Medicine and Health Sciences Commons^™

The Pivotal Position Of 'Liaison People': Facilitating A Research Utilisation Intervention In Policy Agencies, A Haynes, P Butow, S Brennan, A Williamson, S Redman, S Carter, G Gallego, S Rudge

Medical Papers and Journal Articles

Externally designed and implemented organisational change interventions are thought to have a greater chance of success when they are supported by one or more internal staff members acting as facilitators (Greenhalgh, Robert, Macfarlane, Bate, & Kyriakidou, 2004). Such facilitators often manage the administrative tasks associated with an intervention and may be involved in recruitment, consent processes and/or data collection. More importantly, they are social mediators of the ideas and processes central to the intervention. This may involve formal activities such as presentations at staff meetings, but is likely to include ad hoc negotiation and interpretive communication with diverse colleagues and …

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

Medical Papers and Journal Articles

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

A Middle-Aged Man With Cellulitis, R Sullivan, G Fulde

Medical Papers and Journal Articles

A middle-aged man presents with an extremely painful swollen red leg and signs of sepsis. He has a history of chronic venous insufficiency, obesity, diabetes, hypertension and obstructive sleep apnoea. What are your differential diagnoses and how should he be managed?

The Malarial Exported Pfa0660w Is An Hsp40 Co-Chaperone Of Pfhsp70-X, M Daniyan, A Boshoff, E Prinsloo, E Pesce, G Blatch

Medical Papers and Journal Articles

Plasmodium falciparum, the human pathogen responsible for the most dangerous malaria infection, survives and develops in mature erythrocytes through the export of proteins needed for remodelling of the host cell. Molecular chaperones of the heat shock protein (Hsp) family are prominent members of the exportome, including a number of Hsp40s and a Hsp70. PFA0660w, a type II Hsp40, has been shown to be exported and possibly form a complex with PfHsp70-x in the infected erythrocyte cytosol. However, the chaperone properties of PFA0660w and its interaction with human and parasite Hsp70s are yet to be investigated. Recombinant PFA0660w was found to …

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

Medical Papers and Journal Articles

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

Fifteen-Year Survival Of Endoscopic Anterior Cruciate Ligament Reconstruction In Patients Aged 18 Years And Younger, Morgan Matthew, Lucy Salmon, Alison Waller, Justin Roe, Leo Pinczewski

Medical Papers and Journal Articles

Background: The current body of literature surrounding anterior cruciate ligament (ACL) survival and the variables contributing to further ACL injuries after primary ACL reconstruction in children and adolescents is limited, with no long-term evidence examining the incidence and contributing factors of further ACL injuries in this younger patient population.

Purpose: To determine the long-term survival of the ACL graft and the contralateral ACL (CACL) after primary reconstruction in patients aged 18 years and to identify the factors that increase the odds of subsequent ACL injuries.

Study Design: Case series; Level of evidence, 4.

Methods: Patients having undergone primary ACL reconstruction …

Efficacy Of Infant Simulator Programmes To Prevent Teenage Pregnancy: A School-Based Cluster Randomised Trial In Western Australia, Sally A. Brinkman, Sarah E. Johnson, James Codde, Michael B. Hart, Judith Straton, Murthy N. Mittinty, Sven R. Silburn

Medical Papers and Journal Articles

Background: Infant simulator-based programmes seek to prevent teenage pregnancy. They are utilised in western and developing countries but, despite growing popularity, there is no published evidence of their long-term impact. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) Programme, on the pregnancy outcomes of birth and induced abortion.

Methods: Fifty-seven of 66 eligible schools (86%) in Perth, Western Australia enrolled in the pragmatic clustered (by school) randomised trial (ISRCTN24952438) with even randomisation to the intervention and control groups. Between 2003 and 2006, the VIP programme was administered to 1,267 …

Huperzine A For Treatment Of Cognitive Impairment In Major Depressive Disorder: A Systematic Review Of Randomized Controlled Trials, Wei Zheng, Ying-Qiang Xiang, Gabor S. Ungvari, Helen Chiu, Chee H. Ng, Ying Wang, Yu-Tao Xiang

Medical Papers and Journal Articles

Background: Acetylcholinesterase (AChE) inhibitors have been shown to be effective in treating cognitive impairment in animal models and in human subjects with major depressive disorder (MDD). Huperzine A (HupA), a Traditional Chinese Medicine derived from a genus of clubmosses known as Huperzineserrata, is a powerful AChE inhibitor that has been used as an adjunctive treatment for MDD, but no meta-analysis on HupA augmentation for MDD has yet been reported.

