27,637 results for The University of Auckland Library

  • Chronic extra-aortic balloon counterpulsation: First-in-human pilot study in end-stage heart failure

    Hayward, CS; Peters, WS; Merry, Alan; Ruygrok, Peter; Jansz, P; O'Driscoll, G; Larbalestier, RI; Smith, JA; Ho, B; Legget, Malcolm; Milsom, FP (2010-12)

    Journal article
    The University of Auckland Library

    BACKGROUND: Some patients continue to have significant heart failure symptoms despite optimal medical therapy. METHODS: We describe a first-in-human experience with an implantable non-blood-contacting extra-ascending aortic counterpulsation heart assist system (C-Pulse) in 5 end-stage heart failure patients, aged 54 to 73 years. RESULTS: All patients improved by 1 NYHA class and improvements in invasive hemodynamics were documented in 3 patients. Three of 5 patients (60%) had infectious complications. Two patients were explanted at 5 and 7 weeks, respectively, as a result of mediastinal infection related to the implant procedure. One patient was successfully transplanted at 1 month and 1 remained hemodynamically improved on the device at 6 months but suffered infective complications. The device and protocol have been modified as a result of this pilot study with a further multicenter safety study underway. CONCLUSIONS: Although feasibility of this device is suggested by this pilot study, safety and efficacy will need to be examined in a larger cohort with longer follow-up.

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  • 'No matter what the cost': A qualitative study of the financial costs faced by family and whanau caregivers within a palliative care context

    Gott, Caryl; Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, C; Robinson, Jacqualine (2015-06)

    Journal article
    The University of Auckland Library

    BACKGROUND: There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. AIM: To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. DESIGN: In-depth qualitative interviews were conducted with 30 family/wh??nau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. SETTING: Auckland, New Zealand. FINDINGS: Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. CONCLUSION: Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and wh??nau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings.

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  • Improving the quality and safety of patient care in cardiac anesthesia

    Merry, Alan; Weller, Jennifer; Mitchell, Simon (2014-10)

    Journal article
    The University of Auckland Library

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  • Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children

    Merry, Alan; Edwards, K-E; Ahmad, Z; Barber, C; Mahadevan, M; Frampton, C (2013-12)

    Journal article
    The University of Auckland Library

    Purpose: Combined acetaminophen and ibuprofen may be more effective than either constituent alone for pain in adults. The combination was compared with the individual constituents for analgesia following tonsillectomy in children. Methods: One hundred and fifty-two children (6-14 yr) undergoing tonsillectomy were randomized to receive either combination acetaminophen (48 mg??kg-1??day-1) and ibuprofen (24 mg??kg-1??day-1) or the same doses of acetaminophen alone or ibuprofen alone, every six hours for 48 hr. The primary outcome measure was a time-corrected area under the curve (AUCt) calculated from assessments on a 100-mm visual analogue scale (with Wong Baker FACES ?? as anchors). At each assessment the children rated pain while at rest and on swallowing at multiple time points over the study duration. Secondary outcome measures were a global pain rating, requirement for rescue analgesia, sleep disturbance, and frequency of adverse events. Results: The mean [standard error of the mean (SEM)] AUCt values at rest were; combination 29.6 (1.9), acetaminophen 30.4 (2.0), ibuprofen 34 (1.9). The mean (SEM) AUCt values on swallowing were; combination 39.1 (2.0), acetaminophen 39.9 (2.0), ibuprofen 43.7 (1.9). The mean (95% confidence interval) differences in AUCt values between groups on swallowing were: combination vs acetaminophen -0.9 (-6.2 to 4.5); combination vs ibuprofen -4.6 (-9.9 to 0.67) and at rest were: combination vs acetaminophen -0.81 (-6.11 to 4.48); combination vs ibuprofen -4.37 (-9.62 to 0.88). Differences between groups were not clinically important for the pain scores, similarly for the secondary outcomes. Conclusion: The combination of ibuprofen and acetaminophen was not superior to its individual components in the regimen studied in this pediatric population undergoing tonsillectomy. The study was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12607000005459) on January 4, 2007. ?? 2013 Canadian Anesthesiologists' Society.

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  • Medical Students and informed consent: A consensus statement prepared by the Faculties of Medical and Health Science of the Universities of Auckland and Otago, Chief Medical Officers of District Health Boards, New Zealand Medical Student Association and the Medical Council of New Zealand

    Bagg, Warwick; Adams, J; Anderson, L; Malpas, Phillipa; Pidgeon, G; Thorn, M; Tulloch, D; Zhong, C; Merry, Alan (2015)

    Journal article
    The University of Auckland Library

    To develop a national consensus statement to promote a pragmatic, appropriate and unified approach to seeking consent for medical student involvement in patient care. A modified Delphi technique was used to develop the consensus statement involving stakeholders. Feedback from consultation and each stakeholder helped to shape the final consensus statement. The consensus statement is a nationally-agreed statement concerning medical student involvement in patient care, which will be useful for medical students, health care professionals and patients.

