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Faculty Of Health Science The Mark Liveris Health Science

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<strong>Faculty</strong> of <strong>Health</strong> <strong>Science</strong><strong>The</strong> <strong>Mark</strong> <strong>Liveris</strong> <strong>Health</strong> <strong>Science</strong> Research Student SeminarMonday 14 th November 2011Building 213 – Tim Winton Lecture <strong>The</strong>atre8.30am - 2.00pmThis seminar, which includes oral and poster presentations, provides a glimpse of the diverse andinnovative research being undertaken by Doctoral, Masters and Honours students within the<strong>Faculty</strong> of <strong>Health</strong> <strong>Science</strong>s.We would like to thank the <strong>Faculty</strong> of <strong>Health</strong> <strong>Science</strong>s, Curtin <strong>Health</strong> Innovation Research Instituteand Curtin University Postgraduate Student Association (CUPSA) for their continued support of thisevent.


Poster PresentersAn Evaluation of the Impact of Down-Scheduled OphthalmicChloramphenicol on the Management of Acute Bacterial Conjunctivitis inCommunity Pharmacies in Western AustraliaPresented by: Luma Alkhatib, School of PharmacyCourse: Bachelor of Pharmacy (Honours)Supervisors: Prof. Bruce Sunderland, Dr. Petra CzarniakObjective: To evaluate factors influencing pharmacists’ management of eye infections followingthe down-scheduling of ophthalmic chloramphenicol to pharmacist supply.Method: Data were collected using a self-administered questionnaire posted to a random sampleof community pharmacies in urban and rural areas in Western Australia. Data were entered intoExcel and analysed using SPSS v17. Descriptive statistics were used to summarise the responsesand demographics of respondents. Regression analysis was used to identify relationships betweenvariables. Factor Analysis was conducted to pool variables and the derived factors were subjectedto regression analysis.Key findings: <strong>Of</strong> the 240 community pharmacies surveyed, 119 (49.5%) responded (79% urbanand 21% rural pharmacies). On average urban and rural pharmacies provided ophthalmicchloramphenicol 3.6 and 2.9 times weekly respectively, with some pharmacies providing 12 ormore per week. Over 82% of respondents claimed that sales of other OTC products used for acutebacterial conjunctivitis had “decreased/decreased markedly”. A majority of respondents (59%)claimed that there was no change in the number of prescriptions received for ophthalmicchloramphenicol. Most respondents (76.4%) agreed/strongly agreed that pharmacist’s currentlevel of training was adequate to provide ophthalmic chloramphenicol. However approximatelyone-fifth (21.8%) responded that pharmacists required some additional training.Conclusions: Down scheduling of ophthalmic chloramphenicol has improved pharmacists’capability to treat acute bacterial conjunctivitis, largely as a replacement for products previouslyavailable over the counter, rather than less GP consultations. Pharmacists showed overall supportfor the down-scheduling as it enabled better use of professional skills and increased patient accessto treatment.<strong>The</strong> Temporo-Spatial Expression of BMP and FSH Receptors During EarlyFollicular Development in Sheep OvaryPresented by: Sarmed Al-Samerria, School of Biomedical <strong>Science</strong>sCourse: Master of PhilosophySupervisors: Dr. Ghanim Almahbobi, A/Prof. Jim McFarlaneIn mammals the ovary contains a finite number of primordial follicles, which serve as a fertilityreserve for the whole reproductive age. Continuous and high rate usage of these follicles willresults in complete depletion, cessation of ovarian function and infertility. <strong>The</strong> role of bonemorphogenetic proteins (BMPs) in the formation and development of ovarian follicles has beenreported in several animal species. Specifically, it is commonly believed that the process of initialrecruitment of primordial follicles to the pool of growing follicle is not gonadotrophin- but BMPdependant.However, this has not yet been unequivocally confirmed.<strong>The</strong> aim of this study is to elucidate the interplay between BMPs and follicle stimulating hormone(FSH) in folliculogenesis by demonstrating the temporo-spacial protein expression of the BMPreceptors (BMPR) and FSH receptors (FSHR) in resting and growing follicles, usingimmunofluorescence microscopy and computer-based quantitative analysis. Sheep ovaries werecollected and serial 10µm cryosections were prepared for in situ immunolabelling of BMPR andFSHR in several follicular stages. Cell membrane-bound FSHR and BMPR are found in granulosacells of the follicles. While BMPR is expressed in all follicle stages, FSHR is absent in granulosacells of resting primordial follicles.Quantitative analysis based on the intensity of fluorescent signals shows that the expression ofboth receptors significantly increases with follicular development. We conclude that the initialrecruitment of primordial follicles to primary stage is in fact BMP-dependant with no apparent directinput of FSH. <strong>The</strong> interplay between BMPs and FSH becomes increasingly effective from primaryfollicles onward. This outcome is significant in understanding the role of BMP signaling pathway inthe regulation of folliculogenesis, which may lead to a potential application in controlling the rate ofprimordial follicle depletion hence increasing female fertility.


