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Mental healthcare access indicators for trans and non-binary people in Aotearoa/New Zealand
No full textAccess to mental healthcare (MHC) is one of the social determinants of mental health that underlies the large mental health disparities faced by trans and non-binary people (TNB). TNB people may seek MHC for reasons related specifically to gender-affirming needs or for general mental health needs, which also needs to be affirmative of their gender. The topic of general MHC access has received some research, but there are still gaps regarding examining specific MHC settings and demographic differences. Furthermore, research in Aotearoa/New Zealand is still scarce being composed mainly of the Counting Ourselves survey. This thesis aimed to describe the rates of different MHC access indicators for TNB people in Aotearoa/New Zealand, including utilisation, unmet needs, satisfaction levels, and barriers to access. Subsequently, to examine demographic differences in these indicators across age, gender/sex assigned at birth (SAAB), and ethnicity groups. Demographic differences were hypothesised based on existing inequities. Analyses of data from the Counting Ourselves 2022 study were performed, which employed a cross-sectional methodology. Measures included demographic data, use of different MHC providers, unmet need for MHC, satisfaction with different MHC providers, and general and trans-specific barriers to MHC. In total, 2,631 valid responses were analysed, with almost all participants (99.8%) completing the survey online. All participants lived in Aotearoa/New Zealand, and their ages ranged from 14 to 86, with an average age of 27.1. The most common gender/SAAB groups were non-binary AFAB (43.7%) and transgender women (22.1%), while the most frequent ethnicity groups were European (75.3%) and Māori (13.9%). Results showed that the majority (58.1%) of participants had accessed at least one MHC service in the past year, with private MHC professionals being the most frequently accessed provider. Younger participants and non-binary AFAB were more likely to use MHC services, while service use did not differ significantly by ethnicity. Most participants (59.6%) reported an unmet need for MHC in the past year, with younger participants and non-binary AFAB participants being more likely to report this. Satisfaction with MHC providers was relatively positive, but approximately one-third of participants expressed dissatisfaction. Older participants were more satisfied with MHC, and transgender women were more satisfied, only in comparison with transgender men. The most frequent barriers to accessing MHC that are shared with the general population were cost (57.4%) and lack of knowledge of services (44.8%). The most frequent trans-specific barriers were fear of professionals lacking understanding of TNB people (50.2%) and fear of pathologisation (48.9%). Participants reporting most trans-specific barriers were more likely to be younger, and non-binary AFAB participants were more likely to report fear of insufficient understanding and fear of misgendering from providers. These findings indicate that younger and AFAB TNB people may face additional barriers to accessing and being satisfied with MHC, suggesting a need for targeted interventions. Overall, ethnicity did not significantly predict MHC access indicators, suggesting that it might not be a strong predictor of these within this population. Nevertheless, ethnicity findings differ from patterns observed in the general population of Aotearoa/New Zealand, calling for more targeted research. The high rates of use of MHC services as well as unmet needs and experienced barriers underscore the importance of addressing barriers and improving MHC accessibility and quality for TNB people. This should include improving MHC providers’ education and training, as well as implementing routine procedures to ensure a culturally safe and respectful environment
An evaluation of oVRcome, a low-cost vrtual reality exposure therapy app
No full textEmetophobia (fear of vomiting) is an understudied disorder that affects 0.2% of people, with extreme (non-phobic) fear affecting up to 8% of people. The most effective treatment for specific phobias is exposure therapy. One exposure therapy approach, virtual reality exposure therapy (VRET), has become a viable treatment alternative to traditional in vivo or imaginal exposure therapy in recent years. However, using VRET to treat emetophobia has not yet been explored. I used a within-subjects, multiple-baseline-across-participants design with six participants to evaluate the emetophobia programme of oVRcome, a low-cost, Aotearoa New Zealand-based VRET app. After using the oVRcome VRET app, all participants’ phobia severity reduced on one or both measures, with two participants scoring below the threshold for a likely phobia diagnosis. The emetophobia programme of the oVRcome VRET app was effective at reducing emetophobia severity, and my results support research showing eHealth apps can be a low-cost and effective treatment for a range of psychological issues
Estimating pre-historic earthquake parameters in the Hamilton lowlands using laboratory geotechnical analyses of seismically liquefied volcanic-ash layers in lakes
