ORCID Profile
0000-0001-8648-1383
Current Organisation
The University of Notre Dame Australia - Sydney Campus Broadway
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Publisher: Emerald
Date: 12-03-2018
Publisher: Springer Science and Business Media LLC
Date: 09-12-2022
DOI: 10.1186/S12909-022-03927-1
Abstract: The aim of this national study was to explore the learning experiences of Australia’s medical students who trained rurally during the COVID-19 pandemic in 2020. A cross-sectional, national multi-centre survey was conducted in 2020, through the Federation of Rural Australian Medical Educators (FRAME). Participants were medical students who had completed an extended Rural Clinical School (RCS) training placement (≥ 12 months). A bespoke set of COVID-19 impact questions were incorporated into the annual FRAME survey, to capture COVID-19-related student experiences in 2020. Pre-pandemic (2019 FRAME survey data) comparisons were also explored. FRAME survey data were obtained from 464 students in 2020 (51.7% response rate), compared with available data from 668 students in 2019 (75.6% response rate). Most students expressed concern regarding the pandemic’s impact on the quality of their learning (80%) or missed clinical learning (58%) however, students reported being well-supported by the various learning and support strategies implemented by the RCSs across Australia. Notably, comparisons to pre-pandemic (2019) participants of the general RCS experience found higher levels of student support (strongly agree 58.9% vs 42.4%, p 0.001) and wellbeing (strongly agree 49.6% vs 42.4%, p = 0.008) amongst the 2020 participants. Students with more than one year of RCS experience compared to one RCS year felt better supported with clinical skills learning opportunities ( p = 0.015) and less affected by COVID-19 in their exam performance ( p = 0.009). This study has provided evidence of both the level of concern relating to learning quality as well as the positive impact of the various learning and support strategies implemented by the RCSs during the pandemic in 2020. RCSs should further evaluate the strategies implemented to identify those that are worth sustaining into the post-pandemic period.
Publisher: Wiley
Date: 06-08-2023
DOI: 10.5694/MJA2.52021
Publisher: The Royal Australian College of General Practitioners
Date: 06-2023
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.KNEE.2015.07.002
Abstract: Recurrence of acute patellar dislocation affects approximately 30% of in iduals, and up to 75% of those with grade IV instability. The medial patellofemoral ligament (MPFL) is considered to be critical for patellar stabilization. MPFL reconstruction with allografts has been proposed to reduce risk of recurrence, but there is limited evidence about the safety and effectiveness of techniques using synthetic allografts. We present a retrospective case series of 29 in iduals who underwent a MPFL reconstruction between 2009 and 2012, using an artificial ligament for patellar instability by a single surgeon. Clinical, radiological and functional outcomes were measured at a minimum of 24 months. 31 knees (29 in iduals) were followed up for a median of 43 (range: 24-68) months. Using the Crosby and Insall grading system, 21 (68%) were graded as excellent, nine (29%) were good, one (3%) as fair and none as worse at 24 months. The mean improvement in Lysholm knee score for knee instability was 68 points (standard deviation 10). Ligamentous laxity was seen in 17 (55%) of in iduals. In this subset, 12 were graded as excellent, four as good and one as fair. The mean improvement in patellar height was 11% at three months follow-up. All knees had a stable graft fixation with one re-dislocation following trauma. We propose a minimally invasive technique to reconstruct the MPFL using an artificial ligament allowing early mobilization without bracing. This study indicates the procedure is safe, with a low risk of re-dislocation in all grades of instability. Level IV Case Series.
Publisher: Rural and Remote Health
Date: 08-10-2015
DOI: 10.22605/RRH3276
Publisher: Cambridge University Press (CUP)
Date: 12-11-2020
DOI: 10.1017/S1478951519000841
Abstract: Demoralization is prevalent in patients with life-limiting chronic illnesses, many of whom reside in rural areas. These patients also have an increased risk of disease-related psychosocial burden due to the unique health barriers in this population. However, the factors affecting demoralization in this cohort are currently unknown. This study aimed to examine demoralization amongst the chronically ill in Lithgow, a town in rural New South Wales, Australia, and identify any correlated demographic, physical, and psychosocial factors in this population. A cross-sectional survey of 73 participants drawn from Lithgow Hospital, the adjoining retirement village and nursing home, assessing correlating demographic, physical, psychiatric, and psychosocial factors. The total mean score of the DS-II was 7.8 (SD 26.4), and high demoralization scores were associated with the level of education ( p = 0.01), comorbid condition ( p = 0.04), severity of symptom burden ( p = .001), depression ( p = .001), and psychological distress ( p = .001). Prevalence of serious demoralization in this population was 27.4% according to a cutoff of a DS-II score ≥11. Of those, 11 (15%) met the criteria for clinical depression, leaving 9 (12.3%) of the cohort demoralized but not depressed. Prevalence of demoralization was high in this population. In line with the existing literature, demoralization was associated with the level of education, symptom burden, and psychological distress, demonstrating that demoralization is a relevant psychometric factor in rural populations. Further stratification of the unique biopsychosocial factors at play in this population would contribute to better understanding the burdens experienced by people with chronic illness in this population and the nature of demoralization.
