Medicine and Health Sciences Commons^™

Exploration Of The Effects Of Developmental Coordination Disorder On Skeletal Development From Childhood Through To Early Adulthood, Jocelyn Tan

Theses

This thesis examined bone development from childhood into early adulthood in individuals with developmental coordination disorder (DCD) using a life course health development framework. One systematic review was conducted, and four original research studies produced with retrospective data from four unique cohorts in childhood, adolescence, and adulthood. Physical activity was assessed via accelerometry in Finnish child and adult populations and via self-reporting in an Australian population at 17 and 20 years. Bone was assessed via peripheral quantitative computed tomography in adolescents and dual energy x-ray absorptiometry in adults at age 20 years in two Australian cohorts. Bone was assessed cross-sectionally …

Caring For Individuals Who Have Used Methamphetamine: A Study Exploring The Experiences Of West Australian Nurses Working In An Authorised Mental Health Institute, John Kriticos

Theses

Background: Methamphetamine (MA) use in Australia has stabilized over the last 22 years, however changing routes of administration and increased purity of the drug has led to greater rates of physical dependency and higher rates of cardiovascular, neurological, and mental health complications. Challenges managing MA related presentations have been reported in Australian Emergency Departments (ED’s), with limited research considering nurses’ experience treating individual(s) who use MA (IWUM) and require prolonged mental health care. Purpose: The aim of this study was to understand nurses’ experiences who care for IWUM in a West Australian hospital’s inpatient mental health service. Methods: Interpretive phenomenological …

Early Movement Matters: Examining The Influence Of Early Postnatal Caregiving Experiences Of Term Infants On Motor And Head Shape Outcomes Across Infancy, Helen E. Beaton

Theses

The nurturing, handling and positioning exposures infants experience during daily caregiving contribute to their physical, motor, cognitive and social–emotional development. A relationship exists between infant sleep and wake-time positioning, the emergence of motor skills and the development of head shape deformities diagnosed as non-synostotic plagiocephaly (NSP). However, the underlying causal mechanism of the specific caregiving behaviours that may play a role remains unclear.

The purpose of the study was to investigate the association between maternal caregiving behaviours and the developmental outcomes of ‘low-risk’ term infants in the first 10 months of life. The first phase of the research involved the …

An Investigation Of Registered Nurses’ Knowledge And Decision-Making Processes In Relation To The Management Of Adults With Diabetic Ketoacidosis, Megan Alice Westphalen

Theses

Introduction: Diabetic ketoacidosis (DKA) is an acute complication of diabetes. Registered nurses (RNs) knowledge with regard to DKA has never been investigated in any depth, nor has their decision making ever been examined in this specific context.

Research Significance: Nursing research literature acknowledges that nurses have an important role in the management of patient with DKA. However, there is very little empirical evidence available to support this claim. The purpose of this study is to provide evidence of the level of knowledge, the decision-making processes and the factors that influence nurses’ decision making whilst managing patients with DKA.

Methodology: A …

The Accuracy And Validity Of Self-Reported Throwing Loads And The Characteristics Of Throws By Elite Cricket Players In Australia, Zachariah G. Hoyne

Theses

Objectives: To determine the relationship between elite cricket player’s self-reported and independently observed throwing volume. Examine whether sex, playing position, or time to upload self-reported data post training influences the accuracy of self-reported throwing loads. Describe the type and number of throws performed during elite cricket training, and identify characteristics such as type, distance and accuracy of throws.

Design: Cross-sectional study.

Methods: A total of eight female and 18 male professional cricket players participated in the study. Overarm throws from 12 training sessions during the 2020-21 cricket year were observed. Player self-reported throwing volume data were retrieved …

Does Acupuncture/Dry Needling Improve Pain And Itch In Abnormal Hypertrophic Scars, Catherine Tuckey

Theses

This research program investigated the use of acupuncture intervention as an adjunct for hypertrophic scar (HTS) management. Mechanistic evidence from ex vivo and animal studies suggests that acupuncture has the potential to modulate neurogenic inflammation to influence pain and itch associated with HTS. Further, acupuncture may mediate non-neuronal cells involved in the proliferation and remodelling stage of healing to promote scar maturation. Previous studies using acupuncture for scar management demonstrated positive outcomes, however low-quality clinical trials and case studies provide limited evidence for treatment benefit.

A treatment protocol was designed to investigate the effects of locally applied acupuncture compared to …

A Study On Post-Burn Healing: Optimising Scar Outcome Through The Use Of A Silicone-Based Film-Forming Wound Dressing, Fiona Poelchow

Theses

Introduction

The development of scarring is a normal physiological response during burn wound healing for any except the most trivial of injuries. Burn scarring can cause considerable functional and psychological anguish in burn survivors. Prolonged wound healing has been shown to affect scarring outcomes. Superficial cutaneous wound injuries carry a risk of scarring and altered pigmentation after the wound has healed. The primary aim of this study was to explore the effects of topical silicone on the rate of wound healing in superficial wounds. Secondary aims included investigation of scar and pain outcomes.

