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 …

An Assessment Of Health Hazards Associated With The Use Of Water Mist Systems As A Cooling Intervention In Australia, Edmore Masaka

Theses: Doctorates and Masters

Water mist systems (WMS) installed and used for cooling ambient temperatures in public places fall within the category of premise plumbing. Premise plumbing refers to the water distribution networks that lie downstream of the water meter, and within buildings. The colonization of premise plumbing by opportunistic premise plumbing pathogens (OPPPs) such as Legionella pneumophila, Pseudomonas aeruginosa, Mycobacterium avium, Acanthamoeba and Naegleria fowleri is emerging as a challenge for public health and water quality management. Contrary to other premise plumbing features like showers and domestic taps that have been implicated in various waterborne infections, the health risks associated with WMS are …

The Adherence To Group B Streptococcus Screening Guidelines Amongst Pregnant Women In Western Australia – A Quantitative Descriptive Analysis, Sabine Pangerl

Theses: Doctorates and Masters

Colonisation with Group B Streptococci (GBS) is a major risk factor for neonatal infection acquired via vertical transmission during pregnancy, labour, or birth, potentially resulting in significant morbidity and mortality. Universal screening at 35 – 37 weeks gestation for maternal GBS colonisation and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of neonatal Early-Onset GBS Disease (EOGBSD). Women in Western Australia (WA) are offered GBS screening in pregnancy and intrapartum antibiotic prophylaxis. Anecdotal evidence suggests variations in viewpoints and thus low adherence to relevant clinical guidelines amongst midwives and pregnant women in the midwifery …

Delegation Practices Between The Registered Nurse And The Assistant In Nursing In The Acute Care Setting In Western Australia, Carol Crevacore

Theses: Doctorates and Masters

Background:

Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment.

Aim:

The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN.

Methodology:

This study used a mixed method explanatory sequential design. The participants were RNs and AINs working …

The Coaches’ Eye: Exploring Coach Decision-Making During Talent Identification, Alexandra Hannah Roberts

Theses: Doctorates and Masters

For decades, researchers and practitioners interested in talent identification have discussed the coaches’ eye: the elusive ability that allows some coaches to ‘see’ qualities in an athlete that point to their talent or future potential. While there is significant anecdotal evidence of coaches who possess this ability, there is little empirical research supporting the validity or reliability of the coaches’ eye. Guided by ecological dynamics, this thesis employs mixed methodologies to explore the decision-making that underpins how high-level coaches identify talent in Olympic combat sports. These four studies captured the processes of thirty- four coaches during the talent identification process, …

Cost-Effectiveness Of Exercise Medicine For Prostate Cancer, Kim Edmunds

Theses: Doctorates and Masters

Background

Androgen deprivation therapy (ADT) is associated with numerous adverse effects that impact on quality of life and contribute further to the cost burden of prostate cancer (PCa) via treatment and supportive care. Exercise medicine is effective in slowing PCa progression, reversing treatment adverse effects and improving quality of life and survival of patients, however, no economic analyses have been conducted to determine whether exercise is cost-effective in this population.

Objectives

Firstly, to examine the adverse effects of ADT for PCa and the evidence supporting the use of exercise medicine in their management. Secondly, to conduct the first economic evaluations …

Investigation Of A Communication Enhanced Environment Model After Stroke: A Mixed Methods Before-And-After Pilot Study, Sarah D’Souza

Theses: Doctorates and Masters

Background: Aphasia is an acquired communication disorder that affects approximately 30% of first ever stroke survivors and persists one-year post-stroke in up to 61% of survivors. Aphasia impacts on all communication modalities with significant negative consequences for social participation, interpersonal relationships, autonomy, capacity to work and quality of life. It is recognised that the environment can influence neural remapping during early stroke recovery. However, patients with aphasia (PWA) following stroke have been observed to spend less than 30% of their day communicating and 44% of their day alone during their first weeks of in-patient rehabilitation. Inadequate opportunities for communication places …

An Exploration Of The Relationship Between Aphasia Therapy, Depression And Quality Of Life In Post-Stroke Patients After Rehabilitation At 12 And 26 Weeks After Stroke: A Verse Sub-Study, Alia Rashid Khan

Theses: Doctorates and Masters

Background: Depression is a common consequence of stroke, and people with aphasia (PWA) post-stroke have a higher risk of developing depression compared to stroke survivors without aphasia. However, current stroke interventions featuring aphasia therapy tend to neglect the effect of the treatment on mood. There is also a lack of evidence on the impact of stroke education and counselling on PWA in early stroke recovery. Additionally, the research on post-stroke depression often excludes or insufficiently describes PWA in study populations. The influence of direct aphasia therapy on depression in PWA is undetermined. This sub-study investigated: i) the effect of …

Drumbeat© For Arthritis “ A Shared Purpose” Rather Than A “Lonely Struggle”, Jannette Warhurst

Theses: Doctorates and Masters

Australia is regarded as a healthy nation, with life expectancy one of the highest in the world. Yet the latest National Health Survey tells a very different story. Almost 50% of Australians are now living with one or more chronic conditions, with arthritis and other musculoskeletal (MSK) conditions representing the most expensive chronic disease group in Australia. As the leading cause of chronic pain and second most common cause of disability and early retirement due to ill health in Australia, Arthritis is costing the economy over $7 billion a year, in addition to over $1.1 billion in extra welfare costs …

Does Accurate Data, Identifying Obese Patients Impact Nurse Safety And Hospital Finances?, Kim Mcclean

Theses: Doctorates and Masters

Healthcare staff who manage obese patients are at increased risk of sustaining patient handling injuries, and this risk is anticipated to intensify as projected Australian obesity rates increase to 42% by the year 2035 and obese patients admitted to hospitals also increase. High cost burdens to healthcare organisations will result due to increased funding requirements for bariatric risk management solutions and growing costs of workers’ compensation claims of injured staff. Five (5) studies explored if identification of obese patients impacts the safety of nurses and other healthcare staff who manage obese patients and investigated the accuracy of obesity data recorded …

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 …