Medicine and Health Sciences Commons^™

Implementation And Strategies To Address Sensory Regulation Of Students With And Without Disabilities In Two Kindergarten Classrooms, Yvette Rosil Mere-Cook

Doctoral Dissertations

Results from previous research studies suggest that inclusive settings benefit all learners. However, general education teachers often do not have built in supports within the classroom to meet the needs of students with disabilities. Implementing a sensory diet curriculum (SDC) is one instructional practice that addresses needs of students with disabilities, such as autism spectrum disorder, and could be applied widely for students without disabilities. Sensory regulation is defined as the body’s physiological process of adapting arousal or alertness levels to cope with sensory events and situational demands that occur throughout the day. The purpose of this study was to …

Invasion Of Two Tick-Borne Diseases Across New England: Harnessing Human Surveillance Data To Capture Underlying Ecological Invasion Processes, Katharine S. Walter, Kim M. Pepin, Colleen T. Webb, Holly D. Gaff, Peter J. Krause, Virginia E. Pitzer, Maria A. Diuk-Wasser

Biological Sciences Faculty Publications

Modelling the spatial spread of vector-borne zoonotic pathogens maintained in enzootic transmission cycles remains a major challenge. The best available spatio-temporal data on pathogen spread often take the form of human disease surveillance data. By applying a classic ecological approach-occupancy modelling-to an epidemiological question of disease spread, we used surveillance data to examine the latent ecological invasion of tick-borne pathogens. Over the last half-century, previously undescribed tick-borne pathogens including the agents of Lyme disease and human babesiosis have rapidly spread across the northeast United States. Despite their epidemiological importance, the mechanisms of tick-borne pathogen invasion and drivers underlying the distinct …

Roles Of Nitric Oxide On Epithelial To Mesenchymal Transition And Cancer Stem Cell Phenotypes In Anoikis-Resistant Lung Cancer Cells, Phattrakorn Powan

Chulalongkorn University Theses and Dissertations (Chula ETD)

The interconversion between epithelial and mesenchymal is proposed to be a key machinery responsible for metastasis-related deaths. Likewise, cancer stem cells (CSCs) have been proposed to be a key driver of tumor metastasis. The gaseous biological mediator nitric oxide (NO) is also reported to mediate metastasis. However, the linkage between the three events and their control mechanisms under detachment condition are unclear. Since an increase of E-cadherin was frequently found in mesenchymal to epithelial transition (MET) process, we used anoikis resistance H460 lung cancer cells (AR_H460) and a 3D tumor spheroid assay and other CSC-indicating assays to investigate the role …

A Phenomenological Study: Foster Care Youth Aging Out Of The System, Guy Thompson

Theses and Dissertations

The purpose of this applied dissertation was to explore the lived experiences of teens aging out of foster care, in an effort to better understand their needs. While the child welfare system is geared towards family preservation, reunification, and adoption, most young adults transitioning from the foster care system are not reunited with family members or are only reunited as a last resort. Unfortunately, every year, thousands are leaving the support of the foster care system, unprepared. Youth departing the child welfare system are not gradually transitioned into becoming self-sufficient. They do not have an effective support system available if …

A Randomized Controlled Trial Of A Videoconferencing Smoking Cessation Intervention For Korean American Women: Preliminary Findings, Sun S. Kim, Somporn Sitthisongkram, Kunsook Bernstein, Hua Fang, Won S. Choi, Douglas Ziedonis

Publications and Research

Introduction: Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention component for them to quit smoking.

Methods: This study is a pilot clinical trial that examined the acceptability and feasibility of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based intervention. Women of Korean ethnicity were recruited nationwide in the United States and …

The Transformative Meanings Of Viewing Or Not Viewing The Body After Sudden Death, Jane Mowll, Elizabeth Lobb, M Wearing

Medical Papers and Journal Articles

This study investigates the experience of viewing or not viewing the body for 64 relatives bereaved after a sudden and unexpected death1. Thematic analyses of in-depth interviews reveal the importance of viewing and the challenges in providing choice. Some participants experienced difficulties including regret and intrusive images. These are discussed alongside the transformative meanings of seeing or not seeing the body for bereaved relatives.

Hospital Admission Patterns In Children With Cah: Admission Rates And Adrenal Crises Decline With Age, R Louise Rushworth, Henrik Falhammar, Craig F. Munns, Ann M. Maguire, David J. Torpy

Medical Papers and Journal Articles

Objective: To examine patterns of hospitalisation for acute medical conditions in children with congenital adrenal hyperplasia (CAH).

Design: A retrospective study of hospitalisation using administrative data. Setting. All hospitals in NSW, Australia.

Patients: All patients admitted with CAH and a random sample of admissions in patients aged 0 to 18 years without adrenal insufficiency (AI).

