23,577 results for The University of Auckland Library

  • Evaluation of utilisation of the Prevention of Mother-to-Child Transmission of HIV Programme in Central province, Kenya

    Ngugi, Catherine Njeri (2013)

    Masters thesis
    The University of Auckland Library

    Background: The PMTCT HIV programme has been one of the most successful HIV preventive interventions towards HIV-free future generations. However, even though the programme is virtually effective in developed countries, many developing countries are reporting child HIV infections due to the MTCT. The programme has existed in Kenya for more than a decade, yet in 2011, 12,894children were HIV infected due to MTCT Objective: To evaluate the PMTCT programme, especially the HIV testing from the antenatal period to the postnatal period among expectant parents attending Nyeri Provincial General Hospital in Central Province, Kenya. Design: Retrospective analysis of the hospital registers. Methods: Three hospital registers were analysed for the period from July 2009 to September 2012. The registers were for antenatal, intrapartum and postnatal care respectively. Each register documented the utilisation of PMTCT services by the expectant parents. Descriptive and inferential statistics were produced to analyse data from the registers. Results: The PMTCT services utilisation was sub-optimal. Of the 504 expectant mothers who attended the antenatal clinic, 59.9% came once, 80.4% had their first visit in the third trimester (between weeks 28 and 40) and only 6.9% were accompanied by their partners. All the women were HIV tested in their first visit but only 12.1% were rescreened after three months, and only 3.8% had been tested prior to the current pregnancy (p=0.000). No expectant mother was tested for HIV intrapartum or postpartum. The children of the 504 mothers who were HIV tested were those whose parent/s were known to be HIV positive or who had presented to a child welfare clinic with recurring symptoms suggestive of a failing immune system. Conclusion: Public health programs need to strengthen the PMTCT and HIV prevention programmes to ensure that HIV testing preconception and in pregnancy is fully implemented and strengthened, alongside continued education of the public through community programmes and the media. To avert further horizontal and vertical transmission of HIV, there is a need to address urgently the identified missed opportunities in the PMTCT program. These programmatic challenges require health system redesign and strengthening, resource allocation, addressing research gaps and reassessing the current PMTCT policies.

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  • Suicide Pavilions

    Esling, S; Chon, C (2013-12-05)

    Creative work
    The University of Auckland Library

    Artworks ‘Suicide Pavilions’ is a collaborative exhibition of new work between Auckland-based artists Simon Esling and Clara Chon comprising works on paper, a photograph, printed suicide notes and objects. The suicide pavilions themselves are delicate watercolour, ink, and pencil works on paper depicting contemplative spaces for those who harbour the thought of suicide. Central to these pieces is the idea spoken by the protagonist, Harry, in Herman Hesse’s 'Steppenwolf', ‘that to call suicides only those who actually destroy themselves is false’. Instead, it is the tension within the deliberation of suicide - the avoidance of suicide while holding the thought of it - that Esling and Chon have chosen to explore. The architectural atmosphere of Esling’s imagined illustrations plays on the contrasting aspects of the interior and exterior, and their accompanying structural connotations: lightness, darkness - the flow from one place to another (from one state of mind to the next), as well as their ability to elicit a general ambience or mood. In the drawings and suicide notes (which are both real and imagined) Esling captures those fleeting moments of relief, and inevitably, of falling shadow. The selected sculptural objects suggest something more visceral - they become the tangible points for the physical expression of the psychological friction of the suicide. With its requisite holes and straps, Chon’s crafted leather harness speaks to both the freedom and restraint inherent in the mind of the suicide, where a simultaneous desire exists to be freed from one world, yet remain in it. - Jamie Hanton, Director

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  • GPE Analogues and Peptidomimetics

    Abood, NA; Brimble, MA (2003)

    Patent
    The University of Auckland Library

    This invention relates to analogs and peptidomimetics of glycyl-L-prolyl-L-glutamic acid (GPE). In particular, this invention relates to GPE analogs and peptidomimetics that are anti-apoptotic and anti-necrotic, to methods of making them, to pharmaceutical compositions containing them, and to their use.

