Medicine and Health Sciences Commons^™

The Importance Of Telehealth In The Implementation Of Best Practice In Paediatric Burn Management By Non-Burn Specialist Clinicians, Tania Mcwilliams

Theses: Doctorates and Masters

Introduction: Burns are a leading cause of injury worldwide, yet the initial assessment and management of patients following burn injury is often performed by non-burn specialist clinicians. Using the Gilbert Behaviour Engineering Model as a framework, strategies were introduced to support these clinicians. A better understanding was needed, however, of the effectiveness of these strategies, and the experiences of clinicians who provide this initial care.

Aims: This study aims to contribute new knowledge related to paediatric burn care through the evaluation of a state-wide burns telehealth program in Western Australia; specifically, develop a deeper and more relevant understanding of a …

Injury Surveillance In Community Cricket And The Exploration Of Insurance Claims Systems, Geordie Mcleod

Theses: Doctorates and Masters

The aims of this industry funded PhD thesis were 1) To understand the injury causes, trends and burden in community cricket and 2) To examine the Cricket Australia National Club Risk Protection Program (NCRPP) insurance scheme for suitability as an injury surveillance tool for community cricket.

This thesis sought to identify and understand the injury profile of community cricketers through existing literature and injury datasets, being, Victorian Injury Surveillance Unit (VISU) hospital data, Accident Compensation Corporation (ACC) and NCRPP insurance claims data. This thesis also undertook a novel assessment of data validity and completeness from various sources, against industry standards …

Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: A Glaserian Grounded Theory Study, Yakubu Ismaila

Theses: Doctorates and Masters

The midwifery model of care that promotes the employment of trained and regulated midwives for the provision of maternal and neonatal care has been found to be beneficial, especially in Low and Middle-Income Countries that have high maternal and neonatal mortalities. Midwives in those setting are however, facing a myriad of barriers which negatively affect their ability to provide optimal care. Although Ghana is implementing the midwifery model of care, maternal and neonatal mortality remains high in the country. Little is known from the point of view of midwives, who are the primary providers of maternal and neonatal care, about …

Improving Processes For Implementing Evidence-Based Practice In Midwifery: Development Of An Etool(Kit) For Midwives, Annemarie June De Leo

Theses: Doctorates and Masters

Evidence-based practice (EBP) is well-established as the gold standard for service delivery of quality healthcare around the world, yet there remains a significant gap between best available evidence and its everyday use in maternity services. The numerous benefits of EBP are therefore never realised and although a considerable body of knowledge has evolved on how to promote the uptake of new EBPs, little is known about midwives’ experience of implementing EBP or leading practice change projects in clinical areas.

The aim of this study was to work collaboratively with midwives towards the co-development of an evidence implementation resource, designed to …

Drug Users’ Experiences Of A Residential Rehabilitation Program In Western Australia: A Thematic Analysis Of Drug Users Lived Experiences, Michelle Fullam

Theses: Doctorates and Masters

In the last decade, there has been a marked increase in the awareness of drug use and drug-related crime in Australia. As a result, the demand for drug treatment services has increased and 14 recognised government-funded services are now available in Western Australia (WA). The goal of these services is to reduce drug use through full-time intensive programs that are usually residential. This type of drug treatment has been shown to be effective in reducing drug use and promoting pro-social lives post-treatment. However, little is known of the experiences of participants in this type of treatment in WA. As such, …

Gait Entrainment In Coupled Oscillator Systems: Clarifying The Role Of Energy Optimization In Human Walking, Ryan T. Schroeder

Theses: Doctorates and Masters

Empirical evidence suggests that parameters of human gait (e.g. step frequency, step length) tend to minimize energy expenditure. However, it is unclear if individuals can adapt to dynamic environments in real time, i.e. continuously optimize energy expenditure, and to what extent. Two coupled oscillator systems were used to test the learned interactions of individuals within dynamic environments: (1) experienced farmworkers carrying oscillating loads on a flexible bamboo pole and (2) individuals walking on a treadmill while strapped to a mechatronics oscillator system providing periodic forces to the body. Reductionist trajectory optimization models predicted energy-minimizing gait interactions within the coupled oscillator …

Exploring Leadership And Research In Nurse Practitioner Roles Across Australia And Ireland: A Mixed-Methods Study, Mary Ryder

Theses: Doctorates and Masters

Introduction

The Nurse Practitioner role is recognised as the highest level of clinical nursing. Leadership and research are identified as core attributes for Nurse Practitioners in the regulatory frameworks. There is an expectation that as clinical leaders, Nurse Practitioners have the ability to transform healthcare delivery within their specialist area of practice.

