Graduate Research Services

Project Outline:

Neurodegenerative and cerebral vascular disorders continue to challenge our understanding of neuroplasticity, focal localisation, and connectivity from clinical and neuroscientific perspectives. For example, the neuroimaging evidence to date, regarding stroke recovery has tended to focus specifically on motor and/or functional aspects including language recovery, providing anatomical markers of lesion location and size and subsequent function. More recently there has been increasing interest in both structural and functional connectivity approaches in understanding stroke recovery (1, 2) with the emphasis also on motor recovery (3). The human connectome project (4) has given rise to understanding brain connectivity in more detail and has facilitated investigation into structural and functional connectivity from a network perspective in healthy ageing (5) and also for neurodegenerative disorders (6) and neurological disorders post stroke (7-9).

The mechanisms underlying emotion-cognition interactions in healthy brain functioning have been well established from neuroimaging modalities’ evidence (10). However, from studies investigating changes to the ageing brain, the evidence of this interaction is less well known (11), especially following age-related associated diseases such as dementia, cerebral small vessel disease and stroke. The aim of this research is to identify and establish what happens to the cognition-emotion interaction following neurodegenerative and cerebral vascular disorders using neuropsychological assessment and multimodal neuroimaging techniques including connectivity evidence where available. Neuropsychological and neuroimaging evidence of the emotion-cognition interaction will be identified from healthy ageing studies and these in turn will be compared to studies investigating cognition and mood in neurodegenerative and cerebral vascular disorders.

This project is ideal for a nursing candidate that may have a strong interest in cognitive and psychological health of older adults with a particular interest in neuroanatomy and physiology. Full training will be provided on reviewing relevant neuropsychological and neuroimaging evidence for the purposes of the research work.

References

1. Mandeville ET, Ayata C, Zheng Y, Mandeville JB. Translational MR Neuroimaging of Stroke and Recovery. Translational stroke research. 2017;8(1):22-32.
2. Donnellan C, Hevey D, Hickey A, O'Neill D. Adaptation to stroke using a model of successful aging. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2012;19(4):530-47.
3. Grefkes C, Fink GR. Connectivity-based approaches in stroke and recovery of function. The Lancet Neurology. 2014;13(2):206-16.
4. Sporns O, Tononi G, Kotter R. The human connectome: A structural description of the human brain. PLoS computational biology. 2005;1(4):e42.
5. Hirsiger S, Koppelmans V, Merillat S, Liem F, Erdeniz B, Seidler RD, et al. Structural and functional connectivity in healthy aging: Associations for cognition and motor behavior. Human brain mapping. 2016;37(3):855-67.
6. Iturria-Medina Y, Evans AC. On the central role of brain connectivity in neurodegenerative disease progression. Frontiers in aging neuroscience. 2015;7:90-.
7. Baldassarre A, Ramsey LE, Siegel JS, Shulman GL, Corbetta M. Brain connectivity and neurological disorders after stroke. Current opinion in neurology. 2016;29(6):706-13.
8. Lim J-S, Kang D-W. Stroke Connectome and Its Implications for Cognitive and Behavioral Sequela of Stroke. J Stroke. 2015;17(3):256-67.
9. Donnellan C, Hickey A, Hevey D, O'Neill D. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry. 2010;25(12):1288-95.
10. Dolcos F, Iordan AD, Dolcos S. Neural correlates of emotion–cognition interactions: A review of evidence from brain imaging investigations. Journal of Cognitive Psychology (Hove, England). 2011;23(6):669-94.
11. Grady C. The cognitive neuroscience of ageing. Nature reviews Neuroscience. 2012;13(7):491-505.

