44 research outputs found
Influence of domiciliary humidification on symptom burden and feeding tube use up to 2 years postradiation therapy for head and neck cancer: Trans-Tasman Radiation Oncology Group (TROG) 07.03 RadioHUM randomized phase 2 trial secondary analysis
No full textePoster Abstract #1126A.M.J. Macann, T. Fua, C.G. Milross, S. Porceddu, M.G. Penniment, C. Wratten, H. Krawitz, M.G. Poulsen, C.I. Tang, R.P. Morton, V. Thomson, M.L. Bell, M.T. King, C.L. Fraser-Browne, and H.U.P. Hocke
"There’s a problem with BMI”: An exploration of midwives’ perspectives on the provision of maternity care to women with an increased BMI during pregnancy and childbirth in NZ
No full textThe global burden of ‘maternal obesity’1 continues to receive worldwide attention, with the dominating focus being the identification and management of the perceived risks obesity poses to pregnancy. This focus, however, has neglected to seek solutions and perspectives from the individuals themselves and those others that may be best placed to understand the nuanced dynamics and realities. In Aotearoa New Zealand (NZ) over 95% of women2 choose a midwife as their Lead Maternity Carer (LMC) (Ministry of Health [MOH], 2020) yet research exploring midwives’ perspectives on the provision care to women with increased Body Mass Index (BMI) is limited.
The aim for this thesis was to explore ‘the perspectives of midwives in NZ regarding the provision of maternity care to women with an increased body mass index (BMI).’ The research question driving this study was “What are midwives’ perspectives on the provision of maternity care to women with an increased BMI in New Zealand?” To answer this question, this qualitative study utilised a feminist standpoint theoretical lens to explore the experiences of seventeen midwives who provide care to such women, in three separate geographical locations in NZ. Data was collected using focus groups and semi-structured interviews and Braun and Clark’s (2013) thematic analysis process was used to identify four themes.
Midwives within this study perceived that the use of BMI as a single measure of risk in maternity was flawed. They identified that hype exists around increased BMI which leads to over medicalisation and unnecessary and potentially harmful interventions taking place when women present with an increased BMI. Midwives are aware of and witness both discriminatory behaviour towards, and poor treatment of women with increased BMI within their midwifery work. Midwives desire change, yet often feel obstructed and powerless within the current maternity system which is dominated by these practices. The study themes presented are titled, a flawed approach, concern for women's experience, being stuck, and sticking together.
This study suggests that systemic and structural barriers to equitable care exist within the maternity system in NZ regarding the provision of care to women with increased BMI. Viewing this situation from a feminist standpoint perspective has enabled the articulation of a position that despite midwives feeling the system hampers their ability to advocate for women and protect normal birth, their expertise about how to most effectively work with obese women has the potential to transform women’s experience and improve maternity outcomes. Explicit pathways for women who are obese require strengthening within our current system to enable judgment-free informed choice regarding interventionist or non- interventionist care.
1 Maternal obesity is a term used often in literature to refer to women who are obese (≥ 30 kg/m2) in pregnancy. The author acknowledges that this term has the potential to cause offense and is not one that the author condones.
2 The words ‘women/woman/her/she/māmā are used throughout this thesis, yet the author would like to acknowledge trans/nonbinary individuals within our communities and within the maternity spac
Preventing the epidemic of cardiovascular disease: new perspectives in extracorporeal substitutive treatment
No full text
Evaluation of Hygiene and Safety Controls for On-Line Paired Hemodiafiltration (PHF)
No full textBackground On-line hemodiafiltration is gaining popularity due to increasing evidence of clinical benefits however it also requires strict attention to hygiene and safety as notable quantities of liquid are reinfused into the patient. Although most centers are improving their attention to water quality, a frequent concern is the inadvertent or accidental contamination of water and whether the redundant safety controls are sufficient to protect the patient. In the present study, in order to simulate a worst-case safety condition, we tested in vitro the reliability of paired hemodiafiltration – (PHF), under low, moderate and high bacterial contamination of the water supply. Tests were performed using various bacterial concentrations (range 85–2000 cfu/mL) of Pseudomonas Aeruginosa. Samples were analyzed from different sites throughout the entire on-line hemodiafiltration circuit for bacteria endotoxin, fungus and ability to stimulate whole blood production of TNF α. Results In the in vitro contamination study, with the three bacterial concentrations tested at various points of the circuit, bacteria were below the level of detection and endotoxins were < 0.01 UE/mL. Addition of dialysate samples taken after the first stage of microfiltration, as well as after the first and second stage of ultrafiltration and incubated with whole blood were not associated with stimulated production of TNFα. Conclusions PHF appeared to be a safe and feasible method for on-line hemodiafiltration even in the unforeseen presence of bacterial contamination of the feed water or water distribution system. </jats:sec
