Medicine and Health Sciences Commons^™

The Association Between Environmental Cadmium Exposure And All-Cause Mortality And Cardiovascular Disease In A Cohort Of Elderly Western Australian Women, Kane Deering

Theses : Honours

Introduction: Recent research suggests an association between environmental cadmium exposure and increased risk of, and death from, cardiovascular disease, the number one cause of mortality in Australia and worldwide. However, the research to date is neither comprehensive nor have there been any studies conducted on an Australian population. This study identified whether increasing concentrations of urinary cadmium in elderly West Australian women was associated with an increased odds of incidence of, and deaths from CVD, as well as all-cause mortality.

Method: Cadmium excretion was measured in urine samples collected at baseline (1998) from 1359 women from Perth who …

The Feasibility Of Implementing A Novel Electrical Stimulation Device In The Self-Management Of Hand Burn Pain, Katrina Liddiard

Theses : Honours

Burns are widely acknowledged as one of the most painful injuries experienced, and poorly controlled pain following burn injury has been linked to reduced psychological adjustment, lower quality of life, and increased risk of developing a chronic pain state. Transcutaneous electrical nerve stimulation has been used for pain relief in a range of medical conditions, and may have the potential to reduce pain and analgesic consumption for burns patients. The burn care environment presents unique challenges to the introduction of new interventions, and the feasibility of introducing a novel form of electrical stimulation into this environment has not been tested. …

Parkinson's Diagnosis From The Caregiver's Perspective, Helen Maree Bradley

Theses : Honours

Parkinson’s disease (Parkinson’s) is a progressive neurodegenerative disorder. The irreversible and accumulating disability experienced means that people with Parkinson’s progressively lose their autonomy, eventually requiring complete care. Consequently, Parkinson’s significantly impacts sufferers and the people who care for them. Informal care, predominantly provided by female spouses becomes exceptionally demanding over time, and caregivers experience significant morbidity. Stress manifests across all stages of the caregiving trajectory, with diagnosis reported as a particularly stressful period for caregivers; however, few attempts have been made to understand what makes it stressful. The current study explored female spousal caregivers’ subjective experience of the Parkinson’s diagnosis, …

Investigating The Role Of Dachshund Homolog 1 (Dach1) And Mir-200b In Group 4 Medulloblastoma Pathogenesis, Courtney George

Theses : Honours

Medulloblastoma is the most common malignant childhood brain tumour, and the most significant cause of childhood cancer-related mortality. Recently four core molecular medulloblastoma sub-groups have been identified, with distinct pathogenesis and responses to therapies. Current therapies, do not account for this molecular variation, and many patients may receive inappropriate treatment. To address this, targeted therapies for each molecular sub-group would be ideal. Unfortunately, for the more aggressive Group 3 and Group 4 subgroups, the underlying mechanisms of pathogenesis remain poorly understood. The current challenge is to identify the key tumour suppressors or oncogenes involved in Group 3 and Group 4 …

Quantification Of Circulating Melanoma Cells, Jamie Freeman

Theses : Honours

Current prognostic techniques for Cutaneous Malignant Melanoma (CMM), a highly aggressive and drug resistant skin cancer, are inadequate at managing the disease and identifying early stage patients requiring treatment. It is thought that Circulating Tumour Cells (CTCs), which circulate in patient blood after being shed from solid tumours, may be useful in enhancing prognostic techniques and it has previously been shown in other malignancies that the presence of CTCs in patient blood is associated with poor prognosis. In CMM, CTCs can be detected through RT-PCR for melanoma associated markers, although this technique does not allow CTCs to be quantified. In …

Development Of A Blood Test For The Detection Of Cutaneous Malignant Melanoma, Rebecca Slattery

