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Accurate fluid management in the peritransplant period is crucial. In many cases the donor renal allograft will have established acute tubular necrosis due to prolonged cold ischaemic time and will therefore have delayed graft function. A common complication of transplant surgery is over aggressive fluid replacement in a patient who is essentially anuric which may precipitate pulmonary oedema requiring urgent dialysis. On the other hand, inadequate volume replacement in a renal allograft recipient who has immediate graft function can result in hypovolaemia and potentially delayed graft function. The ODM has been used in case series of renal transplantation demonstrating efficacy and safety. This prospective, randomized trial looks at goal directed fluid therapy using the oesophageal doppler monitor versus standard of care fluid therapy in renal transplant patients to determine if there is a reduced length of stay and reduced incidence of delayed graft function.

Background: With the popularity of sports involving contact or collision worldwide, there is an obligation of health care professionals to focus efforts on the better detection, prevention and treatment of the potentially damaging neurological, social, and psychological effects of sports related concussion. Chronic Traumatic Encephalopathy (CTE) is one potential consequence of a career in collision sports but very little knowledge regarding the the onset and progression of the clinical manifestations of CTE is known. The current study seeks to examine this issue amongst current and former professional football players within the National Rugby League (NRL) in Australia. Methods/Design: This is a cross-sectional, prospective study utilising a sample of current (n=30), short-term retired (<10 years, n=30) and long-term retired (10yrs+, n=30) players who will be recruited through their club, or former club to undertake neurological, psychological and cognitive testing, although with ApoE genotyping, balance testing and olfactory stress testing. Initial baseline assessments will be conducted with a subsequent follow-up/review assessment conduted at 18-24 months post-baseline. The primary outcomes (objective cognitive perfromance, neurological examination, psychological questionnaires and neuroimaging data) will be correlated and compared to each player's exposure to concussive injury. Discussion: This study will provide information about the potential cognitive, neurological and psychological consequences of a career in collision sports and may help to identify potential at-risk characteristics for the development of long-term consequences, such as CTE. This study may have far-reaching application in terms of modifing exposure rates through mandatory rest periods or governing body rule modifications.

Infants born very prematurely (under 30 weeks gestation) often require support with their breathing after birth as their lungs are stiff and they find it hard to fill them with air. In order to help infants breathe we use a flow of gas (oxygen and air) to provide pressure to help open their lungs. In this study we are comparing whether it is better to use a gas flow that has been warmed and moistened (humidified), compared to the standard method of using gas directly from the cylinder or wall (unconditioned). Humidifying gases is routine within the setting of the neonatal intensive care but is not extended to use in the delivery room setting. The purpose of this study is to find out whether the use of humidified gases in the delivery room is better in helping premature infants stay warm immediately after birth. The primary outcome will be measurement of rectal temperature on admission to the neonatal and intensive care unit (NISC).

To assist clinical decision making pre-operatively in renal failure patients having fistula formation, using a trans-thoracic echo, in order to improve patient well-being post-operatively

All patients presenting for PICC line insertion will be offered follow-up in this audit of Nurse led PICC insertion at the RMH. Time of insertion, success, complications and patient satisfaction will be measured and this data will be compared to same data subsets acquired from same patient population in 2008, but when the service was physcian led.

Posttraumatic stress reactions have been indetified as a predictor or poorer outcomes for individuals with whiplash injury in longitudinal studies and poorer response to physical therapy in previous research. This study aims to investigate whether or not stress innoculation training added to standard exercise program will decrease pain and disability in people with acute whiplash injury. It is hypothesised that stress iccoculation will decrease physiological arousal and stress reponses in those at risk individuals and thus facilitate the effects of the exercise program.

The purose of this study is to understand how well oxymorphone in combination with tocopheryl phosphate mix (TPM), is absorbed through the skin and into the bloodstream, with the use of a patch.

Although cognitive-reminiscence approaches to the treatment of depressive symptoms have been shown to be highly effective in older adults, to date no studies have determined its efficacy with younger adults. The current study aims to trial a manualised and validated cognitive-reminiscence intervention for depressive symptomatology with young adults. This intervention utilises both cognitive and problem-solving therapy frameworks within a reminiscence-based approach. Individuals systematically review various events, circumstances, and turning-points in their lives while learning adaptive techniques for appraising and interpreting themselves, others, and the world, and applying these techniques to present-day issues. Individuals over the age of 18 who present at a community youth mental health services in Melbourne with elevated depressive symptoms will be recruited and randomised to either six sessions of individual cognitive-reminiscence intervention or treatment as usual. Outcomes in both groups will be assessed by measuring depressive symptomatology, self-esteem, self-efficacy, and meaning in life at baseline, three weeks, six weeks, and one and three month post-treatment. The intervention is predicted to lead to significant reductions in depressive symptomatology.

Transcatheter Aortic Valve Implantation (TAVI) offers an exciting management option for patients with severe aortic stenosis, many of whom are considered too high-risk for traditional surgical aortic valve replacement (SAVR). It has been noted, however, that patients undergoing TAVI have an increased rate of stroke compared to those undergo in alternative management options (namely, medical therapy and SAVR). In these high-risk patients the functional, quality of life and mortality improvement of TAVI outweigh this risk and thus TAVI has had a favourable risk-benefit analysis. As TAVI practice extends in to lower-risk and younger populations, as is being seen in many of the large studies currently recruiting, this risk-benefit analysis may shift due to the better outcomes with SAVR in this group. A better understanding of stroke and neurocognitive impairment in TAVI is required to characterise and understand this risk better allowing for more accurate risk assessments and highlighting strategies for stroke minimisation.

The operation of inguinal herniorraphy is associated with long term pain in 10-12% of patients.There are various factors that might influence the development of chronic post surgical pain after inguinal herniorrhaphy. Using quantitative sensory testing maybe a way to predict the occurrence of chronic post surgical pain syndrome