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A Survey of Neonatal Nurses on Mydriatic Regimens Used in Neonatal Retinopathy of Prematurity Eye Examinations
No full textObjective This study was aimed to determine mydriatic regimen(s) used in neonatal units in Aotearoa New Zealand (NZ) and Australia and to estimate the frequency of adverse drug events following mydriatic administration in preterm neonates.
Study Design A cross-sectional survey was sent to neonatal nursing staff listed in the Australian and New Zealand Neonatal Network contact list. Participants were asked to state what mydriatic regimen they use, and to estimate the frequency of adverse drug events when eye drops were administered for retinopathy of prematurity eye examinations (ROPEE).
Results Thirteen different mydriatic regimens were identified; phenylephrine 2.5% and cyclopentolate 0.5% (1 standard drop of each) was the most commonly used regimen. Two of the regimens exceeded adult doses and five regimens included a mydriatic that is equivalent to an adult dose. Following mydriatic instillation, the three most common adverse effects were apnea, tachycardia, and periorbital pallor.
Conclusion Low-concentration single-microdrop regimens are currently in use and resulting in successful ROPEE, yet doses exceeding adult doses are in use throughout Aotearoa NZ and Australian units. We know from this dataset that neonates are experiencing unwanted and potentially preventable, adverse effects associated with mydriatics, and every effort should be made to minimize this risk.
Key Points
Thirteen different regimens are in use in Aotearoa NZ and Australia.
Three regimens use doses in excess of adult doses.
Phenylephrine 2.5% and cyclopentolate 0.5% (one standard drop of each) is the most common regime
Community based oral health promotion among adult Syrian former refugees resettled in Dunedin, New Zealand
No full textIntroduction: Resettled refugees suffer from unmet dental treatment needs at a high rate and face many challenges in accessing dental healthcare services. Relevant knowledge and favourable self-care practices are key to preventing oral conditions and enhancing engagement with available services.
Aims: To develop and evaluate a culturally appropriate oral health promotion intervention to reduce smoking, support and improve oral self-care behaviours, and facilitate access to dental health care services for a population of former Syrian refugees. This thesis aimed to answer the following questions: (1) What are the main barriers and facilitators former Syrian refugees face when seeking dental care in New Zealand? (2) Does this intervention improve oral health-related knowledge and behaviours of former Syrian refugees?
Materials and methods: This research took a mixed methods approach, including focus group sessions, one-on-one interviewing, questionnaires, and clinical data collection. Consenting former Syrian refugees (n=63, >18 years of age) who arrived in Dunedin, New Zealand, from 2016 to 2019 were invited to complete a dual English/Arabic language electronic questionnaire using the Qualtrics survey platform. This questionnaire collected data on participants’ personal characteristics and oral healthcare habits. Those who completed the questionnaire were then invited to participate in a health promotion intervention in either an online group setting (n=39) or a 1-on-1 clinical dental setting (n=21); in total, 60 people participated, with the remainder not participating any further. , First, to identify challenges faced by Syrian former refugees in seeking oral health care, focus groups were conducted based on existing family/social networks and the interviews were conducted online via Zoom™. Secondly, to ensure cultural appropriateness, participants were invited to co-design a set of dual language (Arabic/English) oral health education resources at the time of focus group meetings. Finally, to test the intervention, those who participated in a 1-on-1 clinical dental setting were dentally examined for caries, missing teeth, periodontal health, and oral hygiene; the findings of these examinations were discussed with each participant in their native Arabic language, and they were motivationally interviewed, encouraged to make a change to their oral self-care relevant to their individual risk factors. The co-designed resources were then sent to all participants monthly for five months, with a new theme for each month (oral home care, how to access dental care in New Zealand, how to quit smoking, sugars and dental health, and a summary in the final month). Finally, after six months, to evaluate the intervention, all participants were invited to complete a follow-up questionnaire (Appendix 11) and those who were in the clinical arm were dentally re-examined. All interviews were recorded, transcribed verbatim then translated to English. Thematic analysis involved familiarisation; coding of data; identifying themes, and collating data into themes; and reporting on the results. Quantitative findings were analysed statistically using the software Stata SE 15.1.
