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The use of umbilical cord blood (CB) as a source of haemopoietic stem cells (HSC) for transplantation is increasing. Advantages of using CB compared to other sources of HSC include a reduction in search time and procurement, a low risk of transmission of viral disease and a reduced incidence of graft versus host disease. Delayed engraftment, due to the low cell number in CB grafts, has emerged as the limiting factor to more widespread use of CB as a source of HSC. Transplantation of multiple CB units is one approach to overcome low cell numbers and preliminary results are encouraging. In this study, patients with high risk haematological malignancy who require a HSC transplant but do not have a related or unrelated donor will receive a double unit CB transplant. The study hypothesis is that transplantation of two cord blood units is feasible and safe to administer.

Decisions about admission to residential care are being made in the acute hospital and at a time of crisis due to a sudden deterioration in the older person’s ability to self-care and/or the informal care support system becoming overwhelmed. Decisions involving the transition from home to nursing home or hostel accommodation are complex due to the involvement of the patient, their next of kin or family and medical and allied health professionals. There are many factors that contribute to the decision to move and the importance of these factors may differ for each person. This study seeks to explore the issues and tensions around movement into residential care and identify the key factors in the decision, from the perspective of older people admitted to the RGH and their carers. This will be achieved through short, semi-structured interviews with patients, carers and ward staff.

This is a clinical trial for patients with prostate cancer. The aim of the project is to provide information about the best timing to start treatment in men who have a rising PSA (prostate specific antigen) blood test, after having had treatment with the aim of curing their prostate cancer. In some men, the surgery or radiotherapy given initially in the attempt to cure the cancer is not successful. One of the earliest ways of detecting recurrence of the cancer in these men is with the PSA blood test, which can detect activity of the cancer months or years before other tests, and usually long before any symptoms appear. We know that treatment with hormone therapy – removing the male hormone testosterone – is helpful in controlling advanced disease causing symptoms, although it is not a cure. This is called ‘androgen deprivation’, testosterone being an androgen hormone. The cancer cells are deprived of a source of energy, keeping them under control for a while, but eventually they tend to start growing again in spite of the treatment. We know that using androgen deprivation usually causes the PSA level in men to fall, including men in your situation who have no other signs of active cancer. What we do not know is whether using androgen deprivation immediately the PSA starts to rise will prolong life more than waiting to start treatment until there are other signs that the disease is progressing. It would be simple to start everyone on treatment with androgen deprivation if there were no side effects with the treatment. However, there are a number of side effects that may interfere with day-to-day living. These include (but are not limited to): hot flushes, tiredness, anaemia, and loss of muscle mass and bone density. There may be weight gain, and nipple tenderness or swelling. Some men notice changes in mental function, or shortness of breath. Most also find that sex drive and erectile function, if normal before starting treatment, cease. Quality of life may be affected. If androgen deprivation therapy is ceased, some of the side effects (such as loss of sex drive, loss of muscle bulk or bone mineral density) may be halted or reversed. Generally the standard approach would be to delay introducing treatment until the disease progresses. So the purpose of the study is to see whether immediate treatment is better or worse than delayed treatment in terms of prolonging lifespan, balanced against the effects on the quality of life.

This study was for patients who had advanced carcinoma of the ovary. The clinical trial compared carbo/cisplatin and cyclophosphamide chemotherapy alone with carbo/cisplatin and cyclophosphamide chemotherapy with the addition of 5 years of tamoxifen hormone treatment. The combination of carbo/cisplatin and cyclophosphamide was the standard treatment for advanced ovarian cancer. Tamoxifen showed marked activity against ovarian cancer when used on its own but it was not known if adding it to the standard treatment would improve disease free survival. Patients were randomly assigned to one of the treatments to assess if either would be a better treatment for ovarian cancer with acceptable side effects.

