Digital Commons Network^™

Machine Learning Prediction Of Incident Hypertension In Australian Men: Integrating Survey, Pharmaceutical And Healthcare Utilisation Data From The Ten To Men Cohort, Ebenezer Afrifa-Yamoah, Emmanuel Peprah-Yamoah, Victor Opoku-Yamoah, Eric Adua

Research outputs 2022 to 2026

Background: Hypertension is a leading modifiable contributor to cardiovascular disease. We developed and evaluated machine learning models to predict incident hypertension in Australian men using baseline survey data linked to pharmaceutical (PBS) and healthcare utilisation (MBS) administrative records from the Ten to Men cohort.

Methods: Among 13,519 men free of hypertension at baseline (2014), incident hypertension over 10 years was ascertained from PBS antihypertensive dispensing. Twenty-five baseline features spanning sociodemographic, anthropometric, lifestyle, clinical and administrative domains were used to train logistic regression, random forest, gradient boosting and XGBoost models, evaluated by five-fold cross-validation with out-of-fold prediction. Discrimination, calibration and threshold-based …

Mental Health Impacts Of Anti-Trans Stigma On Transgender People In Australia: A Mixed-Methods Study, Sav Zwickl, Sasha Bailey, Rin Chan, Shalem Y. Leemaqz, Joel Murray, Stevie Lane, Foster Skewis, Julian Grace, Eli Ward-Smith, Tomi Ruggles, Ada S. Cheung

Research outputs 2022 to 2026

Background: Anti-trans stigma has escalated globally, yet there is limited empirical evidence examining its mental health impacts on trans populations.

Methods: In a May 2024 mixed-methods cross-sectional online survey, trans people aged ≥16 years living in Australia reported the frequency of seven anti-trans stigma experiences in the previous month, including exposure to anti-trans remarks in the news media or online; personal experience of online bullying, harassment or threats; having thought about, seen or heard about anti-trans rhetoric by Australian politicians and high-profile individuals; or anti-trans rallies; or police violence; or international anti-trans legislation and violence. Generalized linear models examined associations …

Multi-Scale Sensor-Aware Variational Autoencoders For Adaptive Iot Security: Integrating Drift Calibration And Cyberattack Detection, Md Kamal Hossain, Iftekhar Ahmad, Daryoush Habibi

Research outputs 2022 to 2026

Existing approaches to Industrial Internet of Things (IoT) anomaly detection treat sensor drift calibration and cyberattack detection as separate problems, overlooking their strong interdependence and the compound failure modes that arise when drift dynamics are exploited by stealthy adversaries. Industrial Internet of IoT sensor networks therefore require a unified framework that jointly models both phenomena. This paper proposes the first unified multi-scale sensor-aware variational autoencoder (MS-VAE) framework that jointly models sensor drift and malicious activity within shared latent representations, enabling integrated calibration and security monitoring. The framework introduces three key components: (i) a multi-scale latent architecture that captures short-term anomalies …

Trends And Indications For Cesarean Section In The Origins Birth Cohort, Kristjana Einarsdottir, Lisa Gibson, Sarah Whalan, Jacqueline Davis, Laurence Amy Payette, Ravisha Srinivasjois, Desiree T. Silva

Research outputs 2022 to 2026

Objective: Cesarean section (CS) rates have increased substantially in Australia, with particularly high use observed in private maternity care and for pre-labor CS. The aim of the present study was to describe the CS rates and the clinical indications for pre-labor CS in the ORIGINS birth cohort.

Methods: This study analyzed data from the ORIGINS birth cohort, a large birth cohort in Western Australia, including 9473 births occurring at Joondalup Health Campus between 2016 and 2024. Rates of CS and pre-labor CS were compared across study periods (2016–2020 and 2021–2024) and by facility type (public vs. private). Indications for pre-labor …

Sheep Industry Pivot Project: Global Comparative Review, James Smith

Research outputs 2022 to 2026

Executive summary: This report forms the first stage of a two-year project led by Edith Cowan University to identify and commercialise new market pathways for Australian sheep products and by-products. The project responds to a period of significant structural change within the industry, most notably the legislated phase-out of live sheep exports by sea by May 2028, which is reshaping market dynamics and supply chain configurations. As an initial global benchmark and review, this report examines international best practice and emerging opportunities to inform industry transition, with the broader project focused on supporting producers and processors to develop and test …