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  • Neuroprotective Bicyclic Compounds and Methods for their Use

    Brimble, MA; Sieg, F; Guan, J (2007)

    Patent
    The University of Auckland Library

    Embodiments of this invention provide novel cyclic compounds structurally related to diketopiperazines and methods for their therapeutic use. Such compounds are neuroprotective and have utility as therapeutic agents for treatment of diseases, injuries and other conditions characterised by neuronal degeneration and/or death. Compounds are also useful for manufacture of medicaments useful for treatment of such conditions.

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  • Indigenous Peoples’ Health Care: New Approaches to Contracting and Accountability at The Public Administration Frontier

    Dwyer, Judith,; Boulton, A; Lavoie, J; Tenbensel, TG; Cumming, J (2013)

    Journal article
    The University of Auckland Library

    This article analyses reforms to contracting and accountability for indigenous primary health care organizations in Canada, New Zealand, and Australia. The reforms are presented as comparative case studies, the common reform features identified and their implications analysed. The reforms share important characteristics. Each proceeds from implicit recognition that indigenous organizations are ‘co-principals’ rather than simply agents in their relationship with government funders and regulators. There is a common tendency towards more relational forms of contracting; and tentative attempts to reconceptualize accountability. These ‘frontier’ cases have broad implications for social service contracting.

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  • Why do children hospitalised with pneumonia not receive antibiotics in primary care?

    Grant, Cameron; Harnden, A; Mant, D; Emery, D; Coster, G (2012-01)

    Journal article
    The University of Auckland Library

    Background: Although antibiotics are recommended for the primary care management of community-acquired pneumonia, a recent UK study reported that most children admitted to hospital had not received antibiotics. Objective: To describe primary care antibiotic use for children subsequently hospitalised with community-acquired pneumonia. Design/methods: A case series of 280 children 15×109/l (RR=2.29; 95% CI 1.61 to 2.98) and bacteraemia (RR=6.68, 95% CI 1.08 to 58.44). Conclusions: Young children with community-acquired pneumonia may not receive an antibiotic before hospital admission because the illness evolves rapidly or the prescribed medicine is not given by parents. However, missed opportunities for appropriate antibiotic prescribing by health professionals in primary care appear to be common.

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  • Proper analytic free maps

    Helton, JW; Klep, Igor; McCullough, S (2011)

    Journal article
    The University of Auckland Library

    This paper concerns analytic free maps. These maps are free analogs of classical analytic functions in several complex variables, and are defined in terms of non-commuting variables amongst which there are no relations – they are free variables. Analytic free maps include vector-valued polynomials in free (non-commuting) variables and form a canonical class of mappings from one non-commutative domain ....

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  • Community Responsibility for Freedom from Abuse: The View from 2011.

    Martin, B; Hand, Jennifer (2011)

    Journal article
    The University of Auckland Library

    This five year update identifies positive changes, areas of ongoing development and a broadening of the scope of attention.While violence persists against women and children there have been some positive changes, for example, community responsibility for addressing gender-based violence is more evident, prompted by perhaps the fact more resources have been afforded to the issue, and a shift in responsibility from the victim to the perpetrator. The voices of men are more prominent. We have also seen the issue placed within a wider context where attention is now paid to neglect and abuse within families, with special consideration being paid to children. This focus on children brings to the fore the issue of family and child poverty.

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  • Change management and the sustainability of health ICT projects.

    Day, Karen; Norris, T (2007)

    Journal article
    The University of Auckland Library

    The development of the electronic health record (EHR) is a strategic and important enabler of the delivery of integrated healthcare. As each innovative aspect of the EHR is implemented in New Zealand, long-term success is essential for its overall sustainability on the national scale. How we achieve this success is dependent upon how people adapt to the changes brought about by the implementation of these innovations. The transition period of the change process we follow during this adaptation is characterized by a capability crisis, in which we tend to predict failure in our attempts to make the changes to which we are committed. This could be a signal of the first step toward sustainable change as people adapt to changed processes, technology and relationships. Once we have mastered the incremental changes brought about by health ICT projects for the implementation of the EHR, we are able to connect health services by means of the same EHR and provide enabled, sustainable integrated healthcare.

