92 research outputs found

    When Are Errors a Crime?—Lessons from New Zealand

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    Studies on estuarine macroinvertebrates

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    The chapter, "Studies on estuarine macroinvertebrates" was written by the listed authors including Casper de Villiers (Douglas College Faculty). Estuaries of South Africa presents an authoritative and comprehensive review of the current status of the country's estuarine research and management. Information is provided on a wide range of topics, including geological, physical and chemical processes, diversity and productivity of plant and animal communities, interactions between estuarine organisms, and system properties, ecological modelling and current management issues. This broad scope is complemented by a comparative perspective, resulting in a volume which provides a unique contribution to the subject of estuarine ecology, relevant to all those working in this field throughout the world. --From publisher description.book chapterPublished

    Big Data, Big Libraries, Big Problems?: the 2014 LibTech Anti-talk?

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    The desire to create automatons is a familiar theme in human history, and during the age of the Enlightenment mechanical automatons became not only an “emblem of the cosmos”, but a symbol of man’s confidence that he would unlock nature’s greatest mysteries and fully harness her power. And yet only a century later, automatons had begun to represent human repression and servitude, a theme later picked up by writers of science fiction. Man’s confidence undeterred, the endgame of the modern scientific and technological mindset, or MSTM, seems to be increasingly coming into view with the rise of “information technology” in general and “Big data” in particular. Along with those who wield them, these can be seen as functioning together as a “mechanical muse” of sorts – surprisingly alluring – and, like a physical automaton can serve as a symbol – a microcosm – of what the MSTM sees (at the very least in practice) as the cosmic machine, our “final frontier”. And yet, individuals who unreflectively participate in these things – giving themselves over to them and seeking the powers afforded by the technology apart from technology’s rightful purposes – in fact yield to the same pragmatism and reductionism those wielding them are captive to. Thus, they ultimately nullify themselves philosophically, politically, and economically – their value increasingly being only the data concerning their persons, and its perceived usefulness. Likewise libraries, the time-honored place of, and symbol for, the intellectual flowering of the individual, will, insofar as they spurn the classical liberal arts (with the idea that things are intrinsically good, and in the case of humans, special as well) in favor of the alluring embrace of MSTM-driven “information technology” and Big data - unwittingly contribute to their irrelevance and demise as they find themselves increasingly less needed, valued, wanted. Likewise for the liberal arts as a whole, and in fact history itself, if the acid of a “science” untethered from what is, in fact, good (intrinsically), continues to gain strengt

    No seed zone effects on the survival, growth and stem form of Pacific silver fir (Abies amabilis (Dougl.) ex Forbes) in Britain

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    Pacific silver fir (Abies amabilis (Dougl.) ex Forbes) was first introduced to Britain in 1830 but has not been widely planted and occupies a minute part of the forest estate. The results of six experiments established in the uplands of Britain examining material from 30 collection sites in 14 seed zones clearly demonstrate that its potential has not been recognised. The trials were assessed after 28 years and show that Pacific silver fir has the potential to be as productive as other common species options. There was little variation in performance between the 14 seed zones and future seed collections could be carried out within a wide geographical range including mainland British Columbia and Vancouver Island and the Olympic Mountains and western Cascades of Washington. The silvicultural characteristics of the species mean that it could be used more widely to diversify forests in Britain both as a plantation species and in the wider use of continuous cover management. More work is justified to determine its susceptibility to Annosum root rot (Heterobasidion annosum (Fr.) Bref), to confirm its productivity on sites with rainfall below 800 mm a-1 and/or with a high peat content, and to provide more detail on its wood properties.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

    Using days alive and out of hospital to measure surgical outcomes in New Zealand: a cross-sectional study

