This project will provide the first robust evidence on the effectiveness of opioids in the treatment of acute low back pain and neck pain. The trial results will improve care for patients suffering acute spinal pain. Low back pain and neck pain place an enormous burden on patients and health services, both nationally and internationally. Despite the widespread use and recommendations in clinical guidelines, there are no randomised controlled trials that have assessed the effectiveness of opioids for acute low back and neck pain. OPAL is a clinical trial to find out whether opioid analgesics are effective in reducing low back or neck pain, compared to placebo. The opioid analgesic medication– oxycodone – will be taken for up to six weeks. During these six weeks, the participant will be reviewed weekly by a treating physician. This study is currently recruiting. You may be eligible to participate if you have experienced low back pain and/or neck pain of at least moderate severity within the last 12 weeks, and are considered by your treating doctor as appropriate for opioid analgesia. Principal Investigator: Professor Christine Lin Chief Investigators: Professor Chris Maher, Professor Jane Latimer, Associate Professor Laurent Billot, Professor Andrew McLachlan, Professor Ric Day and Professor Bart Koes. The sponsor of this trial is the George Institute. The study has received ethics approval from the University of Sydney Human Research Ethics Committee. For more information, please contact the OPAL team. e: sph.opal@sydney.edu.au Trial registered on ANZCTR: ACTRN12615000775516

We hope the findings of this project will lead to improved physical activity levels in people living with moderate to severe traumatic brain injury (TBI). The aim of this project is to develop clinical practice guidelines for physical activity in people across all ages living with moderate-to-severe traumatic brain injury (TBI) in Australia. A plan will also be developed for the effective implementation of these guidelines. The first stage involves evaluating the fit of the 2020 WHO physical activity and sedentary behaviour guidelines for people living with disability to those living with a moderate-to-severe TBI. This includes considering the evidence available regarding physical activity in TBI, preferences for physical activity, perspectives of relevant stakeholders and the feasibility of guideline implementation. Stage two involves auditing brain injury rehabilitation services across Australia to understand how physical activity is delivered and promoted to identify current practice and where practice inconsistencies exist. The third stage involves adapting the WHO guidelines into national clinical practice guidelines for people living with TBI, informed from stages one and two. The final stage involves the development of a plan for implementation of these national practice guidelines based on the identification of barriers and facilitators. Principle Investigator: A/Prof Leanne Hassett Co-Investigators: Prof Gavin Williams (UniMelb); Prof Cathie Sherrington (USyd); A/Prof Sean Tweedy (UQ); Prof Luke Wolfenden (UniNewcastle); Prof Maria Crotty (Flinders); Prof Kirsten Howard (USyd); Dr Abby Haynes (USyd); Emeritus Prof Adrian Bauman (USyd); A/Prof Grahame Simpson (USyd); A/Prof Adam Scheinberg (MCRI); Prof Anne Tiedemann (USyd); Gabrielle Vassallo (consumer representative); Nick Rushworth (BIA) Collaborating Organisations: Brain Injury Australia, Connectivity TBI; icare NSW; Heads Together for ABI Research team: Dr Liam Johnson (UniMelb); Sakina Chagpar (USyd); Belinda Wang (USyd) Funding: MRFF 2020 Traumatic Brain Injury Mission, Stream 2-incubator 2021-2023.

We hope the findings of this project will lead to improved physical activity levels in patients receiving brief physical activity counselling as part of their physiotherapy treatment. BEHAVIOUR is a hybrid type II cluster randomised controlled trial. The aim is to evaluate the effectiveness of a multi-faceted implementation strategy compared to usual care on increasing the proportion of patients receiving brief physical activity counselling as part of hospital-based physiotherapy care, and subsequently improving the physical activity levels among these patients. Physiotherapists in the intervention group will be assigned to receive the multi-faceted implementation strategy immediately to support them to incorporate brief physical activity counselling into their routine care. The main implementation strategies will include education training, creating a learning collaborative, tailored strategies to address community referral barriers, facilitation and audit and feedback. The control group will receive an updated version of the implementation strategy at the end of the trial. The trial will be conducted with physiotherapists across all hospitals in South Western Sydney Local Health District and will include participants from culturally and linguistically diverse backgrounds.