SACM - Australia
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9648
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Item Restricted An acute dietary intervention in lactation has variable impacts on the maternal and infant microbiota and milk antimicrobial proteins(The University of Western Australia, 2025-01-01) Sindi, Azhar; Payne, Matthew; Geddes, Donna; Stinson, LisaThe first years of life are a critical period for microbial colonisation of the infant gut, which has been linked with health and disease outcomes in later life. Breastfeeding has been shown to have a significant impact on both composition and function of the infant gut microbiome. This is due to vertical transmission of microbes and exposure to other non-microbial factors, such as antimicrobial proteins, in human milk (HM). Given the importance of HM and the infant gut microbiome for lifelong health, this thesis investigated factors that influence HM composition (both microbial and non-microbial), with a focus on maternal diet as a modifiable determinant. Further, by utilising an acute maternal dietary intervention during lactation, the significance of maternal diet for infant gut composition and function was explored. While many studies have assessed the determinants of the HM microbiota, this has not been investigated in an Australian population. To address this gap, we first collected HM samples from a small cohort (n=29) of Australian mothers to characterise HM bacterial profiles. We investigated potential associations between HM bacterial composition and maternal factors, such as body mass index (BMI), mode of delivery, breast pump use, allergy, and parity, and infant factors, such as sex, mode of feeding, pacifier use, and introduction of solids. Our findings confirmed previous reports that maternal BMI, mode of delivery, and breast pump use are associated with HM bacterial profiles. Additionally, we found that infant pacifier use was associated with an altered HM microbiome, the first report of such a finding. With a more complete picture of the HM microbiome in Australian women and its key determinants, we next sought to focus on maternal diet and its impact on the maternal and infant microbiota, as diet is the single biggest modifiable determinant of the human microbiome. Previous observational studies have linked maternal diet with the HM microbiota. Such studies have also associated maternal diet during pregnancy with the infant gut microbiota. However, the impact of diet during lactation on the maternal and infant microbiota has not been examined. To address this gap, we performed an interventional study, in which exclusively breastfeeding mothers (n=11) were placed on a low-sugar, low-fat, high-fibre diet for two weeks. We analysed maternal faecal and HM samples collected immediately before, immediately after, and 4-8 weeks after the intervention. Full-length 16S rRNA gene sequencing was used for high-resolution bacterial profiling. Additionally, infant faecal samples were collected for shotgun metagenomic sequencing immediately pre- and postintervention to examine the effect of maternal diet on both composition and function of the infant gut microbiome. The intervention had no significant impact on infant gut microbiome composition; however, it was associated with significant changes in the functional capacity of the infant gut microbiome. The intervention also elicited small changes in a low number of bacterial taxa in both the maternal faecal and HM microbiota, some of which persisted 4-8 weeks post-intervention. Given that the dietary intervention shifted the function, but not the composition, of the infant gut microbiome, we next investigated whether the diet modulated other biologically relevant components in HM, namely the antimicrobial proteins lysozyme and lactoferrin. However, given that little is known about daily, circadian, and between-breast variations in the concentrations of lysozyme and lactoferrin, the stability of these proteins in mature HM needed to first be established. HM samples were collected from 18 mothers who undertook our acute dietary intervention across a 3-week period; daily, three times a day, and from both breasts. Both lactoferrin and lysozyme showed small, but statistically significant, variability over time, with significant day-to-day and circadian differences; however, no significant variation was detected between breasts. These findings underscore the need to standardise sample collection time, or to collect samples at multiple time points throughout the day, in order to obtain reliable estimation of HM lysozyme/lactoferrin content. The concentration of HM lysozyme was reduced during the first week of the dietary intervention, while HM lactoferrin levels were lower in the second week of the intervention. Thus, maternal diet may impact HM antimicrobial protein concentrations. We hypothesise that this may be due to dietary effects on maternal systemic inflammation. Together, these data demonstrate the importance of maternal factors, including BMI and maternal diet and infant feeding practices, including breast pump and pacifier use, as potential modifiers of HM microbial composition. In addition, a controlled maternal dietary intervention elicited small but significant changes to the maternal faecal and HM microbiota, and to HM antimicrobial proteins. While these changes were associated with significant alterations to the functional potential of the infant gut microbiome, they did not affect its composition. The data presented in this thesis therefore highlight potential limitations of maternal diet as a target to improve infant health via manipulation of the microbiome.17 0Item Restricted Equity in Health: Analysing the Accessibility of Australia's Tertiary Public and Private Healthcare(The University of Western Australia, 2026-01-01) azeem, Mazen Ba; Kruger, Estie; Tennant, MarcThis thesis undertakes an exhaustive analysis of tertiary healthcare accessibility in Australia, juxtaposing public and private sector distribution against the backdrop of the socio-economic landscape. It critically assesses healthcare services availability, particularly during the unprecedented challenges posed by the COVID-19 pandemic. The study employs geospatial analysis and GIS mapping to evaluate the socioeconomic status of the population residing near the facilities, location and accessibility of Emergency Departments (EDs) in tertiary public and private healthcare facilities across the country and explore their readiness in the face of potential pandemics. The socio-economic variables within different buffer zones are scrutinised to reveal the impact on healthcare access during the health crisis. By integrating Australian experiences during COVID-19, the research highlights the variances in healthcare accessibility, accentuating the strains on hospitals with EDs and the innovative implementation of field centres in high-density regions to counteract service gaps. The thesis also discusses the socioeconomic determinants that exacerbate disparities in healthcare provision, offering insights into the stratification of health equity. The findings suggest that, despite Australia's robust healthcare system, critical areas require strategic enhancement to ensure preparedness for future pandemics. Recommendations include the need to address healthcare inequalities and improve service accessibility in Australia’s urban, rural and remote areas, as