88,788 results

  • Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

    Dickson JL; Pretty CG; Alsweiler J; Lynn A; Chase JG (2017)

    Journal article
    University of Canterbury Library

    Background: Models of human glucose–insulin physiology have been developed for a range of uses, with similarly different levels of complexity and accuracy. STAR (Stochastic Targeted) is a model-based approach to glycaemic control. Elevated blood glucose concentrations (hyperglycaemia) are a common complication of stress and prematurity in very premature infants, and have been associated with worsened outcomes and higher mortality. This research identifies and validates the model parameters for model-based glycaemic control in neonatal intensive care. Methods: C-peptide, plasma insulin, and BG from a cohort of 41 extremely pre-term (median age 27.2 [26.2–28.7] weeks) and very low birth weight infants (median birth weight 839 [735–1000] g) are used alongside C-peptide kinetic models to identify model parameters associated with insulin kinetics in the NICING (Neonatal Intensive Care Insulin–Nutrition–Glucose) model. A literature analysis is used to determine models of kidney clearance and body fluid compartment volumes. The full, final NICING model is validated by fitting the model to a cohort of 160 glucose, insulin, and nutrition data records from extremely premature infants from two different NICUs (neonatal intensive care units). Results: Six model parameters related to insulin kinetics were identified. The resulting NICING model is more physiologically descriptive than prior model iterations, including clearance pathways of insulin via the liver and kidney, rather than a lumped parameter. In addition, insulin diffusion between plasma and interstitial spaces is evaluated, with differences in distribution volume taken into consideration for each of these spaces. The NICING model was shown to fit clinical data well, with a low model fit error similar to that of previous model iterations. Conclusions: Insulin kinetic parameters have been identified, and the NICING model is presented for glycaemic control neonatal intensive care. The resulting NICING model is more complex and physiologically relevant, with no loss in bedside-identifiability or ability to capture and predict metabolic dynamics.

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  • The impact of social investment perspectives on gender equality: critical review of the EU childcare strategy

    Masselot AM (2017)

    Conference Contributions - Other
    University of Canterbury Library

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  • Hope for Regeneration: Increasing Civic Intentions and Values in Young People

    Hayhurst, Jillian Grace (2017)

    Doctoral thesis
    University of Otago

    Civic engagement is integral to healthy communities and a functioning democracy, yet recent evidence suggests that it is declining, especially among young people. The purpose of this thesis is to address the recent decline by exploring ways by which to increase civic intentions and civic values in young people. To this end, three interventions were investigated. Studies 1a and 1b explored the potential of community-based young changemaker (ReGeneration) events to increase civic intentions (Study 1a) and civic values (Study 1b). The findings from Studies 1a and 1b revealed that ReGeneration events increased civic intentions and civic values, whereas the controls experienced no such changes. Furthermore, generosity uniquely contributed to civic values outcomes after controlling for initial levels of civic values, well- being and civic intentions. A factor analysis revealed that a revised, shorter civic values scale was a better fit in the present context. Study 2 explored the potential for a prosocial behaviour reflection and writing task to influence civic values, happiness and future prosocial spending decisions (i.e. how participants chose to spend a surprise $10 windfall). The findings from Study 2 revealed that (a) following the writing task all participants experienced increases in civic values; and (b) happier people were more likely to spend their money prosocially, regardless of what they wrote about. Neither writing task topic nor windfall spending decision influenced levels of civic values or happiness. Study 3 explored the potential for acute inclusion or exclusion feedback to impact sense of belonging, civic engagement and well-being. The findings from Study 3 revealed that excluded participants had a lower sense of community belonging, but not other differences in well-being or civic engagement compared to the included or no feedback (control) participants. There were no differences between the included and no feedback groups in terms of belonging, civic engagement or well-being. Taken together, results suggest that the most promising findings in terms of increasing civic intentions and civic values were from the community sample, as ReGeneration participants experienced significant increases in both compared to controls (Studies 1a and 1b), although a brief writing task also increased civic values (Study 2). To this effect, the present thesis describes novel ways by which to cultivate civic values, and highlights ways by which to address the recent civic engagement decline. The implications of these results are discussed in terms of theory and practice, and suggestions for future research directions are made.

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  • The Butterfly Effect: An investigation of sealer penetration, adaptation and apical crack formation in filled root canals.

