Medicine and Health Sciences Commons^™

Assessment Of The Clinical Validity Of Ctdna Analysis For Melanoma Management, Anda-Gabriela Marsavela

Theses: Doctorates and Masters

Metastatic melanoma is responsible for almost 80% of all skin cancer-related deaths and the incidence of people affected continues to rise worldwide. The emergence of targeted therapy and immune-checkpoint inhibitors has improved the clinical management of melanoma, but durable survival benefit is only seen in a minority of patients. The use of these very expensive systemic therapies on all appropriate patients also poses a high economic burden on health systems across numerous countries. Currently, surveillance for treatment failure is not optimal. Thus, reliable and accurate biomarkers of patient disease status are urgently required.

Circulating tumour DNA (ctDNA) analysis has emerged …

Unravelling The Potential Applications Of Extracellular Vesicles For The Clinical Management Of Melanoma Patients, Michael Edward Clark

Theses: Doctorates and Masters

Metastatic melanoma is the third most common cancer in Australia with global incidence increasing. After decades without effective systemic treatments for advanced melanoma, the advent of targeted and immune therapies has substantially improved patient survival. While this is encouraging, further research is needed as the majority of patients treated with targeted therapy ultimately develop drug resistance. Immunotherapy can achieve durable responses in many patients however, not all patients respond to current single or a combination of immune checkpoint inhibitors. Considering the cost and potential toxicities to patients being treated with these therapies, there is an urgent need to develop biomarkers …

Quantifying The Heterogeneity Of The Immunoglobulin G N-Glycome In An Ageing Australian Population: The Busselton Healthy Ageing Study, Alyce Russell

Theses: Doctorates and Masters

The use of immunoglobulin G N-glycomics to study chronic non-communicable disorders and other complex phenotypes emerged following the Human Genome Project. The consortium discovered that most phenotypes were too complex to be explained by genetics alone. Thus, the biological importance of epigenetics was recognised; heritable modifications to gene expression rather than the genome itself. Nglycosylation is a form of epigenetic regulation known as a post-translational modification. It stabilises the immunoglobulin G structure and alters downstream responses elicited by the antibody and is extensively studied as a candidate biomarker in the post-genomic era.

The N-glycosylation of immunoglobulin G itself is complex, …

The Impact Of Singing On Pulmonary Function And Quality Of Life In Patients With Muscular Dystrophy, Mia Simonette

Theses : Honours

Muscular dystrophy is a congenital disorder that results in progressive deterioration of muscle strength and function. The genetic disorder is caused by the absence of dystrophin protein which helps to keep muscle cells together, the absence of this protein causes muscles to become weak and fragile. Despite impairment of motor function and muscle strength, a major issue is the progressive impact on the respiratory muscles. Weak pulmonary function can lead to secondary issues such as atelectasis, decreased lung compliance, repeated infections, ineffective cough and ventilation-perfusion during sleep1. Respiratory failure is said to be the most common cause of death in …

Epidemiological Model Of The Transmission And Spread Of Hepatitis B Pandemic In Ghana, Kwaafo Akoto Awuah-Mensah

Theses: Doctorates and Masters

The world's attention to the burden and spread of hepatitis B has increased signicantly in the recent past. A number of interventions by way of treatment and immunisation have been initiated to fight the pandemic, especially in high prevalence regions such as Africa and Asia. Lack of good quality information about hepatitis B is a major hindrance to policy direction and comprehensive implementation of interventions in Sub-Saharan Africa designated as an endemic region. Limited studies on hepatitis B, coupled with lack of adequate health care systems and infrastructure, have led to ignorance or misconceptions and stigmatisation about the disease and …

The Utility Of Multidisciplinary Rehabilitation As A Treatment Strategy For Circadian Rhythm And Sleep Disturbances In Premanifest Huntington’S Disease, Danielle Megan Bartlett

