7,182 results for 2011

  • Medical screening of recreational divers for cardiovascular disease: Consensus discussion at the Divers Alert Network Fatality Workshop

    Mitchell, SJ; Bove, AA (2011-07)

    Journal article
    The University of Auckland Library

    Cardiac events are responsible for a significant proportion of recreational diving fatalities. It seems inescapable that our current systems for selecting suitable recreational diver candidates and for longitudinal monitoring of diver health are failing to exclude some divers at high risk of cardiac events. Based on review of practice in parallel sporting disciplines and of the relevant literature, a series of recommendations for screening questions, identification of disqualifying conditions and risk factors, and investigation of candidates with risk factors was drafted. Recommendations for ongoing health monitoring in established divers were also generated. These recommendations were promulgated and debated among experts at a dedicated session of the Divers Alert Network Fatality Workshop. As a result, we propose a modified list of screening questions for cardiovascular disease that can be incorporated into health questionnaires administered prior to diver training. This list is confluent with the American Heart Association (AHA) preparticipation screen for athletes. The exercise stress test unmasks inducible cardiac ischemia and quantifies exercise capacity, and remains the tool of choice for evaluating diver candidates or divers with risk factors for coronary disease. An exercise capacity that allows for sustained exercise at a 6-MET intensity (possibly representing a peak capacity of 11-12 METS) is an appropriate goal for recreational divers.

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  • "Badges of Tax Avoidance": Reform Options for the New Zealand GAAR

    Cassidy, Julie (2011-12)

    Journal article
    The University of Auckland Library

    South Africa, Australia and New Zealand have sought to tackle the problem of tax avoidance through General Anti-Avoidance Rules (“GAAR”), rather than relying solely on measures that tackle very specific examples of tax avoidance. This article compares and contrasts the approaches taken in South Africa, Australia and New Zealand. The legislative goals of the Australian and South African provisions are very similar but the strategies underpinning each piece of legislation differ. The specific prerequisites in the Australian legislation lead ultimately to the question of whether or not the taxpayer or other participants intended to obtain a tax benefit through the scheme. By contrast, the South African legislation begins with broad terms that cast a wide net, but then hones in on the application of Part IIA by focusing on the common attributes of tax avoidance arrangements. The New Zealand provisions take yet another tack with Parliament leaving it to the courts to develop judicial interpretive techniques to determine if arrangements amount to tax avoidance. The New Zealand GAAR thus echoes the South African approach to some extent, as its application revolves around quite broad terms. Unlike the South African provisions however, there is no legislative directive as to what may be called the “badges of taxavoidance”; namely, indicia of tax avoidance arrangements with these being left to the judiciary to formulate. It is ultimately suggested that this approach is too uncertain and legislative clarification is warranted. Such reform should entail the enactment of “badges of taxavoidance” that will not only give legislative direction to the courts but also provide taxpayers and their advisors with guidelines when determining if the subject arrangement crosses the line between legitimate structuring and a tax avoidance arrangement.

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  • Gems of New Zealand Primary Health Care Research: COPD self-management in New Zealand: patient attitudes and behaviours

    Sheridan, Nicolette; Kenealy, Timothy; Salmon, E; Rea, Harold; Raphael, Deborah; Schmidt-Busby, J (2011)

    Journal article
    The University of Auckland Library

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  • Another Look at the Faunal Remains of CA-SCR-9

    Nims, Reno (2011-06)

