89,483 results

  • Men's health and the health of the nation

    Johnston, L; Huggard, Peter; Goodyear-Smith, Felicity (2008-12-12)

    Journal article
    The University of Auckland Library

    The health of the male population is a substantial contributor to the health of the nation. In general, men have a poorer health status and lower utilisation of health services than women. They have a lower life expectancy and are more likely to die from avoidable deaths than women. Men's health is increasingly being recognised as a specialty area of health promotion and of clinical practice. Male-specific approaches may assist in maximising the positive outcome of interventions aimed at educating men about their health issues, attracting men into seeking clinical services, and establishing and maintaining a gender-orientation in health services that encourages men to engage. With appropriate training and resources, primary health care is ideally placed to provide accessible, male-friendly services with lead to reduction in gender inequalities in health.

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  • Cascading effects of bird functional extinction reduce pollination and plant density

    Anderson, Sandra; Kelly, D; Ladley, JJ; Molloy, S; Terry, J (2011-02)

    Journal article
    The University of Auckland Library

    Reductions in bird numbers could hamper ecosystem services such as pollination, but experimental proof is lacking. We show that functional extinction of bird pollinators has reduced pollination, seed production, and plant density in the shrub Rhabdothamnus solandri (Gesneriaceae) on the North Island ("mainland") of New Zealand but not on three nearby island bird sanctuaries where birds remain abundant. Pollen limitation of fruit set is strong [pollen limitation index (PLI) = 0.69] and significant on the mainland but small (PLI = 0.15) and nonsignificant on islands. Seed production per flower on the mainland is reduced 84%. Mainland sites have similar adult densities, but 55% fewer juvenile plants per adult, than island sites. Seed addition experiments near adult R. solandri plants on the mainland found strong seed limitation 5 years after sowing for R. solandri but not for two other co-occurring woody species. This demonstrates a terrestrial trophic cascade.

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  • Alcohol intake, marijuana use, and sleep deprivation on the risk of falls occurring at home among young and middle-aged adults: a case-crossover study. Original Article

    Thornley, Simon; Kool, Bridget; Marshall, Roger; Ameratunga, Shanthi (2014-11-28)

    Journal article
    The University of Auckland Library

    Aim This study investigated whether hospitalised fall-related injuries among young and middle-aged adults were associated with short term effects of alcohol intake, marijuana use and sleep deprivation. Method A case-crossover design was used to study 690 adults (aged 20 to 64 years) admitted to public hospitals within 48 hours of a fall related injury, occurring at home, in three regions of New Zealand during August 2008 to December 2009. A matched-pair interval method of analysis was used to compare alcohol intake, marijuana use and sleep deprivation before the event with similar information in two control periods: 24 hours-before and one week-before the time of injury. Results After adjustment for other paired exposures, the estimated risk of injury was substantially higher after consuming alcohol within the preceding six hours, with a dose response gradient. After adjusting for confounding variables, the data did not support a significantly elevated risk of fall-related injury associated with sleep deprivation (<6 hours sleep in the preceding 24 hours), or marijuana use in the preceding three hours. Conclusion The findings support the expansion of efforts to reduce the harmful effects of alcohol intake in the home environment.

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  • Perceptions towards lesbian, gay and bisexual people in residential care facilities: A qualitative study

    Neville, SJ; Adams, J; Bellamy, Gary; Boyd, Michal; George, N (2015-03)

    Journal article
    The University of Auckland Library

    Background: Internationally, increases in the numbers of older people will be reflected in larger numbers of more socioculturally diverse groups of older people requiring care provided by residential care facilities. Covert and overt instances of homophobia are evident within residential care services provided to older lesbian, gay and bisexual people. Aims: To explore the perceptions of care staff working in residential care homes towards older lesbian, gay and bisexual people. Design: Critical gerontology formed the methodological foundations for focus group discussions with care staff from seven residential care facilities. Hypothetical vignettes were used to stimulate discussion amongst participants. Results: Thematic analysis of the seven focus group interviews illuminated three themes: ???Knowing me knowing you???, ???Out of sight out of mind??? and ???It's a generational thing???. Subtle as well as not so subtle forms of homophobia were evident in each of the themes. Care staff felt they were largely unprepared to provide care to older lesbian, gay and bisexual people. Conclusion: This small-scale New Zealand study identifies that the residential care sector is not always supportive, or prepared, to provide a care service to those people identifying as lesbian, gay and bisexual. Implications for practice: Findings from this study recommend the implementation of principle-based guidelines, opportunities to participate in ongoing education and partnering with non-heterosexual community organisations in order to provide culturally appropriate care to older lesbian, gay and bisexual people.