well as the establishment of temporary healthcare facilities in strategically identified locations to bolster the resilience of healthcare infrastructure. The conclusions drawn herein provide a pathway for policymakers to fortify healthcare systems against the backdrop of socio-economic disparities, aiming for an equitable distribution of healthcare resources.39 0Item Restricted INSOLVENT TRADING LAWS IN SAUDI ARABIA AND AUSTRALIA: A CRITICAL APPRAISAL(University of Wollongong, 2024-07-03) Alqasmi, Huda Abdullah A; Anthony, Dorothea; Solaiman, S MIn recent years, Saudi Arabia has been on a mission to modernise its commercial laws to develop an attractive environment for foreign investment. Even though both its company law and bankruptcy law have been updated recently, they lack clear mechanisms to prevent companies from trading while they are insolvent or on the brink of insolvency, which can expose stakeholders to a high level of risk. Reforming the law to provide protection for stakeholders would encourage investment and assist the domestic market. Creditors are generally the most vulnerable stakeholder affected by the financial distress of their debtor company. While Saudi law offers minimal protection for creditors, Australian law provides a sound model with an appreciable degree of protection. Australian law has been gradually reformed to protect creditors of distressed companies by placing a specific duty on company directors to prevent insolvent trading. This study critically examines Saudi law concerning insolvent trading in the light of its counterpart in Australia and draws on Australian law on directors’ duties to suggest reforms aimed at strengthening the law of Saudi Arabia.25 0Item Restricted Modelling Health Emergency: An Efficient Approach in Operating via Simulations(The University of Sydney, 2024-06) Alhuntushi, Nasser; Jajo, NethalThis thesis aimed to develop a mathematical model to minimise patient wait times and stay length in the Australian Nepean Hospital's emergency department (ED). The model used integer programming to analyse patient movements and identify bottlenecks. The thesis also adopted a discrete event simulation (DES) generic model for ED patient flow to investigate weekday and weekend patients’ arrival and waiting times and staff utilisation rates, identify resource management problems, and test multiple possible scenarios solutions. The model was based on Nepean hospital’ ED data from the Nepean Blue Mountains Local Health District and analysed during the COVID-19 pandemic. We used Arena software to develop the model, identifying areas where patients may experience long wait times and supporting decision-making to improve ED efficiency. The study aimed to improve patient experience and efficiency. The research reveals that priority queuing theory is crucial for understanding the ED system, with the DES model being more appropriate. The Acute care zone has the longest wait time and highest nurse utilisation, with physician utilisation consistently exceeding 95%. The COVID-19 pandemic has not significantly impacted patient arrivals, but staff reallocation is necessary for efficiency and patient health. The thesis proposes three efficient scenarios based on ED preferences and limits: moving one physician to a new peak hour shift, hiring an extra physician, or rostering a nurse from the Subacute care zone to the morning shift. These results help decision-makers optimise service delivery, reduce wait times, and improve staff utilisation.32 0Item Unknown An Organisational Perspective on the Factors Influencing the Adoption of Blockchain Technology(RMIT University, 2024-02-06) Alharthi, Shaker; Abareshi, Ahmed; Maleki Far, ShaghayeghIncreased levels of competition, customer expectations, and pressures from stakeholders to improve performance and transparency/full disclosure, have all forced organisations to implement new technologies. Blockchain technology is an example of a disruptive technology. It is in fact a distributed ledger system that enables the history of any product to be traced by all the stakeholders involved which can result in improving organisational efficiency. Despite its benefits for businesses such as improving trust and honesty or transparency and reducing costs and complexity, businesses do not all agree on the adoption of such a disruptive technology. The review of the literature reveals a scarcity of in-depth empirical research on the factors that guide the acceptance of blockchain technology. Thus, this study examines empirically the impact of different factors on blockchain adoption in medium-sized and large organisations in Australia, where blockchain offers an effective and efficient way to potentially transform the country’s business environment. Australia is one of the countries that have publicly stated a commitment to adopt blockchain technology, and the Australian federal government predicts that the technology will generate an annual business value of approximately US$175 billion and US$ 3 trillion by 2025 and 2030, respectively. The current study addresses this gap in our knowledge using a quantitative research approach. Based on the recent literature on blockchain, absorptive capacity theory and the Technology-Organisation-Environment (TOE) framework, a new theoretical framework is proposed to further investigate the influence of various factors on blockchain adoption. The data is collected through a survey of 224 IT managers from medium-sized and large organisations in Australia, and partial least squares structural equation modelling (PLS-SEM) serves to examine the hypothesised relationships. Based on the findings of this thesis, perceived security, perceived cost, senior or executive management support, competitive pressure and regulatory support significantly shape organisational adoption of blockchain in Australia. Senior managerial support is found to have a significant mediating role between external factors and the acceptance of blockchain. Further discussions are provided on how the findings of this research will help government and business managers determine the factors that need to be considered prior to implementing blockchain technology. This study contributes to theory by proposing and validating a theoretical model-based framework. The TOE model, which explains the organisational perspective on technology adoption, forms the basis of the model that is then expanded by adding absorptive capacity and the mediating effect of top management support. This expanded model has been shown to provide a more thorough explanation than the original TOE framework. A measuring scale that future research can use in investigating blockchain adoption has also been devised and validated. The research also makes practical contributions since the revised framework provides a reference for managers wishing to obtain deeper insights into the crucial factors that affect blockchain adoption in Australia. Furthermore, the findings are important for the federal government to develop relevant policies to remove any uncertainties hindering blockchain adoption; for example, regulation, skill-building, investment, international competitiveness and collaboration. As blockchain is still in the early stage of adoption in Australia, this research provides more information to firms, in order to plan for the acquisition of blockchain technology and make their business models more compatible with it.66 0