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  • The frontiers of auditing research

    Hay, David (2015-07-01)

    Journal article
    The University of Auckland Library

    Purpose ??? The purpose of this paper is to examine issues at the frontiers of auditing research. After the global financial crisis and the earlier round of reforms, there are many opportunities for research, some driven by current proposals for reforms and some by fundamental research issues. Research can contribute to the development of policy in response to current issues. Research can also be valuable in exploring issues raised in past research. Design/methodology/approach ??? Issues that are currently of concern to regulators and for which research would be of value are reviewed, together with fundamental issues arising from previous research. Findings ??? The introduction of independent regulation, increasing levels of globalization and increased attention to research by regulatory bodies have drawn attention to some research issues, especially auditors providing non-audit services, rotation of audit firms, joint audits and ways to provide increased competition. In addition, there are a number of areas in which there seems to be an obvious need for auditing research, but surprisingly little research is being done. These topics include the impact of higher-quality auditing in developing economies, and assurance for other entities such as charities and small companies. As more attention is now being given to auditing research, there are opportunities in established areas of research as well. Originality/value ??? Research is starting to make a contribution in policy making with relation to auditing, but there is still a need for much more research. The paper provides guidance on areas where further research will be valuable.

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  • Cardiac surgery: all for one and one for all.

    Leslie, K; Merry, Alan (2015-03)

    Journal article
    The University of Auckland Library

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  • M-Protein Analysis of Streptococcus pyogenes Isolates Associated with Acute Rheumatic Fever in New Zealand

    Williamson, DA; Smeesters, PR; Steer, AC; Steemson, John; Ng, ACH; Proft, Thomas; Fraser, John; Baker, MG; Morgan, J; Carter, PE; Moreland, Nicole (2015-11)

    Journal article
    The University of Auckland Library

    We applied an emm cluster typing system to group A Streptococcus strains in New Zealand, including those associated with acute rheumatic fever (ARF). We observed few so-called rheumatogenic emm types but found a high proportion of emm types previously associated with pyoderma, further suggesting a role for skin infection in ARF.

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  • A new virus discovered by immunocapture of double-stranded RNA, a rapid method for virus enrichment in metagenomic studies

    Blouin, Arnaud; Ross, Howard; Hobson-Peters, J; O'Brien, CA; Warren, B; MacDiarmid, Robin (2016-09)

    Journal article
    The University of Auckland Library

    Next-generation sequencing technologies enable the rapid identification of viral infection of diseased organisms. However, despite a consistent decrease in sequencing costs, it is difficult to justify their use in large-scale surveys without a virus sequence enrichment technique. As the majority of plant viruses have an RNA genome, a common approach is to extract the double-stranded RNA (dsRNA) replicative form, to enrich the replicating virus genetic material over the host background. The traditional dsRNA extraction is time-consuming and labour-intensive. We present an alternative method to enrich dsRNA from plant extracts using anti-dsRNA monoclonal antibodies in a pull-down assay. The extracted dsRNA can be amplified by reverse transcriptase???polymerase chain reaction and sequenced by next-generation sequencing. In our study, we have selected three distinct plant hosts: M??ori potato (Solanum tuberosum), rengarenga (Arthropodium cirratum) and broadleaved dock (Rumex obtusifolius) representing a cultivated crop, a New Zealand-native ornamental plant and a weed, respectively. Of the sequence data obtained, 31???74% of the reads were of viral origin, and we identified five viruses including Potato virus Y and Potato virus S in potato; Turnip mosaic virus in rengarenga (a new host record); and in the dock sample Cherry leaf roll virus and a novel virus belonging to the genus Macluravirus. We believe that this new assay represents a significant opportunity to upscale virus ecology studies from environmental, primary industry and/or medical samples.

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  • Coupling of turbulent and non-turbulent flow regimes within pyroclastic density currents

    Breard, ECP; Lube, G; Jones, JR; Dufek, J; Cronin, Shane; Valentine, GA; Moebis, A (2016-10)

    Journal article
    The University of Auckland Library

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  • United Nations Convention on the Rights of Persons with Disabilities and its implications for compulsory treatment and mental health nursing

    O'Brien, Anthony; Thom, Katey (2014-06)

    Journal article
    The University of Auckland Library

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  • Synthesis and cytotoxicity of thieno[2,3-b]quinoline-2-carboxamide and cycloalkyl[b]thieno[3,2-e]pyridine-2-carboxamide derivatives

    Leung, Yee Fun; Pilkington, Lisa; van Rensburg, M; Jeon, CY; Song, M; Arabshahi, HJ; De Zoysa, Gayan; Sarojini Amma, Vijayalekshmi; Denny, William; Reynisson, Johannes; Barker, David (2016)

