27,363 results for The University of Auckland Library

  • Acute Respiratory Tract Infections and Vitamin D: Neonatal vitamin D levels and acute respiratory tract infections in the first year of life

    Saraf, Rajneeta (2016)

    Doctoral thesis
    The University of Auckland Library

    Background There is growing interest in vitamin D as an immune modulator and the role of vitamin D in respiratory illnesses is increasingly being recognised. Respiratory tract infections are a prevalent cause of hospital admission in the preschool-aged population; particularly in the first year of life. In order to try to reduce the ARI disease burden, it is necessary to understand the contribution of different risk factors acting at different phases of a child???s life. One risk factor that is of particular interest for this thesis is vitamin D status at birth. Aim My aim was to investigate the association between 25-hydroxyvitamin D (25[OH]D) status at birth and hospital admission with an acute respiratory tract infection in the first year of life. Two validation studies were also undertaken that allowed us to develop a dried blood spot liquid chromatography tandem mass spectrometry assay in a NZ laboratory and determine whether the developed assay was robust enough to measure 25(OH)D concentrations on dried blood spot samples stored for more than 5 years. Methods I performed a case-control study nested within Growing Up in New Zealand; a longitudinal study that is following 6853 children since their birth in 2009-2010. All the Growing Up in New Zealand cohort children hospitalised due to acute respiratory tract infections (ARI) in their first year of life were identified from linkage to the national collection of hospital events (the national minimum dataset (NMDS)). As part of the National Newborn Screening programme, 4 drops of blood were collected onto absorbent cards called dried blood spot cards (DBS). The DBS samples of respiratory cases (children in the cohort admitted with an ARI) and controls (cohort children matched with date of birth ?? 7 days and not hospitalised with an ARI) were tested for 25(OH)D concentration. Data collected during the antenatal period, birth and during infancy (9 months and immunisation register) were used to identify predictors of ARI in the first year of life. The dried blood spot 25(OH)D concentrations were categorised as deficient (3 people/bedroom (OR=1.84 95% CI 1.08 - 3.17) , living in a damp house (OR=1.54 95% CI 0.83 - 2.89), sleeping in rooms with heavy condensation (OR=1.80 95% CI 1.10 - 2.97), did not receive immunisations on time (OR=1.43 95% CI 0.89 - 2.27), and who spent on average <50 nmol/L) are twice as likely as children who are vitamin D sufficient at birth to be hospitalised with an ARI during infancy. Prevention of vitamin D deficiency during pregnancy and infancy has the potential to reduce the burden of severe ARI during infancy.

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  • What happens at work goes home: Investigating secondary traumatic stress and social support among the partners of New Zealand's Police, Fire, Ambulance and Defence Personnel

    Alrutz, Anna Stowe (2017)

    Doctoral thesis
    The University of Auckland Library

    Police, fire, ambulance and defence force personnel (responders) risk experiencing dangerous activities, traumatic events and the development of post-traumatic stress disorder. In turn, spouses/partners (partners) of these responders risk developing secondary traumatic stress (STS) as they are exposed vicariously to the trauma through communication with their responders. The research aimed to address the question: How do the partners of NZ defence and emergency responders respond to work stress experienced by their responder? The study used six research questions and six hypotheses to identify resources and barriers towards effective management of STS. A mixed methods approach assessed the experience of STS among the partners of New Zealand???s (NZ) responders. Using this approach the researchers interviewed participants prior to survey data collection and again after the survey to facilitate interpretation and incorporate feedback. After pilot-testing, the anonymous online survey was made available nationwide. The survey measured STS in partners, perceived stigma towards help-seeking, partner resilience and relationship satisfaction. The survey asked if the defence and emergency responder???s organisation invited partners to events, offered inductions, or offered informational resources to manage stress. Partners were asked who they turned to when dealing with stressful situations experienced by their responder. The survey concluded with open-ended questions about organisational engagement with the partners and responders. Themes were identified from analysis of the qualitative responses given by the 835 partners of NZ responders. A hypothesised model was produced and tested using multiple regression (n=664) which led to the creation of a structural equation model (SEM) (n=547) to describe interactions between resources and barriers. The study found that 20???35% of partners experience significant symptoms of STS and almost half feel unsupported when managing stressful issues experienced by their responders. Positive organisational communication benefits partners and reduces psychosocial risks. The thematic analyses endorsed increasing partner self-efficacy and encourages organisations to identify partner accessible resources. Triangulating the results obtained from these mixed methods highlights challenges faced by partners of defence and emergency responders and suggest how direct organisational engagement with the partners of their employees could reduce risks associated with secondary exposure to trauma.

