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Ionised serum calcium concentration as a potential indicator of hypophosphataemia and refeeding syndrome in extremely low birthweight babies in the first 2 weeks after birth
No full textPreterm babies, especially those born at extremely low birthweight (ELBW; birthweight < 1000 g), are at risk of being malnourished in utero and developing refeeding syndrome after birth. The initiation of intravenous nutrition (IVN), which ELBW babies require soon after birth, increases the risk of biochemical derangements, most notably hypophosphataemia and hypercalcaemia, and also of a diagnosis of refeeding syndrome. Providing adequate nutrition is essential, but refeeding syndrome has been associated with increased mortality, health complications such as intraventricular haemorrhage and sepsis, and adverse neurodevelopment.
To monitor the biochemical derangements associated with refeeding syndrome, blood samples are taken from ELBW babies on several days across the first two weeks after birth. Although the quantity of blood taken may appear small, for a baby with such a low birthweight and blood volume, the amount is relatively large. The risk of anaemia of prematurity, painful stimuli, and scarring are all increased with this type of monitoring.
The aim of this thesis was to investigate whether ionised serum calcium concentration is a reliable indicator of hypophosphataemia and refeeding syndrome in ELBW babies in the first two weeks after birth. This research is a secondary cohort analysis of the 434 babies involved in the ProVIDe trial, a multicentre, two-arm, blinded, parallel, randomised controlled trial conducted across 6 New Zealand and 2 Australian neonatal intensive care units. De-identified trial data were retrieved from the ProVIDe database, including routine bloods and study bloods, allowing variables for hypophosphataemia (serum phosphate 2.8 mmol.L⁻¹) to be derived in line with the ProVIDe trial definitions.
Ionised calcium concentrations were significantly higher on days 3-5 in babies who had severe hypophosphataemia at the last test (mean time of last test: 4.84 days after birth) compared to those who did not (day 3: 1.42 mmol.L⁻¹ vs 1.32 mmol.L⁻¹ (p < 0.01); day 4: 1.48 mmol.L⁻¹ vs 1.38 mmol.L⁻¹ (p < 0.01), and day 5: 1.54 mmol.L⁻¹ vs 1.39 mmol.L⁻¹ (p < 0.0001)). Similarly, ionised calcium concentrations were significantly higher on days 3-5 in babies who had refeeding syndrome at the last test compared to those who did not (day 3: 1.42 mmol.L⁻¹ vs 1.33 mmol.L⁻¹ (p < 0.01); day 4: 1.50 mmol.L⁻¹ vs 1.37 mmol.L⁻¹ (p < 0.001), and day 5: 1.58 mmol.L⁻¹ vs 1.39 mmol.L⁻¹ (p < 0.0001)). However, it was not possible to identify a clinically useful threshold of ionised serum calcium concentration for predicting hypophosphataemia, severe hypophosphataemia, or refeeding syndrome.
Phosphate concentrations were significantly lower in the first five days after birth in babies who had hypophosphataemia at the last test compared to those who did not (day 1: 1.58 mmol.L⁻¹ vs 1.88 mmol.L⁻¹ (p < 0.01); day 2: 1.45 mmol.L⁻¹ vs 1.79 mmol.L⁻¹ (p < 0.01); day 4: 1.03 mmol.L⁻¹ vs 1.59 mmol.L⁻¹ (p < 0.0001), and day 5: 0.89 mmol.L⁻¹ vs 1.66 mmol.L⁻¹ (p < 0.0001)). Similarly, phosphate concentrations were significantly lower in the first five days after birth in babies who had severe hypophosphataemia at the last test compared to those who did not (day 1: 1.42 mmol.L⁻¹ vs 1.77 mmol.L⁻¹ (p < 0.0001); day 2: 1.32 mmol.L⁻¹ vs 1.66 mmol.L⁻¹ (p < 0.05); day 3; 0.95 mmol.L⁻¹ vs 1.41 mmol.L⁻¹ (p < 0.05); day 4: 0.75 mmol.L⁻¹ vs 1.38 mmol.L⁻¹ (p < 0.0001), and day 5: 0.68 mmol.L⁻¹ vs 1.28 mmol.L⁻¹ (p < 0.0001). In babies who had refeeding syndrome at the last test, their phosphate concentrations were significantly lower compared to babies who did not have refeeding syndrome, on days 4 and 5 after birth (day 4: 0.80 mmol.L⁻¹ vs 1.30 mmol.L⁻¹ (p < 0.05), and day 5: 0.73 mmol.L⁻¹ vs 1.19 mmol.L⁻¹ (p < 0.0001)). A threshold of phosphate concentration of 1.83 mmol.L⁻¹ on day 0 after birth appears potentially to be clinically useful at predicting future hypophosphataemia, but the small sample size of 12 available serum phosphate concentration results limits the validity of this threshold without confirmation from further, larger studies.
