bluuebunny/crossref_metadata_2025 huggingface dataset:
Probing shear-induced rearrangements in Fourier space. I. Dynamic light scattering
Authors: Aime S. , Cipelletti L.
Published: November 2018

Dynamic light scattering coupled to rheology separately probes affine displacements and non-affine rearrangements in soft matter under shear.
The viscoelastic signature underpinning polymer deformation under shear flow
Authors: Korolkovas Airidas , Prévost Sylvain , Kawecki Maciej , Devishvili Anton , Adlmann Franz A. , Gutfreund Philipp , Wolff Max
Published: November 2018

The structure of a large deformed polymer is divided into smaller layers, enabling an analytical fit to neutron scattering data.
Type 3 innate lymphoid cell: a new player in liver fibrosis progression
Authors: Wang Siqi , Li Jing , Wu Shengdi , Cheng Lisha , Shen Yue , Ma Wei , She Weimin , Yang Changqing , Wang Jiyao , Jiang Wei
Published: November 2018

Type 3 innate lymphoid cell (ILC3) has recently emerged as a crucial effector in inflammatory and fibrotic diseases. The present study was designed to determine the roles of ILC3 in liver fibrosis. By flow cytometry, we documented increased frequencies of peripheral ILC3 (Lin−CD127+CD117+CD294− lymphocytes) in patients, especially at the advanced stage of hepatitis B virus (HBV)-related chronic liver diseases, and demonstrated their correlations with disease progression. The in vitro fibrogenic effects by ILC3 were determined by co-culture experiments with LX-2 (a human hepatic stellate cell (HSC) line). The data indicate that pathogenic ILC3 can directly promote LX-2 fibrogenesis in non-contact manners by producing interleukin (IL)-17A and IL-22. Additionally, they had indirect fibrogenic effects by producing IL-22 to suppress interferon (IFN)-γ (a well-known anti-fibrotic cytokine) production by other immune cells. In carbon tetrachloride (CCl4)-induced wild-type mouse liver fibrosis models, we also documented significantly increased frequencies of both non-natural killer (NK) ILC (Lin−CD127+ lymphocytes) and ILC3 (Lin−CD127+RORγt+ lymphocytes) in liver and spleen specimens. Furthermore, the ILC3 from fibrotic mice contained more IL-17A+ILC3 and IL-22+ILC3 subsets than those from normal and less-fibrotic mice. The in vivo effects of ILC3 in liver fibrogenesis were further determined using RAG-1−/− mice with ILC depletion and further adoptive transfer of ILC3 from wild-type mice. The immunohistochemical staining of liver specimens showed the beneficial effects by ILC depletion and the detrimental effects by ILC3 transfer in CCl4-induced mouse liver fibrosis models. Collectively, ILC3 plays a pro-fibrotic role in liver fibrosis progression.
Active contour model based on fuzzy c‐means for image segmentation
Authors: Jin Ri , Weng Guirong
Published: November 2018

In this Letter, the authors propose an active contour model based on the fuzzy c‐means method. Using fuzzy c‐means to calculate the values of two types of cluster centres for all points in the image domain, by which local fitting functions in traditional models are substituted. Since the values are calculated before curve evolution, the proposed model can segment images with intensity inhomogeneity efficiently. Furthermore, it has the good robustness to initial contour. The effectiveness of the proposed model is tested by experiments on some synthetic and real images.
Forward–backward processing for efficient underground channel estimation in 60 GHz MISO FBMC systems
Authors: Belaoura W. , Ghanem K. , Nedil M. , Bousbia‐Salah H.
Published: November 2018

In this Letter, a novel low complexity sparse channel estimation method based on forward–backward processing is proposed for mm‐Wave underground channel incorporating a space‐time‐block coding filter bank multi‐carrier (STBC‐FBMC) system, which employs quadrature amplitude modulation. The proposed estimation algorithm relies on the idea of the channel support forward selection and backward removal, which iteratively expands and compresses the support estimate, hence improving the ability to cover up for the errors made in the conventional orthogonal matching pursuit (OMP) algorithm. By contrast to the latter, the most innovative feature of the proposed approach is its capability of effective channel reconstruction without prior information of the sparsity level and its adaptive step size method to approach the true sparsity level. The proposed approach is shown to achieve a higher estimation accuracy than OMP alternative.
Frequency beam‐scanning substrate integrated waveguide cavity‐backed wide slot antenna with wide‐scanning angle and bandwidth
Authors: Cao Yufan , Qian Zuping , Zhu Lei
Published: November 2018

