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Item Open Access Can we use wearable microtechnology devices to monitor motor changes post-concussion in team sport players?(Australian Catholic University, 2025)Sports-related concussions (SRCs) are common amongst athletes partaking in both contact (e.g., tackle) and non-contact (e.g., struck by ball) sports. Incidence of SRC has seen a steady increase amongst athletes, with proposed reasons including increased physicality, improved diagnostic tests, and increased awareness surrounding concussion and future complications of un-reported cases. Concussion, otherwise referred to as mild traumatic brain injury (mTBI) is described as a transient disturbance of brain function due to direct (e.g., head contact) or indirect (e.g., whiplash) mechanisms. Due to the biomechanical properties of the brain, it has an increased susceptibility to injury under rotational accelerations typically associated with indirect impacts to the head. Symptoms following injury include headache, nausea, behavioural abnormalities (e.g., mood changes), vision and coordination deficits. Current management of SRC is heavily reliant on subjective assessment tools, such as the Sports Concussion Assessment Tool (SCAT6) and, the recently introduced, office-based assessment (SCOAT6). These assessments are multidimensional to account for the wide variety of symptoms that may be experienced by individuals. They are used to assist with both diagnosis and return to play (RTP) clearance. Of particular interest is the assessment of motor function. The Balance Error Scoring System (BESS), it’s modified version (mBESS), and tandem gait tasks are commonly used to assess motor performance, ultimately informing clearance for RTP. Of concern is the use of such tools, initially designed to assist with diagnosis, to evaluate RTP readiness. It is proposed that these assessments may lack the resolution or sensitivity to detect potential changes in motor function due to their simplicity and subjective nature. Given that there appears to be an increased risk of subsequent concussion and musculoskeletal injury upon RTP following SRC, players may be returning with lingering, subclinical deficits in function that go undetected by clinical tests. Laboratory assessments, such as 3D motion analysis or pressure sensitive walkways, may provide detailed insight into the deficits seen post-concussion; however, they are difficult to implement for most practitioners. The aim of this thesis was to establish a more comprehensive motor assessment to further complement the current clinical assessments implemented as part of concussion management protocols. (1) Consolidate the reliability and validity of motor function assessments currently used in concussion management and further summarise their feasibility for clinicians and other end-users. (2) Assess the reliability of ankle, lumbar, and thoracic mounted devices to measure gait parameters on grassed surfaces. (3) Determine if lumbar- and thoracic-mounted IMUs can detect changes in movement strategies amongst athletes returning to play following a diagnosed SRC across a range of movement velocities. The findings from the systematic review identified limitations with currently implemented motor assessments; notably poor sensitivity of these assessments beyond the acute stages of concussion (>7 days). Most motor assessments rely heavily on subjective interpretation (e.g. number of errors) or blunt objective measures (e.g. time to complete task). They do not allow practitioners to understand what may be happening at a neuromuscular level to implement targeted rehabilitation strategies. The systematic review concluded that static and dynamic balance assessments may lack the requisite sensitivity to detect underlying neuromuscular changes in motor performance, especially when performed beyond acute stages. Gait-based assessments (single- and dual-task) were better at distinguishing between concussed and healthy populations, with instrumented versions being superior. Laboratory assessments are valid and reliable and are excellent instruments to obtain objective measures within a research setting. However, the accessibility, associated costs, and controlled environments mean they cannot be used by practitioners to monitor athletes returning to play. Thoracic worn IMUs are currently utilised by many team sport athletes to monitor training and game-play loads. The portability and low-cost of these devices make them suitable for team sport athletes to use within any desired environment. These devices have been shown to be effective at differentiating athletes suffering neuromuscular fatigue and it was hypothesised that this use may also be extended to monitoring the movement changes that present post-concussion. To establish if IMUs can be used in the field to assist with concussion management, this thesis first sought to determine the test-retest reliability of ankle-, lumbar-, and thoracic-mounted IMUs to measure commonly reported linear and non-linear gait variables across set- and self-paced activities of increasing velocities performed on grassed surfaces. These IMU locations have previously demonstrated acceptable reliability for a range of outcome measures. However, these have only been performed within controlled, stable environments (e.g. running track, indoors). Access to these environments may be limited for many team sport athletes, therefore determining the reliability of these device locations on grassed surfaces was warranted. Our findings showed that ankle-, lumbar-, and thoracic-mounted IMUs, in general, displayed acceptable test-retest reliability for a range of linear and non-linear gait variables. These results were consistent across velocities (walk, jog, run) and pace conditions (set- and self-paced). These findings support the use of IMUs to monitor common gait variables within the field, increasing feasibility for practitioners. Nonetheless, limitations for ankle- and lumbar-mounted IMUs do exist. Notably, these locations may impede activities performed in training and game environments (e.g. tackling, kicking a ball). Thoracic-mounted IMUs housed in a tight-fitted vest are already utilised by many team sport athletes and are less affected by sport-specific