2,318 results for Use commercially

  • Reduced crowding and poor contour detection in schizophrenia are consistent with weak surround inhibition

    Robol, V; Tibber, MS; Anderson, EJ; Bobin, T; Carlin, P; Shergill, SS; Dakin, Steven (2013-04-09)

    Journal article
    The University of Auckland Library

    Background Detection of visual contours (strings of small oriented elements) is markedly poor in schizophrenia. This has previously been attributed to an inability to group local information across space into a global percept. Here, we show that this failure actually originates from a combination of poor encoding of local orientation and abnormal processing of visual context. Methods We measured the ability of observers with schizophrenia to localise contours embedded in backgrounds of differently oriented elements (either randomly oriented, near-parallel or near-perpendicular to the contour). In addition, we measured patients??? ability to process local orientation information (i.e., report the orientation of an individual element) for both isolated and crowded elements (i.e., presented with nearby distractors). Results While patients are poor at detecting contours amongst randomly oriented elements, they are proportionally less disrupted (compared to unaffected controls) when contour and surrounding elements have similar orientations (near-parallel condition). In addition, patients are poor at reporting the orientation of an individual element but, again, are less prone to interference from nearby distractors, a phenomenon known as visual crowding. Conclusions We suggest that patients??? poor performance at contour perception arises not as a consequence of an ???integration deficit??? but from a combination of reduced sensitivity to local orientation and abnormalities in contextual processing. We propose that this is a consequence of abnormal gain control, a phenomenon that has been implicated in orientation-selectivity as well as surround suppression.

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  • Spatial-frequency dependent binocular imbalance in amblyopia

    Kwon, M; Wiecek, E; Dakin, Steven; Bex, PJ (2015-11)

    Journal article
    The University of Auckland Library

    While amblyopia involves both binocular imbalance and deficits in processing high spatial frequency information, little is known about the spatial-frequency dependence of binocular imbalance. Here we examined binocular imbalance as a function of spatial frequency in amblyopia using a novel computer-based method. Binocular imbalance at four spatial frequencies was measured with a novel dichoptic letter chart in individuals with amblyopia, or normal vision. Our dichoptic letter chart was composed of band-pass filtered letters arranged in a layout similar to the ETDRS acuity chart. A different chart was presented to each eye of the observer via stereo-shutter glasses. The relative contrast of the corresponding letter in each eye was adjusted by a computer staircase to determine a binocular Balance Point at which the observer reports the letter presented to either eye with equal probability. Amblyopes showed pronounced binocular imbalance across all spatial frequencies, with greater imbalance at high compared to low spatial frequencies (an average increase of 19%, p < 0.01). Good test-retest reliability of the method was demonstrated by the Bland-Altman plot. Our findings suggest that spatial-frequency dependent binocular imbalance may be useful for diagnosing amblyopia and as an outcome measure for recovery of binocular vision following therapy.

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  • Enhanced integration of motion information in children with autism

    Manning, C; Tibber, MS; Charman, T; Dakin, Steven; Pellicano, E (2015-05-06)

    Journal article
    The University of Auckland Library

    To judge the overall direction of a shoal of fish or a crowd of people, observers must integrate motion signals across space and time. The limits on our ability to pool motion have largely been established using the motion coherence paradigm, in which observers report the direction of coherently moving dots amid randomly moving noise dots. Poor performance by autistic individuals on this task has widely been interpreted as evidence of disrupted integrative processes. Critically, however, motion coherence thresholds are not necessarily limited only by pooling. They could also be limited by imprecision in estimating the direction of individual elements or by difficulties segregating signal from noise. Here, 33 children with autism 6-13 years of age and 33 age- and ability-matched typical children performed a more robust task reporting mean dot direction both in the presence and the absence of directional variability alongside a standard motion coherence task. Children with autism were just as sensitive to directional differences as typical children when all elements moved in the same direction (no variability). However, remarkably, children with autism were more sensitive to the average direction in the presence of directional variability, providing the first evidence of enhanced motion integration in autism. Despite this improved averaging ability, children with autism performed comparably to typical children in the motion coherence task, suggesting that their motion coherence thresholds may be limited by reduced segregation of signal from noise. Although potentially advantageous under some conditions, increased integration may lead to feelings of "sensory overload" in children with autism.