Main Outcome Measures: Admissions and comorbidities by age and sex.

Results: Of 573 admissions for medical problems in CAH children, 286 (49.9%) were in males, and 236 (41.2%) had a principal diagnosis of CAH or had an adrenal crisis (AC). 37 (6.5%) ACs were recorded. …

Zoonotic Transmission Of Waterborne Disease: A Mathematical Model, Edward K. Waters

Medical Papers and Journal Articles

Waterborne parasites that infect both humans and animals are common causes of diarrheal illness, but the relative importance of transmission between humans and animals and vice versa remains poorly understood. Transmission of infection from animals to humans via environmental reser12

voirs, such as water sources, has attracted attention as a potential source of endemic and epidemic infections, but existing mathematical models of water borne disease transmission have limitations for studying this phenomenon, as they only consider contamination of environmental reservoirs by humans. This paper develops a mathematical model that represents the transmission of waterborne parasites within and between both animal …

Osseointegrated Total Hip Replacement Connected To A Lower Limb Prosthesis: A Proof-Of-Concept Study With Three Cases, Sarah J. Lord

Medical Papers and Journal Articles

Background

Osseointegrated implants are a suitable alternative for prosthetic attachment in individuals with a transfemoral amputation, who are unable to wear a socket. However, the small bone-implant contact area, reduced muscular leverage, and osteoporosis contraindicate osseointegrated implant use in transfemoral amputees with osteoporosis and a short residuum. We report on the feasibility of combining total hip replacement (THR) with an osseointegrated implant for prosthetic attachment.

Methods

We retrospectively reviewed the cases of three transfemoral amputees who underwent osseointegration with THR between 2013 and 2014. In a two-stage procedure, a custom-made femoral prosthesis was connected to a THR with a modular …

Empathy And Affect: What Can Empathied Bodies Do?, George Marshall Dr.

Medical Papers and Journal Articles

While there has been much interest in the apparent benefits of empathy in improving outcomes of medical care, there is continuing concern over the philosophical nature of empathy. We suggest that part of the difficulty in coming-to-terms with empathy is due to the modernist dichotomies that have structured Western medical discourse, such that doctor and patient, knower and known, cognitive and emotional, subject and object, are situated in oppositional terms, with the result that such accounts cannot coherently encompass an emotional doctor, or a patient as knower, or empathy as other than a possession or a trait. This paper explores …

Body Weight Management In Overweight And Obese Breast Cancer Survivors, Max Bulsara

Medical Papers and Journal Articles

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of different body weight management approaches in breast cancer survivors who are overweight or obese.

Improving The Management And Care Of Refugees In Australian Hospitals: A Descriptive Study, Lindsey Ross, Catherine Harding, Alexa Seal, Geraldine Duncan

Medical Papers and Journal Articles

Objectives: The aim of the study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals’ views regarding improvements that could be made in this area were also sought.

Methods: Two page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site.

Results: Response rates were 50% and 49% at the rural and urban sites respectively. Refugees were seen at least monthly by 40% of the respondents. Additional support was requested …

Figuring Out Fidelity: A Worked Example Of The Methods Used To Identify, Critique And Revise The Essential Elements Of A Contextualised Intervention In Health Policy Agencies, A Haynes, S Brennan, S Redman, A Williamson, G Gallego, P Butow, The Cipher Team

Medical Papers and Journal Articles

Background: In this paper, we identify and respond to the fidelity assessment challenges posed by novel contextualized interventions (i.e. interventions that are informed by composite social and psychological theories and which incorporate standardised and flexible components in order to maximise effectiveness in complex settings). We (a) describe the difficulties of, and propose a method for, identifying the essential elements of a contextualized intervention; (b) provide a worked example of an approach for critiquing the validity of putative essential elements; and (c) demonstrate how essential elements can be refined during a trial without compromising the fidelity assessment. We used an exploratory …

Minimally Invasive Medial Patellofemoral Ligament Reconstruction For Patellar Instability Using An Artificial Ligament: A Two Year Follow-Up, A Khemka, S Lord, Z Doyle, B Bosley, M Muderis

Medical Papers and Journal Articles

Introduction: Recurrence of acute patellar dislocation affects approximately 30% of individuals, and up to 75% of those with grade IV instability. The medial patellofemoral ligament (MPFL) is considered to be critical for patella stabilisation. MPFL reconstruction with allografts has been proposed to reduce risk of recurrence, but there is limited evidence about the safety and effectiveness of techniques using synthetic allografts.