Results: Multiple factors hindered or facilitated the participants’ ability to address their oral health needs, including finances, communication and language, providers’ (poor) cultural competency and inherent process issues (structural); and participants’ expectations of the oral health care system and differences to that in Syria, their oral health care attitudes and beliefs, and specific issues associated with resettlement (sociocultural).. In the co-design of the health education resources, participants engaged well and provided considerable feedback. The resources were judged by participants as useful, easy to read, worthwhile and that even information which they already knew was useful and motivational. Participants’ oral health self-care behaviours significantly improved following receiving these educational resources over a 5-month period. Over half of participants reported improvements to their toothbrushing behaviours, while among those who consumed sugary drinks at least weekly, over 90% reported having taken steps to reduce their sugar intake. None of the smoking participants quit smoking but 52.4% reported cutting back on their smoking. Among those who participated in the clinical arm of the study, oral hygiene was markedly improved (with a reduction in plaque scores of greater than 50%).
Conclusion: Former refugees experience barriers to accessing dental care. Their unique needs should be considered by policymakers and dental clinicians. The participatory intervention designed in this research was found to be effective in helping former refugees adopt better oral health behaviours. Future research should investigate whether this intervention should be implemented more widely among former refugees
Surface modification of orthodontic elastomers to overcome biofilm formation
Get PDFIntroduction: One of the major problems for patients undergoing treatment with fixed orthodontic appliances is the development of oral biofilm-related disease. One way to potentially reduce biofilm formation is to modify the appliance surface characteristics to make it less adherent to bacteria. The aim of this study was to create a superhydrophobic surface on orthodontic elastomeric chain material to reduce bacterial adhesion.
Materials and Methods: Orthodontic elastomeric material was modified with sandpaper of various grit sizes. Custom made jigs were used to stretch the elastomers to 150% and 200% of initial length. Surface characteristics were assessed quantitatively with confocal microscopy and qualitatively with scanning electron microscopy. Contact angles were measured using a goniometer. Bacterial adhesion was measured after incubating saliva coated elastomers with Streptococcus gordonii ATCC10558 for 30 minutes, by counting colony forming units on Columbia sheep blood agar plates.
Results: Abrasion with sandpaper of grit size 80-600 produced elastomers with surface roughness (Ra) of 2-12 µm. The effect of extending these elastomers on roughness was variable. Contact angles were found to follow a quadratic trend with a maximum contact angle of 104°at an Ra of 7-9 µm. Maximum contact angles, when viewed perpendicular to stretch, were found to decrease from 104° to 95° when the extension was increased from 100 to 200% and increased from 102° to 105° when viewed parallel to the stretch. Bacterial adhesion increased exponentially as roughness increased and this effect was more pronounced with elastomer extension.
Conclusions: It was not possible to obtain a superhydrophobic surface, with an advancing contact angle >150° and contact angle hysteresis ≤ 4, using sandpaper abrasion. All surface modifications increased bacterial adhesion to the elastomer
Ecology and conservation of Hector's dolphins in Porpoise Bay, Southland
Get PDFThe small population of Hector’s dolphins that ranges along the Catlins coast forms a crucial genetic link between the dolphins in Otago and in Southland’s Te Waewae Bay. During the austral summer, dolphins from this population frequently use Porpoise Bay, which appears to be an important foraging and calving area. A perceived increase in the number of visitors to the bay raised concerns over the potential effects of interactions with swimmers, and resulted in the need for a comprehensive study to guide management of the dolphins. This thesis details the results of a study conducted during 2019/20 which aimed to update the estimate of abundance, assess the potential effects of recreational swimmers, and quantify the use of Porpoise Bay by Hector’s dolphins. Using capture-recapture modelling of photo-identification data it was estimated that 53 Hector’s dolphins (95% CI = 41-71), including three new calves, used Porpoise Bay during summer 2020. Linear regression analyses showed no evidence of a change in abundance from previous estimates in 1996/97, 2002/03, and 2008, despite the establishment of the Catlins Coast Marine Mammal Sanctuary and the introduction of restrictions on potentially harmful fishing methods in 2008. Land-based theodolite tracking was used to assess the potential effects of recreational swimmers on the behaviour of Hector’s dolphins and evaluate the effectiveness of management guidelines. Dolphins showed significant behavioural responses to swimmer presence, including a reduction in time spent ‘long-diving’ and some evidence of avoidance of swimmers when calves were present. During swimmer-dolphin interactions observed in this study, management guidelines were frequently contravened, particularly section 20(b) of the Marine Mammals Protection Regulations (i.e. persons may not swim with dolphin calves or a pod of dolphins that includes calves). Kernel density estimation and passive acoustic monitoring were used to quantify use of Porpoise Bay by Hector’s dolphins. All analyses indicated that the dolphins’ preferred area was in the south-west corner of the bay, suggesting long-term stability in the core summer habitat of this population. Dolphin presence was greatest during the summer sampling months (January to March), although dolphins were detected in the bay during non-summer months for the first time. In addition, new evidence of variation in the dolphins’ use of the bay over diel and tidal cycles was found. Given that small populations inherently have a high risk of extinction, a precautionary approach to management of the Catlins coast Hector’s dolphins’ key threats is justified. This thesis provides management recommendations designed to minimise disturbance and promote recovery of this important, vulnerable local population of Hector’s dolphins
Gelatinisation and milling whole-wheat increases postprandial blood glucose: randomised crossover study of adults with type 2 diabetes
No full textCardiovascular risk prediction in type 2 diabetes before and after widespread screening: a derivation and validation study
No full textFriendly neighbour or fiendish invader: individual recognition in the upland bully (Gobiomorphus breviceps).