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  • Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design Considerations

    Beier, Susann; Ormiston, J; Webster, M; Cater, John; Norris, Stuart; Medrano Gracia, Pau; Young, Alistair; Cowan, Brett (2016-02)

    Journal article
    The University of Auckland Library

    Stent induced hemodynamic changes in the coronary arteries are associated with higher risk of adverse clinical outcome. The purpose of this study was to evaluate the impact of stent design on wall shear stress (WSS), time average WSS, and WSS gradient (WSSG), in idealized stent geometries using computational fluid dynamics. Strut spacing, thickness, luminal protrusion, and malapposition were systematically investigated and a comparison made between two commercially available stents (Omega and Biomatrix). Narrower strut spacing led to larger areas of adverse low WSS and high WSSG but these effects were mitigated when strut size was reduced, particularly for WSSG. Local hemodynamics worsened with luminal protrusion of the stent and with stent malapposition, adverse high WSS and WSSG were identified around peak flow and throughout the cardiac cycle respectively. For the Biomatrix stent, the adverse effect of thicker struts was mitigated by greater strut spacing, radial cell offset and flow-aligned struts. In conclusion, adverse hemodynamic effects of specific design features (such as strut size and narrow spacing) can be mitigated when combined with other hemodynamically beneficial design features but increased luminal protrusion can worsen the stent???s hemodynamic profile significantly.

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  • Hypoglycaemia and hyperglycaemia are associated with unfavourable outcome in infants with hypoxic ischaemic encephalopathy: a post hoc analysis of the CoolCap Study

    Basu, SK; Kaiser, JR; Guffey, D; Minard, CG; Guillet, R; Gunn, Alistair (2016-03)

    Journal article
    The University of Auckland Library

    To investigate the association of neonatal hypoglycaemia and hyperglycaemia with outcomes in infants with hypoxic ischaemic encephalopathy (HIE).Post hoc analysis of the CoolCap Study.25 perinatal centres in the UK, the USA and New Zealand during 1999-2002.234 infants at ???36???weeks' gestation with moderate-to-severe HIE enrolled in the CoolCap Study. 214 (91%) infants had documented plasma glucose and follow-up outcome data.Infants were randomised to head cooling for 72???h starting within 6???h of birth, or standard care. Plasma glucose levels were measured at predetermined time intervals after randomisation.The unfavourable primary outcome of the study was death and/or severe neurodevelopmental disability at 18???months. Hypoglycaemia (???40???mg/dL, ???2.2???mmol/L) and hyperglycaemia (>150???mg/dL, >8.3???mmol/L) during the first 12???h after randomisation were investigated for univariable and multivariable associations with unfavourable primary outcome.121 (57%) infants had abnormal plasma glucose values within 12???h of randomisation. Unfavourable outcome was observed in 126 (60%) infants and was more common among subjects with hypoglycaemia (81%, p=0.004), hyperglycaemia (67%, p=0.01) and any glucose derangement within the first 12???h (67%, p=0.002) compared with normoglycaemic infants (48%) in univariable analysis. These associations remained significant after adjusting for birth weight, Apgar score, pH, Sarnat stage and hypothermia therapy.Both hypoglycaemia and hyperglycaemia in infants with moderate-to-severe HIE were independently associated with unfavourable outcome. Future studies are needed to investigate the prognostic significance of these associations and their role as biomarkers of brain injury.(ClinicalTrials.gov NCT00383305).