Theses: Doctorates and Masters

Background: Huntington’s disease (HD) is a rare, neurodegenerative disease caused by an expanded cytosine-adenine-guanine (CAG) sequence in the Huntingtin gene, resulting in the production of an aberrant protein, mutant huntingtin (mHTT). The mHTT protein exhibits a toxic loss and gain in function, leading to degeneration of neurons in the brain. Consequently, the classic triad of motor, cognitive and mood features of the disease develop. Among the earliest features of HD are circadian rhythm and sleep disturbances. These anomalies present many years prior to formal clinical diagnosis of HD and, while it has been postulated that these disturbances arise as a …

A Nested Environmental Approach To Typhoid Epidemiology In Central Division, Fiji, Aaron Jenkins

Theses: Doctorates and Masters

Many current disease threats involve interactions within and between nested subsystems of biological organisation. Typhoid fever is a serious disease threat in the South Pacific region, with Fiji reporting the highest annual number of cases, yet risk factors in this setting have been poorly studied. While localised behaviours have dominated perspectives on typhoid transmission, interactions between distal ecological conditions, conditions of the residential environment and localised behaviour deserve greater attention for their potential to influence transmission. This thesis demonstrates a nested approach to typhoid epidemiology using a fivefold methodology to explore how regional, river basin, residential, socio-cultural and behavioural subsystems …

The N-Glycosylation Of Immunoglobulin G As A Novel Biomarker Of Parkinson’S Disease, Alyce Christine Russell

Theses: Doctorates and Masters

For neurodegenerative diseases, interventions during the early stages of the disease, before significant neurodegeneration has occurred, are associated with an increased probability of slowing or halting the disease process. In order to intervene early, it is essential that an accurate diagnosis is obtained and that disease progression can be monitored. This is particularly relevant for Parkinson’s disease (PD; International Classification of Diseases version 10) because significant neurodegeneration has already occurred by the time the clinical motor symptoms are present. Therefore, the development of translatable, high-throughput biomarkers for large scale population screening is a crucial area of research. Of promise are …

The Clinical Utility Of Multidisciplinary Rehabilitation In Individuals With Huntington’S Disease, Travis Miles Cruickshank

Theses: Doctorates and Masters

Background

Huntington’s disease (HD) is a chronic neurodegenerative disorder characterised by a progressive loss of cognitive function, motor control and psychiatric features. Individuals also display a variety of systemic features. Progressive neuronal dysfunction and neuronal cell death are thought to underlie the onset and progression of many clinical features of HD.

Despite scientific progress, there is still no cure or disease modifying therapy for HD, and available pharmaceutical agents only provide partial relief of motor and psychiatric features. An emerging body of evidence indicates that lifestyle enrichment may delay the onset and progression of clinical features, and exert favourable effects …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …

Plasma Insulin-Degrading Enzyme: Characterisation And Evaluation As A Potential Biomarker For Alzheimer's Disease, Michelle Tegg

Theses: Doctorates and Masters

Alzheimer’s disease (AD) is increasing in prevalence due to increasing lifespan and altered lifestyle. It is the fourth major cause of death in Western countries, resulting in significant economic and social impact (Von Strauss, et al., 1999; Goate, 1997). There are no blood biomarkers currently accepted for the diagnosis of AD, and the identification of suitable biomarkers would eventually reduce the necessity for invasive, expensive and slow diagnostic procedures, as well as facilitate prognostic studies. An AD blood test would decrease the need for delaying diagnosis due to ambivalent presentation, and allow therapeutic intervention to commence at an earlier …

Biochemical Markers As Evidence Of The Effects Of Environmental Enrichment On Physiological Processes In Huntington’S Disease Patients, Zarghona Ahmadzai Khan

Theses : Honours

Abstract not available.