Chronic Obstructive Pulmonary Disease (COPD) is often associated with high health care costs and a reduced quality of life for sufferers. Many different approaches have been used to assist patients to manage their condition at home and to improve communication between hospitals and GPs. Some approaches have been very successful, others less so. Some programs are expensive and some patients derive greater benefit than others. This study examines the costs and benefits of a program run by the Southern Adelaide Health Service (SAHS) for people with chronic lung disease, diabetes and heart failure. The study examines what impact the program is having on the rate of readmission to hospital, GP visits and other health costs, including use of medicines, for people with COPD. We will compare the Southern Adelaide program with usual care when a patient has had a recent hospital admission. Measuring lung function when a person with chronic obstructive pulmonary disease (COPD) is well, provides a good indication of disease progression. There may be other simpler indicators however, that help predict when, and how often, a person with chronic lung disease is likely to need hospital care. This is the second question that the study has been designed to answer.

To determine whether contact lenses containing selenium can be worn safely and prevent bacterial colonisation of their surface. Both the dispensing optometrists and contact lens wearers will be masked.

To determine whether an antibacterial contact lens can prevent bacterial colonisation of the lens during wear, and can be worn safely. Both the dispensing optometrist and subject wearing lenses will be masked to which lens is being used

The project will involve monitoring a patient’s activity levels and vital signs to determine their response to targeted exercise therapy, education programs and changes in medications. This data will be measured using an externally worn monitoring device. Changes in medications and related health observations will be captured using a form. Patient’s perceived Quality-of-Life, self assessed activity levels and trial feedback (satisfaction, inconvenience etc) will also be captured by questionnaire. It is also desired to link hospital readmission and length of stay measures with the involvement of participants in the study.

Gestational impaired glucose tolerance, associated with subsequent maternal non-insulin dependent diabetes, is routinely screened for during pregnancy, despite the lack of consensus as to the value of such screening and the subsequent management. Epidemiological studies suggest maternal and perinatal morbidity, often attributed to glucose intolerance in pregnancy, is more likely to be due to the effects of maternal age, maternal obesity or the knowledge of the diagnosis and the consequences of subsequent management. The aim of this multicentre study is to assess two forms of antenatal care in women with impaired glucose tolerance; routine antenatal care with 'diabetic style care'. The primary outcomes relate to important perinatal and maternal morbidity. The results will help answer the question as to whether substantial resources should be applied to the diagnosis and management of glucose intolerance in pregnancy. This trial assesses two forms of care for treating women with glucose intolerance of pregnancy.

The purpose of this study is to assess any benefits of adding a drug called ‘zoledronic acid’ (also known as ZometaTM) to the standard treatments for breast cancer. Zoledronic acid is one of a class of drugs that are known as bisphosphonates. In Australia, bisphosphonates are already approved to treat a number of medical conditions including osteoporosis (thinning of the bones), and in cancer patients to prevent pain and problems that occur when there has been spread of cancer to the bones. However, these drugs are not approved by Australian heatlh authorities for use in reducing the risk of breast cancer spreading to the bones. For this reason, ZometaTM is considered an investigational drug in this study. There is evidence from earlier studies that bisphosphonates may prevent cancer spreading to the bones. This may be through their effects on bone, which make it more difficult for cancer cells to damage bone. Additionally, very strong bisphosphonates like zoledronic acid may have effects on the cancer cells themselves or help the drugs you are receiving to treat your cancer better. This study was developed by doctors from the United Kingdom and Australia . The overall coordination of the trial is being done by the Clinical Trials and Research Unit at the University of Leeds, UK. The trial is being coordinated in Victoria by the Cancer Council Victoria who seek approximately 300 women to take part throughout Australia. Approximately 3,300 women will take part in this study internationally, half of the women who take part will have the standard treatment that is normally given to treat breast cancer (this half are known as the “control group”), and the other half will have standard treatment plus zoledronic acid. Women who choose to enter this trial may have treatments for 5 years and progress assessments for 10 years.