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Pain following tonsillectomy is a big problem for many children. At Perth Children’s Hospital as at other centres, there is a high rate of unplanned re-presentation to hospital with many of these visits due to pain. Some of the pain experienced by children after having their tonsils out is likely neuropathic in nature and less responsive to the standard pain killers which are currently prescribed. There are concerns about the use of the currently used pain relieving medicines for example regular anti-inflammatories in the setting of poor oral intake post operatively and worries over their effects on bleeding risk or the use of opioids in this population at risk of breathing difficulty. Studies to date using gabapentin (a well-known drug to treat neuropathic pain) preoperatively have been encouraging showing a reduction in early pain, strong pain killer requirement and of their side effects. There have been no studies in children using an extended course of the medicine. To help improve post-operative pain management we aim to assess the impact of perioperative gabapentin on postoperative pain levels through a placebo-controlled trial. We will also monitor the return to normal of a number of functional outcomes, for example, eating pattern, sleeping pattern, vomiting. If gabapentin is shown to be effective, then children will not only benefit from reduced pain but may also require less additional doses of breakthrough strong pain killers. Furthermore, better pain control will reduce the number of re-presentations to their general practitioners or hospital benefiting the Health System as a whole. We hypothesise that (1) Gabapentin will significantly decrease the postoperative child and parental reported pain scores following tonsillectomy. 2) Gabapentin will reduce the breakthrough opioid requirement in children following a tonsillectomy. 3) Gabapentin will reduce the medical re-attendance rate for pain following adenotonsillectomy.

Our previous research (UOM HREC ID: 1750491.1) indicated a large proportion of the airline cabin crew experiences fatigue and sleepiness, with 40-68% of the sample population (N=930) screened positive for either insomnia, depression, shift work disorder or a multitude of these disorders. The study also found cabin crew engage in behaviours detrimental to good sleep health, such as large consumption of caffeine daily, and/or use of alcohol and drugs (prescription and non-prescription) as strategies to promote sleep. Based on this result, we have developed a sleep education program (ACCESS; Airline Cabin Crew Educational Strategies for Sleep) based on the relevant components of cognitive behavioural therapy for insomnia (e.g. sleep hygiene, stimulus control, relaxation) to educate and promote behaviours that will improve sleep health in cabin crew. The broad aim of this study is to measure the effectiveness of the ACCESS program compared to the control program (standard sleep education program) in improving sleep health for airline cabin crew.

The aims of this study are as follows: 1. To determine whether an education program directed at nurses, pharmacists and professional care staff will reduce the use of sedative medications in older people with dementia living in Residential Aged Care Facilities (RACF). 2. To determine the effects of the education program and other factors on the number of sedative medications that older people with dementia regularly consume. The sub-project shares the same aims with the main project. The main project is aimed to reduce the use of antipsychotics and benzodiazepines among residents with dementia through the education program. These medications were associated with a significant increase in adverse events and an increased risk of mortality. Previous studies have suggested that these medications can also affect the cognitive state among older adults with dementia. Benzodiazepine use has been associated with accelerated cognitive decline and limited benefits. Antipsychotic medications have also been associated with considerable cognitive adverse effects in people with dementia. Degeneration of cognitive function and mood often reduces quality of life amongst people living with dementia. Therefore, it is important to investigate the effect of these medications on cognitive state and the quality of life of dementia residents .