Theses : Honours

Cutaneous Malignant Melanoma is a highly aggressive form of skin cancer that has a tendency to metastasise. In its early stages, the 5-year survival rate of patients is greater than 90% following surgical excision of an in situ tumour. However, following metastasis of the tumour, the 5-year survival rate declines to 5-35%. Due to the correlation between metastasis and declining survival, studies have attempted to identify potential metastasis as early as possible. Molecular markers of melanoma cells in the peripheral blood of CMM patients have been investigated, as the invasion of tumour cells into the blood is one of the …

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 …

Storying The Body : Women's Narratives Through The Lens Of Breast Cancer, Janet A. Griffin

Theses : Honours

What can women's narratives contribute to our understanding of breast cancer and to feminist theories of the body? This thesis explores the meanings women construct to make sense of embodied experiences of breast cancer, and the profound experience of breast loss. Rich contextual data was elicited from in depth, guided conversations with five premenopausal women who have undergone mastectomy. Adopting feminist methodology, biographic-narrative was used to place the body at the heart of inquiry. This thesis explores the personal and theoretical meanings of mastectomy, embedded in the larger story of how these five women experience their breasts, throughout their lives. …

Placental Peroxisome Proliferator-Activated Receptor Gamma And Leptin Receptor In Human Pregnancy, Gwyneth H. Gladstones

Theses : Honours

Leptin is a 16kDa peptide hormone that has recently been implicated in human reproductive processes. Like other hormones, leptin exerts its influence through its receptor. Of the three major isoforms of the receptor (OB-Ra, OB-Rb, and 0B-Re), OB-Ra (the dominant short form) has been implicated in transport processes within rat and human placentas, suggesting a role for it in implantation and pregnancy maintenance. The peroxisome proliferator-activated receptors (PPARs) are ligand-dependent transcription factors that are a subfamily of nuclear hormone receptors. PPARs form heterodimers with another nuclear hormone receptor, RXRα, before binding to PPAR response elements (PPREs). Recently PPARϒ/RXRα heterodimers have …

General Practitioners' Attitudes To Palliative Care : A Regional Perspective, Richelle Lee-Steere

Theses : Honours

The study explores regional general practitioners' attitudes to palliative care through semi- structured interviewing using a qualitative methodology. Attitudes to palliative care were examined using the general practitioners' accounts of their experiences and perceptions of caring for terminally ill patients. The participants were ten registered general practitioners located within the Greater Sunbury Division of General Practice in the South West of Western Australia. A semi-structured interview schedule containing ten open-ended questions was used to assess regional general practitioners' attitudes to palliative care. Examples of the research questions included: What are regional general practitioners' attitudes to palliative care? What supports are …

What Is The Relationship Between Activity, Social Support And Health-Related Quality Of Life In People Who Are Sixty Years Of Age And Older?, Jaqueline Ebbott

Theses : Honours

Over one third of individuals aged sixty years and older have health conditions which limit their ability to live an independent and active life. With the older Australian population increasing, the prevention of functional decline and preservation of wellbeing in this age group has become a major clinical focus in gerontology research. Therefore an important goal of health professionals is to identify behavioural factors which encourage wellbeing and quality of life in this age group. The purpose of the present study was to explore the importance of physical activity passive activity (activities such as craft, reading and board games) and …

Investigation Of The Contractile And Regulatory Proteins In Malignant Hyperthermia And Normal Skeletal Muscle, Louise C. Norbury

Theses : Honours

Malignant hyperthermia/hyperpyrexia (MH) is a serious human skeletal muscle disorder that manifests itself during general anaesthesia. Currently, the most reliable method of diagnosing this disease is the in-vitro contracture test (IVCT). This procedure is both highly invasive for the patient and expensive to perform. The skinned muscle fibre technique is less invasive, and could possibly be used as an alternative diagnostic test for MH. In this study, skeletal muscle samples were obtained from B adults (age 23-54 years) undergoing elective surgery at Royal Perth Hospital. Six patients were diagnosed as normal (controls) and two equivocal for MH (MHE). Using the …

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

Locus Of Control And Self-Directed Learning As Predictors Of Well-Being In The Elderly, Deborah Gardner

