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Anthropology at the University of the South Pacific: From past dynamics to present perceptions
No full textThe Pacific Island region is a key context in the history of anthropology. Yet, while much has been written about how anthropology of the Pacific Islands contributed to Anglo-American anthropology, the discipline's institutional history in the Pacific Islands has received very little attention. This paper is the first to explore the history of anthropology at the University of the South Pacific (USP). Research findings demonstrate that anthropology lacked practical meaning in an institution established to modernise Pacific Island states. Fieldwork conducted at USP suggests that current perceptions of anthropology held by academic staff are strongly linked to the discipline's classic era. I argue that the anti-colonial version of the Pacific Way from the 1970s onward, coupled with the hegemony of political economist and anti-culturalist approaches among the USP teaching staff in the 1980s, inhibited a meaningful engagement with the Writing Culture debate at USP. This may explain why there has been little influence by the discipline's postmodern transformation over the past thirty years on current perceptions of anthropology at USP.Peer Reviewe
Pre-Contractual Misrepresentations: When does purchaser carelessness count?
No full textRefers to a recent High Court decision in 'Stalker v Duncan [2020] NZHC 1484', which concerns the sale of a farm in 2011. Raises the issue of when a purchaser's carelessness in the face of a misrepresentation is properly taken into account. Goes on to explain why the Contributory Negligence Act 1947 cannot be used to reduce damages for misrepresentation, and explore other ways how purchaser carelessness can be taken into account and might effectively reduce compensation.Peer Reviewe
The effect of ageing and BDNF signalling in post-stroke cognition
No full textEvery year, millions of people worldwide will have a stroke. For those who survive, many will live on with persistent disability, including cognitive impairments. To better understand the mechanisms underlying cognitive deficits that arise from stroke, our laboratory generated a preclinical stroke model that targets the prefrontal cortex (PFC) bilaterally in mice using the photothrombosis method, that results in delayed-onset spatial memory impairment. The overall aim of this thesis was to further characterise this stroke model in aged animals in an attempt to better represent the clinical population disproportionately affected by stroke. To do so, we employed a battery of behavioural tasks, immunohistochemical labelling and real-time quantitative polymerase chain reaction techniques to investigate age- and PFC stroke-mediated cognitive impairments and underlying mechanisms.
Relative to younger counterparts, aged sham animals displayed increased anxiety-like behaviour and an age-related decline in cognitive flexibility as assessed on the elevated plus maze (EPM) and visual discrimination (VD) reversal tasks, respectively. Moreover, age-related reductions in neurotrophic support were evident in the PFC of sham animals, including a reduction in the genetic expression of brain-derived neurotrophic factor (BDNF) and one of its receptors (Ntrk2.fl). Similarly, aged stroke animals displayed dampened stroke-induced elevations in Bdnf mRNA within peri-infarct PFC tissue at four-weeks post stroke. Despite this, young and aged stroke animals presented similar stroke-induced spatial memory impairments in the object location recognition task (OLRT) at four-weeks post-stroke. Tissue collected from all stroke animals (day-56 post-stroke) revealed a significant stroke-induced loss thalamo-PFC connectivity, evidenced by a reduction in cholera toxin subunit-B (CTB)+ve cells in the nucleus reuniens (RE) and mediodorsal thalamus (MD), five-days after injections of CTB into the prelimibic cortex next to the stroke. Lastly, stroke failed to affect VD reversal task performance at 2-3 weeks post-stroke in young animals, but facilitated an improved performance in aged animals. Treatment with the BDNF receptor decoy, TrkB-Fc, dampened this effect, suggesting a BDNF-mediated reopening of a critical window for post-stroke recovery in aged animals.
Given the fundamental role of BDNF in functional recovery following stroke, we investigated the therapeutic potential of BDNF signalling in our aged stroke model. Hydrogel administration of recombinant human BDNF (from day-5 post-stroke) prolonged stroke-induced elevations in Bdnf mRNA at four-weeks post-stroke, but failed to influence performance across all cognitive tasks. Chronic treatment with systemic CX1837, a high-impact AMPAkine that modulates AMPA receptor activity and also elevates BDNF expression, afforded significant improvements to VD reversal learning in aged sham animals and significantly alleviated post-stroke spatial memory impairments in aged animals performing the OLRT. However, CX1837 treatment failed to affect VD reversal learning or thalamo-PFC connectivity in aged stroke animals. The therapeutic potential of two novel glycomimetics (compound A and G) with or without co-administration with rhBDNF, was then assessed in young stroke mice. Both glycomimetics alone failed to affect OLRT performance in stroke animals, despite exerting mild effects of thalamo-PFC connectivity and reactive astrogliosis at day-35 post-stroke (determined by glial-fibrillary acidic protein (GFAP)+ve staining). However, when given in combination with rhBDNF, compound G significantly improved OLRT performance at four-weeks post-stroke, dampened stroke-induced reductions in CTB+ve cells (RE and MD thalamus), and attenuated GFAP+ve staining in the peri-infarct, corpus callosum and infralimbic regions. These data highlight the need for a combinatorial approach for treating strokes occurring in older populations.