Project Area: Stroke and associated cerebrovascular disease

Supervisor(s): Professor Claire Donnellan

Project level: PhD

Start date: Ongoing

Project Outline:

Stroke is the second commonest cause of death and the sixth leading cause of disease burden globally with an estimated 6.5 million stroke deaths annually, expected to rise to 8 million by 2030 (World Stroke Organisation, 2022). The average stroke destroys roughly two million brain cells every minute. Therefore, the quicker a person gets into hospital after sustaining a stroke, the more brain tissue that can be salvaged. The Face Arms Speech Time to Act (FAST) campaign was created to increase public and community awareness to rapidly recognise when a stroke is taking place and to act quickly to get medical treatment and prevent serious damage. FAST campaigns have been reported to improve public awareness regarding the general signs and symptoms of stroke and to seek emergency medical assistance urgently.  However, findings from some studies have reported that many older adults may not recognise early symptoms of stroke in themselves or others and that they may lose vital time in presenting for medical attention. The aim of this research project is to identify how health literacy is facilitated in existing FAST campaigns that have been rolled out in various countries globally; and to determine how these campaigns may be improved upon to include health literacy levels of all populations recognising various diversities e.g., age, language, culture, and ethnicity. Ongoing improvement of public awareness regarding stroke warning signs and risk factors continues to improve chances for recovery and reduce disability, mortality, and morbidity from stroke.

For a culturally focused FAST campaign, see: https://www.youtube.com/watch?v=tZfaOoVEG9g&list=PL91D2BD704EFF967B

https://www.linkedin.com/pulse/producing-first-arabic-fast-stroke-awareness-video-bahrain-rizk

Project Area: Stroke and associated cerebrovascular disease

Supervisor(s): Professor Claire Donnellan

Project level: PhD

Start date: Ongoing

Project Outline:

Intracerebral haemorrhage (ICH) or haemorrhagic stroke is defined as bleeding within the brain parenchyma and occurs without trauma or known bleeding causes such as an arteriovenous malformation, cerebral aneurysm, or tumour. ICH accounts for at least 10-15% of all strokes and is even higher pending ethnicity and global distribution. The overall incidence of ICH is reported to range between 15 to 40 cases per 100,000 and may be higher in Asian populations and in individuals over 75 years. ICH can be classified by its location and is referred to as lobar (15%-30%), deep (35%-70%) and infratentorial (10%-20%). Lobar ICH involves haemorrhages located in cortical-subcortical areas and deep ICH being located within the basal ganglia and internal capsule. Infratentorial ICH is sometimes classified under deep ICH and involves the brainstem and cerebellum. Regarding aetiology, lobar ICH, is caused by several distinct diseases with cerebral amyloid angiopathy (CAA) being the most common and refers to abnormal aggregations of beta amyloid deposits that form in the walls of cerebral arteries, arterioles and capillaries and is considered responsible for increasing bleeding risk and cognitive impairment. The most frequent cause of deep ICH is deep perforating vasculopathy with hypertension being the most important risk factor. With the highest proportion of haemorrhagic strokes caused by undetected hypertension and mild cognitive impairment, there is a dire need for a hypertension and cognition screening protocol to be rolled out in regions where ethnic minority groups are predisposed to the greatest risk of sustaining haemorrhagic stroke. The aim of this research is to develop greater awareness for blood pressure and cognitive screening among health professionals and to monitor at risk groups for haemorrhagic stroke in addition to ischaemic stroke.

For further reading, see

Donnellan, C., Werring, D. Cognitive impairment before and after intracerebral haemorrhage: a systematic review. Neurol Sci 41, 509–527 (2020). https://doi.org/10.1007/s10072-019-04150-5

Project Area: Stroke and associated cerebrovascular disease

Supervisor(s): Professor Claire Donnellan

Project level: PhD

Start date: Ongoing

Project Outline:

Students who are interested in researching the following topics are invited to contact me to discuss potential supervision

• Gender equity in higher education and/or the nursing workforce
• Nurse workforce retention
• Child oral health
• LGBTQI+ student experiences in higher education and/or the workplace
• Nurses in primary health care/ public health
• Work integrated learning
• International university student experience
• Domestic abuse/intimate partner coercion, control, violence

Supervisor(s): Dr Lesley Andrew

My methodology expertise lies in qualitative and mixed method research.

Project level: PhD and Master by Research

Start date: From 2023

Project Outline:

The cannulation of a difficult venous access represents a common challenge in clinical practice. This research study investigates the potential use of a portable point-of-care ultrasound (POCUS) device prior to cannulation of a difficult venous access. POCUS devices are currently used in some haemodialysis clinics in Western Australia, but not everywhere. The uptake of this technology in a broader variety of clinical settings should be supported, nurses need to be trained and educated on how to safely use this new technology, which may lead to improved patient outcomes.

