19683 research outputs found
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Investigating the Role of Extracellular Vesicles and its Cargo in Cancer-Associated Cachexia
No full textSubmitted in total fulfillment of the requirements for the degree of Doctor of Philosophy to the School of Agriculture, Biomedicine and Environment, La Trobe University, Victoria, Australia.This thesis was a recipient of the Nancy Millis Award for theses of exceptional merit.</p
A Fog-Based Security Framework for Internet of Things (IoT) Environments
No full textA thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Computing, Engineering and Mathematical Sciences, La Trobe University, Victoria, Australia.</p
Contraceptive counselling and uptake of contraception among women with cardiovascular diseases: a systematic review and meta-analysis.
No full textTo address the lack of clarity regarding contraceptive counselling and uptake of contraception among women with cardiovascular disease (CVD), this study aimed to conduct a systematic review and meta-analysis on contraceptive counselling and the subsequent uptake of contraception among women with CVD. A search across six databases identified 1228 articles, with 11 studies (2580 participants) included. The pooled prevalence of contraceptive counselling was 63%, varying from 36 to 94% in individual studies. Inconsistent delivery and documentation of counselling were noted, along with a lack of knowledge about pregnancy complications and misconceptions regarding CVD severity. For contraceptive uptake (n = 5), the pooled prevalence was 64% (95% confidence interval, 45 to 82%). Women with CVD were also found to use less effective methods as well as methods not recommended for their condition (e.g., combined hormonal methods among participants with absolute or relative contraindications). Improving contraceptive counselling and choices for women with CVD can not only enhance knowledge and decision-making for women with CVD in line with their reproductive goals and preferences but reduce high-risk unintended pregnancies and adverse pregnancy outcomes. Graphical Abstract: (Figure presented.
‘Being a farmer, I mostly always think there is something more important to do’: A mixed methods analysis of the skin cancer detection practices of Australian farmers
No full textIssue Addressed: Farmers experience skin cancer and die from melanoma at significantly higher rates than the general Australian population. This study examined Australian farmers' engagement with self-skin examinations (SSE), participation in clinical skin examinations (CSE) by a health professional, and self-reported barriers to engagement with these important skin cancer detection practices. Methods: A cross-sectional, mixed-methods design was used. Australian farmers were recruited through an industry-based organisation representing livestock farmers. Farmers (N = 498; 22–89 years; 83.1% male) responded to a paper-based survey that included closed- and open-ended questions. Results: Farmers reported engagement with self-conducted SSE and routine CSE that was comparable to findings in the general population, but 29.4% of farmers reported that they had not sought a CSE as soon as possible after noticing changes to their skin. Farmers reported a range of barriers to SSE, including physical difficulties examining their skin, difficulties identifying changes in their skin, forgetfulness, and lack of motivation. Barriers to CSE included accessibility, cost, difficulties finding the right doctor, and avoidance and complacency. Conclusions: There is a need to make clinical skin cancer detection more accessible to farmers, in addition to promoting self-skin examination and help-seeking behaviours within this at risk population. So What?: Novel approaches are needed to address systemic barriers faced by Australian farmers. These may include the use of teledermatology or artificial intelligence to assist with CSE. Remote training delivery methods may be also utilised to teach SSE skills to farmers who may be otherwise unable to access such opportunities.</p
Developmental Skills Moderate the Association Between Core Autism Features and Adaptive Behaviour in Early Childhood
No full textPurpose: While research indicates that both the core features of autism and associated developmental skills influence adaptive behaviour outcomes, results to date suggest greater influence of the latter than the former, and little attention has been given to how the interaction of both together might impact functional disability. Seeking to expand understanding of associations between young children’s core social autism features, developmental skills, and functional ability/disability, we specifically tested whether early developmental skills might have a moderating effect on the association between early social features and subsequent functional disability. Methods: Data from 162 preschool children were available for this study. These included time-1 measures of social autism features (ADOS-Social Affect score) and developmental skills (MSEL-Developmental Quotient; DQ), and a measure of functional ability/disability (VABS-Adaptive Behaviour Composite; ABC) available at follow-up 1-year later (time-2). Results: Time-1 ADOS-SA and MSEL-DQ scores were concurrently associated with one another, and both prospectively associated with time-2 VABS-ABC scores. Examination of partial correlations (i.e., controlling for MSEL-DQ) demonstrated that the association of time-1 ADOS-SA and time-2 VABS-ABC was accounted for by shared variance with DQ. Formal moderation analysis returned a non-significant overall interaction term, but showed a lower-bound region of significance whereby the association of time-1 ADOS-SA with time-2 VABS-ABC was significant for children with baseline DQ ≤ 48.33. Conclusion: Our results add to a body of empirical evidence consistent with an understanding of the needs of and resources available to autistic people through a ‘cognitive compensation’ lens
Risk controls for preventing work-related musculoskeletal and mental health disorders: A STAMP analysis of the Victorian heavy vehicle transport sector
