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Episiotomy is the most common obstetric operation, which consists of a surgically placed incision on the perineum and posterior vaginal wall. The operation is usually performed at the height of contraction when the birth is imminent or in attempt to shorten the second stage of labour for a foetal indication such as foetal distress, or a maternal indication, such as previous or underlying cardiac disease or potential obstetric anal sphincter inujuries. Midline episiotomy (where an incision is made from the posterior vagina in a vertical line toward the anus) is a known risk factor for obstetric anal sphincter injuries, leading obstetricians and midwives to prefer the use of mediolateral episiotomy (incision at 30-60 degrees). There has been found to be remarkable variation in the techniques and indications for episiotomy amongst midwives and obstetricians which may alter the consequences of a mediolateral episiotomy. While the technique of performing a mediolateral episiotomy is generally understood by accouchers, there are currently no standard guidelines or measurement tools to guide obstetricians and midwives in the length and angle of their incision. To standardised length and angle of episiotomy, Professor Rane developed a prototypal tool, called the 'Episiometer'. The Episiometer is made of transparent paper, the device is then sterilised, and is applied to the perineum to assist the clinician in measuring the angle of the episiotomy incision, given the clinical decision is made to proceed to episiotomy. This feasibility pilot study aims to find whether the Episiometer is a helpful tool for accouchers performing episiotomy and acceptable for women having an episiotomy performed. Primary objectives/outcomes: Assess feedback from clinicians (defined as ‘doctors and midwives’) about: 1.Perceived ease of use 2.Whether use of the device was burdensome (i.e. practicality, time etc.) 3. Opinions on feasibility of the tool (accuracy for performing mediolateral episiotomy) 4. Indication for performing episiotomy at the Townsville Hospital 5. Evaluate clinicians’ opinions about advantages/disadvantages of the device Secondary objectives/outcomes: 1. Assess patients’ attitudes surrounding episiotomy and use of the Episiometer 2. Patients reporting complications experienced following episiotomy at a 6-8 week follow-up (after use of the Episiometer) 3. Understanding current methods used at the Townsville Hospital (and in any clinical setting where the clinician has previously worked) to teach staff how to perform an episiotomy. 4. Comparing patient's opinions of the device with birth outcomes Research questions: -Is the Episiometer is easy to use OR does it interfere with standard of practice? -Do clinicians find the visual guidance that the Episiometer provides to be helpful and beneficial? -What are the advantages/disadvantages/limitations of having a visual device such as this one? -Can the Episiometer be used in everyday practice?

This study aims to evaluate clinical outcomes of patients with non-small cell lung cancer (NSCLC) with specific clinical and tumour mutation characteristics treated with osimertinib in NSW, Australia. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have metastatic EGFR mutated NSCLC with plasma/tumour positivity for T790M, currently taking osimertinib, and were previously treated with first generation EGFR inhibitor (gefitinib/erlotinib). Study details We will perform a retrospective analysis of the clinical outcomes in NSCLC patients. We will follow up on your clinical data (first CT scan results and long term outcome from your treatment) and correlate this with the level of T790M mutation shown in your plasma ctDNA. Participants will not be required to undergo any additional tests beside routine clinical tests requested by their oncologists. It is hoped that this study will add to the currently limited knowledge on the correlation between T790M mutation load (relative allelic frequency) and clinical outcomes.

This secondary analysis aimed at examining the changes and temporal trends in the dietary glycaemic index and glycaemic load of Australian children and adolescents, as well as changes (if any) in the major sources of dietary glycaemic load. It will be performed using data from 3 Australian national nutrition surveys (i.e. 1995 National Nutrition Survey, 2007 Australian National Children's Nutrition and Physical Activity Survey, and 2011-2012 Australian Health Survey).

Purpose of Study It is well known that exercise has numerous health benefits; however, research regarding the effect of exercise on airway inflammation in asthma is scarce. This project will examine the clinical and inflammatory impact of three months of exercise training in adults with asthma. This study will also determine whether this effect varies with exercise intensity. This research is highly significant for asthma management, as those with asthma have been shown to have low exercise levels, possibly stemming from the belief that exercise will worsen asthma. Increasing exercise may reduce the reliance on inhaled corticosteroid medication and offer better asthma control, by reducing inflammation. Hypothesis Exercise training will improve clinical asthma outcomes by reducing eosinophilic airway inflammation in adults with asthma. The beneficial effects of exercise in this setting are only evident with moderate-intensity exercise training. Aims 1. To examine the effects of three months of exercise training on asthma outcomes (quality of life, asthma control, asthma exacerbations, airway hyperresponsiveness, and airway and systemic inflammation); 2. To determine whether, and how, these effects vary by exercise intensity.

