Digital Commons Network^™

Trends In Seasonal Influenza Vaccine Uptake During Pregnancy In Western Australia: Implications For Midwives, Annette Regan, Donna Mak, Yvonne Hauck, Robyn Gibbs, Lauren Tracey, Paul Effler

Medical Papers and Journal Articles

Background: Antenatal influenza vaccination is an important public health intervention for preventing serious illness in mothers and newborns, yet uptake remains low. Aim: To evaluate trends in seasonal influenza vaccine coverage and identify determinants for vaccination among pregnant women in Western Australia.

Methods: We conducted an annual telephone survey in a random sample of post-partum women who delivered a baby in Western Australia between 2012 and 2014. Women were asked whether influenza vaccination was recommended and/or received during their most recent pregnancy; women were also asked why or why they were not immunised.

Findings: Between 2012 and 2014, influenza vaccine …

All Care, But Whose Responsibility? Community Juries Reason About Expert And Patient Responsibilities In Prostate-Specific Antigen Screening For Prostate Cancer, C Degeling, S Carter, L Rychetnik

Medical Papers and Journal Articles

General practitioners have implicitly been given responsibility for guiding men’s decisions about prostate-specific antigen–based screening for prostate cancer, but patients’ expectations of the bounds of this responsibility remain unclear. We sought to explore how well-informed members of the public allocate responsibilities in prostate-specific antigen screening decision-making. In 2014, we convened two Community juries in Sydney, Australia, to address questions related to the content and timing of information provision and respective roles of patients and general practitioners in screening decisions. Participants in the first jury were of mixed gender and of all ages (n = 15); the participants in the second …

Simulation Modelling As A Tool For Knowledge Mobilisation In Health Policy Settings: A Case Study Protocol, Louise Freebairn, Jo-An Atkinson, P. Kelly, Geoff Mcdonnell, Lucie Rychetnik

Medical Papers and Journal Articles

Background: Evidence-informed decision-making is essential to ensure that health programs and services are effective and offer value for money; however, barriers to the use of evidence persist. Emerging systems science approaches and advances in technology are providing new methods and tools to facilitate evidence-based decision-making. Simulation modelling offers a unique tool for synthesising and leveraging existing evidence, data and expert local knowledge to examine, in a robust, low risk and low cost way, the likely impact of alternative policy and service provision scenarios. This case study will evaluate participatory simulation modelling to inform the prevention and management of gestational diabetes …

Student-Centered Interventions The Key To Student Health Care Worker Influenza Vaccination, M Nyandoro, D Kelly, D Macey, D Mak

Medical Papers and Journal Articles

Objectives: To investigate influenza vaccination uptake rates, attitudes and motivations towards influenza vaccination among student health care workers (HCWs).

Methods: Self-reported influenza vaccination uptake among student HCWs at The University of Notre Dame Australia, Fremantle, Western Australia (UNDAF) was surveyed before and after implementation of a peer-led, student-centered campaign to raise awareness of, and improve access to, influenza vaccination. Data were weighted and analysed using logistic regression.

Results: Pre-campaign influenza vaccination uptake was 36.3% (95% CI=31.8%-40.8%), with students identifying lack of awareness of both the Australian Government’s recommendations and university policy, cost, and inconvenience of vaccine access …

Self-Sampling Hpv Testing Versus Mainstream Cervical Screening And Hpv Testing, A Farnsworth

Medical Papers and Journal Articles

No abstract provided.

Development Of A Video-Based Education And Process Change Intervention To Improve Advance Cardiopulmonary Resuscitation Decision-Making, Nicholas Waldron, Clare V. Johnson, P Saul, Waldron Heidi, Jeffrey C. Chong, Anne-Marie Hill, Barbara Hayes

Medical Papers and Journal Articles

Background: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions.