Aim: Conduct a systematic review and meta-analysis of randomized controlled trials (RCTS) about HupA augmentation in the treatment of MDD to evaluate its efficacy and safety.

Methods: Two evaluators independently searched …

Effect Of Medical Student Preference On Rural Clinical School Experience And Rural Career Intentions, L Walters, A Seal, J Mcgirr, R Stewart, D Dewitt, D Playford

Medical Papers and Journal Articles

Introduction: The key parameter for rural clinical schools (RCSs) is to provide at least 1 year of clinical training in rural areas for 25% of Australian Commonwealth supported medical students with the intent to influence future rural medical workforce outcomes. The objective of this study was to describe the association between a medical student’s selection preference and their RCS experience and rural career intent.

Methods: Medical students completing an RCS placement in 2012 and 2013 were encouraged to complete a survey regarding their experience and future career intent. Data were analysed to compare medical students for whom the RCS was …

Complementary Therapies For Labour And Birth: A Randomized Controlled Trial Of Antenatal Integrative Medicine For Pain Management In Labour, K Levett, C Smith, A Bensoussan, H Dahlen

Medical Papers and Journal Articles

Objective: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use.

Design: Open-label, assessor blind, randomized controlled trial.

Setting: 2 public hospitals in Sydney, Australia.

Population: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics.

Methods and intervention: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24–36 weeks’ gestation, and participants attended a …

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

Medical Papers and Journal Articles

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

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

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

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

Medical Papers and Journal Articles

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

Dental Bacterial Dna Are Present In The Amniotic Cavity Of Healthy Pregnant Women At Term, S Vytla, George Mendz, J Quinlivan

Medical Papers and Journal Articles

Aims: To determine if dental bacterial DNA are present in the amniotic cavity of healthy pregnant women undergoing an elective caesarean section at term utilising culture independent techniques.

Methods: Pregnant Australian women undergoing an elective caesarean section were recruited. Women completed questionnaires addressing demographics, past and current pregnancies and medical history. One high vaginal swab and three amniotic cavity swabs (amniotic fluid, newborn axilla and placental) were collected under sterile conditions. Samples were analysed using culture-independent techniques to detect the presence of predefined pathogenic bacterial taxa of the oral microbiome. Taxa isolated from the amniotic cavity swabs were compared to …

Survey Of Australian Father's Attitudes Towards Infant Vaccination: Findings From The Australian Father's Study, N Prosser, R Petersen, J Quinlivan

Medical Papers and Journal Articles

Objective: To investigate the attitudes of expectant Australian fathers towards vaccination, and to identify factors which may influence these attitudes.

Methods: A cross-sectional survey study of 407 Australian men with expectant partners, mean age 30.4 (SD 6.7). Self reported attitude, level of knowledge and information resources accessed regarding pregnancy related issues. Participant demographics collected included: Age, number of children, relationship status, level of education, employment information and smoking status.

Results: Majority (89%) of participants had a positive attitude towards infant vaccination, 9% felt neutral and 2% had negative attitudes. Positive attitudes towards vaccination were associated with lower self-reported knowledge …

New Techniques To Characterise The Vaginal Microbiome In Pregnancy, G Mendz, N Kaakoush, J Quinlivan

Medical Papers and Journal Articles

Understanding of the vaginal microbiome in health and disease is essential to screen, detect and manage complications in pregnancy. One of the major complications of pregnancy is preterm birth, which is the leading world-wide cause of death and disability in children under five years of age. The aetiology of preterm birth is multifactorial, but a causal link has been established with infection. Despite the importance of understanding the vaginal microbiome in pregnancy in order to evaluate strategies to prevent and manage PTB, currently used culture based techniques provide limited information as not all pathogens are able to be cultured.