Governing Professional Mobility: An Llm-Assisted Framework And Empirical Taxonomy Of Health-Professional Mobility Agreements, David C. Benton, Andrew D. Benton

Research outputs 2022 to 2026

Background: Health-professional mobility agreements (eg, compacts, mutual recognition arrangements, memoranda of understanding) are increasingly used to address workforce shortages, support crossborder practice, and enable new technology-mediated modes of service delivery. Regulators need rapid, reproducible ways to assess whether such instruments protect the public while facilitating proportionate professional mobility.

Purpose: To develop and internally test a 10-dimension, 41-subdimension assessment framework for health-professional mobility agreements; examine whether large language model (LLM)–assisted coding can approximate expert legal regulatory assessment; and derive an empirical taxonomy of mobility and other similar instruments.

Methods: A focused documentary synthesis of legal instruments, academic literature, and intergovernmental guidance …

Selective Human Resource Practices, Psychological Safety Climate And Employee Wellbeing, Yvonne Brunetto, Matthew J. Xerri, Geremy Farr-Wharton

Research outputs 2022 to 2026

Purpose: Engineers and healthcare professionals perceive higher levels of stress compared with the general population, suggesting that past human resource management (HRM) systems have failed to manage them appropriately. This study examines whether psychosocial safety climate (PSC) acts as a psychological conduit in translating HRM practices and mediating their impact on wellbeing using the common good HRM (CGHRM) and Conservation of Resources theoretical frameworks.

Design/methodology/approach: Data were collected using surveys collected at two points – one-month apart, and then analysed using structural equation modelling (Analysis of Moment Structures) to manipulate survey data from 300 matched employees.

Findings – The variance …

The Role Of Physical Therapy Across The Transplant Trajectory In Allogeneic Hematopoietic Stem Cell Transplantation, A Systematic Review And Clinical Framework, Houssem Ben Jemia, Rebecca Catterina, Marialaura Calonghi, Maria Anna Dossena, Stefano Giuseppe Lazzarini, Francesco Bettariga, Michele Malagola, Enrico Morello

Research outputs 2022 to 2026

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) increasingly involves older and medically complex patients, in whom impaired pulmonary function and high comorbidity burden adversely affect survival and long-term outcomes. Rehabilitation and exercise interventions are biologically plausible strategies to mitigate deconditioning along the transplant trajectory, but their role in allo-HSCT has not been systematically organized within a phase-specific clinical framework. A systematic review of randomized controlled trials (RCTs) was conducted according to Cochrane guidance and PRISMA 2020, with prospective registration in PROSPERO. PubMed, Embase, PEDro, Web of Science, CENTRAL and Scopus were searched from inception to early 2025, with an updated PubMed …

Navigating The Deep Features Of Change: A Dynamic Approach For Skill Development In The Construction Industry, Keyao Li, Mark A. Griffin, Heap Yih Chong

Research outputs 2022 to 2026

Purpose: Digitalisation promises new levels of productivity and efficiency in construction but requires a well-equipped, skilled workforce to meet future demands. Beyond attracting skilled workers, the industry must understand future skill requirements. This study addresses this need by developing a skill framework that defines key skill levels and patterns in response to evolving demands. Design/methodology/approach: A mixed-methods approach with three consecutive analyses was adopted. First, a theoretical analysis developed a conceptual framework based on work and role performance theories. Second, a scoping review and descriptive analyses provided quantitative insights into the skills covered in current literature. Finally, identified skill groups …

Are Australian Schools Becoming Less Inclusive? Changes To Class Ability Grouping Practices In Australian Secondary Schools, Olivia Johnston, Peter Palamara

Research outputs 2022 to 2026

Class ability grouping does not improve overall academic results, and is inequitable because it segregates students according to their disability, race, class, gender, and other factors that already make students at risk in education. The practice is not inclusive and previous research has shown that it exacerbates social disadvantage. Despite the evidence, historical efforts to change practices in Australia have been unsuccessful and many schools still use class ability grouping. This paper presents analysis of data from the Class Ability Grouping Survey about how often schools reported changing their class ability grouping practices in Year 7–9 Mathematics, English, Science, and …