A novel frequency beam‐scanning substrate integrated waveguide cavity‐backed wide slot antenna with a wide‐scanning angle and bandwidth is investigated. The wide slot etched on the metal substrate is not only the radiating element but also part of the feeding network, which makes the whole structure very compact. The experiment indicates that the design principle is correct. The measured results show that the antenna achieves an enhanced operating bandwidth of about 27% with the gain from 10.12 to 16.25 dBi and the corresponding scanning angle is from 12° to across the band. Good accordance is obtained between the simulated and the measured results.
Spatially resolved mass-to-light from the CALIFA survey
Authors: García-Benito R. , González Delgado R. M. , Pérez E. , Cid Fernandes R. , Sánchez S. F. , de Amorim A. L.
Published: November 2018

We investigated the mass-to-light vs. color relations (MLCRs) derived from the spatially resolved star formation history of a sample of 452 galaxies observed with integral field spectroscopy in the CALIFA survey. We derived the stellar mass (M⋆) and the stellar mass surface density (Σ⋆) from the combination of full spectral fitting (using different sets of stellar population models) with observed and synthetic colors in optical broad bands. This method allows obtaining the radial structure of the mass-to-light ratio (M/L) at several wavelengths and studying the spatially resolved MLCRs. Our sample covers a wide range of Hubble types from Sc to E, with stellar masses ranging from M⋆ ∼ 108.4 to 1012 M⊙. The scatter in the MLCRs was studied as a function of morphology, stellar extinction, and emission line contribution to the colors. The effects of the initial mass function (IMF) and stellar population models in the MLCRs were also explored. Our main results are that (a) the M/L ratio has a negative radial gradient that is steeper within the central 1 half-light-radius (HLR). It is steeper in Sb-Sbc than in early-type galaxies. (b) The MLCRs between M/L and optical colors were derived with a scatter of ∼0.1 dex. The smallest dispersion was found for the combinations (i, g − r) and (R, B − R). Extinction and emission line contributions do not affect the scatter of these relations. Morphology does not produce a significant effect, except if the general relation is used for galaxies redder than (u − i) > 4 or bluer than (u − i)< 0. (c) The IMF has a large effect on MLCRs, as expected. The change from a Chabrier to a Salpeter IMF produces a median shift of ∼0.29 dex when mass loss from stellar evolution is also taken into account. (d) These MLCRs are in agreement with previous results, in particular for relations with g and r bands and the B and V Johnson systems.
Cortical-inspired image reconstruction via sub-Riemannian geometry and hypoelliptic diffusion
Authors: Boscain Ugo , Chertovskih Roman , Gauthier Jean-Paul , Prandi Dario , Remizov Alexey
Published: November 2018

In this paper we review several algorithms for image inpainting based on the hypoelliptic diffusion naturally associated with a mathematical model of the primary visual cortex. In particular, we present one algorithm that does not exploit the information of where the image is corrupted, and others that do it. While the first algorithm is able to reconstruct only images that our visual system is still capable of recognize, we show that those of the second type completely transcend such limitation providing reconstructions at the state-of-the-art in image inpainting. This can be interpreted as a validation of the fact that our visual cortex actually encodes the first type of algorithm.
Magnetresonanztomografie der Sehbahn
Authors: Lützen Niklas , Urbach Horst
Published: November 2018

