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Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care
No full textBackgroundDespite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, variability in the amount (dose) and type of facilitation activities/facilitator roles that make up the facilitation strategies (content), may affect the effectiveness of facilitation. This review aimed to determine if, and how, facilitation dose is measured or reported and the type of facilitation strategies used to support adoption of stroke interventions in hospitals and subacute settings. We also assessed whether the included studies had reporting checklists or guidelines.MethodsThe scoping review was based on Arksey and O'Malley's framework. Cochrane, CINAHL and MEDLINE databases were searched to identify randomised trials and quasi-experimental studies of stroke interventions published between January 2017 and July 2023. Accompanying publications (quantitative, qualitative, mixed methods or process evaluation papers) from eligible studies were also included. Narrative data synthesis was undertaken.ResultsTen studies (23 papers) from 649 full-text papers met the inclusion criteria. Only two studies reported the total facilitation dose, measured as the frequency and duration of facilitation encounters. Authors of the remaining eight studies reported only the frequency and/or duration of varying facilitation activities but not the total dose. The facilitation activities included remote external facilitator support via ongoing telecommunication (phone calls, emails, teleconferences), continuous engagement from on-site internal facilitators, face-to-face workshops and/or education sessions from external or internal facilitators. Facilitator roles were broad: site-specific briefing, action planning and/or goal setting; identifying enablers and barriers to change; coaching, training, education or feedback; and network support. Only two studies included reporting checklists/guidelines to support researchers to describe interventions and implementation studies in sufficient detail to enable replication.ConclusionsThere is a paucity of information on the measurement of facilitation dose and reporting on specific details of facilitation activities in stroke implementation studies. Detailed reporting of dose and content is needed to improve the scientific basis of facilitation as strategic support to enable improvements to stroke care. Development of a standardised measurement approach for facilitation dose would inform future research and translation of findings
Kode Technology
No full textThis DSc thesis is based on publications (journal publications, patents and the “Kode Technology Illustrated Technical Manual” eBook) associated with the author Stephen Henry’s journey in developing Kode Technology. It starts with a pre-Kode Technology exploration of blood group related glycolipids, which evolved into the first generation use as natural glycolipids, before radically morphing into second generation nanotechnology synthetic glycolipids, which further evolved into third generation of Kode constructs, capable of modifying any biological or non-biological surface with almost any small molecule.
Today Kode Technology represents a nanotechnology platform of biosurface modification constructs (Function-Spacer-Lipids, FSLs or Kode constructs) which can enable the non-covalent attachment of essentially any small molecule onto any biological or non-biological surface. Kode Technology constructs although very sophisticated in their chemical composition are extremely low-tech with respect to their methods of use (koding); typically being as simple as bringing a surface (cell, virus, liposome or surface) in contact with a solution of Kode constructs for a short period of time, and the Kode constructs then spontaneously self-assemble into or onto the surface. The resultant controllable FSL construct modified (koded) surface coating is relatively stable, and although not permanent, is sufficient to enable potent biological activity, well within the biological time parameters.
Cells labelled with FSL constructs are known as kodecytes and have been used in a variety of different applications including; antibody diagnostics, quality control and training systems, visualisation, immobilisation, interactions with the immune system (including potential clinical applications), and in bespoke applications. Enveloped viruses labelled with FSL constructs have been used in a variety of similar applications. The power of Kode Technology is its ability (without affecting vitality and normal functionality) to rapidly impart on any living cell or enveloped virus, an additional function.
In addition to modification of biological entities, Kode constructs in solution phase and/or associated with lipid particles including liposomes are able to neutralise antibodies and toxins and adhere to almost any nonbiological surface, including plastics, metals, rubber, glass, silicone, natural fibres, etc. Such koded surfaces have been used in a variety of applications including antibody diagnostics (where the Kode construct is inkjet printed onto the surface as alphanumeric characters), cell/virus surface adhesion and as an anti-microbial coating. With respect to opportunities for Kode Technology, as the functional head of a Kode construct can be almost anything, there is also an almost unlimited number of potential applications, and thus many new
opportunities for the technology to change and reframe paradigms in biological methodology.