    Undergraduate thesis
    The University of Auckland Library

    CA-SCR-9 is an important early Middle Period (3100-2800 cal BP) site from the California central coast region that has been used to characterize residential base camps from that time. Previous studies have attempted to analyze the fauna using incomplete and non-representative samples, creating multiple, contradictory conclusions about the foodways of Middle Period peoples. The goal of this study was to synthesize and analyze all identified material to answer questions about the seasonal use of SCR-9, differences between two possible phases of occupation, and the adaptive strategies of Middle Period peoples on the California central coast. Using a representative sample of the fauna, this paper finds that SCR-9‟s inhabitants primarily preyed upon mule deer. However, diverse species of marine mammals, leporids, terrestrial carnivores, birds, and marine fishes were also deposited at SCR-9, and inland site. The faunal remains from SCR-9 alone are not enough to identify relationships between sites, but these marine materials suggest that SCR-9 may have functioned as a seasonal or year round habitation site from which Middle Period peoples traveled to coastal sites such as SMA-218, which is nearly contemporaneous with SCR-9. Other writers have argued that two separate phases are represented ad SCR-9, including the Sand Hill Bluff Phase and the later Año Nuevo Phase. The fauna from these two phases is extraordinarily homogenous, suggesting there were no changes in adaptive strategy, or that rodent activity has mixed the materials, making it impossible to compare fauna from the Sand Hill Bluff and Año Nuevo phases. Fortunately, the assemblage does shed light on differential handling of taxa, and raises questions about the nature of bone grease extraction practices.

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  • Sustaining lean manufacturing in New Zealand organisations

    Goodyer, J; Grigg, N; Murti, Y (2011)

    Report
    Massey University

    false

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  • Development of Air Transport Industry in the Asia-Pacific Region

    Cullinane, K; Firth, M; Fung, MKY; Gong, Xihe; Law, JS; Zhang, A (2011-02)

    Journal article
    The University of Auckland Library

    The volume of air passengers and cargo in the Asia-Pacific region has grown significantly over the past decade due to the strong impetus of economic growth as well as trade and economic integration at both the regional and global levels. Although public funds have been the main source of financing for airports in most parts of the region, governments have increasingly resorted to privatization or are seriously considering it as a form of private sector participation enabling new airports to be built or existing airports to be upgraded. The present paper provides a brief survey of airport privatization in the Asia-Pacific region, discusses the relevant issues, and introduces the following five papers published in this special section on the air transport industry in the Asia-Pacific region.

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  • Epigenetic modifications may play a role in the developmental consequences of early life events

    Bloomfield, Francis (2011-12)

    Journal article
    The University of Auckland Library

    Many aspects of postnatal development are influenced by events before birth, including cognitive and language development. An adverse intrauterine environment, for example secondary to poor maternal nutritional status, multiple pregnancy, or late preterm birth, is associated with increased risks of delayed or impaired childhood development and altered physiology in adulthood that may predispose to increased risk of adult disease. Maternal periconceptional undernutrition and twin conception can both result in late preterm birth, but it is less clear whether cases of late preterm birth not following a recognized early pregnancy event may still have their origin in the periconceptional period. Thus, the very earliest periods of pregnancy, and perhaps even the pre-pregnancy period, may be an important period determining the developmental trajectory of the fetus, and thus both pregnancy and later health outcomes. Profound epigenetic modifications to the genome occur in the early embryo as a normal part of development. Recent evidence suggests that environmental signals acting during early development may also result in epigenetic changes which may play a role in mediating the association between early life exposures and later phenotype.

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  • Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams

    Weller, Jennifer; Frengley, R; Torrie, Jocelyn; Shulruf, Boaz; Jolly, B; Hopley, L; Henderson, K; Dzendrowskyj, Peter; Yee, B; Paul, A (2011-03)

    Journal article
    The University of Auckland Library

    Background Teamwork failures contribute to adverse events causing patient harm. Establishing and maintaining a team, and managing the tasks is an active process. Medical education largely ignores teamwork competencies. However, lack of robust instruments to measure teamwork limits evaluation of interventions to improve it. Summary of Work We aimed to develop and validate a teamwork measurement instrument. From existing literature, we developed an instrument, then used it to score videotaped simulations until raters agreed the final 21 items, were comprehensive, comprehensible and observable (Appendix 1). Forty intensive care teams participated in four simulated emergencies, all videotaped, randomised and then rated by three trained assessors. . We analysed scores using Generalisability Theory, exploratory factor analysis, measured performance over time and interviewed assessors on item performance. Summary of Results G co-efficients > 0.7 were obtained for overall performance and some individual items. Variance components and interview data provided insight into individual item performance. Exploratory factor analysis confirmed items grouped into themes. Significantly improved performance over time supported construct validity. Items predicting overall performance were identified. Conclusions / take home messages The instrument performed well as did many individual items. Information on low reliability items was used to further develop the instrument which can then be used to robustly evaluate interventions to improve teamwork in healthcare.