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  • The Effect of Short-Term Auditory Training on Speech in Noise Perception and Cortical Auditory Evoked Potentials in Adults with Cochlear Implants

    Barlow, N; Purdy, Suzanne; Sharma, M; Giles, E; Narne, V (2016-02-05)

    Journal article
    The University of Auckland Library

    This study investigated whether a short intensive psychophysical auditory training program is associated with speech perception benefits and changes in cortical auditory evoked potentials (CAEPs) in adult cochlear implant (CI) users. Ten adult implant recipients trained approximately 7 hours on psychophysical tasks (Gap-in-Noise Detection, Frequency Discrimination, Spectral Rippled Noise [SRN], Iterated Rippled Noise, Temporal Modulation). Speech performance was assessed before and after training using Lexical Neighborhood Test (LNT) words in quiet and in eight-speaker babble. CAEPs evoked by a natural speech stimulus /baba/ with varying syllable stress were assessed pre- and post-training, in quiet and in noise. SRN psychophysical thresholds showed a significant improvement (78% on average) over the training period, but performance on other psychophysical tasks did not change. LNT scores in noise improved significantly post-training by 11% on average compared with three pretraining baseline measures. N1P2 amplitude changed post-training for /baba/ in quiet (p???=???0.005, visit 3 pretraining versus visit 4 post-training). CAEP changes did not correlate with behavioral measures. CI recipients' clinical records indicated a plateau in speech perception performance prior to participation in the study. A short period of intensive psychophysical training produced small but significant gains in speech perception in noise and spectral discrimination ability. There remain questions about the most appropriate type of training and the duration or dosage of training that provides the most robust outcomes for adults with CIs.

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  • Effectiveness of seasonal influenza vaccine in preventing influenza primary care visits and hospitalisation in Auckland, New Zealand in 2015: interim estimates

    Bissielo, A; Pierse, N; Huang, Q; Thompson, M; Kelly, H; Mishin, V; Turner, Nicola; SHIVERS (2016-01-07)

    Journal article
    The University of Auckland Library

    Preliminary results for influenza vaccine effectiveness (VE) against acute respiratory illness with circulating laboratory-confirmed influenza viruses in New Zealand from 27 April to 26 September 2015, using a case test-negative design were 36% (95% confidence interval (CI): 11???54) for general practice encounters and 50% (95% CI: 20???68) for hospitalisations. VE against hospitalised influenza A(H3N2) illnesses was moderate at 53% (95% CI: 6???76) but improved compared with previous seasons.

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  • Change in Speech Perception and Auditory Evoked Potentials over Time after Unilateral Cochlear Implantation in Postlingually Deaf Adults

    Purdy, Suzanne; Kelly, Andrea (2016-02)

    Journal article
    The University of Auckland Library

    Speech perception varies widely across cochlear implant (CI) users and typically improves over time after implantation. There is also some evidence for improved auditory evoked potentials (shorter latencies, larger amplitudes) after implantation but few longitudinal studies have examined the relationship between behavioral and evoked potential measures after implantation in postlingually deaf adults. The relationship between speech perception and auditory evoked potentials was investigated in newly implanted cochlear implant users from the day of implant activation to 9 months postimplantation, on five occasions, in 10 adults age 27 to 57 years who had been bilaterally profoundly deaf for 1 to 30 years prior to receiving a unilateral CI24 cochlear implant. Changes over time in middle latency response (MLR), mismatch negativity, and obligatory cortical auditory evoked potentials and word and sentence speech perception scores were examined. Speech perception improved significantly over the 9-month period. MLRs varied and showed no consistent change over time. Three participants aged in their 50s had absent MLRs. The pattern of change in N1 amplitudes over the five visits varied across participants. P2 area increased significantly for 1,000- and 4,000-Hz tones but not for 250 Hz. The greatest change in P2 area occurred after 6 months of implant experience. Although there was a trend for mismatch negativity peak latency to reduce and width to increase after 3 months of implant experience, there was considerable variability and these changes were not significant. Only 60% of participants had a detectable mismatch initially; this increased to 100% at 9 months. The continued change in P2 area over the period evaluated, with a trend for greater change for right hemisphere recordings, is consistent with the pattern of incremental change in speech perception scores over time. MLR, N1, and mismatch negativity changes were inconsistent and hence P2 may be a more robust measure of auditory plasticity in adult implant recipients. P2 was still improving at 9 months postimplantation. Future studies should explore longitudinal changes over a longer period.