No full textSoft-sediment deformation structures caused by pre-historic earthquakes were discovered in volcanicash (tephra) units preserved as discrete layers within soft, organic lake sediments in the Hamilton lowlands, North Island, New Zealand. Complementing a broader paleoliquefaction project that involves geological and seismological perspectives as well, this PhD research was focused on a geotechnical approach in analysing the paleoliquefaction features in the tephra layers across multiple 20 cal-ka-aged lakes in the Hamilton lowlands. Aiming to back-analyse pre-historic earthquakes that might have caused the palaeoliquefaction features, this thesis also had to address literature and knowledge gaps related to cyclic undrained behaviour and liquefaction resistance of pumiceous silts and sand-silt mixtures. Thus, the scope of this research covered the following objectives: (1) analyses of the geotechnical properties of the tephras of interest in order to define their liquefaction susceptibility, (2) investigation of the undrained monotonic and cyclic behaviour of a pumiceous silt (Tuhua silt, from lacustrine Tuhua tephra aged 7.6 cal ka) in order to fill knowledge gaps related to potential particle crushing affecting undrained cyclic behaviour as well as liquefaction resistance in pumiceous silts, (3) identification of the potential threshold of pumice content and/or fines content, at which pumiceous sand-silt mixtures (internal beds from lacustrine Mamaku tephra aged 8.0 cal ka) become crushable, and finally (4) developing a framework, that extends laboratory obtained liquefaction resistance ratios of three different beds of one of the tephras of interest, that provided enough volume for cyclic undrained triaxial testing (Mamaku tephra), into the rest of the tephras across the studied lakes (that only provided small volumes for sampling). The last objective assisted in reaching the main aim of this thesis which was to obtain the equivalent triggering earthquake parameters, i.e., peak ground acceleration, amax and earthquake magnitude, M for the tephras across the lakes, based on their estimated liquefaction resistances. It was found that the tephras in the lakes are pumiceous and liquefiable within the grain-size range: silts to sandy silts to silty sands. The results from undrained triaxial testing on the pumiceous silt showed that no particle crushing occurred and that the silty material behaved closer to the typical trends established for hard-grained soils than to those associated with pumiceous sands. Furthermore, the undrained cyclic triaxial testing program on three different beds, one silt and two silty sands, from one of the tephras of interest (Mamaku tephra), suggested a fines threshold below which begin to crush during cyclic triaxial testing to be somewhere between 31% and 20%. Empirical correlations used to estimate earthquake parameters from liquefaction resistance that are derived for hard-grained soils were, thus, considered reasonable for application to the pumiceous materials considered in the current study. The final results of this study showed that the tephra layers across the lakes were very sensitive and vulnerable to liquefaction at very low peak ground accelerations, i.e. amax ranging from 0.02 to 0.08 g within the range of magnitudes, M = 5 to 8.5. The high vulnerability to liquefaction across all the Mamaku tephra layers in the Hamilton lowlands (~13 lakes) was considered to be the result of the very low in-situ overburden stresses, consequence of their shallow burial depths in the lake environment, as well as the relatively low liquefaction resistance in situ. The results presented in this dissertation, (1) supply valuable information about the liquefaction potential of pre-historically liquefied tephra layers, assisting local paleoliquefaction studies in the Hamilton lowlands area, (2) explore the possibility of applying laboratory-based liquefaction resistance analysis in paleoliquefaction studies, and (3) contribute to better understanding of the undrained behaviour and liquefaction resistance of pumiceous sand-silt mixtures
The effects of allelic hinge variation in IgG3 antibodies on protein dynamics and effector functions
No full textAntibodies play a crucial role in eliminating infections by recognising foreign antigens with high specificity and affinity. If a target is not directly neutralised, antibodies can mediate potent effector function responses by coordinating the recruitment of immune cells through their constant regions. These powerful immune functions are being widely explored in the form of IgG-based monoclonal antibody therapies for the treatment of infections, cancer, and autoimmune diseases. However, the antibody constant region exhibits significant genetic polymorphism, and new variants are rapidly being discovered by advances in genomic sequencing techniques. The documented effects of this diversity include differences in structural dynamics, thermal stability, and Fc-mediated effector functions among a number of antibody subclasses, including IgG1, IgG2, and IgG3. Some variants are reported to be a contributing factor to variability in the outcome of disease and responsiveness to vaccines in humans. The IgG3 subclass, in particular, displays striking differences in the antibody hinge region – responsible for connecting target binding with constant-region-mediated immune function. Here, exon duplications mean the hinge region can vary by as many as 45 amino acids in length. This work seeks to better understand some of the functional consequences of this unusual IgG3 variation.