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  • Gendered Academic Careers: A Comparison of Indonesia and New Zealand

    Toyibah, Dzuriyatun (2017)

    Doctoral thesis
    The University of Auckland Library

    This thesis aims to describe and better understand the gender gap in academic careers in Jakarta (Indonesia) and Auckland (New Zealand). The thesis is intended to measure and explain the operation of the gender gap, while also interrogating the construction of such indices as essentially Western in their assumptions. For example, The Global Gender Gap Report (World Economic Forum, 2015), rates New Zealand 10/145 and Indonesia, 92/145 of countries surveyed. A review of the global rankings shows a patterning of Western and non-Western countries and clearly invites deficit-based explanations in terms of development, culture, religion. As an Indonesian woman, such patterning also invites unease and disquiet. While I have experienced the everyday processes that produce the gender gap in academia and societally, I am also aware of the complexities and countervailing elements that reports like The Global Gender Gap Report might miss. One result of unease with a simple notion of the gender gap index, is to enrich research through the use of mixed methods, combining qualitative and quantitative approaches. This thesis explores and contextualises issues around the gender gap in academic careers, by using mixed methods across institutional cases based in Jakarta and Auckland. The methods used include: (i) secondary research, including analysis of promotion policies; (ii) an autoethnographic account, in which I discuss issues of gender, marriage, religion, patriarchy, motherhood, class, and social status; (iii) a quantitative analysis of differing datasets drawn from Indonesian and New Zealand institutions, using descriptive statistics, binary and ordinal regression; (iv) the non-comparability of datasets and of quantitative analysis reinforced my decision to include qualitative approaches in the mix of methods. Accordingly, I interviewed 30 academics in Auckland and Jakarta. The main findings of the research are: (i) It confirms the literature that male domination in academia is hidden and female academics who are mothers are marginalised. For academics who are also mothers, there is a collective understanding that the barriers are significant; (ii) Racial discrimination exists, but is largely invisible. Participants of colour acknowledged it and indeed had experienced it, though other participants, in the same universities, believed that it no longer occurred. Arguably, gender and race are rendered invisible in academic careers under a neo-liberal system, especially when using statistical analysis, as such elements are considered non-meritocratic factors; (iii) Understanding the academic gender gap in Indonesia is better framed by considering the fact that career progression follows civil servant regulation, and is not perceived as very prestigious in terms of income. Rather, being an academic, according to some Indonesian academics, is about a ???calling??? and devotion to knowledge development; (iv) On the other hand, studies in liberal, Western countries emphasise that family life, children, and domestic work are serious problems for female academics. To be single or childfree is considered to enhancefemale academic careeradvancement. In conclusion, comparing the scale of the gender gap index between liberal countries such as New Zealand and non-liberal countries such as Indonesia is very challenging due to cultural and structural differences. My research underscores that it is important to measure women???s conditions beside indicators developed in the Gender Gap Index (economic participation and opportunity, educational attainment, health and survival and political empowerment). It is necessary to include indicators which are accepted in all cultures and nations, such as the index of happiness, life satisfaction; indicators must align with desires and hopes for the future. Critique is essential to create the conditions for transformative change but that change should align with individual and collective aspirations.

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  • Examining the Roles of Residuals Under an Adaptation Level Theory Model for Tinnitus Perception

    Durai, M (2016)