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    Objectives To measure differences at various deciles in days alive and out of hospital to 90 days (DAOH90) and explore its utility for identifying outliers of performance among district health boards (DHBs).Methods Days in hospital and mortality within 90 days of surgery were extracted by linking data from the New Zealand National Minimum Data Set and the births and deaths registry between 1 January 2011 and 31 December 2021 for all adults in New Zealand undergoing acute laparotomy (AL—a relatively high-risk group), elective total hip replacement (THR—a medium risk group) or lower segment caesarean section (LSCS—a low-risk group). DAOH90 was calculated without censoring to zero in cases of mortality. For each DHB, direct risk standardisation was used to adjust for potential confounders and presented in deciles according to baseline patient risk. The Mann-Whitney U test assessed overall DAOH90 differences between DHBs, and comparisons are presented between selected deciles of DAOH90 for each operation.Results We obtained national data for 35 175, 52 032 and 117 695 patients undergoing AL, THR and LSCS procedures, respectively. We have demonstrated that calculating DAOH without censoring zero allows for differences between procedures and DHBs to be identified. Risk-adjusted national mean DAOH90 Scores were 64.0 days, 79.0 days and 82.0 days at the 0.1 decile and 75.0 days, 82.0 days and 84.0 days at the 0.2 decile for AL, THR and LSCS, respectively, matching to their expected risk profiles. Differences between procedures and DHBs were most marked at lower deciles of the DAOH90 distribution, and outlier DHBs were detectable. Corresponding 90-day mortality rates were 5.45%, 0.78% and 0.01%.Conclusion In New Zealand after direct risk adjustment, differences in DAOH90 between three types of surgical procedure reflected their respective risk levels and associated mortality rates. Outlier DHBs were identified for each procedure. Thus, our approach to analysing DAOH90 appears to have considerable face validity and potential utility for contributing to the measurement of perioperative outcomes in an audit or quality improvement setting

    Using Days Alive and Out of Hospital to measure inequities and possible pathways for them after cardiovascular surgery in Aotearoa New Zealand: study protocol for a secondary data analysis

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    Introduction In Aotearoa New Zealand (NZ), socioeconomic status and being of Māori ethnicity are often associated with poorer health outcomes, including after surgery. Inequities can be partially explained by differences in health status and health system biases are hypothesised as important factors for remaining inequities. Previous work identified inequities between Māori and non-Māori following cardiovascular surgery, some of which have been identified in studies between 1990 and 2012. Days Alive and Out of Hospital (DAOH) is an emerging surgical outcome metric. DAOH is a composite measure of outcomes, which may reflect patient experience and longer periods of DAOH may also reflect extended interactions with the health system. Recently, a 1.1-day difference in DAOH was observed between Māori and non-Māori at a hospital in NZ across a range of operations.Methods and analysis We will conduct a secondary data analysis using data from the National Minimum Data Set, maintained by the Ministry of Health. We will report unadjusted and risk-adjusted DAOH values between Māori and non-Māori using direct risk standardisation. We will risk adjust first for age and sex, then for each of deprivation (NZDep18), levels of morbidity (M3 score) and rurality. We will report DAOH values across three time periods, 30, 90 and 365 days and across nine deciles of the DAOH distribution (0.1–0.9 inclusive). We will interpret all results from a Kaupapa Māori research positioning, acknowledging that Māori health outcomes are directly tied to the unequal distribution of the social determinants of health.Ethics and dissemination Ethics approval for this study was given by the Auckland Health Research Ethics Committee. Outputs from this study are likely to interest a range of audiences. We plan to disseminate our findings through academic channels, presentations to interested groups including Māori-specific hui (meetings), social media and lay press

    The dynamics and regulation of actin filaments in vascular endothelial cells and in a reconstituted purified protein system