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  • The distribution and frequency of blood lipid testing by sociodemographic status among adults in Auckland, New Zealand

    Exeter, Daniel; Moss, L; Zhao, Jinfeng; Kyle, C; Riddell, T; Jackson, Rodney; Wells, Linda (2015-09)

    Journal article
    The University of Auckland Library

    INTRODUCTION: National cardiovascular disease (CVD) guidelines recommend that adults have cholesterol levels monitored regularly. However, little is known about the extent and equity of cholesterol testing in New Zealand. AIM: To investigate the distribution and frequency of blood lipid testing by sociodemographic status in Auckland, New Zealand. METHODS: We anonymously linked five national health datasets (primary care enrolment, laboratory tests, pharmaceuticals, hospitalisations and mortality) to identify adults aged ???25 years without CVD or diabetes who had their lipids tested in 2006???2010, by age, gender, ethnicity and area of residence and deprivation. Multivariate logistic regression was used to estimate the likelihood of testing associated with these factors. RESULTS: Of the 627 907 eligible adults, 66.3% had at least one test between 2006 and 2010. Annual testing increased from 24.7% in 2006 to 35.1% in 2010. Testing increased with age similarly for men and women. Indian people were 87% more likely than New Zealand European and Others (NZEO) to be tested, Pacific people 8% more likely, but rates for Ma??ori were similar to NZEO. There was marked variation within the region, with residents of the most deprived areas less likely to be tested than residents in least deprived areas. DISCUSSION: Understanding differences within and between population groups supports the development of targeted strategies for better service utilisation. While lipid testing has increased, sociodemographic variations persist by place of residence, and deprivation. Of the high CVD risk populations, lipid testing for Ma??ori and Pacific is not being conducted according to need.

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  • Metabolic disruption identified in the Huntington's disease transgenic sheep model

    Handley, Renee; Reid, Susanne; Patassini, S; Rudiger, SR; Obolonkin, V; McLaughlan, CJ; Jacobsen, Jessie; Gusella, JF; MacDonald, ME; Waldvogel, Henry; Bawden, CS; Faull, Richard; Snell, Russell (2016)

    Journal article
    The University of Auckland Library

    Huntington's disease (HD) is a dominantly inherited, progressive neurodegenerative disorder caused by a CAG repeat expansion within exon 1 of HTT, encoding huntingtin. There are no therapies that can delay the progression of this devastating disease. One feature of HD that may play a critical role in its pathogenesis is metabolic disruption. Consequently, we undertook a comparative study of metabolites in our transgenic sheep model of HD (OVT73). This model does not display overt symptoms of HD but has circadian rhythm alterations and molecular changes characteristic of the early phase disease. Quantitative metabolite profiles were generated from the motor cortex, hippocampus, cerebellum and liver tissue of 5 year old transgenic sheep and matched controls by gas chromatography-mass spectrometry. Differentially abundant metabolites were evident in the cerebellum and liver. There was striking tissue-specificity, with predominantly amino acids affected in the transgenic cerebellum and fatty acids in the transgenic liver, which together may indicate a hyper-metabolic state. Furthermore, there were more strong pair-wise correlations of metabolite abundance in transgenic than in wild-type cerebellum and liver, suggesting altered metabolic constraints. Together these differences indicate a metabolic disruption in the sheep model of HD and could provide insight into the presymptomatic human disease.

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  • Measurement of stiffness of standing trees and felled logs using acoustics: A review

    Legg, Mathew; Bradley, Stuart (2016-02)

    Journal article
    The University of Auckland Library

    This paper provides a review on the use of acoustics to measure stiffness of standing trees, stems, and logs. An outline is given of the properties of wood and how these are related to stiffness and acoustic velocity throughout the tree. Factors are described that influence the speed of sound in wood, including the different types of acoustic waves which propagate in tree stems and lumber. Acoustic tools and techniques that have been used to measure the stiffness of wood are reviewed. The reasons for a systematic difference between direct and acoustic measurements of stiffness for standing trees, and methods for correction, are discussed. Other techniques, which have been used in addition to acoustics to try to improve stiffness measurements, are also briefly described. Also reviewed are studies which have used acoustic tools to investigate factors that influence the stiffness of trees. These factors include different silvicultural practices, geographic and environmental conditions, and genetics.

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  • Chemotherapy-induced reversible posterior leucoencephalopathy syndrome

    Yozu, Hye-Won; Findlay, Michael (2010-02)

    Journal article
    The University of Auckland Library

    Reversible posterior leucoencephalopathy syndrome is a neurological condition seen in various areas of acute medicine, including the administration of antineoplastic therapies used in haemato-oncology patients. It is a rare complication that has been increasingly recognized. It is characterized by altered mental status, visual disturbance, headache and seizures. Magnetic resonance imaging typically shows vasogenic oedema in the posterior regions of the brain. Although its name suggests reversibility, it may result in an irreversible brain injury without prompt treatment. Therefore, it is vital for treating clinicians to recognize this syndrome. We describe the case of a 55-year-old woman with advanced pancreatic adenocarcinoma, who developed clinical and radiological manifestations consistent with this syndrome as a complication of gemcitabine monotherapy.

