89,525 results

  • The Financial Inclusion Assemblage: Subjects, Technics, Rationalities

    Schwittay, Anke (2011)

    Journal article
    The University of Auckland Library

    This article introduces financial inclusion as a global assemblage of subjects, technics, and rationalities that aim to develop poor-appropriate financial products and services. Microfinance forms the foundation, but also the boundary of the assemblage, which is premised on the assumption that the 2.7 billion poor people in the world who do not currently have access to formal loan, savings, and insurance products are in need of such offerings. The work of the Institute for Money, Technology and Financial Inclusion at the University of California, Irvine, with its emphasis on ethnographic research into culturally grounded monetary practices and logics, is presented as an alternative to the quantitative, economic, and financial logics that drive the assemblage.

    View record details
  • Thermal limits of portunid crab heart mitochondria: Could more thermo-stable mitochondria advantage invasive species?

    Iftikar, FI; MacDonald, J; Hickey, Anthony (2010)

    Journal article
    The University of Auckland Library

    The distributions of the native crab Ovalipes catharus and the invasive species Charybdis japonica within New Zealand shores may be defined by thermal tolerance. Doppler ultrasound showed that with increasing temperature O. catharus and C. japonica raised their heart rates (p ??? 0.05). However, C. japonica showed greater plasticity in heart beat duration, or contraction rate with increasing temperature, while O. catharus was more inclined to increase heart rate, and already had a shorter more rapid contraction at 19 ??C. Saponin permeabilized heart fibres enabled tests of mitochondrial function in situ and showed that Leak-I respirational flux was highest for O. catharus at all temperatures. C. japonica showed a greater inner mitochondrial membrane integrity which suggests tighter coupling of oxidative phosphorylation. Although Complex I lost function on exposure to 30 ??C in both species, this occurred more rapidly in O. catharus. Complex II function remains stable at high temperature in both species. O. catharus had higher cytochrome c oxidase (CCO) flux at all temperatures compared to C. japonica indicating elevated concentrations of CCO in O. catharus. The scope to increase CCO flux was greater in the more stenothermal O. catharus than in C. japonica. Overall, this study shows substantial differences in heart function and mitochondria between crab species and provides evidence that mitochondrial integrity may limit species survival and potentially future distributions.

    View record details
  • Dietary factors in chronic inflammation: Food tolerances and intolerances of a New Zealand Caucasian Crohn's disease population

    Triggs, Christopher; Munday, K; Hu, Rong; Fraser, Alan; Gearry, RB; Barclay, ML; Ferguson, Lynnette (2010-08-07)

    Journal article
    The University of Auckland Library

    Diet is known to play a major role in the symptoms of the inflammatory bowel disease, Crohn's disease (CD). Although no single diet is appropriate to all individuals, most CD patients are aware of foods that provide adverse or beneficial effects. This study seeks to categorise foods in relation to their effects on symptoms of CD, in a New Zealand Caucasian population. Four hundred and forty-six subjects from two different centres in New Zealand were recruited into the study. An extensive dietary questionnaire (257 food items in 15 groups) recorded self-reported dietary tolerances and intolerances. Across each of the food groups, there were statistically significant differences among responses to foods. A two-dimensional graphical summary enabled stratification of foods according to the probability that they will be either beneficial or detrimental. A small number of foods are frequently considered to be beneficial, including white fish, salmon and tuna, gluten-free products, oatmeal, bananas, boiled potatoes, sweet potatoes (kumara), pumpkin, soya milk, goat's milk and yoghurt. Foods that are typically considered detrimental include grapefruit, chilli or chilli sauce, corn and corn products, peanuts, cream, salami, curried foods, cola drinks, high energy drinks, beer, and red wine. For a number of the food items, the same item that was beneficial for one group of subjects was detrimental to others; in particular soya milk, goat's milk, yoghurt, oatmeal, kiwifruit, prunes, apple, broccoli, cauliflower, linseed, pumpkin seed, sunflower seed, ginger and ginger products, beef, lamb, liver, and oily fish. It was not possible to identify a specific group of food items that should be avoided by all CD patients. The wide range of detrimental items suggests that dietary maintenance of remission is likely to be difficult, and to exclude a substantial number of foods. Personalised diets may be especially important to these individuals.

