User:IntravenousRobbie

I am Robbie, a Wikipedia user from Perth, Western Australia. I contribute to Wikipedia in a NPOV spirit, by ensuring high standards of academic rigour when editing and writing articles. I have a Bachelor of Science from the University of Western Australia where I attained majors in pathology and microbiology as well as completing a significant amount of coursework in biochemistry and immunology. I also attained my Master of Nursing Science from the University of Western Australia which allowed me to become a registered nurse, the profession in which I currently practice. Additionally I gained a Graduate Certificate in Health Promotion from Curtin University and a Graduate Diploma in Nursing (Emergency) from Charles Sturt University before returning to he University of Western Australia to commence my Master of Infectious Diseases with a view towards Doctor of Philosophy candidature. During my time practicing nursing I was in active service in the Australian Army, and retired to return to academia; decorations, ranks and awards here

Areas of Expertise

 * 1) Microbiology
 * 2) Bacteriology
 * 3) Parasitology
 * 4) Mycology
 * 5) Virology
 * 6) Immunology
 * 7) Vaccinology
 * 8) Biotherapeutics & regenerative medicine
 * 9) Gene therapy
 * 10) Use of viral vectors
 * 11) Stem cells
 * 12) Nursing
 * 13) Intensive care nursing
 * 14) Emergency nursing
 * 15) Field nursing
 * 16) Rural & remote nursing
 * 17) Retrieval nursing
 * 18) Search and rescue

Science
My science interests include microbiology, immunology, biochemistry, pathology and the interdisciplinary research and application of these fields.

Microbiology
In microbiology I am interested in antibiotic resistance in all respects. Whilst the typical research focuses on the growing problem of nosocomial and community antibiotic resistance with an evolutionary aetiology; that is, antibiotic resistance that has been acquired by bacteria as a result of the evolutionary pressures exerted by the use of antibiotics clinically. I am more interested in artificial antibiotic resistances and their applications to biological warfare. This is useful yet underfunded research, as it would allow us to develop new antibiotics ahead of the clinical demand, and it would also allow a better insight into disease control strategies should there be a biological attack.

Immunology
In immunology I am most interested in improvements in monoclonal antibody therapies. Such improvements are those which would reduce the price such as “artificial” antibodies, and those which would increase the efficacy such as the conjugation of immunological adjuvants onto the antibodies which promote immune response and even stimulate proliferation of leukocytes. Furthermore, improvements in immunohistochemistry, immunofluorescence and flow cytometry methods which could expand, in a reliable and meaningful way, the scope of these imaging methods into less traditional areas such as animal biology and even botany.

Biochemistry
In biochemistry I am interested in the bacterial or human enzyme kinetics between human and microbiological substrates, respectively. More specifically I am interested in adhesion reactions as virulence factors and how they can be selectively inhibited or reversed to provide clinical protection from, or resolution of, infection. Additionally, examining how the enzymes and cofactors involved in maintaining intracellular osmolarity in bacteria behave may be of merit as selective inhibition or destruction may be valuable in developing cheap and effective antimicrobials for bacteria such as ‘’Vibrio cholerae’’, the pathogen in cholera infection.

Pathology
In pathology I am interested in biotherapeutics and regenerative medicine (|the verbatim name of a pathology unit I took in my final semester). In biotherapeutics I am most interested in gene therapy and its huge scope of applications. In regenerative medicine I am interested in stem cell research and application, specifically the construction of whole tissues (and even organs) from 3D biocompatible scaffolds (such as microperforated collagen scaffolds) and seeded stem cells. The recent advances made possible by the development of induced pluripotent stem cells (IPSCs) are exciting.

Nursing
My nursing interests are more or less extensions of my science interests, but deserve mentioning nonetheless.

Wound Management
The clinical nursing practice surrounding wound healing is an area I would like to develop in the future. In my clinical experience, nursing staff generally treat wounds with significantly less asepsis than they deserve. I think the contribution of poor nursing practice to the reasonably high post-operative infection rate is under-appreciated. In the future, more research discussing the use of face masks whilst performing dressing changes, and the routine use of a sterile field in place of the currently standard ‘aseptic field’. Currently it is common practice to take no further precaution than using a ‘no touch technique’ and using an alcohol based hand rub when changing a dressing. In the future I fully expect the standard to be a face mask, a clean robe, a surgical scrub and sterile gloves.

Critical Care Nursing
Critical care nursing is a large area of interest for me specifically, management of the acutely deteriorating patient in a pre-hospital or emergency department setting. I would like to see the advancement of nursing scope of practice in Australia proliferate to routinely include independent management of the acutely deteriorating patient. That is, free use of the medication required for advanced cardiac life support and rapid sequence induction without prescription, as well as policy that allows the registered nurse to perform surgical airway interventions, and cannulate peripheral arteries for real time blood pressure monitoring. Furthermore, a shift away from the classic doctor-nurse dynamic in a team setting (where the nurse is considered the subordinate) to a new dynamic which recognises each profession's skill set, so that senior nurses may be the leader in a team resuscitation setting (recognising the superior leadership of the nurse), whilst still requiring medical doctors to undertake the specific interventions as ordered by the team leader (recognising the superior skill of the doctor).

Patient Flow
Patient flow in the hospital with an emergency department is also an area I am interested in. Managing the flow of patients from the elective surgery, emergency surgery, emergency medical admissions and booked medical admissions streams is a precarious situation in Australian public hospitals. Oftentimes you have a wait-list manager for elective surgery/admissions, an emergency department coordinator and a hospital bed manager all looking out for different interests and not actually examining the whole situation. To further complicate the situation, systems for timely reporting of discharges (rooms to be cleaned and prepared for a new patient), and reporting of the room being ready are grossly lacking. In my experience at a 600 bed hospital, in any 24 hour period, it’s not unusual to have 100-200 wasted bed hours due to the aforementioned lack of reporting. This may not sound like much, but when the emergency department has ambulances that can’t even get in the door (a common occurrence), then these wasted bed hours can make the difference in patient outcome as well as patient satisfaction. Development of sophisticated patient flow systems and creation of patient flow positions are sorely needed.