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  • Enabling and challenging factors in institutional reform: The case of SCALE-UP

    Foote, Kathleen; Knaub, A; Henderson, C; Dancy, M; Beichner, RJ (2016-02)

    Journal article
    The University of Auckland Library

    While many innovative teaching strategies exist, integration into undergraduate science teaching has been frustratingly slow. This study aims to understand the low uptake of research-based instructional innovations by studying 21 successful implementations of the Student Centered Active Learning with Upside-down Pedagogies (SCALE-UP) instructional reform. SCALE-UP significantly restructures the classroom environment and pedagogy to promote highly active and interactive instruction. Although originally designed for university introductory physics courses, SCALE-UP has spread to many other disciplines at hundreds of departments around the world. This study reports findings from in-depth, open-ended interviews with 21 key contact people involved with successful secondary implementations of SCALE-UP throughout the United States. We defined successful implementations as those who restructured their pedagogy and classroom and sustained and/or spread the change. Interviews were coded to identify the most common enabling and challenging factors during reform implementation and compared to the theoretical framework of Kotter???s 8-step Change Model. The most common enabling influences that emerged are documenting and leveraging evidence of local success, administrative support, interaction with outside SCALE-UP user(s), and funding. Many challenges are linked to the lack of these enabling factors including difficulty finding funding, space, and administrative and/or faculty support for reform. Our focus on successful secondary implementations meant that most interviewees were able to overcome challenges. Presentation of results is illuminated with case studies, quotes, and examples that can help secondary implementers with SCALE-UP reform efforts specifically. We also discuss the implications for policy makers, researchers, and the higher education community concerned with initiating structural change.

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  • Diffusion of research-based instructional strategies: the case of SCALE-UP

    Foote, Kathleen; Neumeyer, X; Henderson, C; Dancy, MH; Beichner, RJ (2014-12)

    Journal article
    The University of Auckland Library

    Background Many innovative teaching strategies have been developed under the assumption that documenting successful student learning outcomes at the development site is enough to spread the innovation successfully to secondary sites. Since this ???show them and they will adopt??? model has yet to produce the desired large-scale transformation, this study examines one innovative teaching strategy that has demonstrated success in spreading. This instructional strategy, Student-Centered Active Learning Environment with Upside-down Pedagogies (SCALE-UP), modifies both the pedagogy and classroom design to maximize interaction and activity-based learning. A web survey was used to develop a census of instructors who have been influenced by SCALE-UP. Results SCALE-UP, which started in large enrollment university physics, has spread widely across disciplines and institutions. The survey identified that SCALE-UP style instruction is currently used in over a dozen disciplines at a minimum of 314 departments in at least 189 higher education institutions in 21 countries. Many more respondents indicated learning about SCALE-UP via interpersonal channels, such as talks/workshops and colleagues, than via mass media channels, such as the Internet and publications. We estimate the dissemination of SCALE-UP in physics may be at the tipping point between adoption by adventurous early users and the more mainstream majority. Implementers demonstrate pedagogical and structural variation in their use of SCALE-UP. Conclusions Leveraging interpersonal networks can help accelerate dissemination of educational innovations and should be used more prominently in change strategies. Since SCALE-UP may be nearing a tipping point within the discipline of physics, now may be the time to modify change strategies to appeal to more typical faculty rather than the early adopters. This may include using successful secondary implementers as like-minded intermediaries to reach out to people considering the use of the innovation in different institutional settings for more practical and relatable advice. For SCALE-UP, having a specialized classroom may improve the likelihood of continued use at an institution. We also hypothesize that having a special classroom may start departmental conversations about innovative teaching and may make instructors less likely to revert back to traditional methods.