Dieser Übersichtsartikel ist speziell auf den praktisch arbeitenden Ophthalmologen zugeschnitten. Im Fokus soll der Umgang mit der Kernspintomografie im Allgemeinen und speziell in der Anwendung/Abklärung von Erkrankungen stehen, welche die Sehbahn beeinträchtigen. Übersichtlich geben mehrere Tabellen Auskunft über die Anwendung von verschiedenen MRT-Protokollen im Bereich der Sehbahn, Eigenschaften häufig angewendeter MRT-Sequenzen sowie häufige Krankheitsbilder in den jeweiligen Abschnitten der Sehbahn. Anhand einzelner ausgewählter Erkrankungen soll die Anwendung und Interpretation der MRT-Bildgebung exemplarisch dargestellt werden. Aufgrund der enormen Vielfalt an Erkrankungen, die Einfluss auf die Sehbahn haben können, kann und will dieser Artikel keinen Anspruch auf Vollständigkeit erheben, sondern vielmehr dem Leser die MRT im Bereich der Sehbahn näherbringen und praktische „Werkzeuge“ für den Alltag (in Form von Tabellen) an die Hand geben. Zudem wird aus aktuellem Anlass auf die laufende Diskussion (Gadolinium-Retention im Gehirn) über den Umgang mit Gadolinium eingegangen.
Systematic tuning of the photo-dielectric effect in Ba(Al1–xZnx)2O4–δ
Authors: Nagai Takayuki , Tanabe Kenji , Terasaki Ichiro , Taniguchi Hiroki
Published: November 2018

Systematic tuning of photo-induced enhancement of the dielectric permittivity (i.e., the photo-dielectric effect) in Ba(Al1–xZnx)2O4–δ (BAZ-x) has been demonstrated by changing Zn concentration x and intensity of the incident light. The relative change of the dielectric permittivity (ε′), defined as Δε′photo/ε′dark, increases linearly with an increase in the Zn concentration (x), finally reaching approximately 30% at 1 MHz. The dependence of Δε′photo/ε′dark on the intensity of the incident light shows a two-step growth as the irradiation light intensity increases, suggesting the existence of multiple photo-induced processes influencing the photo-dielectric effect of BAZ-x. The results of the present study not only give a clue to the mechanism of the photo-dielectric effect but also aid in the development of innovative photo-tunable functional devices.
Prediction of the phase stability and elastic property of ϵ-Pu at high temperature from theoretical study
Authors: Li Chun-Mei , Hu Yan-Fei
Published: November 2018

The phase stability and elastic property of ϵ-Pu at 800 K are predicted through systematically theoretical calculations, by taking the temperature-dependent phonon smearing, spin fluctuation, phonon vibration, and volume expansion effects into account. Dominated by the phonon smearing at 800 K, ϵ-Pu is thermodynamically stabilized in the paramagnetic state with the absolute value of the local magnetic moment (μPu) about 3.8 μB, being smaller than the 0 K value (about 5.0 μB). The resulted thermal spin fluctuation, which prefers the δ−ϵ phase transition, greatly decreases the volume (V) and the shear elastic constants (C′ and C44) of the ϵ phase. However, the phonon smearing itself prefers the expansion of V and also the increase of C′ and C44. Besides the influence of the spin fluctuation and phonon smearing at 800 K, the equilibrium V of ϵ-Pu seems to be dominated by the phonon vibration, and the lattice thermal expansion also further increases C′ whereas decreases C44. The determined V as well as C′ and C44 of ϵ-Pu at 800 K is reasonable in comparison with the previous studies. This insight provides a good understanding of the physical mechanisms driving the thermodynamical stability of ϵ-Pu at high temperature.
Convergence of strong shock waves in non-ideal magnetogasdynamics
Authors: Chauhan Antim , Arora Rajan , Tomar Amit
Published: November 2018

The problem of a strong cylindrical shock wave collapsing at the axis of symmetry is studied in non-ideal magnetogasdynamics. The perturbation approach used in this work provides a global solution to the shock implosion problem in non-ideal magnetogasdynamics in contrast to Guderley’s asymptotic solution that holds in the vicinity of the axis of implosion. We analyze the flow parameters by expanding the solution in powers of time and found the similarity exponents as well as the corresponding amplitudes in the vicinity of the shock-collapse. Along with the higher-order terms in Guderley’s asymptotic solution, the leading similarity exponents have been refined near the center of convergence. The flow parameters and the shock trajectory have been drawn in the region extending from the piston to the center of collapse for different values of the adiabatic coefficient, shock cowling number, and non-ideal parameter.
Metamorphic narrow-gap InSb/InAsSb superlattices with ultra-thin layers
Authors: Ermolaev Maksim , Suchalkin Sergey , Belenky Gregory , Kipshidze Gela , Laikhtman Boris , Moon Seongphill , Ozerov Mykhaylo , Smirnov Dmitry , Svensson Stefan P. , Sarney Wendy L.
Published: November 2018