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  • Study protocol: combining experimental methods, econometrics and simulation modelling to determine price elasticities for studying food taxes and subsidies (The Price ExaM Study)

    Waterlander, Willemina; Blakely, T; Nghiem, N; Cleghorn, CL; Eyles, Helen; Genc, M; Wilson, N; Jiang, Yannan; Swinburn, Boyd; Jacobi, L; Michie, J; Ni Mhurchu, Cliona (2016-07-19)

    Journal article
    The University of Auckland Library

    There is a need for accurate and precise food price elasticities (PE, change in consumer demand in response to change in price) to better inform policy on health-related food taxes and subsidies.The Price Experiment and Modelling (Price ExaM) study aims to: I) derive accurate and precise food PE values; II) quantify the impact of price changes on quantity and quality of discrete food group purchases and; III) model the potential health and disease impacts of a range of food taxes and subsidies. To achieve this, we will use a novel method that includes a randomised Virtual Supermarket experiment and econometric methods. Findings will be applied in simulation models to estimate population health impact (quality-adjusted life-years [QALYs]) using a multi-state life-table model. The study will consist of four sequential steps: 1. We generate 5000 price sets with random price variation for all 1412 Virtual Supermarket food and beverage products. Then we add systematic price variation for foods to simulate five taxes and subsidies: a fruit and vegetable subsidy and taxes on sugar, saturated fat, salt, and sugar-sweetened beverages. 2. Using an experimental design, 1000 adult New Zealand shoppers complete five household grocery shops in the Virtual Supermarket where they are randomly assigned to one of the 5000 price sets each time. 3. Output data (i.e., multiple observations of price configurations and purchased amounts) are used as inputs to econometric models (using Bayesian methods) to estimate accurate PE values. 4. A disease simulation model will be run with the new PE values as inputs to estimate QALYs gained and health costs saved for the five policy interventions.The Price ExaM study has the potential to enhance public health and economic disciplines by introducing internationally novel scientific methods to estimate accurate and precise food PE values. These values will be used to model the potential health and disease impacts of various food pricing policy options. Findings will inform policy on health-related food taxes and subsidies.Australian New Zealand Clinical Trials Registry ACTRN12616000122459 (registered 3 February 2016).

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  • A process evaluation of the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial

    Olstad, D; Ball, K; Abbott, G; McNaughton, S; Le, HND; Ni Mhurchu, Cliona; Pollard, C; Crawford, DA (2016-02-24)

    Journal article
    The University of Auckland Library

    Background Supermarket Healthy Eating for Life (SHELf) was a randomized controlled trial that operationalized a socioecological approach to population-level dietary behaviour change in a real-world supermarket setting. SHELf tested the impact of individual (skill-building), environmental (20 % price reductions), and combined (skill-building???+???20 % price reductions) interventions on women???s purchasing and consumption of fruits, vegetables, low-calorie carbonated beverages and water. This process evaluation investigated the reach, effectiveness, implementation, and maintenance of the SHELf interventions. Methods RE-AIM provided a conceptual framework to examine the processes underlying the impact of the interventions using data from participant surveys and objective sales data collected at baseline, post-intervention (3 months) and 6-months post-intervention. Fisher???s exact, ?? 2 and t-tests assessed differences in quantitative survey responses among groups. Adjusted linear regression examined the impact of self-reported intervention dose on food purchasing and consumption outcomes. Thematic analysis identified key themes within qualitative survey responses. Results Reach of the SHELf interventions to disadvantaged groups, and beyond study participants themselves, was moderate. Just over one-third of intervention participants indicated that the interventions were effective in changing the way they bought, cooked or consumed food (p???<???0.001 compared to control), with no differences among intervention groups. Improvements in purchasing and consumption outcomes were greatest among those who received a higher intervention dose. Most notably, participants who said they accessed price reductions on fruits and vegetables purchased (519 g/week) and consumed (0.5 servings/day) more vegetables. The majority of participants said they accessed (82 %) and appreciated discounts on fruits and vegetables, while there was limited use (40 %) and appreciation of discounts on low-calorie carbonated beverages and water. Overall reported satisfaction with, use, and impact of the skill-building resources was moderate. Maintenance of newly acquired behaviours was limited, with less than half of participants making changes or using study-provided resources during the 6-month post-intervention period. Conclusions SHELf???s reach and perceived effectiveness were moderate. The interventions were more effective among those reporting greater engagement with them (an implementation-related construct). Maintenance of newly acquired behaviours proved challenging. Trial registration Current controlled trials ISRCTN39432901.