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  • Te Reo T??tai: Te R??hita Motuhake o te Ako (Specialised Language Register of Learning and Teaching: Mathematics)

    Trinick, T; Dale, Darrell (2012)

    Journal article
    The University of Auckland Library

    Kei te ??rohi t??nei pepa ki te reo o te ako m?? te huarahi o te reo M??ori mai i te tirohanga Systemic Functional Linguistics (SFL). Ko te tino whakaaro o SFL he nui ng?? rerek??tanga o te reo whakamahia ai i te kura i ?? te reo whakamahia ai i waho i te kura n?? te mea he rerek?? ng?? horopaki reo. E ai ki ng?? ari?? SFL, ko te "r??hita " te hanga matua e whakam??rama ana i taua rerek??tanga. Kei nga marau p??r?? i te p??ngarau he "r??hita " motuhake t??na. Kua waihangatia te r??hita, ki ??na ake kupu, ki t??na ake takatoranga reo. A t??na w?? ka tino whakararuraru ng?? ??huatanga o te r??hita i te ako o ng?? ??konga. Kua whakaaturia e nga rangahau te tino tikanga o te reo i te akoranga p??ngarau me te tino mahi a te pouako hei whakatauira i te reo m?? ng?? ?? konga. Kei te ?? rohi t??nei p??pa kapehea ng?? pouako e ako ai i te r??hita me ng?? rautaki ka whakamahia e ng?? pouako hei ako i ng?? kupu motuhake.This paper examines the language of learning and teaching in Maori medium schooling from the perspective of Systemic Functional Linguistics (SFL). Essentially SFL suggests that language use in school differs in important ways from language use outside the classroom. Because language situations differ, the primary construct in SFL theory for explaining linguistic variation is the "register". Subjects such as mathematics are characterised by specialised registers. The register is made up of linguistic features that can pose difficulties for the learner. Research has highlighted the role of language in learning mathematics and the key role of teachers in modelling the register for learners. This paper examines how teachers learn the register, in particular the strategies teachers use in Maori medium kura to learn the specialised terms.

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  • Microbiological Contamination of Drugs during Their Administration for Anesthesia in the Operating Room.

    Gargiulo, Derryn; Mitchell, Simon; Sheridan, Jane; Short, TG; Swift, Simon; Torrie, Jocelyn; Webster, Craig; Merry, Alan (2016)

    Journal article
    The University of Auckland Library

    Background: The aseptic techniques of anesthesiologists in the preparation and administration of injected medications have not been extensively investigated, but emerging data demonstrate that inadvertent lapses in aseptic technique may be an important contributor to surgical site and other postoperative infections. Methods: A prospective, open, microbiological audit of 303 cases in which anesthesiologists were asked to inject all bolus drugs, except propofol and antibiotics, through a 0.2-??m filter was performed. The authors cultured microorganisms, if present, from the 0.2-??m filter unit and from the residual contents of the syringes used for drawing up or administering drugs. Participating anesthesiologists rated ease of use of the filters after each case. Results: Twenty-three anesthesiologists each anesthetized up to 25 adult patients. The authors isolated microorganisms from filter units in 19 (6.3%) of 300 cases (3 cases were excluded), including Staphylococcus capitis, Staphylococcus warneri, Staphylococcus epidermidis, Staphylococcus haemolyticus, Micrococcus luteus/lylae, Corynebacterium, and Bacillus species. The authors collected used syringes at the end of each case and grew microorganisms from residual drug in 55 of these 2,318 (2.4%) syringes including all the aforementioned microorganisms and also Kocuria kristinae, Staphylococcus aureus, and Staphylococcus hominus. Participants??? average rating of ease of use of the filter units was 3.5 out of 10 (0 being very easy and 10 being very difficult). Conclusions: Microorganisms with the potential to cause infection are being injected (presumably inadvertently) into some patients during the administration of intravenous drugs by bolus during anesthesia. The relevance of this finding to postoperative infections warrants further investigation.

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  • Psychiatric comorbidity in psychogenic nonepileptic seizures compared with epilepsy

    Diprose, W; Sundram, Frederick; Menkes, David (2016-03)

    Journal article
    The University of Auckland Library

    Psychogenic nonepileptic seizures (PNESs) are closely linked with psychological distress, but their etiology is not well-understood. We reviewed psychiatric comorbidity in PNESs and epileptic seizures (ESs) with an aim to assist understanding, diagnosis, and management of PNESs.A search of Web of Science, MEDLINE (PubMed), PsycINFO, and Scopus identified 32 relevant studies on the prevalence of psychiatric comorbidity in PNESs. We used meta-analysis to compare psychiatric comorbidity between PNESs and ESs.Samples with PNESs had high rates of psychiatric comorbidity overall (53-100%), notably including posttraumatic stress disorder (PTSD), depression, and personality and anxiety disorders. Compared with ESs, samples with PNESs had more psychiatric comorbidity overall (RR: 1.30, 95% CI: 1.14-1.48, p<0.0001) with significantly elevated risks found for PTSD, personality disorder, and anxiety but not depression.Psychiatric disorders are more common in PNESs than ESs. Because of methodological limitations of available studies, causality cannot be established; prospective longitudinal designs are required.