Theses : Honours

Elderly people who remain mentally and physically active are more likely to be happy than those who do not (George, 1980; Toscland & Sykes, I 977). Demographic factors have usually accounted for only a small amount of the variance in well-being (Diener, 1984 ). Internal control, personal growth and direction in life might have more to do with well-being than demographic or personality factors (Ryff, 1995). This study examined the theoretical relationship between locus of control and self-directed learning readiness in the elderly and the predictability of self reported well-being from an internal locus of control and a self-directed learning …

Nutritional Problems And Information Needs Of Patients Receiving Chemotherapy And Radiation Therapy, Margaret Joan Robinson

Theses : Honours

Nutritional status is a major factor in determining the successful outcome of treatment for cancer. The combined effect of cancer, and the treatment for cancer, has the potential to severely impair nutritional status. The purpose of this study was to investigate the incidence and severity of treatment-related side-effects which affect nutritional status in cancer patients and to determine the sources and helpfulness of information about nutrition which had been utilised by patients. A descriptive study was used to investigate two groups of patients, one group who was receiving chemotherapy, and the other, radiation therapy. A questionnaire developed by the researcher …

The Role Of Social Support Networks In The Independent Functioning Of Elderly Persons, Maree Gabbedy

Theses : Honours

There is conclusive evidence which highlights the importance of physical and mental health in the ability of elderly persons to function within society, and elderly persons who require services to maintain their independence, are assumed to have lower levels of functioning than persons who do not apply for, or require assistance. Individuals, however, are rarely totally independent, as most people are involved in social networks, where the reciprocal exchange of money, emotional support, goods and services are exchanged with friends family and neighbours. This study, examined the role of social support networks in the independent functioning of the elderly, in …

Perceptions Of Control And Satisfaction With Hospital Birth Experiences For First-Time Mothers, Clelia Tedeschi

Theses : Honours

Satisfaction with childbirth is associated with women's future emotional wellbeing. This study examined whether first- time mother's antenatal expectations, postnatal evaluations of control during labour and delivery, and the discrepancy between expectations and evaluations were significant predictors of women's satisfaction with their childbirth experiences. The effect of medical interventions (e.g., obstetrical interventions and pain relief medication) on women's perceptions of control and satisfaction was also examined. The purposive sample of eighty first-time mothers, mean age 26 years (excluding women who had caesareans) delivered at the public hospital where they attended antenatal classes. During their fourth antenatal class women completed a …

Localisation Of The Gene For A Novel Form Of Charcot-Marie-Tooth Disease In An Isolated Population, Kaite Honeyman

Theses : Honours

Localising the gene for a previously undescribed autosomal recessive form of CMT involved the use of a relatively new approach to rapid genome screening based on the identification of segments which are inherited identical by descent (IBD) from common founding ancestors. It is most feasible for populations which have been founded relatively recently (say less than 25 generations) and which have remained relatively isolated either geographically or culturally. The method is not suitable for highly inbred populations, that is with first and second cousin matings, as many segments will be inherited by chance. It appears to be a suitable screening …

Long Term Restoration Of Peak Torque, Endurance And Muscle Activation Post Anterior Cruciate Ligament Reconstruction, Darryl Alan Turner

Theses : Honours

In recent years, Accelerated Rehabilitation (A.R.) protocols have been used following Anterior Cruciate Ligament (A.C.L.) reconstructions, the longer term effects of these programs are seldom analysed. This study examined musculoskeletal mechanisms that might affect long term functional restoration, the control subjects (n = 19) of mixed age and gender, had no previous knee deficiencies and were recreationally fit. The experimental subjects (n = 17) had undergone intra-articular A.C.L reconstruction, using bone patellar-tendon bone grafts performed by the same surgeon and had also participated in the A.R. protocol, similar to that described by Shelbourne and Nitz (1990). The experimental group attended …