Although Kode Technology was co-invented by the author from the seeds of several decades of blood group glycolipid research, in reality the technology owes its existence to the extensive contributions from numerous colleagues and collaborators. This thesis, as well as extensively exploring the authors (and co-authors) contributions to Kode Technology, also includes the Kode Technology Illustrated Technical Manual Kode eBook https://natlib.govt.nz/records/50606977 which extensively covers all known published and unpublished Kode Technology data (up to 2022)
Whatu & Form : Weaving Korero and Craft
No full text“Raranga whakapaepae ana rā, Taku kete taku tō…He taura tangata I tō mai I te pō. I takea mai nei I Hawaiki rā anō”
“The sacred basket of knowledge, Here delicately woven before you…A human bond that connects us from the homeland. Through the passages of time.” – Derek Lardelli
Materiality and movement, customary craft as a primary communicator, connecting the passages of time and people, past, present and future, driven by the
practices of Indigenous craft, focusing on the native culture of New Zealand, Māori. This thesis draws upon cultural craft and the architectural capabilities held within their construction and crafting processes and how this can be explored through evolving explorations, forms, materiality and mediums to establish a space that enables the revitalisation of community connection and reclamation of
identity. Enabling and cultivating relationships, connecting people to people,
people to place, people to language, and people to craft.
Beyond a glass manifestation or laser-cut steel as decorative elements on
architecture, how can the integration of customary practices such as traditional Māori crafting techniques into architectural design facilitate iwi [re]connection and the progression of ancestral skills and knowledge?
Moving over, under and around itself, woven crafts intersect at every point,
promoting the maintenance of cultural progression through the practice of arts. Kākahu and Raranga weaving offer themselves to the evolution of form and
materiality. This thesis intends that through research and explorative weaving
processes, a design outcome will reveal a space that nurtures old skills and
encourages the development of new skills. A place that enables the continuation and preservation of ancestral skills and knowledge, fostering cultural richness among Māori communities. Finding the intersection of customary craft and
architecture to aid [re]connection and reclamation of cultural identity.
A story familiar to many Māori. A loss of land, community and identity.
Disconnected from Marae. I live here (Big City), but my Marae is there (Small Town).
Through the years of colonisation and discrimination, Māori have had their land, language, culture, and history, as well as their own identities, stripped away,
resulting in generations of damage. Their ways of life have been belittled, and their traditions have been discarded. Not too long ago, previous generations moved from rural to suburban in hopes of better education and job opportunities — from small rural towns to big cities. Unknowingly displacing and depriving future
generations of their Iwi (community), Marae, and their identities. The internal
migration has resulted in disconnection, loss of place and lack of practices. We now battle the early stages of repair and revitalisation as many Māori seek to
reclaim their past and reconstruct communities.
Belonging but not connected. Where does one belong when by indigenous
heritage they’re rooted in the grounds of their biological culture but not physically connected to tribal lands and spaces
Nonlinear vibration isolator with tuneable stiffness and damping
No full textThesis embargoed until 06/202
Reviving the Ministry of Works: Filling the Void in New Zealand's Climate and Crisis Response Infrastructure
No full textAotearoa faces mounting pressures to address two interwoven infrastructure crises: the accelerating effects of climate change and an acute housing shortage. Confronted with an increasing frequency of climate-induced natural disasters and a severe shortage of affordable, responsible housing. Reliance on short-term political cycles only offers opposing and fragmented solutions, hindering our ability to implement meaningful, long-lasting solutions. These issues take no consideration of our lack of action, which is growing in urgency each year.
This thesis explores the potential for reinstating a Ministry of Works-type body that operates independently of political term constraints and conflicting opinions. The public infrastructure required to meet New Zealand’s growing demands requires and deserves a long-term approach and commitment. Drawing from historical and international precedents, understanding the undoing and undermining of the past. To evaluate the role such a body could play in delivering the nation’s needs.
Central to this understanding is showing, in an architectural sense, how this would look through a design-based project. With a theme of climate response in mind, this thesis focuses on developing and showcasing a deployable climate response community. A transportable, prefabricated, modular and adaptive housing/ community model ready to support those affected in the unfortunate scenario of a climate emergency event. Primarily, it will help the country's immediate to medium-term response, with a secondary purpose of offering a short-term housing solution whenever required rather than relying on costly hotel and motel accommodation.