    Doctoral thesis
    The University of Auckland Library

    Background: Tinnitus is the perception of sound in the absence of sound in the environment (1-4). The precise mechanisms giving rise to tinnitus perception and distress are still not fully known. The Adaptation Level Theory (ALT) model of tinnitus (5, 6) is an ecological framework which takes a holistic approach to understanding tinnitus and its complexity, in which tinnitus magnitude estimates are based on interactions between the focal component (tinnitus), contextual component (any background noise or applied sounds), and residual components (individual cognitive and behavioural characteristics). Aim: To empirically explore the influence and strength of individual residual factors under a novel Adaptation Level Theory (ALT) model of tinnitus perception. Personality traits, emotion and prediction/anticipation of sounds were residuals examined. Methods: Seven studies were undertaken as part of this doctoral thesis: 1) A scoping review investigated key personality traits relevant to tinnitus, and the relationship between affective disorders and tinnitus. 2) A web-based survey was administered to 154 individuals with tinnitus and 61 age, gender and hearing level-matched non-tinnitus controls. The survey measured four key self-reported personality traits (social closeness, stress reaction, alienation and self-control), tinnitus characteristics and hearing handicap. 3) A behavioural experiment (N=22) introduced short-term emotional stimuli, differing along valence and arousal dimensions, and measured tinnitus loudness and annoyance characteristics. Stimuli were presented in two modalities: auditory and visual. 4) A comprehensive narrative synthesis of current research assessed the feasibility of a relationship between auditory memory, predictive coding and tinnitus generation. 5) A short-term adaptation experiment (N=23) and two-week feasibility trial (N=7) compared the effect of predictable and unpredictable amplitude-modulated computer surf sound on tinnitus loudness and annoyance characteristics. 6) An electroencephalography (EEG) study that compared mean ERP amplitudes and oscillatory band activity in response to tone deviants and tone omissions (at the pitch of tinnitus) between individuals with tinnitus (N=16) and hearing-level matched controls (N=14). 7) A randomized tinnitus sound therapy clinical trial (N=18) was conducted comparing the effectiveness of nature sounds with neutral broadband noise. Multiple experimental outcomes relating to tinnitus, emotion, attention and psychological state were measured at three time points: at sound fitting, 4 weeks after administration and 8 weeks after administration. Results: 1) The scoping review concluded personality traits to have a consistent association with the distress experienced by adult tinnitus help-seekers, and help-seekers were also more likely to experience anxiety and depression symptoms and/or disorders. Limitations present in current research were lack of appropriately controlled comparisons when assessing personality trait profiles of tinnitus sufferers and non-tinnitus individuals. 2) Tinnitus sufferers displayed higher levels of stress reaction, lower social closeness, lower self-control and higher alienation than the control group in the web-based survey. 3) In the behavioural emotion experiment, low valence (unpleasant) auditory stimuli led to higher subjective tinnitus loudness ratings in males and females and higher subjective distress ratings in males only. Visual emotional stimuli did not have an effect on tinnitus characteristics. 4) The narrative review provided theoretical support and indirect electrophysiological evidence for continuous prediction errors generated within the auditory system driving tinnitus perception and distress, as well as eliciting global disruptions to attention and working memory. 5) Both short-term Unpredictable and Predictable sound administration led to a decrease in tinnitus loudness in the adaptation experiment, however, only Unpredictable sound lowered tinnitus distress ratings. 6) A larger N1c waveform was elicited in the absence of any tone deviation within the left primary auditory cortex of tinnitus participants for the EEG study. Abnormal N1c waveform growth was present across levels of deviant conditions for the tinnitus group. There was limited evidence to support the Thalamocortical Dysrhythmia hypothesis of greater theta and gamma activity present among individuals with tinnitus. A role for attention and auditory scene analysis in driving tinnitus perception and salience was supported. No differences were present between groups for tone omissions. Different levels of activity between tinnitus and control groups were observed in regions corresponding to attentional as well as limbic networks. 7) The administration of sound therapy led to significant reduction in tinnitus impact over 8 weeks; this effect was largely due to BBN sound therapy which resulted in significantly greater reduction of tinnitus impact compared to nature sounds. The positive effect of sound on tinnitus was supported by secondary tinnitus and psychologicalrelated outcome measures, but not interviews. BBN sound resulted in an increase in loudness level matches needed to match tinnitus; there was minimal change in loudness level matches for nature sounds. There were indications of individual preferences and individual outcome effects observed. The presence of tinnitus subgroups was apparent in terms of which sound was most favoured, which sound had the most benefit, as well as in how sound-tinnitus interactions occurred as time progressed. Conclusions: Personality traits, emotion and prediction all play a significant role as residual factors under the ALT model to shape final tinnitus perception and experience as well as in influencing response of tinnitus to introduction of external sound introduction. Overall, tinnitus magnitude appears to increase with high stress reaction, low social closeness, low self-control and high alienation personality trait levels, as well as by the introduction of unpleasant auditory stimuli. In contrast, the presence of sound therapy stimuli decreases tinnitus magnitude and demonstrates psychological benefit over time. This thesis provides some empirical support for the ALT model of tinnitus. Further research is needed to examine attention as a weighting factor, develop clinically useful indicators of ideal sound therapy levels under the ALT framework, as well as customize therapeutic sound to tailor for individual residual levels, needs and preferences over time. Development of computational models based on the ALT which integrate residual factors, weighting factors and tinnitusexternal sound interactions may be useful for delineating subgroups and predicting how an individual might respond to potential treatments. The findings from this thesis can form a basic computational template to build-on.

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  • When to Start, What to Start and Other Treatment Controversies in Pediatric HIV Infection

    Turkova, A; Webb, Rachel; Lyall, H (2012-12)

    Journal article
    The University of Auckland Library

    Over the last decade there have been dramatic changes in the management of pediatric HIV infection. Whilst observational studies and several randomized control trials (RCTs) have addressed some questions about when to start antiretroviral therapy (ART) in children and what antiretrovirals to start, many others remain unanswered. In infants, early initiation of ART greatly reduces mortality and disease progression. Treatment guidelines now recommend ART in all infants younger than 1 or 2 years of age depending on geographical setting. In children >1 year of age, US, European (Paediatric European Network for Treatment of AIDS; PENTA) and WHO guidelines differ and debate is ongoing. Recent data from an RCT in Thailand in children with moderate immune suppression indicate that it is safe to monitor asymptomatic children closely without initiating ART, although earlier treatment was associated with improved growth. Untreated HIV progression in children aged over 5 years is similar to that in adults, and traditionally adult treatment thresholds are applied. Recent adult observational and modeling studies showed a survival advantage and reduction of age-associated complications with early treatment. The current US guidelines have lowered CD4+ cell count thresholds for ART initiation for children aged >5 years to 500 cells/mm3. Co-infections influence the choice of drugs and the timing of starting ART. Drug interactions, overlapping toxicities and adherence problems secondary to increased pill burden are important issues. Rapid changes in the pharmacokinetics of antiretrovirals in the first years of life, limited pharmacokinetic data in children and genetic variation in metabolism of many antiretrovirals make correct dosing difficult. Adherence should always be addressed prior to starting ART or switching regimens. The initial ART regimen depends on previous exposure, including perinatal administration for prevention of mother to child transmission (PMTCT), adherence, co-infections, drug availability and licensing. A European cohort study in infants indicated that treatment with four drugs produced superior virologic suppression and immune recovery. Protease inhibitor (PI)-based ART has the advantage of a high barrier to viral resistance. A recent RCT conducted in several African countries showed PI-based ART to be advantageous in children aged <3 years compared with nevirapine-based ART irrespective of previous nevirapine exposure. Another trial in older children from resource rich settings showed both regimens were equally effective. Treatment interruption remains a controversial issue in children, but one study in Europe demonstrated no short-term detrimental effects. ART in children is a rapidly evolving area with many new antiretrovirals being developed and undergoing trials. The aim of ART has shifted from avoiding mortality and morbidity to achieving a normal life expectancy and quality of life, minimizing toxicities and preventing early cancers and age-related illnesses.

