22,237 results for Journal article

  • Bow-tie diagrams for risk management in anaesthesia

    Culwick, MD; Merry, Alan; Clarke, DM; Taraporewalla, KJ; Gibbs, NM (2016-11)

    Journal article
    The University of Auckland Library

    Bow-tie analysis is a risk analysis and management tool that has been readily adopted into routine practice in many high reliability industries such as engineering, aviation and emergency services. However, it has received little exposure so far in healthcare. Nevertheless, its simplicity, versatility, and pictorial display may have benefits for the analysis of a range of healthcare risks, including complex and multiple risks and their interactions. Bow-tie diagrams are a combination of a fault tree and an event tree, which when combined take the shape of a bow tie. Central to bow-tie methodology is the concept of an undesired or 'Top Event', which occurs if a hazard progresses past all prevention controls. Top Events may also occasionally occur idiosyncratically. Irrespective of the cause of a Top Event, mitigation and recovery controls may influence the outcome. Hence the relationship of hazard to outcome can be viewed in one diagram along with possible causal sequences or accident trajectories. Potential uses for bow-tie diagrams in anaesthesia risk management include improved understanding of anaesthesia hazards and risks, pre-emptive identification of absent or inadequate hazard controls, investigation of clinical incidents, teaching anaesthesia risk management, and demonstrating risk management strategies to third parties when required.

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  • Cellular degradation of 4-hydroxy-2-oxoglutarate aldolase leads to absolute deficiency in primary hyperoxaluria type 3

    MacDonald, JR; Huang, AD; Loomes, Kerry (2016-05)

    Journal article
    The University of Auckland Library

    Primary hyperoxaluria type-3 is characterized by increased oxalate production caused by mutations in the HOGA1 gene encoding 4-hydroxy-2-oxoglutarate aldolase (HOGA1). How the most commonly occurring mutations affect the cellular fates of the expressed HOGA1 mutants is still unknown. We show that two prevalent recombinant HOGA1 mutants are thermally unstable with evidence for chaperone-mediated degradation when expressed in E. coli. In stably transformed HEK-293 cells, protein expression of the Glu315 deletion mutant only becomes detectable during incubation with a 26S proteasome inhibitor. These findings suggest that failure of chaperone-assisted folding leads to targeted cellular degradation and an absolute absence of HOGA1 function.

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  • Fluorescence markers in some New Zealand honeys

    Bong, Nee; Loomes, Kerry; Schlothauer, RC; Stephens, JM (2016-02)

    Journal article
    The University of Auckland Library

    The fluorescence characteristics of various New Zealand honeys were investigated to establish if this technique might detect signatures unique to manuka (Leptospermum scoparium) and kanuka (Kunzea ericoides) honeys. We found unique fluorescence profiles for these honeys which distinguished them from other New Zealand honey floral types. Two excitation-emission (ex-em) marker wavelengths each for manuka and kanuka honeys were identified; manuka honey at 270-365 (MM1) and 330-470 (MM2) nm and kanuka honey at 275-305 (KM1) and 445-525 (KM2) nm. Dilution of manuka and kanuka honeys with other honey types that did not possess these fluorescence profiles resulted in a proportional reduction in fluorescence signal of the honeys at the marker wavelengths. By comparison, rewarewa (Knightia excelsa), kamahi (Weinmannia racemosa), and clover (Trifolium spp.) honeys did not exhibit unique fluorescence patterns. These findings suggests that a fluorescence-based screening approach has potential utility for determining the monoflorality status of manuka and kanuka honeys.

