Or will research groups become more established? Or because some big groups are publishing studies in very high quality journals, does that release more funding to come into IPC research? What do you

think? Yeah, that's why we were interested in doing the Australian piece of work a little bit more, just to understand that.

It's very difficult because I don't understand the landscape in individual countries so much, but I can really speak to Australia.

And in Australia, it's been a similar trend.

And I think perhaps part of the reason, I speculate here, but part of the reason for that is in the early 2010s, there was a Center for Research Excellence in QUT, which built up a lot of research capacity.

And obviously there were a number of PhD students.

And I think now those PhD students, 10, 15 years on, are now leading their own pieces of research, leading their own programs of research, doing both RCTs but also general other IPC research.

Because there's a lot of healthcare as the population ages, a lot of healthcare going on in aged care, big impact on readmission to hospitals, et cetera, et cetera.

How did you end up working with Lauren and Aline? Had you all already worked together before? What's sort of the origin story of The Happen Trial?

We haven't really formally worked together on any project yet, but we've spoken.

So I guess the origins for the HAPPEN trial were at conferences for the last 10 years, point prevalence studies have been presented showing that pneumonia is one of the most common infections.

It gets repeated time and time again in point prevalence studies in Europe, the U.S., and Australia, and they always ask the question, so what are we actually doing about it? It's like collecting data and doing nothing about it.

And it's like beating your head up against a wall.

I would get up and ask the question at times, so we found this again, what are we doing about it? And I think there were similar voices by similar people asking similar questions to this.

And so I think it was just coincidental.

So Brett, can you summarise for us the HAPN trial design, please, first, and then we'll ask you about the results later on.

And do you have any thoughts or any theories as to why you might not have seen as much of an impact on those conditions?

Yeah, it's a good question.

And I think the 60% probably also, I guess it was a bit of a surprise in terms of the reduction.

But at the same time, it's consistent with other studies in conducting an aged care and another cluster ICT done in the US.

So it was very comparable, which I guess in some ways is reassuring.

But yeah, we wanted to look at these extra secondary outcomes.

I guess one of the theories we had about why we didn't see reductions in upper and lower respiratory tract infection was possibly that these are going to be more viral, caused by viruses more than bacteria, where bacteria are probably going to be the main focus of our intervention.

So I think that was the most rewarding part of being involved in this trial is seeing that consumer involvement in action.