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  • Review of: Conny Kristel, De Oorlog van Anderen. Nederlanders en Oorlogsgeweld, 1914 - 1918. Amsterdam, De Bezige Bij, 2016

    Abbenhuis, Maartje (2017-03)

    Journal article
    The University of Auckland Library

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  • Prevalence of Rheumatic Heart Disease and Other Echocardiographic Abnormalities in Polynesian Young Adults in South Auckland, New Zealand

    Webb, Rachel; Culliford-Semmens, N; Mow, AC; Doughty, R; Tilton, E; Peat, B; Stirling, J; Gentles, T; Stewart, J; Wilson, N (2016-06)

    Conference item
    The University of Auckland Library

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  • Long-Term Outcomes of New Zealand Children and Young Adults Undergoing Surgery for Rheumatic Heart Disease

    Webb, Rachel; Remenyi, B; Finucane, K; Lennon, D; Gentles, T; Sidhu, K; Wilson, N (2016-06)

    Conference item
    The University of Auckland Library

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  • Sequential Intravenous High Dose Oral Antibiotics in the Treatment of Osteoarticular Infections in Children: A Randomized Controlled Trial

    Tsui, K; Crawford, H; Mow, FC; Webb, Rachel; Voss, LM; Stott, NS; Stewart, J; Lennon, DR (2016)

    Conference item
    The University of Auckland Library

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  • The Microbiology of Septic Arthritis in Young Auckland Children

    Boom, MVD; Webb, Rachel; Lennon, DR; Crawford, H; Freeman, J; Castle, J; Mistry, R (2016-12-01)

    Conference item
    The University of Auckland Library

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  • Development of novel nanoparticulate delivery system for oral delivery of gemcitabine to treat breast cancer

    Chen, Guanyu (2016)