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  • Phylogenetic Diversity within Seconds

    Minh, BQ; Klaere, Steffen; von Haeseler, A (2006)

    Journal article
    The University of Auckland Library

    We consider a (phylogenetic) tree with n labeled leaves, the taxa, and a length for each branch in the tree. For any subset of k taxa, the phylogenetic diversity is defined as the sum of the branch-lengths of the minimal subtree connecting the taxa in the subset. We introduce two time-efficient algorithms (greedy and pruning) to compute a subset of size k with maximal phylogenetic diversity in O(n log k) and O[n + (n-k) log (n-k)] time, respectively. The greedy algorithm is an efficient implementation of the so-called greedy strategy (Steel, 2005; Pardi and Goldman, 2005), whereas the pruning algorithm provides an alternative description of the same problem. Both algorithms compute within seconds a subtree with maximal phylogenetic diversity for trees with 100,000 taxa or more.

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  • Three Hierarchies of Simple Games Parameterized by "Resource" Parameters

    Gvozdeva, T; Hemaspaandra, L; Slinko, Arkadii (2011-11-23)

    Journal article
    The University of Auckland Library

    This paper contributes to the program of numerical characterization and classification of simple games outlined in the classic monograph of von Neumann and Morgenstern. We suggest three possible ways to classify simple games beyond the classes of weighted and roughly weighted games. To this end we introduce three hierarchies of games and prove some relationships between their classes. We prove that our hierarchies are true (i.e., infinite) hierarchies. In particular, they are strict in the sense that more of the key “resource” (which may, for example, be the size or structure of the “tie-breaking” region where the weights of the different coalitions are considered so close that we are allowed to specify either winningness or nonwinningness of the coalition) yields the flexibility to capture strictly more games.

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  • Initial clinical experience with a sac-anchoring endoprothesis for aortic aneurysm repair

    Holden, Andrew; Donayre, C; Zarins, C; Krievins, D; Hill, A; Calderas, C; Velez, J; White, R (2011)

    Journal article
    The University of Auckland Library

    The objective of this report is to review the author's initial clinical experience with screening a population of patients with abdominal aortic aneurysm, to describe the selection criteria for endovascular repair and to report results from a single institution. The technique of transfemoral repair of abdominal aortic aneurysm uses the endovascular graft system that is currently in a Food and Drugs Administration approved protocol for investigation in the United States. Some 69 patients with abdominal aortic aneurysm were screened in order to find ten suitable candidates. Ten implantations were carried out, of which eight were successful and two required conversion to conventional open aneurysm repair without complication. There were no deaths or complications. It is concluded that tube graft repair by the transfemoral route is feasible and applicable to approximately one patient in seven. The availability of a bifurcated graft will enhance the percentage of aneurysm patients treatable by this technique. Long-term results, at this time, are unknown.

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  • Preptin, another peptide product of the pancreatic beta-cell, is osteogenic in vitro and in vivo

    Cornish, Jillian; Callon, Karen; Bava, Urwashi; Watson, M; Xu, X; Lin, JM; Chan, V; Grey, Andrew; Naot, Dorit; Buchanan, Christina; Cooper, Garth; Reid, Ian (2005)

    Journal article
    The University of Auckland Library

    Preptin, another peptide product of the pancreatic -cell, is osteogenic in vitro and in vivo. Am J Physiol Endocrinol Metab 292: E117–E122, 2007. First published August 15, 2006; doi:10.1152/ajpendo.00642.2005.—Several hormones that regulate nutritional status also impact on bone metabolism. Preptin is a recently isolated 34-amino acid peptide hormone that is cosecreted with insulin and amylin from the pancreatic -cells. Preptin corresponds to Asp 69 -Leu 102 of pro-IGF-II. Increased circulating levels of a pro-IGF-II peptide complexed with IGF-binding protein-2 have been implicated in the high bone mass phenotype observed in patients with chronic hepatitis C infection. We have assessed preptin’s activities on bone. Preptin dose-dependently stimulated the proliferation (cell number and DNA synthesis) of primary fetal rat osteoblasts and osteoblast-like cell lines at periphysiological concentrations ( 10 11 M). In addition, thymidine incorporation was stimulated in murine neonatal calvarial organ culture, likely reflecting the proliferation of cells from the osteoblast lineage. Preptin did not affect bone resorption in this model. Preptin induced phosphorylation of p42/p44 MAP kinases in osteoblastic cells in a dose-dependent manner (10 8 -10 10 M), and its proliferative effects on primary osteoblasts were blocked by MAP kinase kinase inhibitors. Preptin also reduced osteoblast apoptosis induced by serum deprivation, reducing the number of apoptotic cells by 20%. In vivo administration of preptin increased bone area and mineralizing surface in adult mice. These data demonstrate that preptin, which is cosecreted from the pancreatic -cell with amylin and insulin, is anabolic to bone and may contribute to the preservation of bone mass observed in hyperinsulinemic states such as obesity