Nevertheless, these data indicate that it may be possible to identify babies at risk of hypophosphataemia as early as the first 24 hours after birth, suggesting that monitoring serum concentrations during this interval merits further investigation. These results suggest further research in another large cohort would be useful to validate our results
Rethinking AI Governance and Digital Sustainability in Tertiary Education
No full textAs tertiary education embraces openness, an unexpected challenge has emerged: the digital systems built to share knowledge are being overloaded by AI bots harvesting content at scale. Institutional repositories and digital collections are experiencing increasing outages, bandwidth strain, and rising infrastructure costs—driven not by cyberattacks, but by high-frequency AI crawlers extracting data for commercial model training.
This presentation highlights findings from COAR’s global repository survey and recent reporting on the toll these bots are taking on the sector. Many crawlers ignore ethical norms and technical limits, shifting risk and resource burdens onto universities and public platforms.
We invite ICT professionals, librarians, repository teams, and digital strategists to explore:
How do we protect openness without compromising resilience?
What shared technical or policy tools might help manage AI scraping?
Should we coordinate sector-wide standards for bot control, metadata use, or AI licensing?
This is a call for collaboration—not just to mitigate current issues, but to shape a sustainable future for open knowledge
Feasibility and acceptability of WeCare Mentoring, an online peer mentoring program for aged care support workers
No full textBackground and objectivesIn recognition of the aging population and aged care workforce shortages, calls have been made for responsive and effective strategies for this workforce group. This study aimed to investigate the feasibility, acceptability, and preliminary efficacy of an online mentoring program for aged care support workers serving older adults in New Zealand residential care facilities.Research design and methodsThis mixed-methods study consisted of (1) a nonrandomized single-arm intervention study, with outcome measurement at baseline, 3- and 6-month (Satisfaction with Life Scale, Generic Job Satisfaction, Perceived Stress Scale, and General Self-Efficacy Scale) and (2) a post-intervention qualitative descriptive study exploring perceived acceptability and feasibility aspects of the proposed intervention. Participants met once a month, for 30-60 min. They followed a program manual to work on self-identified goals.ResultsThirty-eight support workers enrolled, and 22 of them took part and completed the 6-month program. The recruitment target was reached within the proposed 3-month timeframe. Data collection procedures were considered practical and convenient. Participants (13 mentees and 9 mentors) reported that the program was appealing and relevant, its duration and intensity appropriate, and the online delivery acceptable. Participants proposed refinements to improve their experience further. Exploratory outcomes analysis found all measures trended in the expected direction.Discussion and implicationsThe WeCare Mentoring Program was found to be a feasible and acceptable intervention. Participants reported several improvements in their well-being and their caregiving-related skills. The next step is to test the intervention's effectiveness in a definitive controlled trial or quasi-experimental study. If future efficacy trials prove successful, this program can offer a much-needed support to the aged care workforce, and lead to better outcomes for them and the people they care for
Yeast-Derived Microcarrier Systems for Enhanced Synthesis, Delivery, and Biocidal Efficacy of Metallic Nanoparticles
No full textThesis embargoed until 07/202
Re-sensing economies Artistic and embodied knowing for more-than-capitalist futures
No full textIf we want to survive the climate crisis with human and ecological health intact, we need ways of theorising economy that push back against the rationalist abstract way of knowing, which economic theorists have become known for. The way in which the economy is theorised is performative; economic theories come to make and remake the world in their image. The rationalist, discursive theorisation of economics and the privileging of abstractified forms of knowing and representing economies is part of the historical milieu that resulted in the violence of colonisation, in extractive and oppressive regimes of labour, and the separation of humans from the environment or 'natural resources'. This chapter asks, what alternative modes of theorising might be suited to imagining and enacting postcapitalist futures? Reflecting on our practices, including performance art, comedy, alternative community spaces, gardening and improvisational music, we explore approaches to re-sensing economy that value the body, senses and relationships, promote connectivity and interdependence, and embrace pluriversal ways of knowing
Characterising ADHD brain structures with Multimodal MRI: Towards a Brain Atlas for ADHD
No full textADHD is a common condition involving difficulty with executive function and sustained
attention. Unaddressed, it can lead to adverse life outcomes. Diagnosis can be challenging
due to comorbidities, similarities to other disorders and gender-based differences. Because
diagnosis is based on behavioural symptoms, a quantitative physiological measure of ADHD
could help the diagnostic process.
