CONFERENCE PRESENTER: Jia Thadani, 2025 Year 4 MD students, presented at the 10th Rural and Remote Health Symposium, Rural Innovations Changing Healthcare (RICH) 2025 Conference and the annual 3+1Q Competition
The Summer Scholarship Project team proudly presented their research, “Walking Towards Wellbeing: Evaluating the Effectiveness of Bathurst Women Walk and Social Prescribing,” at the 10th Rural and Remote Health Symposium in Alice Springs. Presented by Jia Thadani, the session drew strong interest and sparked thoughtful discussion, showcasing the project’s relevance to rural health innovation.
A collaboration between the WSU Bathurst Rural Clinical School and the Central West Women’s Health Centre, the project explores how community-led programs like Bathurst Women Walk can boost women’s wellbeing through connection, activity, and empowerment. Guided by Dr. Uchechukwu Levi Osuagwu (Academic Lead in Rural Health) and CWWHC members, the team evaluated the program as a rural model of social prescribing that links research with community action.
The symposium was an enriching experience, bringing together clinicians, researchers, community representatives, and policymakers from across Australia. It highlighted key issues in rural healthcare, including accessibility, workforce development, and community-led innovation, while providing valuable networking and collaboration opportunities.
In addition to the symposium, the project was presented at the Rural Innovations Changing Healthcare (RICH) 2025 Conference and the annual 3+1Q Conference, where Jia's presentation earned second place overall, a recognition that highlights both the quality of the research and the team’s dedication.
The project is also scheduled for upcoming presentations at the Western New South Wales Health Research Network (WHRN) Conference in Orange and the Australasian Council for Undergraduate Research 2025 Conference. Attendance at these events has been made possible through generous scholarships from Western Sydney University and the WHRN, whose support is greatly appreciated.
The team’s work has also been featured in Rural Health Pro and the Western Advocate, highlighting the project’s growing impact and recognition within the rural health community.
The team extends sincere thanks for the sponsorship provided by The BRCS Research Team led by Dr Uchechukwu Levi Osuagwu, which made this experience possible. This support enabled participation in a national platform, fostering professional growth, and reinforcing the team’s commitment to improving health outcomes in rural and remote communities.
2025 Joint Program of Medicine 3+1Q Student Research Competition
A heartfelt congratulations to all the winners of the 3+1Q Competition held via Zoom on Monday, 20 October 2025.
This annual competition features research presentations by JPM students showcasing the project that they worked on during the year, spanning across different areas of medical research including evidence-based investigations, clinical audits, systematic reviews and biomedical research in rural and metro settings, demonstrating a high level of innovative research design, planning and execution. It provides an opportunity for students to practice their oral communication skills and present their research in a friendly supportive forum.
Overall Winner, Mahica Jain, Year 4, 2025 student presented her MD Project research topic " Mind the Gap: Assessing the Immunisation Gap in Western Sydney's Immunosuppressed Population".
Special mention to Jia Thadani (First Runner-Up), Prathik Subbanna (Second Runner-Up, and Jared Li (People's Choice Winner).
Mahica then represented WSU at the Medical Deans Australia and New Zealand Medical School 3+1Q Competition on 22 November 2025, where she placed 3rd overall!
Mahica Jain - Overall Winner
Jia Thadani - First Runner-Up
Prathik Subbanna - Second Runner-Up
Jared Li - People's Choice
STUDENT PROJECT FEATURE: Seth Hennessy, 2025 Year 4 (TS1)
Student: Seth Hennessy
Supervisor: Dr Rossana Rosa Porto, Behavioural Neuroscience Group
Stream: Biomedical Sciences
Thanks to Professor Tim Karl, the members of Behavioural Neuroscience group & the animal facility staff for their additional support – Seth Hennessy
Alzheimer’s disease (AD) is the most common form of dementia and a leading cause of death in Australia. With limited effective treatments, non-pharmacological interventions like heat therapy (HT) offer promising therapeutic potential. This MD project investigated the effects of HT in a tauopathy mouse model of AD (TAU58/2 mice), focusing on behavioural recovery at later disease stages.
Male transgenic and wild-type mice were treated with HT (42°C, 20 minutes, twice weekly) for eight weeks. Behavioural assessments showed that HT significantly improved motor coordination, locomotion, and spatial memory in TAU58/2 mice, with a trend toward enhanced sensory gating. Notably, HT was well tolerated and induced thermotolerance over time, suggesting feasibility for clinical translation.
These findings align with epidemiological studies linking sauna use to reduced dementia risk and suggest that HT may act via mechanisms such as upregulation of heat shock proteins like HSP70. While prior research used recombinant HSP70, our study is among the first to show behavioural benefits of HT itself in a tauopathy model.
Future work will explore the molecular mechanisms of HT, expand female cohorts, compare different treatment frequencies, and evaluate HT in preventative models. We will also conduct pilot studies in older adults to determine optimal HT parameters, laying the groundwork for clinical trials in patients with mild cognitive impairment and early-stage AD. Ultimately, this project supports HT as a feasible, non-invasive strategy with the potential to benefit not only AD but also other neurodegenerative conditions.