Method: We present a retrospective case series of 29 individuals who underwent a MPFL reconstruction between 2009 and 2012, using an artificial ligament for patellar instability by a single surgeon. Clinical, radiological and functional outcomes were measured at a …

The Performance Of Risk Prediction Models For Pre-Eclampsia Using Routinely Collected Maternal Characteristics And Comparison With Models That Include Specialised Tests And With Clinical Guideline Decision Rules: A Systematic Review, Z Al-Rubaie, L Askie, J Ray, H Hudson, S Lord

Medical Papers and Journal Articles

Background: Risk prediction models may be valuable to identify women at risk of pre-eclampsia to guide aspirin prophylaxis in early pregnancy.

Objective: To assess the performance of ‘simple’ risk models for pre-eclampsia that use routinely collected maternal characteristics; compare with ‘specialised’ models that include specialised tests; and to guideline recommended decision rules.

Search strategy: MEDLINE, Embase and PubMed were searched to June 2014.

Selection criteria: We included studies that developed or validated pre-eclampsia risk models using maternal characteristics with or without specialised tests and reported model performance.

Data collection and analysis: We extracted data on study characteristics; model predictors, validation …

Poly-Arginine Peptides Reduce Infarct Volume In A Permanent Middle Cerebral Artery Rat Stroke Model, D Milani, V Clark, J Cross, R Anderton, N Knuckey, B Meloni

Medical Papers and Journal Articles

Background: We recently reported that poly-arginine peptides have neuroprotective properties both in vitro and in vivo. In cultured cortical neurons exposed to glutamic acid excitotoxicity, we demonstrated that neuroprotective potency increases with polymer length plateauing at R15 to R18 (R = arginine resides). In an in vivo study in rats, we also demonstrated that R9D (R9 peptide synthesised with D-isoform amino acids) administered intravenously at a dose of 1000 nmol/kg 30 min after permanent middle cerebral artery occlusion (MCAO) reduces infarct volume. Based on these positive in vitro and in vivo findings, we decided to examine the neuroprotective efficacy of …

The R18 Polyarginine Peptide Is More Effective Than The Tat-Nr2b9c (Na-1) Peptide When Administered 60 Minutes After Permanent Middle Cerebral Artery Occlusion In The Rat, D Milani, N Knuckey, R Anderton, J Cross, B Meloni

Medical Papers and Journal Articles

We examined the dose responsiveness of polyarginine R18 (100, 300, and 1000 nmol/kg) when administered 60 minutes after permanent middle cerebral artery occlusion (MCAO).The TAT-NR2B9c peptide, which is known to be neuroprotective in rodent and nonhuman primate stroke models, served as a positive control. At 24 hours afterMCAO, there was reduced total infarct volume in R18 treated animals at all doses, but this reduction only reached statistical significance at doses of 100 and 1000 nmol/kg. The TAT-NR2B9c peptide reduced infarct volume at doses of 300 and 1000 nmol/kg, but not to a statistically significant extent, while the 100 nmol/kg dose …

Relationship Between Community Drug Administration Strategy And Changes In Trachoma Prevalence, 2007 To 2013, Bette Liu, Carleigh Cowling, Andrew Hayen, Gabrielle Watts, Donna Mak, Stephen Lambert, Hugh Taylor, John M. Kaldor

Medical Papers and Journal Articles

Australia is the only high income country with persisting endemic trachoma and a national control program has been in place since 2006. The program involves annual screening of children for trachoma in communities designated to be at high risk of disease and treatment of those affected with the antibiotic azithromycin. Depending on the level of trachoma detected in children, antibiotic treatment is also given to households and other community members. We used data collected annually from 2007 to 2013 to examine what effect the extent of azithromycin treatment had on subsequent levels of trachoma in children aged 5–9 years. We …

Engaging Australian Aboriginal Narratives To Challenge Attitudes And Create Empathy In Health Care: A Methodological Perspective, Toni Wain, Moira Sim, Dawn Bessarab, Donna Mak, Colleen Hayward, Cobie Rudd

Medical Papers and Journal Articles

Background: Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients’ experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians’ experiences with health care in Western Australia. …

Seasonal Trivalent Influenza Vaccination During Pregnancy And The Incidence Of Stillbirth: Population-Based Retrospective Cohort Study, Annette Regan, Hannah C. Moore, Nicholas De Klerk, Saad B. Omer, Geoffrey Shellam, Donna Mak, Paul Effler

Medical Papers and Journal Articles

Concern for the safety to the fetus is a commonly cited reason for vaccine refusal during pregnancy. Results from this investigation support the safety of seasonal influenza vaccination during pregnancy and suggest seasonal influenza vaccination may be protective against stillbirth.

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 …

Accuracy Of Screening Tools For Pap Smears In General Practice, C Harding, A Seal, G Duncan, R Huynh, R Mcwilliam, L Pilotto, S Blake, M Mackey

Medical Papers and Journal Articles

Background: Data extraction tools (DETs) are increasingly being used for research and audit of general practice, despite their limitations.