requirements, making them suitable for most athletes and sports. Practitioners can be confident that thoracic-mounted IMUs can reliably measure variables of gait over a five-week period based on the current research. Upon establishing the test-retest reliability of ankle-, lumbar-, and thoracic-mounted IMUs, this thesis sought to determine whether there were differences in gait derived from the lumbar- and thoracic-mounted IMUs between concussed and control athletes at a range of movement velocities. To date, post-concussion gait assessments have been isolated to walking tasks which may not accurately represent the demands required upon return to play. Therefore, we aimed to investigate if increasing velocities (jog and run) also displayed between-group differences and assess whether they existed beyond RTP clearance. Our findings suggest that variations in gait strategies still exist beyond RTP timelines. These variations were evident across linear and non-linear outcome measures collected via lumbar- and thoracic-mounted IMUs. Previous literature has suggested concussed athletes have a slower gait when walking. Whilst our findings supported this, concussed athletes performed jog and run activities at faster speeds than healthy controls. Largest between-group differences were seen for measures of sample entropy (vertical and mediolateral acceleration), mediolateral acceleration profiles, and centre of mass (COM) displacement. Concussed athletes demonstrated greater mediolateral movement, indicating more side-to-side movement, and reduced COM displacement and vertical acceleration, suggesting reduced lower-limb stiffness. Non-linear analysis showed greater irregularity for vertical accelerations across all activities for concussed athletes, indicating a less predictable movement pattern for these participants. In general, this score improved for walk and run activities, with no change seen for jogging. Differences between device locations were particularly evident for the assessment of sample entropy and mediolateral acceleration. Data obtained from the thoracic-mounted IMUs suggest greater variability in mediolateral acceleration, while the lumbar-mounted IMUs only showed greater irregularity for walk activities. Due to being further up the kinetic chain, thoracic-mounted IMUs may be more influenced by upper-limb and trunk movements, whereas measures from lumbar-mounted IMUs may better represent lumbo-pelvic movements and COM displacement. Both sites can provide valuable information, but practitioners must be aware of the limitations or bias (e.g. magnitude of some outcome variables) associated with each location when interpreting results. Notably, lumbar-mounted devices are not commonly worn and therefore require the attachment of an additional device. Thoracic mounted devices are commonly worn during team sport training and competition and may allow for pre-injury measures and regular post-injury measures of gait to be performed with relative ease to aid decision making in team sport. In conclusion, the studies within this thesis found that ankle-, lumbar-, and thoracic-mounted IMUs can reliably measure a range of linear and non-linear gait metrics during activities across a range of velocities when performed on grassed surfaces. In addition, lumbar- and thoracic-mounted IMUs can be used to show differences between concussed and healthy athletes for various linear and non-linear outcome measures up to 50-days post-concussion. These findings support the use of IMUs in the field to provide a more comprehensive assessment of gait following concussion. The low-cost and portability of IMUs make them easy for many team sport athletes and practitioners to access and use to assess any potential changes in gait strategies following injury. Use of instrumented gait assessments across increasing velocities may provide important insight to inform an athlete’s RTP readiness when compared with more traditional clinical assessments (e.g. BESS) and may inform practitioners of additional assessment requirements to ensure player safety and well-being following RTP.Item Restricted Beguiled by the 'Glittering Prize' : Systemic and ethical culture failings in the management of Informer 3838(Edward Elgar Publishing, 2026-04)Politicians and public alike wanted to know why Victoria Police (Australia) were making little substantive headway investigating a seemingly unstoppable wave of serious and organized crimes, manifested not least in a murderous gangland war that had lasted over a decade (AAP, 2014). Whoever was really in control of the streets of Melbourne, through journalism’s lens it did not appear to be Victoria Police. For the both the organization’s executive command, and for frontline detectives – feeling the heat of public and political scrutiny (McMurdo, 2020:v1, pp.80-81) - when presented with an unparalleled, unprecedented, opportunity to gather information from a source trusted by those under investigation; a source who knew exactly how and in what ways the suspects were vulnerable; a source who could provide information that would not only secure evidence but also inform prosecution strategy and so secure convictions, the attraction of the proposition seemed a no-brainer: why wouldn’t you?Item Open Access The validity and reliability of player tracking technology in team sports(Australian Catholic University, 2025-11-12)The quantification of a player’s external training load (i.e., work performed) is important and is commonplace to numerous levels of team sport. These data are often used to establish match demands of a sport; and then incorporated into a feedback loop where they are used to: (1) prescribe training that is specific to those demands; (2) monitor training loads to ensure the desired outcomes are achieved; and (3) adjust loads for subsequent training periods, which can vary from within a session, to between seasons. All these steps are used to minimise injury risk, optimise adaptations and deliver successful performances. Historically this tracking was performed by charting player movements during match-play live or retrospectively. Semi- and fully-automated computer-vision tracking systems were then used but are labour intensive and therefore not suitable for the fast-paced nature of