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    Assessing the carbon footprint of digital health interventions: a scoping review
    Lokmic-Tomkins, Z ; Davies, S ; Block, LJ ; Cochrane, L ; Dorin, A ; von Gerich, H ; Lozada-Perezmitre, E ; Reid, L ; Peltonen, L-M (OXFORD UNIV PRESS, 2022-11-14)
    OBJECTIVE: Integration of environmentally sustainable digital health interventions requires robust evaluation of their carbon emission life-cycle before implementation in healthcare. This scoping review surveys the evidence on available environmental assessment frameworks, methods, and tools to evaluate the carbon footprint of digital health interventions for environmentally sustainable healthcare. MATERIALS AND METHODS: Medline (Ovid), Embase (Ovid). PsycINFO (Ovid), CINAHL, Web of Science, Scopus (which indexes IEEE Xplore, Springer Lecture Notes in Computer Science and ACM databases), Compendex, and Inspec databases were searched with no time or language constraints. The Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA_SCR), Joanna Briggs Scoping Review Framework, and template for intervention description and replication (TiDiER) checklist were used to structure and report the findings. RESULTS: From 3299 studies screened, data was extracted from 13 full-text studies. No standardised methods or validated tools were identified to systematically determine the environmental sustainability of a digital health intervention over its full life-cycle from conception to realisation. Most studies (n = 8) adapted publicly available carbon calculators to estimate telehealth travel-related emissions. Others adapted these tools to examine the environmental impact of electronic health records (n = 2), e-prescriptions and e-referrals (n = 1), and robotic surgery (n = 1). One study explored optimising the information system electricity consumption of telemedicine. No validated systems-based approach to evaluation and validation of digital health interventions could be identified. CONCLUSION: There is a need to develop standardised, validated methods and tools for healthcare environments to assist stakeholders to make informed decisions about reduction of carbon emissions from digital health interventions.
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    Endothelial protein C receptor is increased in preterm preeclampsia and fetal growth restriction
    Andres, F ; Hannan, NJ ; Walker, SP ; MacDonald, TM ; Wong, GP ; Murphy, C ; Cannon, P ; Kandel, M ; Masci, J ; Nguyen, T-V ; Abboud, A ; Idzes, D ; Kyritsis, V ; Pritchard, N ; Tong, S ; Kaituu-Lino, TJ (WILEY, 2022-12)
    Placental dysfunction is the leading cause of both preeclampsia and fetal growth restriction. This study aimed to characterize endothelial protein C receptor (EPCR) in preterm preeclampsia, term preeclampsia, and fetal growth restriction (defined by delivery of a small for gestational age [SGA] infant [<10% birthweight centile]) and examine its regulation in primary syncytiotrophoblast. Placental EPCR mRNA and protein were significantly increased in patients with preterm preeclampsia (<34 weeks gestation) compared to gestation-matched controls (p < .0001). In the plasma, EPCR was also significantly elevated (p = .01) in established preterm preeclampsia while its substrate, protein C (PC) was significantly reduced (p = .0083). Placentas from preterm small for gestational age (SGA) cases, had elevated EPCR mRNA expression (p < .0001) relative to controls. At 36 weeks, no significant changes in plasma EPCR were detected in samples from patients destined to develop preeclampsia or deliver an SGA infant at term. In terms of syncytiotrophoblast, hypoxia significantly increased EPCR mRNA expression (p = .008), but Tumor Necrosis Factor Alpha (TNF-α) decreased EPCR mRNA. Interleukin-6 (IL-6) had no significant effect on EPCR mRNA expression. When isolated syncytiotrophoblast was treated with metformin under hypoxia (1% O2 ) or normoxia (8% O2 ), EPCR mRNA expression was significantly reduced (p = .008) relative to control. In conclusion, EPCR is markedly elevated in the placenta and the circulation of patients with established preterm preeclampsia and placental increases may be associated with hypoxia. Additionally, fetal growth-restricted pregnancies (as defined by the delivery of an SGA infant) also demonstrated elevated placental EPCR.