Students With ASCs’ Perceived Participation in Schools; Do <strong>The</strong>ir TeachersKnow?Presented by: Marita Falkmer, School of Occupational <strong>The</strong>rapy and Social WorkCourse: Doctor of PhilosophySupervisors: Prof. M Granlund, Prof. C NilholmStudents with impairments rate their participation in mainstream schools lower than their peers.Factors restricting participation are lack of communicational and social skills. Autism spectrumconditions (ASC) includes diagnoses that are characterized by these features. Due to difficulties insocial communication, teachers might not be aware of these students’ perceived participation.Twenty-two students with ASC and their 382 classmates were investigated regarding perceivedparticipation in schools. Correlations between what the students wanted to do and did wereinvestigated. Furthermore, how well teachers’ ratings matched with the ratings of their 22 studentswith ASC were investigated. <strong>The</strong> impact of the teachers’ self-reported interest in working withstudents with ASC on classroom activities and their rating precision was examined.On 57% of the questionnaire items, students with ASC perceived lower participation than theirclassmates. Students with ASC did less often what they wanted to do. Agreement betweenteachers’ and students’ ratings on perceived participation was moderate to high. A high degree ofchoosing to teach students with ASC and good precision in rating the students’ participationcorrelated. Teachers implemented activities to improve the attitudes of peers if the student withASC was bullied or unpopular and adapted tasks to enhance their understanding. Knowledgeabout the students’ participation did not correlate with activities to enhance social relations.<strong>The</strong> results emphasize the importance to take students perceived participation into consideration.Information on what students want to do is important when interpreting self-rated participation.Teachers’ personal interest is a profound factor when planning for placements of students withASC in schools.Visual Tests Associated With Driving Difficulty Before and After First EyeCataract SurgeryPresented by: Michelle Fraser, School of Public <strong>Health</strong>Course: Master of PhilosophySupervisors: Prof. Andy Lee, A/Prof. Lynn Meuleners<strong>The</strong> incidence of cataract is increasing due to the ageing population of Australia. Currently, fitnessto drive for older adults with cataract is largely determined by a simple visual acuity test. However,research has shown that this measure may not adequately assess the visual skills necessary forsafe driving.This study aimed to evaluate the association between three visual tests and self-reported drivingdifficulty in cataract patients before and after first-eye cataract surgery. A cohort of 99 drivers aged55 years and older was recruited over a one year period from three Perth public hospitals. <strong>The</strong>ywere assessed during the week before and three months after first-eye cataract surgery.Assessments consisted of three visual tests (visual acuity, contrast sensitivity and stereopsis),cognitive tests and a questionnaire. Information on driving exposure and self-reported drivingdifficulty was collected via the researcher-administered Driving Habits Questionnaire. Twoseparate conditional logistic regression models were used to determine visual tests associated withdriving difficulty before and after surgery.Before first eye cataract surgery, 66 participants (66.7%) reported driving difficulty. Three monthsafter surgery, 37 participants (37.4%) reported driving difficulty. Before surgery, contrast sensitivityin the worse eye was the only visual test associated with driving difficulty in the logistic regressionmodel (OR: 0.18, 95% CI: 0.04-0.75). After surgery, stereopsis was the only visual test associatedwith driving difficulty (OR: 5.09, 95% CI: 1.71 – 15.14). Visual acuity was not associated withdriving difficulty before or after surgery. <strong>The</strong>se findings indicate that contrast sensitivity andstereopsis tests may be more appropriate than the widely used visual acuity test for predictingdriving difficulty in cataract patients before and after first eye surgery. <strong>The</strong>se results may haveimplications for vision testing practices for licensing of older drivers with cataract in WesternAustralia.