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  • Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH): process evaluation of a randomised controlled trial intervention

    Foley, L; Ni Mhurchu, Cliona; Marsh, Samantha; Epstein, LH; Olds, T; Dewes, Ofanaite; Heke, I; Jiang, Yannan; Maddison, R (2016-05-26)

    Journal article
    The University of Auckland Library

    The Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH) trial tested a family intervention to reduce screen-based sedentary behaviour in overweight children. The trial found no significant effect of the intervention on children's screen-based sedentary behaviour. To explore these null findings, we conducted a pre-planned process evaluation, focussing on intervention delivery and uptake.SWITCH was a randomised controlled trial of a 6-month family intervention to reduce screen time in overweight children aged 9-12 years (n???=???251). Community workers met with each child's primary caregiver to deliver the intervention content. Community workers underwent standard training and were monitored once by a member of the research team to assess intervention delivery. The primary caregiver implemented the intervention with their child, and self-reported intervention use at 3 and 6??months. An exploratory analysis determined whether child outcomes at 6??months varied by primary caregiver use of the intervention.Monitoring indicated that community workers delivered all core intervention components to primary caregivers. However, two thirds of primary caregivers reported using any intervention component "sometimes" or less frequently at both time points, suggesting that intervention uptake was poor. Additionally, analyses indicated no effect of primary caregiver intervention use on child outcomes at 6??months, suggesting the intervention itself lacked efficacy.Poor uptake, and the efficacy of the intervention itself, may have played a role in the null findings of the SWITCH trial on health behaviour and body composition.The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12611000164998 ); registration date: 10/02/2011.

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  • Modeling health gains and cost savings for ten dietary salt reduction targets

    Wilson, N; Nghiem, N; Eyles, Helen; Ni Mhurchu, Cliona; Shields, E; Cobiac, LJ; Cleghorn, CL; Blakely, T (2016-04-26)

    Journal article
    The University of Auckland Library

    Dietary salt reduction is included in the top five priority actions for non-communicable disease control internationally. We therefore aimed to identify health gain and cost impacts of achieving a national target for sodium reduction, along with component targets in different food groups.We used an established dietary sodium intervention model to study 10 interventions to achieve sodium reduction targets. The 2011 New Zealand (NZ) adult population (2.3 million aged 35+ years) was simulated over the remainder of their lifetime in a Markov model with a 3 % discount rate.Achieving an overall 35 % reduction in dietary salt intake via implementation of mandatory maximum levels of sodium in packaged foods along with reduced sodium from fast foods/restaurant food and discretionary intake (the "full target"), was estimated to gain 235,000 QALYs over the lifetime of the cohort (95 % uncertainty interval [UI]: 176,000 to 298,000). For specific target components the range was from 122,000 QALYs gained (for the packaged foods target) down to the snack foods target (6100 QALYs; and representing a 34-48 % sodium reduction in such products). All ten target interventions studied were cost-saving, with the greatest costs saved for the mandatory "full target" at NZ$1260 million (US$820 million). There were relatively greater health gains per adult for men and for M??ori (indigenous population).This work provides modeling-level evidence that achieving dietary sodium reduction targets (including specific food category targets) could generate large health gains and cost savings for a national health sector. Demographic groups with the highest cardiovascular disease rates stand to gain most, assisting in reducing health inequalities between sex and ethnic groups.

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  • "Smart" RCTs: Development of a Smartphone App for Fully Automated Nutrition-Labeling Intervention Trials

    Volkova, Ekaterina; Li, N; Dunford, E; Eyles, Helen; Crino, M; Michie, J; Ni Mhurchu, Cliona (2016-01)