Emerging Stronger From Challenging Times: How Servant Leaders Manage Workplace Spirituality And Employee Flourishing, Mahdi Vesal, Muhammad Aftab Alam

Research outputs 2022 to 2026

Business leaders, particularly in challenging times like the post-COVID era, grapple with fostering employee well-being and addressing spiritual needs. Our research explores the link between workplace spirituality—marked by meaningful work, community, and value alignment—and employee flourishing, with a focus on the role of servant leadership. Using self-determination theory, we analyzed survey data from SMEs in Iran and India, where employees navigated challenging times amid COVID-related difficulties. Study 1 (303 employees in 128 Iranian firms) found meaningful work and a sense of community positively influence employee flourishing, while value alignment has a curvilinear effect. Study 2 (215 senior Indian employees) replicated …

Using Drawings To Understand Undergraduates’ Perceptions Of Politics—The Us And Ireland, John Hogan, Sharon Feeney, Paul Kosempel

Research Outputs: 2025-Present

Purpose: This article seeks to gain insights from the interpretations of freehand drawings produced by American and Irish students, young voters, in response to the question: “What is American/Irish politics?” Our goal in using freehand drawing is to foster a collaborative and critical learning environment where participants enhance their ability to interpret and engage in self-reflection. Design/methodology/approach: Freehand drawing is a visual representation method that can bypass cognitive verbal processing pathways as part of a critical pedagogy. This approach enables participants to create clear, more critical, and inclusive depictions of their understanding of a topic, regardless of their vocabulary. Over …

Readability Of Online Patient Education Materials For Myopia Management, Monica Jong, Michelle Waugh, Pinar Ozmizrak, Ian Flitcroft

Research Outputs: 2025-Present

Purpose: Patients are turning to the internet to access educational materials to help them make healthcare decisions, making readability an important factor. This cross-sectional study assessed the readability of online patient education materials for myopia management treatments that have regulatory approval. Methods: The top 10 Google search results from May 2024 for freely available online patient information on myopia management modalities and regulatory-approved products in Canada and Australia were analysed for readability. The modalities included orthokeratology, myopia control spectacle lenses, myopia control soft contact lenses and atropine. The products included MiYOSMART® [HOYA®], Stellest® [Essilor®], MyoCare® [ZEISS], MiSight® 1 day [CooperVision®], …

The Past, Present, And Future Of Customer Knowledge Management: A Review And Research Agenda, Victoria Y. Ourzik

Research Outputs: 2025-Present

We develop and present a framework for research in customer knowledge management (CKM) that synthesizes insights from a comprehensive literature review spanning 2000 to 2024. This framework highlights the determinants, impacts, and moderators shaping CKM and its role in contemporary organizations. Using this approach, we organize and categorize existing research across various disciplines, identifying multiple definitions of customer knowledge based on their theoretical underpinnings and research fields. Building on this synthesis, we propose an interdisciplinary definition of the CKM construct that integrates diverse perspectives. Finally, we outline evolving issues within CKM, highlight key research gaps, and set a forward-looking agenda …

Volatility In Transition: Fossil Fuel Dependence, Renewable Shifts, And Financial Risk Across Europe’S Eastern Divide, Lucía Morales, Daniel Rajmil, Bernadette Andreosso-O’Callaghan

Research Outputs: 2025-Present

Europe’s energy landscape has undergone profound disruptions following the escalation of the Russo-Ukrainian war, exposing deep structural vulnerabilities in the continent’s persistent reliance on fossil fuels. The crisis intensified political and economic tensions across the longstanding European Eastern divide, as the abrupt suspension of Russian gas disrupted energy security, triggered unprecedented price volatility, and accentuated disparities in the capacity of European Union Member States to pursue their green transitions. This paper investigates the asymmetric dynamics of fossil-fuel dependency and renewable energy expansion across ten Central/East European countries (CEEs, namely Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, …

An Analysis Of Diet Sustainability Among Different Dietary Patterns In The Portuguese Adult And Elderly Population, Mariana Rei, Áine Burke, Sadhbh O’Shea, Annemarie E. Bennett, John M. Kearney, Sara S.P. Rodrigues