Lastly, we aimed to further investigate post-stroke spatial memory impairments observed in our young stroke model using the translational, touchscreen-based TUNL task. By varying the spatial separation and delay between stimuli, we were able to demonstrate novel stroke-induced impairments to both spatial and working memory components of the TUNL task. Moreover, we reported significant positive correlations between the degree of TUNL impairment and GFAP+ve staining in the IL and CC regions at day-56 post-stroke, providing further support for the involvement of reactive astrogliosis in post-stroke cognitive impairment. Overall, this thesis has addressed the importance of using an aged stroke model to better assess age-related differences in stroke pathology. Further, we highlight the importance of neurotrophic support to the ischaemic brain, and identify a novel glycomimetic/rhBDNF treatment that showed promise for promoting functional recovery in our PFC stroke model
Study Protocal: Doctors’ Reflections on Performing Face-to-Face Voluntary Medical Assistance in Dying
No full textProtocol for 'Doctors’ Reflections on Performing Face-to-Face Voluntary Medical Assistance in Dying
Class Actions, Crown Negligence, Immunities and Epidemics on Trial: AG v Strathboss [2020] NZCA 98
Get PDFMight the Crown be held liable for permitting the incursion of a contagious disease into New Zealand, resulting in epidemic spread and significant economic loss? Should it be liable? While these questions might attract interest due to New Zealand’s COVID-19 response, and on-going outbreaks related to border controls, the Court of Appeal recently answered this question regarding a bacterial disease (Psa3) affecting kiwifruit in Attorney-General v Strathboss Kiwifruit Ltd [2020] NZCA 98. In Strathboss the Court of Appeal found that the Crown was immune from liability in tort for the spread of the Psa3 bacterium amongst kiwifruit orchards in New Zealand, from 2010.This case is foremost a consideration of Crown immunity in tort, and secondarily an analysis of negligence. Yet it raises significant and broader issues, such as statutory interpretation of Parliamentary intention, class actions, public authorities, cost-shifting, suing the proper defendant, and border security. Many of those issues cannot be fully analysed here. Given the factual density, the complex legal issues,and the length ofthe High Court and Court of Appeal decisions, this case note briefly summarises the key issues under consideration by the Court of Appealand its findings. As the Supreme Court has granted leave to appeal on broad grounds (Strathboss Kiwifruit Ltd v Attorney-General[2020] NZSC68), we highlight aspects of the decision that require further scrutiny and clarification.Peer Reviewe
Inflammatory profiles in acute coronary syndromes
Get PDFInflammation is vital in the repair following an acute coronary syndrome (ACS). Studies suggest that excess inflammation is pathological and may lead to major adverse cardiovascular events (MACE). Hence, inflammatory markers may be potential MACE predictors, although it is currently unknown which marker(s) best predict MACE.
We firstly investigated common inflammatory markers as MACE predictors in two acute myocardial infarction (AMI) cohorts, using simple methods of combining markers to determine if such approaches could better predict MACE. The first study with 860 patients investigated white blood cell subtypes, markers routinely used in clinical practice. Individual subtypes were not associated with MACE. Ratios of these subtypes were predictive on univariate, but not multivariate analysis. The second study measured a small panel of inflammatory markers (C-reactive protein, interleukin (IL) -6 and tumour necrosis factor alpha) in a case-control study. Cases were defined as patients who developed MACE within one year. No significant association was found with MACE when using individual or combined markers. This finding might have been influenced by time as a confounder, as we did not strictly control the sampling time.
Next, we investigated cytokines because these markers are more reflective of acute inflammatory changes. We conducted a systematic review to investigate whether a combined cytokine approach would be superior to individual cytokines to predict MACE in ACS. Analysis of 10 studies meeting our eligibility criteria revealed inconsistent associations with MACE for an identical cytokine. The four studies using simple combined cytokine approaches found significant associations with MACE, suggesting that a combined approach could be superior to an individual one for MACE prediction. However, the 10 studies could not answer how best to combine the non-independent cytokines, or when it was best to measure them.