    View record details
  • Helicobacter pylori and iron deficiency in teenage females in New Zealand

    Fraser, Alan; Scragg, Robert; Schaaf, D; Metcalf, Patricia; Grant, Cameron (2010)

    Journal article
    The University of Auckland Library

    Background Iron deficiency is an important problem in New Zealand children and young adults. Iron deficiency and Helicobacter pylori (H. pylori) infection are each more common in Maori and Pacific Island ethnic groups. Aims This study seeks to determine if H. pylori infection is associated with iron deficiency. Methods 792 female students from 7 Auckland high schools (median age 16 years) had H. pylori serology and tests for iron deficiency assessed by a combination of serum ferritin, iron saturation and mean cell volume. Results The prevalence of positive H. pylori serology was highest for Pacific Island students (49.0%; CI 38.0???60.0), intermediate for Maori (26.7%; CI 16.9???36.4) and Asian (24.7%; CI 12.6???36.7) and lowest for European (13.7%; 6.0???21.4) p<0.0001. Students with positive H. pylori serology had lower mean levels of iron saturation (p=0.013), but not of ferritin (p=0.068), haemoglobin (p=0.08) or mean cell volume (p=0.16), compared to those with negative serology. Positive H. pylori serology was associated with increased risk of iron deficiency (RR 1.20; CI 1.08???1.34), but not anaemia (RR 1.01; CI 0.87???1.18), after adjusting for age, ethnicity and school SES decile. Conclusions This study indicates that H. pylori infection is associated with iron deficiency in adolescent females. There are significant differences in H. pylori serology amongst different ethnic groups in New Zealand

    View record details
  • Early organ-specific mitochondrial dysfunction of jejunum and lung found in rats with experimental acute pancreatitis

    Mittal, A; Hickey, Anthony; Chai, CC; Loveday, BPT; Thompson, NM; Dare, AJ; Delahunt, B; Cooper, Garth; Windsor, John; Phillips, Anthony (2011)

    Journal article
    The University of Auckland Library

    Introduction:??? Multiple organ dysfunction is the main cause of death in severe acute pancreatitis. Primary mitochondrial dysfunction plays a central role in the development and progression of organ failure in critical illness. The present study investigated mitochondrial function in seven tissues during early experimental acute pancreatitis. Methods:??? Twenty-eight male Wistar rats (463 ?? 2 g; mean ?? SEM) were studied. Group 1 (n= 8), saline control; Group 2 (n= 6), caerulein-induced mild acute pancreatitis; Group 3 (n= 7) sham surgical controls; and Group 4 (n= 7), taurocholate-induced severe acute pancreatitis. Animals were euthanased at 6 h from the induction of acute pancreatitis and mitochondrial function was assessed in the heart, lung, liver, kidney, pancreas, duodenum and jejunum by mitochondrial respirometry. Results:??? Significant early mitochondrial dysfunction was present in the pancreas, lung and jejunum in both models of acute pancreatitis, however, the Heart, liver, kidney and duodenal mitochondria were unaffected. Conclusions:??? The present study provides the first description of early organ-selective mitochondrial dysfunction in the lung and jejunum during acute pancreatitis. Research is now needed to identify the underlying pathophysiology behind the organ selective mitochondrial dysfunction, and the potential benefits of early mitochondrial-specific therapies in acute pancreatitis.

    View record details
  • A radical approach to beating hypoxia: depressed free radical release from heart fibres of the hypoxia-tolerant epaulette shark (Hemiscyllum ocellatum)

    Hickey, Anthony; Renshaw, GMC; Speers-Roesch, B; Richards, JG; Wang, Y; Farrell, AP; Brauner, CJ (2012-01)

    Journal article
    The University of Auckland Library

    Hypoxia and warm ischemia are primary concerns in ischemic heart disease and transplant and trauma. Hypoxia impacts tissue ATP supply and can induce mitochondrial dysfunction that elevates reactive species release. The epaulette shark, Hemiscyllum ocellatum, is remarkably tolerant of severe hypoxia at temperatures up to 34??C, and therefore provides a valuable model to study warm hypoxia tolerance. Mitochondrial function was tested in saponin permeabilised ventricle fibres using high-resolution respirometry coupled with purpose-built fluorospectrometers. Ventricular mitochondrial function, stability and reactive species production of the epaulette shark was compared with that of the hypoxia-sensitive shovelnose ray, Aptychotrema rostrata. Fibres were prepared from each species acclimated to normoxic water conditions, or following a 2??h, acute hypoxic exposure at levels representing 40% of each species' critical oxygen tension. Although mitochondrial respiratory fluxes for normoxia-acclimated animals were similar for both species, reactive species production in the epaulette shark was approximately half that of the shovelnose ray under normoxic conditions, even when normalised to tissue oxidative phosphorylation flux. The hypoxia-sensitive shovelnose ray halved oxidative phosphorylation flux and cytochrome c oxidase flux was depressed by 34% following hypoxic stress. In contrast, oxidative phosphorylation flux of the epaulette shark ventricular fibres isolated from acute hypoxia exposed the animals remained similar to those from normoxia-acclimated animals. However, uncoupling of respiration revealed depressed electron transport systems in both species following hypoxia exposure. Overall, the epaulette shark ventricular mitochondria showed greater oxidative phosphorylation stability and lower reactive species outputs with hypoxic exposure, and this may protect cardiac bioenergetic function in hypoxic tropical waters.