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  • Combining embolic protection and the "No Touch" technique

    Holden, Andrew (2009)

    Journal article
    The University of Auckland Library

    Aprocedure-related deterioration in renal function after renal artery stent revascularization occurs at an incidence of 10% to 20% in many reported series. 1,2 Many authors have postulated that atheromatous embolization is a major cause of this acute decline in renal function. Techniques to minimize the incidence and impact of atheromatous embolization during renal artery revascularization have received increased attention and include the use of embolic protection devices and the “no-touch” technique. In this article, the feasibility of combining these two techniques will be demonstrated and the potential benefits discussed.

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  • Working bilingually with language disordered children: what is the evidence?

    Hand, Linda (2011)

    Journal article
    The University of Auckland Library

    Speech pathology has been facing the challenge of working with clients and families from multilingual and multicultural contexts for some time now. However, it is an area in which professionals continue to feel a lack of sufficient knowledge or skills, and where there seems to be little consensus. This edition of What’s the evidence draws on codes of ethics documents and human rights principles to suggest that speech pathologists could take a more advanced view of practices with bilingual clients. It then discusses how the current evidence base may be used to support the arguments for bilingual support and intervention for language disordered populations.

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  • Imaginative Motivation

    Kroon, Frederick (2009)

    Journal article
    The University of Auckland Library

    This article argues for a certain picture of the rational formation of conditional intentions, in particular deterrent intentions, that stands in sharp contrast to accounts on which rational agents are often not able to form such intentions because of what these enjoin should their conditions be realized. By considering the case of worthwhile but hard-to-form ‘non-apocalyptic’ deterrent intentions (the threat to leave a cheating partner, say), the article argues that rational agents may be able to form such intentions by first simulating psychological states in which they have successfully formed them and then bootstrapping themselves into actually forming them. The article also discusses certain limits imposed by this model. In particular, given the special nature of ‘apocalyptic’ deterrent intentions (e.g. the ones supposedly involved in nuclear deterrence), there is good reason to think that these must remain inaccessible to fully rational and moral agents.

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  • Using simple learning objects to enhance early skills learning

    Wearn, Andrew; Bhoopatkar, Harsh (2008)

    Journal article
    The University of Auckland Library

    Clinical skills centres commonly employ a mixture of peer physical examination, live simulated patients, real patients and training models/aids to facilitate clinical skills learning. A wide array of training models are now commercially available, ranging from part-task trainers to high fidelity manikins. However, they are relatively expensive and models to demonstrate or complement a specific skill may not exist. In particular, medium-high fidelity simulators may not be used to their full potential at the basic skills level and the cost-benefit ratio has to be considered. We suggest that there is an alternative solution in some cases: centre staff can create simple cheap learning objects to illustrate some of the context, findings, or application of basic examination skills. Unfortunately, very few of these locally derived learning objects are shared more widely in the literature. One of the reasons for lack of dissemination may be problems in designing meaningful evaluation strategies for these objects. This paper describes the development and deployment of four learning objects introduced into early clinical skills learning within the medical programme at The University of Auckland: (1) percussion tubs to illustrate different percussion notes, (2) hen’s eggs for demonstrating transillumination, (3) an intravenous fluid set to illustrate principles of jugular venous pressure, and (4) socks with objects inside to help develop descriptive skills for palpation. Formal evaluation of the objects has not been carried out. However, informal feedback from students was positive. Through using the objects, students were able to gain insights, confidence and understanding. All of the objects offer immediate feedback to the students which they found rewarding. In conclusion, we feel that simple, cheap learning objects can play an important role in early skills learning. Although there are some barriers to formal evaluation, we hope to encourage other centres to share their innovations and evaluation strategies.