Methods: Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated ‘Goals of Patient Care’ (GOPC) form and process; (ii) an education video and resources for teaching advance CPR …

Therapists' Experiences Of Alliance Formation In Short-Term Counselling, Mark Pearson, Caroline Bulsara

Medical Papers and Journal Articles

While therapeutic alliance formation has been widely researched over many sessions of psychotherapy, the question of alliance formation in short-term counselling has been less explored. Given the increasing evidence in the literature for the positive impact of alliances on therapy outcomes, providing counsellors - who may work with clients for a limited number of sessions - with enhanced insight into alliance formation will be of value. This qualitative study investigated the experiences of eight counsellors forming alliances with clients over short periods. Semi-structured interviews were analysed using interpretive phenomenological analysis. Five major themes emerged, that while congruent with the alliance …

Sequence Variants In The Ptch1 Gene Associate With Spine Bone Mineral Density And Osteoporotic Fractures, U Styrkarsdottir, G Thorleifsson, S Gudjonsson, A Sigurdsson, J Center, S Lee, T Nguyen, T Kwok, J Lee, S Ho, J Woo, P Leung, B Kim, T Rafnar, L Kiemeney, T Ingvarsson, J Koh, N Tang, J Eisman, C Christiansen, G Sigurdsson, U Thorsteinsdottir, K Stefansson

Medical Papers and Journal Articles

Bone mineral density (BMD) is a measure of osteoporosis and is useful in evaluating the risk of fracture. In a genome-wide association study of BMD among 20,100 Icelanders, with follow-up in 10,091 subjects of European and East-Asian descent, we found a new BMD locus that harbours the PTCH1 gene, represented by rs28377268 (freq. 11.4–22.6%) that associates with reduced spine BMD (P=1.0 × 10⁻¹¹, β=−0.09). We also identified a new spine BMD signal in RSPO3, rs577721086 (freq. 6.8%), that associates with increased spine BMD (P=6.6 × 10⁻¹⁰, β=0.14). Importantly, both …

Doctors' Perspectives On Psa Testing Illuminate Established Differences In Prostate Cancer Screening Rates Between Australia And The Uk: A Qualitative Study, K Pickles, S Carter, L Rychetnik, V Entwistle

Medical Papers and Journal Articles

Objectives: To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different.

Design: A grounded theory study.

Setting: Primary care practices in Australia and the UK.

Participants: 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included.

Results: GPs’ accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the …

Effectiveness Of A Service Learning Model With Allied Health Assistant Students In Aged Care, D Zulch, R Saunders, J Peters, J Quinlivan

Medical Papers and Journal Articles

This mixed methods audit explores the impact of a student learning activity involving service learning. As part of a vocational course in the Academy of Health Sciences at the West Coast Institute, Allied Health Assistant (AHA) students participated in a service learning program focused on work-based learning in residential aged care. Students delivered a therapy program for residents at the facility. Students completed validated evaluation questionnaires on conclusion of study. Of 121 students completing the audit, 91% thought the experience challenged their way of thinking. Only 2% disagreed with this concept. A majority of students (93%) reported the experience interesting …

The Cart Before The Horse? Exploring The Potential Of Eportfolios In A Western Australian Medical School, F Bate, J Macnish, C Skinner

Medical Papers and Journal Articles

In 2014, the School of Medicine Fremantle of the University of Notre Dame Australia initiated a study to explore the curriculum underpinning portfolios used by first-year medical students. The School had used portfolios since 2005 and judged it timely to consider digital technologies as a mechanism to enhance student learning and improve efficiencies. A qualitative approach was adopted that investigated how the curriculum intersected with two ePortfolio platforms: Blackboard and Mahara. Data pertaining to the way in which Blackboard and Mahara ePortfolio platforms supported existing curriculum were collected from students through focus groups and tutors via interviews. As a measure …

Clinical Audit Project In Undergraduate Medical Education Curriculum: An Assessment Validation Study, E Tor, C Steketee, D Mak

Medical Papers and Journal Articles

Objectives: To evaluate the merit of the Clinical Audit Project (CAP) in an assessment program for undergraduate medical education using a systematic assessment validation framework.

Methods: A cross-sectional assessment validation study at one medical school in Western Australia, with retrospective qualitative analysis of the design, development, implementation and outcomes of the CAP, and quantitative analysis of assessment data from four cohorts of medical students (2011-2014).