Investigating The Impact Of Cd147 And Its Expression On Neurodegenaration And Alzheimer's Disease (Ad), Limbikani J. Kanyenda

Theses: Doctorates and Masters

CD147, also known as basigin, extracellular matrix metalloproteinase inducer, neurothelin, tumour cell-derived collagenase stimulatory factor, M6, HT7, OX47 or gp42, is a transmembrane glycoprotein of the immunoglobulin super-family. It is expressed in many neuronal and non-neuronal tissues with high expression in the hippocampus, pre-frontal cortex, thyroid, heart, early erythroid, amygdala and placenta. This protein is involved in various cellular and biological functions such as lymphocyte migration and maturation, tissue repair, cancer progression, T and B lymphocyte activation and induction of extracellular matrix metalloproteinase. The CD147 protein interacts with with cyclophilin A, cyclophilin B, sterol carrier protein, caveolin-1 and integrins, and …

New Perspectives On Melanoma: The Role Of Pax3, Sandra Medic

Theses: Doctorates and Masters

Background: Cutaneous melanoma is an aggressive form of skin cancer, arising in cutaneous melanocytes. The transcription factor PAX3 is critical for the proper development of neural crest lineages including melanocytes. Melanocytic cells show continued PAX3 expression from melanoblast formation in the neural crest to their differentiation into melanocytes. While many studies clarify the importance of PAX3 in embryonic development of melanocytes, less well understood, and more perplexing, is the continued PAX3 expression in adult skin melanocytes. By contrast PAX3 is frequently found in melanomas and naevi, and its expression correlates with melanoma staging. In this study we explore the multiple …

Occupational Respiratory Health Surveillance At Minara Resources, Murrin Murrin Mine Site, Martyn Cross

Theses: Doctorates and Masters

This thesis outlines the results of occupational respiratory health surveillance at Minara Resources, Murrin Murrin mine site. The research was conducted as part of a collaborative agreement between Edith Cowan University and Minara Resources, the overarching title of which was ‗Establishing best practice protocols in the management of occupational and environmental health in a high-risk mining and ore-processing environment‘. To form the basis of this research it was hypothesised that although the chemical hazards had been adequately identified, and the occupational exposures in each work area at Murrin Murrin were generally well below their respective occupational exposure levels, it was …

Spirituality And Organised Religion In Supporting Parents Of Children With Down Syndrome And Intellectual Disability, Divia Pillay

Theses : Honours

Background: Raising a child with an intellectual disability can present parents with many challenges. Factors that have been demonstrated to positively impact on the mental and physical health of parents of children with an intellectual disability include greater clinical, family and social supports. One avenue of support that has been rarely explored is the role of spirituality and organised religion in supporting parents of children with an intellectual disability. Aim: The aim of this literature review was to investigate the role of spirituality and organised religion in the lives of parents of children with intellectual disability, specifically Down syndrome. Methods: …

Powered Mobility As An Intervention For Children With Cerebral Palsy: A Systematic Review ; The Smart Wheelchair: Is It An Appropriate Mobility Training Tool For Children With Cerebral Palsy?, Sarah Mcgarry

Theses : Honours

Purpose. To systematically review the effectiveness of powered mobility training interventions in improving driving skills and psychosocial outcomes in children with cerebral palsy. Method. Electronic searches of CINAHL, Medline and Meditext were conducted. Using two assessment tools, two independent reviewers assessed the quality of selected studies and level of evidence. Studies were included if a powered mobility training intervention was described, at least one participant had cerebral palsy and if the majority of participants were aged between 18 months and 18 years old. A narrative analysis was conducted. Results. Seven articles were eligible for inclusion. Intervention protocols included computer simulator …

An Analysis Of Use Of Equipment And Respite Services By Families With A Daughter With Rett Syndrome, Anna Urbanowicz

Theses : Honours

Purpose: This literature review examines the body of knowledge concerning the use of respite services and assistive products and technology, child and family characteristics, and parental well-being among families with a daughter with Rett syndrome or with a child with another developmental disability. Method: Literature published in the time period 1983-2009 was searched. Studies were included in this review if they reported use of respite services or assistive products and technology among families with a daughter with Rett syndrome or with a child with another developmental disability. Child and family characteristics and parental well-being were also considered. Results and conclusions: …