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  • Shrinking social space in the doctor-modern patient relationship: a review of forces for, and implications of, role convergence.

    Buetow, Stephen; Jutel, A; Hoare, Karen (2009)

    Journal article
    The University of Auckland Library

    Objective Forces for modernisation appear to have led to role convergence and reduced social distances between doctors and modern patients. This review aims to document and understand this process in theory and practice, and to consider the implications for modern patients in particular but also non-modern patients and doctors. Method Narrative review of published and grey literature identified from sources including electronic databases, the Internet and reference lists of retrieved works. Results Forces for role convergence between doctors and modern patients include consumerism and increased patient literacy; socio-technological changes; values convergence; increased licence for doctors to use their emotions in patient care; and structural changes in the social organisation of health care. As a result, modern patients appear to have gained more in health care than they have lost and more than have the non-modern (or less modern) patients. Doctors have lost authority and autonomy in patient care. Conclusion The net impulse toward role convergence is, on balance, a positive development. The differential uptake of modernisation by patients has increased health inequalities between modern and non-modern patients. The need of doctors to accommodate these changes has contributed to a form of reprofessonalisation. Practice implications A key challenge is to make available the benefits of modernisation, for example through patient education, to as many patients as possible while minimising the risk of harm. It is important therefore to elucidate and be responsive to patient preferences for modernisation, for example by enlisting the support of the modern patients in overcoming barriers to the modernisation of non-modern patients. There is also a need to support doctors as they redefine their own professional role identity.

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  • New gastropods from the Jurassic of Orville Coast, Ellsworth Land, Antarctica

    Hikuroa, Daniel; Kaim, A (2007)

    Journal article
    The University of Auckland Library

    The Latady Group (southern Antarctic Peninsula) hosts the most diverse assemblage of Jurassic molluscs from this continent. A new gastropod mollusc, Silberlingiella latadyensis sp. nov. and three forms assigned to Rissoidae, Pseudomelaniidae and Bullinidae from the Middle-Late Jurassic, Bathonian-Kimmeridgian Hauberg Mountains Formation, Ellsworth Land, Antarctic Peninsula are described herein. Silberlingiella is transferred to Eustomatidae and is the first confirmed record of this family in the Southern Hemisphere, indicating a much more widespread Jurassic distribution. The Triassic and Jurassic species of Silberlingiella are compared with the coeval European genus Diatinostoma. Eustomatidae is proposed as an ancestral group for Potamididae and Batillariidae. The composition of the gastropod association described herein differs markedly from the only other Antarctic Jurassic fauna from Alexander Island.

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  • Clinical Features and Pharmacological Treatment of Migraine Patients Referred to Headache Specialists in Canada

    Jelinski, SE; Becker, WJ; Christie, SM; Giammarco, R; Mackie, GF; Gawel, MJ; Eloff, AG; Magnusson, Jane (2006)

    Journal article
    The University of Auckland Library

    We set out to examine selected clinical characteristics of migraine patients referred to neurologists specializing in headache in Canada, and to document their pharmacological therapy both before and after consultation with the neurologist. Demographic, clinical and pharmacotherapy data were collected at the time of consultation for 606 patients referred to five headache clinics and who were given a migraine diagnosis by the neurologist. Data were analysed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project. The mean age of the migraine patients was 39.7 years; and 82.5% were female. The majority of patients suffered severe impact from their headaches. Prior to consultation, 48.7% were taking a triptan; after consultation, 97.2% were on a triptan. Before consultation, 30.9% were on a prophylactic drug; after consultation, 70.4% were. 20.8% of patients were medication overusers. Of these medication overusers, 42.4% were overusing an opiate, usually in combination with other analgesics; 21.6% were overusing a triptan. Medication changes made by the neurologists at consultation included a large increase in the use of both triptans and prophylactic medications. Medication overuse, particularly opiate overuse, remains a significant problem in patients with migraine in Canada.

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