Undermanaged pain among older patient with dementia continues to impact on patient centre care provided among acute care settings. As the dementia population continues to grow, there is a need to address this issue by finding the solution for a better outcome. The challenges in assessing pain in dementia play a major barrier for nurses in conducting effective pain management (Bruneau & Benjamin, 2014; Coker et al., 2008; De Witt Jansen et al., 2017; Laflamme et al., 2012; Rantala, Kankkunen, Kvist, & Hartikainen, 2014b). This intervention study aims to investigate if nurses’ daily pain assessment and management for older patients with dementia can be improved by a simple and routinised intervention program. The project will introduce an innovative intervention program, which prompts nurse participants to undertake pain assessment during their routine vital sign round, that is, pain become embedded as a fifth vital sign. The study aims: 1). To explore if older people with dementia provide self-report of pain while hospitalised; 2). To examine whether routinisation of pain assessment and subsequent management by nurses has an effect on pain management in older people with dementia in hospital settings. Study hypothesis: H0: 1. There are no differences before and after the intervention program in the level of self-reported pain by older patients with dementia between two groups; intervention groups and control groups. 2. There are no effect on nurses’ practice in the routinisation of pain assessment and management for older patients with dementia before and after the intervention program between two groups; intervention groups and control groups. Ha: 1. There are differences before and after the intervention program in the level of self-reported pain by older patients with dementia between two groups; intervention groups and control groups. 2. There are effect on nurses’ practice in routinisation of pain assessment and management for older patients with dementia before and after the intervention program between two groups; intervention groups and control groups.

The purpose of this physiology study is to determine the effects of high dose zopiclone (15mg) on obstructive sleep apnoea severity, upper airway muscle activity, the respiratory arousal threshold and breathing parameters during sleep.

Ureteral stents can often cause significant post-stent morbidity and discomfort. There are many different brands of stents currently available but there is no evidence that there is any difference between them in terms of stent related symptoms. This study aims to compare the Cook Universa Soft and Bard Inlay Optima Stents post-op stent related symptoms (SRS) in relation to the validated Ureteral Stent Symptom Questionnaire. This comparison will be through a randomized double-blinded trial of the two different brands of stents.

The aim of the project is to explore the effectiveness of Building Bridges Triple P in promoting parent skills and reducing the parent reported behavioural and emotional problems of adolescents with a developmental disorder, addressing relationships within the family, and improving outcomes for teens and parents. Parenting programs have been shown to have significant benefits for both parents and children. Parenting programs centered on social learning principles have been recognized by the World Health Organisation (2009) as the ‘gold standard’ in preventing behavioural problems and promoting healthy childhood development and wellbeing. While research has supported the efficacy of parenting programs for teens and children with disabilities, there is an absence of parenting-based intervention programs tailored to parents of adolescents with a developmental disability. This is particularly concerning given the increased vulnerability of teenagers to a range of factors during this developmental period relative to earlier periods of childhood and the difficulties faced by parents to manage these. The current project aims to evaluate the efficacy of the Building Brides Triple P program, a parent skills training program specifically targeting the unique needs of this population.

This study aims to evaluate the utility of blood based testing ('liquid biopsy') in the management of patients with Epidermal Growth Factor Receptor mutated (EGFR+) non-small cell lung cancer (NSCLC) Who is it for? You may be eligible to join this study if you are aged 18 years or above and have metastatic EGFR+ NSCLC and will be starting treatment with EGFR inhibitors. Study details We will perform a prospective follow up study to investigate if liquid biopsy could be used to monitor the treatment response and detect treatment resistance in EGFR+ NSCLC patients. Participants will be required to have blood collected (3 tubes of 9ml blood sample each time) before they start treatment, 1 month into treatment, 3 months into treatment and 6 months into treatment. We will be analysing cancer cells and cancer DNA which may be found in the blood (ie. circulating cancer cells/CTC and circulating tumour DNA/ctDNA). It is hoped that this study will add to the currently limited knowledge on whether we could use CTC/ctDNA to predict the effectiveness of a treatment, as well as clinical outcomes for patients. This study will also hopefully answer the question of whether common mutations and novel mutations causing treatment resistance could be detected in liquid biopsy, and therefore could replace the more invasive tissue biopsy in the future to diagnose and monitor treatment response for patients with EGFR+ lung cancer.

This research project aims to investigate the effect of two different home-based physical training programs on the functional well-being of adults with Multiple Sclerosis (MS). Functional well-being is often hindered by MS, as it affects the ability to perform Activities of Daily Living (ADLs). ADLs are the tasks that one completes every day, such as using cutlery, tying shoelaces and brushing one’s teeth. These tasks require fine motor skills that involve the use of small intricate muscles in the hands and arms. When these muscles become tired, completing ADLs can feel taxing due to fatigue, which can result in losses of concentration and difficulty maintaining focus. Both yoga and strength training have separately been recognised as forms of therapy for their ability to improve body awareness, release tension and decrease fatigue. Fine motor training has also been reported as having an impact in improving ADL’s and reducing fatigue in adults with MS. For this project, we wish to combine a strength and yoga home program and compare it to a fine motor home program. The aim of this project is to examine the impact of two separate home-based physical training programs, (1) fine motor training and (2) strength and yoga training to determine which one has an impact in reducing fatigue, and improving ADLs, dexterity, and strength to hopefully maintain physical independence at home.