Bakgrund Trycksår är ett stort problem inom hälso- och sjukvården som kan ge allvarliga fysiska och psykiska konsekvenser för patienter som drabbas. Forskning visar på bristande kunskap och utbildning hos sjuksköterskor om preventiva åtgärder vid risk för trycksår. Syfte Att beskriva vilka preventiva åtgärder sjuksköterskan kan använda i sitt arbete med patienter för att minska uppkomsten av trycksår, samt beskriva en metodologisk aspekt i de valda artiklarna. Metod Litteraturstudie med deskriptiv design som utgår från 12 vetenskapliga artiklar med kvantitativ ansats, framsökta från databasen MedLine genom sökmotorn Pubmed. Resultat I föreliggande studies resultat framgick det att tre kategorier har betydande roll i det preventiva arbetet mot att minska uppkomsten av trycksår; Riskbedömningar, Lägesändringar samt Klassifikation och dokumentation. För att upptäcka patienter som ligger i riskzon till att utveckla trycksår är riskbedömningsinstrument användbara verktyg och bättre än enbart kliniska bedömningar. Varierande och systematiska lägespositioner minskar förekomsten av trycksår då patientens kroppstyngd fördelas jämt och förhindrar ett långvarigt tryck över ett specifikt område. Genom att utbilda sjuksköterskor om riskbedömningar och trycksårsklassifikation ökade kunskapen och kännedomen om det preventiva arbetet, vilket tillsammans med noggrann dokumentation bidrog till lägre förekomst av trycksår. Slutsats En stor del av det preventiva arbetet mot trycksår utgörs av riskbedömningar, lägesändringar samt klassifikation och dokumentation. Med riskbedömningsinstrument kan noggranna undersökningar utföras och i ett tidigt stadie se vilka patienter som löper större risk än andra. Vissa instrument visade sig även vara bättre än andra, därför bör valet av dessa övervägas. Hur ofta patientens lägesposition ändras och vilken lägesändring som väljs har betydelse för uppkomsten av trycksår. Korrekt klassificering och dokumentation kan bidra till att reducera antalet trycksår. / Background Pressure ulcers are a major problem in health care that can cause serious physical and psychological consequences for affected patients. Research shows that there is a lack of knowledge and education of nurses regarding preventive measures when risk for developing pressure ulcer. Objective To describe the preventive measures the nurse can use in their work with patients to reduce the prevalence of pressure ulcers, and describe a methodological aspect of the selected articles. Method Literature study with a descriptive design that is based on 12 scientific articles with quantitative approach, retrieved from the database MedLine through the PubMed search engine. Results In the present studie’s result it is revealed that three categories have a significant role in the preventive work toward reducing the prevalence of pressure ulcers; Risk assessments, Location positioning, and Classification and documentation. To detect patients who are at risk for developing pressure ulcers, risk assessment instruments are useful tools and better than clinical judgements alone. Varied and systematic location positioning reduces the prevalence of pressure ulcers as the patient's body weight is distributed evenly and therefore prevent a prolonged pressure over a specific area. By educating nurses about risk assessments and pressure ulcers classification, increased the knowledge and awareness of the preventive work, whichtogether with accurate documentation contributed to the lower prevalence of pressure ulcers. Conclusion A big role of the preventive work against pressure ulcers consists of location positioning, education and risk assessments. How often the change of the patient's location positioning is carried out and the position that is chosen has an important role for the emergence of pressure ulcers. Education can help to increase nurses' knowledge to recognize and classify pressure ulcers and therefore reduce these.With risk assessment instruments, proper examinations can be carried out and at an early stage ensure which patients are at greater risk than others. Some instruments also turned out to be better than others, so the choice of these should be considered.

Stroke is a significant contributor to the global burden of disease in adults. With the risk of recurrent stroke high, preventative medicines aimed at risk factor reduction are the method of choice for addressing the challenge of increased morbidity and mortality and improving patient outcomes. Research in stroke has shown that adherence to medication is problematic and survivors face considerable practical and physical barriers to taking prescribed medicines. Understanding these challenges can inform the development of strategies to improve medication taking behaviour through delivery of interventions in the primary care setting. This thesis aims to identify potential strategies to inform interventions to improve medication taking in stroke. The research: identified key barriers and facilitators of medication adherence for the secondary prevention of stroke - firstly from within the primary care setting and then from the perspective of an online stroke forum; explored the appropriateness of the online forum as a method of data collection for conducting qualitative research compared with a traditional qualitative interview approach; investigated medication taking among community stroke survivors to characterise patients who receive help with medicines and estimate the proportion who have unmet needs and miss medicines; and examined attitudes from across the stroke spectrum towards a novel approach to medication taking for secondary prevention (i.e. fixed-dose combination polypill). Findings showed that survivors face considerable barriers to medicine taking, but that facilitators, particularly the caregiver role, can encourage good medication taking practice. The online forum has potential as a source of data to understand stroke survivors' behaviour, and a novel strategy to taking stroke medicines has promise. These findings enhance current thinking around medicine taking behaviour in stroke and can inform the development of effective interventions to improve medication taking practices and address nonadherence among stroke survivors. Implications for clinical practice are discussed, and recommendations are provided for future research.