Research Outputs: 2025-Present

Purpose: Dietary patterns influence human and environmental health. Shifts toward convenience and ready-to-eat ultra-processed foods have contributed to the rising prevalence of malnutrition, chronic disease, and ecological harm. This study examined the associations between dietary patterns and diet sustainability among Portuguese adults. Methods: Data from 2287 individuals aged 18–84 years were obtained from the last National Food, Nutrition, and Physical Activity Survey (2015–2016). Three dietary patterns were identified based on food composition and processing: Traditional, Diet Concerns, and Unhealthy; while four dietary patterns were categorized according to food preparation location: At home by themselves, At home by relatives or friends, …

Alignment Of The Planetary Health Diet With Pregnancy Dietary Guidelines: Insights From Two Cohorts, Aoife Davis, Sophie Callanan, Gillian A. Corbett, Eileen C. O’Brien, Alexander Douglass, Fionnuala M. Mcauliffe

Research Outputs: 2025-Present

The Planetary Health Diet (PHD) is a mostly plant-based diet that aims to optimise human health whilst minimising the environmental impact of food production. Limited data exists on whether the PHD fulfils key nutritional requirements during pregnancy. This research aimed to examine the PHD in early pregnancy and how it aligns with daily nutrient intake and European Food Safety Authority (EFSA) dietary guidelines. Pregnant women (n=678) from two Irish cohorts (ROLO and MicrobeMom) were analysed. Dietary intakes in early pregnancy were determined using a 3-day food diary and used to calculate PHD Index (PHDI) scores. Women were dichotomised by the …

Study Investigating The Thermal Behavior Of An Atmospheric Pressure Plasma Jet On Conductive And Nonconductive Mesh Surfaces, James Lalor, Tristan Orlic, Vladimir Milosavljevic

Research Outputs: 2025-Present

This study investigates the thermal behavior of conductive and nonconductive mesh substrates during exposure to a custom built atmospheric pressure plasma jet (APPJ). The jet operates using a coaxial dielectric barrier discharge configuration with a novel gas diffusing dielectric core. It is powered by a high frequency AC source operating at 21 kHz with a 33% duty cycle. The surface temperature was recorded in real time using a calibrated FLIR i7 infrared camera, a method increasingly used in plasma thermal studies for its noninvasive mapping of heat transfer. The following three parameters were varied: working gas (argon or helium), jet …

Physique Development And Management Shape Experiences Of Low Energy Availability Risk In Elite Professional Male Rugby Union Players, Gary Sweeney, Siobhain Mcardle, Nessan Costello, Kieran Collins

Research Outputs: 2025-Present

This study aimed to explore elite male rugby union players’ perceptions and lived experiences of physique development and management in relation to low energy availability risk. Semi-structured interviews (29 ± 8 min) were conducted with 18 players (senior: n = 9; academy: n = 9; mean age: 23 ± 3) across four professional rugby union clubs in Ireland. Through reflexive thematic analysis, the following themes were constructed. Players had limited awareness of low energy availability, yet described experiences consistent with symptoms, including fatigue, low mood and reduced libido. A pervasive physique culture, characterised by body composition ‘ideals’ and weight or …

Exploration Of Best Practice Of Market Surveillance And Type Approval Of Internal Combustion Engines Emissions For Non-Road Mobile Machinery (Examine_Nrmm), Rita Hagan, Eoin Mcgillicuddy, Aoife Donnelly

Research Outputs: 2025-Present

This study examines market surveillance methods for engines in non-road mobile machinery (NRMM) in selected European Union (EU) Member States and the UK, to inform the development of an Irish NRMM market surveillance process in accordance with Regulation (EU) 2016/1628. The research found NRMM market surveillance approaches vary across Europe, with no uniform market surveillance strategy in place. Some countries, including Ireland, are currently developing an approach, while other countries have no set process in place. In countries, with an existing strategy, the process can be proactive, reactive or a combination of both.Findings highlight opportunities for Ireland to design a …

Understanding The Epigenetic Landscape Of Barrett's Esophagus And Esophageal Cancer: A Review Of Current Findings, Caveats And Future Directions, Louise Lawless, Trevor Doherty, Carla Surlis, Niamh Gilmartin, Therese M. Murphy