    Doctoral thesis
    The University of Auckland Library

    Background and Aim: In New Zealand women, breast cancer has a highest rate of incidence of any cancer. In 2015, there were approximate 60,300 new cases of breast cancer diagnosed globally, which is second most common cancer overall. To address breast cancer, chemotherapy is typically administered parenterally. However, this is an unpleasant and inconvenient administration route, and often leads to high peak levels of drug in the systemic circulation above the maximum tolerated concentration (MTC) resulting in a multitude of side effects. Oral chemotherapy is attractive with better patient acceptability, good therapeutic efficacy, and low cost. However, there are many obstacles to achieve oral drug delivery including physical and biochemical barriers, such as the epithelial barrier of the small intestine, degradation through the acidic environment of the stomach and digestive enzymes throughout the gastrointestinal tract, as well as efflux pumps which limit oral drug absorption. Gemcitabine is a promising drug candidate with proven activity against breast cancer, however, it has an oral bioavailability of less than 10%, due to its high hydrophilicity and low permeability through intestinal epithelium. Therefore, the aim of this project was to develop a novel nanoparticulate drug delivery system for oral delivery of gemcitabine, to improve its oral bioavailability. Methods: Two different polymeric nanoparticulate delivery systems were designed suitable for the oral delivery of gemcitabine. The first was gemcitabine-loaded TMC modified PLGATPGS nanoparticles (NPs) prepared through a modified solvent evaporation technique. The PLGA-TPGS random copolymer was synthesized prior to the fabrication of NPs. A central composite design (CCD) was applied to optimize the formulation parameters. The second delivery system of gemcitabine loaded TMC-CSK NP was fabricated via an ionic gelation method. The TMC polymer was synthesized by using a new two-step methylation method prior to preparing the TMC based NPs. The physical and chemical properties of both nanoparticulate delivery systems were determined including particles size, zeta potential, entrapment efficiency, in-vitro drug release and ex-vivo drug permeation over the porcine epithelial membrane, and the optimal formulations were selected. A co-cultured Caco-2 and HT29-MTX-E12 cell model was set up to determine cytotoxicity, cellular uptake and transport studies of the drug solution and optimal drug loaded NPs. Finally, the pharmacokinetic parameters associated with different formulation were determined using a Sprague-Dawley (SD) rat model. The tumour growth rate associated with the drug solution and the drug loaded NPs were investigated using a BALB/c nude mouse model. Results and discussion: The optimal formulations of drug loaded TMC modified PLGATPGS NPs and drug loaded TMC-CSK NPs showed particle size of 243.21 ?? 21.72 nm, and 173.60 ?? 6.82 nm, zeta potential of +14.70 ?? 1.31 mV, and +18.50 ?? 0.22 mV, entrapment efficiency of 76.43 ?? 0.21%, and 66.43 ?? 0.13%, respectively. Particles of less than 500 nm show significantly higher absorption than larger particles across intestinal epithelium, thus the particle sizes of both NPs are suitable for oral absorption. NPs with zeta potentials more positive than +15 mV or more negative than -15 mV are considered stable, thus the two NPs are considered having good steric stability. In addition, the positive charged NPs promote mucoadhesion with the negatively charged intestinal mucosa, through electrostatic interaction. The high entrapment efficiency results were promising and are higher than most polymeric NPs delivery systems reported. Scanning electron microscopy (SEM) showed the TMC modified PLGA-TPGS NPs were spherical with a smooth particle surface, while the TMC-CSK NPs had more irregular shape with a craggy particle surface. They both showed sustain drug release profiles during in vitro drug release studies, and greater drug permeation compared to drug solution over porcine epithelial membrane in the ex-vivo drug permeation studies. Moreover, both optimal drug loaded NPs exhibited good stability in terms of particle size and drug entrapment over 3 months stored at 4??C. The cytotoxicity of gemcitabine solution, gemcitabine loaded TMC modified PLGA-TPGS NPs, and gemcitabine loaded TMC-CSK NPs on Caco-2/HT29-MTX-E12 cells showed dose dependence and with IC50s of 529.4 ?? 67.2 ??g.mL-1, 1881.4 ?? 51.5 ??g.mL-1 and 1682.4 ?? 27.9 ??g.mL-1 respectively, indicating the drug loaded NPs were less toxic to the intestinal epithelial cells compared to the drug solution. The rate of cellular uptake of both optimal drug loaded NPs was time-, temperature-, and concentration- dependant. Cellular uptake for the gemcitabine loaded TMC modified PLGA-TPGS NPs undergo active transport involving adsorptive mediated endocytosis and caveloae mediated endocytosis, while the gemcitabine loaded TMC-CSK NPs was through active transport associate with adsorptive mediated, clathrin and caveolae mediated endocytosis. In cellular transport studies, both drug loaded NPs had greater drug transport capability compared to drug solution over the Caco-2/HT29- MTX-E12 cell membrane. For the transport mechanism studies, both NP formulations showed electrostatic interaction with the intestinal epithelial cells. P glycoprotein (P-gp) efflux affected the cellular transport for both NPs. By blocking the P-gp efflux pump, more drug loaded NPs were transported through the cell membrane. The multiple resistance protein-2 (MRP2) only affected TMC-CSK NPs to some extent. Interestingly, for the TMC modified PLGA-TPGS NPs, the addition of the MRP2 inhibitor resulted in a reduction in the efflux of gemcitabine suggesting that the role of MRP2 in the efflux of gemcitabine loaded TMC modified PLGA-TPGS NPs can be neglected. Moreover, EDTA is able to activate the cellular protein kinase C (PKC) by depletion of extracellular calcium via chelation, resulting in tight junction opening. The addition of EDTA significantly enhanced the cellular transport for both drug loaded NPs, facilitating the transport of the NPs via the paracellular route. In the in vivo pharmacokinetic studies, the half-life (t1/2) and oral bioavailability of gemcitabine were significantly improved in drug loaded NPs compared to drug solution group. The t1/2 of gemcitabine loaded TMC-CSK NPs and gemcitabine loaded TMC modified PLGA-TPGS NPs were of 77.16 ?? 24.20 hr and 69.98 ?? 20.50 hr, respectively, compared with 9.40 ?? 2.13 hr for the gemcitabine solution. The absolute oral bioavailability of gemcitabine loaded TMC-CSK NPs (55.20%), was 1.1-fold and 6.1-fold higher than that of gemcitabine loaded TMC modified PLGA-TPGS NPs (49.92%) and gemcitabine solution (9.86%), respectively. In pharmacodynamics studies, the drug loaded NPs had greater inhibition of tumour growth rate compared with the drug solution (p < 0.01). The gemcitabine loaded TMC-CSK NPs group had the greatest inhibition of tumour growth, with 3.12-fold and 1.78-fold reduction compared to saline control group and gemcitabine solution group, respectively. This result corresponds to the pharmacokinetic studies with greater oral bioavailability and longer plasma half-life of gemcitabine loaded TMC-CSK NPs group compared to all other groups. Conclusion: This project has demonstrated that TMC modified PLGA-TPGS NPs and TMCCSK NPs can be utilised as controlled release drug delivery systems for the oral delivery of gemcitabine. Encapsulated gemcitabine is able to overcome the physical and biochemical barriers in GIT, to enhance the drug absorption over the intestinal epithelial membrane, therefore improving the oral bioavailability of gemcitabine, and promoting the anticancer therapeutic efficacy. The promising results confirmed the two developed NPs are promising platforms for developing future oral chemotherapy products loaded with gemcitabine.