The …

Employment May Protect Fathers In The Setting Of Maternal Teenage Pregnancy From Anxiety And Depression: Findings From The Australian Father's Study, A Atkinson, R Petersen, J Quinlivan

Medical Papers and Journal Articles

Objective: There is limited research on fathers in the setting of maternal teenage pregnancy. Most studies report data from regions of social disadvantage and low education. We report on the levels of anxiety, depression and quality of life of fathers in the setting of maternal teenage pregnancy in an area where the unemployment rate is low.

Methods: Observational study of 50 fathers in the setting of maternal teenage pregnancy and 100 fathers whose partners were not teenagers (control), living within the same metropolitan healthcare region with high employment rates. Fathers were enrolled within the larger Australian Father’s Study and were …

Circadian Rhythmicity In Emerging Mood Disorders: State Or Trait Marker?, A Grierson, I Hickie, S Naismith, D Hermans, E Scott, J Scott

Medical Papers and Journal Articles

Background: Circadian rhythm disturbances overlap with the symptoms of mood episodes and may trigger or prolong mood symptoms. There is limited research on the role of circadian disturbances in mood disorders in young people and/or first episode cases of unipolar and bipolar disorders.

Methods: Actigraphy was undertaken for about 14 days in 63 post-pubertal individuals aged 13–25 years with a recent onset of a mood disorder meeting recognised diagnostic criteria. We examined associations between three easily interpretable markers of circadian rhythm activity (amplitude, acrophase and rhythmicity index) and demography and clinical characteristics. Then, circadian markers were compared between diagnostic groups, …

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

Medical Papers and Journal Articles

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

A Patient Preference Study That Evaluated Fluticasone Furoate And Mometasone Furoate Nasal Sprays For Allergic Rhinitis, A Yanez, A Dimitroff, P Bremner, C Rhee, G Luscombe, B Prillaman, N Johnson

Medical Papers and Journal Articles

Background: Corticosteroid nasal sprays are the mainstay of treatment for allergic rhinitis. These sprays have sensory attributes such as scent and/or odor, taste and aftertaste, and run down the throat and/or the nose, which, when unpleasant, can affect patient preference for, and compliance with, treatment.

Objective: This study examined patient preference for fluticasone furoate nasal spray (FFNS) or mometasone furoate nasal spray (MFNS) based on their sensory attributes after administration in patients with allergic rhinitis.

Methods: This was a multicenter, randomized, double-blind, cross-over study. Patient preferences were determined by using three questionnaires (Overall Preference, Immediate Attributes, and Delayed Attributes).

Results: …

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

Medical Papers and Journal Articles

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

Are Primetime Diets Congruent With Dietary Recommendations? Content Analyses Of Food Advertisements In The United States, China, And Singapore, Su Lin Yeo, Wonsun Shin, May O. Lwin, Jerome Williams, Ying-Yi Hong

Research Collection Lee Kong Chian School Of Business

Despite public programs to promote healthy eating among populations in developed and developing countries, the increase in obesity as a result of poor dietary patterns continues to persist. As food advertising has been implicated for contributing to this global health challenge, this study aims to provide empirical evidence on food advertising in a broader global context, across economically and culturally different nations. We conducted a large scale content analysis of the types of food advertised on primetime television in the United States, China, and Singapore, which resulted in the collection of 1,008 television hours. Using the dietary blue2376s proposed by …

From Qasc To Qascip: Successful Australian Translational Scale-Up And Spread Of A Proven Intervention In Acute Stroke Using A Prospective Pre-Test/Post-Test Study Design, S Middleton, A Lydtin, D Comerford, D Cadilhac, P Mcelduff, S Dale, K Hill, M Longworth, J Ward, N Cheung, C D'Este

Health Sciences Papers and Journal Articles

Objectives: To embed an evidence-based intervention to manage FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia’s most populous state.

Design: Pre-test/post-test prospective study.

Setting: 36 NSW stroke services.