Hemodialysis patients are at high risk of acquiring a blood stream infection (BSI), the second leading cause of death in this population. The purpose of this project was to create a clinical practice guideline (CPG) based on current evidence-based practice (EBP) that would bring a cohesiveness to the policies and provide an auditing tool to monitor infection control practices. Current literature supports the bundle approach, a small set of EBPs combined as a group of recommended interventions that apply to a specific patient population with the goal of improved delivery of care. The hemodialysis bundle project incorporated the theory of planned behavior to create a set of evidence-based interventions developed from an in-depth review of current, peer-reviewed studies. Three experts reviewed the CPG using the Appraisal of Guidelines for Research and Evaluation Instrument II; the scores from the 6 domains showed approval of the guideline as it was created with a score of greater than 90%. The three experts were chosen because they are responsible for updating and writing policies for the hemodialysis units. The creation of a CPG to improve infection control practices might benefit hemodialysis staff by providing an organized and cohesive method of following current policies. The new CPG might impact social change by applying current EBP to a clinical practice with end results of improving hemodialysis care and patient outcomes.

Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.

Cardiovascular disease and cancer are the two most common causes of death worldwide. Angiogenesis plays a critical role tumourigenesis and atherogenesis. As a member of the basic region-leucine zipper protein family, c-Jun, has been linked with cell proliferation, migration and cell survival. However, the relationship between c-Jun and angiogenesis has not been firmly established. In this thesis, strategies targeting c-Jun mRNA such as DNAzyme and siRNA have been designed and evaluated for their ability to inhibit the c-Jun mRNA and c-Jun protein expression in vitro and in vivo. These agents block c-Jun expression and inhibit DNA binding activity of c-Jun. Luciferase assay showed that c-Jun siRNA suppressed c-Jun/AP-1-dependent reporter activity. The processes of cell proliferation, migration, invasion and tube formation were all down-regulated after treatment with c-Jun targeting agents. In vivo, c-Jun DNAzymes and siRNA inhibit angiogenesis in multiple models of angiogenesis in multiple models of angiogenesis, including tumour angiogenesis and growth, matrix angiogenesis, corneal angiogenesis and retinal neovascularization. This is mediated, at least in part, by c-Jun siRNA or DNAzyme inhibition of MMP-2 expression. These findings demonstrate the critical role played by c-Jun in the involvement of neovascularization and suggest that DNAzymes or siRNAs are efficient gene-silencing agents. The ability to identify and control key genes in angiogenesis provides opportunities for developing therapeutic molecular tools to treat cancer or other angiogenesis related diseases.

This thesis concerns domestic violence in New Zealand. Its aim is to help find effective ways of preventing domestic violence in our homes through community level public education/awareness interventions. Domestic violence has a damaging effect within a large number of New Zealand households; the primary aim of this thesis is to contribute research to the efforts in New Zealand directed at preventing domestic violence.This thesis situates domestic violence within both a sociological and theoretical framework as well as within the context of New Zealand public education campaigns. Central to this thesis is a critical analysis of one particular community level public education and awareness intervention that was implemented in the United States throughout the 1990s. The core community-level principles of this US project have been analysed with regard to the suitability of integrating them into a hypothetical domestic violence public awareness campaign in New Zealand (one that would aim to help victims seek appropriate help from their situation).This US community level intervention was called the AIDS Community Demonstration Project (ACDP), its aim being to increase HIV risk reduction behaviours amongst at-risk people within the community. It is acknowledged throughout this thesis that the risk of HIV infection and the nature of domestic violence are very different issues although both are key health issues. However, the analysis of the ACDP was chosen predominantly because of the broad community focussed principles that it followed. The core research question of this thesis is as follows: Are the broad principles used within the ACDP suitable to be integrated into a victim-based domestic violence public awareness campaign in New Zealand? If so, to what extent? If not, why?My critical analysis has been informed by qualitative interviews with key experts in the field of domestic violence prevention in New Zealand. This critical analysis has highlighted a number of key elements in the complex task of domestic violence prevention and discusses the measures needed to sustain an abuse-free New Zealand.

Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.

Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.

Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.