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  • The Intracranial Distribution of Gliomas in Relation to Exposure From Mobile Phones: Analyses From the INTERPHONE Study

    Grell, K; Frederiksen, K; Schüz, J; Cardis, E; Armstrong, B; Siemiatycki, J; Krewski, DR; McBride, ML; Johansen, C; Auvinen, A; Hours, M; Blettner, M; Sadetzki, S; Lagorio, S; Yamaguchi, N; Woodward, Alistair; Tynes, T; Feychting, M; Fleming, SJ; Swerdlow, AJ; Andersen, PK (2016-12-01)

    Journal article
    The University of Auckland Library

    When investigating the association between brain tumors and use of mobile telephones, accurate data on tumor position are essential, due to the highly localized absorption of energy in the human brain from the radio-frequency fields emitted. We used a point process model to investigate this association using information that included tumor localization data from the INTERPHONE Study (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the United Kingdom). Our main analysis included 792 regular mobile phone users diagnosed with a glioma between 2000 and 2004. Similar to earlier results, we found a statistically significant association between the intracranial distribution of gliomas and the self-reported location of the phone. When we accounted for the preferred side of the head not being exclusively used for all mobile phone calls, the results were similar. The association was independent of the cumulative call time and cumulative number of calls. However, our model used reported side of mobile phone use, which is potentially influenced by recall bias. The point process method provides an alternative to previously used epidemiologic research designs when one is including localization in the investigation of brain tumors and mobile phone use.

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  • Mitochondrial dysfunction in peripheral blood mononuclear cells in early experimental and clinical acute pancreatitis

    Chakraborty, Mandira; Hickey, Anthony; Petrov, MS; Macdonald, JR; Thompson, N; Newby, L; Sim, D; Windsor, John; Phillips, Anthony (2016-09)

    Journal article
    The University of Auckland Library

    Background/objectives Mitochondrial dysfunction occurs in vital organs in experimental acute pancreatitis (AP) and may play an important role in determining severity of AP. However, obtaining vital organ biopsies to measure mitochondrial function (MtF) in patients with AP poses considerable risk of harm. Being able to measure MtF from peripheral blood will bypass this problem. Furthermore, whether mitochondrial dysfunction is detectable in peripheral blood in mild AP is unknown. Therefore, the objective was to evaluate peripheral blood MtF in experimental and clinical AP. Method Mitochondrial respiration was measured using high resolution oxygraphy in an experimental study in caerulein induced AP and in a separate study, in patients with mild AP. Superoxide, cytochrome c, mitochondrial membrane potential (ΔΨ) and adenine triphosphate (ATP) were also measured as other markers of MtF. Results Even though some states of mitochondrial respiration were increased in both experimental and clinical AP, this did not lead to an increase in net ATP in patients with AP. The increased leak respiration in both studies was further proof of dyscoupled mitochondria. In the clinical study there were also features of mitochondrial dysfunction with increased leak flux control ratio, superoxide, ΔΨ and decreased cytochrome c. Conclusion There is evidence of mitochondrial dysfunction with dyscoupled mitochondria, increased superoxide and decreased cytochrome c in patients with mild acute pancreatitis. Further studies should now determine whether mitochondrial function alters with severity in AP and whether mitochondrial dysfunction responds to treatments.

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  • The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise

    Peake, JM; Roberts, LA; Figueiredo, VC; Egner, I; Krog, S; Aas, SN; Suzuki, K; Markworth, JF; Coombes, JS; Cameron-Smith, David; Raastad, T (2016-11)