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  • The first metatarsophalangeal joint in gout: a systematic review and meta-analysis

    Stewart, S; Dalbeth, Nicola; Vandal, AC; Rome, K (2016-01)

    Journal article
    The University of Auckland Library

    The aim of this review was to qualitatively synthesise studies that have investigated characteristics of the first metatarsophalangeal joint (1(st) MTP) in gout and to undertake a meta-analysis to estimate the average prevalence of acute 1(st) MTP arthritis across studies in people with gout.Studies published in English were included if they involved participants who had a diagnosis of gout and presented original findings relating to the following outcome measures associated with the 1(st) MTP: epidemiology; clinical features; structural and functional characteristics; and microscopic and imaging features.Forty-five studies were included in the qualitative synthesis. 1(st) MTP pain was a prominent feature in people with gout. People with 1(st) MTP gout reported walking- and general-disability. Structural and functional characteristics of 1(st) MTP gout included hallux valgus, osteoarthritis, and restricted joint motion. Successful crystal aspiration ranged from 81 to 91??% and positive crystal identification via microscopy ranged from 83 to 93??% in patients with a history of 1(st) MTP gout. Imaging features were common at the 1(st) MTP including the double contour sign, tophi and erosions. Eleven studies involving 2,325 participants were included in the meta-analysis, providing an estimate of the average prevalence of acute 1(st) MTP arthritis across studies of 73??% (95??% prediction interval 40-92??%; range 48-97??%; I(2)???=???93??%).1(st) MTP acute arthritis is highly prevalent in people with gout and has a substantial impact on patient-reported pain and disability. Gout affects the structure and function of the 1(st) MTP. Microscopic and imaging studies have demonstrated crystal deposition and joint damage at the 1(st) MTP in people with gout.

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  • Profile of paediatric low vision population: a retrospective study from Nepal

    Uprety, S; Khanal, Safal; Morjaria, P; Puri, LR (2016)

    Journal article
    The University of Auckland Library

    Background Childhood blindness and low vision have become major public health problems in developing countries. The purpose of this study was to categorise the causes of visual impairment according to aetiology and provide detailed local information on visually impaired children seeking low-vision services in a tertiary eye centre in Nepal. Methods A retrospective study was conducted of all visually impaired children (visual acuity of less than 6/18 in the better eye), aged less than 17 years seen in the low-vision clinic at the Sagarmatha Chaudhary Eye Hospital in Lahan between January 1, 2012 and December 31, 2013. Results Of the 558 visually impaired children, the majority were males, 356 (63.7 per cent). More than half (56.5 per cent) of the children were in the 11 to 16 years age group. Many of the low-vision children (52.9 per cent) were identified as having moderate visual impairment (visual acuity less than 6/18 to 6/60). Most children were diagnosed with childhood (36.2 per cent) or genetic (35.5 per cent) aetiology, followed by prenatal (22.2 per cent) and perinatal (6.1 per cent) aetiologies. Refractive error and amblyopia (20.1 per cent), retinitis pigmentosa (14.9 per cent) and macular dystrophy (13.4 per cent) were the most common causes of paediatric visual impairment. Nystagmus (50.0 per cent) was the most common cause of low vision in the one to five years age group, whereas refractive error and amblyopia were the major causes in the six to 10 and 11 to 16 years age group (17.6 and 22.9 per cent, respectively). Many of the children (86.0 per cent) were prescribed low-vision aids and 72.0 per cent of the low-vision aid users showed an improvement in visual acuity either at distance or near. Conclusion Paediatric low vision has a negative impact on the quality of life in children. Data from this study indicate that knowledge about the local characteristics and aetiological categorisation of the causes of low vision are essential in tackling paediatric visual impairment. The findings also signify the importance of early intervention to ensure a better quality of life.

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