Objective: This study explores the accuracy of Pap smear rates obtained with a DET compared to that of the Pap smear rate obtained with a manual file audit.

Method: A widely available DET was used to establish the rate of Pap smears in a large multi-general practice (multi-GP) in regional New South Wales followed by a manual audit of patient files. The main outcome measure was identification of possible discrepancies between the rates established.

Results: The DET used significantly underestimated the …

The Presence And Predictors Of Complicated Grief Symptoms In Perinatally-Bereaved Mothers From A Bereavement Support Organization, Margaret Mcspedden, Barbara Mullan, Louise Sharpe, Lauren J. Breen, Elizabeth Lobb

Medical Papers and Journal Articles

The present study investigated the presence and possible predictors of complicated grief symptoms in perinatally-bereaved mothers (N = 121) up to 5 years post-bereavement. The presence of complicated grief scores in the clinical range was 12.4%, which is higher than in many other bereaved populations, and the presence of other living children may protect against the development of complicated grief symptoms. The majority of the women were able to negotiate a perinatal loss without developing complicated grief; however, there remains an important group of women who up to 5 years later score in the clinical range for complicated grief symptoms.

An International Randomised Controlled Trial To Compare Targeted Intraoperative Radiotherapy (Targit) With Conventional Postoperative Radiotherapy After Breast-Conserving Surgery For Women With Early-Stage Breast Cancer (The Targit-A Trial), J Vaidya, F Wenz, M Bulsara, J Tobias, D Joseph, C Saunders, C Brew-Graves, I Potyka, S Morris, H Vaidya, N Williams, M Baum

Medical Papers and Journal Articles

Background: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed – the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies.

Objective: To compare TARGIT within a risk-adapted approach with whole-breast external beam radiotherapy (EBRT) over several weeks.

Design: The TARGeted Intraoperative radioTherapy Alone (TARGIT-A) …

Overexpression And Knock-Down Studies Highlight That A Disintegrin And Metalloproteinase 28 Controls Proliferation And Migration In Human Prostate Cancer, C Rudnicka, S Mochizuki, Y Okada, C Mclaughlin, P Leedman, L Stuart, M Epis, G Hoyne, S Boulos, L Johnson, M Schlaich, V Matthews

Medical Papers and Journal Articles

Prostate cancer is one of the most prevalent cancers inmen. It is critical to identify and characterize oncogenes that drive the pathogenesis of human prostate cancer. The current study builds upon previous research showing that a disintegrin and metalloproteinase (ADAM)28 is involved in the pathogenesis of numerous cancers. Our novel study used overexpression, pharmacological, and molecular approaches to investigate the biological function of ADAM28 in human prostate cancer cells,with a focus on cell proliferation andmigration. The results of this study provide important insights into the role of metalloproteinases in human prostate cancer.

The expression of ADAM28 protein levels was assessed …

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 …

Assessing The Feasibility Of A Web-Based Registry For Multiple Orphan Lung Diseases: The Australasian Registry Network For Orphan Lung Disease (Arnold) Experience, K Casamento, A Laverty, M Wilsher, J Twiss, E Gabbay, I Glaspole, A Jaffe

Medical Papers and Journal Articles

Background: We investigated the feasibility of using an online registry to provide prevalence data for multiple orphan lung diseases in Australia and New Zealand.

Methods: A web-based registry, The Australasian Registry Network of Orphan Lung Diseases (ARNOLD) was developed based on the existing British Paediatric Orphan Lung Disease Registry. All adult and paediatric respiratory physicians who were members of the Thoracic Society of Australia and New Zealand in Australia and New Zealand were sent regular emails between July 2009 and June 2014 requesting information on patients they had seen with any of 30 rare lung diseases. Prevalence rates were calculated …

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 …

Abnormal Plasma Dna Profiles In Early Ovarian Cancer Using A Non-Invasive Prenatal Testing Platform: Implications For Cancer Screening, P Cohen, N Flowers, S Tong, N Hannan, M Pertile, L Hui

Medical Papers and Journal Articles

Background: Non-invasive prenatal testing (NIPT) identifies fetal aneuploidy by sequencing cell-free DNA in the maternal plasma. Pre-symptomatic maternal malignancies have been incidentally detected during NIPT based on abnormal genomic profiles. This low coverage sequencing approach could have potential for ovarian cancer screening in the non-pregnant population. Our objective was to investigate whether plasma DNA sequencing with a clinical whole genome NIPT platform can detect early- and late-stage high-grade serous ovarian carcinomas (HGSOC).

Methods: This is a case control study of prospectively-collected biobank samples comprising preoperative plasma from 32 women with HGSOC (16 ‘early cancer’ (FIGO I–II) and 16 ‘advanced cancer’ …

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 …