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Surgery is the standard treatment for melanoma that has spread to nearby lymph glands, but it sometimes recurs despite surgery. Radiotherapy given soon after surgery may redue the risk of the melanoma coming back, but mat also cause side effects. This national randomised trial will determine the benefits and side effects of adding radiotherpay after surgery.

While positive end expiratory pressure (PEEP) is always used during intermittent positive pressure ventilation (IPPV), there are no current recommendations about the use of PEEP or continuous positive airway pressure (CPAP) during neonatal resusciation. The Neopuff is a manual ventilation device which delivers PEEP or CPAP. The Laerdal bag is the commonest manual ventilation device in use worldwide and does not deliver PEEP. Our hypothesis is that the delivery of PEEP or CPAP to very premature infants at birth may lead to a more rapid improvement in lung volume and therefore oxygenation.

A key goal in our research is to develop an empirically validated, cost effective psycho-educational coping program to improve pyshcoloigcal and physical adjustment for women with breast cancer and their nominate support persons.

Patients with type 2 diabetes are at risk of developing cardiovascular disease. Lifestyle changes and an exercise program may reduce damage to the structure and function of blood vessels and improve heart function. In this trial, subjects with type 2 diabetes will be randomly assigned to one of two groups – “Usual care” (ie standard treatment of diabetes according to guidelines) or “Active intervention” (additional measures such as frequent follow-up, additional dietary advice and an exercise program, in addition to usual care). The efficacy of these interventions on cardiovascular structure and function, exercise capacity, attainment of target biochemistry and outcome will be assessed after 1 month, 1 year and 3 years

Not all of the heart muscle involved in a heart attack is irreversibly damaged. Although bypass operations may lead to improvement in the function of this tissue, the procedure is risky for very many patients who are elderly or sick from other conditions. A number of pieces of evidence suggest that this damaged but viable tissue can be improved by drugs that optimize the use of oxygen in the muscle cells. We will study patients with damaged heart muscle, using one particular agent (perhexilene) that is produced in Australia. We anticipate that therapy will improve regional and global function of the heart, prevent enlargement and improve exercise capacity, and that these changes will correspond to the effects of the drug on cardiac metabolism. This study is based on particular strengths in measurement of regional and global function and use of cardiac magnetic resonance to improve our understanding of the effect of the amount of scarring.

The primary purpose of this study is to test whether intramuscualr methadone-naloxone in a 50:1 ratio precipitates withdrawal in opioid dependent individuals.

The DAISI project is investigating treatments for comorbid depression and alcohol use disorders. Specifically, this project aims to directly compare the effectiveness of four approaches to psychological treatment with varying emphasis on depression and alcohol use. Four programs of Cognitive Behaviour Therapy (CBT) and motivational interviewing will be delivered, and outcomes compared over a 3-year period: (i) 10-sessions of CBT that targets depression only (CBT-Dep); (ii) 10-sessions of CBT that targets alcohol use only (CBT-Alc); (iii) 10-sessions of CBT that targets depression and alcohol use concurrently (CBT-Int); and (iv) Brief intervention that targets depression and alcohol use concurrently (BI - control). It is hypothesised that this research will result in the development of an effective treatment program for people with comorbid alcohol and depressive disorders. We further hypothesise that the integrated CBT (CBT-Int) will produce greater, more sustainable reductions in both depressive and alcohol use outcomes relative to the other treatment conditions at the post-treatment follow-up assessments. The knowledge obtained through this research would assist counsellors in the field of alcohol and other drug treatment and mental health professionals to choose the most appropriate treatment for their clients who present with this comorbidity.

More than 50% of patients requiring surgery for enlargement (aneurysm) of the aorta or narrowing of the carotid or limb arteries have coexistent coronary disease. Indeed, cardiac problems account for the majority of operative complications in patients undergoing vascular surgery. Individuals who have a low cardiac risk from these operations can be identified by clinical evaluation, especially if a stress test is negative. However, if a test is positive, the risk of having a cardiac complication is <20-30%. The optimal response to this finding is still unclear. In this situation, patients are often referred for bypass surgery or coronary balloon angioplasty in order to treat their coronary disease. However, this approach may be inappropriately aggressive, as 70% or more of the patients will undergo their vascular surgery uneventfully. Moreover, patients with vascular disease are often elderly, and have other diseases that make heart operations more difficult and risky than usual. An alternative is the use of medical therapy to protect the heart, but the efficacy of this approach in reducing peri-operative complications is debated. This multicentre study, based at hospitals in the mainland capital cities of Australia, will examine patients with a positive stress test, and then use the results of the test to identify high and intermediate risk levels. Patients will be excluded from the study if the stress test is strongly positive, and a heart operation is definitely in the patient's best interests. In other situations, where the best approach to therapy is unproven, patients will be randomized to a regimen involving intensive medical therapy to protect the heart, or coronary angiography with the intent of myocardial revascularization if possible. Patients will be followed up for events of the time of surgery, and outcome (including quality of life) will be assessed six months after the operation.

This is a 5-year randomised, double blind, placebo controlled study to evaluate the relative benefits of vitamin D and calcium supplementation and calcium alone compared to placebo on hip bone mineral density and bone related biochemistry in ambulant elderly Western Australian women aged 70-80 years at baseline.

This study will explore the clinical significane of interactions between commonly used herbal medicines with the anti-coagulant warfarin. In total 5 independent three- treatment cross over randomnised clinical trials will be conducted with similar study design. In each trial 2 herbs will be studied.