To assess the effects of allelic hinge variation on protein dynamics and effector functions, we have expressed a panel of seven anti-CD20 antibodies with unique constant region allele sequences from subclasses IgG1, IgG2, and IgG3. Sequence verified plasmids were used to express full-length antibodies in HEK293 cells at high purity. We first used small angle X-ray scattering (SAXS) to assess the variability in size and structural flexibility between the allelic variants and compared our data with previous research on the same variant panel with antiHER2 variable domain sequences. Following this structural analysis, we next undertook ADCC (antibody-dependent cellular cytotoxicity) and ADCP (antibody dependent cellular phagocytosis) assays to determine if differences in structural dynamics between the polymorphic variants could be linked to differences in effector function. These assays specifically used genome-engineered reporter cell lines to evaluate the ability of allelic variants to engage constant region binding FcyRIIIa and FcyRIIa Fc receptors, typically found on peripheral blood mononuclear cells. Activation was measured by quantifying the levels of luciferase expressed as a reporter.
The findings provided in this study demonstrate that allelic variants with longer hinges have larger and more flexible structures and tend to present weaker ADCC and ADCP responses. The data presented here is the basis for future work on the influence of IgG constant region diversity on antibody structural dynamics and effector functions, which could contribute to improvements in the design of therapeutic antibodies
Supercapacitor-based pulse generator with waveform adjustment capability for small animal transcranial magnetic stimulation
No full textIn transcranial magnetic stimulation (TMS), pulsed magnetic fields are applied to the brain, typically requiring high-power stimulators with high voltages and low series impedance. TMS pulse generators for small animal coils, are underexplored, with limited dedicated circuits and simulation models. Here, we present a new design for a high-power TMS pulse generator for small animals, utilizing a pre-charged supercapacitor that is sufficient to produce repeated pulses for TMS applications without the need for recharging. This approach eliminates the need for expensive high-voltage components and a high-voltage power supply. In this paper, we detail the design approach and basic block diagrams of a supercapacitor (SC) based TMS pulse generator, along with its experimental results. The findings indicate that the new circuit enables a complete test using just a single charge of an SC module. The proposed circuit functions as a versatile pulse-shaping device, where the MOSFET is treated as a dynamically varying resistor element rather than a traditional switch; allowing pulse parameter variations. We analyze a novel circuit for generating and controlling TMS pulses in small animal coils, and demonstrate its effectiveness through experimental results
The experience of homemaking in unaffordable and precarious housing
No full textHousing is the platform on which people build their lives. The experience of homemaking in unaffordable and precarious housing (Barrett, P., Cram, F. & James, B, 2024) is a new monograph from the Affordable Housing for Generations programme. Across 110 pages, 10 housing researchers share experiences from different groups of people in Aotearoa, burdened by the insecurity of unaffordable housing. The findings show how institutional, social and market dynamics impacting on life circumstances can cause people to be in precarious housing situations. Yet people continue to love homemaking and being contributors to their communities. Reinforcing the pivotal nature of housing in supporting all peoples’ health and wellbeing, this research demonstrates how much more can be achieved through improving access to stable, affordable housing and by understanding what is at the heart of a home
Enhancing aerial imagery analysis: Leveraging explainability and segmentation
No full textIn the field of aerial and satellite remote sensing, the widespread adoption of deep learning brings new possibilities. Current approaches, however, often overlook the unique characteristics of aerial data. This study introduces a methodology that capitalizes on distinctive features, leveraging additional annotations for enhanced neural network training. Despite modest gains in classification accuracy, the synergy of enhanced explainability, automated segmentation, and targeted classification demonstrates nuanced improvements. Preliminary results showcase potential applications in land cover mapping. This work can be extented towards reducing dependency on labor-intensive human annotations through an iterative annotation and training loop