Background

The voice of Nurse Practitioners is limited in the current literature related to how they view their leadership contribution to Nursing. There has been some criticism in the evidence to date related to volume, consistency and transferability of Nurse Practitioner research. However, there is a shortage of …

The Effects Of Environmental Temperature On High-Intensity Interval Training, Jason R. Boynton

Theses: Doctorates and Masters

Endurance athletes typically spend the large majority of training (> 70%) at low intensities (i.e. below lactate threshold) coupled with short and intermittent bouts of high-intensity exercise or interval training (HIIT). Despite HIIT being a relatively small part of training in terms of duration, it has a substantial effect on the adaptations to endurance training. While it is well-established endurance exercise performance is affected in both hot and cold environmental conditions, the effect ambient temperature (TA; frequently referred to as environmental temperature) has on HIIT as performed by an endurance athlete population is not well understood. Therefore, the overall purpose …

Appraisal Of Free Online Symptom Checkers And Applications For Self-Diagnosis And Triage: An Australian Evaluation, Michella Gaye Hill

Theses: Doctorates and Masters

The internet has impacted society and changed the way companies and individuals operate on a daily basis. Seeking information online via computer or mobile device is common practice. The phrase ‘Google it’ is now part of modern vernacular and is a resource increasingly utilised by young and old alike. Around 80% of Australian’s search health-related information online as it is convenient, cheap, and available 24/7. Symptom checkers are one tool used by consumers to investigate their health issues. Symptom checkers are automated online programs which use computerised algorithms, asking a series of questions to help determine a potential diagnosis and/or …

Mechanisms Underpinning An Improvement In Dynamic Muscle Force Production Following A High-Intensity Warm-Up, Cody J. Wilson

Theses: Doctorates and Masters

The present research explored the mechanisms underpinning the enhancement of voluntary knee extensor torque after (1) extensive task-specific practice, and then (2) brief, intense warm-up exercise (conditioning activity; CA) as part of a complete warm-up routine. The same warm-up was completed in two Experiments (detailed below). In Experiment 1, voluntary (180⁰·s-1; T180) and electrically-evoked (isometric) knee extensor torques and electromyogram (EMG) and muscle temperature (Tm) data were recorded before and after (1) extensive task-specific practice where peak voluntary knee extensor performance was achieved, and (2) two isokinetic CAs matched for total concentric contraction time (CA60: 5 repetitions at 60⁰·s-1 vs. …

Bilateral And Unilateral Resistance Training And Athletic Performance, Brendyn B. Appleby

Theses: Doctorates and Masters

Specificity is a key programming principle for optimal transfer of physiological adaptation of training to improved athletic performance. In resistance training, it has long been identified that the closer the mechanical specificity between the training exercise and outcome performance, the greater the transfer of improved capacity. Bilateral resistance exercises are predominately prescribed for the development of maximum strength and are well demonstrated to enhance athletic performance. However, unilateral exercises appear to demonstrate greater specificity to movements such as running and change of direction as these movements are predominantly single leg actions. Nonetheless, the unstable nature and comparatively lower magnitude of …

The Ward-Based Nurse Clinical Educator: Impact On Student Learning Outcomes And Student And Preceptor Experiences, Karen Ann Mccarthy

Theses: Doctorates and Masters

Aim

This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility.

Question

The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on …

A Qualitative Study Into The Communication Surrounding The Initiation And Withdrawal Of Non-Invasive Ventilation (Niv) In People With Motor Neurone Disease, Charlotte Chapman

Theses: Doctorates and Masters

Introduction

Motor neurone disease (MND) is a degenerative disease that adversely affects the nervous system and muscular control. Eventually respiratory muscles weaken, causing breathing, communication and swallowing difficulties, and ultimately, respiratory failure and death. Improved quality of life and potentially a short extension of life can be provided with non-invasive ventilation (NIV), which is offered to people with MND when symptoms of respiratory distress become evident.