Prevalence and Associations of Vaping in Young People Entering Youth Custody in New South Wales, Australia—A Retrospective Cross-Sectional Study
Leigh Haysom, Abdul Nasser, Calla Lee, Anna Barker, Penelope Abbott
Published 7 May 2025
ABSTRACT
Aim
Australia is a leader in rates of youth vaping. Previous research has shown that at-risk youth include young women, cigarette smokers, and young people experiencing mental distress. These risk factors suggest that young people entering custody in New South Wales, Australia, are likely to have high vaping rates, but the research is lacking.
Methods
This retrospective cross-sectional study analysed data from all young people entering the six youth justice facilities in New South Wales, Australia between February 2024 and July 2024 (prior to vape regulations), describing self-reported information about vaping, other smoking behaviours, and mental distress.
Results
474 young people aged 11 to 20 years participated in an Initial Assessment on reception to custody. Almost two-thirds (N = 283, 61.3%) reported current vaping, with almost all vaping daily or on most days (N = 240, 84.8%) and more than half being nicotine dependent. Significant associations with vaping were a younger age, being female, living in a metro area, smoking cigarettes and cannabis, and higher levels of mental distress.
Conclusions
Vaping is common in young people entering custody, is more likely in young women, and is associated with other smoking behaviours and higher mental distress. Most vaping young people are nicotine dependent, with many reporting difficulties with quitting. Targeted strategies addressing these factors will better support young people in the smoke-free custodial environment and help prevent their relapse to vaping and smoking in the post-release period.
Social prescribing in rural settings: A mapping review of benefits, challenges, and implementation strategies for rural Australia
Imran Saddiq, Peter Simmons, Uchechukwu Levi Osuagwu
Published 8 April 2025
ABSTRACT
Background: Social prescribing (SP) models, which connect individuals to non-medical community-based services, are widely established in the UK and Europe, yet remain in early development stages in Australia. SP is commonly but informally practiced by healthcare professionals in Australia, and despite promising results in other countries there is limited empirical evidence of its effectiveness in Australia, particularly in rural contexts. This study aimed to review the literature on SP in rural contexts, identifying benefits, challenges, and logistical considerations for establishing formal SP programs while highlighting gaps to guide future research.
Methods: This mapping review followed the PRISMA extension for scoping reviews. A systematic search across MEDLINE (Ovid), EMBASE, and CINAHL was conducted from July 5th to 7th, 2024, yielding 145 articles. After duplicate removal and screening, 27 articles underwent full-text review. Thematic analysis identified key themes relevant to SP in rural contexts.
Results: Three main themes were identified: benefits of SP, logistical considerations, and challenges in rural settings. SP positively impacted rural health issues such as loneliness, social isolation, and mental health. Logistical factors included the importance of the link worker model and engagement with local community groups. Various SP delivery modes (online, face-to-face, hybrid) were identified, each with unique advantages. Key challenges included inadequate funding, limited-service availability, and insufficient training for link workers and stakeholders.
Conclusion: Social prescribing shows considerable promise in addressing health challenges and improving health outcomes in rural Australia, but success will depend on overcoming significant logistical, financial, and training challenges. Future research should focus on developing tailored, scalable SP models for rural communities.
Living well with advanced cancer: a scoping review of non-pharmacological supportive care interventions
Brinda Kumar, Moe Thet Htaa, Kim Kerin‑Ayres, Andrea L. Smith, Judith Lacey, Sarah Bishop Browne, Suzanne Grant
Published 7 November 2024
ABSTRACT Purpose The increasing number of people living longer with advanced cancer presents unique physical, psychosocial, financial, legal, practical and complex care needs. Supportive care interventions aim to address these needs by improving symptom management, promoting wellbeing, enhancing quality of life and potentially improving prognosis. To integrate supportive care interventions into clinical practice, a comprehensive review of existing studies is needed. This scoping review maps the evidence on non-pharmacological supportive care interventions for people with advanced cancer and identifies gaps to inform future research. Methods We systematically searched four electronic databases—CINAHL, Medline, Cochrane and PsycINFO—for peerreviewed original research on non-pharmacological supportive care interventions for adults with advanced cancer, published from January 1, 2013, to July 1, 2024. Results Out of 3716 studies, 84 publications met the inclusion criteria. These studies were categorised into key supportive care domains: physical activity, psychosocial support, patient care and autonomy, multimodal approaches and others. Most publications focused on interventions addressing physical and psychosocial needs, showing benefits such as reduced fatigue, pain and improved mood. However, significant gaps were found in research on interventions addressing practical needs essential to autonomy, including health system and information needs, patient care and support and financial needs. Conclusion Mapping the studies to the needs of the advanced cancer population showed that domains with greatest unmet needs have the fewest interventions available. Our scoping review suggests that non-pharmacological supportive care interventions can improve the wellbeing and quality of life of people living with advanced cancer. However, addressing methodological limitations requires further large-scale, multi-centre studies focusing on the identified gaps to inform the implementation of suitable supportive care programs. Implications for Cancer Survivors Non-pharmacological interventions can boost wellbeing and quality of life for advanced cancer survivors, but addressing gaps in practical and systemic support is crucial.