Near-Infrared Sensitized Photocathodes and Film Sensitivities for Typical Xenon-Lamp Radiation and Related Subjects
No full textAuthor Institution: Solid State Physics Research Laboratory, Wright-Patterson Air Force Base, Ohio 45433Weighting or assessment factors of near-infrared photocathodes and Kodak 5424 film are determined for xenon-lamp illumination. These values are important for selecting detectors and determining the basic sensitivity for a given situation and instrumentation; for example, in medicine, when obtaining retinal pictures. Some other typical applications are also discussed. Charts showing the radiation from a xenon-arc lamp, with a 0.5 mm arc length and 800 watt input, and the typical efficiency values of photocathodes and film to xenon-lamp radiation are presented at spectral intervals of 20 nm for the range of 400 to 1100 nm, with and without Kodak Wratten filter 89b
Ecosystem Services on New Zealand Arable Farms
No full textResearchers have estimated the total economic value of global ecosystem goods and services showing that a significant portion of humanity's economic well being is unaccounted for in conventional GNP accounting (Constanza et al., 1997). To demonstrate this point, authors have conventionally used highly aggregated landscape units for analysis (e.g., biomes), and average, not marginal values, of each ecosystem good or service are estimated for each unit using value transfer methodologies (Wilson et al., 2004). For example, Patterson and Cole (1999a, b) replicated the Constanza et al., (1997) approach by estimating economic values for Waikato and New Zealand ecosystem goods and services associated with standard land cover classes including horticulture, agriculture and cropping. As a result, Patterson and Cole (1999b) argue that only five ecosystem services associated with cropping have non-zero value. One of the reasons for this low number of non-zero values assorted with arable lands is that the original economic studies used by Patterson and Cole, are heavily weighted towards natural and undisturbed ecosystems rather than disturbed systems like agricultural or urban landscapes. To address this issue, more recently researchers have noted that many landscapes are actively modified by humans who seek to realise economic gain and this topic is thus an important one because in the 21st century, many of our homes, workplaces and recreational spaces are embedded within, or adjacent to, landscape mosaics that are to a greater or lesser degree affected by the conscious efforts of people to harness goods and services provided by ecological systems (Palmer et al., 2004). An engineered or designed ecosystem is one that has been extensively modified by humans to explicitly provide a set of ecosystem goods and services including more fresh water, trees, and food products and fewer floods and pollutants. These modified landscapes provide a range of ecosystem goods and services, particularly food production as farmers seek to maximize commercial gain from land use. The current paper examines issues in valuation of ecosystem goods and services derived from land used for arable farming in New Zealand and proposes ways to provide more detailed estimates of the flow and value of the flow of ecosystem services provided.Ecosystem management, Arable farming, Engineered ecosystem, Agricultural and Food Policy, Community/Rural/Urban Development, Crop Production/Industries, Environmental Economics and Policy, Farm Management, Land Economics/Use,
Removal of constitutive and inducible nitric oxide synthase-active compounds in a modified hemodiafiltration with on-line production of substitution fluid: the contribution of convection and diffusion
No full textChronic renal failure and the uremic state lead to accumulation of various endogenous inhibitors of nitric oxide synthase. Previous studies on end-stage uremic patients nitric oxide synthase activity in murine vascular endothelium and cytokine-induced macrophage cell lines was shown to be modulated during treatment (Nephrol Dial Transplant 1995; 10: 1386-96). Paired filtration dialysis, a modified hemodiafiltration technique, physically separates convection from diffusion. Plasmas, ultrafiltrates and dialysates from seven uremic patients undergoing paired filtration dialysis performed using ultrapure apyrogen substitution fluid in the absence (first 120 min) or presence (last 120 min) of extracellular fluid reduction were tested for their inhibitory/stimulatory effect on ecNOS, constitutively expressed on t. End 1 cell line, a murine vascular endothelium, or for their inducing effect on iNOS, inducible on J774 cells, a macrophage cell line. On ecNOS, Group 1 (stimulatory, 3/7 patients) markedly enhanced the ecNOS activity as compared to control plasma, whereas group 2 plasma (inhibitory, 4/7 patients) inhibited ecNOS plasma. Post-dialysis plasma samples from all Group 1 and 2 patients showed a marked decrease of the predialysis stimulatory and inhibitory activity, respectively. On iNOS: all patient plasmas stimulated iNOS activity. The UF and particularly the dialysate had a remarkable iNOS inducing effect (Group 1). The substitution fluid obtained at 120 min during treatment in Group 1 and 2 had no effect on NOS activity. No correlation was found between predialysis ecNOS or iNOS activity values with mean systolic or diastolic pressures. These studies suggest a complex balance of ecNOS inhibitors/stimulators and iNOS inducers in uremia. Dialysis may remove ecNOS inhibitors and stimulators by convection and, in the latter case, by diffusion. iNOS inducers are removed during dialysis, suggesting the biocompatibility of the dialysis system with the on-line production of ultrapure substitution fluid.</jats:p