It is recommended that end-of-life communication, encompassing the benefits and burdens of symptom-relieving interventions (NIV and percutaneous gastrostomy tube to assist with nutrition), NIV withdrawal (proposed when continued use is considered futile) and other …

Velocity-Based Training: Monitoring, Implementation And Effects On Strength And Power, Henry G. Banyard

Theses: Doctorates and Masters

Traditionally, resistance training has been prescribed using percent-based training (PBT) methods that use the loads relative to a maximal load lifted for one repetition (1RM). However, PBT does not take into account possible day-to-day fluctuations in performance that may occur from physical or psychological stressors. One approach to address this limitation is to monitor velocity changes during resistance training, based on research showing that declines in velocity are highly correlated with fatigue. Therefore, velocity-based training (VBT) methods are proposed to provide a more objective method to modify resistance training sessions based on individual differences in day-to-day performance and the rate …

Chemical Composition And Toxicity Of Emissions From Burning Five Vegetation Types Of Western Australia Under Experimental Combustion Conditions, T T Trang Dong

Theses: Doctorates and Masters

This study investigated the emission factors (EFs) for inorganic gases (CO2, CO, SO2, NO and NO2), carbonyls (formaldehyde, acetaldehyde, acetone, propionaldehyde, butyraldehyde and benzaldehyde), volatile organic compounds (VOCs) and particulate matter (PM2.5 and PM10) from laboratory-based fires of vegetation from five typical vegetation types of Western Australia. Species burnt were three grasslands (Spinifex represented by Triodia basedowii, Kimberley grass represented by Sehima nervosum and Heteropogon contortus, and an invasive grass represented by Ehrharta calycina (Veldt grass)), Banksia woodland and Jarrah forest under different combustion conditions. Chemical composition (water-soluble metals and polycyclic aromatic hydrocarbons – PAHs) and in vitro toxicity …

Heat Exposure And Adaptation Strategies Of Outdoor Informal Sector Workers In Urban Bulawayo - Zimbabwe, Bigboy Ngwenya

Theses: Doctorates and Masters

Ambient temperatures have risen over the past few decades and are expected to increase even further due to climate change impacts. Extreme temperatures, accompanied by high humidity levels, will exacerbate occupational heat stress, heat related illnesses and mortality amongst vulnerable groups, particularly among outdoor workers in developing countries in the tropics. In Bulawayo, Zimbabwe, a large portion of the population work outdoors in the informal sector as street vendors (hawkers) due to a lack of employment opportunities. These hawkers spend long hours in the sun or under makeshift sheds with poorly developed adaptation strategies, and no access to cooling systems …

A Public Health Perspective Of The Higher Education Experiences Of Women Studying Nursing: A Hermeneutic Inquiry Into Commencement And Progression, Lesley Jane Andrew

Theses: Doctorates and Masters

While student retention is a central goal across higher education, the projected shortage in the Australian health workforce has intensified its importance to undergraduate nursing.

Nursing degrees attract a higher proportion of mature-age women students than ever before. More are therefore beginning university at life stage characterised by marriage (or co-habitation) and traditional family structures. Nursing retention strategies require an understanding of the unique university experiences of these women, however, this is missing in the nursing literature. This study is the first to explore the experiences of these women students, doing so from the perspective of Bachelor of Science (Nursing) …

The Manifestations Of Fatigue In Amateur Boxing Performance, Emily C. Dunn

Theses: Doctorates and Masters

A subjective method of judgment, the “Ten Point Must-System” (TPMS), was introduced into amateur boxing in 2013. To be successful, boxers must deliver forceful punches and exert dominance over an opponent. There has been limited research examining the strategies used by boxers to win fights under the TPMS and whether these strategies induce fatigue that is sufficient to significantly affect punch force. The overall objective of the five studies contained in this thesis was to describe, in relation to fatigue, the performance characteristics of male amateur boxers under the TPMS, and improve our understanding of the physical characteristics associated with …

Moving On After Critical Incidents In Health Care. Second Victims: A Qualitative Study Of The Experiences Of Nurses And Midwives, Melanie Buhlmann

Theses: Doctorates and Masters

Aims: The aims of this study were to gain a deeper understanding of the experiences of nurses and midwives who have been involved in a critical incident in a non-critical care area and to explore how they have ‘moved-on’ from the event.