"On November 19, I had the privilege of attending the WHRN2024 Research Symposium in Dubbo to deliver an oral presentation on my Summer Research Scholarship project ‘Longitudinal Assessment of Medical Students’ Perceptions of Social Isolation and Wellbeing: A 5-Year Analysis of FRAME Surveys (2017-2022)’, which I completed under the supervision of Professor Levi Osuagwu. Our research examined the trends and changes over the five years to better understand the evolving challenges faced by medical students.
The symposium was an enriching experience that offered me the chance to connect with fellow researchers, share our findings with an esteemed audience and gain valuable insights from others’ research. One highlight was the keynote speech by Hsien Seow, founder of the ‘Waiting Room Revolution’, which emphasised the importance of supporting palliative patients through the entirety of their medical journey and equipping them with the tools to take charge of their healthcare. Professor Lynette Riley highlighted the significance of Indigenous-led research in driving healthcare innovation, while Kelly Jones shed light on the ethical protocols essential for research involving Indigenous communities.
Presenting at the conference allowed me to practise and gain more confidence in my public speaking skills, as well as develop spontaneous critical thinking in response to the audience’s questions. I am incredibly grateful to the event organisers and sponsors WSU staff for contributing to such a remarkable event. I also want to give a special thank you to Professor Levi, Zelda Doyle, Tracy McFarlane, Jodie Bailie, Peter Simmons and Sari Dewi, whose support and contributions made this research project possible. The symposium was a truly invaluable experience that I will carry forward into my future research endeavour." - Minha Lee
Minha won First Runner Up at the 2024 WSU Joint Program of Medicine 3+1Q Student Research Competition in October. Minha then represented WSU at the ANZ Medical Schools 3+1Q Competition in November, where she won People's Choice award for her Summer Research Scholarship project on ‘Longitudinal Assessment of Medical Students’ Perceptions of Social Isolation and Wellbeng: A 5-Year Analysis of FRAME Surveys (2017-2022)’. In addition, Minha also received the winning prize for Best Oral Presentation in December, at the Australasian Council for Undergraduate Research. We are proud of Minha's achievements and look forward to seeing more future successes.
2024 Joint Program of Medicine 3+1Q Student Research Competition
Congratulations to the winners of the 3+1Q Competition held via Zoom on Monday, 21 October 2024. This annual competition provides an opportunity for students to practice their oral communication skills and present their research in a friendly supportive forum.
Congratulations to the Overall Winner, Christopher Farag, current Year 4, 2024 student who presented on his MD Project research topic "AUTO-HIS: an AI model for the automated extraction of Past Medical History Information from electronic medical records".
Christopher will be representing WSU at the Medical Deans Australia and New Zealand Medical School 3+1Q Competition on 30 November 2024.
A heartfelt congratulations to all the competitors including the First Runner-Up, Second Runner-Up, and People's Choice winner!
Factors associated with loneliness in rural Australia: A web-based cross-sectional survey
Jackson Barton, Uchechukwu Levi Osuagwu, Krista Cockrell-Reed, Robyn Vines
Published 8 October 2024
ABSTRACT
Background: Loneliness affects approximately 35% of rural Australians with detrimental impacts on physical, emotional, and social health. This study aims to identify the factors associated with loneliness among adults in a rural Australian population.
Methods: The study was a web-based cross-sectional survey conducted between February and April 2023 among adults living in a rural Australian population. The survey, which was distributed using social media, consisted of 37 items including demographic information (17 items) and the UCLA Loneliness Scale Version 3 (20 items). Collected data were analysed using univariate and multivariable analysis to identify the factors associated with loneliness in this population.
Results: A total of 225 respondents, mostly aged 30–49yrs (42.7%) participated in this study. The majority were Australia-born (88.4%), females (79.6%), employed (70%) and a third of participants were married (34.7%) at the time of this study. The median loneliness score (55 [IQR 47.0–61.0]) was significantly lower among participants who took part in community, sporting or hobby groups (36.2%) compared to those who abstained from these activities (51.5, [IQR 45.3–58.0] vs 56.0 [IQR 48.0–62.0]; p = 0.037). However, this association was nullified, after adjusting for covariates. Those who rated their overall health as worse (i.e., ‘poor’ 62.5 [IQR 54.8–64.0]) had significantly higher median loneliness scores than those who self-rated their overall health as ‘excellent’ (46.0 [IQR 32.3–54.3]; p < 0.001). After adjusting for covariates, poorer self-rated overall health remained significantly associated with loneliness, in contrast to ratings of ‘good’, ‘very good’ and ‘excellent’.
Conclusions: Results indicate that in this rural Australian population, loneliness is associated with worse selfreported overall health, whilst participation in social groups appear to ameliorate loneliness. Policy aimed at reducing loneliness should therefore facilitate measures that improve this population’s physical and mental health.