Metamorphic strain compensated InSb/InAsSb0.52 superlattices (SLs) with ultrathin layers and different periods grown on GaSb substrate were designed, fabricated, and characterized. It was shown that a period increase from 3 to 6.2 nm reduced the effective bandgap energy from 70 to 0 meV. A further increase in the period leads to inversion of the valence and conduction bands. Magneto-optical experiments demonstrated that Dirac-like carrier dispersion is characteristic of almost gapless InSb/InAsSb0.52 SLs. Indication of hole transport enhancement over that found in InAsSb/InAsSb SL structures is presented.
A transport model and constitutive equation for oppositely charged polyelectrolyte mixtures with application to layer-by-layer assembly
Authors: Salehi Ali , Larson Ronald G.
Published: November 2018

We develop a general framework for transport of polyions, solvent and salt, with intended application to Layer-by-Layer (LbL) assembly of polyelectrolyte monolayers (PEMs). The formulation for the first time includes electrostatics, chemical potential gradients, and mechanical stress gradients as driving forces for mass transport. The general model allows all species to be mobile throughout the process and avoids the assumptions of stepwise instantaneous equilibrium and/or immobilized structures typical of previous approaches, while reducing to these models in appropriate limits. A simple constitutive equation is derived for a mixture of oppositely charged polyelectrolytes that accounts for network strand dilution and cross-chain ion pairing by appending reactive terms to the Smoluchowski probability diffusion equation for network strand end-to-end vectors. The resulting general framework encompasses the Poisson equation describing the electrostatic potential distribution, an osmotic pressure balance, a stress constitutive equation, and a generalized flux law of polymer transport. The computational domain is split into a PEM phase and an external solution phase with an appropriate boundary condition derived for the interface between the two. The mobile species (water and small salt ions) are taken to be in a state of dynamic equilibrium with their distributions enslaved to the perturbations in the two polyion compositions. The proposed model captures the swelling response of PEM films to external solutions. For the first time, we studied the effects of the temporal evolution of electrostatic and stress distribution on the rate of chain loss and absorption during rinsing and dipping of an idealized and arbitrarily selected and rigid brush layer into external solutions. The temporal evolution provides a kinetic basis for the ability of LbL films to grow under conditions that thermodynamics alone suggests would cause them to be washed away and to account for partial desorption during washing. The proposed transport framework constitutes a solid basis for eventual quantitative modeling of LbL assembly and transport in polyion networks more generally.
Fast identification of crystalline orientation of anisotropic two-dimensional materials using scanning polarization modulation microscopy
Authors: Jiang Hu , Shi Hongyan , Sun Xiudong , Gao Bo
Published: November 2018

In this work, we have demonstrated that scanning polarization modulation microscopy (SPMM) provides a fast method for the identification of crystalline orientation of anisotropic two-dimensional (2D) materials. Using home-built 532 nm excited transmission SPMM, we identified the crystalline orientation of 2D orthorhombic black phosphorus, monoclinal 1T′-MoTe2, and triclinic ReS2 by measuring signals in only two incident polarization directions. So, it took just a few seconds to identify the crystalline orientation of anisotropic 2D materials. Our studies revealed that the SPMM method could be applied to arbitrary anisotropic 2D materials when selecting a suitable wavelength.
Incremental embedding: A density matrix embedding scheme for molecules
Authors: Ye Hong-Zhou , Welborn Matthew , Ricke Nathan D. , Van Voorhis Troy
Published: November 2018