A Narrative Analysis Of The Experiences Of Living With Hiv For Heterosexual Men, Tanya Millard

Theses : Honours

The number of heterosexual men presenting with Human Immunodeficiency Virus (HIV) is steadily increasing in Australia. A paucity of literature currently exists surrounding the experience of living with HIV for heterosexual men, with most information targeted towards gay men, injecting drug users (IDUs) and women. This narrative literature review examines the body of knowledge concerning the experiences of heterosexual men living with HIV. The findings of this review indicate that for heterosexual men, HIV significantly impacts on their physical, psychological and social well being. In particular, they struggle with social and intimate relationships, negotiating disclosure, managing their stigmatised identity, and …

Medical Conditions In Children With Down Syndrome: A Literature Review ; Changes Over Time In Medical Conditions And Service Use By Children With Down Syndrome, Kelly Thomas

Theses : Honours

Background: Children with Down syndrome experience an array of medical conditions and health care problems. Although there have been vast improvements in the medical management of these conditions, they still significantly impact on quality of life for families and children with Down syndrome. However, despite the magnitude of this problem limited literature has described the overall health status of children with Down syndrome. Aim: The purpose of this review was to describe the medical conditions commonly experienced by children with Down syndrome and to consider the clinical implications of this knowledge. Methods: Databases Medline, CINHAL and PsychINFO were electronically searched …

Leisure Participation For School-Aged Children With Down Syndrome, Alinta Oates

Theses : Honours

Background. A review of existing literature is necessary to determine the future directions required in research exploring friendships and leisure for school-aged children with Down syndrome. Purpose. This review examines research published in peer-reviewed journals describing participation in friendships and leisure for school-aged children with Down syndrome. The review is guided by the theoretical framework of the World Health Organisation's International Classification of Functioning, Disability and Health (ICF ). Methods. Electronic searches of PubMed, PsychInfo, CINAHL, SportsDiscus and ERIC were conducted using the key terms Down syndrome, leisure and friendships. Keywords identified while using the ICF framework to explore factors …

Gross Motor Abilities And Interventions In Girls And Women With Rett Syndrome: A Literature Review ; Longitudinal Video Analysis Of Gross Motor Abilities Of Girls And Women With Rett Syndrome, Kitty-Rose R. Foley

Theses : Honours

Objective: To explore research relevant to an understanding of gross motor abilities and highlight possible directions for gross motor intervention in girls and women with Rett syndrome. A secondary objective was to describe mouse model research which has the potential to add to an understanding of gross motor abilities in this population. Methods: Electronic searches of five databases, manual searches of an external resource library and manual searches of reference lists were undertaken. The key words imputed during these searches included; mobility, Rett syndrome, functioning, mouse model, therapy and intervention. Search terms were truncated, exploded and adjusted to achieve optimum …

Effect Of A Paediatric Incentive Spacer And Reinforcement Of Inhalation Technique Training In Preschool Children, Jasminka Murdzoska

Theses : Honours

Incorrect inhaled drug delivery technique is a common problem in paediatric asthma [1-4]. Previously, device technique training has been shown to significantly improve inhaler skills, using subjective methods, namely check-list analysis [5-8]. However, more objective measures are needed to examine more comprehensively the effect of training in preschool children and parents. Resistance to regular asthma therapy is also a frequent problem when attempting to treat young children. Reasoning with young children can be very difficult and parents often have to struggle with their child to achieve compliance [2]. The Funhaler spacer (FH) (Funhaler™; InfaMed, Australia) has been developed in an …

Resistance Exercise In Men Receiving Androgen Deprivation Therapy For Prostate Cancer, Daniel A. Galvao

Theses: Doctorates and Masters

This thesis encompasses two literature reviews (chapter 2 & 3) and two experimental chapters (4 and 5) examining the available literature on exercise and cancer, resistance training and its anabolic responses in older men and women, the side effects of Androgen Deprivation Therapy (ADT) for prostate cancer and finally, the role of resistance exercise as a clinical intervention to counteract such changes as an adjuvant therapy.