Methods: Our clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the …

An Examination Of The Correlation Amongst Trunk Flexibility, X-Factor And Clubhead Speed In Skilled Golfers, Christopher Joyce

Health Sciences Papers and Journal Articles

Skilled golfers are reported to be more flexible than lesser able golfers, which may assist in increased x-factor (shoulder – pelvis separation) at the top of the backswing. However, it is unknown if increased flexibility produces faster clubhead speed. The aim of this study was to investigate the correlations amongst trunk flexibility and x-factor, as well as the association between flexibility and clubhead speed in low handicap golfers. Fifteen low handicap male golfers who displayed a modern swing, had their trunk static anatomical end-range of motion (ROM) (flexibility) and driver swing kinematics were measured. Although Pearson correlations revealed trunk extension …

Relationship Between Pre-Season Testing Performance And Playing Time Among Ncaa Dii Basketball Players, Jay J. Dawes, Marshall M, Tania Spiteri

Health Sciences Papers and Journal Articles

Purpose: The purpose of this study was to investigate the relationships between pre-season testing performance and playing time within a men’s Division II basketball team.

Methods: Archival data from pre-season athletic performance testing for ten (n=10) male NCAA Division II basketball players was collected and analyzed to determine if there was a relationship between anthropometric data (height, weight, wingspan), physical performance tests (vertical jump height, lane agility test, 5 and 20 m sprint time, National Basketball League (NBA) line drill and 20 m multi-stage fitness test (MSFT)), and playing time in the subsequent collegiate season.

Results: Pearson’s product …

Predicting Academic Success Of Health Science Students For First Year Anatomy And Physiology, R Anderton, P Chivers

Health Sciences Papers and Journal Articles

Students commencing tertiary education enter through a number of traditional and alternative academic pathways. As a result, tertiary institutions encounter a broad range of students, varying in demographic, previous education, characteristics and academic achievement. In recent years, the relatively constant increase in tertiary applications in Australia has not translated to an increase in student retention or graduate numbers. The Health Sciences discipline typically falls within this paradigm, prompting various approaches to promote academic success and overall student retention. In this study, the demographic and previous education of health science students at an Australian University, were analysed along with first year …

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

Health Sciences Papers and Journal Articles

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

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

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

Faculty, Staff and Student Publications

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

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

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

Phylogenetic Analysis Of Bunyamwera And Ngari Viruses (Family Bunyaviridae, Genus Orthobunyavirus) Isolated In Kenya, C. Odhiambo, M. Venter, O. Lwande, R. Swanepoel, R. Sang

All Peer-Reviewed Publications

Orthobunyaviruses, tri-segmented, negative-sense RNA viruses, have long been associated with mild to severe human disease in Africa, but not haemorrhagic fever. However, during a Rift Valley fever outbreak in East Africa in 1997-1998, Ngari virus was isolated from two patients and antibody detected in several others with haemorrhagic fever. The isolates were used to identify Ngari virus as a natural Orthobunyavirus reassortant. Despite their potential to reassort and cause severe human disease, characterization of orthobunyaviruses is hampered by paucity of genetic sequences. Our objective was to obtain complete gene sequences of two Bunyamwera virus and three Ngari virus isolates from …

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

Ellmer School of Nursing Faculty Publications

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

The Effectiveness Of An Anesthesia Handoff Tool: An Electronic Health Record Application To Enhance Patient Safety, Karen Gillikin, Nathaniel Apatov

Ellmer School of Nursing Faculty Publications

Perioperative patient care handoffs are complex and multidimensional and require accurate attention to detail. Communication failures among healthcare providers increase the risk of morbidity and mortality. Utilizing a standardized handoff tool located within the electronic anesthesia record formalizes the handoff process and improves patient safety. Prior to the introduction of the Electronic Anesthesia Handoff Tool, 82 patient care transfer observations were conducted; subsequent to the launch of the tool, 75 patient care transfer observations were conducted, and then before and after comparisons were made. Descriptive statistics, a two-tailed t-test, and Spearman’s correlations were conducted. Alpha level was set at p < 0.05. There were significantly (p< .05) fewer errors made in all categories of patient information following the introduction of the Electronic Anesthesia Handoff Tool. Though there were trends towards more omissions occurring after 3:00 p.m., the difference in most patient information categories was not significant (p< .05). In addition, there were no differences in omissions related to the severity of patient co-morbidities based on patients’ American Society of Anesthesiologists physical status classification. This study provided information regarding the incidence of patient information inaccuracies and omissions during patient care transfer before and after implementation of an electronic patient care transfer tool.