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  • Does Accessibility Planning address what matters? A review of current practice and practitioner perspectives

    Curl, A.; Nelson, J.D.; Anable, J. (2011)

    Journal Articles
    University of Canterbury Library

    The motivation for this paper is to explore how local transport planners are using Accessibility Planning to address inequalities and disadvantage in accessibility. The research seeks to contribute to the existing literature on accessibility measurement by providing evidence to understand how such measures are used in one practical application: the English Accessibility Planning process; and reacts to the assertion that measures may not assess the complex social interactions, perceptions and behaviours which influence travel and ultimately the accessibility of individuals. As such, measuring accessibility in this way may not lead to desired improvements in social welfare. The paper therefore seeks to understand which measures can lead to the outcomes desired from Accessibility Planning.

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  • Wildlife Zoonoses

    Hayman, DTS (2011-12-20)

    Journal article
    Massey University

    Infectious diseases are still to be found among the top causes of human deaths globally. The majority of human pathogens are zoonotic and many have their origins in wildlife. The cost of new infections to societies in terms of human mortality and morbidity can be enormous. Humans have contact with vastly more infectious agents of wildlife origin than spillover and emerge in human populations. Therefore, understanding and predicting zoonotic infection emergence is complex. Changes in the ecology of the host(s), the infection or both, are thought to drive the infection emergence in a range of different host-infection systems. Here key recent studies regarding how changes in host ecology, receptor use and infection adaptation relate to spillover and emergence from wildlife reservoirs are reviewed. The challenges wildlife zoonoses pose to epidemiologists are also discussed, along with how developments in technology, such as PCR, have changed perspectives relating to wildlife as hosts of zoonotic infections.

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  • Failure to ventilate with supraglottic airways after drowning

    Baker, Paul; Webber, Jonathon (2011-07)

    Journal article
    The University of Auckland Library

    We report the failure of an i-gel and an Ambu AuraOnce supraglottic airway to ventilate a drowning victim. Failure was attributed to changes in lung physiology following submersion and inhalation of water that may have required ventilation pressures up to 40 cmH2O to treat the victim's hypoxaemia. The ease of use and rapid insertion of supraglottic airways without interrupting cardiac compression has prompted recommendations for their use during resuscitation. The relatively low leak pressures attainable from many supraglottic airways, however may cause inadequate lung ventilation and entrainment of air into the stomach when these devices are used in drowning victims.

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  • The influence of a new signal offset optimiser on travel reliability and drivers' route choices (INSTInCt)

    Bezuidenhout, U; Ranjitkar, Prakash; Wang, J (2011-09)

    Journal article
    The University of Auckland Library

    This PhD study sets out to develop a new algorithm that will better estimate and adjust offset plans in an adaptive signal controller such as SCATS (Sydney Coordinated Adaptive Traffic System) and other proprietary UTMC software. Furthermore, the effect of this new optimiser will be studied in the context of its effect on route travel reliability and its influence on drivers' route choices during congested and non- congested periods. The study will investigate in detail how drivers' process and act on the visual cues when approaching signalised intersections, and how they apply this visual information to unplanned short-term decisions that result in lane changes, and ultimately route changes at the next intersection due to observing queue and/or traffic signal light changes or states. Anecdotal and empirical evidence support that drivers sometimes make these snap decisions on route choices on approach to a signal, contrary to following their habitual or pre-planned path. Gross route choices are significantly influenced by drivers' network familiarity and experience. This study hypothesis is set to determine optimising techniques that have a significant effect in manipulating driver behaviour using signal states and other visual cues. The study will utilise both simulated and live traffic conditions to study the effects.