Research Outputs: 2025-Present

Esophageal cancer (OC) is currently the eighth most common form of cancer worldwide with a 5-year survival rate of 10%–20%, with the primary risk factor of esophageal adenocarcinoma (OAC) being the development of Barrett's Esophagus (BO). Despite its clinical significance, the molecular pathogenesis underlying both BO and OC is not well understood. In recent years, epigenetic dysregulation, particularly aberrant DNA methylation, has emerged as a critical area of investigation, given its potential utility in the identification of diagnostic, prognostic, and therapeutic biomarkers. This review examines the evolving epigenetic landscape of esophageal cancer, including a focus on its origins in BO …

A Comparative Analysis Of The Efficacy, Safety And Mechanism Of Action Of Flebogamma Dif, Fostamatinib And Romiplostim In Immune Thrombocytopenia, Mary Akinyemi, Kamna Ravi, Furong Tian, Baljit Singh

Research Outputs: 2025-Present

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by immune-mediated platelet destruction, resulting in a platelet count below 100 × 10⁹/L and an increased risk of bleeding complications that significantly impair quality of life. Despite advances in ITP management, the unpredictable and heterogeneous nature of the disease continues to challenge treatment selection. This review compares the efficacy, safety, and mechanisms of action of Fostamatinib, Flebogamma DIF, and Romiplostim in adult and pediatric ITP patients. Peer-reviewed studies published over the past 20 years, including randomized and non-randomized clinical trials, observational studies, and real-world evidence, were screened for relevance, with …

Sustainable Remediation Of Antibiotic Contaminants Using Engineered Biochar And Composite Materials, Arvind Kumar, Prerna Sunar, Duraisamy Ramamoorthy, Swapnamoy Dutta, Ravikant Verma, Km Smriti Jaiswal, Krishna Kumar Jaiswal, Vinod Kumar, Amit K. Jaiswal, Mahaveer D. Kurkuri

Research Outputs: 2025-Present

Antibiotic contamination is a growing global crisis due to widespread use and unregulated disposal, contributing to the proliferation of antibiotic-resistant microbes and ecological risks. This review critically evaluates antibiotic contamination and its impact on the environment and human health. Biochar and modified biochar modulate antibiotic resistance gene (ARG) dynamics and the destruction of ARG transfer. Optimization of biochar properties includes surface chemistry, structure, synthesis process, and surface engineering to enhance antibiotic adsorption and degradation. Therefore, a comprehensive evaluation of biochar and modified biochar for the adsorption and degradation of different antibiotics under diverse water and soil chemistry conditions is needed. …

Investigation Of Different Aeration Strategies For The Production Of Kombucha With Defined Co-Cultures, Marie Ludszuweit, Leon Bender, Gayatri Mehta, Martin Hageböck, Brian Gibson, Martin Senz

Research Outputs: 2025-Present

Kombucha fermentation is a complex process influenced by many different process parameters and the dynamics of the microorganisms present. Since no universally established standards exist for large-scale production of kombucha, manufacturers still need to acquire the knowledge to establish controllable and reproducible processes. The aim of this study was to investigate the extent to which the kombucha fermentation process can be influenced by varying the oxygenation regime and the initial pH value. For this purpose, co-culture fermentations with the yeast Zygosaccharomyces bailii and the acetic acid bacterium Komagataeibacter hansenii were carried out under defined conditions, varying the type and intensity …

Biogenic Chitosan-Encapsulated Cu/Zno Nanocomposite Surface Coating Inhibits Mdr Pseudomonas Aeruginosa Biofilm Establishment On Orthopedic Implants, Bushra Uzair, Zukhra Abbasi, Fehmida Fasim, Shoaib Alam, Apori Samuel Obeng, Furong Tian

Research Outputs: 2025-Present

Orthopedic implant-associated infections (IAIs), predominantly caused by Pseudomonas aeruginosa, represent a major clinical challenge due to antibiotic resistance and biofilm formation, which together contribute to their chronic nature. This research presents a biogenic biofilm-resistant chitosan encapsulated Cu/ZnO nanocoating (CS-Cu/ZnO NC) synthesized using Euphorbia thymofolia metabolites and applied on orthopedic implant surface (Tubular bone locked stainless steel plates). The synthesized CS-Cu/ZnO NCs were characterized physicochemically (UV–Vis, FTIR, XRD, SEM) and biologically (antibacterial, antibiofilm, antivirulence, hemolysis and cytotoxicity). Microstructural analysis using UV–Visible Spectroscopy (UV–Vis), X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM) confirmed the successful synthesis, crystallinity …

Editorial: Food Safety In The Context Of One Health: Current Trends, Challenges And Perspectives, Daniel Ekhlas, Yosra A. Helmy, Federica Savini, Arturo B. Soro, Elena Alexandra Alexa

Research Outputs: 2025-Present

No abstract provided.