Development of a Web-enabled Spatial Decision Support System (SDSS) ForPrevention of Tick Borne Disease in Kuantan, MalaysiaPresented by: Kasmah Hamid, Department of Spatial <strong>Science</strong>sCourse: Master of PhilosophySupervisors: Dr. Robert Corner, Prof. Geoff West, Dr. Jianhong (Cecilia) XiaTicks are the second most common vector of human disease after mosquitoes. <strong>The</strong>y are found onmany small mammal hosts and also blood-feed on humans with the risk of transmitting diseases.In Malaysia, they are known to cause human otoacariasis disease along the east coast area aswell as being the vector for other diseases such as lyme disease in other countries. Given theimpact of this disease, this study will investigate the potential for a web-enabled spatial decisionsupport system (SDSS) for prevention of tick borne diseases specifically in Kuantan, Malaysia. Inorder to achieve this goal, five specific objectives have been defined, which are 1) to investigatethe major components of a SDDS system, 2) to understand the decision making process forpreventing tick borne disease, 3) to understand the different needs of stakeholders, 4) to explorethe potential of interactive Web 2.0 technologies, and 5) to investigate the Web GeographicInformation Systems (GIS) techniques for disease information management.Four principle study components have been identified. <strong>The</strong>se are: the disease, the user, web GIStechnologies and SDSS components. This study will develop novel spatial methods for an SDSSand show how an SDSS can benefit the users and stakeholders by allowing different levels of userto access and share the information via the World Wide Web (WWW). Furthermore, it willdemonstrate how it can be an effective tool for decision makers to get relevant information at theright time in order to perform disease surveillance, policy making, and to apply disease preventionmethods.A Comparison of Overall <strong>Health</strong> Between Asians and Australians fromEuropean Background: A West Australian Study of Chronic Disease, Diet &Metabolic Syndrome Risk FactorsPresented by: Majid Meshkini, Centre for International <strong>Health</strong>Course: Doctor of Philosophy, International <strong>Health</strong>Supervisors: A/Prof. Jaya Earnest, Dr. Cyril MamotteBackground: In the last three decades, the trend of disease is changing from communicable tonon-communicable chronic diseases like cardiovascular diseases, cancer and diabetes causing aworldwide estimated 35 million deaths annually. Metabolic syndrome and its consequences andimpact have a significant role in burden of disease. Obesity, impaired glucose tolerance, insulinresistance, dyslipidaemia and high blood pressure are important risk factors for metabolicsyndrome. <strong>The</strong> rate and impact of chronic diseases are increasing in Australia, namely theincidence of Diabetes Mellitus type 2 increased from 2.4% to 3.5% between 1995 and 2005. Inaddition, national health survey in 2004-5 revealed that 18% of Australians, (about 3.5 million), hada circulatory system condition.Aim: <strong>The</strong> main objective of this study is to investigate the effects of ethnicity on metabolicsyndrome risk factors and related components in overweight and obese subjects.Methodology: <strong>The</strong> study design is a randomized, and cross-sectional that investigates thecomponents of metabolic syndrome risk factors on 109 overweight and obese immigrants fromIndia, Iran and European ethnic background. Participants are aged more than 18 years have livedin Australia for at least 5 years. Variables used in the research are categorised in four main groupsthat include - anthropometrical, physical, biochemical, and food items.Results: Results indicate significant differences between Iranian and European migrants in totalbody fat percentage; however the differences between European and Indian as well as Indian andIranian were not significant.


Osteoarthritis: More than Just a Pain in the Knee?Presented by: Penny Moss, School of Physiotherapy, Curtin UniversityCourse: Doctor of PhilosophySupervisors: Prof. Tony Wright, A/Prof. Heather BensonBackground: A proportion of patients with osteoarthritis (OA) respond poorly to standardinterventions, with 15% reporting ongoing pain and disability post-surgery (1). Those who developa resistant problem may experience widespread or neuropathic symptoms perhaps characteristic ofa more centrally driven pain disorder (2).Objectives: Investigate in subjects with knee OA: 1 Extent of cold & mechanical hyperalgesia atboth local & distant sites; 2 Intensity & quality response to topical cold; 3 Extent of neuropathic-typesymptoms; 4 Association between disability & hyperalgesia.Methods: 31 subjects with knee OA but no other chronic pains were recruited. Subjects washedout their usual analgesia or NSAIDs before testing. Self-report WOMAC and PainDETECT, aneuropathic pain (NP) screening tool (3) were completed. Cold sensation and pain thresholds weretested using a peltier thermode (Medoc, Israel) and pressure pain thresholds using a digitalalgometer (Somedic, AB). All were applied at three sites: medial knees and R elbow. Standardmethods were used, the mean of 3 trials analysed. Response to topical cold (TC) was also testedusing a small menthol patch applied to the forearm (4). During TC and CPT subjects were asked torate intensity with electronic VAS scales and to select quality descriptors from a McGill Pain list (6).Results: 36% subjects showed widespread cold hyperalgesia: mean CPT across all sites >15ºC.<strong>The</strong>se subjects also showed greater mechanical hyperalgesia (p=.047) and higher WOMAC scores(p=.035). Pain quality also differed significantly. During CPT and TC, even on upper limb sites,those with CPT >15ºC were more likely to choose unpleasant and paradoxical words such as“stinging” and “burning”: CPT p= .001; TC p