CONFERENCE POSTER: Neil Wang, 2023 Year 4 MDP student, poster presentation at the 2024 Australasian Assocation for Academic Primary Care (AAAPC) Annual Research Conference
Conference Dates: 16-18 September 2024
CONFERENCE POSTER: Neil Wang, 2023 Year 4 MDP student, poster presentation at the 2024 Australasian Assocation for Academic Primary Care (AAAPC) Annual Research Conference
Conference Dates: 15 - 16 August 2024
"I found my experience at the AAAPC research conference to be enlightening and helpful for my learning. The experience gave me insight into the various research topics and research opportunities available in General practice. One thing that surprised me about the conference was the number of fellow medical students I met at the conference. It really helped shed the apprehension I felt presenting my poster in front of more experienced researchers. I would definitely recommend taking any opportunities you can for research in medical school to help develop your research skills and network with other like-minded clinicians. Finally I would like to express my thanks to my supervisors Dr Wendy Hu and Dr Phyllis Chan for their support and advice throughout my MD project." - Neil Wang
Retrospective audit compares screening and treatment of pregnancy-related anaemia in regional New South Wales with Australian guidelines
Mariam Ebrahim1 , Priya Dharshini Vadive1 , Tegan Dutton1 , Anayochukwu Edward Anyasodor2 , Uchechukwu Levi Osuagwu1* and Jannine Bailey
Published 4 July 2024
Background: Anaemia during pregnancy is common worldwide. In Australia, approximately 17% of non-pregnant women of reproductive age have anaemia, increasing to a rate of 25% in pregnant women. This study sought to determine the rate of screening for anaemia in pregnancy in regional New South Wales, and to determine whether screening and treatment protocols followed the recommended guidelines.
Methods: This retrospective study reviewed antenatal and postnatal (48 h) data of women (n=150) who had a live birth at Bathurst Hospital between 01/01/2020 and 30/04/2020. Demographic data, risk factors for anaemia in pregnancy, antenatal bloods, treatments provided in trimesters one (T1), two (T2) and three (T3), and postpartum complications were recorded. These were compared to the Australian Red Cross Guidelines (ARCG) using descriptive statistics.
Results: Of the women with screening data available (n=103), they were mostly aged 20-35yrs (79.6%), 23.3% were obese, 97.1% were iron deficient, 17% were anaemic and only a few (5.3%) completed the full pregnancy screening as recommended by the ARCG while a majority completed only partial screenings specifically Hb levels in T1 (56.7%), T2 (44.7%) and T3 (36.6%). Compliance to oral iron was largely undocumented, but constipation was a common side effect among the women. IV iron was administered in 14.0% of women, approximately 1.75x higher than the recommended rate.
Conclusions: This study provided useful information about compliance to screening and treatment guidelines for anaemia in pregnancy. We identified the need for improved documentation and communication between various health providers to ensure adequate antenatal care to prevent maternal complications during pregnancy. This will improve patient care and encourage further developments in maternal care, bridging the rural health gap.
Keywords: Pregnancy, Anaemia, Guidelines, Iron supplements, Rural
Young people's experiences of the Northern Rivers 2017 flood and its effects on their mental health
Michelle Luk, Jo Longman
Published 8 March 2024
Abstract
Objective: To explore young people's (YP) experiences of catastrophic flooding in the Northern Rivers area of northern NSW in 2017 and its effect on their mental health.
Design: Content analysis of free-text survey responses (written responses to open questions, rather than selecting a response option).
Setting: Northern Rivers NSW.
Participants: YP aged 16–25 years who were Northern Rivers residents at the time of the 2017 flood.
Results: YP found their flood experience to be novel and challenging. They expressed worry, distress, anxiety, and worsened pre-existing mental health issues as a result of the flood. YP reported a number of primary stressors (inadequate preparedness, warning and support during the flood) and secondary stressors (loss/ damage of property and possessions, financial strain and disruptions to daily life) which potentially contributed to poor mental health. Some YP reported positive outcomes from their flood experience, notably increased community connectedness and personal resilience. However, they also expressed concern for the future, particularly potential reoccurrence of extreme floods as well as climate change. YP conveyed a desire for better community involvement to improve preparedness for future floods and a clear motivation to take action on climate change.
Conclusion: The flood was a challenging experience for YP which was commonly described as negatively affecting their mental health. Understanding what YP view as significant events or issues arising from their personal flood experience may help target support mechanisms and services to maintain their mental. More focus on community-based initiatives to improve disaster preparedness can support mental health in YP.
Medical Students' Awareness of Overdiagnosis and Implications for Preventing Overdiagnosis
Lucinda Colbert, Iman Hegazi, Kath Peters and Natalie Edmiston
Published 8 March 2024
Abstract: Overdiagnosis is a growing health issue, yet our understanding of medical students’ exposure to this concept within medical education is limited. Our aim was to explore students’ experience of diagnostic learning to identify how overdiagnosis may be understood by students. During in-person and online semi-structured interviews throughout 2021, we explored the education experience of twelve Western Sydney University medical students in years 3–5. Through inductive thematic analysis we identified four themes. These themes encompassed student commitment to learning about diagnosis, lack of certainty surrounding diagnosis and emotional factors of medical care, overdiagnosis as seen through the lens of high and low-value care during clinical placements and student-identified missed learning opportunities related to overdiagnosis. This study found that medical students develop inherent knowledge of overdiagnosis through an interplay of personal factors, medical school curriculum and the setting in which their training takes place. Our findings allow insight for future improvement of medical curriculum to produce exceptional medical graduates.