The Prevalence Of Behavioural Risk Factors Associated With Sudden Infant Death Syndrome, Ann M. Callaghan

Theses : Honours

Sudden Infant Death syndrome (SIDS) is a major cause of death in the first year of life. In Western Australia (WA), two infants in every thousand live births die from SIDS each year. The aim of this study was to ascertain the prevalence in WA of three risk factors which have been associated with SIDS, namely prone lying, maternal smoking and lack of breast feeding. In addition the study sought to determine the significant influences that encourage change in infant care practices by parents. The study obtained information from child health nurses and midwives regarding the advice they provide on …

Comparison Of Primiparous Women's Expected And Experienced Pain In Labour, Shelagh Lawrence

Theses : Honours

Pain is a subjective phenomenon and is, in varying degrees, an inherent part of the childbirth experience. However, most Western societies view suffering as unacceptable and as such, regard analgesia as a necessity. Many women do not anticipate the intensity of pain experienced in childbirth and are, therefore, not ready to manage this amount of pain when it occurs. This prospective study compared the expected and experienced labour pain of 99 primiparous women, aged 17-40 years. The relationship between expected and experienced pain and acceptance of pregnancy; identification with the motherhood role; relationship with mother; relationship with husband/partner; preparation for …

The Measurement Of Knowledge, Attitudes And Knowledge-Seeking Behaviours Of Women In Relation To The Menopause And Health Related Issues, Amanda Devine

Theses : Honours

Research suggests that women are not well informed about the health related issues which are associated with the menopause. The purpose of this study was to determine women's: current knowledge of the menopause and of the disease osteoporosis; attitudes to estrogen replacement therapy (ERT); frequency of menopausal symptoms; knowledge-seeking behaviours In relation to the menopause; and, open-ended responses to menopausal issues. This study surveyed 70 women who responded to an advertisement in Community Newspapers. Data were collected using a "Knowledge and attitudes to the menopause and health related issues" (KAMHRI) questionnaire. The KAMHRI questionnaire was developed by the researcher and …

The Use Of Self Blood Glucose Monitoring And Its Relationship To Effective Management For People With Insulin Dependent Diabetes Mellitus, Maureen Unsworth

Theses : Honours

It is believed that people who effectively self manage their own diabetes will achieve higher levels of health and well being (Pender, 1987). Although diabetes education has increased rapidly in the last 10 years, the emphasis has been placed on increasing people's knowledge of diabetes as a medical condition, which does not necessarily ensure effective self management of diabetes. Previous research suggests that self blood glucose monitoring (SBOM) is an effective tool for promoting the use of blood glucose levels as a basis for initiating behaviour changes related to eating, exercise and insulin dosage. Yet, while most people with diabetes …

Prophylatic Cord Care: Is It Necessary?, Karen Coyle

Theses : Honours

Since the evolution of 'open' cord care in 1974, the umbilical cord of the newborn has been treated prophylactically with many different forms of antibacterial solutions. Recent studies have demonstrated that cord separation is facilitated by bacteria and many of the current treatments, such as the use of alcohol, actually delay separation. The purpose of this study was to compare cleaning the cord with alcohol to dry cord care, a method of cord care which is now being considered as an acceptable alternative to prophylactic umbilical cord treatment. A convenience sample of 205 babies was taken from a small private …

Evaluation Of A Patient Education Program For Patients With Non-Insulin Dependent Diabetes (Type Ii), Helen M. Walker

Theses : Honours

The purpose of this study was to evaluate a group outpatient program for patients with non-insulin dependent diabetes (Type II). It endeavoured to establish whether at the completion of a patient education program, and again at the 3 month follow-up period, the patients were complying with : (a) the recommended dietary plan, (b) the exercise program, and (c) were monitoring blood glucose levels at home, as evidenced by weight loss and metabolic control of their diabetes. The study also investigated factors influencing non-compliance. The theoretical rationale used for this study was Pender's Health Promotion Model, which theorises that health-promoting behaviour …