Medicine and Health Sciences Commons^™

Advances In Personalized Targeted Treatment Of Metastatic Melanoma And Non-Invasive Tumor Monitoring, Dragana Klinac, Elin S. Gray, Michael Millward, Mel R. Ziman Dr

Research outputs 2013

Despite extensive scientific progress in the melanoma field, treatment of advanced stage melanoma with chemotherapeutics and biotherapeutics has rarely provided response rates higher than 20%. In the past decade, targeted inhibitors have been developed for metastatic melanoma, leading to the advent of more personalized therapies of genetically characterized tumors. Here we review current melanoma treatments and emerging targeted molecular therapies. In particular we discuss the mutant BRAF inhibitors Vemurafenib and Dabrafenib, which markedly inhibit tumor growth and advance patients’ overall survival. However this response is almost inevitably followed by complete tumor relapse due to drug resistance hampering the encouraging initial …

Two Case Studies Assessing The Effect Of Oral Contraceptive Pills Upon Serum Amh Concentrations: Results From An External Quality Assurance (Eqa) Scheme, Emily Zuvela, Melanie Walls, Phillip Matson

Research outputs 2013

Objective: To describe the effect of combined oral contraceptives (COC) on serum AMH level in 2 women.

Methods: The COC was initially stopped after over 12 years use then restarted, with the serum being analysed by 6–8 laboratories in an EQA scheme using the same assay (Beckman Coulter Gen II).

Results: In both women, the AMH rose significantly after cessation of the pill, and then dropped after resumption.

Conclusions: In summary, AMH was affected by the combined oral contraceptive pill and further studies on the effect of oral contraceptives are warranted.

Internal Quality Control For The Direct Mar Igg Test: A Simple And Effective Method Using Spiked Seminal Plasma, Kailin Yap, Tara Cawley, Phillip Matson

Research outputs 2013

Objective: To introduce a system using spiked seminal plasma for the QC of the MAR direct test, and to facilitate the determination of assay variability.

Methods: A simple quality control (QC) system for use in the direct MAR test was developed using samples prepared by adding serum to antibody-negative centrifuged seminal plasma to obtain optimal binding, and storing 0.4 mL aliquots at −20 °C in straws. The serum was either from vasectomised men (positive control) or an antibody-negative woman (negative control). QC samples were thawed and mixed 1:1 with donor semen and pre-incubated for 1 hr at 37 …

Neonatal Outcomes After Preterm Birth By Mothers' Health Insurance Status At Birth: A Retrospective Cohort Study, Kristjana Einarsdóttir, Fatima A. Haggar, Amanda T. Langridge, Anthony S. Gunnell, Helen Leonard, Fiona J. Stanley

Research outputs 2013

Background: Publicly insured women usually have a different demographic background to privately insured women, which is related to poor neonatal outcomes after birth. Given the difference in nature and risk of preterm versus term births, it would be important to compare adverse neonatal outcomes after preterm birth between these groups of women after eliminating the demographic differences between the groups. Methods: The study population included 3085 publicly insured and 3380 privately insured, singleton, preterm deliveries (32–36 weeks gestation) from Western Australia during 1998–2008. From the study population, 1016 publicly insured women were matched with 1016 privately insured women according to …

Women Who Stutter : Experiences Of Developing Self-Management And Quality Of Life, Katherine Milton

Theses : Honours

Background and Purpose: Research suggests that stuttering can impact an individual’s quality of life and how they perceive themselves in interactions with others. As a larger proportion of adults who stutter are men, limited research is available regarding the specific experiences of women who stutter (WWS). Existent literature regarding WWS was mainly published in the 1970s -1980s and may no longer represent current issues. This study aimed to explore the current influences on quality of life, perception of stuttering, self-management strategies, and gender issues experienced by WWS.