Background: It is irrefutable that health care is intrinsically risk-laden and perceived to be personally and professionally demanding for those who are employed within it. The term ‘second victim’ has been assigned to health care professionals who experienced emotional distress as a result of their involvement in critical incidents. Despite the recognition that critical incidents contribute to workrelated …

Factors Affecting The Survival And Implantation Of Human Blastocysts Following Vitrification, Hamish Barblett

Theses: Doctorates and Masters

The increased cell numbers, presence of the blastocoel and rapid cell re-organisation have required the development of specific survival criteria post warm to effectively select the most viable blastocyst for transfer. Pre-freeze blastocyst expansion and post warm re-expansion have been shown to contribute significantly to the chances of an implantation and subsequent live birth. The aim of this study was to explore factors that influence the outcome of blastocyst transfers after vitrification and warming, and hopefully improve outcomes by further applying improvements in future cycles. Variables from 8 years of vitrified/warmed blastocysts were retrospectively compiled and analysed to determine the …

Linking Patient Safety To Clinical Practice: The Insight Of New Graduate Registered Nurses, Melanie Murray

Theses: Doctorates and Masters

New graduate registered nurses’ (NGRNs) transition to practice with limited clinical experiences and skills. The related anxiety and stress predispose new graduate nurses to increased risk of contributing to preventable errors or adverse events. This risk, together with the new graduate’s fledgling ability to manage clinical deterioration, potentially compromises quality and safety of patient outcomes.

A longitudinal mixed methods design was used to develop an understanding of new graduate registered nurses’ patient safety knowledge and actions within the first year of nursing registration and offer important insights into NGRNs’ transition with a patient safety focus. New graduate registered nurses employed …

Factors Associated With Anxiety, Depression, Burnout, And Ptsd In Australian Paramedics, Timothy Rankin

Theses: Doctorates and Masters

Background

Paramedics are at higher risk of anxiety, depression, burnout, and PTSD compared to the general population. Factors that have been associated with mental disorders include occupational stress, fatigue, sleep quality, chronic pain, physical activity, perceived social support, and overall quality of life. To date only a few of these factors have been investigated simultaneously in Australian paramedics.

Aim

This study aimed to investigate occupational stress, fatigue, sleep quality, chronic pain, physical activity, perceived social support, and overall quality of life, and their associations with anxiety, depression, burnout and PTSD in Australian paramedics.

Methods

Sixty-three paramedics, working for ambulance services …

Treatment Fidelity In The Very Early Rehabilitation In Speech (Verse) Randomised Controlled Trial: An Exploration Of Treatment For Aphasia, Emily Louise Brogan

Theses: Doctorates and Masters

Background

Aphasia is a neurological condition that affects the expression and/or comprehension of language and can have considerable impact on a person’s quality of life. Treatment for aphasia from speech language pathologists is effective. However, more information is needed on the nature of effective intervention including consideration for what therapy is provided, when it is commenced and how it is delivered. Treatment fidelity is concerned with ensuring research treatment protocols are implemented as they were intended, which assists in uncovering the specifics of how and why treatments work. When treatment fidelity is investigated thoroughly, researchers and research consumers can be …

The Placenta And Cardiovascular Disease: A Meta-Analysis, Ruben Phillips

Theses: Doctorates and Masters

The uterine environment in which a fetus grows and develops is now recognised as a risk factor for the development of adult diseases such as cardiovascular disease (CVD). A fetus relies on the nutrients and conditions delivered via the placenta, and as such the placenta plays a vital role in the establishment and maintenance of appropriate uterine conditions. Unfavourable uterine conditions such as an inadequate resource flow from the placenta can lead to diminished growth of the fetus and may ultimately result in both short and long-term increases in risk of CVD for the baby. This has been demonstrated in …