A 3T MRI scanner was used to collect multi-shell diffusion MRI on 22 ADHD and 21
neurotypicals to explore multimodal ADHD biomarkers in DTI and fMRI. For DTI, TBSS and
connectivity analyses were performed, and an individualised mesh-morphing technique and
PCA were applied to 24 regions of interest. For fMRI, mesh-morphing and PCA were used on
default mode network prefrontal activation zones to analyse shape trends. SVM, logistic
regression and random forest models were performed on DTI PCA, with 10-fold and Leave-
One-Out Cross-Validation (LOO-CV).
Lower FA and higher MD and RD were found in ADHD white matter, especially in the left
hemisphere, in regions associated with attention, executive function, memory, language,
visual processing and emotional regulation. This implies reduced myelination, and disruption
or increased crossing of fibres.
DTI PCA revealed trends towards tract separations between ADHD and neurotypicals,
especially in the posterior corpus callosum and inferior occipito-frontal fasciculus. FA and RD
correlated with symptoms in several tracts, implying ADHD’s spectrum-based nature.
Structural connectivity showed increased global efficiency in ADHD. Nodes involved with
sensory processing, attention, coordination, emotion processing, memory, executive function,
sleep and social cognition were less connected. Nodes involved with decision-making,
emotional regulation, motor control, spatial and visual processing were more connected,
suggesting compensation or neurodiversity.
No trends were found in default mode network prefrontal cortex shape, although ADHD brains had a nonsignificant tendency to remain in the default mode network at task state.
SVM achieved an accuracy of 86% for the right cingulum under LOO-CV, indicating potential
future diagnostic use. Combining high-performing tracts increased accuracy in 10-fold
validation; adding low-performing tracts decreased accuracy.
This thesis represents one of the first studies to involve voxel-specific mesh-morphing in a
multimodal study of TBSS, DTI, connectivity, fMRI, symptoms and machine learning, building
towards possibilities of quantitative diagnostic measures
The expanding scope of the Aotearoa New Zealand optometric workforce
No full textIn July 2022, Aotearoa New Zealand reformed its national health system, and the 20 former District Health Boards were replaced with a single national agency, Health New Zealand | Te Whatu Ora. A key objective of this reform is to improve the utilisation of community health services, strengthening community services to reduce the burden on public hospitals.
Te Whatu Ora reports that a third of ophthalmology public hospital appointments exceed the maximum four-month wait, with one in five people waiting 50% longer than recommended for their treatment.Citation2 As the ageing population will further increase demand, the reform suggests greater involvement of optometrists, orthoptists, and nurse practitioners, offering alternatives to the traditional medical model of care.