Methods and Procedures: This grounded theory study used a convenience sample of eight …

Searching For Health Information On The Internet : The Experiences Of Western Australian Adolescents, Lee-Anne Martins

Theses : Honours

Adolescents readily engage in online entertainment pursuits, however, it is their online social activities and health information searches that encourage psychosocial development and influence identity formation and autonomy. Considerable research has been completed on various aspects of adolescents’ encounters with online health information (for example, see Percheski & Hargittai, 2011), yet minimal research has been conducted using Australian adolescents. This study extends existing research utilising Western Australian adolescents who have used the Internet to obtain health information. The areas explored include how Western Australian adolescents search for online health information, by means of which devices, and their experiences of using …

An Analysis Of Treatment Retention And Attrition In An Australian Therapeutic Community For Substance Abuse Treatment, Mark Robert Porter

Theses: Doctorates and Masters

Research undertaken in the last three decades has consistently reported that the length of time spent in inpatient and outpatient alcohol and other drug (AOD) treatment programs predicts treatment success (De Leon, Melnick, Kressel, & Jainchill, 1994; Hubbard, Craddock, & Anderson, 2003; Simpson, Joe, Fletcher, Hubbard, & Anglin, 1999). However, treatment attrition rates are high and present a major problem for improving treatment outcomes. Various factors that have been reportedly associated with increased AOD treatment attrition rates include being female, younger clients, clients using methamphetamines, and clients with elevated psychopathology scores. The aim of this thesis is to improve understanding …

Pediatric Medical Traumatic Stress : The Impact On Children, Parents And Staff, Sarah Mcgarry

Theses: Doctorates and Masters

Burns are one of the most painful and traumatising injuries an individual can sustain and constitute a serious global health threat to children. Despite the magnitude of this public health problem, little research has examined the psychological burden of these injuries. This study used a mixed-methods approach to investigate the effect of paediatric medical trauma on children who have sustained a burn, their parents and the healthcare professionals caring for these patients. The paediatric medical traumatic stress model provided a theoretical framework for this study.

Firstly, this study aimed to gain an understanding of the lived experience of children who …

Neuromuscular Fatigue And Biomechanical Alterations During High-Intensity, Constant-Load Cycling, Amanda Julie Overton

Theses: Doctorates and Masters

Neuromuscular fatigue is an inevitable process at play during prolonged exercise, and may be caused by multiple alterations within the central nervous system and peripheral musculature. As fatigue develops, the neuromuscular system must adapt to these changes by making compensatory movement pattern adjustments so as to use motor pathways that are less fatigued in an effort to maintain task performance; motor variability is thus increased. The primary purpose of the four studies contained within this doctoral thesis was to detail the progression of exercise-induced neuromuscular fatigue, and to improve our understanding of the muscle activation and joint kinematic alterations that …

The Governance Schema Of Regional And Rural Public Hospital Nurses: How Relevant Are The Dimensions Of Stewardship Governance And Trust In Management?, Kim Clark

Theses: Doctorates and Masters

This study broadly pertained to the issue of public health sector governance. The field of healthcare governance had been characterised as having challenges of greater intricacy and sensitivity than those found in any other sector (Philippon & Braithwaite, 2008). While increasingly regarded as important to health system performance, governance had, however, been evaluated as poorly understood in conceptual and practical terms and subject to competing ideas regarding its role and challenges (Brinkerhoff & Bossert, 2013). Specifically, the thesis elucidated frontline regional and rural hospital nurses’ cognitive schema of strategic aspects of governance practice of managers in the Western Australian Country …

Effects Of Pulsed Electromagnetic Field Therapy On Symptoms Associated With Eccentric Exercise-Induced Muscle Damage, Henry Banyard

Theses: Doctorates and Masters

Unaccustomed exercise consisting of eccentric contractions induces muscle damage that is characterised by muscle weakness, soreness, swelling and increased muscle stiffness. These symptoms affect daily activities and athletic performance; therefore, interventions to attenuate the symptoms and enhance recovery from muscle damage are necessary. Pulsed electromagnetic field therapy (PEMFT) is anecdotally reported to increase muscle blood flow and oxygenation to enhance tissue healing. One previous study showed that PEMFT was effective for alleviating muscle soreness and losses in range of motion after exercise. However, studies investigating the effect of PEMFT on recovery of muscle strength following eccentric exercise are lacking. The …

Systematic Review Of Research Into The Psychological Aspects Of Prostate Cancer In Asia: What Do We Know?, Suzanne Kathleen Chambers, Melissa Karen Hyde, David Fu-Keung Ip, Jeffrey Charles Dunn, Robert Alexander Gardiner

Research outputs 2013

Background: To review the peer reviewed literature on the psychological aspects of the prostate cancer experience of men in Asia.

