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There is increasing evidence that nutrient stimuli in the gut, especially in the small intestine, induce changes in gut motor and hormonal functions that play a central role in the control of energy intake and blood glucose. Previous research by our group has shown individual amino acids (L-tryptophan) and free fatty acids (lauric acid) to markedly reduce energy intake at a subsequent meal when administered intraduodenally or orally, respectively. This study aims to investigate the effects of the amino acids L-leucine, alone or in combination with L-tryptophan or lauric acid, on gut motility, gut hormone release, blood glucose control and energy intake in healthy lean individuals and obese patients with T2DM. We hypothesise that L-leucine, administered in combination with L-tryptophan or lauric acid, will take advantage of the several pathways activated by these two classes of nutrients enhancing their potency and thus, resulting in a marked improvement in the beneficial effects on gut functions and energy intake regulation previously associated with these nutrients alone.

Mindfulness-based intervention programs are a promising intervention in the treatment of psychological distress in a range of clinical populations including pain disorders, cancer and other medical problems. There is, however a paucity of studies that have examined mindfulness in people with diabetes. The few studies that have been undertaken have shown the intervention to result in improvements in emotional well-being (anxiety and depression), improved self-care behaviours and decreased HbA1c values. This study will assess the effects of a mindfulness-based intervention undertaken and self-directed in people with diabetes at home over an eight-week period. This study will seek to determine whether a mindfulness-intervention undertaken in the patients’ home can: Reduce anxiety and depression Reduce perceived diabetes –specific stress Improve diabetes self-care and management Improve glycemic control (HbA1c) Increase mindfulness strategies (acceptance and action) in relation to diabetes

Participation in the workforce is often not possible for people who have sustained a severe traumatic brain injury (TBI). Furthermore, a large proportion of those who are unable to return to work also do not engage in any meaningful occupation in lieu of work. Such people generally have sustained major impairments of the cognitive functions essential to the development of meaningful occupational activities; specifically the ability to plan, initiate action, and to monitor and/or sustain activity. They often require structure and support if they are to develop a program of meaningful activities. This project specifically addresses the issue of diminished meaningful occupational activity for those who have sustained a TBI and are unable to return to work. Using single case experimental design methodology this study will provide individual intervention specifically aimed at increasing the person’s engagement in meaningful activity.

The cocooning strategy, which was implemented in Australia in 2009, can have a strong protective effect (indirect) against pertussis in infants. To achieve high maternal coverage, understanding maternal attitudes and other potentially influential factors is important. In this study, we examined the influence of baseline attitudes, modifiable factors and health message framing on pertussis booster vaccine uptake among postpartum women in the public hospital setting.

Betahistine dihydrochloride administered off-label intranasally is an experimental drug being investigated for its potential as a treatment for otitis media with effusion for this clinical trial. lt is hoped that this information will lead to improved clinical management of this condition.

Vitamin D deficiency is prevalent in the elderly and Vitamin D status has been correlated with cognitive performance in a number of epidemiological studies. However, the potential benefit of correcting Vitamin D status on cognition is unknown. The Vitamin D content of mushrooms can be increased to biologically useful levels by a short exposure time to UV light. The aim of this study is to determine if increasing vitamin D status by consumption of either Vitamin D2-enriched mushrooms (VDM) or Vitamin D3 supplement, will improve cognitive function and affect depressive symptoms in healthy aged people (Primary Outcomes). Controls will include a placebo and also standard mushrooms (low Vitamin D) so as to resolve the effects of Vitamin D2 per se from other mushroom-derived nutrients, including micro-nutrients and neurotrophic factors, which have some evidence for benefits to cognition per se.

The study is evaluating the feasibility of an E-Health eating and nutrition intervention (called ENeRgy-KIDS) for children after cancer treatment. Who is it for? Parents/carers and their children may be eligible to join this study if the child has been treated for childhood cancer at Sydney Children’s Hospital within the previous 5 years, and is aged 12 years or less. The child should also have been clinically identified as having a maladaptive feeding behaviour of 'fussy eating' post cancer treatment. Trial details All eligible parents/carers and their children will receive the ENeRgy-KIDS intervention. This is a parent and child targeted E-health diet and feeding behaviour program. The program consists of weekly, 90 minute E-Health treatment sessions, delivered over 6 weeks to provide diet education specific to the needs of childhood cancer patients after cancer treatment. The program will include information on how to manage child feeding behaviors, evidence-based best feeding practices by parents, healthy nutrition/diet after cancer treatment, medical long term effects of cancer treatment, healthy lifestyle now and in the future and goal setting. The program will also consist of a 15 minute child component that will deliver nutrition information and feeding therapy techniques through fun messy play and workbook activities. Children will undergo dietary assessment and body composition measurements at enrolment, at the end of the program, and 3 months later in order to assess the feasibility of the intervention. Parents will provide information on their child’s eating behaviours and diet at enrolment, at the end of the program, and 3 months later in order to assess the feasibility of the intervention. Parents will also provide information on how useful and easy to use the program was at the end of the program.