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    A single-blind, randomised controlled trial of a physical health nurse intervention to prevent weight gain and metabolic complications in first-episode psychosis: the Physical Health Assistance in Early Psychosis (PHAstER) study
    O'Donoghue, B ; Mifsud, N ; Castagnini, E ; Langstone, A ; Thompson, A ; Killackey, E ; McGorry, P (CAMBRIDGE UNIV PRESS, 2022-10-18)
    BACKGROUND: Factors that contribute to the early mortality observed in psychotic disorders, specifically obesity, smoking and sedentary behaviour, occur early in the disorder. AIMS: We aimed to determine whether the integration of a physical health nurse in the care of young people with first-episode psychosis could prevent clinically significant weight gain (≥7% body weight). Secondary outcomes included rates of smoking, metabolic syndrome and sedentary behaviour. METHOD: In this single-blind, randomised controlled trial, participants who had received under 4 weeks of antipsychotic medication were randomly allocated to either the intervention (addition of a physical health nurse to their care) or treatment as usual (TAU) for 12 weeks. RESULTS: Of the 77 participants, there were follow-up data for 86.8% (n = 33) of the intervention group and 82.1% (n = 32) of the TAU group. After 12 weeks, 27.3% of the intervention group experienced clinically significant weight gain compared with 34.4% of the TAU group (odds ratio 0.72, 95% CI 0.25-2.06, P = 0.54). After 6 months, 40.7% of the intervention group gained clinically significant weight compared with 44.1% of the TAU group (P = 0.79). There was no difference in mean change in weight between groups after 12 weeks (2.6 kg v. 2.9 kg, P = 0.87) or 6 months (3.6 kg v. 4.3 kg, P = 0.64). There were no differences in the rates of tobacco smoking cessation, prevalence of metabolic syndrome or physical activity levels. CONCLUSIONS: This intervention failed to prevent the metabolic complications that are highly prevalent in psychotic disorders in the short to medium term, indicating that more intensive interventions are required.
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    No turning back on global open access.
    Barbour, V ; Flanagan, D ; Tairi, K (BMJ, 2022-10-05)
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    Application profile for machine-actionable data management plans
    Miksa, T ; Walk, P ; Neish, P ; Oblasser, S ; Murray, H ; Renner, T ; Jacquemot-Perbal, MC ; Cardoso, J ; Kvamme, T ; Praetzellis, M ; Suchánek, M ; Hooft, R ; Faure, B ; Moa, H ; Hasan, A ; Jones, S (Ubiquity Press, Ltd., 2021-01-01)
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    An Interdisciplinary Partnership Approach to Improving the Digital Literacy Skills of Nursing Students to Become Digitally Fluent, Work-Ready Graduates.
    Lokmic-Tomkins, Z ; Cochrane, L ; Celeste, T ; Burnie, M (IOS Press, 2021-12-15)
    Digital transformation and the development of a digitally fluent nursing workforce are necessary for engagement with digital technologies in healthcare settings. For this purpose, educators aim to develop workforce-ready graduates equipped with disciplinary knowledge, expertise, and digital capabilities supportive of further professional development. Having identified a subset of nursing students with low levels of digital literacy, the nursing faculty engaged with library services and the academic skills unit to develop and embed a sustainable Nursing Digital Literacy Module in the graduate entry to practice nursing program. This paper reports on the model created and early evaluation of the student uptake of the module.
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    Optimal Cosmic Microwave Background Lensing Reconstruction and Parameter Estimation with SPTpol Data
    Millea, M ; Daley, CM ; Chou, T-L ; Anderes, E ; Ade, PAR ; Anderson, AJ ; Austermann, JE ; Avva, JS ; Beall, JA ; Bender, AN ; Benson, BA ; Bianchini, F ; Bleem, LE ; Carlstrom, JE ; Chang, CL ; Chaubal, P ; Chiang, HC ; Citron, R ; Moran, CC ; Crawford, TM ; Crites, AT ; de Haan, T ; Dobbs, MA ; Everett, W ; Gallicchio, J ; George, EM ; Goeckner-Wald, N ; Guns, S ; Gupta, N ; Halverson, NW ; Henning, JW ; Hilton, GC ; Holder, GP ; Holzapfel, WL ; Hrubes, JD ; Huang, N ; Hubmayr, J ; Irwin, KD ; Knox, L ; Lee, AT ; Li, D ; Lowitz, A ; McMahon, JJ ; Meyer, SS ; Mocanu, LM ; Montgomery, J ; Natoli, T ; Nibarger, JP ; Noble, G ; Novosad, V ; Omori, Y ; Padin, S ; Patil, S ; Pryke, C ; Reichardt, CL ; Ruhl, JE ; Saliwanchik, BR ; Schaffer, KK ; Sievers, C ; Smecher, G ; Stark, AA ; Thorne, B ; Tucker, C ; Veach, T ; Vieira, JD ; Wang, G ; Whitehorn, N ; Wu, WLK ; Yefremenko, V (American Astronomical Society, 2021-12-01)
    We perform the first simultaneous Bayesian parameter inference and optimal reconstruction of the gravitational lensing of the cosmic microwave background (CMB), using 100 deg2 of polarization observations from the SPTpol receiver on the South Pole Telescope. These data reach noise levels as low as 5.8 µK arcmin in polarization, which are low enough that the typically used quadratic estimator (QE) technique for analyzing CMB lensing is significantly suboptimal. Conversely, the Bayesian procedure extracts all lensing information from the data and is optimal at any noise level. We infer the amplitude of the gravitational lensing potential to be A f =0.949\,\pm \,0.122 using the Bayesian pipeline, consistent with our QE pipeline result, but with 17% smaller error bars. The Bayesian analysis also provides a simple way to account for systematic uncertainties, performing a similar job as frequentist "bias hardening"or linear bias correction, and reducing the systematic uncertainty on A f due to polarization calibration from almost half of the statistical error to effectively zero. Finally, we jointly constrain A f along with A L, the amplitude of lensing-like effects on the CMB power spectra, demonstrating that the Bayesian method can be used to easily infer parameters both from an optimal lensing reconstruction and from the delensed CMB, while exactly accounting for the correlation between the two. These results demonstrate the feasibility of the Bayesian approach on real data, and pave the way for future analysis of deep CMB polarization measurements with SPT-3G, Simons Observatory, and CMB-S4, where improvements relative to the QE can reach 1.5 times tighter constraints on A f and seven times lower effective lensing reconstruction noise.