Time To Hang Up The Gloves: A Scoping Review Of Evidence On Non-Sterile Glove Use During Intravenous Antimicrobial Preparation And Administration, Natasya Raja Azlan, Debbie Massey, Lesley Andrew, Amanda Towell-Barnard, Seng Giap Marcus Ang, Carol Crevacore, Martina Costello, Aaron Alejandro, Weiting Liu, Naila Zaman, Peta Anne Zimmerman

Research outputs 2022 to 2026

Aims: To systematically summarise evidence related to the use of non-sterile gloves when preparing and administering intravenous antimicrobials. Design: Scoping review. Methods: A rigorous scoping review was undertaken following Arksey and O'Malley's (2005) framework and the modified Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review guidelines (2018). Five databases and grey literature were included in the search. Literature published between 2009 and 2024 was included. Data Sources: Five databases (Medline, CINAHL, EMBASE, Scopus and Web of Science) and the grey literature were searched in February 2024. Results: Three studies were included; however, none directly addressed correct …

Young People Healing And Growing In Trauma-Informed Positive Music Education, Jason Goopy

Research outputs 2022 to 2026

Trauma-informed positive education (TIPE) is a recent approach that combines trauma-informed practices and strengths-based positive psychology. This study investigated how young people use music to heal and grow in a community music education programme informed by TIPE. A narrative inquiry was conducted at an Australian community music organisation supported by a global record label to offer a specialised programme developing music and life skills for youth experiencing adversity, such as mental illness, homelessness, abuse, and discrimination. Data were generated by participation and observation in programme sessions, and individual narrative share and tell interviews were conducted with three programme participants. Stories, …

Blood Flow Restriction During Small-Sided Games Enhances Physiological Adaptations And Performance Improvements In Well-Trained Basketball Players: A Randomized Controlled Trial, Hengxian Liu, Mingyue Yin, Kai Xu, Shengji Deng, James R. Mckee, Brendan R. Scott, Olivier Girard, Mingxin Zhang

Research outputs 2022 to 2026

This study examined whether adding blood flow restriction (BFR) to small-sided games (SSG) augments cardiorespiratory/anaerobic adaptations and lower-limb muscular performance in well-trained male collegiate basketball players. Twenty-four atheletes (age: 21.0 ± 1.6 years) were randomized to either an experimental (SSG+BFR; 100–130% of leg systolic pressure) or a control group (SSG; without BFR) and completed eight 3 vs. 3 player-SSG sessions over four weeks (4 sets of 3–4.5-min bouts; 3-min rest intervals). Peak aerobic power, Peak oxygen uptake [VO2peak], Wingate 30-s peak/mean power, lower-limb performance (back-squat 1RM, countermovement-jump [CMJ] height/power, T-test, 30-m sprint, repeated-sprint ability [RSA best/mean and decrement score]) were …

Bridging Idealism And Reality: Nursing Students’ Perceptions About The Impact On Their Wellbeing From Being A Nurse: A Qualitative Study, Louise M. Allen, Karen Missen, Simon J, Cooper

Research outputs 2022 to 2026

Background: Nursing students often enter undergraduate nursing programs with idealistic perceptions of how nursing can impact personal wellbeing. The gap between expectations and clinical realities may hinder progress and contribute to attrition. Aim: To explore nursing students' perceptions of how the nursing profession impacts a nurse's wellbeing. Methods: This descriptive qualitative study, informed by Transformational Learning Theory, involved semi-structured online interviews with 23 nursing students from three Australian universities. Interviews were transcribed verbatim and thematically analysed. Results: Students began the program with idealistic views about the physical, emotional and social impacts of nursing. Clinical placements played a key role in …