Congratulations to Year 5, 2023 student, Dharmesh Sharma, Overall Winner of the School of Medicine's 2023 3+1Q Student Research Competition
On Monday, 30 October 2023, the event showcased a high level of wide-ranging student research engagement and Dharmesh presented, via Zoom, on his MD Project topic "Clinical Outcomes of Upper Gastrointestinal Cancer Resection". Presenting the winning talk, Dharmesh also won the People's Choice Award.
We wish Dharmesh well as he represents WSU at the Medical Deans Australia and New Zealand Medical School 3+1Q Competition in November 2023.
CONFERENCE SPEAKER: Josephine Canceri, 2022 Year 4 MDP student, presenting at the 2023 WONCA World Conference in Sydney
Impact of multidisciplinary care of diabetic foot infections for inpatients at Campbelltown Hospital
Timothy Choi, Uchechukwu Levi Osuagwu, Chau Tran, Krupali Bulsari and David Simmons
Published 19 October 2023
Background: Diabetic foot infection (DFI), including diabetic foot ulcer, is a serious complication of diabetes, particularly in the South Western Sydney (SWS) region where it is a leading cause of diabetes-related hospitalisations. Multidisciplinary team (MDT) involvement is effective at improving the health outcomes of DFI patients. This study investigated the impact of MDT (High Risk Foot Service, HRFS) on the length of stay and surgical outcomes of inpatients with DFI in a Sydney tertiary hospital.
Method: A retrospective audit of electronic medical records of inpatient admissions for DFI at Campbelltown Hospital between January 2019 - December 2021, was performed. The main outcome of the study was MDT involvement, defined as having two or more specialities involved in the patient’s treatment. The other measured variables included length of stay (defined as the total duration from admission to discharge), and surgical outcomes including debridement, minor amputation, and major amputation.
E-Prescription: Views and Acceptance of General Practitioners and Pharmacists in Greater Sydney
Phyllis Lau, Minh Thuan Tran, Ricky Yong Kim, Alsayed Hashem Alrefae, Sangwoo Ryu and Jim Chyuan Teh
Published 15 September 2023
Background: Electronic prescription (e-prescription) was introduced in 2020 in Australia during the COVID-19 pandemic. This research aimed to explore general practitioners (GPs) and community pharmacists’ experience with, and facilitators and barriers to, the use of e-prescription.
Listen to Dr Natalie Edmiston, Senior Lecturer, Rural Research, Lismore presenting on this topic in August 2023 on The BMJ Podcast (fast forward to the last 7 minutes where Dr Edmiston is featured).
REPORT: 2022 ANZ Research Educators Network 3+1Q Competition
Determining Efficacy of Dynamic Multimedia Bowel Preparation Instructions Versus Standard Instructions on Adenoma Detection and Patient Reported Measures (DIGICLEAN Trial): a Study Protocol for a Multicentre, Colonoscopist-Blinded, Randomised Controlled Trial
Michal Au, Patrick Low, Michael Rennie, Marriam Mohseni, Yang Song, Narae Kim, Brandon Baraty, Nikola Mitrev, Emily He, Vincent Ho, Rupert Leong, Viraj Kariyawasam
Published 08 June 2023
Introduction: Colonoscopy plays important roles in bowel cancer screening and treatment. Poor bowel preparation occurs in 20–25% of colonoscopies. This negatively impacts adenoma and sessile serrated lesion detection rates, procedural time, requirement for repeat colonoscopies, healthcare costs and likelihood of patient withdrawal from screening programmes. It is unclear whether a combination of multimedia modalities can improve bowel preparation quality, adenoma detection rates and patient-reported measures in those undergoing colonoscopy assessment.
Does Social Media Usage Ameliorate Loneliness in Rural Youth? A Cross Sectional Pilot Study
Lachlan Gregory, Tegan Dutton, Uchechukwu Levi Osuagwu and Robyn Vines
Published 26 May 2023
Aim To invesitgate the relationship between social media use and loneliness and psychological wellbeing of youth in rural New South Wales.
Design Design This was a web-based cross-sectional survey.
Methods The survey consisted of 33 items including demography (12 items), participants’ social media use (9 items), mood and anxiety (6 items), perceived loneliness (6 items), the impact of COVID-19 on social media usage or perceived loneliness (2 items). The participants’ mood and anxiety were evaluated using the psychological distress tool (K6), while loneliness was measured using the De Jong Gierveld 6-item scale. Total loneliness and psychological distress scores were compared between demographic variables.
Results A total of 47 participants, aged 16–24 years took part in the study. The majority were women (68%) and many had K6 score that was indicative of psychological distress (68%). About half of the participants indicated that Facebook (FB) was their most used social media platform and two in five participants were on social media within 10 min of waking up each day, about 30% spent more than 20 h per week on social media, and more than two-third sent private messages, images, or videos, multiple times a day. The mean loneliness score was 2.89 (range, 0 to 6), with 0 being ‘not lonely’ and 6 being ‘intense social loneliness’. One-way ANOVA and χ2 test results showed that those who used FB most frequently had significantly higher mean scores for loneliness compared to those that used other social media platforms (p = 0.015). Linear regression analysis revealed that those who commonly used FB were more likely to report higher loneliness scores (coefficient = –1.45, 95%CI –2.63, –0.28, p = 0.017), while gender (p = 0.039), age (p = 0.048), household composition (p = 0.023), and education level (p = 0.014) were associated with severe psychological distress.