    Journal article
    The University of Auckland Library

    KEY POINTS: Cold water immersion and active recovery are common post-exercise recovery treatments. A key assumption about the benefits of cold water immersion is that it reduces inflammation in skeletal muscle. However, no data are available from humans to support this notion. We compared the effects of cold water immersion and active recovery on inflammatory and cellular stress responses in skeletal muscle from exercise-trained men 2, 24 and 48 h during recovery after acute resistance exercise. Exercise led to the infiltration of inflammatory cells, with increased mRNA expression of pro-inflammatory cytokines and neurotrophins, and the subcellular translocation of heat shock proteins in muscle. These responses did not differ significantly between cold water immersion and active recovery. Our results suggest that cold water immersion is no more effective than active recovery for minimizing the inflammatory and stress responses in muscle after resistance exercise. ABSTRACT: Cold water immersion and active recovery are common post-exercise recovery treatments. However, little is known about whether these treatments influence inflammation and cellular stress in human skeletal muscle after exercise. We compared the effects of cold water immersion versus active recovery on inflammatory cells, pro-inflammatory cytokines, neurotrophins and heat shock proteins (HSPs) in skeletal muscle after intense resistance exercise. Nine active men performed unilateral lower-body resistance exercise on separate days, at least 1 week apart. On one day, they immersed their lower body in cold water (10°C) for 10 min after exercise. On the other day, they cycled at a low intensity for 10 min after exercise. Muscle biopsies were collected from the exercised leg before, 2, 24 and 48 h after exercise in both trials. Exercise increased intramuscular neutrophil and macrophage counts, MAC1 and CD163 mRNA expression (P < 0.05). Exercise also increased IL1β, TNF, IL6, CCL2, CCL4, CXCL2, IL8 and LIF mRNA expression (P < 0.05). As evidence of hyperalgesia, the expression of NGF and GDNF mRNA increased after exercise (P < 0.05). The cytosolic protein content of αB-crystallin and HSP70 decreased after exercise (P < 0.05). This response was accompanied by increases in the cytoskeletal protein content of αB-crystallin and the percentage of type II fibres stained for αB-crystallin. Changes in inflammatory cells, cytokines, neurotrophins and HSPs did not differ significantly between the recovery treatments. These findings indicate that cold water immersion is no more effective than active recovery for reducing inflammation or cellular stress in muscle after a bout of resistance exercise.

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  • Relationship between the exocrine and endocrine pancreas after acute pancreatitis.

    Das, SLM; Kennedy, JIC; Murphy, Rinki; Phillips, Anthony; Windsor, John; Petrov, Maxim (2014-12-07)

    Journal article
    The University of Auckland Library

    To determine the prevalence and time course of pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.Relevant literature cited in three major biomedical journal databases (EMBASE, MEDLINE, and Scopus) was reviewed independently by two authors. There were no language constraints but the search was limited to human studies. Studies included were cohort studies of adult patients who were discharged after an attack of acute pancreatitis. Patients were excluded if they were under 18 years of age or had a previous diagnosis of prediabetes or diabetes mellitus, pancreatic exocrine insufficiency, or chronic pancreatitis. The main outcome measure was the prevalence of concomitant pancreatic exocrine insufficiency in patients who were diagnosed with prediabetes and diabetes mellitus after an attack of acute pancreatitis. Subgroup analysis was conducted for patients who were diagnosed with prediabetes only and those who were diagnosed with diabetes mellitus only. Subgroup analysis looking at the time course of concomitant pancreatic exocrine and endocrine insufficiency was also conducted. Pooled prevalence and corresponding 95% confidence intervals were calculated for all outcome measures and P-values < 0.05 were deemed statistically significant.Eight clinical studies comprising of 234 patients met all eligibility criteria. The pooled prevalence of newly diagnosed prediabetes or diabetes in individuals after acute pancreatitis was 43% (95%CI: 30%-56%). The pooled prevalence of pancreatic exocrine insufficiency in individuals after acute pancreatitis was 29% (95%CI: 19%-39%). The prevalence of concomitant pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes was 40% (95%CI: 25%-55%). The prevalence of concomitant pancreatic exocrine insufficiency among individuals with prediabetes alone and diabetes mellitus alone was 41% (95%CI: 12%-75%) and 39% (95%CI: 28%-51%), respectively. Further analysis showed that the prevalence of concomitant pancreatic exocrine insufficiency in individuals with prediabetes or diabetes decreases over time after an attack of acute pancreatitis.Pancreatic exocrine insufficiency occurs in 40% of individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis. Further studies are needed to investigate the pathogenesis of diabetes in this setting.