The idea of using fragment embedding to circumvent the high computational scaling of accurate electronic structure methods while retaining high accuracy has been a long-standing goal for quantum chemists. Traditional fragment embedding methods mainly focus on systems composed of weakly correlated parts and are insufficient when division across chemical bonds is unavoidable. Recently, density matrix embedding theory and other methods based on the Schmidt decomposition have emerged as a fresh approach to this problem. Despite their success on model systems, these methods can prove difficult for realistic systems because they rely on either a rigid, non-overlapping partition of the system or a specification of some special sites (i.e., “edge” and “center” sites), neither of which is well-defined in general for real molecules. In this work, we present a new Schmidt decomposition-based embedding scheme called incremental embedding that allows the combination of arbitrary overlapping fragments without the knowledge of edge sites. This method forms a convergent hierarchy in the sense that higher accuracy can be obtained by using fragments involving more sites. The computational scaling for the first few levels is lower than that of most correlated wave function methods. We present results for several small molecules in atom-centered Gaussian basis sets and demonstrate that incremental embedding converges quickly with fragment size and recovers most static correlation in small basis sets even when truncated at the second lowest level.
Nonlinear converse magnetoelectric effects in a ferromagnetic-piezoelectric bilayer
Authors: Fetisov L. Y. , Chashin D. V. , Burdin D. A. , Saveliev D. V. , Ekonomov N. A. , Srinivasan G. , Fetisov Y. K.
Published: November 2018

The strain mediated nonlinear converse magnetoelectric effect (CME) is investigated in a bilayer of an amorphous ferromagnet FeBSiC and piezoelectric lead zirconate titanate (PZT). The magnetic response of the sample to an AC electric field (e) applied to PZT at an acoustic resonance frequency of 76 kHz was measured with a coil wound around the bilayer. With an increase in the amplitude of e over the range 0–250 V/cm, the variation in amplitude of the first and the second harmonics of the induced voltage due to the variation in the magnetic induction B was measured for DC bias magnetic field H = 0–80 Oe. The coefficients of the linear and nonlinear converse ME effects were 5.5 G cm/V and 1.9 × 10−2 G cm2/V2, respectively. The nonlinearity of the CME arises due to the nonlinear dependence of the magnetic induction on the stress. A theoretical model for the nonlinear CME is discussed.
Communication: Constrained molecular dynamics for polarizable models
Authors: Coretti Alessandro , Bonella Sara , Ciccotti Giovanni
Published: November 2018

A new algorithm to solve numerically the evolution of empirical shell models of polarizable systems is presented. It employs constrained molecular dynamics to satisfy exactly, at each time step, the crucial condition that the gradient of the potential with respect to the shell degrees of freedom is null. The algorithm is efficient, stable, and, contrary to the available alternatives, it is symplectic and time reversible. A proof-of-principle calculation on a polarizable model for NaCl is presented to illustrate its properties in comparison with the current method, which employs a conjugate-gradient procedure to enforce the null gradient condition. The proposed algorithm is applicable to other cases where a minimum condition on a function of an auxiliary set of driven dynamical variables must be satisfied.
Open-circuit voltage deficit in Cu2ZnSnS4 solar cells by interface bandgap narrowing
Authors: Park Ji-Sang , Kim Sunghyun , Hood Samantha N. , Walsh Aron
Published: November 2018

There is evidence that interface recombination in Cu2ZnSnS4 solar cells contributes to the open-circuit voltage deficit. Our hybrid density functional theory calculations suggest that electron-hole recombination at the Cu2ZnSnS4/CdS interface is caused by a deeper conduction band that slows electron extraction. In contrast, the bandgap is not narrowed for the Cu2ZnSnSe4/CdS interface, consistent with a lower open-circuit voltage deficit.
Practical Pointers: Clinically important drug-drug interactions and how to manage them*
Authors: Bryant Linda , Fishman Tana
Published: November 2018

* This article is designed to be read in conjunction with the A3 table of drug interactions provided as an insert in this issue of the Journal of Primary Health Care and also available on the journal website.
Perspectives of general practitioners towards evaluation and treatment of cardiovascular diseases among older people
Authors: Weiner Michael , Wells Susan , Kerse Ngaire
Published: November 2018