    Journal article
    The University of Auckland Library

    There is substantial interest in the effects of nutrition labels on consumer food-purchasing behavior. However, conducting randomized controlled trials on the impact of nutrition labels in the real world presents a significant challenge.The Food Label Trial (FLT) smartphone app was developed to enable conducting fully automated trials, delivering intervention remotely, and collecting individual-level data on food purchases for two nutrition-labeling randomized controlled trials (RCTs) in New Zealand and Australia.Two versions of the smartphone app were developed: one for a 5-arm trial (Australian) and the other for a 3-arm trial (New Zealand). The RCT protocols guided requirements for app functionality, that is, obtaining informed consent, two-stage eligibility check, questionnaire administration, randomization, intervention delivery, and outcome assessment. Intervention delivery (nutrition labels) and outcome data collection (individual shopping data) used the smartphone camera technology, where a barcode scanner was used to identify a packaged food and link it with its corresponding match in a food composition database. Scanned products were either recorded in an electronic list (data collection mode) or allocated a nutrition label on screen if matched successfully with an existing product in the database (intervention delivery mode). All recorded data were transmitted to the RCT database hosted on a server.In total approximately 4000 users have downloaded the FLT app to date; 606 (Australia) and 1470 (New Zealand) users met the eligibility criteria and were randomized. Individual shopping data collected by participants currently comprise more than 96,000 (Australia) and 229,000 (New Zealand) packaged food and beverage products.The FLT app is one of the first smartphone apps to enable conducting fully automated RCTs. Preliminary app usage statistics demonstrate large potential of such technology, both for intervention delivery and data collection.Australian New Zealand Clinical Trials Registry ACTRN12614000964617. New Zealand trial: Australian New Zealand Clinical Trials Registry ACTRN12614000644662.

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  • Effects of plain packaging, warning labels, and taxes on young people's predicted sugar-sweetened beverage preferences: an experimental study

    Bollard, T; Maubach, N; Greenaway, Natalie; Ni Mhurchu, Cliona (2016-09)

    Journal article
    The University of Auckland Library

    Consumption of sugar-sweetened beverages (SSBs) is associated with increased risk of obesity, diabetes, heart disease and dental caries. Our aim was to assess the effects of plain packaging, warning labels, and a 20??% tax on predicted SSB preferences, beliefs and purchase probabilities amongst young people.A 2????????3????????2 between-group experimental study was conducted over a one-week period in August 2014. Intervention scenarios were delivered, and outcome data collected, via an anonymous online survey. Participants were 604 New Zealand young people aged 13-24 years who consumed soft drinks regularly. Participants were randomly allocated using a computer-generated algorithm to view one of 12 experimental conditions, specifically images of branded versus plain packaged SSBs, with either no warning, a text warning, or a graphic warning, and with or without a 20??% tax. Participant perceptions of the allocated SSB product and of those who might consume the product were measured using seven-point Likert scales. Purchase probabilities were measured using 11-point Juster scales.Six hundred and four young people completed the survey (51??% female, mean age 18 (SD 3.4) years). All three intervention scenarios had a significant negative effect on preferences for SSBs (plain packaging: F (6, 587)???=???54.4, p s predicted preferences for, and reported probability of purchasing, SSBs.

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  • Seallagain: Gaelic Grammar at a Glance

    Parsons, Catrìona NicÌomhair (2016)

    Book
    University of Otago

    A native Gaelic speaker born in the Isle of Lewis and a graduate of Edinburgh University, Scotland, Catrìona NicÌomhair Parsons has been involved in the teaching of Gaelic language and song in North America for decades. For thirty summers, she taught Scottish Gaelic at the Gaelic College, St. Ann’s, Cape Breton, Nova Scotia, where she was commissioned to prepare Gàidhlig troimh Chòmhradh, a Gaelic course in three volumes with recorded text. For many years, she taught in the Celtic Studies Department of St. Francis Xavier University, Nova Scotia; after retiring, she spent six years working for the newly constituted Nova Scotia Office of Gaelic Affairs. She has written well over a hundred Gaelic-English articles for local newspapers. Her poetry has been published in Scottish Gaelic periodicals GAIRM and GATH, and she has produced her solo CD of Gaelic songs entitled “Eileanan mo Ghaoil” in tribute both to Cape Breton and Lewis. From Seattle, Washington, to Grandfather Mountain, North Carolina; from Toronto to Nova Scotia, Canada; from Sydney, Australia, to Dunedin, New Zealand, Catrìona has been privileged to share her beloved language and culture with motivated students, many of whom are now instructors themselves. This, her most recent work, is a synthesis of all of the grammatical insights garnered from decades of experience teaching Scottish Gaelic to learners around the world. It clearly demonstrates in easy-to-read chapters, tables, and examples how the Gaelic language is structured. Rules, forms, pronunciation, and a host of other issues are all logically and systematically explained. Furthermore, this book can act as a handy reference for either the beginner or native speaker.