<strong>The</strong> Sustainability of a Physical Activity and Nutrition Program for SeniorsPresented by: Maria Pasalich, School of Public <strong>Health</strong>Course: Bachelor of <strong>Science</strong> (<strong>Health</strong> <strong>Science</strong>) (Honours)Supervisors: Dr. Jonine Jancey, Prof. Andy Lee, Linda BurkeOlder adults, a growing segment of the population are at an increased risk of developing chronichealth problems, and this is not simply due to the physiological changes associated with ageing.This age group is becoming increasingly inactive and a large proportion of them are not meetingthe recommended daily intake for fruit and vegetables. Both of these factors have contributed tothe high levels of overweight and obesity, a major public health issue in Australia. Regular physicalactivity and a nutritionally balanced diet lead to a range of health benefits, and play a preventativerole for several chronic health conditions such as type 2 diabetes and cardiovascular disease. It istherefore vital that efforts be made to improve the physical activity and dietary behaviours of theolder population through healthy lifestyle promotion.<strong>The</strong> PANS (Physical Activity and Nutrition for Seniors) program was developed for insufficientlyactive, younger seniors groups (aged 60 to 70 years) living in low to medium socioeconomicsuburbs. This 12-month randomised controlled trial involved a 6-month home-based, semi-tailoredphysical activity and nutrition intervention, which incorporated goal setting and social support.<strong>The</strong> current focus of this research is to assess the long-term impact of the PANS program inrelation to self-reported physical activity, dietary behaviours and anthropometric measures, at 6-months post-program. Evaluation at this time point is important as there is insufficient evidenceregarding the sustainability of health promotion interventions for older adults. This follow-upresearch will provide valuable insight into the effectiveness of interventions after a no-contactperiod, an area of program sustainability which has been largely ignored.Family Functioning in Families with a Child with Down Syndrome: A MixedMethods ApproachPresented by: Kate Povee, School of Psychology and Speech PathologyCourse: Bachelor of Psychology (Honours)Supervisors: Dr. Lynne Roberts, Dr. Helen LeonardThis study aimed to explore the factors that predict functioning in families with a child with Downsyndrome using a combination of quantitative and qualitative research methodologies. <strong>The</strong>quantitative component examined the effect of maladaptive and autism-spectrum behaviours onthe functioning of the family whilst the qualitative component explored the impact of having a childwith Down syndrome on family holidays, family activities and general family functioning.Participants in this study were 256 primary care givers of children with Down syndrome aged 4-25years (57.47% male; 42.53% female) currently residing in Western Australia (75.10% inmetropolitan Perth and 24.90% in rural Western Australia).In 2004, primary care givers completed the multi-dimensional, self-report Down syndrome NOWquestionnaire. <strong>The</strong> scales used in this study assessed family functioning, marital adjustment,maladaptive behaviour, autism-spectrum behaviour and functional ability. Maladaptive and autismspectrumbehaviour accounted for a significant 5.64% of the variance in family functioning. Meantotal scores on the measures of family functioning and marital adjustment were comparable to thatof families of typically developing children.Consistent with the quantitative findings, normality was the most common theme to emerge in thequalitative data. Child problem behaviours were also identified by parents/carers as having anegative impact of the family. This study has implications for the development of programs tosupport families with a child with Down syndrome and may dispel some of the myths surroundingthe impact of intellectual disability on the family.


Optimizing Vitrification of Human Oocytes for In-vitro Fertilization (IVF)ApplicationPresented by: Vicky Y. K. Seet, School of Biomedical <strong>Science</strong>sCourse: Bachelor of <strong>Science</strong> (Molecular Genetics and Biotechnology) (Honours)Supervisors: Dr. Ghanim Almahbobi, Dr. James StangerOocyte cryopreservation is a powerful clinical practice currently used in IVF clinics, allowing fertilitypreservation in women for several reasons. Vitrification of oocytes involves ultrarapid cooling usinghigh concentrations of cryoprotectants to minimise injuries of oocytes due to ice formation.However, usage of high concentrations of cryoprotectants can have detrimental toxic effects on thequality of the oocyte and eventually the health of the offspring. Also, the assessment of oocytequality has commonly been performed based only on the morphological appearance of oocytes.Using both morphological and functional parameters, this project determines whether acombination of multiple cryoprotectants at lower concentrations will have less toxicity and result inbetter cryosurvival than the use of single cryoprotectant at a higher concentration. Surplus oocytesfrom patients attending Pivet IVF clinic were collected and vitrified based on the Cryotop method,using three different cryoprotectants either individually or in combination. <strong>The</strong> morphological andfunctional integrity of the vitrified oocytes were investigated using light microscopy and computerbasedquantitative immunofluorescence of mitochondria, DNA and microtubules, respectively.<strong>The</strong> results show that the rate of morphological and functional integrity in oocytes vitrified with acombination of cryoprotectants was significantly higher than in oocytes vitrified with singlecryoprotectant. However, the quality of vitrified oocytes significantly varied depending on thespecific cryoprotectant and the type of combination. <strong>The</strong> results of this study has not only allowedus to determine that a combination of cryoprotectants will have the least detrimental effects onvitrified oocytes, but also provide evidence that observations based purely on oocyte morphologicalassessment is insufficient and sometimes misleading. This outcome will have a significantimplication in the area of oocyte cryopreservation as an important approach of assistedreproductive technology for the purpose of fertility preservation.Antenatal Physical Activity and NutritionPresented by: Jenna Smedley, School of Public <strong>Health</strong>Course: Bachelor of <strong>Science</strong> (<strong>Health</strong> Promotion) (Honours)Supervisors: Dr. Jonine Jancey, Prof. Peter Howat, Ginny MontieroPurpose: Explore women’s behaviours in regard to physical activity and nutrition and identify whatchanges take place when they enter pregnancy; Assess the knowledge they have concerning thebenefits of physical activity and healthy eating during pregnancy and conversely the consequencesof inactivity and an unhealthy diet; Identify their attitude toward physical activity and healthy eatingand its relationship to weight management.Method: This exploratory research project was completed over an 8-month period. <strong>The</strong> studypopulation included women over the age of 18; pregnant within the last 12-months; and with nopre-existing illness. Most participants were recruited through mothers groups located in the Perthmetropolitan area and Geraldton in the Mid-west. Qualitative data was collected via one-on-oneinterviews. This helped inform the development of the quantitative self-complete surveys. Datawas collected on participants physical activity behaviour; frequency of food consumption based onfat, fibre and sugar before and during pregnancy; sources of health behaviour information; and thepreferred format, delivery, time and frequency of a health promotion interventions duringpregnancy. Finally demographic data were collected.Preliminary Results: In total, nineteen interviews were completed, and the response rate for theself-complete survey was 68% (n=95), with participants being drawn from high, medium and lowSES as determined by SEIFA scores. <strong>The</strong> sample population was comprised of women aged 19-40 years (mean age=30), 70.4% (n=64), were born in Australia, 65.9% (54) had a healthy weightaccording to the Body Mass Index (BMI 18 - 25).Women reported eating 5 serves of vegetable a day in a usual week more frequently whilepregnant and decreased their frequency of fast food consumption. Women who reported beingmore active prior to pregnancy (47%, n=44) were 1.75 (OR 47.7/27.2) times more likely to havehad a healthier diet before falling pregnant, 25% (n=11) of women reported being unsure if theirdiet was more or less healthy.Conclusion: Pregnancy represents an opportune time to influence the uptake of positive lifestylebehaviours among women. This information will be useful as it will help inform the development ofeducation for women during pregnancy.