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  • Children with Disabilities and Disaster Risk Reduction in New Zealand

    Ronoh, Steve (2017)

    Doctoral thesis
    The University of Auckland Library

    The global rise in the number of disasters is largely due to the interplay between environmental and human factors. Children and especially children with disabilities are disproportionately impacted by disasters, with an estimated seven million children affected worldwide annually. Children with disabilities can have increased vulnerabilities because of mobility difficulties, pre-existing medical conditions, existing socio-economic barriers and policies that fail to recognise the diverse needs of this group. Indeed, researchers and practitioners have historically overlooked the experiences and needs of children, particularly so for those with disabilities, who are disproportionately affected by natural hazards and disasters. Their capacities, needs, and, importantly, potential roles in disaster risk reduction (DRR) have received little consideration from researchers and policy makers. This thesis draws on the findings of a multi-case study of three New Zealand schools working with children having diverse disabilities. The schools are in the regions of Canterbury, Hawke???s Bay and Auckland. It aims to generate new information to help inform DRR and give direction, and provide a holistic framework towards the development of an inclusive approach to DRR. This orientation aims to specifically integrate the experiences, perspectives and needs of children with disabilities. Although grounded in disaster studies, this thesis frequently draws upon the wider scholarship related to children, participatory approaches and disability. The central goal of the study is to assess and interpret the experiences of children with disabilities in dealing with natural hazards, and to identify their actual and potential contribution to DRR. It presents the use of flexible participatory tools which support a sustained continuum of engagement among children with diverse disabilities, skills, and experiences. Crucially, this work offers a bridge and conceptual framework that recognises communication as a two-way process between adults and children by requiring adults to learn how children express their views, thus according participants a voice in DRR research. The case studies reveal considerable variation on how children with disabilities access available resources, and how they perceive, face and cope with natural hazards. The research also identifies constraints and complexities towards achieving disability-inclusive DRR and shows that ideas about DRR are shaped and influenced by socio-economic structures. Based on the participants??? existing variation of potential vulnerabilities and capacities (individual and group) and their potential contribution in DRR, the thesis offers suggestions for policy and practice of a more inclusive approach to DRR. It emphasises the need to direct resources and programmes that facilitate and strengthen effective communication between adults and children to encourage sustained participation along children???s spectrum of abilities. Finally, the thesis recommends a framework incorporating a shift in attitude to children with disabilities as integral and active participants in DRR.

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  • Investigating the application of human induced neural precursor cells for generating dopamine neurons in vitro

    Playne, RG (2017)

    Doctoral thesis
    The University of Auckland Library

    Parkinson???s disease (PD) is a common neurological disease characterised by progressive degeneration of substantia nigra dopamine neurons and the deposition of intracellular proteinacious aggregates called Lewy bodies. Reprogramming technology holds great promise for the study and treatment of PD, as patient-specific ventral midbrain dopamine (vmDA) neurons can be generated in a dish. This should facilitate the investigation of early changes occurring during PD pathogenesis, allowing for the identification of new drug targets and providing a platform for drug screening. To date, most research using reprogramming technology to study PD has been conducted on induced pluripotent stem cells. Research into PD using direct reprogramming has been limited, primarily due to an inability to generate high yields of authentic human vmDA neurons. Nevertheless, direct reprogramming offers a number of advantages, and development of this technology is warranted. A method to directly reprogram adult human dermal fibroblasts into induced neural precursors (iNPs) by non-viral SOX2/PAX6 transfection was developed in our laboratory. This thesis aimed to investigate if vmDA neurons could be generated from iNPs. First, the regional identity of iNPs was investigated by examining temporal changes in gene expression through quantitative real-time PCR and immunocytochemistry. Overall, iNPs showed a mixed regional identity, with widespread expression of the anterior neuroepithelial markers SOX1, PAX6 and FOXG1. There was limited expression of most of the vmDA markers examined, however some late markers were expressed, including NURR1 and PITX3. Next, iNPs were differentiated to a neuronal fate with or without exposure to the patterning molecules SHH/FGF8, and it was found that established iNPs did not respond to patterning cues. Subsequently, a series of experiments was performed to investigate if temporal exposure to a range of patterning factors during the reprogramming process, and/or exposure to vmDA-related transgenes, could induce a vmDA iNP fate. Ultimately, these strategies did not prove effective at inducing an authentic vmDA iNP fate. Nevertheless, this thesis reports for the first time that iNPs, which have been reprogrammed from adult human cells using non-viral expression of lineagespecific factors, can give rise to dopamine neuronal-like cells that express TH, AADC, VMAT2, DAT and GIRK2.

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  • Genetic studies of obesity in New Zealand: A Children of SCOPE study

    Krishnan, Mohanraj (2017)