Results: The CAP is fit for purpose with clear external and internal alignment to expected medical graduate outcomes. Substantive validity in students’ and examiners’ response processes is ensured through relevant methodological and cognitive processes. Multiple …

The Western Australian Clinical Senate As A Model For State-Wide Clinical Engagement, J Quinlivan, T Basile, K Gibson, D Xu, N Croker

Medical Papers and Journal Articles

International reforms in healthcare have established the principal that embracing clinical engagement can drive healthcare reform and improved safety and quality outcomes. Most attention has focussed on how clinicians might be engaged at a local or hospital level. However, healthcare reforms are usually initiated at a state or national level. Less attention has gone into exploring the key elements of a model to achieve clinical engagement at state or national level. This paper explores the key elements of a successful state-wide clinical engagement model including culture and leadership, membership, decision-making processes and accountability and discusses how the current model of …

An Integrated General Practice And Pharmacy-Based Intervention To Promote The Use Of Appropriate Preventive Medications Among Individuals At High Cardiovascular Disease Risk: Protocol For A Cluster Randomized Controlled Trial, A Hayek, R Joshi, T Usherwood, R Webster, B Kaur, B Saini, C Armour, I Krass, T Laba, C Reid, L Shiel, C Hespe, F Hersch, S Jan, S Lo, D Peiris, A Rodgers, A Patel

Medical Papers and Journal Articles

Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; …

Changing The Antibiotic Prescribing Of General Practice Registrars: The Chap Study Protocol For A Prospective Controlled Study Of A Multimodal Educational Intervention, Mieke L. Van Driel, Simon Morgan, Amanda Tapley, Lawrie Mcarthur, Patrick Mcelduff, Lucy Yardley, Anthea Dallas, Laura Deckx, Katie Mulquiney, Joshua S. Davis, Andrew Davey, Kim Henderson, Paul Little, Parker J. Magin

Medical Papers and Journal Articles

Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career …

Triage, Treatment And Transfer Of Patients With Stroke In Emergency Department Trial (The T3 Trial): A Cluster Randomised Trial Protocol, Sandy Middleton, Chris Levi, Simeon Dale, N. Wah Cheung, Elizabeth Mcinnes, Julie Considine, Catherine D'Este, Dominique A. Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise E. Craig, Verena Schadewaldt, Patrick Mcelduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward, T3 Trialist Collaborators

Health Sciences Papers and Journal Articles

Background: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T3) of patients with acute stroke to improve 90-day death and dependency. Organisational and contextual factors associated with intervention uptake also will be evaluated.

Methods: This prospective, multicentre, parallel group, cluster randomised trial with blinded outcome assessment will be conducted …

Cme/Cne Article: A Framework Of Care In Multiple Sclerosis, Part 1, Scott D Newsome, Philip J Aliotta, Jacquelyn Bainbridge, Susan E Bennett, Gary Cutter, Kaylan Fenton, Fred Lublin, Dorothy Northrop, David Rintell, Bryan D Walker, Megan Weigel, Kathleen Zackowski, David E Jones

Faculty, Staff and Student Publications

Activity Available Online: To access the article, post-test, and evaluation online, go to http://www.cmscscholar.org.

TARGET AUDIENCE: The target audience for this activity is physicians, physician assistants, nursing professionals, and other health-care providers involved in the management of patients with multiple sclerosis (MS).

LEARNING OBJECTIVES: Apply new information about MS to a comprehensive individualized treatment plan for patients with MSIntegrate the team approach into long-term planning in order to optimize rehabilitation care of patients with MSAccreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) …

Maize Landraces Are Less Affected By Striga Hermonthica Relative To Hybrids In Western Kenya, Charles A.O. Midega, John Pickett, Antony Hooper, Jimmy Pittchar, Zeyaur R. Khan