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  • Phylogeography of Rattus norvegicus in the South Atlantic Ocean

    Hingston, Melanie; Poncet, S; Passfield, K; Tabak, MA; Gabriel, SI; Piertney, SB; Russell, James (2016-12-20)

    Journal article
    The University of Auckland Library

    Norway rats are a globally distributed invasive species, which have colonized many islands around the world, including in the South Atlantic Ocean. We investigated the phylogeography of Norway rats across the South Atlantic Ocean and bordering continental countries. We identified haplotypes from 517 bp of the hypervariable region I of the mitochondrial D-loop and constructed a Bayesian consensus tree and median-joining network incorporating all other publicly available haplotypes via an alignment of 364 bp. Three Norway rat haplotypes are present across the islands of the South Atlantic Ocean, including multiple haplotypes separated by geographic barriers within island groups. All three haplotypes have been previously recorded from European countries. Our results support the hypothesis of rapid Norway rat colonization of South Atlantic Ocean islands by sea-faring European nations from multiple European ports of origin. This seems to have been the predominant pathway for repeated Norway rat invasions of islands, even within the same archipelago, rather than within-island dispersal across geographic barriers.

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  • Enhancing suicide risk assessment: a novel visual metaphor learning tool

    Alyami, M; Alyami, H; Sundram, Frederick; Cheung, G; Haarhoff, BA; Lyndon, MP; Hill, Andrew (2016-12)

    Journal article
    The University of Auckland Library

    Suicide risk assessment is variably taught and learnt by health professionals. The literature indicates that training programs of this fundamental competency need to be enhanced. To facilitate teaching and learning of this core clinical skill, we propose a novel visual metaphor in order to conceptualize suicide risk factors. The design of the proposed visual metaphor was informed by the Cognitive Load Theory to enhance deep learning of the various suicide risk factors.The visual metaphor depicting suicide risk factors can potentially improve memory and recall. It activates prior knowledge and is based on educational theory informed design principles.

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  • The safety and efficacy of benzbromarone in gout in Aotearoa New Zealand

    Stamp, LK; Haslett, J; Frampton, C; White, Douglas; Gardner, D; Stebbings, S; Taylor, G; Grainger, R; Kumar, R; Kumar, S; Kain, T; Porter, D; Corkill, M; Cathro, A; Metcalfe, S; Wyeth, J; Dalbeth, Nicola (2016-09)

    Journal article
    The University of Auckland Library

    Benzbromarone is a potent uricosuric, but is not widely available due to concerns about hepatotoxicity. In Aotearoa New Zealand benzbromarone has been available since April 2013, subject to funding restrictions, for patients with inadequate urate-lowering response or intolerance to allopurinol and probenecid.The aim of this study was to assess the safety and efficacy of benzbromarone in a real-life setting.All patients who received funding for benzbromarone from 1/4/2013 to 30/9/2014 were identified. Prescribers were sent a questionnaire for each individual. Information on demographics, efficacy of previous urate-lowering drugs and reasons for discontinuation were collected. Specific information about the dose, effect on serum urate, adverse effects and liver function tests after commencing benzbromarone was recorded.Completed questionnaires were returned for 123/164 (75%) patients. Mean (SD) serum urate prior to benzbromarone was 0.57 (0.12) mmol/l and estimated glomerular filtration rate (eGFR) 50.3 (22.8) ml/min/1.73 m(2) . The median dose of benzbromarone was 100 mg/day (25-200 mg/day). Six months after commencing benzbromarone, mean (SD) serum urate was 0.35 (0.12) mmol/l. Benzbromarone related adverse events included rash (n = 4), diarrhoea (n = 9), nausea (n = 6), and urate stones (n = 3). Liver function tests abnormalities were uncommon and tended to be mild. There were 14 patient deaths; none were considered related to benzbromarone. Allopurinol had been prescribed prior to benzbromarone in 117/123 patients; median maximum allopurinol dose was 200 mg/day (range 25-600 mg/day), and 19% patients received allopurinol >300 mg/day.Benzbromarone provides useful urate-lowering efficacy and does not appear unsafe in patients with gout. Urate-lowering therapy prescribing requires further optimisation.