Conclusions The study found that social media usage, particularly FB, as measured by time used and active or passive engagement with the medium, was significantly linked to loneliness, with some impact on psychological distress. Social media use within ten minutes of waking increased the likelihood of psychological distress. However, neither loneliness nor psychological distress were associated with rurality among the rural youth in this study.
The neuromodulator dopamine plays a significant role in light adaptation, eye growth, and modulation of neuronal circuitry in the retina. Dopaminergic amacrine cells in the adult retina release dopamine in response to light stimulation, however, the light-induced activity of these cells in during postnatal development is not known. We assessed the activity of dopaminergic amacrine cells in the retina response to a light pulse in C57BL/6 wild-type animals across various postnatal ages. Expression of tyrosine hydroxylase (TH) in dopaminergic amacrine cells was apparent from postnatal day 3 (P3) and restricted to the dorso-temporal region; by P8 TH+ cells were uniformly distributed across the retina. TH cell density increased until P8 and then markedly decreased by P10 to then remain at this density into adulthood. Light-induced c-fos expression was observed in all light-pulsed retinae, however, no c-fos was ever found to be co-localised with TH prior to P12. At P14, one day after eye opening, 100% of TH cells co-localised with c-fos and this was maintained for all older ages analysed. Dopamine and its primary metabolite DOPAC were measured in the vitreous of animals P8-P30. Both analytes were found in the vitreous at all ages, however, a significant difference in dopamine concentration between dark and light-pulsed animals was only observed at P30. DOPAC concentration was found to be significantly light-induced from P16, and the amplitude of this difference increased over time. Our data suggests that dopaminergic cell activation and light-induced dopamine release in the retina is primarily driven by classical photoreceptors after eye-opening.
Antibacterial Properties ofEucalyptus globulusEssential Oil against MRSA: A Systematic Review
Shakthi Elangovan and Poonam Mudgil
Published 27 February 2023
Abstract: Antimicrobial resistance is a huge threat against the public health sphere and is a major cause of global mortality and morbidity. Antibiotic misuse and overuse have led to the development of many resistant bacterial strains. One particular bacterium of concern is methicillin-resistant Staphylococcus aureus (MRSA), which is the most common resistant bacteria in humans. Antibiotic development has been unable to keep up with the rapid evolution of antibiotic-resistant organisms, and there is an urgent need to identify alternative agents to combat this problem. The purpose of this systematic review is to explore the literature on the antibacterial properties of Eucalyptus globulus essential oil against MRSA. The articles used in this review were obtained through a systematic search of the literature across four databases, with the timeline being between 2002 and 2022. Twenty studies were included in this review, which used various methods to investigate the antibacterial properties of E. globulus essential oil, alone or in combination with other agents, against MRSA. The findings suggest that E. globulus essential oil has antibacterial properties against MRSA, which can be enhanced when used in combination with other agents, such as other essential oils and antibiotics.
What are the Predictors of Change in Multimorbidity Among People with HIV? A Longitudinal Observational Cohort Study
Michael Casten, Simone Herbert, David J. Smith, Kathy Petoumenos, Craig Coorey and Natalie Edmiston
Published 27 February 2023
Abstract
Introduction: Multimorbidity is common among people living with HIV (PLWH), with numerous cross-sectional studies demonstrating associations with older age and past immunosuppression. Little is known about the progression of multimorbidity, particularly in the setting of long-term access to antiretrovirals. This study aims to determine factors predictive of change in multimorbidity in PLWH.
Methods: People living with HIV who attended a regional HIV service were recruited to a consented observational cohort between September 2016 and March 2020. Demographic data, laboratory results and a Cumulative Illness Rating Scale (CIRS) were collected at enrolment and first clinical review of every subsequent year. Change in CIRS score was calculated from enrolment to February 2021. Associations with change were determined through univariate and multivariate linear regression.
Results: Of 253 people, median age was 58.9 [interquartile range (IQR): 51.9–64.4] years, 91.3% were male, and HIV was diagnosed a median of 22.16 years (IQR: 12.1–30.9) beforehand. Length of time in the study was a median of 134 weeks (IQR: 89.0–179.0), in which a mean CIRS score change of 1.21 (SD 2.60) was observed. Being older (p < 0.001) and having a higher body mass index (p = 0.008) and diabetes (p = 0.014) were associated with an increased likelihood of worsening multimorbidity. PLWH with a higher level of multimorbidity at baseline were less likely to worsen over time (p < 0.001).
Conclusion: As diabetes and weight predict worsening multimorbidity, routine diabetes screening, body mass index measurement, and multimorbidity status awareness are recommended.
