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Undesirable tooth movement following orthodontic treatment is common. Retention refers to the period of treatment after your braces have been removed and is required to help prevent teeth from moving back to their original positions. One method of retention is to use removable or fixed retainers (retainers are orthodontic devices that help to keep your teeth in the correct position and they can either be removable or be glued discreetly onto the teeth). The eruption of second and third molars is sometimes held responsible for unwanted tooth movement and many third molars (wisdom teeth) are removed as part of the orthodontic treatment plan (before treatment, as part of or after orthodontic treatment). The delay in removal of the third molars is not uncommon where the third molars are delayed in development. The aim of this study is to compare some regularly used retention regimes and the following will be tested; Whether there is a difference in outcomes between two commonly used maxillary, top teeth retainers, Whether there is a difference in outcomes of two commonly used mandibular, bottom teeth retainers;whether there is a difference between subjects who retain their third molars and those who have their third molars removed at the completion of treatment

This study is designed to assess rate of sexual dysfunction in men following treatment with radiotherapy and surgery for rectal cancer. It aims to identify potential causes of sexual dysfunction in this group of patients, including assessing testicular hormone function following this treatment.

Food cravings frequently lead to consumption of the craved food (Hill & Heaton-Brown, 1994), are positively correlated with BMI (Delahanty, Meigs, Hayden, Williamson, & Nathan, 2002; Franken & Muris, 2005) and obese adults report preferences for high fat foods (Drewnowski et al., 1985), therefore addressing these cravings in treatment is paramount. This study will examine treatment of food cravings in overweight or obese adults. Food craving is hypothesised to be an important intervening causal variable in the development of obesity. Research examining meridian-based procedures (e.g. Emotional Freedom Techniques, EFT) for food cravings has recently found significant improvements occurred in weight, body mass index, food cravings, subjective power of food, craving restraint and psychological coping for participants from pre- to 12-months after a 4-week treatment (p<0.05). This randomised clinical trial intends to extend this work and compare EFT treatment for food cravings, with a gold standard treatment strategy, Cognitive Behavioural Therapy (CBT), in addition to a control group.

The aim of the study is to evaluate the effectiveness of intravitreal Aflibercept in the treatment of choroidal neovascularisation secondary to age-related macular degeneration. The hypothesis of this study is that intravitreal Aflibercept injection may be effective in causing resolution of persistent sub or intraretinal fluid in patients with previous treatment of Lucentis or Avastin.

The peri-operative management of patients on long-term warfarin therapy is a common clinical problem which poses particular problems and uncertainties given the absence of clinical trials. Approximately 400,000 patients are assessed annually in North America for temporary interruption of warfarin therapy for elective surgical or invasive procedures. In Australia, this amounts to approximately 23,000 patients per year, and it is estimated that 700 such patients undergo surgical intervention annually at Southern Health. It is also likely that warfarin will remain the predominant form of anticoagulation for a long time despite the arrival of the novel anticoagulants. For many procedures, patients need to stop their warfarin to avoid bleeding at surgery and resume this postoperatively to prevent thrombosis. The literature does not define a standard of care so that there is considerable variability in how this is achieved with strategies ranging from cessation of warfarin 5 days prior, to “bridging” with heparin therapy when the INR falls below 2. The former approach is simpler but can expose high-risk patients to a significant risk of thrombosis whereas the latter requires timely coordination, and is resource intensive as well as costly. On the other hand, if warfarin is inadequately reversed many elective procedures might be cancelled at short notice inconveniencing patients and wasting valuable surgical operating times. Therefore, there is a need to identify a safe, simple, effective and readily available strategy to reverse warfarin across a broad spectrum of perioperative scenarios. Recently, Burbury et al (BJH 2011) demonstrated that 3 mg of intravenous (IV) Vitamin K (VK1) administered on the eve of surgery is effective and safe at reversing the anticoagulant effect warfarin in most patients. Furthermore, neither warfarin “resistance” nor thrombo-embolism was observed when warfarin was resumed postoperatively (0%, 95%CI: 0% to 2.6%). However, this approach requires the inconvenience of attending an outpatient clinic for insertion of an intravenous cannula for IV VK1 administration. Moreover, there is a small risk (3 in 10, 000) of allergic/anaphylactic reaction with the IV route. Although slower in its onset of action, a few studies have shown that given sufficient time, oral VK1 is as effective and safe in reversing warfarin as IV VK1. The oral dose represents a convenient and cheaper way of administration with minimal adverse reaction when compared to the IV formulation. Moreover, oral VK1 is a convenient way of administration with minimal adverse reaction compared to the IV route. This oral approach, if proven, would simplify pre-operative management of warfarin therapy, and has the potential to improve the care of thousands of patients in the perioperative setting. However, the optimal dose of VK1 that is required to reverse the INR of the majority (95%) of patients without causing warfarin resistance is uncertain. Firstly, we propose a prospective phase 2 dose finding study using pharmacological modeling and simulation to predict the effective dose for oral VK1 capable of reversing warfarin induced anticoagulation in a group of patients who are going to complete a defined period of anticoagulation therapy and therefore at minimal risk. Once an effective oral VK1 dose is identified, we plan to validate this dose in a prospective phase 3 clinical trial involving elective surgical patients.

