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Patients with ulcerative colitis or Crohn's colitis have a slightly higher risk of bowel cancer after having the disease for a number of years. Colonoscopy is recommended to find polyps which can be flat and sometimes difficult to detect. This study aims to test the safety and efficacy of a new device named the Endocuff-vision, for surveillance for cancer and dysplasia in inflammatory bowel disease. Who is it for? You may be eligible to join this study if you aged 18 years or above and have ulcerative colitis or Crohn’s colitis involving more than one third of the colon in clinical remission, and are planned for routine colonoscopy for dysplasia surveillance. Study details All participants in this study will proceed with regular colonoscopy with the addition of the use of Endocuff-vision equipment during the procedure. This is a soft, rubber-like cap that fits to the end of the regular colonoscopy equipment, with a row of finger-like projections that extend when the colonoscope is pulled out. The aim of this device is to assist in anchoring the bowel wall and flattening mucosal folds to allow better vision of the bowel. The duration of the colonoscopy will be longer by about 10 - 15 minutes, as we will do the colonoscopy first without the Endocuff-vision device, then with the Endocuff-vision device, or vice versa. All test results will be analysed to determine whether the Endocuff-vision device is objectively better at detecting polyps. A member of the research team will also contact study participants at 21 days after the colonoscopy to ascertain if there have been any complications.

The increasing popularity of low carbohydrate diets in the community has meant that people with Type 1 Diabetes are adopting these diets, with the expectation of improved glucose control and weight loss. Where there is very limited research to guide this practice in people with Type 1 Diabetes, this project aims to assess whether lowering dietary carbohydrate improves glucose control and clinical outcomes for adults with Type 1 Diabetes Mellitus. This study is a randomized controlled study of adults with Type 1 Diabetes, that aims to compare the effect of a lower carbohydrate diet (average intake of less than 100g per day) with standard dietary recommendations (more than 150g per day) on glucose control, insulin doses, rates of hypoglycaemia, perceived quality of life and treatment satisfaction. We seek to explore potential mechanisms for changes in glucose control, focusing on the impact of dietary changes on the gut microbiome, intestinal epithelial permeability, body composition and inflammatory mediators. We hypothesise that intentional lowering of dietary carbohydrate will be associated with reduced dose requirement of insulin, reduced glucose variability and rates of hypoglycaemia, improved measures of perceived quality of life and alteration of gut microbiome. We expect to see a difference in the groups at 3 months, and will extend the intervention to 6 months to assess whether this dietary change is sustainable for people with Type 1 Diabetes. Participants will receive detailed education regarding carbohydrate counting, recommendations for meal plans that contain a reduced carbohydrate content and advice regarding insulin dose adjustments according to changing glucose levels. Close follow-up will be maintained by diabetes health care professionals. Data will be collected at baseline, 3 months and 6 months, to investigate traditional clinical outcomes - HbA1c, lipid profile, urinary protein and glucose variability as well as perceived quality of life. The effect of the dietary change will also be assessed on the intestinal microbiome, epithelial permeability and body composition.

Hospital readmissions are common and are risky for the patients and imposes additional financial burden on already constrained health care resources. Although numerous readmission predictor tools have been developed their ability to accurately identify patients at high risk of unplanned readmissions is only modest. Experts believe that this could be due to unknown variables, which needs to be identified. Majority of studies predicting hospital readmissions have so far been carried out in United States and only limited studies are available in Australia. Moreover, these studies are centred on 30-day readmission rate, as this is a commonly used benchmark to reimburse hospitals in US. The present study aims to study predictors, which can influence very early and late readmissions in medical inpatients and whether nutrition status as determined by Malnutrition universal screening tool (MUST) can be used as a predictor of hospital readmissions.

Obstructive sleep apnoea (OSA) is a condition in which the upper airway of patients closes off during sleep. This leads to low levels of oxygen and multiple awakenings during the night. There are many factors contributing to the abnormal blockage of the upper airway including the shape, length and strength of the airway itself. Upper airway surgery can help influence these factors. However, there are still patients with residual sleep apnoea despite upper airway surgery. The aim of this study is to test the impact of oxygen therapy in patients with residual sleep apnoea following upper airway surgery. Oxygen therapy will lower the sensitivity of participants ventilator control system and is expected to help further improve their OSA. The study is intended to discover if the combination of oxygen therapy and upper airway surgery can completely resolve OSA in patients where surgery is not able to resolve OSA on its own. The study will involve each identified participant to undergo two sleep studies over two nights. These visits will tell us if the administration of oxygen therapy after upper airway surgery can completely resolve OSA in patients who still snore. All participants will receive one night without oxygen, and one night with oxygen, to be used as a direct comparison. Measurements of breathing pattern, heart beat, blood pressure, muscle activity, eye movements, brain activity and the level of oxygen in the blood in the blood will be recorded and later interpreted by investigators specialized in OSA. We believe that the combination of oxygen and upper airway surgery could positively impact patients OSA and their quality of life. It can potentially provide additional treatment options for sufferers of residual OSA despite surgical management.

