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Liver transplantation is established as the most effective therapy for patients who have end stage liver failure. Criteria to measure therapeutic success from a medical perspective are well established. Recently more attention has been focused upon quality of life issues - including societal reintegration, community engagement and employment, and their relationship to medical outcomes. At Sir Charles Gairdner Hospital there have been 223 patients who have received a liver transplant since 1994. This study will include all liver transplant who have received a liver transplant between 1994 and 2008. The aim of this study is to identify the relationship between specific psychosocial factors and the patient’s return to employment following liver transplant. The psychosocial factors to be addressed have been categorised into three groups, ‘interpersonal’ ( e.g. family and social support, strengths), ‘intrapersonal’ (e.g. motivation level, self esteem, evidence of depression ) and ‘environmental’ (e.g. income, housing, education). Patients will be asked questions in relation to these factors; the analysis will determine the degree of relationship between the factors and the incidence of return to work following transplantation. Hypotheses: Patients who have positive psychosocial influences will be more likely to return to employment post transplant. We plan to interview all patients who have had a liver transplant. Outcome measures include: Questionnaire covering demographic data, pre and post transplant employment details, income and educational levels. The questionnaire will also address psychosocial factors, which may influence return to work.

Falls are a significant cause of injury and death in the population aged over 65 years. Following a fall, people often report they have become fearful that they will fall again and restrict their activities in order to try to reduce their perceived risk. As a result, a previously active person may become housebound or restrict outdoor activities to essential chores, such as General Practitioner visits. Such behaviour does not necessarily reduce the risk of another serious fall and can lead to the person becoming depressed, frailer and having a much higher likelihood of being admitted to residential care. Recent research has shown that exercise is an effective way to reduce participants’ risk of falls and also to keep people on their feet and doing the activities which they enjoy. There is uncertainty about the exact nature that the exercise component should take. Many programmes use a combination of balance and strength-based exercises to train for better balance. However new research has suggested that training on variable surfaces may be a better way to develop balance skills and reduce the risk of falls. To test this idea, this study will assign participants to two different exercise groups. Participants will attend weekly one hour sessions of the exercise group to which they have been randomly assigned for eight weeks. Measurements of balance, level of falls risk, fear of falling and actual number of falls experienced will be taken prior to commencing the programme and at the end of the eight week course. Researchers will then be able to examine whether the novel exercise regimen is more effective than the traditional form of exercises for reducing falls and fear of falls, and improving balance capacity. Treatment of falls-related injuries such as a broken hip is costly not only to the health service but also to the affected person, so any preventative strategy that enables at-risk individuals to develop higher levels of balance within an eight week period will be welcomed by clients, clinicians and service providers alike.

Effect and effect mechanism of neuromagnetic treatment for pain of knee osteoarthritis. Application of neuromagnetic devices for decreasing pain and increasing function of participants suffering from mild to moderate osteoarthritis of the knee.

It is not clear whether children with asthma should be advised to avoid feather pillow and quilts in case feather bedding makes asthma symptoms worse. Some exploratory studies have suggested feather bedding might actually be better for children with asthma. The trial was designed to assess whether a new feather pillow and quilt was associated with a reduction in asthma severity among house dust mite sensitised children with asthma over a one year period compared to the use of non-feather bedding

Women requiring hormonal contraception who have consented to enter the study will complete a menstrual attitude questionnaire and undergo physical and gynaecological examination and routine haematological and biochemical tests before being randomly assigned to continuous ring or pill use. Women will maintain menstrual diaries for the 12 month study duration. If a bleeding/spotting episode excedes 4 days they will stop their method for 4 days and restart on the fifth day. Women will be contacted monthly to ensure compliance and will be seen at 2 months, 6 months and 12 months from randomisation for follow up At each visit the women will complete an acceptability questionnaire and a menstrual attitudes questionnaire at the final visit.

Continuous passive motion (CPM) machines, which move the leg up and down, are often used for patients who have had knee replacement surgery to improve knee movement. Studies have shown CPM does not improve knee movement or function if used routinely for all patients who have had knee replacement surgery. In this study we want to find out whether or not CPM is beneficial for patients who are slow to regain knee movement after knee replacement surgery, compared to standard physiotherapy treatment without CPM. Our standard practice at the Royal Adelaide Hospital is to use CPM only for those patients who are slow to regain knee movement after knee replacement surgery but no studies have investigated the use of CPM in this setting.

The effectiveness of psychological treatments for depression in People with epilepsy (PWE) is currently unknown, although there are some encouraging results to suggest that Cognitive Behavioural Therapy (CBT) might have a useful role (Ramarantnam, Baker, & Goldstein, 2008). This study aims to assess the effectiveness of a CBT intervention to improve Quality of Life (QoL) and mood in people with epilepsy. This study will be the first to help us to assess the effectiveness of CBT interventions in an Australian sample to improve quality of life and mood in PWE. In addition, it will help us to develop an understanding of two important additional questions: do particular sub-groups benefit more than others from CBT and what are the mechanisms of treatment change? The costs of depression in epilepsy are high both for the individuals concerned, in terms of quality of life and seizure activity, but also for society due to greater economic and health care costs in those with untreated depression and epilepsy (Cramer, Blum, Fanning, & Reed, 2004). Neurologists report that they tend not to screen for depression due to lack of available resources for its treatment (Gilliam et al., 2004), and so the development of an effective and available local service may increase the overall rates of detection and treatment in this group.

Removal of the laryngeal mask airway can be performed while children are still deeply anesthetized or when they are awake (as defined by eye opening, grimacing, coughing, and purposeful movements). Each technique has its own advantages and disadvantages. In healthy children, it has been shown that there are no clinical differences between removal of the laryngeal mask airway in the awake state vs anesthetized state. In patients with a high risk of developing a postoperative respiratory problems (e.g. coughing) such as those with asthma, it may be preferable to remove the laryngeal mask airway while the patients are still anesthetized to avoid airway stimulation and consecutively bucking, coughing and bronchospasm. The results of a recent large prospective cohort study at our institution with over 9000 children allow to identify children with a high risk for developping postoperative respiratory complications. The aim of this present randomized controlled trial is to assess whether children at a high risk for respiratory problems benefit from anethetized removal of the laryngeal mask airway as compared to awake removal of the laryngeal mask airway following adenoidectomy. We hypothesize that children with a high risk for respiratory problems defined by the presence of either airway susceptibility, eczema or a positive family history who have their laryngeal mask airway removed deeply anaesthetised will demonstrate less respiratory problems compared with high risk children who have it removed awake.

We will recruit ACS patients who exhibit signs of depression from six hospitals, randomise them to MOOD-CARE or usual care (UC), and follow them for up to 2 years. MOOD-CARE is a state-of-the-art telephone counselling program which has the potential to improve psychological, physical, social and vocational functioning; reduce demands on the health system; and potentially, to extend survival for the growing number of Coronary Heart Disease patients in Australia.