No full textDespite extensive research to demonstrate the influence of psychosocial hazards on the development of musculoskeletal and mental health disorders (MSDs and MHDs), current research demonstrates a significant evidence to practice gap in this area. This study investigated current risk management practices for prevention of these complex disorders in the Victorian Heavy Vehicle (HV) sector. A preliminary Systems Theoretic and Accident Model and Processes (STAMP) framework was constructed to represent management of Work Health and Safety (WHS) in this sector, based on Leveson's generic socio-technical control model, and review of grey literature and peer reviewed papers. The model was refined and updated following feedback from 13 subject matter experts. Key findings included: 1) risk management practices for preventing MSDs and MHDs were limited to reductionist approaches, including a narrow focus on management of physical hazards (MSDs) and modifying individuals’ behaviour (MSDs and MHDs); and 2) a high number of actors at the upper levels of the WHS system are a key barrier to the transfer of critical information to and from actors at the lower levels of the WHS system. In conclusion, to reduce the high prevalence of MSDs and MHDs in the Victorian HV sector, an urgent need exists for HV organisations to expand the current focus on safety and trauma outcomes to include health and wellbeing risks (such as MSDs and MHDs), and transition from a reductionist approach to systems thinking that reflects the complex aetiology of these disorders
Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis
No full textObjectives: Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary). Methods: A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs). Results: Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI −0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI −0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD −0.38, 95%CI −0.62 to −0.14, n = 5). Conclusions: Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit
Effect of impaction on third molar development and age estimation – A study in a female black South African population
No full textSummary The impact of impaction on the development of third molars remains a subject of debate within the scientific literature, given the lack of consensus. Simultaneously, there has been a call for dental age estimation studies to consider population-specific factors. This research was conducted with the objective of examining the influence of impaction on the formation of third molars in a cohort of female individuals of black South African descent. The study population comprised 428 panoramic radiographs, focusing on females within the age range of 15 to 23.9 years. Within this sample, mandibularthird molars were categorized based on their positioning into two groups: non-impacted and impacted. Dental development stages were assessed and classified according to Demirjian’s 8-level staging system. Descriptive statistics were performed. The outcomes of the independent t-test revealed statistically significant differences in developmental stages, specifically stage G for tooth #38 and stage F for tooth #48, suggesting that impaction had an impact on dental development, albeit not consistently across all developmental stages. Nonetheless, it is noteworthy that the minimum and mean ages across all developmental stages were higher among impacted teeth. In summary, our findings support the conclusion that mineralization of impacted mandibular third molars in South African female subjects proceeds at a slower pace compared to their non-impacted counterparts. Consequently, when estimating dental age in the context of South African females, itis advisable to prioritize non-impacted third molars whenever feasible </p
Lurbinectedin in small cell lung cancer: real-world experience of a multicentre national early access programme
No full textBackground and Aims: Lurbinectedin is a novel oncogenic transcription inhibitor active in several cancers, including small cell lung cancer (SCLC). We aimed to describe the first Australian experience of the clinical efficacy and tolerability of lurbinectedin for the treatment of SCLC after progression on platinum-containing therapy. Methods: Multicentre real-world study of individuals with SCLC initiating lurbinectedin monotherapy (3.2 mg/m2 three-weekly) on an early access programme between May 2020 and December 2021. Key outcomes were clinical utilisation, efficacy and tolerability. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Outcome data were collected within the AUstralian Registry and biObank of thoRacic cAncers (AURORA). Results: Data were analysed for 46 individuals across seven sites. Lurbinectedin was given as second- (83%, 38/46) or subsequent- (17%, 8/46) line therapy, mostly with prior chemoimmunotherapy (87%, 40/46). We report dose modifications (17%, 8/46), interruptions/delays (24%, 11/46), high-grade toxicities (28%, 13/46) and hospitalisations (54%, 25/46) during active treatment. The overall response rate was 33% and the disease control rate was 50%. Six-month OS was 44% (95% confidence interval (CI): 29.0–57.1). Twelve-month OS was 15% (95% CI: 6.5–26.8). From lurbinectedin first dose, the median PFS was 2.5 months (95% CI: 1.8–2.9) and OS was 4.5 months (95% CI: 3.5–7.2). From SCLC diagnosis, the median OS was 12.9 months (95% CI: 11.0–17.2). Individuals with a longer chemotherapy-free interval prior to lurbinectedin had longer PFS and OS. Conclusion: This real-world national experience of lurbinectedin post-platinum chemotherapy and immunotherapy for individuals with SCLC was similar to that reported in clinical trials
A Framework for Cleaning Streaming Data in Healthcare: A Context and User-Supported Approach
No full textNowadays, ubiquitous technology makes life easier, especially devices that use the internet (IoT). IoT devices have been used to generate data in various domains, including healthcare, industry, and education. However, there are often problems with this generated data such as missing values, duplication, and data errors, which can significantly affect data analysis results and lead to inaccurate decision making. Enhancing the quality of real-time data streams has become a challenging task as it is crucial for better decisions. In this paper, we propose a framework to improve the quality of a real-time data stream by considering different aspects, including context-awareness. The proposed framework tackles several issues in the data stream, including duplicated data, missing values, and outliers to improve data quality. The proposed framework also provides recommendations on appropriate data cleaning techniques to the user to help improve data quality in real time. Also, the data quality assessment is included in the proposed framework to provide insight to the user about the data stream quality for better decisions. We present a prototype to examine the concept of the proposed framework. We use a dataset that is collected in healthcare and process these data using a case study. The effectiveness of the proposed framework is verified by the ability to detect and repair stream data quality issues in selected context and to provide a recommended context and data cleaning techniques to the expert for better decision making in providing healthcare advice to the patient. We evaluate our proposed framework by comparing the proposed framework against previous works.</p