Get PDFIndividual recognition behaviour is where an organism can identify another based on its individual characteristics. This behaviour is widespread throughout a variety of taxa. To be used successfully, an organism must be able to both send and receive signals. There are plenty of studies identifying recognition both intra- and inter-specifically, particularly in social animals. Territorial fish are a commonly used study species for recognition behaviour studies as these animals need to be able to differentiate threats and rivals from potential mates and familiar neighbours. This study aimed to investigate individual recognition through visual cues in a native New Zealand territorial fish.
In chapter two, a literature review was conducted on individual recognition, with a particular focus on visual cues. This review demonstrates that although individual recognition is widely studied, there are gaps in our understanding of the cues used for individual recognition. In particular, I focus on identifying pattern location on an animal’s body and how this influences communication between individuals. There is a lack of research exploring how and why the visual cues need to be placed in a specific location on the body to allow for more direct communication. Another area which was covered in the review was how morphological constraints impact an organism’s ability to use extravagant ornaments as visual cues. Animals’ lifestyles vary among species, but for those with restricted body shapes, like fish, the use of a visual cue other than morphology is crucial for communication. This review provides a comprehensive review on individual recognition and what areas need further investigation.
In chapter 3, 30 upland bullies (Gobiomorphus breviceps), a native New Zealand territorial freshwater species, were collected from two locations in north Otago. Fish were paired together for a week to create a familiar pairing before being exposed to their familiar pair and then to an unfamiliar pair. Behaviours of the fish were filmed for 30 minutes when exposed to familiar and unfamiliar fish. The behavioural response of the upland bullies when exposed to familiar and unfamiliar fish were measured using video recordings analysed in BORIS (Behavioural Observation Research Interactive Software). Five behaviours were observed for analysis, aggression, movement, resting, duration inside the territory, and duration spent at the connective wall area. Neither males nor females showed any evidence for individual recognition, as none of the behaviours differed between familiar and non-familiar neighbours, which was likely due to a small sample size and seasonal restrictions due to the COVID-19 pandemic. The repeatability of the behaviours were also estimated. Overall, all behaviours, for both males and females, were highly repeatable, suggesting that the upland bully exhibits consistent individual differences in behaviour (i.e., personality).
While the results did not support the hypothesis that upland bullies would differentiate familiar from unfamiliar fish based on visual cues, it poses new ideas around visual recognition cues and shows that the upland bully is displays consistent individual differences in behaviour study species, and thus could be a promising study species for more personality related studies. Future research should focus more on the specific cues used by territorial fish for identification.