Materials and Methods: Medline and PsycINFO, CINAHL, ProQuest, and Web of Science (1999 – November Week 4, 2012) were searched. Inclusion criteria were: included men with prostate cancer and/or their partners or caregivers who identify as Asian recruited in an Asian country; and assessed health-related quality of life, psychological and social adjustment relating to prostate cancer and published in English after 1st January 1999 and prior to 30th November, 2012.

Study aims: design; quality; level of evidence, and key results …

Viral Escape From Hiv-1 Neutralizing Antibodies Drives Increased Plasma Neutralization Breadth Through Sequential Recognition Of Multiple Epitopes And Immunotypes, Constantinos K. Wibmer, Jinal N. Bhiman, Elin S. Gray, Nancy Tumba, Salim S. Abdool Karim, Carolyn Williamson, Lynn Morris, Penny L. Moore

Research outputs 2013

Identifying the targets of broadly neutralizing antibodies to HIV-1 and understanding how these antibodies develop remain important goals in the quest to rationally develop an HIV-1 vaccine. We previously identified a participant in the CAPRISA Acute Infection Cohort (CAP257) whose plasma neutralized 84% of heterologous viruses. In this study we showed that breadth in CAP257 was largely due to the sequential, transient appearance of three distinct broadly neutralizing antibody specificities spanning the first 4.5 years of infection. The first specificity targeted an epitope in the V2 region of gp120 that was also recognized by strain-specific antibodies 7 weeks earlier. Specificity …

Enhancing The Uptake Of Learning Through Simulation In Health, Cobie Rudd

Research outputs 2013

The initial reason that a simulated learning environment (SLE) was pursued was to offer university-based health students a safe and authentic environment in which to learn and practise their skills. Since that time, some eight years later, experience has shown that an SLE needed multiple dimensions to its work, based on evidence. In addition, a new approach to applying and integrating learning through simulation within health curricula, that was replicable and affordable, was required...

The Validity Of The Distress Thermometer In Prostate Cancer Populations, Suzanne Chambers, Leah Zajdlewicz, Danny R. Youlden, Jimmie C. Holland, Jeff Dunn

Research outputs 2013

Background: The Distress Thermometer (DT) is widely recommended for screening for distress after cancer. However, the validity of the DT in men with prostate cancer and over differing time points from diagnosis has not been well examined. Method: Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT compared with three commonly used standardised scales in two prospective and one cross-sectional survey of men with prostate cancer (n = 740, 189 and 463, respectively). Comparison scales included the Impact of Event Scale – Revised (IES-R, Study 1), the Hospital Anxiety and Depression Scale (HADS, Study 2) …

Internet-Based Photoaging Within Australian Pharmacies To Promote Smoking Cessation: Randomized Controlled Trial, Oksana Burford, Moyez Jiwa, Owen B. Carter, Richard Parsons, Delia Hendrie

Research outputs 2013

Background: Tobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers. Objective: To conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting. Methods: A trial was designed with 80% power based on the effect size observed in a …

Predicting Optimal Cancer Rehabilitation And Supportive Care (Polaris): Rationale And Design For Meta-Analyses Of Individual Patient Data Of Randomized Controlled Trials That Evaluate The Effect Of Physical Activity And Psychosocial Interventions On Health-Related Quality Of Life In Cancer Survivors, Laurien M. Buffart, Joeri Kalter, Mai Jm Chinapaw, Martijn W. Heymans, Neil K. Aaronson, Kerry S. Courneya, Paul B. Jacobsen, Robert Newton, Irma M. Verdonck-De Leeuw, Johannes Brug