    Russell, Assil (2017)

    Doctoral thesis
    University of Otago

    Background The butterfly effect is an optical phenomenon seen in some root cross-sections and is related to density and direction of dentinal tubules. Aim The aim of the present study was three-fold. (i) To investigate the quality of adaptation and depth of penetration of root canal sealers (AH Plus®, EndoREZ®, Kerr Pulp Canal Sealer®, MTA Fillapex®) and obturation material (ProRoot® MTA) into the bucco-lingual and mesio-distal aspects of roots with and without the butterfly effect. (ii) To investigate apical cracks in roots which exhibit the butterfly effect and undergo apical resection and ultrasonic root-end cavity preparation. Finally, (iii) the effect of obturation material on crack formation was also studied. Methodology 120 extracted single-rooted teeth were decoronated at the cemento-enamel junction. Roots were viewed under a light microscope (x10) and coded according to the presence or absence of the butterfly effect. Canals were prepared using ProTaper Next files to size X3. Debris was removed using 15% EDTA and 5.25% NaOCl. 100 roots randomly assigned to five obturation groups (gutta-percha (GP) with AH Plus®, GP with EndoREZ®, GP with Kerr Pulp Canal Sealer®, GP with MTA Fillapex®, and ProRoot® MTA alone). Each group contained 10 butterfly, and 10 non-butterfly roots. Control groups of (10 butterfly and 10 non-butterfly) prepared roots were used to confirm smear layer removal. Roots were embedded in resin such that the apical third was exposed. Forty roots (20 GP with AH Plus® and 20 ProRoot® MTA) were resected perpendicular to their long axis, 3 mm from the apex and cavities cut using ultrasonic retrotips. Resin replicas were used for crack imaging with scanning electron microscopy (SEM). 100 roots were then cut horizontally to yield coronal and middle sections. Sections were observed with confocal laser scanning microscope (CLSM) (x10) and “bird’s eye-view” images taken. Depth of penetration was measured using Image J software (National Institute of Health, Bethesda, MD, USA). Sections were then observed with SEM (x400) and images taken from the dentine-sealer or ProRoot® MTA interface. Adaptation was scored as good, reasonable, poor or absent. Statistical analyses were completed with Stata 13.1 (StataCorp, College Station, TX, USA). Results Teeth with the butterfly effect had greater mean penetration bucco-lingually (766.25 µm) compared with mesio-distally (184.09 µm), a significant difference (P = 0.003). In contrast, teeth without the butterfly effect had no significant difference between bucco-lingual (385.78 µm) and mesio-distal (387.03 µm) penetrations (P = 0.98). Teeth with the butterfly effect had significantly greater penetration bucco-lingually compared to teeth without the effect (P = 0.01) and significantly less penetration mesio-distally (P = 0.008). Coronal sections had the greatest mean penetration (430.79 µm) compared with middle sections (247.25 µm), a significant difference (P = 0.006). Adaptation was also significantly more favourable in coronal sections (78% good or reasonable) than middle sections (57% good or reasonable) (P = 0.0012). Depth of penetration and quality of adaptation varied between the sealer groups and ProRoot® MTA, however these did not reach significance. Following root-end resection and cavity preparation, cracks occurred more frequently in teeth with the butterfly effect (80%) compared to those without (20%), a significant difference (P = 0.001). Most cracks (73%) ran bucco-lingually. Teeth obturated with MTA developed fewer cracks (40%) compared to those obturated with GP and AH Plus® (60%), but this was not significant. Conclusion The butterfly effect influences sealer penetration and adaptation inside root canals. Roots with the butterfly effect have greater penetration bucco-lingually. This may enhance entombment of bacteria, which could lead to improved treatment outcomes. Root-ends with the butterfly effect have a significantly higher number of bucco-lingual cracks following resection and ultrasonic root-end preparation. This might explain the development of some vertical root fractures, which usually run bucco-lingually. Canal obturation with MTA may be protective.