We next examined temporal variation of six cytokines in 23 AMI patients. This was to determine if time was a potential confounder and if an optimal timepoint existed to capture peak cytokine levels (representing excess inflammation). There was significant variation in cytokine concentrations over time, so no optimal timepoint could be determined. Only IL-6 had a clear trend with a peak on Day 1, and this peak was produced by half the cohort. The observed variation could not be explained by clinical risk factors or surrogate markers of infarct size. We concluded sampling time might be an important consideration when designing future studies.
Finally, we trialled the use of principal component analysis (PCA), a mathematical technique allowing non-independent variables to be reduced into combined scores, to create a combined cytokine score and tested its prognostic utility. Six cytokines were measured in a cohort of 320 patients. We found that IL-6, IL-8, all cytokines combined into a PCA score, and an IL-6-IL-8 PCA score univariately predicted MACE. Only the IL-6-IL-8 score and IL-6 were independently associated with MACE, with the IL-6-IL-8 score having a stronger relationship than IL-6 alone.
Collectively, these studies demonstrate the complexity of inflammation in ACS. While we could not answer how best to characterise inflammation, we showed that using single biomarkers was unlikely to be sufficiently representative of pathological inflammation. As a proof-of-concept, we demonstrated PCA was one mathematical approach that could be used to combine collinear markers. However, further studies are required to determine the best method to create a prognostic inflammatory score and the best time to measure inflammatory markers
From hearth to health: An investigation into the health impacts of the Warm Up New Zealand home insulation subsidy programme
No full textBackground: Excess winter mortality and morbidity are often greatest in countries with relatively mild climates, probably due to poorer thermal housing standards compared to well-insulated houses in colder climates. Cold houses are also associated with indoor dampness and mould. Cold temperatures have been linked to worsening of cardiovascular disease symptoms, whilst indoor dampness and mould have been consistently linked to increased risk of respiratory symptoms. Most New Zealand homes are cold by international standards and do not meet the World Health Organization (WHO) recommended minimum indoor temperature of 18°C. Prior to a 1977 amendment to the building code, there was no requirement to insulate homes. Since then, insulation of new homes has been mandatory, but retrofitting insulation into existing homes has been at the discretion of the homeowner. In 2009, the Energy Efficiency and Conservation Authority (EECA) established an insulation subsidy programme for existing homes, Warm Up New Zealand Heat Smart (WUNZ). WUNZ ran from June 2009 to July 2014, with the aim of providing “warm, dry and more energy efficient homes” and represented a NZ$347 million government investment.
Aim: To assess whether residents experienced a reduction in severity and frequency of cold-associated ill health following insulation retrofits in their homes. Four measures of health outcome were used: pharmaceuticals dispensed for respiratory illness, respiratory disease incidence (based on pharmaceuticals dispensed), hospital admissions and mortality.
Objectives: To develop a data linkage method for tracking residents of houses over time. To investigate the modifying effect between different groups within the population based on socio-demographic and environmental influences.
Methods: A quasi-experimental retrospective cohort study design linked a dataset of houses insulated through the WUNZ subsidy programme to health and socio-demographic records. A difference-in-difference model compared changes in health outcomes in an intervention group that had received insulation through WUNZ to a control group from the same WUNZ dataset that subsequently received insulation. Health outcomes measured by this method included: pharmaceuticals dispensed for cold-associated respiratory disease; and acute and cold-associated hospital admissions. Direct comparisons between the intervention and control groups determined whether there was any difference in chronic respiratory disease incidence post-insulation, using two prescription medication measures: prevention medication and exacerbation sensitive medication. Prevention medication included prescription medicines taken regularly to manage the illness. Exacerbation sensitive medication included medicines prescribed for use when symptoms became more acute, for example to prevent an asthma attack. Survival analysis determined any differences in cold-associated mortality between the intervention and control groups.
Results: There were statistically significant improvements in residents’ health across the four outcome measures. A statistically significant lower risk of chronic respiratory disease incidence was found amongst the intervention group compared to the control group for both a prevention of symptoms indicator: risk ratio (RR1) 0.92 (0.89-0.98) and for an exacerbation sensitive medication indicator: RR1 0.88 (0.83-0.92). Relative rates of pharmaceuticals dispensed were lower in the intervention group compared to the control group for infectious respiratory disease: relative rate ratio (RRR) 0.98 (95 % confidence interval: 0.98-0.99) and exacerbation sensitive medication used to treat symptoms of chronic respiratory disease: RRR 0.96 (0.96-0.97). Relative rates of acute hospital admissions were also lower in the intervention group RRR 0.89 (0.87-0.91) and fell further when specific cold-associated respiratory and cardiovascular diseases were considered. There was no statistically significant reduction in mortality overall, however, results were statistically significant when heating was installed alongside insulation: hazard ratio (HR) 0.77 (0.61-0.97).