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  • Re-envisaging and reinvigorating school–university practicum partnerships

    Grudnoff, Alexandra; Haigh, Mavis; Mackisack, Vivienne (2017)

    Journal article
    The University of Auckland Library

    The study that provides the context for this article developed from a major overhaul of the practicum in an undergraduate initial teacher education degree in which practicum roles and relationships were re-envisaged. The aim was to reinvigorate university–school practicum relationships through the collaborative development of a practicum where teacher professional knowledge and university scholarly knowledge could come together in the service of student teacher learning. The article reports a qualitative study involving 72 participants from one university and four primary schools. Analysed through the lens of “third space” the findings indicated that relationship and role transformations undertaken by the participants, along with collaborative practice during the practicum, were key to reinvigorating the practicum. In the discussion, we examine the main factors that contributed to the development of a “third space” between the university and participating practicum schools, and also note some cautions related to this development.

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  • Big Data for Supply Chain Management in the Service and Manufacturing Sectors: Challenges, Opportunities, and Future Perspectives

    Zhong, Runyang; Newman, ST; Huang, GQ; Lan, S (2016-11)

    Journal article
    The University of Auckland Library

    Data from service and manufacturing sectors is increasing sharply and lifts up a growing enthusiasm for the notion of Big Data. This paper investigates representative Big Data applications from typical services like finance & economics, healthcare, Supply Chain Management (SCM), and manufacturing sector. Current technologies from key aspects of storage technology, data processing technology, data visualization technique, Big Data analytics, as well as models and algorithms are reviewed. This paper then provides a discussion from analyzing current movements on the Big Data for SCM in service and manufacturing world-wide including North America, Europe, and Asia Pacific region. Current challenges, opportunities, and future perspectives such as data collection methods, data transmission, data storage, processing technologies for Big Data, Big Data-enabled decision-making models, as well as Big Data interpretation and application are highlighted. Observations and insights from this paper could be referred by academia and practitioners when implementing Big Data analytics in the service and manufacturing sectors.

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  • Disorders of sex development: insights from targeted gene sequencing of a large international patient cohort

    Eggers, S; Sadedin, S; van den Bergen, JA; Robevska, G; Ohnesorg, T; Hewitt, J; Lambeth, L; Bouty, A; Knarston, IM; Tan, TY; Cameron, F; Werther, G; Hutson, J; O’Connell, M; Grover, SR; Heloury, Y; Zacharin, M; Bergman, P; Kimber, C; Brown, J; Webb, N; Hunter, MF; Srinivasan, S; Titmuss, A; Verge, CF; Mowat, D; Smith, G; Smith, J; Ewans, L; Shalhoub, C; Crock, P; Cowell, C; Leong, GM; Ono, M; Lafferty, AR; Huynh, T; Visser, U; Choong, CS; McKenzie, F; Pachter, N; Thompson, EM; Couper, J; Baxendale, A; Gecz, J; Wheeler, BJ; Jefferies, C; MacKenzie, K; Hofman, Paul; Carter, P; King, RI; Krausz, C; van Ravenswaaij-Arts, CMA; Looijenga, L; Drop, S; Riedl, S; Cools, M; Dawson, A; Juniarto, AZ; Khadilkar, V; Khadilkar, A; Bhatia, V; Dũng, VC; Atta, I; Raza, J; thi Diem Chi, N; Hao, TK; Harley, V; Koopman, P; Warne, G; Faradz, S; Oshlack, A; Ayers, KL; Sinclair, AH (2016-11-29)