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  • Measurement of true ileal calcium digestibility of feed ingredients for broiler chickens : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Animal Science at Institute of Veterinary, Animal and Biomedical Science (IVABS), Massey University, Palmerston North, New Zealand

    Anwar, Muhammad Naveed

    Thesis
    Massey University

    The recent interest towards the use of digestible phosphorus (P) in poultry feed formulations necessitates the measurement of true calcium (Ca) digestibility of feed ingredients because of the close relationship between these two minerals for their absorption and post absorptive utilisation. When this thesis research was initiated, no published data were available on Ca digestibility of feed ingredients for broiler chickens. The major objective of the studies reported in this thesis was to determine the true Ca digestibility of feed ingredients for broiler chickens. In total, nine studies were conducted. The first study (Chapter 4) was conducted to determine the effect of methodology on ileal endogenous Ca losses. Three methods, namely feeding a Ca- and P-free diet, maize gluten meal based diet and egg albumen based diet, were used. Ileal endogenous Ca losses differed among different methodologies. The highest ileal endogenous losses of 125 mg/kg dry matter intake (DMI) were recorded on the Ca- and P-free diet, followed by 77 and 43 mg/kg DMI on maize gluten meal and egg albumen diets, respectively. In the second and third studies (Chapters 5 and 6), regression and direct methods, respectively, were used to determine the true Ca digestibility of meat and bone meal (MBM). The true Ca digestibility coefficient of MBM samples were ranged from 0.41 to 0.60. No difference was observed between true Ca digestibility coefficients of MBM determined by regression and direct methods. Since the direct method is less laborious and cost effective compared to regression method, this method was used in subsequent studies (Chapters 7 to 10) to determine the true Ca digestibility of a range of Ca sources. In fourth and fifth studies (Chapters 7 and 8), the influence of dietary P, particle size and Ca to non-phytate P ratio was investigated on the true Ca digestibility of limestone for broiler chickens. The true Ca digestibility of three limestone samples varied from 0.56 to 0.62. Supplementation with recommended dietary P (4.5 g/kg) increased the true Ca digestibility of limestone when compared to diets without P. An increase in particle size from <0.5 to 1-2 mm increased both the Ca digestibility and retention of both Ca sources, and increased the Ca concentration of gizzard contents. The study reported in Chapter 10 was conducted to determine the true Ca digestibility of dicalcium phosphate (DCP), monocalcium phosphate (MCP), canola meal, poultry by-product meal and fish meal, and to compare the effect of dietary adaptation length on true Ca digestibility of DCP and MCP. The true Ca digestibility coefficients of these feed ingredients were lower than MBM, limestone and oyster shell, and ranged from 0.24 to 0.33. It was speculated that the length of adaption to the assay diets may be responsible for the lower than expected estimates. The effect of dietary adaptation length (24, 48 or 72 hrs) was subsequently examined, but had no effect on true Ca digestibility of DCP and MCP. In the final study (Chapter 11), the true Ca digestibility of DCP was determined using different methodologies (regression, difference and direct methods). The true Ca digestibility coefficients of DCP were 0.34 and 0.21 with direct and different methods, respectively. A very low digestibility coefficient of 0.13 was determined by the regression method. In conclusion, the true Ca digestibility coefficient of major Ca sources (limestone, oyster shell and MBM) is not high and varied from 0.40 to 0.70. Particle size of limestone and oyster shell influenced Ca digestibility, with coarser particles having higher digestibility. The direct method appears to be suitable for the determination of true Ca digestibility of limestone, oyster shell and MBM, but may not be appropriate for other Ca sources with intrinsic imbalance of Ca and P.

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  • Raising a child with an Autism Spectrum Disorder : the experience of stigma by association, its impact on caregiver wellbeing, the influence of signature strengths, and the experience of growth : a thesis presented in partial fulfillment of the requirements for the degree of Doctorate of Clinical Psychology at Massey University, Manawatu, New Zealand