    View record details
  • The marketization of poverty

    Schwittay, Anke (2011)

    Journal article
    The University of Auckland Library

    Increasingly, transnational corporations (TNCs) see themselves, and are seen by multilateral development organizations and national governments, as part of the solution to global poverty alleviation. Guided by C. K. Prahalad’s theories about the “bottom of the pyramid” (BoP), TNCs are developing products and services for the billions of people living on a few dollars a day that are supposed to enable these poor people to enterprise themselves out of poverty. In the process, poverty and the poor are made amenable to market interventions by being constituted as a potential new market for TNCs. Hewlett-Packard’s (HP’s) e-Inclusion program was the first corporate-wide BoP initiative in the high-tech industry that aimed to create corporate and social benefits. An analysis of its companyinternal evolution from an intrapreneurial initiative to a fully incorporated business operation is complemented by a study of e-Inclusion’s activities in Costa Rica, which aimed to improve the lives of rural Costa Ricans by providing access to HP technology and by creating new sources of income for electronic entrepreneurs. However, transforming the poor into protoconsumers of TNC products and services cannot address the structural drivers of their circumstances and will lead to neither the eradication of poverty nor a corporate fortune at the BoP.

    View record details
  • A modified audit production framework: Evaluating the relative efficiency of audit engagements

    Knechel, Warren; Rouse, Antony; Schelleman, C (2009)

    Journal article
    The University of Auckland Library

    We develop a model of audit production based on Data Envelopment Analysis (DEA) using labor cost as input and hours spent on evidence-gathering activities that determine the level of assurance as output. Client characteristics are considered exogenous factors that affect audit production as a whole. We apply the model to a sample of U.S.-based engagements from an international accounting firm. Results indicate that a constrained DEA model using variable returns to scale is appropriate for modeling audit production. We find that audits are more efficient for clients that are larger, have a December year-end, and are highly automated. Audits are less efficient when the auditor relies on internal control, tax services are provided, and the client has subsidiaries. We also find that a well-specified regression-based production model can control for factors that influence auditor efficiency. Finally, we find that inefficiencies are impounded in fees for some industries and firm offices.

    View record details
  • A history of ENSO events since A.D. 1525: implications for future climate change

    Gergis, JL; Fowler, Anthony (2009)

    Journal article
    The University of Auckland Library

    Reconstructions of past climate are important for providing a historical context for evaluating the nature of 20th century climate change. Here, a number of percentile-based palaeoclimate reconstructions were used to isolate signals of both phases of El Ni??o-Southern Oscillation (ENSO). A total of 92 (82) El Ni??o (La Ni??a) events were reconstructed since A.D. 1525. Signi cantly, we introduce the most comprehensive La Ni??a event record compiled to date. This annual record of ENSO events can now be used for independent veri cation of climate model simulations, reconstructions of ENSO indices and as a chronological control for archaeologists/social scientists interested in human responses to past climate events. Although extreme ENSO events are seen throughout the 478-year ENSO reconstruction, approximately 43% of extreme and 28% of all protracted ENSO events (i.e. both El Ni??o and La Ni??a phase) occur in the 20th century. The post-1940 period alone accounts for 30% of extreme ENSO years observed since A.D. 1525. These results suggest that ENSO may operate diff erently under natural (pre-industrial) and anthropogenic background states. As evidence of stresses on water supply, agriculture and natural ecosystems caused by climate change strengthens, studies into how ENSO will operate under global warming should be a global research priority.