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  • The effect of a diet moderately high in protein and fiber on insulin sensitivity measured using the Dynamic Insulin Sensitivity and Secretion Test (DISST)

    Te Morenga, Lisa; Docherty, Paul; Williams, Sheila; Mann, Jim (2017-11-08)

    Journal article
    University of Otago

    This paper is a version chapter from a PhD thesis (Te Morenga, L. A. (2010). The effects of altering macronutrient composition on diabetes risk (Thesis, Doctor of Philosophy). University of Otago. Retrieved from http://hdl.handle.net/10523/439) and as such has been externally reviewed by experts in the field. It is currently under peer review.

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  • Herr Daniel Bandmann and Shakespeare vs the World

    Warrington, Lisa (2016-12-27)

    Journal article
    University of Otago

    German actor Daniel Bandmann played his first Hamlet at the age of 20, and made his English language debut as Shylock in New York, 1863. In his prime, he performed extensively in America, Great Britain, Australia, and New Zealand, amongst other countries. Though he played roles which ranged from Narcisse and the Corsican twins to Jekyll and Hyde, he was perhaps most closely identified with a handful of Shakespearean roles: Hamlet, Shylock, Macbeth, Othello, Iago. His apparently ungovernable temper led to a love/hate relationship with the critics, played out in public through the newspapers. His responses to criticism open a window into his playing of these roles. This paper examines Bandmann’s acting in the role of Hamlet and the critical interchanges he engaged in around the world, as an exemplar of the interaction of theatre and the global media.

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  • Effect of a price discount and consumer education strategy on food and beverage purchases in remote Indigenous Australia: a stepped-wedge randomised controlled trial

    Brimblecombe, J; Ferguson, M; Chatfield, MD; Liberato, SC; Gunther, A; Ball, K; Moodie, M; Miles, E; Magnus, A; Ni Mhurchu, Cliona; Leach, AJ; Bailie, R (2017-02)

    Journal article
    The University of Auckland Library

    Background Evidence is mounting that price discounts can be effective in improving diet. This study examined the effectiveness of a 20% price discount on food and drink purchases with and without consumer education in remote Indigenous Australia. Methods A 20% discount on fruit, vegetables, water, and artificially sweetened soft drinks was applied for 24 weeks in 20 communities in remote Indigenous Australia where the community store was managed by the Arnhem Land Progress Aboriginal Corporation (ALPA) or Outback Stores (OBS) in a stepped-wedge randomised trial. Communities were randomly allocated to a fixed framework of five sets of four stratified by store association; ten stores (two in each set) were randomly assigned to receive consumer education. A store from each of the ALPA and OBS store groups (contained in separate opaque envelopes) was selected, and stores in turn continued to be consecutively allocated to the fixed store set framework, starting with the first store slot in the first store set, until all stores had been allocated. The effect of the discount on the weight of fruit and vegetables purchased (the primary endpoint) was assessed using weekly store sales data and mixed models per protocol. We did sensitivity analyses by repeating the analyses with the outliers included and repeating the analyses for the primary outcome measure removing each store one at a time. This trial was registered with Australian New Zealand Clinical Trials Registry, number ACTRN12613000694718. Findings Weekly store sales data on all food and drink products sold in 20 stores were collected from July 1, 2012, to Dec 28, 2014. Price discount alone was associated with a 12??7% (95% CI 4??1???22??1) increase in purchases in grams of fruit and vegetables combined (primary outcome), and a 19??8% (6??2???35??1) increase post discount (after vs before); an effect of 12 g and 18 g per capita per day. Sensitivity analyses did not modify the results for the primary outcome measure. Interpretation A 20% discount can only increase fruit and vegetable purchases to help protect against obesity and diet related disease to a certain extent. Large discounts might have a greater impact than small discounts. Creative merchandising approaches to consumer education could also be considered alongside fiscal interventions to achieve marked improvements in diet.