    Weastell, Katie

    Thesis
    Massey University

    The life of a child with an Autism Spectrum Disorder (ASD) is known to include many difficulties, not only due to social, behavioural and communication difficulties, but also as the child does not fit society’s specifications of ‘normal.’ Stressors encountered by caregivers raising a child with an ASD are well documented; however one often overlooked stressor for caregivers is stigma by association. Research to date has begun to explore the impact of stigma by association on the wellbeing of caregivers raising children with an ASD. However research is scarce, and has not yet addressed how some caregivers who experience stigma by association manage to resist this negative influence. Through two studies this thesis explored the experience of caregivers of children with ASDs New Zealand, looking in particular at stigma by association and whether personal signature strengths (particularly hope, gratitude and curiosity) may decrease its impact on caregiver wellbeing. It also examined whether, in spite of documented negative outcomes for caregivers, there is in fact room for a caregiver to experience growth as a byproduct of raising a child with an ASD. Participants took part in interviews (Study One, six participants), or completed an online questionnaire (Study Two, 100 participants). All caregivers spoke of difficulties associated with raising their child which on the whole reflected previous research. Difficulties included practical restrictions, personal costs and social stigma. Every caregiver was found to have experienced stigma by association. Study Two participants had all encountered both enacted and internalised stigma by association in the previous six months, and stigma by association had a significant negative relationship with caregiver wellbeing. Positively, if a caregiver possessed higher levels of hope or gratitude, mediation analysis found the presence of these strengths decreased the influence of stigma by association on wellbeing. Promisingly, all caregivers were also able to identify many ways in which they had grown as a byproduct of the experience of raising their child, whether it was through increased positive emotions, experiences, or personal development. Findings suggest that in spite of caregiver’s challenges they may not only survive, but thrive.

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  • Building stories -- the art of the project manager in exhibition development : an analysis of Death and Diversity at Wellington Museum : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Museum Studies, at Massey University, Manawatū, New Zealand

    Fafeita, Brent Raymond

    Thesis
    Massey University

    This thesis examines the role of both project management and the project manager in museum exhibition development at one museum. Specifically it investigates the necessity of such practice and the various inherent factors that lead to exhibition development success. It argues that project management is not only vital to this success but that such success is dependent on the unique skill and ability of the project manager. Ultimately this thesis advocates for a special breed of project manager suited to the museum environment. Owing to limited museum-based research in this field, it is unclear how effective project management is in developing museum exhibitions and subsequently, understanding the effectiveness of the project manager’s contributions to this process. This research provides a much-needed qualitative study that not only examines the role, but also provides insight into the mindset of one such professional. In addition to introducing museum project management, an in-depth case study focusing on the Wellington Museum (former Museum of Wellington City & Sea) investigates the intricacies associated with this practice. In particular it centres on the Death and Diversity exhibition staged in 2011, where the Museum initiated an inaugural project manager role and then retained it for a large-scale capital development planned for completion in 2020. Utilising qualitative research methods this thesis builds three sections: a context chapter, one case study, and an ethnographic study. Open-ended, in-depth interviewing of both the Museum’s project manager and the director give valuable insight into the practice and perceptions about the role. An observational study examines project manager behaviour and interaction during project meetings. The analysis highlights the complexities of contemporary exhibition development. In an increasingly evolving and resource-limited world of equally increasing scrutiny, this advocates for a profession tailor-made for such complexity in the unique museum environment.

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  • "Pharmacology of salicin derivatives in sheep" : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Animal Science, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand

    Mathurkar, Shashwati Chandrakant

    Thesis
    Massey University

    Content removed from thesis due to copyright reasons: Figure 1.20(e). S. viminalis. Retrieved from Valerie J.:http://gardeners-word.blogspot.co.uk/

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  • Priming good parenting : can positive affective priming influence fathers' causal attributions and consequent disciplinary responses for child misbehaviour? : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Palmerston North, New Zealand

    Mackie, Kayla Louise

    Thesis
    Massey University

    This thesis combines affective priming with the cognitive processes and behavioural sequences found in parenting decisions, to explore whether a father’s attributions for child misbehaviour and consequent disciplinary responses can be influenced by a priming intervention. Forty eight fathers of children aged between 5 and 12 years were questioned on their opinions regarding the causes of child behaviour, and how they would choose to respond to or discipline such behaviour, before and following a priming intervention consisting of full-colour images of fathers interacting with their children. These primes differed in content in both emotional valence and the fathering roles depicted dependent upon the group to which participants were randomly assigned. These groups were General Positive, General Negative, Evolutionary Positive, and Evolutionary Negative priming images. Results showed that all research groups were successfully primed, as measured by a word completion task, however consistent and expected changes in attributions for child behaviour and disciplinary choices did not occur due to the priming intervention. Proposed reasons for this include unforeseen priming effects obscuring the main effect, additional corrective cognitive factors altering or obscuring the priming effect, or difficulties with the way the cognitive and behavioural changes were measured. Proposed methods for further exploration in future research regarding how to translate a priming effect into meaningful and consistent change are discussed. Priming as an adjunctive parenting intervention remains an interesting and worthwhile consideration, and ideas around utilisation of this technique are discussed in light of the results of this research.