    View record details
  • Mindful pedagogy in dance: Honoring the life of the child

    Sansom, Adrienne (2009)

    Journal article
    The University of Auckland Library

    Recent Innovations in the field of early childhood education have prompted a rethinking of teaching and learning. Traditional notions of child development have been undergoing some radical changes and, as such, have resulted in a reviewing and re-formulation of early years pedagogy. In Aotearoa New Zealand the field of early childhood education has reflected these changes primarily through the development of a new national early childhood curriculum based on bicultural values and beliefs. This paper traces the history and development of the curriculum document Te Wh riki, New Zealand???s first codified early childhood curriculum, which is seen as an empowering and holistic curriculum underpinned by principles and goals rather than being content driven. The ensuing discussion describes what this means for early years dance education, particularly at the level of pre-service teacher education programs and the emerging issues and concerns that arise from a reconceptualization of curriculum this is open to interpretation. Central to the Conceptualization of Te Wh riki is the premise of the image of the competent and confident child. In support of this the paper examines the teaching and learning of dance in early childhood settings whereby opportunities are afforded for the provision of dance where children are acknowledged as active agents in directing their own learning. The paper concludes by positing a new vision for dance education in Aotearoa New Zealand as well as suggesting possible implications for dance Internationally.

    View record details
  • ENSO history recorded in Agathis australis (kauri) tree rings. Part B: 423 years of ENSO robustness

    Fowler, Anthony (2008)

    Journal article
    The University of Auckland Library

    Part A of this study identified the potential of kauri tree rings for reconstructing the history of past ENSO activity. Plausible indices of multidecadal to centennial-scale ENSO activity (phase dominance and robustness) that could be derived from kauri regional master chronologies are hypothesized here, and they are tested against the instrumental SOI record, using partitioning and graphical analyses. The subset of the indices passing this first screening are then tested for sensitivity to the complex evolving sample depth and site-composition mix that characterizes regional tree-ring chronologies. Corrections for evolving sample depth are developed where possible. The two indices of ENSO activity remaining after these two screening phases (evolving chronology time-series variance and decadal-scale spectral signature) are used to infer 423 years of ENSO robustness and the results are compared to two multiproxy ENSO reconstructions. Results suggest that ENSO robustness (1) peaked in the 20th century, (2) is characterized by persistent 55???80 year cyclicity, (3) was low in the mid-20th century only relative to robust ENSO activity at the beginning and end of that century, (4) reached a pre-20th century peak in the mid-18th century, and (5) was weakest near the beginning of the 19th century.

    View record details
  • Data Envelopment Analysis: A Practical Tool to Measure Performance

    Rouse, Antony; Harrison, Julie; Chen, Li (2010)

    Journal article
    The University of Auckland Library

    This paper describes a productivity method, data envelopment analysis (DEA), and how it can be used to measure performance using multiple performance measures. DEA compares organisations or parts of organisations that share common goals and use similar resources to produce similar products, and calculates the technical efficiency with which firms convert bundles of inputs into bundles of outputs. DEA has been used in both public and private settings, and the paper describes some of its applications within Australasia. A case study of New Zealand dairy farms is used to demonstrate the benchmarking capability of DEA. While built upon solid theoretical foundations, DEA is essentially a practical tool that can be used by academics for research as well as by managers and practitioners for improved performance measurement and accountability.

    View record details
  • New Zealand triplefin fishes (family Tripterygiidae): contrasting population structure and mtDNA diversity within a marine species flock

    Hickey, Anthony; Lavery, Shane; Hannan, DA; Baker, Charles; Clements, Kendall (2009)

    Journal article
    The University of Auckland Library

    Triplefin fishes (Family Tripterygiidae) dominate the New Zealand temperate coastal fish fauna in diversity (26 endemic species, 14 genera). Most species appear to have evolved as a local radiation and mostly occupy sympatric distributions throughout New Zealand. To investigate the forces driving current gene-flow patterns and past evolutionary histories, we searched for common patterns of population genetic subdivision within eight species sampled throughout their distributions [mitchochondrial DNA (mtDNA) control region, n = 1086]. We hypothesised that common phylogeographical and population differentiation patterns would reveal past or ongoing physical processes, with differences reflecting stochastic or species-specific processes. Striking differences between species were apparent, with strong phylogeographical structure detected in Grahamina capito and the estuarine species G. nigripenne. G. capito fell into three distinct geographically restricted lineages. G. nigripenne largely separated into northern and southern lineages (??ST 0.834). Strong population structuring and isolation by distance was evident in Bellapiscis medius, B. lesleyae and Forsterygion lapillum (??ST 0.686, 0.436 and 0.115, respectively). High gene flow was apparent in G. gymnota and Ruanoho whero, and F. varium. However, for the latter species, isolation was apparent with samples collected from the offshore Three Kings Islands. Overall, a strong relationship was found between habitat depth and population structure among species, and species inhabiting shallower water habitats showed lower genetic diversity with higher levels of population subdivision. High-latitude populations generally showed low haplotype and nucleotide diversity. These data suggest that processes resulting from intraspecific differences in habitat preference, climatic histories and/or larval ecologies have subdivided populations of shallow water triplefin species.