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  • Know Your Noodles! Assessing Variations in Sodium Content of Instant Noodles across Countries

    Farrand, C; Charlton, K; Crino, M; Santos, J; Rodriguez-Fernandez, R; Ni Mhurchu, Cliona; Webster, J (2017-06)

    Journal article
    The University of Auckland Library

    Reducing salt intake is a cost-effective public health intervention to reduce the global burden of non-communicable disease (NCDs). Ultra-processed foods contribute ~80% of dietary salt in high income countries, and are becoming prominent in low-middle income countries. Instant noodle consumption is particularly high in the Asia Pacific region. The aim of this study was to compare the sodium content of instant noodles sold worldwide to identify potential for reformulation. Analysis was undertaken for 765 instant noodle products from 10 countries using packaged food composition databases of ultra-processed foods compiled by the Global Food Monitoring Group (GFMG) and national shop survey data. Sodium levels were high and variable, within and between countries. Instant noodles in China had the highest mean sodium content (1944 mg/100 g; range: 397-3678/100 g) compared to New Zealand (798 mg/100 g; range: 249-2380 mg/100 g). Average pack size ranged from 57 g (Costa Rica) to 98 g (China). The average packet contributed 35% to 95% of the World Health Organization recommended daily salt intake of <5 g. Forty-one percent of products met the Pacific Island (PICs) regional sodium targets, 37% met the South Africa 2016 targets, and 62% met the UK 2017 targets. This study emphasises a need for stronger regulation and closer monitoring to drive rigorous reformulation of salt in ultra-processed foods.

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  • Indicators of the relative availability of healthy versus unhealthy foods in supermarkets: a validation study

    Vandevijvere, Stefanie; Mackenzie, T; Ni Mhurchu, Cliona (2017-04-26)

    Journal article
    The University of Auckland Library

    In-store availability of healthy and unhealthy foods may influence consumer purchases. Methods used to measure food availability, however, vary widely. A simple, valid, and reliable indicator to collect comparable data on in-store food availability is needed.Cumulative linear shelf length of and variety within 22 healthy and 28 unhealthy food groups, determined based on a comparison of three nutrient profiling systems, were measured in 15 New Zealand supermarkets. Inter-rater reliability was tested in one supermarket by a second researcher. The construct validity of five simple indicators of relative availability of healthy versus unhealthy foods was assessed against this 'gold standard'.Cumulative linear shelf length was a more sensitive and feasible measure of food availability than variety. Four out of five shelf length ratio indicators were significantly associated with the gold standard (?????=???0.70-0.75). Based on a non-significant difference from the 'gold standard' (d???=???0.053????????0.040) and feasibility, the ratio of cumulative linear shelf length of fresh and frozen fruits and vegetables versus soft and energy drinks, crisps and snacks, sweet biscuits and confectionery performed best for use in New Zealand supermarkets.Four out of the five shelf length ratio indicators of the relative availability of healthy versus unhealthy foods in-store tested could be used for future research and monitoring, but additional validation studies in other settings and countries are recommended. Consistent use of those shelf length ratio indicators could enhance comparability of supermarket food availability between studies, and help inform policies to create healthy consumer food retail environments.

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  • Advocating for a More Relational and Dynamic Model of Participation for Child Researchers

    Ergler, Christina R. (2017)

    Journal article
    University of Otago

    Primary school children participating as researchers has become a moral obligation to meet the goal of children’s participation rights. Yet, critical voices rarely question the ethical and practical implications of turning young children into mini-clones of adult researchers. While enabling and constraining aspects of participatory methods and inherent power issues per se are widely discussed, adult researchers still seem to struggle to critically engage with celebratory accounts of children as researchers. In particular, the practical obligations, ethical challenges and tensions that impact on primary school children’s research experiences, are underexplored. Findings from two projects on play, which engaged children as active researchers, suggest that more attention needs to be paid to the messy realities of becoming and being a child researcher. In particular, researchers should be more attuned to children’s capabilities and the ethical hurdles for child and adult researchers. This article argues therefore for a more dynamic, meaningful and realistic model of participation, that speaks to the messy realities of becoming and being a child-researcher. In other words, the article questions the dominant orthodoxy of children as researchers as the ‘gold standard’ of participatory research with children.