    Journal article
    The University of Auckland Library

    Seventy nine derivatives of thieno[2,3-b]quinolines, tetrahydrothieno[2,3-b]quinoline, dihydrocyclopenta[b]thieno[3,2-e]pyridine, cyclohepta[b]thieno[3,2-e]pyridine and hexahydrocycloocta[b]thieno[3,2-e]pyridine were either synthesized or obtained commercially and tested for their antiproliferative activity against HCT116, MDA-MB-468 and MDA-MB-231 human cancer cell lines. The most potent eight compounds were active against all cell lines with IC50 values in the 80-250nM range. In general hexahydrocycloocta[b]thieno[3,2-e]pyridines were most active with increasing activity observed as larger cycloalkyl rings were fused to the pyridine ring.

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  • Evidence of bias in assessment of fisheries management impacts

    Slooten, E; Simmons, Glenn; Dawson, SM; Bremner, G; Thrush, Simon; Whittaker, H; McCormack, F; Robertson, BC; Haworth, Nigel; Clarke, PJ; Pauly, D; Zeller, D (2017-06-20)

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    The University of Auckland Library

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  • Tramadol: Keep calm and carry on

    Anderson, Brian; Thomas, J; Ottaway, K; Chalkiadis, GA (2017-08)

    Journal article
    The University of Auckland Library

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  • Acute rheumatic fever

    Webb, Rachel; Grant, Cameron; Harnden, A (2015-01)

    Journal article
    The University of Auckland Library

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  • Pharmacokinetic and anti-cancer properties of high dose ascorbate in solid tumours of ascorbate-dependent mice

    Campbell, EJ; Vissers, MCM; Wohlrab, C; Hicks, Kevin; Strother, RM; Bozonet, SM; Robinson, BA; Dachs, Gabriele (2016-10)

    Journal article
    The University of Auckland Library

    Despite recent evidence for an anti-tumour role for high-dose ascorbate, potential mechanisms of action are still unclear. At mM concentrations that are achieved with high-dose intravenous administration, autoxidation of ascorbate can generate cytotoxic levels of H2O2. Ascorbate is also a required co-factor for the hydroxylases that suppress the transcription factor hypoxia-inducible factor (HIF-1). HIF-1 supports an aggressive tumour phenotype and is associated with poor prognosis, and previous studies have shown that optimizing intracellular ascorbate levels down-regulates HIF-1 activation. In this study we have simultaneously measured ascorbate concentrations and the HIF-1 pathway activity in tumour tissue following high dose ascorbate administration, and have studied tumour growth and physiology. Gulo-/- mice, a model of the human ascorbate dependency condition, were implanted with syngeneic Lewis lung tumours, 1g/kg ascorbate was administered into the peritoneum, and ascorbate concentrations were monitored in plasma, liver and tumours. Ascorbate levels peaked within 30min, and although plasma and liver ascorbate returned to baseline within 16h, tumour levels remained elevated for 48h, possibly reflecting increased stability in the hypoxic tumour environment. The expression of HIF-1 and its target proteins was down-regulated with tumour ascorbate uptake. Elevated tumour ascorbate levels could be maintained with daily administration, and HIF-1 and vascular endothelial growth factor protein levels were reduced in these conditions. Increased tumour ascorbate was associated with slowed tumour growth, reduced tumour microvessel density and decreased hypoxia. Alternate day administration of ascorbate resulted in lower tumour levels and did not consistently decrease HIF-1 pathway activity. Levels of sodium-dependent vitamin C transporters 1 and 2 were not clearly associated with ascorbate accumulation by murine tumour cells in vitro or in vivo. Our results support the suppression of the hypoxic response by ascorbate as a plausible mechanism of action of its anti-tumour activity, and this may be useful in a clinical setting.

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  • Survey of the bp/tee genes from clinical group A streptococcus isolates in New Zealand - implications for vaccine development

    Steemson, John; Moreland, Nicole; Williamson, D; Morgan, J; Carter, PE; Proft, Thomas (2014-12)