Children’s vegetable intake is below recommendations in Australia, with low acceptance of vegetables’ sensory properties being a main reason. Vegetable liking can be learned, and childhood is a critical time in the development of these preferences. Increasing acceptance and willingness to try vegetables has important benefits on students’ health and wellbeing in the short and long term, since preferences and dietary behaviours track from childhood into adulthood. The school environment provides good opportunities to promote healthy eating among children, and thereby contribute to setting lifelong healthy eating habits. A teacher-led vegetable education program (VERTICAL- Vegetable Education Resource To Increase Children’s Acceptance and Liking) was developed by CSIRO scientists and educators which aimed to meet three main objectives: 1) to be effective in achieving change amongst children in factors known to be associated positively with vegetable consumption; 2) fulfilling curriculum objectives, and 3) facilitate ease of use by teachers in the classroom. The theoretical framework of the program is based on sensory education and scientific insights on children’s development of vegetable acceptance, with a large emphasis on experiential learning and vegetable tastings. A previous pilot study indicated that the program positively predisposed children towards vegetable consumption. This study aimed to evaluate: 1) the effectiveness of the program on a larger scale and, 2) two forms of teacher training on the effectiveness of the program. The main research questions were: • Does the vegetable educational program lead to a change in student outcomes positively associated with vegetable consumption? • Does the type of teacher training preceding implementation of the program effect the student outcomes?

The purpose of the Mega-ROX study is to determine the effect of two approaches to oxygen therapy on the risk of death in patients who need emergency life support (a breathing machine) in the ICU. Oxygen is essential for life and is given to all patients on life support. Often these patients receive more oxygen than they need to make their body oxygen levels normal. Some research suggests that giving more oxygen than is needed to achieve normal oxygen levels in the body may be harmful while other research suggests that it is not, and it may even be beneficial. This study compares two ways of giving oxygen to patients on life support. The first is to give a little more oxygen and the second is to give a little less. Both approaches are safe but is not clear which approach is the most effective. All patients in this study can be allocated to either of the approaches to oxygen therapy being tested. However, the study is designed so that as the chances that one approach is better for patients with particular problems increases, the number of new patients given oxygen using that approach also increases. In a sense this means that every patient in this study benefits from the information gained from previous patients and every patient helps future patients.

The present study seeks to evaluate a brief online intervention, Managing Emotion, which has been developed by the present investigators for the purpose of supporting the psychological and emotional well-being of university students. The intervention content seeks to increase understanding of the relationship between thoughts, emotions, and behaviour, and discusses a number of evidence-based strategies for managing one’s emotions, particularly during times of stress. The intervention content is divided into four self-paced modules, to be completed over the course of one week. Each module includes a number of brief engaging videos, light reading material, and take-home activities. A set of questionnaire measures will be administered immediately before and after completion of the Managing Emotion program to provide an initial evaluation of the effectiveness, acceptability and feasibility of this intervention. We predict that completion of the Managing Emotion program will be associated with an increase in participants' ability to regulate their own emotions, an increase in participants' perceived self-efficacy and resilience, and reductions in reported depressed mood, anxiety and stress.

Management of self-care during the postdischarge period for general surgical patients is often challenging due to pain, fatigue and the presence of a surgical wound. Discharge education has been viewed as a critical part of meeting the patient’s continuing care needs and is crucial to enable patients to recognise when professional intervention is required. This transition period exposes patients to unnecessary risks related to inadequate preparation before leaving the hospital, potentially leading to postoperative complications and patient harm. With shorter hospitalisations, limited time and patients in a haste to leave the hospital, critical information may be poorly understood by patients or inadequately imparted by the health professionals facilitating the discharge process. Advances in web-based technology have introduced approaches that support effective and affordable healthcare delivery and patient education. The PREVENT discharge education package was designed to guide patients in recognising and understanding the signs and symptoms that patients may face at home after general surgery Discharge instructions for patients can be simplified to warning signs in understandable language as patients can be taught how to recognise and identify the warning signs, and how to contact the healthcare system using a standardised language.