The project showcases how historical analysis and innovative design with centralised, long-term planning can address multiple of New Zealand’s most pressing challenges in a way that transcends political cycles
Causal analysis of the Aotearoa Concussion Cost-Effectiveness of Services Study
No full textAim: To estimate the effect of early presentation (≤ 40 days) compared to late presentation (≥ 41 days) to ACC-funded concussion treatments on:
1. concussion symptoms at one year post-presentation, measured by the Rivermead Post-Concussion Questionnaire (RPQ-16)
2. self-rated quality of life at one year post-presentation, measured by the EuroQol Visual Analogue Scale (EQ VAS).
Methods: The Aotearoa Cost Effectiveness of Concussion Services (ACCESS) study is a longitudinal observational study that collected data between 2021 - 2023 on individuals receiving ACC-funded treatment for mild traumatic brain injury (mTBI). This thesis is focussed on the statistical methods employed to perform causal inference on the ACCESS study data in order to achieve our research objectives. A causal diagram was drawn to identify confounders. Inverse probability weighting of propensity scores was used to alleviate confounding. Missingness in the data was handled with multiple imputation methods. A linear mixed model was employed for mean estimation, and sandwich variance estimation was used to find robust variance estimates.
Results: The expected reduction in RPQ-16 over the first year post-presentation is 0.62 points greater (95% CI[-21.3, 22.5]) for an early presenter compared to a late presenter. At one year post-presentation, the expected RPQ-16 for an early presenter will have decreased by 15.39 points (95% CI[-29.7,-1.1]) compared to their RPQ-16 at the time of presentation. For a late presenter, the expected RPQ-16 at one year post-presentation will be 16.01 points (95% CI[-32.7, 0.7]) lower than the expected RPQ-16 at presentation. The expected increase in EQ VAS over the first year post-presentation is 2.04 points greater (95% CI[-37.3, 41.4]) for a late presenter compared to an early presenter. At one year post-presentation, the expected EQ VAS for an early presenter will have increased by 24.64 points (95% CI[-3.1, 52.4]) compared to their EQ VAS at presentation. Comparatively, for a late presenter, the expected EQ VAS at one year post-presentation will have increased by 26.69 points (95% CI[-1.3, 54.7]) from the time of presentation.
Conclusion: We cannot conclude that there is a difference in the rate of symptom reduction or the rate of change in quality of life between early and late presenters to ACC-funded concussion services over the first year following presentation
Using machine learning to identify ground beetles (Coleoptera: Carabidae) in New Zealand
No full textInsects represent one of the most diverse and abundant groups of organisms on Earth, inhabiting virtually every type of habitat. Due to their sensitivity to environmental changes, they are commonly employed as indicators for monitoring ecosystem health, ecological restoration, and biodiversity. Ground beetles (Carabidae) are widely used as indicators in Europe, as they are relatively easy to identify, and their biology is well documented. However, in New Zealand, the scientific identification of ground beetles remains challenging due to their high species diversity and the limited availability of identification guides. This study investigates the application of machine learning for the identification of New Zealand ground beetles and assesses the performance of a deep-learning convolutional neural network in recognising tribe, genus, and species (limited to tiger beetles) from images. All identification models were developed in Python using the Ultralytics platform with the YOLOv9 model. Each model was evaluated using independent image sets that were excluded from the training phase. A total of 2,556 specimen images representing 76 genera were obtained from the New Zealand Arthropod Collection to build the “Specimen model,” while 1,859 field images representing 21 genera were sourced from iNaturalist to construct the “Field model.” A third “Combination model” was developed by merging the specimen and field datasets. The final models demonstrated strong predictive performance, with correct identification rates of 78% for the Specimen model, 83% for the Field model, and 83% for the Combination model. These results indicate that dorsal images focusing on the thorax and elytra have substantial predictive value for ground beetle identification. Future research should focus on further expanding the imaging datasets, reducing errors related to overfitting, and determining which model type (specimen, field, or combination) is most appropriate for various ecological and practical applications
Partnering with Young Parents to Improve Early Hearing Detection and Intervention Programmes