Opportunistic screening for chronic kidney disease in the primary care health setting plays an integral role in early detection and subsequent management. However, there are significant deficits in current screening practices despite early identification being a national kidney health priority. Consequently, there is a need to identify strategies to improve screening practices. One potential way is through the education of practice nurses. However equitable access to professional development opportunities, particularly for nurses from rural and remote communities, can be challenging. E-learning provides a potential solution to this challenge. This study will use a single blinded randomised controlled trial to evaluate the effectiveness of an asynchronous e-learning module on learner satisfaction, knowledge acquisition and changes in behavioural intentions related to the primary health care nurses intentions to perform a kidney health check. The primary hypothesis of the study is that participants randomised to an asynchronous e-learning group will have an increase in behavioural intention of at least 0.3 standard deviation within one week follow-up, measured using the theory of planned behaviour, compared with participants randomised to an active control group. Behaviour intention will be evaluated using a an instrument constructed with reference to the Theory of Planned Behaviour and will be the major focus of this study.

Studies are increasingly exploring the neurobiology of Neurodevelopmental Disorders and linking atypical neurophysiological patterns to clinical behaviour. The ability to regulate emotional state has been identified as a core feature of many psychopathologies including anxiety, attention problems, depression neurodevelopmental delays and autism (Beauchaine, 2001). The Polyvagal Theory (PVT) provides a framework for interpreting physiological systems in relation to emotional regulation for adaptive prosocial behavioural responses (S. W. Porges, 2001). Autism Spectrum Disorders (ASD) present with primary dysfunction in social interactions, communication impairments and restricted and repetitive patterns of interests and behaviours (American Psychiatric Association, 2013). Although not typically part of diagnostic criteria, auditory processing or hyperacusis are often evident in ASD and can impact emotional regulation and prosocial behaviours. ASD is a complex neurodevelopmental disorder and therapeutic interventions typically employed utilize behavioural strategies to address the range of behavioural difficulties presented. The Safe & Sound Protocol (SSP) is a novel intervention intended to impact neural systems supporting psychological experience and behaviour. Hypothesis That the Safe and Sound Protocol results in decreased auditory hypersensitivities and improved auditory processing, with associated improved autonomic and cortical neural regulation enabling prosocial behaviors.

The purpose of this study is to investigate the effectiveness of a self-help workbook “Face Your Fears” (Author Dr. D.F. Tolin). This workbook is written by a leading expert in the field and contains cognitive behavioural therapy skills to equip participants to learn how to address all anxiety disorders.

The Wicking Dementia Research and Education Centre at the University of Tasmania has received federal funding to conduct a study into how changes in oral care may reduce aspiration pneumonia risk for adults living in residential aged care, especially adults who have cognitive impairment or dementia. Masonic Care Tasmania, through the Fred French and Peace Haven Homes, has agreed to participate in this oral health study. Aspiration pneumonia is a lung infection for which people are often hospitalised, and people with dementia seem to be particularly vulnerable. Aspiration pneumonia develops when food, liquid and/or saliva containing harmful oral bacteria is misdirected (aspirated) into the airway and then into the lungs and the lungs cannot clear the aspirated material. Studies show that keeping the mouth clean plays a critical role in preventing aspiration pneumonia. Keeping the mouth clean is best done by conducting an oral health screening to see how healthy each person’s mouth is, taking care of any immediate oral and/or dental problems, and then ensuring that people residing in aged care clean their teeth for 2 minutes after each meal or clean their dentures each day and remove them for sleep. Our aim is to see if oral health screening followed by a 3-month intervention period of 2 minutes of teeth cleaning after meals or daily cleaning of dentures with removal for sleep reduces clinical signs of aspiration pneumonia, especially for people with dementia who live at Masonic Care Tasmania/Launceston.

Gay and other men who have sex with men (MSM) with HIV infection have the highest rates of anal cancer. The HPV vaccine is not beneficial for adult MSM with HIV who already have high risk HPV types. As treatment for the precursor to anal cancer (anal intraepithelial neoplasia, or AIN) is both invasive and inefficient, a method of clearing anal HPV before it progresses to AIN is needed for MSM with HIV. The aim of this pilot study is to determine the proportion of MSM with HIV and high risk types of HPV that can tolerate 5% imiquimod cream three times a week for 16 weeks followed by weekly imiquimod cream for 12 months. The secondary aim is to determine the proportion of individuals with HIV and high risk types of HPV who agree to be part of the trial. We will recruit MSM who have HIV from Melbourne Sexual Health Centre when they present to clinic for routine care. Consenting men will be tested for high risk types of HPV in the anus and only those with at least one high risk type will be eligible. Eligible men will receive the HPV vaccine and imiquimod treatment for 3x/week application for 4 months followed by 1 year of 1x/week application. We expect MSM with HIV and high risk HPV will tolerate this treatment and it will clear HPV.

To compare QoR-40 scores twenty-four hours post-operatively in patients who have undergone general anaesthesia using propofol infusion as maintenance to those in whom sevoflurane inhalation is used as maintenance. To compare rates of nausea and vomiting, pain scores and opioid consumption twenty-four hours post-operatively in patients who have undergone general anaesthesia using intravenous agents only as maintenance to those in whom sevoflurane inhalation is used as maintenance. To achieve this, participants will be asked to complete Visual Analogue Scale (VAS) questionnaires, one for pain and one for nausea, at baseline and at the twenty-four hour post-operative visit.