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  • Volcanic geology and hydrothermal alteration of the Onemana Area, Eastern Coromandel Peninsula

    Aldrich, Sean Mark (1995)

    Masters thesis
    University of Waikato

    The Onemana Peninsula is located on the eastern side of the Coromandel Peninsula north of the township of Whangamata. This study investigates the volcanology, structure and hydrothermal alteration of the northern half of the Onemana Peninsula. The study area is dominated by rhyolite domes and lava flows, with minor andesite lavas, rhyolite pyroclastics and lake sediments. The central region is extensively hydrothermally altered, with high levels of the original system preserved including hydrothermal eruption breccias and sinters. The Onemana area is dominated by three rhyolite dome complexes: Pohakahaka, Pokohino, and Wharekawa. The Pohakahaka Dome Complex in the south of the study area consists of pyroxene rhyolite domes, lavas and autoclastic breccias. The Pokohino Dome Complex in the central region of the study area consists of biotite rhyolite domes, lavas and autoclastic breccias. Lavas appear to have erupted as coulees and have flowed in a SE direction from a NE-trending ridge. The Wharekawa Dome Complex and Eastern Flows are dominated by biotite rhyolites. Pyroclastic and epiclastic material is overlain by rhyolite lavas in coastal sections north of Pokohino Beach, suggesting explosive activity preceded the eruption of some lavas. Some Eastern Flow lavas have flowed into water and produced a hyaloclastite in the north of the area. The deposition of the Glassy Dome Pyroclastics is thought to have resulted from the collapse of a rhyolite dome. Andesite lavas occur in the west of the study area, and their compositions suggest that they are related to the McBeths Andesite which outcrops 6 km to the NW. A hornblende-biotite ignimbrite is exposed in the north of the area, and is thought to have been erupted from outside the area. Thick lake sediments occur between the Pokohino and Wharekawa dome complexes and infill a graben structure. A hydrothermal eruption breccia resulting from over-pressuring of a geothermal system overlies the lake sediments. The structure of the area is dominated by NW, N, and NE striking faults, and minor EW striking faults. The local structure plays an important role in controlling the locations of volcanism and hydrothermal activity. Older N-striking structures appear to have controlled vent locations for the pyroxene rhyolites, while NE-striking structures have controlled the location the biotite rhyolites and hydrothermal alteration. Mineralised structures are controlled by NW and N striking faults between the NE striking Whitipirorua and Pokohino Faults. XRF analysis of selected volcanic rocks from Onemana show the area to be dominated by medium-K to high-K rhyolites (75-78 wt% SiO₂), with minor andesite (56-58 wt% SiO₂). On the basis of Zr abundance the rhyolites can be divided into high Zr (pyroxene rhyolites) and low Zr (biotite rhyolites, Glassy Dome Rhyolite). The rhyolites are thought to be closely associated with partial melting of the continental crust in a rifting environment. Pervasive to weak alteration occurs within a NE-trending corridor bounded by the Whitipirorua and Pokohino Faults. There are two main alteration types in the area which represent different hydrothermal environments: alkaline and acid alteration. Alkaline alteration consists of an inner core of quartz silicification, surrounded by quartz+ K-feldspar alteration, which grades out into epidote and weak clay alteration assemblages. Zeolites also occur as an overprinting alteration assemblage. Acid alteration consists of pervasive kaolinite alteration, with small areas of quartz + illite/smectite ± pyrophyllite alteration and opaline quartz silicification. The Onemana area shows many volcanic and hydrothermal features that are typical of caldera settings and are comparable with the rhyolite volcanic centres in the TVZ. It is suggested that the rhyolitic volcanism at Onemana resulted from late stage volcanism along the ring fracture of a large caldera structure.