modern day sport. Hence the introduction of wearable microtechnology in the field of sport science has become the most common means of quantifying player movements. Recently, computer-vision and artificial intelligence (AI) have experienced rapid growth in the area of tracking player movements. Given the widespread use of these technologies, it is important to ensure their output is understood to facilitate effective use in practice. First and foremost, the validity and reliability of these devices must be understood. As such, the overall aim of this thesis was to establish the validity and reliability of common tracking technologies used in team sports. This thesis comprises a systematic review and three experimental studies. The systematic review appraised studies that investigated the validity and/or reliability of the wearable microtechnology devices used in team sports. After assessing the eligibility of the 384 retrieved studies, 72 were eligible and therefore included in the review. Global navigation satellite systems (GNSS) were examined in 47 studies, local positioning systems (LPS) in 12 studies and inertial measurement units (IMUs) in 25 studies. It was difficult to collectively synthesise the validity and reliability of wearable microtechnologies, given the methodological heterogeneity among the included studies. However, whilst validity and reliability varied across studies, in general there was a trend for improved validity and reliability as sampling frequency increased. Typically, the devices offered suitable accuracy for monitoring key metrics such as peak speed and distance covered. Significant gaps identified in the literature included: 1) the validity and reliability of the most recent and commonly used GNSS devices had not yet been examined in peer-reviewed research; 2) Intra-device reliability had been inadequately assessed; and 3) Validity and reliability had not yet been assessed over multiple days. Given the findings of the systematic review, Chapter 4 investigated the inter-device and inter-manufacturer reliability of Catapult (Vector S7) and Statsports (Apex Pro) devices over time. It was found that the devices possessed consistently suitable reliability for most metrics apart from threshold-based acceleration and deceleration metrics. There were also large differences between the outputs of both manufacturers. Chapter 5 assessed the validity of the same devices to measure instantaneous speed and acceleration during straight-line sprinting across multiple sessions. It was found that both devices possessed suitable validity for measuring speed and acceleration compared to a laser criterion. There were small differences in validity across sessions for Catapult units, but these were not practically meaningful. Chapter 6 assessed the ability of computer-vision and AI models to track players position and speed using broadcast video footage. The results showed that players can be accurately tracked but this is dependent upon the computer-vision and AI techniques implemented. Overall, modern day (≥10-Hz) GNSS devices provide suitable validity and reliability. Further, it appears that computer-vision tracking may be a suitable alternative provided players are detected by the software. However, future research should focus on this area given it is in its infancy. In particular, the methods used to estimate a player’s position when they are not detected by the software (e.g., outside of the camera’s field of view, occluded) currently lack suitable accuracy and should be further developed. It may be that more training data are required for the machine learning algorithms to develop sufficient accuracy to predict player position accurately in these situations. Collectively, this thesis consolidates the work pertaining to the validity and reliability of wearable player tracking devices. It provides practitioners with an understanding of the precision and accuracy of the metrics commonly assessed using wearable devices and highlights the viability of using computer-vision and AI to track players using broadcast footage.Item Open Access Reducing the environmental impact of surgery on a global scale: Systematic review and co-prioritization with healthcare workers in 132 countries(Oxford University Press, 2023)Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.Item Open Access Motivation of sessional teaching staff to remain employed in pre-registration nursing programs: A systematic review(Elsevier Ltd, 2025-06-19)Aim: To identify motivational and demotivational factors for sessional teaching staff to undertake employment in pre-registration nursing programs. Background: Sessional teaching staff are part of the nurse education team; however high turnover can cause challenges to the university and impact the quality of teaching and learning for students. Understanding the motivational factors for working as sessional staff can help create a more sustainable nurse education workforce. Design: Systematic review. Methods: The review protocol was registered with the Open Science Framework and the search was conducted in September 2024 using the databases CINAHL, Education Source, ERIC, PsycInfo® and MEDLINE. The inclusion criteria were sessional teaching staff, teaching into pre-registration nursing programs in tertiary education settings. Themes were deductively developed following data extraction. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Results: Four studies were included in this review. Two themes were developed: i) Motivation to remain employed; ii) Demotivational factors to remain employed. The top motivating elements for sessional staff were the enjoyment of teaching, the work flexibility and the ability to nurture the next generation of nurses. Demotivational factors for working sessionally included feeling disconnected from the nursing school and not having adequate resources and support for teaching. Conclusions: Sessional teaching staff provide benefits to nurse education programs. Universities need to enhance motivational factors such as flexibility and address the lack of sense of belonging, support and resourcing of sessionals to create a sustainable academic workforce and to ensure the quality of nurse education.
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