Job satisfaction and career prospects of Oral Health Therapists in Aotearoa/New Zealand: A research update and call for further research in light of the COVID-19 pandemic
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Envisioning relational reproductive justice in surrogacy: Recognising the invisible experiences of intended parents
No full textIndia has become notorious as a multibillion-dollar surrogacy industry. This industry flourished when India allowed commercial surrogacy and attracted many international intended parents to engage with widely available Indian private fertility clinics to achieve parenthood. This industry raised legal, ethical, social, moral and political issues due to cross-border travel for reproduction and the wider socio-economic gap between Indian surrogate mothers and international intended parents. Consequently, Indian surrogacy gained much attention in policy, media and research, which identified surrogacy as a cause of exploitation, commodification and injustice for surrogate mothers and children born via surrogacy. This led to the announcement of ban of commercial surrogacy in India in 2016, which stopped not only internationals but also Indian nationals who engage with commercial surrogacy. In policy discussions and academic research much focus is on surrogate mothers, while a specific focus on Indian intended parents is hardly visible.
Given the Indian context, where parenthood and childbearing play important socio-cultural and religious roles, there is a need to understand the surrogacy journeys of Indian intended parents. Further, understanding intended parents’ experiences in the wider socio-cultural context is essential if surrogacy is to be and ethical for the ‘surrogacy triad,’ namely surrogate mother, intended parents and child. This is because surrogacy is a relational and mutual process, where all members of the surrogacy triad are dependent on each other for care and trust. Hence, this thesis moves beyond the exploitation and commodification debates and envisions relational reproductive justice which may include ethics of care as a way forward. This thesis contributes empirically to these broader discussions of relational reproductive justice by exploring Indian intended parents’ representation, experiences, and their struggles in light of wider societal structures such as stigma.
The present study is conceptualised using reproductive justice framework, the concept of stigma and Foucauldian power theory. Using a qualitative research methodology, I employ two qualitative research methods, namely discourse analysis of newspaper articles and thematic analysis of in-depth interviews of the intended parents. The results from this analysis are triangulated to gain a holistic understanding of intended parents’ experiences. For the discourse analysis, 196 newspaper articles published on surrogacy from 2002-2017 were selected. A Foucauldian discourse analysis of these newspaper articles allowed my analysis to understand the broader societal framing, representation of intended parents and social context in which intended parents experience their surrogacy journeys. Further, I conducted a thematic analysis of eight in-depth semi-structured interviews of intended parents who I interviewed in India from January to May 2018. A thematic analysis informed by Foucauldian power concepts and stigma theory allowed me to understand the intended parents’ stigma experiences, subjectivities and power relations experienced in the wider society. Collectively these two analyses shed light on factors constraining ethics of care and vision of relational reproductive justice.
This thesis primarily argues that stigma and commercialisation constrain the potential for relational reproductive justice. Stigma results in invisibility and secrecy of intended parents’ surrogacy journeys and minimal interaction and interpersonal relationship with the surrogate mothers. Surrogate mothers and their relationship with the child also remain invisible and unrecognised. The invisible and lonely journeys of intended parents worsen when intended parents struggle with a commercialised neoliberal fertility market, experiencing a lack of proper health care, economic constraints and implications of frequent surrogacy policy changes. I suggest stigma and commercialisation affect the caregiving and receiving, and the wellbeing of the surrogacy triad. This thesis concludes by proposing the need to achieve ethics of care for the surrogacy triad and addressing stigma by redefining broader societal discourses about surrogacy. This helps in building interpersonal relations, and practice of care and responsibility between the surrogate mother and intended parents, recognising surrogacy as a relational reproduction process, and furthering a just experience for those involved. Encouraging this potential relational and care perspective can allow children to meet their surrogate mothers or donors, recognising surrogate mother’s role in child’s life and in future extending the definition of families
Cost-(in)effective public good provision: An experimental exploration
Get PDFThis paper investigates the determinants of cost-(in)effective giving to public goods. We conduct a pre-registered experiment to elucidate how factors at the institutional and individual levels shape individual contributions and the cost-effectiveness of those contributions in a novel public good game. In particular, we examine the role of consequential uncertainty over the value of public good contributions (institutional level) as well as individual characteristics like risk and ambiguity attitudes, giving type, and demographics (individual level). We nd that consequential uncertainty tends to reduce overall contributions, but not the cost-effectiveness of those contributions. Meanwhile, cost-effectiveness varies by giving type-which is a novel result that is consistent with hypotheses we generate from theory-but other individual characteristics have little influence on contributions or cost-effectiveness. Our work has important positive and normative implications for charitable giving and public good provision in the real world, and it is particularly germane to emerging online crowdfunding and patronage platforms that confront users with a multitude of competing opportunities for giving