Methods

This thesis presents two studies which …

Personalised Antimicrobial Dosing In Paediatric Cystic Fibrosis, Sahand Imani

Theses

Children with cystic fibrosis (CF) are predisposed to recurrent pulmonary exacerbations throughout their lifetime. This is characterised by an acute worsening of respiratory symptoms in the setting of bacterial infection and results in significant morbidity and mortality. Appropriate antimicrobial therapy is fundamental to management, in particular aminoglycoside antibiotics. Tobramycin is the preferred aminoglycoside of choice, usually administered intravenously for 7 to 14 days.

Tobramycin dosing can be challenging in patients with CF. This is due to the underlying pharmacokinetic derangements (e.g., volume of distribution, organ function) frequently observed in this population. Accordingly, the use of standard dosing (based on age …

From Isolation To Inclusion: Embracing Local Perspectives In Examining The Treatment Model Of Care For Aboriginal Persons Affected By Tuberculosis Or Leprosy In The Kimberley Region, North Western Australia, Stefanie Jane Oliver

Theses

In the remote Kimberley region of North Western Australia, tuberculosis (TB) and leprosy continue to affect a small number of Aboriginal people, despite historical efforts to eliminate either disease. Treatment, predominantly antibiotic therapy, is a principal therapeutic intervention used to cure TB and leprosy and halt infection transmission. Decisions made around treatment therefore impact not only the individual person affected, but also their families and communities. The well-worn models of Directly Observed Therapy (DOT) and case management are used nationally to assist treatment continuity and completion. Neither model has been substantiated for cultural appropriateness nor for meeting the specific needs …

Proactive Management Of Acute Oedema Following Hand And Minor Burn Injury, Dale O. Edwick

Theses

Burn injury is a unique trauma. The inflammatory process initiated with burn injury adversely influences all of the Starling equation variables, resulting in increased transvascular fluid filtration, so that oedema as a product of burn injury is more readily formed than in other forms of trauma. Localised wound oedema forms due to minor burn injury, with increasing systemic oedema associated with increased size of burn. It is now recognised that a marked inflammatory and immune response is created with non-severe burn injury, indicating a systemic component with all burns. The effect of oedema formation on the course of the burn …

An Examination Of Pain Education Of Medical Students In Australia And New Zealand, Elspeth Shipton

Theses

Background: Unrelieved pain is a significant public health challenge in Australia and New Zealand. Medical practitioners play an essential role in the management of acute, cancer and chronic non-cancer pain.

Aim: This thesis aimed to examine the delivery of pain education at medical schools in Australia and New Zealand, and to determine how effectively it equips medical students with pain medicine competencies required for internship.

Methods: An explanatory sequential mixed methods approach was used. Quantitative studies focused on gathering information regarding the pain-related content of medical curricula of all medical schools; and on testing pain medicine competencies of final-year medical …

Understanding Falls In People With Intellectual Disability In Western Australia, Portia Ho

Theses

Adults with intellectual disability (ID) experience earlier age-related changes, compared with other age-matched populations, but concurrently their life expectancy is increasing. Falls often result in serious injuries and reduced health-related quality of life, however there is limited research regarding falls in older adults with ID. The purpose of this research was to investigate falls among community dwelling older adults with ID, including the epidemiology, risk factors and experiences when engaging with health services after a fall.

A meta-analysis of the incidence and prevalence of falls in adults with ID was initially conducted to inform the research aims. Prospective research was …

Exploring The Validity Of Script Concordance Testing To Assess The Clinical Reasoning Of Medical Students, Micahel Sh Wan

Theses

Assessment of clinical reasoning is often challenging, as it is a complex process of thinking and decision making. Script Concordance Testing (SCT), using authentic clinical scenarios with diagnostic or management uncertainties, has been developed to assess clinical reasoning. As SCT is a relatively new assessment modality, more empirical evidence is needed to support the validity of SCT scores.

This thesis examines key aspects of the validity of SCT scores in the assessment of the clinical reasoning ability of medical undergraduates. A review of the current literature informs the use, design and standard setting of SCT, as well as evidence for …

Early Post-Operative Rises In Serum Metal Ion Levels In Total Hip Arthroplasty: A Prospective Cohort Study, Michael Le

Theses

Background: Serum Cobalt (Co) and Chromium (Cr) forms part of the diagnostic process for metallosis following Total Hip Arthroplasty (THA). While knowledge exists on longer term metal ion levels, expected early post-operative rises in serum Co and Cr in Metal-on-Polyethylene (MoP) THAs are currently unknown. This study aims to describe early rises in serum Co and Cr at 6 months post-operatively.

Methods: A prospective cohort study of 84 consecutive patients with an uncemented titanium stem from a single THA manufacturer was performed. Patients had either a metal (n=43) or ceramic (n=41) head articulating with a highly cross-linked polyethylene. Serum Co …

Outcomes Of Resistance Exercise Training In Adults With Acute Burn Injury, Paul M. Gittings

Theses

Decreased quality-of-life and impairments in physical function, muscle strength and muscle volume are known complications of a burn injury. As such, rehabilitation is an important aspect of the burn care journey. Rehabilitation of burn injury is currently hampered by a lack of tools to reliably measure muscle strength and lower limb function, as well as an incomplete understanding of the effect of resistance training after a burn injury. Specifically, there is currently no data on the safety or efficacy of resistance training immediately after a burn injury.