Project Area: Nursing Safety and Quality; Workforce; Improving outcomes for adults with chronic kidney disease

Supervisor(s): Dr Ulrich Steinwandel

Project level: PhD

Funding: Applicant should apply for ECUHDR or RTP Scholarship

Start date: From 2023

Project Outline:

In order to evaluate the quality of care provided by nurses in primary health care settings, we first need to find ‘measures’ of quality and ensure they are appropriate and measurable within the primary health care setting. This project could be focused on one particular indicator, e.g. failure to rescue or could be expanded to a larger suite of indicators appropriate to a PhD study.
This study could also be oriented to the work of Nurse Practitioners in primary health care settings.

Desired Skills: Experience in primary health care settings, preferably in rural or remote areas is ideal, but the project could be oriented towards general practice in urban settings.

Project Area: Workforce, quality and safety

Supervisor(s): Dr Kylie McCullough and Dr Gemma Doleman

Project level: Masters, PhD

Funding: Applicant should apply for ECUHDR or RTP Scholarship

Start date: From 2023

Project Outline:

My research is situated within the child and family health nursing framework. I am interested in topics that investigate issues impacting on child and family health outcomes. I am particularly interested in the following;

1. Child health/neonatal research topics
2. Mental health of fathers in the neonatal unit
3. Support needs of fathers with sick infants in the neonatal unit
4. Children with complex medical health issues

This project will use either qualitative, quantitative or mixed methodologies

Project Area: Childbearing, Children and Young People

Supervisor(s): Dr Esther Adama

Project level: Honours, Masters, PhD

Funding: Applicant should apply for ECUHDR or RTP Scholarship; Industry PhD Scholarship available

Start date: Ongoing

Project Outline:

The project will be situated within a program of research on the prevention of hospital acquired complications and will align with the Australian National Safety and Quality Health Service (NSQHS) Standards and Western Australian Sustainable Health Review that aim to protect the public from harm and improve the quality of acute health service provision.
Patients who are admitted to hospitals are extremely sick, have high acuity levels, are frail, often older, with multiple comorbidities and are extremely vulnerable to acquiring a hospital acquired complication. Recent Australian data shows that one if every nine patients will develop a hospital acquired complication costing the Australia’s health system at least $5 billion per year (Grattan Institute, 2018). This vulnerable group of patients will be exposed to highly invasive procedures and despite the frequency of these procedures there is a paucity of research guiding the best evidence-based research practice.
Depending on the student’s background and preference, the PhD project will be in one of the following areas:

1. Vascular access
   1. Peripheral vascular access
   2. Haemodialysis vascular access
2. Indwelling urinary catheter management
3. Prevention of pressure injury

Other topics related to improving patient outcomes in an acute care setting may be considered.

Desired skills: Experience with statistical analysis and related software (e.g., Stata, SAS, R, SPSS)

Project Area: Safety and Quality in Healthcare

Supervisor(s): Dr Linda Coventry, Professor Lisa Whitehead

Project level: PhD

Funding: School scholarship available

Start date: From 2023

Project Outline:

Peripheral intravenous cannula (PIVC) are a universally known intervention for patients in acute health services to assist with management of conditions, and are the most commonly inserted vascular access device. Most PIVCs are inserted to administer intravenous fluids, medications or to obtain pathology blood tests.  There is a great degree of variance in practice regarding dwell time, insertion techniques, obtaining blood samples and management of intravenous cannulas between health services, states in Australia, and individual nurses. Aim: To explore the evidence for best practice in peripheral intravenous care in Australian health services.

Project Area: Nursing Safety and Quality

Funding: Applicant should apply for ECUHDR or RTP Scholarship

Supervisor(s): Dr Linda Coventry, Dr Hugh Davies

Project level: Masters, PhD

Start date: Ongoing

Project Outline:

A potential research study investigating how patients with diabetes who are hospitalised for foot surgery sustained their foot ulcers. This is an interesting research idea because patients might not seek medical advice because they have no insight into their disease process. Financial implications of seeing a medical professional and the geographical location are determinants of the accessibility of care. This investigation will enable findings risks in the community, and then prevention efforts will target these risks.

Project Area: Adult health/ prevention/ self-care

Supervisor(s): Dr. Ma’en Zaid Abu-Qamar

Project level: Masters, PhD

Start date: From 2023