There was not an even distribution of health gains from the WUNZ subsidy across ethnicities. Health gains for Pacific Peoples were more pronounced than other ethnicities whilst those for Māori were less pronounced.
Additional health gains were demonstrated when an energy efficient heater was installed alongside insulation in two of the four health outcomes investigated (pharmaceuticals dispensed and mortality) and were comparable to installing whole house insulation when hospital admissions were examined.
Conclusion: Taken together these results provide strong evidence to support housing interventions that increase thermal efficiency to improve health outcomes for residents. Delivery of such interventions may need further thought however, to ensure equity of health outcomes across socio-demographic groups.
Further research should incorporate intervention datasets into the integrated data infrastructure (IDI) to understand the impact on health outcomes of household tenure, lifestyle factors and comorbidities better. The data generated from the study could update cost-effectiveness analyses of future housing interventions.
Future research should incorporate a holistic approach to improving thermal efficiency that also addresses the more complex nature of the relationship between housing and health. This would help to improve the delivery of structural interventions to increase equity of health outcomes and fully realise health gains
Explaining and changing the price of litigation services
Get PDFThis article shows that there are many other potential points for reform that stretch beyond the calls for more legal aid or more pro bono and look towards making the private market accessible to those who it is meant to serve. This includes looking at who can offer legal services and how pricing is set and monitored, points that are much less frequently discussed in access to justice conversations. Lower prices may also be supported through indirect change including to legal education, court procedure, and changes to the delivery of legal services. These points of reform – including more pro bono and more legal aid – together offer the potential for putting civil dispute resolution advice and representation into the hands of all New Zealanders
Effectiveness of a science outreach programme in regional communities of Thailand
Get PDFA visit to informal science learning settings such as science museums and science centres can influence multidimensional aspects of visitor experiences and outcomes including cognition, affect, attitude, interest, motivation and behaviour related to science and learning. While many informal settings aim to provide science learning opportunities for the general public, geographic distance can exclude some social groups, particularly in regional and rural areas. To overcome obstacles of distance and travel expense to museums, science outreach programmes can bring science to target audiences who would not or could not come to visit the museums. Evaluating such programmes can help determine the impact of participation on visitors’ learning experiences. This thesis is a case study examination of the impact of an outreach programme run by the National Science Museum (NSM) of Thailand – the NSM Science Caravan. Science Caravan has been organised as part of equity works to increase access to museums for Thai children, particularly those in rural areas around the country.
To measure changes in students’ attitude and motivation towards science learning as a result of participation in Science Caravan, a pre-test/ post-test design was used to analyze the difference before (N = 1,424) and after (N = 1,104) participation in the intervention. Direct observation was conducted as an unobtrusive approach to investigate students’ learning-related behaviours while they engaged with interactive exhibits (N = 589). Semi-structured interviews were conducted with 43 high school students from four provinces to provide further reflection and self-report.
The quantitative analysis of changes in students’ attitude and motivation towards science learning was based on psychometric measurements. One advantage of this study is that different aspects of attitude and motivation towards science learning were defined and measured separately with reliable and unidimensional measures. The results of self-report questionnaires showed that participation in Science Caravan activities had a positive impact on all three elements of attitude towards science learning: (1) Affect - Personal feelings; (2) Cognition - Perceived value; and (3) Behavioural intention - Future participation, as well as three dimensions of motivation towards science learning: (1) Interest; (2) Intrinsic motivation; and (3) Self-efficacy.
Data analysis involved structural equation modelling - based on the theoretical framework developed in this study - to predict an intention of future participation in science. Results showed that engaging in Science Caravan activities had a more substantial impact on students’ attitudes about science than on their motivation towards
learning science. However, both constructs influenced students’ intention of future participation in science. There were no effects of gender or education levels on either the attitude or motivation construct. Observation of students while they engaged with exhibits provided empirical evidence of learning-related behaviours and potential learning-related outcomes. A large majority (80%) of observed students showed overt active engagement that can contribute to affective and cognitive learning. Exhibits which present a combination of counterintuitive phenomenon together with multiple options of manipulation encouraged higher levels of learning-related engagement. This has potential to influence in-depth learning outcomes and would be interesting to address in future studies