Networks And Narratives: An Exploration Of Their Relationship And Potential For Understanding The Actual Experiences Of Women With Hiv/Aids, Purity N. Irungu

Theses: Doctorates and Masters

This study set out to examine literature relating to social network theory and narrative theory in order to explore how their potential connection could be used in future to understand and improve the actual life-experiences of women infected by the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). The thesis was done entirely by library research using secondary sources but is original in its intent. It includes a critical examination of some of the work of earlier researchers, including Lockhart's (2000) anthropological study of the social construction of `risk' of AIDS in urban Tanzania. Much previous research studied …

Sex Differentiation And Sexually Dimorphic Disease, Emily A. Jefferson

Theses : Honours

Sexual dimorphism of the central nervous system is a still widely debated and an area of much research. Conclusive evidence that anatomical and physiological differences in the CNS exist has been reported by post-mortem studies and magnetic resonance imaging (MRI). This present study seeks to contribute to the understanding of the differences in the brain between genders and to ascertain reasons as to why the literature is so varied. A number of structures such as the cerebral cortex, hypothalamic nuclei and the amygdala have proven to be significantly larger within males as opposed to females. The nuclei of the hypothalamus …

Hepatitis C, Quality Of Life And Cognitive Function : An Exploratory Study, John Caithness

Theses : Honours

Active chronic hepatitis C (CHC) is a viral infection that affects approximately 150,000 Austra1ians. It has various quality of life impacts and the literature suggests some cognitive ramifications. In this Western Australian exploratory study, 13 healthy students from Edith Cowan University made up a control group. One experimental group consisted of 11 people with CHC and mild liver damage, and a second experimental group consisted of 8 people with CHC and at least moderate liver damage. The participants were assessed with a health-related quality of life questionnaire, the Short Form 36 Health Survey (SF-36); a test of cognitive functioning, the …

Living With Hepatitis C : A Literature Review, & The Physical, Psychological And Social Impacts Of Hepatitis C And The Effects On Quality Of Life, Narelle Cockman

Theses : Honours

Hepatitis C (HCV) is a blood borne virus that affects the liver. It has become one of the most widespread blood borne viruses in Australia, now reaching epidemic proportions within the population. Given that HCV is a chronic long-term illness, with long term effects, a positive diagnosis potentially impacts on various aspects of' a person's life. The aim of this paper was to review HCV related research to examine what it is like for people living with the virus and the possible personal and social impacts of a positive diagnosis. The nature of HCV, including current incidence and prevalence rates, …

Fear, Frustration And The Will To Overcome: A Social History Of Poliomyelitis In Western Australia, John H. Smith

Theses: Doctorates and Masters

This thesis investigates community responses to Poliomyelitis, and the Impact of the disease on those who experienced It, particularly during the epidemics that occurred In Western Australia between 1938 and 1956. The research sources an.: W.A. Health Department records, held mostly at the Battye Library, records held by Australian Archives and Royal Perth Hospital, newspaper reports, comparative studies from several states in Australia and overseas, oral history interviews, biographies and personal records. The history of polio has several layers and the presence or the disease In the community evoked varied and ambiguous reactions, summarised here as fear, frustration and the …

Issues That Concern Prison Officers About Hiv Positive Prisoners In Western Australia, David Francis Cain

Theses : Honours

In 1988 the Department of Corrective Services established an AIDS Standing Committee to draw up an HIV positive/AIDS policy. The Committee consists of ten members, two of whom are union members who represent the issues that concern 1,227 prison officers statewide. The Policy which was issued in 1989 medically isolated HIV positive prisoners from the mainstream prison population. The aim of this research is to identify and quantify the issues that concern prison officers about HIV positive prisoners in Western Australia. Such information will act as a medium through which these will be communicated to the AIDS Standing Committee. Structured …