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  • Untangling glycaemia and mortality in critical care

    Uyttendaele V; Dickson JL; Shaw GM; Desaive T; Chase JG (2017)

    Journal article
    University of Canterbury Library

    Hyperglycaemia is associated with adverse outcomes in the intensive care unit, and initial studies suggested outcome benefits of glycaemic control (GC). However, subsequent studies often failed to replicate these results, and they were often unable to achieve consistent, safe control, raising questions about the benefit or harm of GC as well as the nature of the association of glycaemia with mortality and clinical outcomes. In this study, we evaluated if non-survivors are harder to control than survivors and determined if glycaemic outcome is a function of patient condition and eventual outcome or of the glycaemic control provided.Clinically validated, model-based, hour-to-hour insulin sensitivity (SI) and its hour-to-hour variability (%ΔSI) were identified over the first 72 h of therapy in 145 patients (119 survivors, 26 non-survivors). In hypothesis testing, we compared distributions of SI and %ΔSI in 6-hourly blocks for survivors and non-survivors. In equivalence testing, we assessed if differences in these distributions, based on blood glucose measurement error, were clinically significant.SI level was never equivalent between survivors and non-survivors (95% CI of percentage difference in medians outside ±12%). Non-survivors had higher SI, ranging from 9% to 47% higher overall in 6-h blocks, and this difference became statistically significant as glycaemic control progressed. %ΔSI was equivalent between survivors and non-survivors for all 6-hourly blocks (95% CI of difference in medians within ±12%) and decreased in general over time as glycaemic control progressed.Whereas non-survivors had higher SI levels, variability was equivalent to that of survivors over the first 72 h. These results indicate survivors and non-survivors are equally controllable, given an effective glycaemic control protocol, suggesting that glycaemia level and variability, and thus the association between glycaemia and outcome, are essentially determined by the control provided rather than by underlying patient or metabolic condition.

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  • How to conduct meta-analysis: a basic tutorial

    Basu A (2017)

    Journal article
    University of Canterbury Library

    Meta analysis refers to a process of integration of the results of many studies to arrive at evidence syn- thesis. Meta analysis is similar to systematic review; however, in addition to narrative summary that is conducted in systematic review, in meta analysis, the analysts also numerically pool the results of the studies and arrive at a summary estimate. In this paper, we discuss the key steps of conducting a meta analysis. We will discuss the steps of a simple meta-analysis with a demonstration of the key steps based on a published paper on meta-analysis and systematic review of the effectiveness of salt restricted diet on blood pressure control. This paper is a basic introduction to the process of meta-analysis. In subsequent papers in this series, we will show how you can conduct meta-analysis of diagnostic and screening studies, network meta analyses, and those of diagnostic and screening studies.

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  • Transition from visual condition rating of cracking, shoving and ravelling to automatic data collection

    Henning, Theunis; Morrow, GJ (2017-05-29)

    Report
    The University of Auckland Library

    Robust condition data feeding into asset management processes is a key step towards having confidence in long-term strategies for renewals and replacements. The manual condition rating system was originally developed as an input into the treatment selection algorithm; however, in later years the data has been used for pavement deterioration modelling and trend monitoring, which are outside the intended scope of the rating system. It was therefore not unexpected that both field inspectors and researchers highlighted shortcomings in the quality and repeatability of manually recorded data. Automated scanning technologies promise to overcome many of the issues associated with manual condition data collection. However, before a wide-spread adoption of the scanning technology is possible, research had to prove the accuracy of the measurements and determine the impact of new data items in the asset management processes. This research addressed both these items and has concluded the technology is ready for adoption in New Zealand. However, fully automated surveys yield less than desirable accuracy with a high portion of false negatives identified. All scanning surveys must be supplemented by appropriate manual quality assurance processes.

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  • The relationship between vehicle axle loadings and pavement wear on local roads

    Arnold, G; Henning, Theunis; Alabaster, D; Greenslade, F; Fussell, A; Craw, R (2017-06-14)

    Report
    The University of Auckland Library

    In New Zealand heavy vehicles are charged for using the road based on the damage caused passing over the road. The current approach to charging has its origins in American research that found doubling an axle load increased the damage as a power function with an exponent of 4, known as the Fourth Power Law. This was developed with limited pavement and vehicle load types not representative of most of the roads in New Zealand. This research provided reliable evidence on the wear characteristics of New Zealand local road pavements from accelerated pavement loading studies at the Canterbury Accelerated Pavement Testing Indoor Facility (CAPTIF). The aim was to determine the relative damage on different pavement types/strengths. The data was extended with rut depth modelling with repeated load triaxial data and validated with field data from the nationwide long-term pavement performance sites. A relationship was found between pavement life tested at CAPTIF plus the rut depth modelling and the damage law exponent for the 4 and 6 tonne equivalent axle loads. For short-life pavements the damage law exponent increased.

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