    Journal article
    The University of Auckland Library

    Background Disorders of sex development (DSD) are congenital conditions in which chromosomal, gonadal, or phenotypic sex is atypical. Clinical management of DSD is often difficult and currently only 13% of patients receive an accurate clinical genetic diagnosis. To address this we have developed a massively parallel sequencing targeted DSD gene panel which allows us to sequence all 64 known diagnostic DSD genes and candidate genes simultaneously. Results We analyzed DNA from the largest reported international cohort of patients with DSD (278 patients with 46,XY DSD and 48 with 46,XX DSD). Our targeted gene panel compares favorably with other sequencing platforms. We found a total of 28 diagnostic genes that are implicated in DSD, highlighting the genetic spectrum of this disorder. Sequencing revealed 93 previously unreported DSD gene variants. Overall, we identified a likely genetic diagnosis in 43% of patients with 46,XY DSD. In patients with 46,XY disorders of androgen synthesis and action the genetic diagnosis rate reached 60%. Surprisingly, little difference in diagnostic rate was observed between singletons and trios. In many cases our findings are informative as to the likely cause of the DSD, which will facilitate clinical management. Conclusions Our massively parallel sequencing targeted DSD gene panel represents an economical means of improving the genetic diagnostic capability for patients affected by DSD. Implementation of this panel in a large cohort of patients has expanded our understanding of the underlying genetic etiology of DSD. The inclusion of research candidate genes also provides an invaluable resource for future identification of novel genes.

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  • Modular Modelling with Physiome Standards

    Cooling, Michael; Nickerson, David; Nielsen, Poul; Hunter, Peter (2016-12-01)

    Journal article
    The University of Auckland Library

    The ability to produce and customise complex computational models has great potential to have a positive impact on human health. As the field develops towards whole-cell models and linking such models in multi-scale frameworks to encompass tissue, organ, or organism levels, reuse of previous modelling efforts will become increasingly necessary. Any modelling group wishing to reuse existing computational models as modules for their own work faces many challenges in the context of construction, storage, retrieval, documentation and analysis of such modules. Physiome standards, frameworks and tools seek to address several of these challenges, especially for models expressed in the modular protocol CellML. Aside from providing a general ability to produce modules, there has been relatively little research work on architectural principles of CellML models that will enable reuse at larger scales. To complement and support the existing tools and frameworks, we develop a set of principles to address this consideration. The principles are illustrated with examples that couple electrophysiology, signalling, metabolism, gene regulation and synthetic biology, together forming an architectural prototype for whole-cell modelling (including human intervention) in CellML. Such models illustrate how testable units of quantitative biophysical simulation can be constructed. Finally, future relationships between modular models so constructed and Physiome frameworks and tools are discussed, with particular reference to how such frameworks and tools can in turn be extended to complement and gain more benefit from the results of applying the principles.

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  • Adding value to first-year undergraduate marketing education: team-based learning as a strategic response to changing modern educational environments

    Carrie, DG; Mulla, Parizad; Patterson, A; Kilkolly-Proffit, Michelle; Brookes, R; Sima, H; Agee, T (2017)

    Journal article
    The University of Auckland Library

    This paper explains the University of Auckland Business School’s strategic response to a rapidly changing global educational environment through the redevelopment of its first-year core undergraduate curricula experience. Central to this was the decision to adopt team-based learning (TBL) as a key component in the design and delivery of a new approach. Not simply adding value to marketing education, the delivery of its first-year academic content is from a highly interdisciplinary perspective, thereby substantially differentiating it from traditional ‘Marketing 101’. This adoption of TBL emphasizes a strategic focus on achieving three key objectives: to take an integrated and interdisciplinary approach to the first-year undergraduate business experience; to embed a strong focus on the development of students’ academic and professional skills; and to place a strong focus on supporting the first-year transition. The paper details the implementation of this strategy and its subsequent and ongoing continuous improvement processes. It contributes to the literature on TBL by demonstrating the strategic benefits and challenges of a large-scale implementation, and the successful integration of content, graduate capabilities and transitional goals.