    Doctoral thesis
    The University of Auckland Library

    Childhood obesity is a global health problem and is associated with an increased risk of type 2 diabetes (T2D), cardiovascular disease and premature mortality. The prevalence of childhood and adolescent obesity is rising in New Zealand with the most recent health survey estimating 10% of all children (aged 2-14) are obese (2014/2015 New Zealand Health Survey). However, obesity varies with ethnicity, with the M??ori (14.8%) and the Pacific Island (29.7%) children exhibiting higher rates of obesity when compared to the Asian (7.2%) and European/Other (7.7%) children. Although this obesity trend is underpinned by the presence of an ???obesogenic??? environment, it is facilitated by the individual???s genetic susceptibility to excessive weight gain. This helps to explain some of the individual phenotypic variations in development. Further characterisation of these obesity related gene variants would assist with unravelling the molecular mechanism of an affliction that affects approximately 10% of New Zealand children, opening up new avenues in the management of a disease for which no effective treatment currently exists. The aim of this thesis was to characterise the relative contributions between 80 putative genetic variations and obesity traits (BMI z-scores and Percentage Body Fat) in the Auckland Children of SCOPE cohort; a follow-up cross sectional survey of six year old children whose mothers were participants of the landmark SCOPE study. In addition, we investigated the interplay between genetic and modifiable environmental influences (???healthy??? dietary pattern, physical activity levels and average sleep duration) on the predisposition to childhood obesity. Recently, a genome wide study in the Samoan population has identified a protein-altering variant (p.Arg475Gln) in CREBRF as being associated with discordant risks of BMI and T2D. We have tested for the presence and association of CREBRF ???rs373863828 using the ???Genetics of Gout, Diabetes and Kidney Disease in Aotearoa??? case-control study recruited by the University of Otago. This study has shown that genetic variants identified in adult studies, were also associated with obesity traits in six year old New Zealand European children. This would suggest that gene variants that influence weight gain in adults, may direct growth patterns and adiposity from childhood. We have also captured additional loci (not previously detected in our earlier genetic association analysis) from the gene-by-environmental interaction analyses. From this research, we propose that there is a role for these gene variants to control body weight through satiety, energy extraction from diet and dissipation of energy as heat, and therefore act as the underlying cause behind the increased weight gain in children. We have also confirmed the presence of the CREBRF ???rs373863828 variant in the broader Polynesian population residing in Aotearoa New Zealand and replicated the association with increased BMI and reduced odds of T2D. This emphasises a need for obesity genetic research away from European dominant studies. This study offers a unique opportunity to advance our understanding of the complex relationship between genetic influences, and environmental factors, in relation to childhood obesity. The health importance for New Zealand is from identifying potentially modifiable risk factors for childhood obesity, which can then be evaluated in future intervention studies. Factors identified early in the life cycle may be more amenable to interventions compared with strategies which target children who are already overweight or obese.

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  • Interprofessional supervision: Opportunities and challenges

    Davys, Allyson; Beddoe, Elizabeth (2015-12-11)

    Book item
    The University of Auckland Library

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  • Stone as drawing: Drawing stone [Exhibition catalogue entry]

    Jenner, Gordon (2016)

    Unclassified
    The University of Auckland Library

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  • Knowledge typologies for professional learning: Educators??? (re)generation of knowledge when learning open educational practice

    Hood, Nina; Littlejohn, A (2017-12)

    Journal article
    The University of Auckland Library

    Open education resources (OER) and accompanying open education practices (OEP), are changing the education landscape. For educators to take full advantage of the opportunities OER offer they must engage in learning activities to facilitate the extension and adaption of their practice. This paper forms part of a larger study exploring how adult educators learn from and through their engagement with OER in the contexts of their work. Following a quantitative investigation of the learning behaviours of 521 educators around OER use, follow up interviews were conducted with 30 participants. The interviews explore in greater detail the ways knowledge is being (re)generated and used by the educators as they learn new practices with and through OER. Six broad knowledge types were identified as supporting the expansion of practice. The data suggest educators not only require multiple types of knowledge, but also must be able to move fluidly among these different types of knowledge.

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  • Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents

    Eccleston, C; Cooper, TE; Fisher, E; Anderson, Brian; Wilkinson, NMR (2017)

