Medicine & Health

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Now showing 1 - 5 of 5
  • (2022) Sloane, Jennifer
    Thesis
    From a child interrupting a conversation between her parents to ask "What's for dinner?" to a nurse interrupting a physician in the middle of a complex procedure with an urgent message, interruptions are an inevitable part of our daily lives no matter who we are, where we live, or what we do. Interruptions can have a variety of affects on people's performance and behavior. While interruptions may sometimes facilitate performance, often interruptions have negative consequences. For example, interruptions may result in people making more errors or forgetting to complete a prior task altogether. This thesis examines existing strategies to help mitigate interruption costs and explores the effects of interruptions within different decision environments. Chapter I introduces the topic by discussing a few theoretical frameworks of interruptions and reviewing prior research on what makes interruptions disruptive. One strategy to minimize interruption costs is to use what is called an interruption lag, which can be thought of as taking time to prepare for a pending interruption. Chapter II presents a novel experiment to systematically explore the potential benefits of interruptions lags and an alternative intervention (i.e. providing feedback) when interruption lags are not possible. Chapters III and IV discuss the results from three experiments and a final replication study that all focus on how interruptions affect people's decision making in unique environments. The environments consist of easy problems (i.e. basic arithmetic problems) and trick problems, designed in such a way to lead the reader down an incorrect path. Results from these studies were mixed. While there was some evidence that interruptions may make people more susceptible to falling for the trick answer, this finding was inconsistent across all the experiments. Chapter V applies the findings from the previous chapters to a medical context. This chapter presents novel medical cases that were developed with the help of a medical expert. These cases consisted of easy, hard, and trick cases designed for medical students. The goals of this chapter were to validate the cases and to investigate the effects of interruptions within the different case types. The final chapter (Chapter VI) concludes with a general discussion of the experimental findings, the theoretical implications of the results, and the broader implications of this research for the field of medicine.

  • (2022) Cao, Jun
    Thesis
    This thesis focuses on the development and applications of magnetic resonance electrical properties tomography (MREPT), which is an emerging imaging modality to noninvasively obtain the electrical properties of tissues, such as conductivity and permittivity. Chapter 2 describes the general information about human research ethics, MRI scanner, MR sequence and the method of phase-based MREPT implemented in this thesis. Chapter 3 examines the repeatability of phase-based MREPT in the brain conductivity measurement using balanced fast field echo (bFFE) and turbo spin echo (TSE) sequences, and investigate the effects of compressed SENSE, whole-head B_1 shimming and video watching during scan on the measurement precision. Chapter 4 investigates the conductivity signal in response to short-duration visual stimulus, compares the signal and functional activation pathway with that of BOLD, and tests the consistency of functional conductivity imaging (funCI) with visual stimulation across participants. Chapter 5 extends the use of functional conductivity imaging to somatosensory stimulation and trigeminal nerve stimulation to evaluate the consistency of functional conductivity activation across different types of stimuli. In addition, visual adaptation experiment is performed to test if the repetition suppression effect can be observed using funCI. Chapter 6 explores if resting state conductivity networks can be reliably constructed using resting state funCI, evaluates the consistency of persistent homology architectures, and compares the links between nodes in the whole brain. Chapter 7 investigates the feasibility of prostate conductivity imaging using MREPT, and distinctive features in the conductivity distribution between healthy participants and participants with suspected abnormalities.

  • (2023) Listiyandini, Ratih Arruum
    Thesis
    Psychological distress is prevalent among university students worldwide, including in Low-and-middle income countries, such as Indonesia. Considering its promising scalability, a culturally relevant Internet-delivered mindfulness intervention has potential to treat psychological distress among Indonesian university students. However, there is no previous research into the development and impact of culturally relevant internet-delivered mindfulness interventions for Indonesian university students, leaving a gap in the research literature. The current thesis aims to: a) develop a culturally adapted internet-delivered mindfulness intervention and evaluate its relevancy for Indonesian university students; b) assess its feasibility and acceptability in a pilot open trial, and c) investigate its effectiveness for treating distress among Indonesian students in a randomised controlled trial. To achieve the thesis objectives, the systematic cultural adaptation framework proposed by Barrera and colleagues (2006; 2013) was employed as a guiding framework for culturally adapting an Australian internet-delivered mindfulness program to be more relevant for Indonesian university students. The development of a culturally adapted internet-delivered mindfulness intervention was achieved through two studies using mixed-methods approach. Study 1 was an online cross-sectional survey of Indonesian students’ openness and preferences toward an internet-delivered mindfulness program. Study 2 engaged Indonesian university students, as well as mindfulness or mental health experts in focus group discussions, structured interviews, and the completion of cultural relevancy questionnaires. The purpose of Study 2 was to gain feedback on an initial version of the culturally adapted program. These studies showed that an internet-delivered mindfulness intervention is relevant for Indonesian university students, but some adjustments needed to be made to enhance its cultural suitability and engagement. Based on these studies, an Indonesian counsellor-guided internet-delivered mindfulness program, called PSIDAMAI (Program Intervensi Mindfulness Daring Mahasiswa Indonesia) was developed. Subsequently, Study 3 assessed the feasibility, acceptability, and preliminary clinical outcomes of counsellor guided PSIDAMAI using a pre-post open trial study design. Study 3 showed that PSIDAMAI was feasible, acceptable, and associated with significant improvements in psychological distress between baseline and post-treatment, with good completion rates (70%). In Study 4, the clinical efficacy of PSIDAMAI was tested in a randomized controlled trial using a wait-list control group as a comparator. Study 4 found that PSIDAMAI was more effective at improving psychological distress compared to the wait-list control group with medium to large between-group effect sizes. The improvements were maintained up to one-month follow-up. In summary, the thesis is the first to demonstrate evidence that a culturally adapted internet-delivered mindfulness intervention is relevant, acceptable, feasible, effective, and has positive impacts for Indonesian university students’ mental health. Thus, strategies for wider implementation within the Indonesian higher education mental health system are now needed.