The Application Of Maximal Mean And Critical Speed And Metabolic Powers For The Quantification Of External Load In Soccer, Cameron Nicholas Lord

Theses: Doctorates and Masters

In Association football, often referred to as “soccer”, competitive match play is typically known to represent the greatest physical demand that players experience. The demands associated with match running performance may impact training outcomes and injury risk. As a result, practitioners evaluate these demands to ensure that performance is optimised. To assist in this process, global positioning systems (GPS) are typically used to quantify displacement variables and, more recently, the interaction between running speed and acceleration. However, traditional player monitoring methods tend to apply identical and somewhat arbitrary displacement, velocity and acceleration bands to describe movement “intensity”, and thus to …

Social Impacts Of Climate Change And Occupational Heat Stress And Adaptation Strategies Of Mining Workers In Ghana, Victor Fannam Nunfam

Theses: Doctorates and Masters

Excessive heat exposure due to rising temperatures associated with climate change adversely affects workers’ health, safety, productivity, and psychosocial well-being in occupational settings. In the hot and tropical regions of developing countries, long hours of physically demanding work, coupled with inadequate adaptation policies to climate change, increases the occurrence of heat-related illnesses and injuries, and contributes to the loss of productive capacity, poor decision making, and other negative effects on the social well-being of workers.

Based on the theories of social impact assessment, risk assessment, adaptation and resilience planning, this study assesses the social impacts of climate change and occupational …

Analysis Of Perceptual-Motor Calibration Processes In Indoor Climbing, Andrew Stephen Walsh

Theses: Doctorates and Masters

This research programme examines how people perceive maximal reach-and grasp-ness in climbing, and as such these questions will be limited to climbing.

Is experienced gained from performing daily submaximal reaching sufficient for the accurate perception of maximal horizontal reaching affordances in rock climbing?

How is perception of maximal horizontal boundary of reach-and grasp-ness affected by: hold size, body position, additional load, or fatigue.

How will inducing fatigue affect how a participant calibrates distance and their movement economy?

The Influence Of Barbell And Body Position On Force-Time Characteristics In The Isometric Mid-Thigh Pull, Stuart Nathan Guppy

Theses: Doctorates and Masters

Publication 1: The Isometric Mid-Thigh Pull: A Review and Methodology – Part 1 Isometric tests are commonly used to monitor physical qualities that underpin athletic performance. As single-joint laboratory-based tests display poor relationships to the multi-joint movements found in sport, multi-joint isometric tests like the isometric midthigh pull (IMTP) are commonly used instead. Force-time characteristics in these multijoint tests typically display stronger relationships to dynamic performance, particularly in the case of the isometric mid-thigh pull. As such this review focuses on the relationships between force-time characteristics in the IMTP and dynamic athletic performance.

Publication 2: The Isometric Mid-Thigh Pull: A …

Dna Methylation Of The Clusterin Promoter: Associations With Alzheimer’S Disease Risk And Related Phenotypes, Madeline Peretti

Theses: Doctorates and Masters

Background

In 2017 approximately 50 million people worldwide were living with dementia. With Alzheimer’s disease (AD), accounting for 50-70% of dementia cases making this debilitating disease, with no current effective prevention, treatment or cure, a critical healthcare concern. Genome wide association studies (GWAS) have identified a number of risk genes for late onset AD (LOAD); Apolipoprotein E (APOE), a gene involved in the cholesterol/lipid pathway is considered the gene with the greatest risk. The third most associated AD risk gene is Clusterin (CLU), is also involved in the cholesterol/lipid pathway. CLU has been implicated in both …

An Exploration Of The Critical Success Factors Associated With Implementing A Public Health Plan In Local Governments Within Western Australia, Anne Polley

Theses: Doctorates and Masters

Public Health planning in local governments in Western Australia (WA) is a relatively new approach to addressing local health needs. The Western Australian Public Health Act came into effect in 2016. The Public Health Act 2016 encompasses a range of legislative requirements, some of which include the development of Local Public Health Plans. A range of roles within the local government workforce therefore are likely to require support to plan and implement Public Health Plans, which in the past have not directly been a component of their role. There is limited understanding and evidence of the barriers and enablers that …