All Peer-Reviewed Publications

Production of maize in western Kenya is severely constrained by the parasitic weed striga. Although productivity of maize can be improved through adoption of improved varieties, adoption of such varieties remains low in the region, as the majority of smallholder farmers still grow unimproved open-pollinated varieties (landraces). The performance of two improved hybrid varieties was evaluated against six landraces in striga-infested soils in western Kenya. The varieties were planted in plots under natural striga infestation and were supplemented with pot experiments under artificial infestation. Striga emergence was lower in landraces than in the hybrid varieties in both field and pot …

A "Clarion" Call For Embracing Ipe As The Status Quo For Preparing Health Professionals To Engage In Interprofessional Health Research, Kimberly Adams Tufts

Ellmer School of Nursing Faculty Publications

Complex health conditions and the social-economic determinants that contribute to disease and injury incidence, prevalence, and health inequalities require multifaceted evidence-based interventions that only interprofessional research teams who collaborate across traditional disciplinary lines can generate. Interprofessionally driven and derived research evidence is the method of du jour. Nonetheless as a whole, health professionals who are often members of interprofessional health research teams are products of educational systems wherein they were educated in disciplinary silos. Health professionals that learn about, with, from, each other during their foundational education will be better prepared to function as interprofessional research team members. With the …

Understanding The Problem Solving Approaches Of Special Educators Through The Lens Of Adaptive Expertise, Serra T. De Arment

Theses and Dissertations

The purpose of this research was to investigate special educators’ problem solving approaches through the lens of adaptive expertise. An explanatory sequential mixed methods design was used with participants of varying experience levels and teaching contexts from one Mid-Atlantic state. Participants responded to a researcher-developed survey about their orientations to problem solving (N = 162), then a purposive sample completed semi-structured interviews (N = 8). Following survey measure refinement and validation, quantitative data were analyzed through descriptive statistics, z-scores, correlation, and chi-square test of independence. Subsequently, qualitative data were analyzed through iterative cycles of hypothesis and open coding. …

Documenting Student Connectivity And Use Of Digital Annotation Devices In Virginia Commonwealth University Connected Courses: An Assessment Toolkit For Digital Pedagogies In Higher Education, Laura Gogia

Theses and Dissertations

Virginia Commonwealth University (VCU) is implementing a large scale exploration of digital pedagogies, including connected learning and open education, in an effort to promote digital fluency and integrative thinking among students. The purpose of this study was to develop a classroom assessment toolkit for faculty who wish to document student connectivity in course-related blogging and microblogging (“tweeting”) activities. Student use of digital annotation devices, including hyperlinks, embedded images, mentions, and hashtags, were studied in four university courses as potential indicators of student connectivity, defined as the ability to connect current thoughts and experience with other concepts and people across space …

“I Just Need To Get Myself Supervised:” Exploring Transformative Learning In The Development Of Professionalism Among Physicians In The First Year Of Graduate Medical Education, Elizabeth P. Marlowe

Theses and Dissertations

The study explored the learning experiences of first-year resident physicians during the first year of graduate medical education. The experiences of four intern physicians in the first year of residency training at an urban academic health system provided the site for the research. An exploratory case study research design was employed to examine the learning experiences of these new physicians. A qualitative approach was used to analyze data from interviews and ethnographic observations. The findings of this research study provide evidence surrounding how and what these physician trainees learned regarding professionalism during the first year of residency training.

The findings …

Viewing Victorian Prisoners: Representations In The Illustrated Press, Painting, And Photography, Lauren Boasso

Theses and Dissertations

Victorian prisoners were increasingly out of sight due to the ending of public displays of punishment. Although punishment was hidden in the prison, prison life was a frequent subject for representation. In this dissertation, I examine the ways Victorian illustrated newspapers, paintings, and photographs mediated an encounter with prisoners during a time when the prison was closed to outsiders. Reports and images became a significant means by which many people learned about, and defined themselves in relation to, prisoners. Previous scholarship has focused on stereotypes of prisoners that defined them as the “criminal type,” but I argue prisoners were also …