INTRODUCTION: Risk of cardiovascular disease (CVD) events increases with age. With treatment, individuals with highest risk accrue greater absolute risk reduction. New Zealands CVD guidelines provide no upper age limit for risk assessment. Guidance for treating those over 75 years is limited. Little is known about GPs attitudes regarding assessing and managing cardiovascular risk among older people. METHODS: A 39-item questionnaire including three cases representing various risk was developed and administered to 500 GPs randomly selected from a registry. RESULTS: Of the GPs, 379 were eligible; 86 (22%) responded to the questionnaire. Most were male (57%), between 40 and 59 years of age (74%), of European ethnicity (57%), had a medical degree from NZ (60%), and had been practising for at least 10 years (98%). Respondents were less likely to assess risk with increasing patient age and more likely to manage risk according to individual risk factors, rather than absolute risk. Marked variation occurred in intent to assess risk for a patient aged 78 years, according to living environment, co-morbidity, and functional status. In general, respondents indicated that they would usually assess risk for a 78-year-old community-dwelling patient without dementia but not for such a patient living in residential care or with dementia. DISCUSSION: This is New Zealands first report of GPs perspectives about assessing and managing CVD risk for older patients. Findings are consistent with international studies. More support and training in lifestyle assessment is needed, as well as clearer guidance for assessing and managing risk among older patients. KEYWORDS: Cardiovascular diseases; risk assessment; preventive medicine; geriatrics; public health
Relationship of root canal treatment to C-reactive protein as an inflammatory marker for cardiovascular disease
Authors: Arroll Bruce , Dhar Divya , Cullinan Mary
Published: November 2018

INTRODUCTION: Periodontal disease and elevated C-reactive protein (CRP) tests both are positively correlated with cardiovascular disease (CVD) in many studies. Some health practitioners have concerns that root canal treatment may provide a source for inflammation and hence increase the risk for CVD. AIM: To explore the relationship between CRP as a marker of inflammation and presence and number of root canal treatments in primary care patients. METHODS: Cross-sectional questionnaire about dental care followed by a blood test for serum CRP in patients from two New Zealand urban family practices. RESULTS: One hundred and 34 patients participated. The study showed no significant association between CRP and root canal treatment on multivariate analysis controlling for socioeconomic status, age, gender and smoking. The CRP level for those with =3 root-treated teeth was 1.68 while the level for those with <3 was 2.36, but the p-value was not statistically significant (p=0.198). Age, missing teeth and smoking were all significantly related to CRP levels so the sample has biological validity. DISCUSSION: Root canal treatment was not associated with higher CRP levels. The CRP levels were non-significantly lower in those with higher numbers of root-treated teeth. While there are a number of potential biases in this paper, the dataset appears to be biologically valid and consistent with known facts. These findings do not support the hypothesis that root canal treatment is associated with higher levels of inflammation. At this point patients should not consider having their root canal teeth removed. KEYWORDS: Periodontal diseases; C-reactive protein; inflammation; cardiovascular diseases; gingivitis; root canal treatment
A raised thyroid stimulating hormone result - a 12-month follow-up study in general practice
Authors: Gibbons Veronique , Conaglen John , Lawrenson Ross
Published: November 2018

INTRODUCTION: Subclinical hypothyroidism (SCH) is common in older patients. AIM: To review the management of patients identified with a raised thyroid stimulating hormone (TSH) result in a 12-month period and compare this to current guidelines from the New Zealand Best Practice Advocacy Centre (BPAC). METHODS: We collected laboratory data on thyroid function tests (TFTs) that were reported between December 2005 and November 2006 from two general practices with an adult population of approximately 21 000. Data were collected on symptoms, investigations, thyroid medication, family history and comorbidities. We used chi-squared tests to compare findings by age, gender and ethnicity. RESULTS: Older women of European descent were more likely to be to have initial results suggesting SCH. The number of follow-up tests ranged from 0 to 5 tests in a 12-month period. Forty-eight percent of individuals did not have any follow-up investigations. Seventy-three percent of FT4 tests taken are requested concurrently with TSH. Of those who had a repeat TSH test, just over 40% had a result within the reference interval. Twenty-eight percent had two TSH results consistent with SCH. Thirty-five percent of patients with antibody results were positive. The most commonly-recorded symptoms were tiredness and weight gain. DISCUSSION: We found inconsistencies in the management of SCH which were not related to patient characteristics such as age, gender or ethnicity. Further research is needed to determine if SCH is associated with increased morbidity and to provide a clear rationale for management of patients with SCH. KEYWORDS: Hypothyroidism; family practice; quantitative research; general practice
Development, validation (diagnostic accuracy) and audit of the Auckland Sleep Questionnaire: a new tool for diagnosing causes of sleep disorders in primary care
Authors: Arroll Bruce , Fernando III Antonio , Falloon Karen , Warman Guy , Goodyear-Smith Felicity
Published: November 2018