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  • Declining towns and rapidly growing cities in New Zealand: developing an empirically-based model that can inform policy

    Brabyn, Lars (2017)

    Journal article
    University of Waikato

    Understanding and predicting spatial patterns in population change has significant implications for infrastructure, property investments, and national spatial planning. It is also at the core of understanding what motivates people to move to different places, and the underlying geographical conditions that are important to people. During recent times, the population growth of large cities in New Zealand (particularly Auckland, but Tauranga has had faster growth) has resulted in severe social and infrastructural problems, such as sky-rocketing house prices, homelessness, and congestion of roads. At the same time, many small towns have had significant population decline, with no proposed solutions apart from acceptance or undertaking so-called “managed decline” (McMillan 2016; Wood 2017). As will be described in this article, net migration has been a significant component of the spatial variation in population change, while natural change does not have a significant spatial variation and has been generally positive for all urban places. A policy response to the spatial variation of net migration needs to be based on an empirically based understanding of what drives net migration.

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  • The latest international survey of adult skills: What does PIAAC mean for us in New Zealand?

    Coben, Diana; Earle, David (2014)

    Conference item
    University of Waikato

    • What can PIAAC tell us – and what can it not tell us? • What kinds of shifts in adults skills in the population might we expect to see since the ALL Survey reported in 2006? • What might PIAAC mean for adult literacy and numeracy educators, learners and the general public? • What are the implications of PIAAC for educators?

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  • Establishment of the absolute configuration of the bioactive marine alkaloid eudistomin X by stereospecific synthesis

    Finlayson, R; Brackovic, A; Simon-Levert, A; Banaigs, B; O'Toole, RF; Miller, CH; Copp, Brent (2011-02-16)

    Journal article
    The University of Auckland Library

    A stereospecific synthesis of both enantiomers of the marine alkaloid eudistomin X using the amino acid chiral pool is achieved. Comparison of 1H and 13C NMR chemical shifts of the synthetic product as either the free base, mono-salt or disalt with those reported for the natural product established that the ascidian metabolite was originally characterised as a mono-salt and that the absolute configuration was (10R).

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  • A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women

    Farquhar, Cynthia; Ekeroma, Alec; Furness, Susan; Arroll, Bruce (2003-06)

    Journal article
    The University of Auckland Library

    Background.??? To determine the accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women. Design.??? Systematic review of common diagnostic imaging tests. Data sources.??? Relevant papers were identified through electronic searching of MEDLINE (1980 to July 2001) and EMBASE (1980 to July 2001) and manual searching of a bibliography of primary and review articles. Review methods.??? Studies were selected if accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy was compared with a reference standard and included data that could be abstracted into a two-by-two table in order to calculate sensitivity and specificity. Quality assessment and data extraction were performed by at least two independent reviewers. Diagnostic accuracy was determined by calculating positive and negative likelihood ratios for all intrauterine pathologies, submucous fibroids and endometrial hyperplasia. Results.??? Nineteen studies met the inclusion criteria. Statistically significant heterogenenity was present between the likelihood ratios for studies of transvaginal ultrasound. A positive test result with sonohysterography diagnosed submucous fibroids with a pooled likelihood ratio of 29.7 (17.8, 49.6). A positive test result with hysteroscopy diagnosed submucous fibroids with a pooled likelihood ratio of 29.4 (13.4, 65.3), and any intrauterine pathology with a pooled likelihood ratio of 7.7 (4.3, 13.7). A negative test result with hysteroscopy for diagnosing any intrauterine pathology had a pooled likelihood ratio of 0.07 (0.04, 0.15). Conclusion.??? Although there was considerable variability present between the studies, all three diagnostic tests were moderately accurate in detecting intrauterine pathology. However, sonohysterography and hysteroscopy performed better than transvaginal ultrasound in detecting submucous fibroids.