No full textBackground: Early Hearing Detection and Intervention (EHDI) programmes must partner effectively with families navigating complex circumstances. Adolescent parents (APs) in Teen Parent Units (TPUs) represent a dynamic group demonstrating resilience as they balance childcare, education, and their own developmental journeys. This study explores their understanding of infant hearing, sources of knowledge, and the development of an effective teaching tool. Methods: A qualitative study was conducted with AP learners at a TPU in Aotearoa, New Zealand. Following a period of relationship-building, three focus groups were held. Data were analysed using content analysis and reflexive thematic analysis. Results: AP learners demonstrated a strong awareness of multisensory interactions. Major sources of knowledge included their relational interactions with people they trusted (midwives and family members), rather than social media. Four key themes emerged in the teaching tool’s development: (1) the effectiveness of multimodal teaching tools, (2) the benefits of peer-supported group learning, (3) the impact of high strain, and (4) the importance of Te Ao Māori (a Māori worldview). Conclusions: This study highlights the importance of culturally grounded health interventions for families navigating complex life circumstances. Group-based learning fostered peer support, hands-on multimodal teaching was effective, and culturally relevant materials and pedagogies enhanced engagement. EHDI programs may more effectively support infants from families navigating complex circumstances by collaborating with trusted support people, integrating with wraparound care networks, utilising safe and familiar settings, and delivering interventions in an engaging and culturally appropriate manner.</jats:p
An Introduction to Structural Phylogenetics for Biomedical Sciences
No full textStructural phylogenetics offers a powerful framework for understanding the molecular basis of
neural function and disease by combining evolutionary analysis with three-dimensional protein
structure. While traditional phylogenetics relies mostly on amino acid sequences, recent advances
in AI-based structure prediction have accelerated the integration of protein tertiary structures
into phylogenetic studies. Since structure is more conserved than sequence, this approach may
provide increased resolution in cases of high sequence divergence or mutational saturation, common issues in the study of complex, ancient, or fast-evolving protein families. In biomedical
research, phylogenetics is a powerful approach for tracing the evolutionary origins and diversification of disease-related proteins. It provides a comparative framework to identify conserved
structural motifs, function shifts, and predict potential targets for drug discovery and innovation. In neuroscience, these insights are especially valuable for uncovering the evolutionary basis
of neural signalling, plasticity, and dysfunction. This chapter serves as a user-friendly practical
tutorial for conducting structural phylogenetic analyses using accessible and computationally
efficient tools, using synaptotagmins – calcium-sensing proteins essential for synaptic vesicle
fusion – as a running example. This resource is designed for biomedical researchers seeking to
integrate phylogenetics as a tool to build a comparative basis to strengthen their experimental
design and improve their understanding of protein diversity and function
Optimisation of liver graft preservation: from pre-clinical to clinical trials
No full textAim:
This study aimed to evaluate the impact of ischaemia reperfusion injury (IRI) on mitochondrial function during liver transplantation. Additionally, the goal was to assess the efficacy of M101 in mitigating IRI to improve liver function. A network meta-analysis (NMA) was conducted on current dynamic machine perfusion modalities in human liver transplantation.
Methods:
A rodent model was used to examine mitochondrial function during hypothermic liver preservation with and without M101 supplementation. M101 is a medical device with a proposed benefit of delivering oxygenation to grafts, thereby reducing IRI and preserving mitochondrial function. High-resolution respirometry was performed to measure mitochondrial function. Additionally, an NMA was conducted on the current dynamic machine perfusion modalities using metainsight and R.
Findings:
Rodent studies demonstrated that mitochondrial function remained stable after 24 hours of hypothermic storage in University of Wisonsin (UW) solution, with no significant difference from M101 supplementation. Mitochondrial respiration remained coupled, and ROS production did not increase significantly over time. However, the lack of a reperfusion phase limited the ability to assess ischemia-reperfusion injury (IRI). The NMA indicated that hypothermic machine perfusion (HMP) ranked higher than normothermic machine perfusion (NMP) in reducing early allograft dysfunction and biliary complications while marginally improving graft survival, though effect size differences were minor.
Conclusions
The findings suggest that M101 does not significantly enhance mitochondrial preservation under static cold storage, necessitating further studies incorporating a reperfusion phase within a transplantation model. Of the existing dynamic human machine perfusion modalities, HMP ranks higher than NMP in preserving graft function and decreasing biliary complications