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  • Designing for the sun

    Goodwin, David (2011-03)

    Journal article
    University of Otago

    Non Peer Reviewed

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  • Splitting the atom of communal land tenure, with specific reference to Māori freehold land.

    Goodwin, David (2011)

    Journal article
    University of Otago

    This article begins by contextualizing Māori Freehold Land (MFL) within a wider global debate on communal land that is in transition to more individualised forms of tenure. A comparison is made between Ngai Tahu MFL and another case of transitional communal land, in Zimbabwe. One conclusion is that, for many Ngai Tahu Māori, general land and the State now cater for shelter, sustenance and other functions formerly supported by MFL, while remaining MFL now handles disproportionately more of the cultural functions and interpersonal ties that are generally divorced from “western” tenure forms. This raises the question of whether MFL should now be managed with an emphasis on fulfilling those functions not met by formal, individualised tenure, and if so, how this should best be achieved in practice.

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  • Blood flow redistribution and ventilation-perfusion mismatch during embolic pulmonary arterial occlusion

    Burrowes, Kelly; Clark, Alys; Tawhai, Merryn (2011)

    Journal article
    The University of Auckland Library

    Acute pulmonary embolism causes redistribution of blood in the lung, which impairs ventilation/perfusion matching and gas exchange and can elevate pulmonary arterial pressure (PAP) by increasing pulmonary vascular resistance (PVR). An anatomically-based multi-scale model of the human pulmonary circulation was used to simulate pre- and post-occlusion flow, to study blood flow redistribution in the presence of an embolus, and to evaluate whether reduction in perfused vascular bed is sufficient to increase PAP to hypertensive levels, or whether other vasoconstrictive mechanisms are necessary. A model of oxygen transfer from air to blood was included to assess the impact of vascular occlusion on oxygen exchange. Emboli of 5, 7, and 10 mm radius were introduced to occlude increasing proportions of the vasculature. Blood flow redistribution was calculated after arterial occlusion, giving predictions of PAP, PVR, flow redistribution, and micro-circulatory flow dynamics. Because of the large flow reserve capacity (via both capillary recruitment and distension), approximately 55% of the vasculature was occluded before PAP reached clinically significant levels indicative of hypertension. In contrast, model predictions showed that even relatively low levels of occlusion could cause localized oxygen deficit. Flow preferentially redistributed to gravitationally non-dependent regions regardless of occlusion location, due to the greater potential for capillary recruitment in this region. Red blood cell transit times decreased below the minimum time for oxygen saturation (<0.25 s) and capillary pressures became high enough to initiate cell damage (which may result in edema) only after ~80% of the lung was occluded.

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  • Relocation Cases - the rhetoric and the reality of a child's best interests - a view from the bottom of the world

    Henaghan, Mark (2011)

    Journal article
    University of Otago

    Relocation cases have become a very significant aspect of family law. This article examines the difficulties in deciding (and predicting the outcomes of) national and international relocation cases. This article questions the usefulness of using checklists of non-prioritised, non-exhaustive factors to decide relocation cases based on the uncertainty such general checklists create for litigants and their children. This inevitably leads to increased litigation and appeals until the litigant finds a judge who will see the facts the litigant’s way. The article seeks to find a more principled way to decide relocation cases that would enable litigants to be given a realistic assessment of their likelihood of success at the outset. The article examines social science research for potential answers, but finds that there is no clear social science basis to support a policy either for or against relocation. The article discusses different theoretical frameworks, and argues that power between parents in relation to relocation should be allocated on the basis of actual responsibility for children. The article ultimately concludes by suggesting a prioritised ‘discipline’ for the values that need to be considered in relocation disputes. This discipline attempts to provide a visible framework for litigants, lawyers and judges to follow, which is designed to enhance consistency and predictability in decision making, and to give real meaning to the welfare principle.