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  • Combined therapy with tiotropium and formoterol in chronic pulmonary disease: Effect on the 6-minute walk test

    Jayaram, L; Wong, C; McAuley, S; Rea, Harold; Zeng, Sui; O'Dochartaigh, C (2013)

    Journal article
    The University of Auckland Library

    Combined therapy with tiotropium and long-acting beta 2 agonists confers additional improvement in symptoms, lung function and aspects of health-related quality of life (QOL) compared with each drug alone in patients with COPD. However, the efficacy of combined therapy on walking distance, a surrogate measure of daily functional activity and morbidity remains unclear. The aim was, therefore, to quantify the benefit of this therapy on the six minute walk test. Secondary outcomes included change in lung function, symptoms, the BODE index and QOL. In a double-blind, crossover study, 38 participants with moderate to severe COPD on tiotropium were randomised to receive either formoterol or placebo for 6 weeks. Following a 2-week washout period, participants crossed over to the alternate arm of therapy for a further 6 weeks. Thirty-six participants, with an average age of 64.3 years and FEV1 predicted of 53%, completed the study. Combined therapy improved walking distance by a mean of 36 metres [95% CI: 2.4, 70.1; p = 0.04] compared with tiotropium. FEV1 increased in both groups (160 mL combination therapy versus 30 mL tiotropium) with a mean difference of 110 mL (95% CI: -100, 320; p = 0.07) between groups, These findings further support the emerging advantages of combined therapy in COPD. Australian New Zealand Clinical Trials.

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  • Transiently raised IOP equivalent to that experienced during ocular surgery causes moderate inflammation but does not affect retinal function or result in retinal ganglion cell loss in an animal model

    Zhang, Jie; Cole, RN; Lin, P; Acosta Etchebarne, Monica; Green, Colin; Danesh-Meyer, Helen (2017-05-17)

    Journal article
    The University of Auckland Library

    Purpose: High intraocular pressure (IOP) is known to result in retinal ganglion cell (RGC) loss, both with chronically raised intraocular pressure (such as with glaucoma) and with acute raises in pressure (due to injury or acute angle closure). Because IOP is often raised during ocular surgery, the purpose of this study was to evaluate the effect of transient moderate IOP on retinal function, RGC survival and the expression of Connexin 43 (Cx43) and glial fibrillary acidic protein (GFAP), ubiquitously expressed central nervous system (CNS) proteins that are known to be elevated during the retinal inflammatory response to injury. Materials and Methods: Wistar rats were exposed to transient IOP at 40 mmHg for 5 or 30 minutes, and 60 mmHg for 5 minutes (via cannulation of the anterior chamber with a saline reservoir raised to a height corresponding to the desired IOP), mimicking potential IOP rises during surgery such as DSAEK and some laser procedures (LASIK and femtosecond laser cataract surgery). Separate groups of animals had IOP maintained at 10 mmHg for 5 or 30 minutes as cannulation controls, or 120 mmHg for 60 minutes as positive controls. Changes in the optic nerve and retina were assessed immunohistochemically for GFAP and Cx43 expression. Retinal function was assessed using electroretinography (ERG) recorded at baseline and 14 days after the IOP rise and compared with RGC counts. Results: Results showed that there was a differential GFAP labelling pattern observed in the anterior optic nerve in the 40 mmHg 30 minute and 60 mmHg 5 minute groups 4 hours after manipulation. Gap junction protein Cx43 was minimally up-regulated in the retina in the short-term. There was, however, minimal long-term effect on retinal function and no RGC loss. Conclusions: In conclusion, elevations of IOP that are short in duration such as those occurring during surgical procedures, do not cause significant changes long-term in retinal function or RGC survival. Key Messages: Cx43 and GFAP are known to be elevated during the retinal inflammatory response to injury. No previous study has explored the effect of moderate and relatively short increases in IOP on the initial inflammatory response. We observed a mild glial inflammatory response in the anterior optic nerve, but only a minimal up-regulation of Cx43. However, transient and moderate IOP rises did not induce long term disruption to RGC function or number as measured by electrophysiology and RGC counts, respectively. This is applicable to clinical practice, as it means the IOP elevations that occur during some surgical procedures are unlikely to be causing long term damage in retinal function or RGC survival.

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  • Using the rd1 mouse to understand functional and anatomical retinal remodelling and treatment implications in retinitis pigmentosa: A review

    Kalloniatis, Michael; Nivison-Smith, L; Chua, J; Acosta Etchebarne, Monica; Fletcher, EL (2016-09)

    Journal article
    The University of Auckland Library

    Retinitis Pigmentosa (RP) reflects a range of inherited retinal disorders which involve photoreceptor degeneration and retinal pigmented epithelium dysfunction. Despite the multitude of genetic mutations being associated with the RP phenotype, the clinical and functional manifestations of the disease remain the same: nyctalopia, visual field constriction (tunnel vision), photopsias and pigment proliferation. In this review, we describe the typical clinical phenotype of human RP and review the anatomical and functional remodelling which occurs in RP determined from studies in the rd/rd (rd1) mouse. We also review studies that report a slowing down or show an acceleration of retinal degeneration and finally we provide insights on the impact retinal remodelling may have in vision restoration strategies.