We propose to undertake a 12-month intervetion study to measure energy requirements of severe burn injury patients who have undergone application of Novosorb® Biodegradable Temporising Matrix (BTM) as part of their surgical management. BTM is a relatively new dermal substitute now used at the Royal Adelaide Hospital (RAH) and other burns units nationally and internationally. The nutritional requirements for ensuring optimal integration of this product prior to surgical wound closure has not been studied previously, and current nutritional prescriptions are based on predictive equations developed from historic surgical and therapy techniques. Energy expenditure will be measured at pre-determined times (pre- and post-surgery and weekly until discharge) using indirect calorimetry, which represents the gold standard for assessment of energy expenditure. This will enable real-time adjustment of nutritional prescriptions to meet measured energy requirements determined via indirect calorimetry. As part of this study, we will also collect actual energy and protein intake data, to determine the adequacy of the nutrition prescription delivered. In order to ascertain how measured energy requirements compare to the conventional use of predictive equations in this population, a comparison of measured vs predicted requirements at each time point will be undertaken. This will assist with guiding future dietetic practice regarding the use of predictive equations or the need for ongoing use of indirect calorimetry for optimal clinical care in this patient population.

GDM is the fastest growing type of diabetes in Australia, affecting approximately 1 in every 7 pregnancies. In the Illawarra Shoalhaven Local Health District (ISLHD) ~840 women per year attend the diabetes clinic for treatment/management of GDM. Here, there has been a significant increase in the number of GDM women requiring treatment for fasting hyperglycaemia. This is both because of an increased prevalence (overweight/obesity, gestational age of mother) and because of a lowering of the diagnostic criteria following results from the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study. Despite this, there is no clear treatment approach for fasting hyperglycaemia. Elevated nocturnal (overnight) glucose levels, manifesting as elevated fasting hyperglycaemia, are due to a combination of insulin resistance and insufficiency. Consuming a meal/snack prior to bed can help maintain insulin levels across the night. However, despite popular advice from health care practitioners to consume a bedtime snack to help control fasting (and overnight) glucose, few studies exist to support this recommendation. Pilot data from a recent study conducted in our lab showed that 3-days of consuming a high-protein, low-carbohydrate snack consumed 30 minutes prior to bed significantly improves fasting glucose, insulin sensitivity and nocturnal hyperglycaemia compared to a moderate-carbohydrate snack or no bedtime snack in 15 patients with type 2 diabetes. The amount and glycemic index of carbohydrates in the last meal before bedtime has the largest impact on fasting and nocturnal hyperglycaemia. Therefore, if a snack should be consumed, minimising the carbohydrate appears to be of importance. Given the increasing prevalence of GDM and the complications of fasting hyperglycaemia for mother and baby (including risk for future diabetes), a safe, easily implemented and cost-effective intervention is urgently needed. The main objective of this research is to test whether consuming a snack 30 minutes prior to bed is a viable treatment option for fasting hyperglycaemia in women with GDM.

Greater trochanteric pain syndrome (GTPS), also referred to as gluteal tendinopathy, is a painful, debilitating disorder of the hip. Symptoms arise primarily from pathology of one or more of the soft tissues located over its lateral aspect, including the gluteal muscles, tendons and bursae. People with GTPS frequently demonstrate lower physical activity levels, lower workforce participation, and lower quality of life. Walking is the most common aggravating activity, with over 50% of those with GTPS experiencing symptoms after just a few minutes. Fatigue of the gluteal muscles/tendons is considered to be the primary cause of pain during walking. Foot orthoses are contoured shoe inserts worn in everyday footwear that have been shown to improve pain in people with foot and knee symptoms. Therapeutic effects of foot orthoses are hypothesised to occur through either biomechanical, neuromuscular or load attenuation mechanisms. Pilot data acquired by our team from healthy adults demonstrates that unmodified ‘off-the-shelf’ foot orthoses reduce gluteal muscle activity during gait by up to 37%. Therefore, it is plausible that foot orthoses, by reducing gluteal muscle activity, may have positive effects on pain in people with GTPS. The primary aims of this study are to: (i) evaluate changes in pain and function after 12 weeks of foot orthoses use, and (ii) identify clinical predictors of foot orthoses efficacy in individuals with GTPS. The secondary aim is to undertake a process evaluation, through qualitative interviews, to determine barriers and enablers of foot orthoses use in this patient population.