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  • Patient Perspectives About Follow-Up Care and Weight Regain Following Sleeve Gastrectomy

    Lauti, Melanie; Stevenson, S; Hill, Andrew; MacCormick, Andrew (2011-11)

    Journal article
    The University of Auckland Library

    Weight regain following sleeve gastrectomy is an increasingly recognised and important problem. Similar to other centres, we have noticed an association between the onset of weight regain and discharge from the bariatric service. We aimed to elucidate this further from the patient perspective.Patients at least 2 years from sleeve gastrectomy, who had experienced weight regain, were invited to participate in a focus group discussion. Participants were asked to complete a demographic survey and discussions were audio-recorded. Transcripts underwent content analysis using an inductive approach.Thirty-eight participants participated in one of seven focus group discussions. The majority of participants were female, European and satisfied with the surgery and follow-up care. Participants described positive and negative aspects of the surgery, their follow-up care and causes of weight regain. Important emergent themes included the desire for more support, that is delivered within the overarching principles of providing individualised, specialised care by providers that maintain good rapport and assist in maintaining motivation. Furthermore, this follow-up support may be delivered in non-traditional ways rather than conventional face-to-face consultations.Explorative focus group discussions in a group of patients who had regained weight following sleeve gastrectomy revealed a desire for more support after discharge from the bariatric service.

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  • Aesthetics and astronomy: Studying the public's perception and understanding of imagery from space

    Smith, Lisa F; Smith, Jeffrey K; Arcand, Kimberly K; Smith, Randall K; Bookbinder, Jay; Keach, Kelly (2011)

    Journal article
    University of Otago

    NOTE: This manuscript was preprinted in Online First at http://scx.sagepub.com/content/early/recent and in Instrumentation and Methods for Astrophysics at http://arxiv.org/abs/1009.0772

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  • Are twins growth restricted?

    Muhlhausler, BS; Hancock, SN; Bloomfield, Francis; Harding, R (2011-08)

    Journal article
    The University of Auckland Library

    It is now well established that IUGR is associated with an increased risk of a range of adult onset diseases, including cardiovascular disease, obesity, and type 2 diabetes. Infants from twin pregnancies are generally born smaller than singletons; therefore, it has been suggested that twins represent a naturally occurring model of IUGR. Although twin gestations contribute significantly to the population burden of preterm birth and small size at birth, whether twins have the same long-term health consequences as IUGR singletons remains unclear. The purpose of this review is to consider what is currently known about the clinical implications of twinning, the differences that exist between the growth and developmental profiles of singleton and twin fetuses, and to use this as a basis for exploring the question of whether fetuses conceived as twins are analogous to IUGR singletons of similar birthweight and gestation. This question is increasingly important in both the clinical and research settings, because the incidence of twinning is increasing and the long-term implications of reduced size at birth are mostly investigated in species which bear multiple offspring.

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  • Does more protein in the first week of life change outcomes for very low birthweight babies?

    Cormack, Barbara; Bloomfield, Francis; Dezoete, A; Kuschel CA (2011-12)

    Journal article
    The University of Auckland Library

    Background: Following publication of revised recommended nutrient intakes (RNI) for infants < 0.001) but more protein (3.2 ± 0.6 vs. 2.4 ± 0.5 g/kg/day, P < 0.001) in the first week of life. There were no differences in clinical outcome, growth z-scores at 4 weeks of age or neurodevelopmental outcome at 18 months CA between the ‘before’ and ‘after’ infants. Enteral protein intake in the first 2 weeks of life was positively associated with neurodevelopmental outcome (cognitive score r2= 0.13 P= 0.03, motor score r2= 0.27 P= 0.001). Conclusion: Although the new IVN regimen achieved intakes closer to RNI, there were no major effects on growth, clinical outcome or neurodevelopmental outcome at 18 months CA. Enteral protein intake in the first two weeks was positively associated with neurodevelopmental outcome, suggesting early enteral protein intake is important for optimal brain function.

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