    View record details
  • Meeting the Graduating Teacher Standards: The added benefits for undergraduate university students who mentor youth

    Bullen, Patricia; Farruggia, SP; Rozas Gomez, CA; Hebaishi, Ghada; Alansari, Mohamed (2010)

    Journal article
    The University of Auckland Library

    Although research has clearly demonstrated the benefits of mentoring for mentees, much less is known about how mentoring impacts mentors and, in particular, their professional development. Using a mixed-methods design, this study investigated the impact that mentoring youth had on the professional development of first- and second-year university students, primarily preservice teachers. Researchers collected quantitative data from twenty-eight undergraduate university student mentors pre- and post-program, as well as twenty-nine ninth-grade mentees post-program. In addition, a focus group was conducted with six mentors post-program. The data analyses were guided by the Graduating Teacher Standards: Aotearoa New Zealand (GTS), which outline what a beginning teacher should know at the conclusion of a professional teacher education degree program. The results indicated that mentoring had a positive impact on mentors' development of the values, skills, relationships, and knowledge required to satisfy the GTS. The implications of these findings are discussed within the context of professional development. (Contains 3 tables.)

    View record details
  • Pricing Public Health Care Services using DEA: Methodology versus Politics

    Rouse, Antony; Swales, R (2006)

    Journal article
    The University of Auckland Library

    The NewZealand public health sector has usedDEAsince 1997 to identify efficient expenditure levels to set prices for hospital services at the DRG level. Given the size of the expenditure (NZ$ 2.6 billion), considerable robustness was required for the results and sophistication of the models/process. While the model development and application appeared to be successful, politics overturned the results in the short run. In the longer term, the results have been shown to be reasonably robust and have become a base-line reference for future developments. As such, this paper reports a relatively successful transfer of theory into practice.

    View record details
  • Regional climate regime classification as a qualitative tool for interpreting multi-proxy palaeoclimate data spatial patterns: A New Zealand case study

    Lorrey, Andrew; Fowler, Anthony; Salinger, J (2007)

    Journal article
    The University of Auckland Library

    The precipitation characteristics of three basic circulation types for New Zealand weather [Kidson, J.W. 2000. An analysis of New Zealand synoptic types and their use in defining weather regimes. International Journal of Climatology. 20, 299???316] are explored here as a palaeoclimate reconstruction tool, and are utilised as a way to interpret spatial patterns exhibited by diverse multi-proxy data assemblages. The technique is founded on a modern climate shift analogue for New Zealand where regional precipitation spatial changes accompanied the 1976/77 Inter-decadal Pacific Oscillation (IPO) phase change. The analysis here indicates multi-decadal-scale circulation changes (both in frequency and strength) resulted from the 1976/77 IPO phase change primarily during mid???late summer, late autumn and late winter, and a significant change (a zonal regime frequency and strength increase) occurred for August. From the climatological results, the eastern North Island along with the western and eastern South Island are crucial regions to include in a spatial pattern-based palaeoclimate reconstruction because of sensitivities to zonal circulation changes. Ascribing a climate regime classification to multi-proxy data was subsequently attempted for three discrete timeslices in the Late Holocene, and illustrates that many different types of multi-proxy terrestrial data can successfully be assimilated with some evident advantages and shortcomings. Climate regime classification has good potential for highlighting spatial and temporal gaps in regional palaeoclimate proxy networks, and in the case of New Zealand, potential for connecting local and regional palaeoclimate data to conditions associated with westerly circulation changes, the IPO, and for exploration of Australasian and extra-tropical palaeoclimate archive connections.