Measuring Arterial Oxygen Saturation During Exercise in People with COPDUsing Finger and Forehead SensorsPresented by: Stephanie Wilson, School of PhysiotherapyCourse: Bachelor of <strong>Science</strong> (Physiotherapy) (Honours)Supervisors: A/Prof. Sue Jenkins, Dr. Kylie Hill, Michelle Melang, Nola CecinsBackground: During exercise training and testing, arterial oxygen saturation is commonlymeasured by pulse oximetry via a finger sensor (SpO 2 ). However, finger sensors have beenassociated with erroneous readings. We sought to determine whether an alternative sensor (i.e.positioned on the forehead) provides more accurate measures of SpO 2 compared with a fingersensor in people with chronic obstructive pulmonary disease (COPD) who were known todesaturate during lower limb exercise.Methods: During a standard lower limb exercise task, SpO 2 was measured continuously by twopulse oximeters; one attached via a finger sensor and one attached via a forehead sensor.Arterialised capillary samples were collected as a gold standard measure of arterial oxygensaturation, prior to the start (rest) and at completion of exercise test (end-exercise).Results: 13 participants completed the study (forced expiratory volume in one second = 0.77 [0.27]L; 6 males). Compared with measures obtained in arterialised capillary blood, on average, thefinger sensor under-read SpO 2 by 2% (limit of agreement 3%) and the forehead sensor over-readSpO 2 by 2% (limit of agreement 3%). <strong>The</strong> magnitude of change in arterial oxygen saturationbetween rest and end-exercise was similar between the finger, forehead and arterialised capillarysamples, being -6%, -7% and -7%, respectively (p = 0.48).Conclusion: Arterialised capillary samples comprise a mixture of arterial and venous blood andtherefore the oxygen saturation in these samples is slightly less than that of arterial blood. As thearterial oxygen saturation measured using the forehead sensor was slightly higher than thatmeasured in the arterialised capillary sample, it is likely that this sensor produced measures thatwere more concordant with arterial oxygen levels. Both sensors were accurate in detecting themagnitude of exercise-induced desaturation.Investigating the Role of Tumour Associated Macrophages in MesotheliomaPresented by: Teong Ling Yeoh, School of Biomedical <strong>Science</strong>sCourse:Bachelor of <strong>Science</strong> (Medical <strong>Science</strong>) (Honours)Supervisors: Dr. Delia Nelson, Dr. Connie JackamanMalignant Mesothelioma (MM) is a cancer usually located in the pleural cavity and is caused byinhalation of asbestos fibres. <strong>The</strong> median survival of MM patients post diagnosis is 12 months, andcurrent treatment options extend survival by a few months. <strong>The</strong>re is increasing evidence that theanti-tumour immune response is impaired in MM patients. Multiple mechanisms of immunesuppression may be involved to ensure immune sabotage.One possible mechanism is mediated via specific macrophage subsets. Classically activatedmacrophages are classified as M1 cells and alternatively activated macrophages are M2 cells. M1cells are proinflammatory cells and M2 cells are generally anti-inflammatory cells. A furthermacrophage-like subset is referred to as Myeloid Derived Suppressor Cells (MDSCs) which areimmature cells of myeloid origin. MDSCs have been shown to suppress immune responses. M2cells and MDSC cells are associated with progressing tumour growth. <strong>The</strong>se macrophage subsetsare plastic and can be polarized from one subset to another by appropriate stimuli.This honours project aims to characterise macrophage subsets in progressing murine MM tumours,and to assess if they can be therapeutically modulated. Preliminary in vitro studies co-culturingsupernatant generated from murine MM tumour cells with murine macrophages suggest that thetumour environment may promote an M2-like phenotype. In vivo analysis was subsequentlyperformed on tumours, bone marrow and spleen collected at various stages of MM tumour growth.Immunohistochemistry and flow cytometry showed that tumour-infiltrating macrophages were seenin very high numbers at the early stages of tumour growth and significantly increased duringtumour growth. MDSCs were also significantly increased within the tumour, spleen and bonemarrow during tumour progression. This project will next investigate whether polarisingmacrophages to immunogenic subsets will inhibit MM growth in vivo. <strong>The</strong>se results may provideinsights into new potential therapeutic targets for MM.