  • (2023) Sucquart, Irene
    Thesis
    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and the leading cause of anovulatory infertility. PCOS has a complicated pathophysiology that encompasses endocrine, reproductive, metabolic, and psychological traits. Hyperandrogenism is a key trait driving the pathogenesis of PCOS through androgen receptor related actions. The brain has recently been revealed as an important site of androgen action in PCOS. Currently, PCOS has no cure and treatment options are suboptimal and are all symptom based. PCOS significantly impacts a woman’s quality of life and therefore there is a necessity to understand the underlying mechanism of neural androgen signaling in PCOS in the hopes of finding a cure or effective therapeutic options. The main aim of this research was to investigate the involvement of different androgen mediated neuron pathways in the development of PCOS using an established PCOS androgenized mouse model. The first study investigated the effect of therapeutic inhibition of kisspeptin-neurokinin B- dynorphin (KNDy) neurons on the development of PCOS traits. The results revealed that inhibition of KNDy neuron activity ameliorated PCOS associated weight gain, adiposity and increased respiratory exchange ratio in the mouse model. The second study examined the role of androgen signaling gamma-aminobutyric acid (GABA) neurons in PCOS development using genetically modified GABA neuron androgen receptor (AR) knock-out mice. The findings revealed that the development of PCOS traits was not affected in these mice despite the lack of GABA AR signaling. The third chapter aimed to investigate the role of agouti-related protein (AgRP) expressing neurons in the pathogenesis of PCOS. In this study, AgRP neurons were chemogenetically inhibited following the establishment of PCOS traits in the mouse model. The study found that while overall AgRP inhibition did not impact PCOS trait development, the results suggest that a hyperandrogenic environment may disrupt the role of AgRP neurons in glucose metabolism and cholesterol homeostasis. Overall, these results support the use of targeted neuroendocrine therapies for PCOS, narrow down the likely neuron pathways involved in pathogenic androgen actions, and add to the growing knowledge of neuroendocrine androgen driven disruption in PCOS.

  • (2023) Hagos, Amanuel Kidane
    Thesis
    In most developed countries, the rapid increase in the number of older incarcerated adults along with their complex health and social service needs has become a challenge for both correctional and health systems. Existing evidence consists of largely secondary data and addresses single issues such as mental health. The purpose of this body of work was to explore current practices in the care and management of older people in prison and those transitioning to community and provide recommendations for policy, practice, and future research in the field. The body of work employed a combination of exploratory sequential and concurrent mixed methods study design. The work started with a scoping review to identify international best practices in the care and management of older incarcerated adults. This review further informed two subsequent qualitative studies and a collective mixed methods case study in New South Wales, Australia. The two qualitative studies used focus group discussions with Corrective Services New South Wales (CSNSW) staff and applied thematic analysis to analyse the data. The collective mixed methods case study used interviews and online survey with CSNSW and Justice Health and Forensic Mental Health Network staff and older incarcerated adults. A constant comparative analysis was applied to analyse interviews using NVivo version 12. Qualtrics and SPSS version 26.0 were used to administer and analyse the quantitative data. The series of studies in this thesis have resulted to key empirical and conceptual contributions including: i) best practices to optimise the care and management of older incarcerated adults in mainstream prisons, ii) barriers and enablers to in-prison care and the transition to community, iii) attributes of competing logics (e.g. differing power and priorities) between health and custody in the care and management of older incarcerated adults, iv) sub-optimal application of the principles of equivalence of care, v) weak communication and relationships among prison staff (Relational Coordination index of 2.9 (SD = 0.7), and vi) ad hoc approaches to the care and management of the older incarcerated adult population. In a summary, the evidence from this body of work revealed that the care and management of older incarcerated adults operates through an intersecting triad of correctional safety and security requirements, prison health services ethos and older incarcerated adults’ needs where safety and security considerations take precedence over health services, limiting older incarcerated adults’ involvement and preferences and compromising equivalence of care. More collaborative work between health and custody can improve the organisation and provision of care to older incarcerated adults and achieve equivalence of care in correctional centres.