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    Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2001.Includes bibliographical references.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cell motility and shape change are complex processes that depend primarily on the cytoplasmic dynamics and distribution of actin monomer and polymer. Proteins that regulate actin cycling control cellular architecture and movement. One method to measure parameters that characterize actin dynamics is photo activation of fluorescence (PAF), which can simultaneously estimate the fraction of total actin polymerized (PF) and the lifetime of actin filaments (t). By deciphering the relationships between actin dynamics and regulatory proteins, the complicated motions of cells and biological consequences of these movements can be better understood. In purified actin solutions at steady-state, actin filament dynamics can be analyzed with PAF at long times following photoactivation. By increasing the width of the photoactivated band, actin filament turnover (t ~ 8 hours) can be distinguished from actin filament diffusion. Proteins believed to stabilize actin filaments against depolymerization markedly slow actin filament turnover in wide photoactivated bands (t ~ 65 hours). Decreasing the band width causes photoactivated fluorescence to decay more rapidly (t ~ 3 hours) due to a combination of actin filament diffusion and turnover. Addition of actin binding protein forms crosslinked actin gels that hinder filament diffusion and slow filament turnover (t ~ 12 hours) in narrow photoactivated bands. Endothelial cells decrease t and PF in order to accelerate their migration speed, consistent with mechanisms attributed to ADF/cofilin in vitro. Removal of gelsolin in fibroblasts produces a similar correlation between motility, t, and PF. Consistent with increased actin filament severing, fast-moving endothelial cells have an increased number of short actin filaments and more uncapped barbed ends, but paradoxically bind less cofilin. A mechanism of increasing endothelial cell motility is proposed that relies on actin filament severing to create uncapped pointed ends for ADF/cofilin-mediated depolymerization.by Eric A. Osborn.S.M

    Long-term lived experiences of patients with chronic pain or angina pectoris treated with spinal cord stimulation: A qualitative study

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    Objective:To explore the short-term and long-term lived experiences of patients with chronic pain and angina pectoris with spinal cord stimulation. Design:An interpretive qualitative study with thematic analysis of one-off, semistructured interviews, following Braun and Clarke (2006). Setting:A multidisciplinary, publicly funded pain service in Auckland, New Zealand. Patients usually undergo a comprehensive medical, psychological and functional assessment and an in-house pain management programme before proceeding to spinal cord stimulator implantation. Participants Participants implanted with a spinal cord stimulator between 1998 and 2019 who had their stimulator for ≥1 year, purposively sampled to increase the range of ethnicities. Main outcome:The themes identified from the interviews. Results:24 participants with chronic pain of varied aetiology and a median (range) of 5.2 (2.4-23.2) years since stimulator implantation participated. 22 participants had the device in situ, and 2 had been explanted. Five main themes were identified: (1) embodiment: stimulator and body as one; (2) technical factors: batteries and type of stimulation; (3) improved well-being; (4) social connection and (5) healthcare system interaction. Most participants reported pain relief, but many had experienced complications and discomfort. They emphasised the importance of ongoing support from the pain service. Acceptance of pain, coping and embodiment emerged as common motifs across these themes. 21 participants were satisfied with their treatment. Conclusion:Within the context of a multidisciplinary pain clinic, despite some discomfort and various complications, most participants valued the ongoing reduction of pain achieved with spinal cord stimulation. Timely access to support from the pain service influenced their experience and satisfaction with their stimulators. Acceptance of pain and embodiment of the stimulator helped participants adapt to living with their stimulator, often over many years

    Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study

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    Unique aspects of New Zealand’s (NZ) health system allow for a novel pharmacoepidemiologic approach to conducting population-based clinical research. A defined cohort of surgical and trauma patients would facilitate future studies into opioid utilisation, outcomes, and other questions related to surgery and trauma. We aimed to describe all patients admitted to a NZ hospital with trauma or to undergo surgery between 1 January 2007 to 31 December 2019. This was a retrospective population-based study involving all hospital centres in NZ. We excluded patients with hospitalisation episodes for surgery or trauma one year before the event. We identified 1.78 million surgical only patients, 633,386 trauma only, and 250,800 trauma with surgery patients. Trauma only patients had the highest prevalence of death within one year of event (17.8%), history of opioid dispensing (18.3%), mental health disorders (17.0%) and chronic pain (2.3%). Moreover, trauma patients also had the highest prevalence of those with higher comorbidity burden. We plan to use this dataset for future research into the prevalence and outcomes of persistent opioid use, and to make our dataset available to other researchers upon request. Our findings of significant differences between cohorts suggest studies should treat surgical and trauma patients separately
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