Optometrists are well placed to meet this need, as autonomous and independent eye healthcare professionals who are spread across the country.Citation3 However, communications with the Optometrists and Dispensing Opticians Board (ODOB) highlight a lack of awareness of optometrists’ roles from public health officials, ophthalmologists,Citation4 other allied health, and even optometrists themselves. Therefore, this communication serves to update the sector on the current scope of optometric practice in Aotearoa New Zealand, to help facilitate the health reforms
Priorities, concerns, and potential compromises amongst urban forest stakeholders: international lessons from Aotearoa New Zealand
No full textUrban forests provide numerous benefits including habitat for wildlife, improving human health, purifying air and water, and preventing and mitigating the effects of climate change. The need to protect and improve our urban forests will only increase as populations increase and cities densify and expand over time. However, urban forest establishment and maintenance is challenging due to a lack of effective policies, delays, lack of communication, inappropriate targets, and lack of recognition, disunity, or resourcing amongst stakeholders. Here we present the results from a joint urban forest symposium-workshop that sought to determine the priorities and challenges of different stakeholder groups in New Zealand, including arborists, ecologists, non-ecologist researchers, indigenous peoples, and planners. We synthesise these lessons as recommendations to improve urban forest planning, design, establishment, and minimise conflicts between stakeholder groups. While the highest priorities of each stakeholder group are fairly distinct, there are high levels of overlap in the general priorities and challenges they face in working towards advancing those priorities. We suggest a 3-phase framework to deliver progress that broadly considers (1) data collection, (2) policy development, and (3) resource development. We suggest this framework should be supported by continual monitoring and data sharing, an increased investment in green employment and education, and further recognition of urban foresters, indigenous communities, and ecologists. We suggest that an inclusive approach based on a shared understanding of forest values and removing barriers is most likely to result in long-term success
Like you, I am here
No full textLike you, I am here is a close reading of the spatial traces we passively leave behind through our everyday activities and examines the value of these accumulative traces. Our inhabited spaces serve as a container for our repetitive, habitual activities. They can reaffirm our lived experiences and existence and act as a protective shelter and agent from our existential fears and anxieties.
This thesis explores the trace, a byproduct of a haptic relationship between the fabric of architecture and our lived everyday, as a tangible expression of time that has the ability to give us a sense of place, belonging and connection. If our built environment is the space where our everyday lives play out and can soothe us from our existential fears, what happens when our environments are made to actively resist the impression of time and our inhabitation?
When we are quick to erase, replace, and discard these traces, we build an environment devoid of a deeper reciprocal relationship between us and our built environment. This thesis aims to challenge our perceptions of the unassuming scuff, chip, and scratch – all forms of a human patina, as anchorage points of intimate tactile moments of humanistic connection. By bearing witness to the traces of the past and by engaging in the same habitual action, they, in turn, allow us to participate in a collective time that is reflective of our own existential reality that extends beyond our individual time.
This thesis emphasises the value of everyday traces and their importance in enriching our inhabited spaces and advocates for architectural practitioners to be mindful of and work in a way conducive to everyday traces
Fields and Texts: The Missionary Translator William Edward Soothill (1861–1935)
No full textMy study casts a spotlight on the British Protestant missionary and translator William Edward Soothill (1861–1935). From 1882 to 1911, Soothill lived in China as a missionary, educationalist, and translator before being appointed Professor of Chinese at Oxford University in 1911. He then embarked on the translation of two significant Chinese texts into English: the Confucian Analects (1910a) and the Buddhist Lotus Sutra (1930). Rather than reducing Soothill to discourses of orientalism and cultural imperialism, I highlight the entanglement and interactions of Protestant missionary translators as social agents constrained by socialized dispositions and specific struggles in a complex sociopolitical arena.
The study combines archival research, sociological perspectives, and detailed analysis of missionary texts. Bourdieu’s concepts of field, capital, habitus, and symbolic power demonstrate Soothill’s personal trajectory and navigation of the dynamic power relations across religious, translation, and intellectual fields. The textual analysis of his translations adds insight into how he used translation strategically to further his religious, intellectual, and social goals.
The field of missionary translation can be understood as a site of struggle in which Soothill competed with his fellow missionaries and, later, others for various forms of capital. Soothill’s choice of the Analects, was a strategic endeavor aimed at claiming his spot within the intellectual field. An examination of his interactions with the eminent missionary sinologist, James Legge, reveals Soothill’s ambivalent response, displaying both subversion and submission to Legge’s symbolic power. In the decade that followed, Soothill leveraged his growing authority to ascend socially as an Oxonian professor. However, during the Lotus Sutra translation, his pursuit of religious capital exposed the limits of his symbolic power. Silencing his collaborator Kato Bunno (1888–1934), he produced a less impactful translation due to insufficient cultural capital.
By conceptualizing missionaries as social agents operating within overlapping religious, intellectual, and colonial fields, the research provides a replicable framework for analyzing how translators negotiate identity, authority, and cultural representation