Performance of a fast-track pathway for giant cell arteritis in Waikato, Aotearoa New Zealand
No full textGiant cell arteritis (GCA) is the most common primary vasculitis in adults over 50 years of age. To facilitate early diagnosis and reduce harms from corticosteroids and temporal artery biopsies, fast-track pathways have been established. We review the benefits of the fast-track pathway set up in Waikato, Aotearoa New Zealand. methods: Patients were collected prospectively as part of the fast-track pathway from 2014 to 2022. Their records were then reviewed retrospectively to collect data on clinical features, investigations and treatment. results: There were 648 individual patients over the study period who had a colour Doppler ultrasound (CDUS) of the temporal arteries. There were 17 true positive CDUS, giving a sensitivity of 10.3% (95% confidence interval [CI] 6.3–15.5%) and specificity of 99.8% (95% CI 99.1–100%). Patients with GCA and a positive scan had significantly fewer steroids than those with GCA and a negative scan (p=0.0037). There were 376 patients discharged after a CDUS who did not have a diagnosis of GCA, resulting in reduced corticosteroid and temporal artery biopsy exposure. conclusions: This is a real-life study that reflects the benefits of fast-track pathways in Aotearoa New Zealand to patients and healthcare systems. It also shows the effect of corticosteroids on positive CDUS, an important consideration when setting up an fast-track pathway
Investigation of the potential of repurposing medium-density fiberboard waste as an adsorbent for heavy metal ion removal
No full textMedium-density fiberboard (MDF) waste generation has increased steadily over the past decades, and therefore, the investigation of novel methods to recycle this waste is very important. The potential of repurposing MDF waste as an adsorbent for the treatment of Cd(II), Cu(II), Pb(II), and Zn(II) ions in water was investigated using MDF offcuts. The highest adsorption potential in single-metal ion solution systems was observed for Pb(II) ions. The experimental data of Pb(II) ions fit well with the Freundlich isotherm and pseudo-second-order kinetic models. Complexation and electrostatic interactions were identified as the adsorption mechanisms. The adsorption behavior of multi-metal ion adsorption systems was investigated by introducing Cd(II) ions as a competitive metal ion. The presence of the Cd(II) ions reduced the adsorption potential of Pb(II) ions, yet the preference for the Pb(II) ions remained. Regeneration studies were performed by using 0.1 M HCl as a regeneration agent for both systems. Even though a significant amount of adsorbed metal ions were recovered, the adsorption potential of the MDF was reduced in the subsequent adsorption cycles. Based on these results, MDF fines have the potential to be used as an economical adsorbent for remediation of wastewater containing heavy metal ions
Dealing with uncertainty in flood risk management and land use planning decisions: Insights from Aotearoa New Zealand
No full textFlooding with increasing intensity and frequency is presenting significant challenges for risk management and land use planning in urban areas. This is further exacerbated by uncertainties regarding how flood patterns are changing because of climate change. However, how such uncertainties are considered to inform flood risk management and land use planning decisions can vary largely from place to place and remain unclear in the literature. This paper contributes to this by examining how uncertainty is dealt with in flood risk management and land use planning in Aotearoa New Zealand. Drawing on empirical data at the local level, findings indicate that Aotearoa New Zealand’s decision-makers face challenges in considering and communicating uncertainty due to the prevalence of outdated approaches and regulatory constraints, fragmented risk governance, and lack of appropriate understanding of different perceptions and assumptions regarding flood risk between different stakeholders. Based on findings, the paper discusses the critical role of a national-level adaptive flood risk governance in helping to ensure consistency and coherency across different jurisdictions and levels of government, regarding the incorporation of uncertainty into flood risk management and land use planning. This includes the provision of national directives for incorporating uncertainty in decision-making whilst leaving room for innovation and targeted variability at the local level