Jamaican Revolts In British Press And Politics, 1760-1865, Thomas R. Day

Theses and Dissertations

This research examines the changes over time in British Newspaper reports covering the Jamaican rebellions of 1760, 1832 and 1865. The uprisings: Tacky’s Rebellion, the Baptist War and the Morant Bay Rebellion respectively, represented three key moments in the history of race, slavery and the British Empire. Though all three rebellions have been studied, this work compares the three events as moments of crisis challenging the British public discourse on slavery, race and subjecthood as it related to the changing Atlantic Empire. British newspapers provided the most direct way in which popular readers and the growing literate public examined and …

Understanding The Impact Of A Global Universal Design For Learning (Udl) Virtual Classroom On Jamaican Educators Through The Lens Of How People Learn (Hpl), Kathryn W. Best

Theses and Dissertations

This case study examined learning components and outcomes of the UDL Virtual Classroom project, a web-based professional development program that was a collaboration between educators in the United States and Jamaica. The study applied the HPL lens (NRC, 2000) in order to understand the ways that Jamaican educator-participants perceived the integration of learner-centered learning, knowledge-centered learning, assessment-centered learning, and community-centered learning in the program itself, and also examined the impact of these components, despite numerous hurdles, on teachers’ mindsets and practices and the engagement and performance of students in their schools and classrooms. The researcher’s intent was to address the …

Allegories Of The Modern: The Female Nude In Art Nouveau, Emily Winthrop

Theses and Dissertations

Modernism is a plurality, not a singular concept. This project explores examples of Art Nouveau nudes to describe the particular expressions of the modern through varied and complicated allegorical bodies. The female nude as a nexus for ideals of gender, art, and beauty, is informed by and constructs the understanding of these ideals within society. Art Nouveau thus employed the nude to represent complex manifestations of modernity. Three diverse cases provide the subjects of each chapter. All explore modernism through objects and interiors, in public and private environments, and each connects the decorative arts with accounts of European modernism in …

Causes And Consequences Of Peer Victimization Among Adolescents With Autism, Sarah T. Doyle

Theses and Dissertations

A significant, yet understudied issue that demands attention is the experience of peer victimization among adolescents with autism spectrum disorders (ASDs). Research indicates that youth with disabilities, including those with ASDs, are victimized more frequently as compared to their typically developing peers. However, little is known about the peer victimization experience for adolescents with ASDs beyond its frequency of occurrence. This study examined relations between peer victimization and individual, peer, and parent factors and outcomes including internalizing and externalizing symptoms among adolescents with ASDs. No significant indirect effects were found for peer victimization on relations between individual social-cognitive and emotion …

The Entertainment Is Terrorism: The Subversive Politics Of Doing Anything At All, Joe Woods

Theses and Dissertations

When the body is observed through a certain combination of technologies, there can be subversive politics to doing anything at all. The nature of media and biopolitics has permitted for a set of systems aimed at total control of the human body; a power which can permeate all facets of life. This thesis is a collection of essays which argues that speculative fiction contains multitudes of approaches to biopolitical discourse, permitting the reader of the text to approach politics from their own set of experiences, but not allowing the political to be ignored. These chapters contain three separate but interrelated …

Sweaty Mother Slow Groove, Devin Kylie Harclerode

Theses and Dissertations

Sweaty Mother Slow Groove is an engagement in magical thinking that proposes a displacement of swamp methodologies into the virtual realm, existing during the fourth wave. In doing so the cyborg and goddess are united in a re-routing of essentialism and the neo-liberal domination of technology. The metaphorical swamp is the possibility of a mushy danger zone that harnesses the absorption of an unwanted space: a disintegration of the binary and the soft-coded awareness of the body as a process, not a site.

Virtual / Reality: Designing Permeable Spaces For Social Well-Being In The Digital Age, Thomas R. Kennedy

Theses and Dissertations

The digital age has pushed people closer together than ever before. A device that fits in the palm of your hand allows instantaneous communication with billions of other human beings. People share everyday experiences, passing thoughts, personal photos, sometimes privately, often publicly. Distances between people and places feel reduced. Never has it been so easy to be so emotionally close to so many people.

But as digital experiences become routine, our collective perceptions of closeness and distance shift. As virtual communities become larger, so does our awareness of the actual distance between things. Even though humans can be genuinely close …