Chondroitin Sulfate Proteoglycan 4 as a Marker for Aggressive Squamous Cell Carcinoma
Kathryn Chen, Joel Yong, Roland Zauner, Verena Wally, John Whitelock, Mila Sajinovic, Zlatko Kopecki, Kang Liang, Kieran Francis Scott and Albert Sleiman Mellick
Published 13 November 2022
Abstract: Chondroitin sulfate (CS) proteoglycan 4 (CSPG4) is a cell surface proteoglycan that is currently under investigation as a marker of cancer malignancy, and as a potential target of anticancer drug treatment. CSPG4 acts as a driver of tumourigenesis by regulating turnover of the extracellular matrix (ECM) to promote tumour cell invasion, migration as well as inflammation and angiogenesis. While CSPG4 has been widely studied in certain malignancies, such as melanoma, evidence is emerging from global gene expression studies, which suggests a role for CSPG4 in squamous cell carcinoma (SCC). While relatively treatable, lack of widely agreed upon diagnostic markers for SCCs is problematic, especially for clinicians managing certain patients, including those who are aged or infirm, as well as those with underlying conditions such as epidermolysis bullosa (EB), for which a delayed diagnosis is likely lethal. In this review, we have discussed the structure of CSPG4, and quantitatively analysed CSPG4 expression in the tissues and pathologies where it has been identified to determine the usefulness of CSPG4 expression as a diagnostic marker and therapeutic target in management of malignant SCC.
Mindfulness-based Interventions and Yoga for Managing Obesity/Overweight After Breast Cancer: A Scoping Review
Vicki Vuong, Vibhuti Rao and Carolyn Ee
Published 20 October 2022
Abstract Introduction Weight gain after breast cancer is common, and obesity after breast cancer increases breast cancer recurrence and mortality. Mindfulness-based interventions (MBIs) and yoga have been shown to be effective in managing obesity/overweight in people without breast cancer. There is a need to systematically map the extent and range of evidence on yoga and MBIs for managing obesity/overweight after breast cancer in order to aid planning and commissioning of future research. Methods We conducted a scoping review informed by methods described by Levac et al. Five electronic databases were searched for any peer-reviewed original research (including systematic reviews) that examined the role of yoga and/or MBIs for managing overweight/obesity after breast cancer. Data were extracted on study, population, intervention, comparator and outcome characteristics, and described narratively. Results: We found 18 publications representing 15 unique studies (11 clinical trials, 2 systematic reviews, and 2 observational studies). There were 10 studies on yoga, and 5 on MBIs. Of the clinical trials, only 4/11 examined a weight-related outcome as the primary outcome. The remaining trials examined lifestyle or metabolic outcomes (5/11) or unrelated outcomes such as psychological health (2/11). Gaps in the literature included small sample sizes, lack of cultural diversity amongst participants, inadequate reporting of the intervention, few lifestyle co-interventions offered, lack of active comparator groups, and inadequate safety reporting. Conclusions: There is a need for adequately-powered RCTs that adhere to reporting guidelines. The use of gold-standard methods for measuring outcomes, and active comparator groups, is also recommended.
Congratulations to Year 4, 2022 student, Anneliese McConnell, the overall winner of the School of Medicine's inaugural 3+1Q Student Research Competition
Anneliese presented on her MD Project topic "Exploring Associations Between Hallucinogen Persisting Perception Disorder and Non-Visual Perceptual Disturbances: An Observational Study".
We wish Anneliese well as she represents WSU at the Medical Deans Australia and New Zealand Medical School 3+1Q Competition in November 2022.
Our congratulations also to runner-up Josephine Canceri, another Year 4, 2022 MD Project student, who presented on Rural GP Perspectives on Bowel Cancer Screening.
"Serious Toilet Talk" - Exploring Rural GP Perspectives on the National Bowel Cancer Screening Program
The National Rural Health Conference (NRHC) is a biennial conference and the largest public event for those interested in improving health and wellbeing within rural and remote Australia. The conference this year was hosted in Brisbane during 2-4 August 2022. I had the privilege to be invited to present my MD Project research as a ‘Lightning Talk’. This type of presentation requires you present your research thesis, methods, and outcomes in 5 minutes. Whilst a challenging exercise, it is an excellent way to concisely describe your research work to a lay audience. Titled ‘Serious Toilet Talk’, my research explored rural GP perspectives on the National Bowel Cancer Screening Program. Through my research, I was able to learn of the common barriers to patient participation as deemed by rural practitioners, as well as the factors which serve as facilitators. Furthermore, I was provided insight as to potential strategies which GPs believe could help to enhance bowel screening uptake by the eligible population.
The NRHC was an excellent opportunity to meet and network with individuals at the forefront of rural health leadership and innovation. Presentations from nursing, physiotherapy, and other allied health professionals provide great insight into how each of these disciplines are working to improve the health of their rural patients. It was an exciting opportunity to pay witness to the novel advancements working to close the health gap defined by postcode across the Australian landscape.
Diagnostic Stewardship - The Impact of Rapid Diagnostic Testing for Paediatric Respiratory Presentations in the Emergency Setting: A Systematic Review
Keshani Weragama, Dr Poonam Mudgil and Prof John Whitehall
Published 13 August 2022
Congratulations to Keshani Weragama, 2022 Year 4 MD Project student for achieving another milestone, having a second research paper published. A remarkable achievement being the first student to have research work published in both MD Project years.