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  • Understanding property market operations from a dual institutional perspective: The case of Lagos, Nigeria

    Agboola, AO; Scofield, D; Amidu, Abdul-Rasheed (2017-11)

    Journal article
    The University of Auckland Library

    This paper examines the Nigeria Land Use Act and considers how provisions of the Act inform and influence traditional landholding systems, the operation of the commercial real estate market, and the activities of the ???omo-onile.??? The research adopts a qualitative strategy and combines analysis of legal statute with in-depth, semi-structured interviews with market participants active in different capacities within the land and property markets of Lagos, Nigeria. The paper identifies a number of inconsistencies in the provisions of the Act and concludes that the recognition given to the traditional landholding system by the Act has not been effective in tackling informality and illegality in Lagos land and property markets. The paper provides insight into how informal institutions of norms, culture, and conventions of a real estate market characterize property ownership and affect transaction processes. This study shows how informal institutions may be used to circumvent formal institutions of a market when formal rights to property are poorly delineated and assigned. In these conditions market actors will incur higher transaction costs in the process of policing transactions and enforcing contractual agreements.

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  • Effect of nurse-led randomised control trials on cardiovascular risk factors and HbA1c in diabetes patients: A meta-analysis

    Daly, Barbara; Tian, CJL; Scragg, Robert (2017-09)

    Journal article
    The University of Auckland Library

    A systematic review and meta-analysis identified 42 randomised control trials comparing a nurse-led intervention with 'usual care' to quantify their effect on glycated haemoglobin (HbA1c) and major cardiovascular risk factors in diabetes patients. All relevant databases were systematically searched for publications to February 2016: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE and Cumulative Index to Nursing & Allied Health Literature (CINAHL). The 42 trials recruited 9955 diabetes patients (5022 randomised to intervention and 4933 to 'usual care'). For patients receiving the nurse-led intervention, compared with 'usual care', there were small but significant mean reductions for HbA1c [-0.28%; 95% CI -0.38%, -0.18%; p-value for HbA1c, serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management.

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  • Bacterial colonization and succession in a newly opened hospital

    Lax, S; Sangwan, N; Smith, D; Larsen, P; Handley, Kim; Richardson, M; Guyton, K; Krezalek, M; Shogan, BD; Defazio, J; Flemming, I; Shakhsheer, B; Weber, S; Landon, E; Garcia-Houchins, S; Siegel, J; Alverdy, J; Knight, R; Stephens, B; Gilbert, JA (2017-05)

    Journal article
    The University of Auckland Library

    The microorganisms that inhabit hospitals may influence patient recovery and outcome, although the complexity and diversity of these bacterial communities can confound our ability to focus on potential pathogens in isolation. To develop a community-level understanding of how microorganisms colonize and move through the hospital environment, we characterized the bacterial dynamics among hospital surfaces, patients, and staff over the course of 1 year as a new hospital became operational. The bacteria in patient rooms, particularly on bedrails, consistently resembled the skin microbiota of the patient occupying the room. Bacterial communities on patients and room surfaces became increasingly similar over the course of a patient's stay. Temporal correlations in community structure demonstrated that patients initially acquired room-associated taxa that predated their stay but that their own microbial signatures began to influence the room community structure over time. The ??- and ??-diversity of patient skin samples were only weakly or nonsignificantly associated with clinical factors such as chemotherapy, antibiotic usage, and surgical recovery, and no factor except for ambulatory status affected microbial similarity between the microbiotas of a patient and their room. Metagenomic analyses revealed that genes conferring antimicrobial resistance were consistently more abundant on room surfaces than on the skin of the patients inhabiting those rooms. In addition, persistent unique genotypes of Staphylococcus and Propionibacterium were identified. Dynamic Bayesian network analysis suggested that hospital staff were more likely to be a source of bacteria on the skin of patients than the reverse but that there were no universal patterns of transmission across patient rooms.

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