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    Examining Effectiveness and Predictors of Treatment Response of Pivotal Response Treatment in Autism: An Umbrella Review and a Meta-Analysis
    Uljarevic, M ; Billingham, W ; Cooper, MN ; Condron, P ; Hardan, AY (FRONTIERS MEDIA SA, 2022-01-27)
    The current study aimed to provide a comprehensive appraisal of the current evidence on the effectiveness of Pivotal Response Training (PRT) for individuals with autism spectrum disorder (ASD) and to explore predictors of treatment response. We conducted a systematic review of the following electronic databases and registers: PsycINFO, Medline, Embase, Cochrane Central Register of Controlled Trials, ERIC, Linguistics and Language Behavior Abstracts. Six systematic reviews were identified, two with meta-analytic component. Identified reviews varied widely in terms of their aims, outcomes, and designs which precluded a unified and consistent set of conclusions and recommendations. Ten RCTs were identified. Eight of identified RCTs reported at least one language and communication-related outcome. Statistically significant effects of PRT were identified across a majority of identified RCTs for a range of language and communication skills. However, evidence for positive treatment effects of PRT on outcome measures assessing other domains was less robust and/or specific. Overall, both previous systematic reviews and new meta-analysis of the RCTs suggest that PRT shows promise for improving language and communication. Only four RCTs examined the association between baseline child characteristics and treatment outcomes, however, no consistent pattern emerged. This review has identified several key methodological and design improvements that are needed to enable our field to fully capitalize on the potential of RCT designs and characterize detailed profiles of treatment responders. These findings are essential for informing the development of evidence-based guidelines for clinicians on what works for whom and why.
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    Evaluation of microRNA expression in a sheep model for lung fibrosis
    Perera, UE ; Derseh, HB ; Dewage, SN ; Stent, A ; Wijayarathna, R ; Snibson, KJ (BMC, 2021-11-17)
    BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibroproliferative disorder that has one of the poorest prognoses amongst interstitial lung diseases. Recently, the finding of aberrant expression levels of miRNAs in IPF patients has drawn significant attention to the involvement of these molecules in the pathogenesis of this disease. Clarification of the differential expression of miRNAs in health and disease may identify novel therapeutic strategies that can be employed in the future to combat IPF. This study evaluates the miRNA expression profiles in a sheep model for lung fibrosis and compares them to the miRNA profiles of both IPF patients and the mouse bleomycin model for pulmonary fibrosis. Pathway enrichment analyses were performed on differentially expressed miRNAs to illustrate which biological mechanisms were associated with lung fibrosis. RESULTS: We discovered 49 differentially expressed miRNAs in the sheep fibrosis model, in which 32 miRNAs were significantly down regulated, while 17 miRNAs were significantly upregulated due to bleomycin-induced lung injury. Moreover, the miRNA families miR-29, miR-26, miR-30, let-7, miR-21, miR-19, miR-17 and miR-199 were aberrantly expressed in both sheep and mouse models, with similar differential miRNAs expression observed in IPF cases. Importantly, 18 miRNAs were aberrantly expressed in both the sheep model and IPF patients, but not in mice. CONCLUSION: Together with pathway enrichment analyses, these results show that the sheep model can potentially be used to characterize previously unrecognized biological pathways associated with lung fibrosis.
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    Employability development and career outcomes from short-term learning abroad programmes
    Potts, D (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022-06-07)
    Learning abroad has become a central component in the internationalisation strategies of many Australian universities, following trends in other countries such as France, Germany, USA, Singapore and Japan. To expand access to different types of students and to diversify host destinations, short-term programmes have been the focus of institutions over the last five years. However, little is known about the outcomes of short-term learning abroad programmes. This article explores the connection between short-term learning abroad experiences, career outcomes and employability skills development of graduates in the Australian context. In the first national study of learning abroad outcomes, most former participants were positive about the perceived benefits provided by their international study experiences in terms of their employment outcomes. Respondents strongly supported the role of learning abroad in the development of core employability skills. The findings confirm an amplified impact on participants in internship programmes and multiple learning abroad programmes. The results of this study support the further development of short-term learning abroad opportunities for students, with considerations for access to programmes for those from underrepresented backgrounds.