Abstract: Antimicrobial resistance is a growing public health crisis, propelled by inappropriate antibiotic prescription, in particular the over-prescription of antibiotics, prolonged duration of antibiotic therapy and the overuse of broad-spectrum antibiotics. The paediatric population, in particular, those presenting to emergency settings with respiratory symptoms, have been associated with a high rate of antibiotic prescription rates. Further research has now shown that many of these antibiotic prescriptions may have been avoided, with more targeted diagnostic methods to identify underlying aetiologies. The purpose of this systematic review was to assess the impact of rapid diagnostic testing, for paediatric respiratory presentations in the emergency setting, on antibiotic prescription rates. To review the relevant history, a comprehensive search of Medline, EMBASE and Cochrane Database of Systematic Reviews was performed. Eighteen studies were included in the review, and these studies assessed a variety of rapid diagnostic testing tools and outcome measures. Overall, rapid diagnostic testing was found to be an effective method of diagnostic antibiotic stewardship with great promise in improving antibiotic prescribing behaviours. Further studies are required to evaluate the use of rapid diagnostic testing with other methods of antibiotics stewardship, including clinical decisions aids and to increase the specificity of interventions following diagnosis to further reduce rates of antibiotic prescription.
Determining Obstacles in Obtaining Stroke Treatment Faced by First Nations Population in Shoalhaven
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Upon Dr Ryan Dashwood and Lavina Mital, 2022 Year 4 WSU MD Project student being awarded one of the Australasian Stroke Academy Research Fellowship Grant, Lavina was invited to present her research goals and findings at the Australasian Stroke Academy Convention on 18 July 2022 in Adelaide.
According to Mital, their goal is to "determine obstacles faced by the First Nations population of Shoalhaven, NSW to ultimately improve their opportunities for time-critical and life-saving stroke treatment to reduce mortality and loss of disability adjusted life years following stroke."
"The public health burden of stroke is set to rise and it is paramount that acute stroke is recognised in regional Australia as a condition that requires emergency action... I am reminded about how research, teamwork and leadership can contribute to the social health and wellbeing of First Nations Australians... engage with your Aboriginal Liaison Officers and find out what you can do as stroke physicians to get more of your patients to you and earlier," says Mital.
Paediatric Antimicrobial Stewardship for Respiratory Infections in the Emergency Setting: A Systematic Review
Keshani Weragama, Poonam Mudgil and John Whitehall
Published 8 November 2021
Abstract: Antimicrobial resistance occurs due to the propensity of microbial pathogens to develop resistance to antibiotics over time. Antimicrobial stewardship programs (ASPs) have been developed in response to this growing crisis, to limit unnecessary antibiotic prescription through initiatives such as education-based seminars, prescribing guidelines, and rapid respiratory pathogen (RRP) testing. Paediatric patients who present to the emergency setting with respiratory symptoms are a particularly high-risk population susceptible to inappropriate antibiotic prescribing behaviours and are therefore an ideal cohort for focused ASPs. The purpose of this systematic review was to assess the efficacy and safety of ASPs in this clinical context. A systematic search of PubMed, Medline, EMBASE and the Cochrane Database of Systematic Reviews was conducted to review the current evidence. Thirteen studies were included in the review and these studies assessed a range of stewardship interventions and outcome measures. Overall, ASPs reduced the rates of antibiotic prescription, increased the prescription of narrow-spectrum antibiotics, and shortened the duration of antibiotic therapy. Multimodal interventions that were education-based and those that used RRP testing were found to be the most effective. Whilst we found strong evidence that ASPs are effective in reducing antibiotic prescribing, further studies are required to assess whether they translate to equivalent clinical outcomes.
Peripheral Cytokine Levels as a Prognostic Indicator in Gastric Cancer: A Review of Existing Literature
Elton Yang 1,2, Wei Chua 1,2,3,4, Weng Ng 1,2,3,4 and Tara Laurine Roberts 1,2,4,*
Published 14 December 2021
Abstract: Although strong connections exist between the carcinogenesis of gastric cancer and chronic inflammation, gastric cancer is unique in that the chronic gastritis which frequently precedes carcinogenesis is strongly associated with H. pylori infection. The interplay between H. pylori virulence factors and host immune cells is complex but culminates in the activation of inflammatory pathways and transcription factors such as NF-κB, STAT3, and AP-1, all of which upregulate cytokine production. Due to the key role of cytokines in modulating the immune response against tumour cells as well as possibly stimulating tumour growth and proliferation, different patterns of cytokine secretion may be associated with varying patient outcomes. In relation to gastric cancer, interleukin-6, 8, 10, 17A, TNF, and IFN-γ may have pro-tumour properties, although interleukin-10, TNF, and IFN-γ may have anti-tumour effects. However, due to the lack of studies investigating patient outcomes, only a link between higher interleukin-6 levels and poorer prognosis has been demonstrated. Further investigations which link peripheral cytokine levels to patient prognosis may elucidate important pathological mechanisms in gastric cancer which adversely impact patient survival and allow treatments targeting these processes to be developed.