    View record details
  • Examining the cultural context of mentoring: A systematic review

    Farruggia-Sherman, Susan; Bullen, Patricia; Solomon, F; Collins, E; Dunphy, A (2011)

    Journal article
    The University of Auckland Library

    While research in youth mentoring is extensive in the U.S., little research has explored its effectiveness in New Zealand, despite its growth in the past 20 years. While arguments have been raised that overseas models may not fit all cultural contexts within New Zealand, there appears to be limited evidence supporting this contention. Further, little is known about associations between effectiveness and the cultural appropriateness of programs and research. This systematic review of youth mentoring programs in New Zealand is based on 26 studies that met inclusion criteria. Of those, 14 had a significant proportion (15% or more) of indigenous M??ori youth and six had a significant proportion of Pasifika (Pacific Islander) youth. While almost all programs and associated research were culturally appropriate to the overall New Zealand context, they tended to be less culturally appropriate for programs working with M??ori and Pasifika youth. Further, there was a negative association between cultural appropriateness and program effectiveness.

    View record details
  • Personal project commitment in adolescence: The role of relatedness, competence and integrity

    Harre, Nicole; Bullen, Patricia (2010)

    Journal article
    The University of Auckland Library

    University (n???=???175) and high school (n???=???162) students rated their commitment to three personal projects self-identified as central to their lives, the extent to which each project generated experiences of relatedness, competence and integrity, and how much approval it received from significant others. This study compared the ???life??? (hobbies, fitness, church, life transitions, intrapersonal, etc.) and education projects of participants who spontaneously generated an example of each (98 university and 70 high school participants). Integrity and competence received higher ratings than relatedness and were the most important predictors of commitment to both types of project. For both groups, education projects received more family/adult approval than life projects and there was much greater variation in approval ratings for the latter. The results suggest that, at least for young people in New Zealand, feeling that you are good at a project and it fits with your values, is almost a proxy for commitment. It is possible that social factors play a less direct role, perhaps by influencing the choice of interpersonal settings in which to carry out important projects.

    View record details
  • Is there an indication for embolic protection in renal artery intervention?

    Holden, Andrew (2011-06)

    Journal article
    The University of Auckland Library

    The role of endovascular treatment of atherosclerotic renal artery disease is uncertain, particularly after the publication of the Angioplasty and Stenting for Renal Artery Lesions trial and other randomized trials. These trials have shown that nonselective treatment of patients with renal artery stenosis does not result in a benefit when compared with best medical therapy. However, all trials have identified a subgroup of patients who do respond favorably to revascularization. In particular, patients with a degree of chronic renal insufficiency, critical renal artery stenosis, and a recent decline in renal function are likely to respond positively to revascularization. Endovascular treatment of renal artery stenosis must be performed safely, particularly in the high-risk patient group with background chronic renal insufficiency. Atheroembolization occurs during renal artery revascularization, as demonstrated by ex vivo studies and the high embolic yield obtained in published series of protected renal artery revascularization. The evidence supporting embolic protection includes single-center series wherein excellent results for renal function preservation have been reported. One small, randomized, controlled trial demonstrated a significant benefit if both embolic protection and abciximab were used. There are unique demands on an embolic protection device in the renal artery circulation and a dedicated device has not been developed. Both distal filters and occlusion balloons have been successfully used. Both devices can normally be primarily passed through the stenosis, allowing the remainder of the procedure to be protected. Filters have the advantage of maintaining renal perfusion throughout the procedure. Distal occlusion balloons can capture embolic particles of all sizes although the clinical advantage is uncertain.

    View record details
  • Understanding students' concerns about peer physical examination using an activity theory framework

    Wearn, Andrew; Rees, CE; Bradley, P; Vnuk, A (2008)

    Journal article
    The University of Auckland Library

    Context??? Peer physical examination (PPE) has been employed for several decades as part of the formal curriculum for learning clinical skills. Most of the existing studies exploring students??? attitudes towards PPE are single-site and use quantitative methods. Currently, there is a lack of theoretical underpinning to PPE as a learning method. Methods??? Using an adaptation of the Examining Fellow Students questionnaire, we captured qualitative data from Year 1 medical students about their views and concerns around learning using PPE. The study was set in six schools across five countries (the UK, Australia, New Zealand, Japan and Hong Kong). Students provided free text comments that were later transcribed and analysed using framework analysis. Results??? A total of 617 students provided comments for analysis. This paper focuses on several related themes about the complexities of students??? relationships within the context of PPE and their reflections on peer examination in comparison with genuine patient examination. Students drew parallels and differences between the peer examiner???examinee relationship and the doctor???patient relationship. They explained how these two types of relationship differed in nature and in terms of their levels of interaction. Discussion??? Our findings illuminate the interactional and complex nature of PPE, drawing out concerns and ambiguities around relationships, community and rules. We discuss our results in light of Engestr??m???s model of activity theory (AT) and provide recommendations for educational practice and further research based on the principles of AT.

    View record details