The series of studies presented in this thesis aimed to: 1) systematically review …

Bioimpedance Spectroscopy - Can It Be Used As A Tool For Monitoring Fluid Shifts In Burns?, Pippa Kenworthy

Theses

Large fluid shifts and oedema are features of burn injuries. Oedema hampers burn wound healing and is directly related to the size and depth of the burn. The degree of oedema in burns covers a broad spectrum: Minor burns cause localised or peripheral oedema, whilst major burns may result in a systemic inflammatory response which can be life threatening and necessitates formal fluid resuscitation. Acute burn fluid resuscitation is paramount in decreasing patient morbidity and mortality but can contribute to already large amounts of oedema. There is currently no single clinically applicable, non-invasive and accurate outcome measure to titrate fluid …

Does Temporarily Altering Visual Perception Of Limb Size Have A Modulatory Effect On Deep-Tissue Pain? A Repeated-Measures Within-Subjects Randomised Study, M Van Selm

Theses

No abstract provided.

Evaluating The Impact Of A Falls Prevention Community Of Practice In A Residential Aged Care Organisation, Jacqueline Francis-Coad

Theses

Falls in the residential aged care (RAC) sector are a global concern with humanitarian and economic consequences. Reducing falls using a multifactorial approach involving multidisciplinary staff is recommended, but it is not clear how RAC organisations in Australia can achieve this in a resource constrained environment. One potential solution is to develop a sustainable means of addressing falls prevention from within an organisation, creating a forum for staff to share ideas, expertise and achieve goals in a community of practice (CoP). The purpose of this research was to evaluate the impact of a falls prevention CoP on falls outcomes in …

The Impact Of Peer-Led Falls Prevention Education On Community-Dwelling Older Adults: A Mixed Methods Evaluation, Linda Khong

Theses

Older adults are not optimally engaged in falls prevention strategies. Peer education may be an approach to improving engagement and uptake of falls prevention strategies by community-dwelling older adults. However, empirical research regarding this approach has been inconclusive. Accordingly, the primary aim of this research was to design a peer-led falls prevention education program and evaluate its impact on community-dwelling older adults’ beliefs, knowledge, motivation, and intention to engage in falls prevention strategies. This research was a mixed methods study conducted in two phases. Phase 1 comprised three concurrent studies. These aimed to elucidate the issues regarding falls prevention education …

The Prevalence, Characteristics, Impact And Management Of Headache In People With Schizophrenia And Schizoaffective Disorder: A Cross Sectional Cohort Study, Joanne Connaughton

Theses

Headache is the most common pain problem reported by people with schizophrenia, with 12 month prevalence rates of around 50%. Despite this little research has been conducted into the characteristics, impact and management of headaches in this population. There is evidence to support the efficacy of physiotherapy treatment of cervicogenic headache and tension type headache and determining the prevalence, impact and current management of these types of headache was of particular interest.

A pilot study was first undertaken to identify and refine an appropriate headache questionnaire, develop an algorithm to use for classification of headache and test the repeatability and …

Evaluating Web-Based Pelvic Floor Muscle Education For Pregnant Women, Judith Wilson

Theses

Background: Guidelines recommend that when pregnant women attend antenatal education they gain adequate knowledge about pregnancy-related topics, including the function of pelvic floor muscles and how to undertake a pelvic floor muscle exercise programme. Evidence is limited about how this information can be optimally delivered to pregnant women such that they gain knowledge, confidence and motivation to engage in a pelvic floor muscle exercise programme during the antenatal period. The primary objectives of the research were to evaluate the effect of delivering a web-based pelvic floor muscle education intervention in addition to usual antenatal care on primiparae women’s awareness; knowledge; …

Optimising Motor Learning Of Infants At High Risk Of Cerebral Palsy Using Goal-Oriented And Environmental Interventions, Catherine Morgan

Theses

Background and aims: Cerebral palsy (CP) is the most common physical disability of childhood occurring in 1 in 500 live births in developed countries. Although CP starts in infancy because of a lesion in the developing brain, it is usually not diagnosed until about 19 months. The problem with late detection has meant that early neurorehabilitation is not accessed until motor impairment is evident. Consequently the dose of active intervention during the critical period for brain plasticity is often inadequate. Little evidence exists for the effectiveness of early intervention (EI) protocols for infants with CP. In particular, interventions that take …

Knowledge Translation Intervention To Improve Evidence-Based Practice Behaviour Of Allied Health Professionals: A Cluster Randomised Controlled Trial And 2-Year Follow-Up Study, Lanie Campbell

Theses

Background:

It is difficult to foster the use of research findings among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions, but little is known about: (a) the impact and viability of multifaceted KT strategies using an online KT tool, (b) their immediate and longer-term effectiveness with AHPs, and (c) their effect on evidence-based practice (EBP) decision-making behaviour. The aim of this project was to measure the effectiveness of a multifaceted KT intervention including a customised KT tool, to change EBP behaviour, knowledge and attitudes …