Publisher: Springer Science and Business Media LLC
Date: 28-06-2018
DOI: 10.1007/S10943-017-0440-Y
Abstract: Some studies have found an association between spirituality and/or religiosity (SpR) and cardiovascular health, for reasons which remain unclear. This study explores whether SpR is linked to physical activity whilst young, which in turn is linked to long-term cardiovascular health. Students at a Catholic University in Australia completed a survey combining the SpREUK-P SF 17 SpR questionnaire with elements of the long-form 7-day recall International Physical Activity Questionnaire. Respondents who scored highly in the unconventional spiritual practices components of SpREUK-P engaged in moderate intensity physical activity more frequently. This finding may have implications for health promotion.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.AVSG.2015.08.014
Abstract: Thoracic aortic aneurysms (TAAs) contribute significant mortality if left untreated, but surgical repair has historically carried substantial risks. We sought to observe trends and outcomes of open and endovascular thoracic endovascular aneurysm repair thoracic aortic repairs, so conducted a retrospective review of all patients who presented for management of TAAs from 2003 to 2013 at 2 hospitals in Sydney, Australia. A total of 179 patients presented with TAAs over the study period, including 5 ruptures. Fifty-two were treated nonoperatively, with 127 surgically repaired. Operative duration was significantly shorter in endovascular than open repair of arch (193 ± 108 vs. 396 ± 98 min, P = 0.0001) and descending aneurysms (242 ± 116 vs. 422.5 ± 161 min, P = 0.003). There were no differences in mortality or complication rates (including paraplegia), duration of hospital or intensive care unit stay, or transfusion requirements between endovascular and open TAA repairs. Apart from reduced surgical duration, this study revealed no benefits of endovascular over open TAA repair. Overall morbidity and mortality were low, even in elderly patients.
Publisher: Inishmore Laser Scientific Publishing Ltd
Date: 08-2023
DOI: 10.29392/001C.83912
Abstract: Cervical cancer (CC) is the second leading cause of cancer among women in the Philippines, mainly caused by a persistent human papillomavirus infection (HPV). We aimed to determine the prevalence of HPV and compare screening methods within a socio-economically deprived rural community in the Philippines. We conducted a retrospective audit of the medical records of 872 women from the free Women’s clinic in a regional Philippines community over the period, 2013-2019. All participants were screened for CC using the VIA/VILI method, with only 284 women tested for HPV using the HPV-polymerase chain reaction (HPV-PCR) method. For the 284, we compared their HPV-PCR and VIA/VILI results. Data was de-identified and descriptively analysed. Thirteen different HPV subtypes, all oncogenic, exist in the community. HPV was detected in 32 (11%) of the 284 women tested. Of note, 28 patients who had an oncogenic HPV infection had a normal VIA/VILI inspection result. The bivalent vaccine protects only 6% of the HPV-positive cases in the clinic. This study suggests HPV-PCR testing is superior at detecting HPV before cervical changes occur. The different oncogenic HPV strains reflect the low coverage of the bivalent HPV vaccination in the community – a key area for practice and policy reforms. Further studies on the prevalence of oncogenic HPV strains will be vital in designing suitable preventive care programs for CC.
Publisher: Wiley
Date: 07-01-2019
DOI: 10.1111/AJD.12984
Publisher: Wiley
Date: 15-06-2017
DOI: 10.1111/AJR.12355
Abstract: Clinical guidelines recommend that patients who sustain a minimal trauma fracture (MTF) should receive a bone mineral density (BMD) scan and bisphosphonate (or equivalent) therapy if diagnosed with osteoporosis. A pilot fracture liaison service (FLS) was implemented in regional NSW to improve adherence to the guidelines. Prospective cohort study with an historical control. Primary care. Control (n = 47) and cohort (n = 93) groups comprised patients consenting to interview who presented with a MTF to the major referral hospital 4 months before and 12 months after FLS implementation respectively. Primary outcome measures were the rates of BMD scans and anti-osteoporotic medication initiation/review after MTF. Hospital admission data were also examined to determine death and refracture rates for all patients presenting during the study period with a primary diagnosis of MTF within 3 years of their initial fracture. Although there was no improvement in BMD scanning rates, the reported rate of medication initiation/review after fracture was significantly higher (P < 0.05) in the FLS cohort. However, once adjusted for age, this association was not significant (P = 0.086). There was a lower refracture rate during the cohort period (P = 0.013), however, there were significantly more deaths (P = 0.035) within 3 years of initial fracture. When deaths were taken into account via competing risk regression, patients in the cohort period were significantly less likely to refracture than those in the control period (Hazard ratio = 0.576, P = 0.032). A rurally based nurse-led FLS was associated with modest improvement after MTF. Consideration should be given to ways to strengthen the model of care to improve outcomes.
Publisher: Informa UK Limited
Date: 30-01-2015
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Zelda Doyle.