    Journal article
    The University of Auckland Library

    Group A streptococcus (GAS) is responsible for a wide range of diseases ranging from superficial infections, such as pharyngitis and impetigo, to life-threatening diseases, such as toxic shock syndrome and acute rheumatic fever (ARF). GAS pili are hair-like extensions protruding from the cell surface and consist of highly immunogenic structural proteins: the backbone pilin (BP) and one or two accessory pilins (AP1 and AP2). The protease-resistant BP builds the pilus shaft and has been recognized as the T-antigen, which forms the basis of a major serological typing scheme that is often used as a supplement to M typing. A previous sequence analysis of the bp gene (tee gene) in 39 GAS isolates revealed 15 different bp/tee types. In this study, we sequenced the bp/tee gene from 100 GAS isolates obtained from patients with pharyngitis, ARF or invasive disease in New Zealand. We found 20 new bp/tee alleles and four new bp/tee types/subtypes. No association between bp/tee type and clinical outcome was observed. We confirmed earlier reports that the emm type and tee type are associated strongly, but we also found exceptions, where multiple tee types could be found in certain M/emm type strains, such as M/emm89. We also reported, for the first time, the existence of a chimeric bp/tee allele, which was assigned into a new subclade (bp/tee3.1). A strong sequence conservation of the bp/tee gene was observed within the individual bp/tee types/subtypes (>97???% sequence identity), as well as between historical and contemporary New Zealand and international GAS strains. This temporal and geographical sequence stability provided further evidence for the potential use of the BP/T-antigen as a vaccine target.

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  • Connective Tissue Disease-associated Interstitial Lung Diseases (CTD-ILD) - Report from OMERACT CTD-ILD Working Group

    Khanna, D; Mittoo, S; Aggarwal, R; Proudman, SM; Dalbeth, Nicola; Matteson, EL; Brown, K; Flaherty, K; Wells, AU; Seibold, JR; Strand, V (2015-03)

    Journal article
    The University of Auckland Library

    OBJECTIVE: Interstitial lung disease (ILD) is common in connective tissue disease (CTD) and is the leading cause of mortality. Investigators have used certain outcome measures in randomized controlled trials (RCT) in CTD-ILD, but the lack of a systematically developed, CTD-specific index that captures all measures relevant and meaningful to patients with CTD-ILD has left a large and conspicuous gap in CTD-ILD research. METHODS: The CTD-ILD working group, under the aegis of the Outcome Measures in Rheumatology (OMERACT) initiative, has completed a consensus group exercise to reach harmony on core domains and items for inclusion in RCT in CTD-ILD. During the OMERACT 12 meeting, consensus was sought on domains and core items for inclusion in RCT. In addition, consensus was pursued on a definition of response in RCT. Consensus was defined as ??? 75% agreement among the participants. RESULTS: OMERACT 12 participants endorsed the domains with minimal modifications. Clinically meaningful progression for CTD-ILD was proposed as ??? 10% relative decline in forced vital capacity (FVC) or ??? 5% to < 10% relative decline in FVC and ??? 15% relative decline in DLCO. CONCLUSION: There is consensus on domains for inclusion in RCT in CTD-ILD and on a definition of clinically meaningful progression. Data-driven approaches to validate these results in different cohorts and RCT are needed.

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  • Robust Vehicle Detection and Distance Estimation Under Challenging Lighting Conditions

    Rezaei, Mahdi; Terauchi, M; Klette, M (2015-05)

    Journal article
    The University of Auckland Library

    Avoiding high computational costs and calibration issues involved in stereo-vision based algorithms, this article proposes real-time monocular-vision based techniques for simultaneous vehicle detection and inter-vehicle distance estimation, in which the performance and robustness of the system remain competitive, even for highly challenging benchmark datasets. The paper develops a collision warning system by detecting vehicles ahead, and by identifying safety distances to assist a distracted driver, prior to occurrence of an imminent crash. We introduce adaptive global Haar-like features for vehicle detection, tail-light segmentation, virtual symmetry detection, inter-vehicle distance estimation, as well as an efficient single-sensor multifeature fusion technique to enhance the accuracy and robustness of our algorithm. The proposed algorithm is able to detect vehicles ahead both at day or night, and also for short- and long-range distances. Experimental results under various weather and lighting conditions (including sunny, rainy, foggy, or snowy) show that the proposed algorithm outperforms state-of-the-art algorithms.

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  • Estimating Core Number in Assemblages: Core Movement and Mobility During the Holocene of the Fayum, Egypt

    Phillipps, Rebecca; Holdaway, Simon (2016-06)

    Journal article
    The University of Auckland Library

    The utility of the cortex ratio first developed by Dibble et al. (American Antiquity, 70(3), 545???560, 2005) and extended by Douglass et al. (American Antiquity, 73(3), 513???526, 2008) is examined in contexts where cores rather than flakes may be transported. The cortex ratio is used to demonstrate the movement of artifacts by quantifying missing surface area, typically where it is the flakes that were removed and the cores that were left behind. In such situations, the removal of flakes with small volumes will result in the removal of relatively large cortical surface areas resulting in a low cortex ratio. However, when it is the cores that were removed, assemblages will lose greater proportions of artifact volume relative to the loss of artifact surface area. Here, we propose methods to investigate the effects of high-volume artifact removal from archeological assemblages as a proxy for human movement in addition to the cortex ratio. We apply the methods to stone artifact assemblages from the Fayum, Egypt, where changes in mid-Holocene mobility are closely linked to food production.

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