improve mood and mental abilities such as short-term memory and the ability to concentrate better in postmenopausal women (at least 6 months after ceasing menstruation). Blood flow to the brain will be measured non-invasively with ultrasound. We will also use surveys to monitor their mood, sleep, quality of life (including chronic pain) and menopausal symptoms during the study.

ATL1103 is being developed as a potential treatment for acromegaly, a disease of excessive growth hormone and insulin-like growth hormone (IGF-I) action. Approximately four acromegaly patients will receive 300mg ATL1103 twice a week for 13 weeks. All treatments will be administered by subcutaneous injection. The primary objectives of the study are to evaluate the safety and tolerability of a high dose of ATL1103, and to investigate the pharmacokinetic profiles of ATL1103. The effect of ATL1103 on serum IGF-I levels and on other pharmacodynamic markers will also be measured.

This feasibility study will determine the local effects of thermal vapour ablation of operable cancer lesions in the lung. Who is it for? You may be eligible to join this study if you are aged 18 to 75 years and have been diagnosed with non-small cell lung or metastatic lung cancer suitable for resection. Study details: All participants will receive one treatment of thermal vapour ablation via a bronchoscopy procedure before undergoing surgical lung resection within 3 days of the thermal vapour ablation treatment. Resected tissue will be examined to determine effectiveness of treatment. Participants will be followed-up according to standard lung resection procedures. Official study follow up is completed once the resection occurs but patients will be monitored for Adverse Events in the standard lung resection follow up procedure, in order to determine efficacy, safety and feasibility of the study.