A limited amount is known about the key determinants of the health and social outcomes for people who have sustained an injury as a result of a land transport crash and, in particular, the extent to which determinants specifically related to the compensation process are relevant. The proposed investigation will seek to: 1) Identify individual and system factors influencing the health and social outcomes of people who have sustained an injury related to a land transport crash and who seek compensation through a compulsory third party (CTP) compensation scheme; 2) Identify individual and system factors influencing the health and social outcomes of people who have sustained a non­compensable injury in a land transport crash in NSW; 3) Identify the key factors that explain the differences between those who apply for compensation and those who are eligible to apply but do not. There are a number of domains, which relate to the individual and the system, which will be explored: ­ Characteristics related to the individual that influence the likelihood of applying for compensation ­ Characteristics related to the health service experience process ­ Characteristics related to the claims process ­ Characteristics related to the liability and fault process ­ Characteristics related to the legal representation process The study will utilise an inception cohort design, with a sample size of 1,500 participants aged 17 years or older, who are injured as a result of a crash involving a motorised vehicle in NSW and who have been diagnosed with an injury within 28 days of the crash. Recruitment will be through metropolitan and rural hospital emergency departments, general practitioners, physiotherapy clinics, police crash records and the Motor Accidents Authority claims database. People with severe injury, those unable to give consent due to cognitive impairment, those with minor localised soft tissue injury, those with a self harm related injury or those where a family member has died as a result of the crash, will be excluded. Data about health and social recovery outcomes and variables that potentially influence these outcomes will be collected by questionnaire administered by telephone or by written questionnaire for people who are deaf or prefer to complete a written questionnaire. There will be a focus on key variables identified in the literature that are associated with health outcomes. The questionnaire will be no longer than 45 minutes and be conducted at baseline (within 28 days of the motor vehicle crash), 6, 12 and 24 months post­injury. Detailed statistical analyses will explore the associations and interactions between the measured variables and health and social recovery outcomes.

The aim of this study is to assess whether exercise combined with advice is more effective than advice alone in reducing the incidence of lymphoedema following surgery for gynaecological cancer. Who is it for? You may be eligible to join this study if you are a female aged 18 years or above who is scheduled to undergo inguinal or pelvic lymph node dissection for gynaecological cancer management at Monash Medical Centre, Moorabbin campus. Trial Details Participants in this study will be randomly (by chance) allocated to one of two groups. Participants in one group will undertake a lower limb exercise programme and receive advice about the prevention of lymphoedema. The exercise programme will be taught by a physiotherapist and then completed by the participant in their own home. The exercises will take 15 minutes to complete twice a day for a 3 month duration. A rubber exercise band will be required for some of the exercises and will be provided by the physiotherapist at no cost to the participant. Participants in the other group will receive advice only. this is provided by the physiotherapist in an education leaflet which details strategies for reducing the risk of triggering lymphoedema e.g. skin care, weight maintenance etc Participants will be assessed pre-operatively, at 1 month post-operatively, and then at 6 weeks after chemotherapy or radiotherapy or at 3 months if no adjuvant therapies are required. The assessments will involve measurements of lower limb volume and completion of a quality of life questionnaire

The main aim of this study is to investigate whether increasing the amount of physical activity results in better mobility outcomes in frail, older people. This study will be performed during hospital based rehabilitation and will be compared to mobility outcomes resulting from usual care. A second aim is to investigate whether this physical activity intervention results in improvements in quality of life. Finally we plan to investigate whether increasing the amount of physical activity during rehabilitation is cost effective. Participants will be recruited from two Victorian hospitals which offer inpatient rehabilitation to older adults. Older people receiving inpatient rehabilitation will be randomly assigned to an intervention group or a control group. The intervention group will receive extra physical activity on weekdays and weekends while the control group will receive additional social interaction. Both groups will be assessed at baseline, discharge from hospital and at 6 months. The primary outcome for this study is gait speed, as measured by the 6 metre walk test. Other outcomes relating to mobility, function and quality of life will also be assessed. At the end of the study a health economic analysis will be performed to assess whether the extra physical activity provided was cost effective, all factors considered.