Paper PresentersOsteoarthritis of the Knee Self-Management Education Program Delivered byMultidisciplinary <strong>Health</strong> Professionals; a Randomised Controlled TrialPresented by: Sophie Coleman, School of PhysiotherapyCourse: Doctor of PhilosophySupervisors: A/Prof. Kathy Briffa, Prof. Joan ColePurpose: To determine whether a disease specific self-management program (OAK) for peoplewith osteoarthritis (OA) of the knee, implemented by multidisciplinary health professionals in aprimary health care setting, could achieve and maintain clinically meaningful improvementscompared to a control group.Relevance: Self-management is thought to be an effective strategy in the treatment of chronicillness like OA although there is no robust evidence to support it. OAK is a disease specific OA selfmanagementeducation program designed for delivery by multidisciplinary health professionals toenhance participant’s self-efficacy and promote long-term changes in behaviour. Within theconstructs of self-management, exercise and disease coping strategies are promoted as a meansto improve quality of life, general health and pain.Description: Participants: Medical practitioners referred 146 participants (37 male and 109 female)with established OA knee, mean age of 65 years. Volunteers were excluded for coexistentinflammatory joint disease or serious co-morbidities.Interventions: Participants were randomised into either control or OAK groups (ratio 1:1). <strong>The</strong> OAKgroup completed the six-week self-management education program. <strong>The</strong> control group had a sixmonthwaiting period before receiving the OAK program.Measurements: All participants were assessed at baseline, eight-weeks and six-months. Primaryoutcomes: VAS pain, WOMAC and SF-36 questionnaires were completed. Secondary outcomeswere: a modified “timed get up and go” test, quadriceps and hamstring strength- isometriccontraction assessed using a dynamometer, and knee range of motion (ROM) using a goniometer.Response to treatment was determined using responder and minimal clinically important criteria(MCII).Evaluation: In the OAK group, VAS pain improved during the eight week clinic phase, mean (SE)5.21 (0.30) to 3.65 (0.29) p=


<strong>The</strong> Effect of Mesothelioma Tumours on Dendritic Cell SubsetsPresented by: Scott M.J. Cornwall, School of Biomedical <strong>Science</strong>sCourse: Doctor of PhilosophySupervisors: Dr. Delia Nelson, Prof. Anna NowakMalignant mesothelioma (MM) is an aggressive cancer affecting the mesothelium surrounding thepleura. Diagnosis is associated with a poor prognosis as death generally occurs within the nexttwelve months. Current treatment options including surgery, chemotherapy and/or radiotherapyimprove life expectancy by a few months; thus, improved treatment strategies are needed. Onepossibility is including immunotherapy in the treatment protocol. Dendritic cells (DCs) are criticalcells involved in inducing and maintaining adaptive immune responses. Many immunotherapiestarget DCs yet their functional status in MM patients is unknown. Thus, this project aimed to assessthe functional capacity of specific human blood DC subsets in MM patients. To date, 49 MMpatients have been compared to 52 healthy controls.Our preliminary results show a decrease in three populations of blood DCs (plasmacytoid DCs,myeloid DC1 and 2) in MM patients. Furthermore, the capacity of blood monocytes to differentiateinto CD1a + monocyte-derived DCs (MoDCs) in the presence of GM-CSF and IL-4 was impaired.MoDCs from MM patients also demonstrated reduced antigen processing capacity. Finallyresponses to the maturation stimuli LPS +/- IFNg were weaker in MM patient MoDCs relative totheir age-matched healthy controls. Exposing MoDCs prepared from healthy humans to MMtumour cell derived supernatant revealed similar results. Taken together, these data imply that thesecretion of soluble factors from MM tumours significantly impairs DC function in vivo.<strong>The</strong>se data add to the pool of information showing numerical and functional defects in DCs incancer patients. Further studies will investigate whether these defects can be overcome followingdifferent treatment strategies. If so, this may identify a window of opportunity for includingimmunotherapy in treatment for MM patients.Structural Bioinformatics and Molecular Modelling in GlycobiologyPresented by: Neha S. Gandhi, School of Biomedical <strong>Science</strong>sCourse: Doctor of PhilosophySupervisor: Prof. Ricardo L. ManceraComplex carbohydrates such as sulphated glycosaminoglycans (sGAGs) represent a particularlychallenging class of molecules for the molecular modelling of their three-dimensional structure andinteractions with proteins. Due to their inherent molecular flexibility and anionic nature, theseoligosaccharides adopt different conformations in aqueous solution and when bound to their proteintargets. <strong>The</strong> development of bioinformatics and molecular modelling methods to study sGAGs hasbeen a widely neglected and unexplored area.In this work a few examples are presented that illustrate the use of computational techniques topredict the binding of sGAGs with various proteins, such as PECAM-1, CXCL-8 and heparanase,which are involved in leukocyte migration, inflammation, and angiogenesis and metastasis,respectively. Homology modelling and protein sequence and structural analyses were used topredict sGAG binding sites.Molecular docking and free energy calculations were used toinvestigate the effects of various factors that affect binding affinity, such as pH and the length andconformation of sGAG oligosaccharides. <strong>The</strong>se findings can be beneficially exploited for therational design of novel molecules (GAG mimetics) that target sGAG recognition domains oftherapeutic importance in various disease states.