Research outputs 2013

Effective interventions to improve quality of life of cancer survivors are essential. Numerous randomized controlled trials have evaluated the effects of physical activity or psychosocial interventions on health-related quality of life of cancer survivors, with generally small sample sizes and modest effects. Better targeted interventions may result in larger effects. To realize such targeted interventions, we must determine which interventions that are presently available work for which patients, and what the underlying mechanisms are (that is, the moderators and mediators of physical activity and psychosocial interventions). Individual patient data meta-analysis has been described as the ‘gold standard’ of systematic review …

Health-Related Quality Of Life And Life Satisfaction In Colorectal Cancer Survivors: Trajectories Of Adjustment, Jeff Dunn, Shu Kay Ng, William Breitbart, Joanne Aitken, Pip Youl, Peter D. Baade, Suzanne K. Chambers

Research outputs 2013

Background: This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors.Patients and methods: A population-based sample of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism; cancer threat appraisal; perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL); and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors.Results: Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. …

Assisted Vaginal Deliveries In Mothers Admitted As Public Or Private Patients In Western Australia, Kristjana Einarsdottir, Fatima Haggar, Sarah Stock, Anthony Gunnell, Fiona Stanley

Research outputs 2013

Background: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries.

Methods and findings: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA) Department of …

Scripting Therapeutic Screen Stories : Animating The Healing Potential Of Film Narratives, Andrew Levett

Theses : Honours

Beyond entertainment, animated narratives can potentially induce psychological healing, termed “individuation.” Stories exist in many forms, like literature, film and conversation, as well as in the human mind, or “psyche.” These “self-narratives” use life experience to shape consciousness. Therefore, effective storytelling based on archetypal myths can restructure the psyche. Film narratives communicate meaning through symbols, termed “textual cues”, while screenwriters employ specific templates, which organise story information into familiar structures. These guide audiences towards predetermined meaning. Through bibliotherapy, which is the use of literature for therapeutic purposes, audiences project their unconscious content onto narrative components that resonate with it. Ego-consciousness …

The Stigmatisation Of Alcohol And Other Drug Services, Kim Eaton

Theses : Honours

People who are dependent on alcohol and other drugs (AOD) are often stigmatised. Evidence suggests that the people who provide AOD users with health and welfare supports also feel the stigma experienced by users. However, the literature supporting this proposition consists of inadvertent findings and findings generalised from other populations. A systematic review of the limited research into stigma experienced by people working in the AOD field was conducted. This involved a multi-phase database, journal and website search, with additional hand searching of relevant referenced articles. Overall, 146 relevant studies were found, 38 of which were applicable to this review, …

Communication Disorders And Indigenous Australians : A Synthesis And Critique Of The Available Literature, Jasmyn Hall

Theses : Honours

Purpose: To synthesise and critique the available diverse literature related to communication disorders experienced by Indigenous Australians. This is in order to provide health professionals with a resource guide for evidence based decision making. The review has a specific focus on prevalence, assessment and effective treatment of communication disorders and explores these across the lifespan.

Method: A three phase systematic search process was adopted. A number of key databases, speech pathology journals and grey literature sources were searched to obtain articles relevant to the research aims. Two researchers independently rated articles for inclusion as well as methodological quality using the …

Self-Efficacy And Nutrition Knowledge Of Parents In Western Australia, Karen Lombardi

Theses : Honours

Background: Poor dietary choices and increasingly sedentary lifestyles mean childhood obesity is an increasing problem. Parents have the capacity to significantly affect the food choice of children; therefore by improving their self-efficacy, their nutrition knowledge, attitudes and behaviour, and by providing access to sound nutritional information, the health of children may be improved.

Purpose: This research sought to gather preliminary information required to inform the development of nutrition education materials for parents, which will parallel those currently under development for teaching children in schools as part of the Australian curriculum. Research has demonstrated that while educating children about healthy eating …

Improving Functional Outcomes For Children And Adolescents With Anxiety Related Disorders Through Occupational Thrapy : A Narrative Review ; Perceptions Of The Role Of Occupational Therapy In Community Child And Adolescent Mental Health Services (Camhs), Paula J. Anderson

Theses : Honours

Background/Aim: Children and adolescents experiencing anxiety find it challenging to maintain optimal occupational performance, thus the specific role of occupational therapy in the management of anxiety requires investigation. This narrative review examines the current available literature surrounding the use of occupational therapy approaches for children and adolescents experiencing anxiety.