    Journal article
    The University of Auckland Library

    Background Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children???s persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children???s pain have changed over time, and relief of pain is now seen as important. We designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, nonsteroidal anti-inflammatory drugs, opioids, and paracetamol) in order to review the evidence for children???s pain utilising pharmacological interventions. As the leading cause of morbidity in the world today, chronic disease (and its associated pain) is a major health concern. Chronic pain (that is pain lasting three months or longer) can arise in the paediatric population in a variety of pathophysiological classifications (nociceptive, neuropathic, or idiopathic) from genetic conditions, nerve damage pain, chronic musculoskeletal pain, and chronic abdominal pain, as well as for other unknown reasons. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat pain, reduce fever, and for their anti-inflammation properties. They are commonly usedwithin paediatric painmanagement.Non-steroidal anti-inflammatory drugs are currently licensed for use inWestern countries, however they are not approved for infants under three months old. The main adverse effects include renal impairment and gastrointestinal issues. Common side effects in children include diarrhoea, headache, nausea, constipation, rash, dizziness, and abdominal pain. Objectives To assess the analgesic efficacy and adverse events of NSAIDs used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of StudiesOnline,MEDLINE via Ovid, and Embase via Ovid from inception to 6 September 2016. We also searched the reference lists of retrieved studies and reviews, as well as online clinical trial registries. Selection criteria Randomised controlled trials, with or without blinding, of any dose and any route, treating chronic non-cancer pain in children and adolescents, comparing any NSAID with placebo or an active comparator. Data collection and analysis Two review authors independently assessed studies for eligibility.We planned to use dichotomous data to calculate risk ratio and number needed to treat for one additional event, using standard methods.We assessed GRADE and created three ???Summary of findings??? tables. Main results We included seven studies with a total of 1074 participants (aged 2 to 18 years) with chronic juvenile polyarthritis or chronic juvenile rheumatoid arthritis. All seven studies compared an NSAID with an active comparator. None of the studies were placebo controlled. No two studies investigated the same type of NSAID compared with another. We were unable to perform a meta-analysis. Risk of bias varied. For randomisation and allocation concealment, one study was low risk and six studies were unclear risk. For blinding of participants and personnel, three studies were low risk and four studies were unclear to high risk. For blinding of outcome assessors, all studies were unclear risk. For attrition, four studies were low risk and three studies were unclear risk. For selective reporting, four studies were low risk, two studies were unclear risk, and one study was high risk. For size, three studies were unclear risk and four studies were high risk. For other potential sources of bias, seven studies were low risk. Primary outcomes Three studies reported participant-reported pain relief of 30% or greater, showing no statistically significant difference in pain scores between meloxicam and naproxen, celecoxib and naproxen, or rofecoxib and naproxen (P > 0.05) (low-quality evidence). One study reported participant-reported pain relief of 50% or greater, showing no statistically significant difference in pain scores between low-dose meloxicam (0.125 mg/kg) and high-dose meloxicam (0.25 mg/kg) when compared to naproxen 10 mg/kg (P > 0.05) (low-quality evidence). One study reported Patient Global Impression of Change, showing ???very much improved??? in 85% of ibuprofen and 90% of aspirin participants (low-quality evidence). Secondary outcomes All seven studies reported adverse events. Participants reporting an adverse event (one or more per person) by drug were: aspirin 85/ 202; fenoprofen 28/49; ibuprofen 40/45; indomethacin 9/30; ketoprofen 9/30; meloxicam 18/47; naproxen 44/202; and rofecoxib 47/209 (very low-quality evidence). All seven studies reported withdrawals due to adverse events. Participants withdrawn due to an adverse event by drug were: aspirin 16/ 120; celecoxib 10/159; fenoprofen 0/49; ibuprofen 0/45; indomethacin 0/30; ketoprofen 0/30; meloxicam 10/147; naproxen 17/285; and rofecoxib 3/209 (very low-quality evidence). All seven studies reported serious adverse events. Participants experiencing a serious adverse event by drug were: aspirin 13/120; celecoxib 5/159; fenoprofen 0/79; ketoprofen 0/30; ibuprofen 4/45; indomethacin 0/30; meloxicam 11/147; naproxen 10/285; and rofecoxib 0/209 (very low-quality evidence). There were few or no data for our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning as defined by validated scales; and quality of life as defined by validated scales (very low-quality evidence). We rated the overall quality of the evidence (GRADE rating) for our primary and secondary outcomes as very low because there were limited data from studies and no opportunity for a meta-analysis. Authors??? conclusions We identified only a small number of studies, with insufficient data for analysis. As we could undertake no meta-analysis, we are unable to comment about efficacy or harm from the use of NSAIDs to treat chronic non-cancer pain in children and adolescents. Similarly, we cannot comment on our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning; and quality of life. We know from adult randomised controlled trials that some NSAIDs, such as ibuprofen, naproxen, and aspirin, can be effective in certain chronic pain conditions

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  • Metabolic and spatio-taxonomic response of uncultivated seafloor bacteria following the Deepwater Horizon oil spill

    Handley, Kim; Piceno, YM; Hu, P; Tom, LM; Mason, OU; Andersen, GL; Jansson, JK; Gilbert, JA (2017-11)

    Journal article
    The University of Auckland Library

    The release of 700 million liters of oil into the Gulf of Mexico over a few months in 2010 produced dramatic changes in the microbial ecology of the water and sediment. Here, we reconstructed the genomes of 57 widespread uncultivated bacteria from post-spill deep-sea sediments, and recovered their gene expression pattern across the seafloor. These genomes comprised a common collection of bacteria that were enriched in heavily affected sediments around the wellhead. Although rare in distal sediments, some members were still detectable at sites up to 60???km away. Many of these genomes exhibited phylogenetic clustering indicative of common trait selection by the environment, and within half we identified 264 genes associated with hydrocarbon degradation. Alkane degradation ability was near ubiquitous among candidate hydrocarbon degraders, whereas just three harbored elaborate gene inventories for the degradation of alkanes and aromatic and polycyclic aromatic hydrocarbons (PAHs). Differential gene expression profiles revealed a spill-promoted microbial sulfur cycle alongside gene upregulation associated with PAH degradation. Gene expression associated with alkane degradation was widespread, although active alkane degrader identities changed along the pollution gradient. Analyses suggest that a broad metabolic capacity to respond to oil inputs exists across a large array of usually rare indigenous deep-sea bacteria.

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  • Ideological motives in spoiler violence: Postconflict Assam, Northeast India

    Wilson, Christopher (2017)

    Journal article
    The University of Auckland Library

    Spoilers of peace agreements are normally seen as motivated by utility maximization, their actions intended to gain a larger proportion of postconflict political power or economic wealth. In this article, I examine this perspective via a comparative analysis of two cases of spoiler violence in Assam, India, one involving a spoiler excluded from the agreement and the other a spoiler central to the peace process and the postconflict political and economic milieu. Both cases suggest that some spoiling action following peace agreements is less instrumental and driven more by emotional and ideological phenomena than this leading understanding suggests.

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