Endurance Athletes Risk Potassium DepletionPresented by: Nicola Holmes, School of Public <strong>Health</strong>Course: Doctor of PhilosophySupervisors: Dr. Veronica Miller, Dr. Graham Bates, Dr. Yun ZhaoHeat acclimatisation results in several thermoregulatory adaptations that serve to reduce thephysiological strain associated with exercise in the heat. <strong>The</strong>se include an increase in sweat rateand conservation of sweat sodium. Few studies have investigated the effect on sweat potassiumlosses. <strong>The</strong> aim of this study was to investigate the effect of seasonal heat acclimatisation onsweat rate and sweat electrolyte losses (sodium and potassium) in order to be able to moreaccurately determine sodium and potassium requirements in athletes.Twenty-six endurance athletes completed 2 exercise sessions on separate days in anenvironmental chamber. Trials were completed at the end of both the summer and winter months.Sweat rate was calculated from loss of body mass over time. Sweat collecting devices wereattached to the upper arms and legs.Sweat rates were higher and sodium concentrations were lower at the end of the summer periodindicating that the subjects were heat acclimatised. Estimated sodium loss (mg/hr), based on anathlete’s sweat rate was significantly higher at the end of summer. Sweat potassium concentrationwas significantly greater (p


Migration Patterns and the Impact of Internal Remittances on Poverty andHuman Capital in Timor-LestePresented by: Tambri Housen, Centre for International <strong>Health</strong>Course: Doctor of PhilosophySupervisors: A/Professor Jaya Earnest, Prof. Sandra HopkinsRemittances (money transfers by migrants) are recognised as important in improving thelivelihoods of rural households. <strong>The</strong> multiplier effects of remittances can be substantial, promotingpoverty reduction, improving health and education and overall development in low incomecountries. <strong>The</strong> overall purpose of the study is to map migration and internal remittance flows in 3districts of Timor-Leste and analyse the impact of these remittances on poverty, health, educationand human capital.Findings show that the desire for more education is the predominant reason for migration withhuman capital benefits such as increased education and skill base, having the greatest effect onmigrant households. Public transfers are shown to be far more common than private transfers withremittances primarily spent on daily needs, education, social/cultural celebrations and health care.Remittances constitute a significant proportion of total household consumption of the pooresthouseholds, providing some indication that remittances indeed play an important role in povertymitigation.<strong>The</strong> study findings add to the limited body of knowledge on the impact of internal remittances inlow-income countries and will serve to inform local and national government agency’s with the aimof guiding policy formulation that strengthens the link between migration, health improvement andpoverty-reduction at village level.A Framework for Evaluating Peer Based Youth ProgramsPresented by: Roanna Lobo, School of Public <strong>Health</strong>Course: Doctor of PhilosophySupervisors: Dr. Graham Brown, Prof. Bruce Maycock,Prof. Alexandra McManusThis paper will present the findings of a participatory action research study to develop a practicebasedand theory-based evaluation framework for practitioners of peer-based youth programsincluding drop-in centres, peer support groups and online discussion forums. <strong>The</strong> focus of thestudy was on evaluation of peer-based programs for youth aged 12-25 years at high risk of poormental health outcomes. Target groups included teenage parents, youth experiencing socialisolation, young people at risk of depression, self-harm or suicide, and youth of diverse gender orsexuality. Twelve peer-based programs, eight youth service provider organisations and four Curtinresearch centres collaborated in the three year study which was completed in August 2011.<strong>The</strong> study identified seven broad objectives for peer-based youth programs and the barriers andenablers associated with program evaluation. <strong>The</strong> framework arising from this study specifiedcomprehensive evaluation parameters for the attributes of youth most at risk, moderating factors,external factors, environment factors, program factors, peer group factors, short term impacts onindividuals or others, and long term outcomes which may result from participating in a peer-basedprogram. Seven features of effective programs which may be particularly significant for programstargeting youth at most risk were also identified.<strong>The</strong> findings of the study highlighted the need to establish more relevant reporting systems formeasuring the effectiveness of peer-based youth programs. <strong>The</strong> findings also highlighted the needfor capacity building initiatives to improve levels of program evaluation, including training andpartnerships between practitioners, researchers and young people. Improved evaluation and theavailability of more evidence demonstrating program effectiveness will contribute to betterresourced, more sustainable programs.