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  • The effect of the Shorter Stays in Emergency Departments health target on the quality of ED discharge summaries

    Harper, A; Jones, P; Wimsett, J; Stewart, Joanna; Le Fevre, James; Wells, Linda; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi (2016-12)

    Journal article
    The University of Auckland Library

    Time targets for ED stays are used as a policy instrument to reduce ED crowding. There is debate whether such policies are helpful or harmful, as focus on a process target may divert attention from clinical care. The objective of this study is to investigate whether the Shorter Stays in Emergency Departments target in New Zealand was associated with a change in the quality of ED discharge information provided to primary care providers.The quality of discharge summaries was assessed retrospectively over time using chart review. Logistic regression was used to account for secular trends with adequate or not as the dependent variable. Explanatory variables were: age, ethnicity, deprivation, triage category, year, the step at target introduction (2009) and the change in slope before and after the target.Of 500 randomly selected discharge summaries, 491 (98.2%) were included in the analysis. There was evidence of a decrease over time in the proportion of adequate discharge summaries before the introduction of the target (slope estimate (SE) -0.43 (0.20), p=0.02). A step at the target introduction could not be shown (p=0.47). There was evidence of an improvement over time from pre-target to post-target: slope afterwards 0.33, estimate of change in slope (SE) 0.76 (0.27), p=0.006.There was no reduction in the quality of discharge summaries following the introduction of the shorter stays in ED target and trends in quality improved. These findings deserve replication in other hospitals which may experience different challenges.

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  • Necessary but not yet sufficient: a survey of aged residential care staff perceptions of palliative care communication, education and delivery

    Frey, Rosemary; Boyd, Michal; Foster, Susan; Robinson, Jacqualine; Gott, Caryl (2016-12)

    Journal article
    The University of Auckland Library

    Previous research has indicated that staff in aged residential care (ARC) may be unprepared for their role in palliative care provision. The need for palliative care knowledge among ARC staff has been characterised as 'pervasive'. Determining the palliative care education, communication and support needs of ARC clinical care staff is, therefore, of critical importance to the delivery of quality healthcare in this setting.A survey of clinical staff (n=431) in 52 ARC facilities in 1 urban district health board was conducted, using a paper-based questionnaire. Instruments included the 3-item Experiences with End of Life scale, developed measures of communication and support (13 items), support accessibility (12 items), and palliative care education (19 items).Only 199 (46.2%) of staff participants reported undertaking palliative care education. Nurses were more likely to have engaged in palliative care education in comparison with healthcare assistants (HCAs) (χ(2)(1, N=387)=18.10, p=0.00). Participants (n=347) who wanted further education preferred an interactive, hands-on applied education (13.9%) in comparison to short topic-specific sessions/seminars (6.5%) or lecture-based courses (7.7%).The study reveals an ongoing need for staff palliative care education. Results suggest the development of an integrated model of care which draws on both hospice and ARC staff expertise.

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  • Contrasting changes in the abundance and diversity of North American bird assemblages from 1971 to 2010

    Schipper, AM; Belmaker, J; de Miranda, MD; Navarro, LM; Böhning-Gaese, K; Costello, Mark; Dornelas, M; Foppen, R; Hortal, J; Huijbregts, MAJ; Martín-López, B; Pettorelli, N; Queiroz, C; Rossberg, AG; Santini, L; Schiffers, K; Steinmann, ZJN; Visconti, P; Rondinini, C; Pereira, HM (2016-12)