It is well known that being physically active is important for maintaining good health. However, new evidence has emerged showing that being sedentary (sitting for prolonged periods) is adversely associated with indicators of poor health, such as elevated blood glucose and blood fats. Recent experimental evidence suggests that breaking up sitting time throughout the day with light-intensity activity (ie. walking) results in lower blood glucose and blood fat levels than sitting for prolonged periods without activity breaks. However, it is not known whether short-duration bouts of standing, of comparable frequency, can elicit similar metabolic benefits to those observed with treadmill walking. Consequently, this study aims to test the acute (7-hour) effect of prolonged sitting on glucose metabolism and vascular function with and without intermittent breaks of standing.

The purpose of this study is to determine heart function in pregnant women after they are treated for the disease of preeclampsia. The reason to do this is that the drug treatments that are used to control the high blood pressure in this disease have not been examined with respect to how they alter heart function in these sick pregnant women.

Metformin is a first line drug treatment in overweight patients with type 2 diabetes mellitus and has been used for decades in the treatment of these patients. People with type 2 diabetes mellitus can produce some insulin (which is different from patients with type 1 diabetes who need insulin to survive), but the body tissues are resistant to insulin leading to high blood glucose (sugar) because glucose in the blood is not absorbed. Many people with type 1 diabetes mellitus also have insulin resistance and in addition the insulin therapy that they need to survive often leads to weight gain. Metformin works by decreasing blood glucose (sugar) levels by increasing insulin sensitivity in muscle cells, decreasing glucose production in the liver and delaying glucose uptake from the guts. Metformin also have beneficial effects on weight management and risk of stroke and heart attacks in people type 2 diabetes mellitus. Some studies have found evidence that metformin added to insulin therapy in type 1 diabetes mellitus leads to weight loss and reduced requirement for insulin, but the results are not conclusive. We are conducting this trial to investigate if metformin is useful as an addition to insulin therapy to lose weight, improve glucose control, reduce insulin dose requirement and improve blood lipids in people with type 1 diabetes mellitus.

This study has the primary aim of comparing the effect of foot massage versus a control activity of silent resting on perceived stress levels of care staff caring for people with dementia in long-term care. A secondary aim is to explore the effects on participants’: physiological indicators of stress, including blood pressure (BP), heart rate (HR) and temperature (T); anxiety levels; mood state; somatic symptoms; and experiences of working with people with dementia.

Behavioural changes including agitation occur to a significant degree in up to 90% of people with dementia. This experimental, within-subjects, crossover design study with nursing home residents aims to compare the effects of foot massage and quiet presence on agitated behaviours in people living with moderate to severe dementia in residental care settings.