Methods: Academic journals as well as a variety of sources were considered, due to the paucity of literature surrounding this topic. Articles were included if they discussed the occupational therapy role in treatment of children experiencing anxiety symptoms, including anxiety related disorders such as post traumatic stress disorder (PTSD) and obsessive …

Speech And Language Processes In Children Who Stutter Compared To Those Who Do Not Within An Oral Narrative Task, Sarah Pillar

Theses : Honours

Background and Purpose: Language ability in children who stutter has been linked to the occurrence of stuttering, however, the validity of research supporting this connection has been recently questioned. Previous research, within this area, has been limited by methodological confounds, such as lack of appropriately matched comparison groups, and the use of measures with insufficient sensitivity to potentially examine the subtle differences between children who stutter (CWS) and children who do not stutter (CWNS). Frequent hesitations or pauses are defining characteristics of the speech of people who stutter. However, little is known about the nature and frequency of the pauses …

The Use Of The Communication Checklist - Adult (Cc-A) For Assessing The Communication Abilities Of Individuals Post Traumatic Brain Injury, David B. Fitzgerald

Theses : Honours

Background and aims: Standardised and non-standardised assessments are used in speech pathology to evaluate an individual’s communication abilities post traumatic brain injury (TBI; e.g. Turkstra et al., 2005b). However, valid, reliable and norm-referenced standardised assessments that examine functional communication abilities of individuals post TBI outside of the clinical environment are limited. This study sought to investigate the validity of the Communication Checklist - Adults (CC-A; Whitehouse & Bishop, 2009), a caregiver questionnaire that assesses the communication abilities of individuals post TBI.

Method: The project recruited 14 participants post TBI with varying communicative impairment severities. Each participant completed a routine communication …

Tackling Overweight And Obesity: Does The Public Health Message Match The Science?, Katherine Hafekost, David Lawrence, Francis Mitrou, Therese O'Sullivan, Stephen R. Zubrick

Research outputs 2013

Background

Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinning current research about weight-loss intervention from the field of public health, and to determine whether they are consistent with the model provided by basic science. EMBASE was searched for papers published in 2011 on weight-loss interventions. We extracted details of the population, nature of the intervention, and key …

Analysing A New Mobile Bilateral Audiology Test For Children, Luke J. Brook

Theses : Honours

Hearing loss in Australian children, primarily Aboriginal and Torres Strait Islanders, is a growing concern for the Australian public health sector. In certain rural communities up to 90 per cent of children have been found to experience some form of hearing loss. Although hearing loss can be the result of a number of different causes, including congenital influences, the most common cause of hearing loss in Australian children is attributed to a common middle ear infection, otitis media.

To address the issue, numerous solutions have been proposed, tested and implemented, although the problem persists due to geographic, environmental and cultural …

Comparison Of The 400 Metre Timed Endurance Surf Paddle Between Elite Competitive Surfers, Competitive Surfers And Recreational Surfers, Oliver Farley, Joseph Coyne, Josh Secomb, Lina Lundgren, Tai T. Tran, Chris Abbiss, Jeremry Sheppard

ECU Posters

Surf competitions demand the ability to out paddle opposition to gain an optimal position for wave take offs. Those who can out paddle a heat opponent and catch waves at the most critical point when breaking are likely to maximize their scoring potential. Currently appropriate and valid testing protocols evaluating the physiological fitness of surfing athletes are not well established. The purpose of this study was to determine whether the testing procedure of a pool based, 400 endurance time trial is more appropriate (compared to geometry testing) given the nature of the sport, and pride a test that is a …

Review Of Ear Health And Hearing Among Indigenous Peoples, Jane Burns, Neil Thomson

Research outputs pre 2011

This review of ear health and hearing among Indigenous Australians has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to ‘closing the gap’ in health between Indigenous people1 and other Australians. The aim is to make relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community. The review is an example of the HealthInfoNet’s translational research, defined as ‘comprehensive applied research that strives to translate the available knowledge and render it operational’

The main purpose of the review, which follows the model of …