Evaluating an Internet <strong>The</strong>rapy Service: <strong>The</strong>rapeutic Alliance and OutcomesPresented by: Ben Mullings, School of Psychology and Speech PathologyCourse:Doctor of PhilosophySupervisors: A/Prof. Jan Grant, Dr. Clare Rees, Dr. Bob Kane<strong>Health</strong> practitioners are increasingly using the Internet to deliver web-based services, but to date,most of the research has focused on self-guided approaches where interactions between the clientand therapist are minimal. This research explores the potential for Internet communication todeliver psychological services, by directly comparing the processes and therapeutic outcomes oftherapy delivered either face-to-face or over Internet chat communication.A team of 20 therapists provided psychological services to clients who self-selected either face-tofaceor Internet chat therapy. Measures of the alliance and symptom severity were obtained andinterviews with both clients and therapists were conducted to explore the experiences of peopleusing Internet chat for therapy.Strong main effects were found for improvement across the first 3 sessions in both treatmentgroups, but differences between treatment groups were not statistically significant on most of thekey variables. <strong>The</strong>rapist-rated symptom severity did not show significant levels of improvementover the first 3 sessions and clients receiving face-to-face therapy rated the alliance significantlyhigher. Qualitative data generated from interviews at the conclusion of Internet therapy showed theimportance of therapeutic distance for people who select this form of treatment. Participants alsodescribed the formation of mental images of the other party and the role this had in terms ofconstructing a sense of interaction with the other person. Although this had an impact on the qualityof the working alliance that developed, both clients and therapists were generally satisfied with thetherapeutic relationship overall. Given that meta-analytic reviews show larger treatment effects areassociated with web-based interventions where there is greater therapist involvement, the presentstudy raises questions about whether Internet chat could be better utilised.A Mother’s Knowledge and Understanding of her Child’s Care at the Time ofCardiac SurgeryPresented by: Mary Tallon, School of Nursing and MidwiferyCourse: Master of <strong>Science</strong> (Nursing)Supervisors: Dr. Garth Kendall, Dr. Paul Snider<strong>The</strong> earliest years of a child’s life are the most crucial for life-long health and wellbeing. <strong>The</strong> child’smain carer, usually the mother, is most influential in helping her child regulate early developmentalprocesses. When a young child requires heart surgery the stress and anxiety associated with therisks of the operation to health and long-term development can make it very difficult for mothers toremember important information about the appropriate care of their child. Nurses could do a greatdeal more to help parents to learn about these special care requirements.This quantitative cross sectional study aimed to validate an instrument to measure maternalknowledge and understanding (KU) at the time of surgery and explore the impact of stress, anxiety,depression and social support on KU. Mothers attending the Children’s Cardiac Centre at PrincessMargaret Hospital between Aug 2008 and April 2010 were invited to complete a questionnaire.Validated instruments were used to measure levels of maternal stress, anxiety, depression andsocial support, while a consensual instrument was developed to measure KU. Descriptive,bivariate and multiple regression analyses were completed.<strong>The</strong> response rate was 61%. <strong>The</strong> KU instrument demonstrated high internal consistency(Cronbach’s Alpha .78). Significant stress was experienced by 29% of mothers, anxiety by 28%and depression by 22%. In bivariate analyses, family financial strain was associated withincreased anxiety and the severity of the child’s heart problem was associated with greaterlikelihood of depression. In a multiple regression model mother’s increased anxiety, dissatisfactionwith partner support, and insufficient support from relatives were all independently associated withlower KU scores.This study calls for further research to validate an instrument to measure Maternal KU forapplication across the paediatric setting. This work highlights the need for nurses to work within afamily-centred care framework that includes diligent attention to early child development, maternalmental health, empowerment theory, and partnership development.


Growing up Australian: Exploring how Second Generation VietnameseYouth in Perth negotiate an (Ethnic) IdentityPresented by: Selina Tang, School of Occupational <strong>The</strong>rapy and Social WorkCourse: Doctor of PhilosophySupervisor: Dr. <strong>Mark</strong> Liddiard, A/Prof. Frances Crawford<strong>The</strong>re has been limited examination of second generation Vietnamese youth growing up inAustralia, with existing research literature focused on the refugee experience. Bearing little or nomemory of Vietnam, these young people may have very different experiences growing up inAustralia compared to those arriving under refugee status. With the growing number ofVietnamese youth in Australia, it is imperative that human and health services are informed by adeeper understanding of these young people.<strong>The</strong>refore, this paper expands upon previous findings and develops a more sophisticatedunderstanding of the second generation Vietnamese youth growing up in Australia today, inparticular, how they negotiate an (ethnic) identity. For ethnic minority youth, identity formation isfurther complicated by culture and acculturation – not only do they need to grapple with loyalty totheir own culture of origin, but also with adjustment to the dominant culture, including youth culture.<strong>The</strong>y may face especially complex issues, as they find their place in two potentially conflictingworlds: that of their parents’ and ethnic community, and that of their peers and the dominantsociety.Traditionally communal in texture, the Vietnamese culture is one in which family interests often takeprecedence over personal interests. <strong>The</strong>se normative prescriptions for familial relations are oftenat odds with the mainstream emphasis on individuality, self-assertion and egalitarian relationshipsin Australia. This may then challenge many of the traditional values in the Vietnamese culture,creating tension and friction within immigrant Vietnamese families, which may in turn, affect thenegotiation of one’s ethnic identity as a Vietnamese young person. Adopting a narrative approachto explore the life experiences of second generation Vietnamese youth, this paper illustrates thesocio-cultural dimensions of their life experiences as they navigate their transition into adulthoodand negotiate an ethnic identity as they walk between two cultures.

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