    Journal article
    The University of Auckland Library

    Although it is generally recognized that global biodiversity is declining, few studies have examined long-term changes in multiple biodiversity dimensions simultaneously. In this study, we quantified and compared temporal changes in the abundance, taxonomic diversity, functional diversity, and phylogenetic diversity of bird assemblages, using roadside monitoring data of the North American Breeding Bird Survey from 1971 to 2010. We calculated 12 abundance and diversity metrics based on 5-year average abundances of 519 species for each of 768 monitoring routes. We did this for all bird species together as well as for four subgroups based on breeding habitat affinity (grassland, woodland, wetland, and shrubland breeders). The majority of the biodiversity metrics increased or remained constant over the study period, whereas the overall abundance of birds showed a pronounced decrease, primarily driven by declines of the most abundant species. These results highlight how stable or even increasing metrics of taxonomic, functional, or phylogenetic diversity may occur in parallel with substantial losses of individuals. We further found that patterns of change differed among the species subgroups, with both abundance and diversity increasing for woodland birds and decreasing for grassland breeders. The contrasting changes between abundance and diversity and among the breeding habitat groups underscore the relevance of a multifaceted approach to measuring biodiversity change. Our findings further stress the importance of monitoring the overall abundance of individuals in addition to metrics of taxonomic, functional, or phylogenetic diversity, thus confirming the importance of population abundance as an essential biodiversity variable.

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  • Reduced bone density and cortical bone indices in female adiponectin-knockout mice

    Naot, Dorit; Watson, M; Callon, Karen; Tuari, D; Musson, David; Choi, AJ; Sreenivasan, D; Fernandez, Justin; Ting Tu, P; Dickinson, M; Gamble, Gregory; Grey, Andrew; Cornish, Jillian (2016-09)

    Journal article
    The University of Auckland Library

    A positive association between fat and bone mass is maintained through a network of signaling molecules. Clinical studies found that the circulating levels of adiponectin, a peptide secreted from adipocytes, are inversely related to visceral fat mass and bone mineral density (BMD), and it has been suggested that adiponectin contributes to the coupling between fat and bone. Our study tested the hypothesis that adiponectin affects bone tissue by comparing the bone phenotype of wild-type and adiponectin-knockout (APN-KO) female mice between the ages of 8-37 weeks. Using a longitudinal study design, we determined body composition and bone density using dual energy X-ray absorptiometry. In parallel, groups of animals were sacrificed at different ages and bone properties were analyzed by micro computed-tomography (microCT), dynamic histomorphometry, three-point bending test, nanoindentation and computational modelling. APN-KO mice had reduced body fat and decreased whole-skeleton BMD. MicroCT analysis identified reduced cortical area fraction and average cortical thickness in APN-KO mice in all the age groups, and reduced trabecular bone volume fraction only in young APN-KO mice. There were no major differences in bone strength and material properties between the two groups. Taken together, our results demonstrate a positive effect of adiponectin on bone geometry and density in our mouse model. Assuming adiponectin has similar effects in humans, the low circulating levels of adiponectin associated with increased fat mass are unlikely to contribute to the parallel increase in bone mass. Therefore, adiponectin does not appear to play a role in the coupling between fat and bone tissue.

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  • Closed-loop feedback control and bifurcation analysis of epileptiform activity via optogenetic stimulation in a mathematical model of human cortex

    Selvaraj, P; Sleigh, James; Kirsch, HE; Szeri, AJ (2016-01-26)

    Journal article
    The University of Auckland Library

    Optogenetics provides a method of neuron stimulation that has high spatial, temporal, and cell-type specificity. Here we present a model of optogenetic feedback control that targets the inhibitory population, which expresses light-sensitive channelrhodopsin-2 channels, in a mean-field model of undifferentiated cortex that is driven to seizures. The inhibitory population is illuminated with an intensity that is a function of electrode measurements obtained via the cortical model. We test the efficacy of this control method on seizurelike activity observed in two parameter spaces of the cortical model that most closely correspond to seizures observed in patients. We also compare the effect of closed-loop and open-loop control on seizurelike activity using a less-complicated ordinary differential equation model of the undifferentiated cortex in parameter space. Seizurelike activity is successfully suppressed in both parameter planes using optimal illumination intensities less likely to have adverse effects on cortical tissue.

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