INTRODUCTION: Sleep disorders are common in the community and in primary care populations. Epidemiological surveys generally report insomnia rather than specific diagnoses. AIM: Our aim was to develop a questionnaire that could diagnose common sleep disorders in primary care in order to be able to make a diagnosis of primary insomnia by excluding other causes. Having created such a questionnaire, we then validated it (assessed the diagnostic accuracy). METHODS: The questionnaire was developed from the International Classification of Sleep Disorders using the criteria to create operational criteria. This was used in a primary care survey. A sub-sample of 36 primary care patients (aged over 15 years) was chosen to give a spectrum of disorders. A second sample of 85 patients was taken from a sleep disorder private practice to act as an extra test of validity. RESULTS: The response rate was 73% (36/49) for the primary care validation. The sensitivity and specificity of primary insomnia was 0.78 and 0.77, mood disorders 0.67 and 0.97, obstructive sleep apnoea 0.8 and 0.94, delayed sleep phase disorder was 0.8 and 0.97 and for health problems affecting sleep 0.92 and 0.76. There were a wider range of findings in the private practice audit. DISCUSSION: The validity of the Auckland Sleep Questionnaire is promising. The second version of the questionnaire will use this study to improve its functionality. KEYWORDS: Sleep disorders; validation studies; primary health care
Disposal practices for unused medications in New Zealand community pharmacies
Authors: Tong Alfred , Peake Barrie , Braund Rhiannon
Published: November 2018

INTRODUCTION: One of the recommended methods for households to dispose of unused medications in many countries is to return them to community pharmacies. However, such a practice will only reduce the environmental levels of pharmaceuticals if the medications are also disposed of and destroyed properly by the pharmacies. AIM: This study reports the results of a questionnaire sent to New Zealand community pharmacists regarding disposal practices for unused or expired medications in their workplaces. METHODS: A pre-tested, self-administered questionnaire was sent to 500 randomly selected community pharmacies from all areas of New Zealand. The participants were asked how they disposed of a variety of medications. In addition, participants were also asked about whether they knew how unused medications were destroyed if their pharmacy used a third-party contractor or distributor to dispose of them. RESULTS: Of the 265 respondents, 80.4% and 61.1% respectively reported that solid and semi-solid medications were removed by contractors. However liquid and Class B controlled drugs were predominantly disposed of down the pharmacy sink. Over 60% of the participating pharmacists indicated that they believed the contractors incinerated the collected pharmaceutical waste, and over 90% of the participating pharmacists indicated their wish for a state-run disposal and destruction system. DISCUSSION: Liquid medications and Class B controlled drugs, which were commonly reported to be disposed of down the sewerage system, may increase the potential for environmental pollution by pharmaceuticals in New Zealand. There is a need for increased environmental awareness amongst community pharmacists in New Zealand. KEYWORDS: Medication disposal; pharmaceutical waste; environment; excess medication; community pharmacist
Exploring resilience in families living with addiction
Authors: Moriarty Helen , Stubbe Maria , Bradford Sarah , Tapper Sophie , Teng Lim Bee
Published: November 2018

INTRODUCTION: Information about the impact of addiction on New Zealand (NZ) families is scarce. A good understanding of the nature and extent of family problems is essential to help families become more resilient and minimise the consequences. This study aimed to explore experiences of NZ families living with addiction, identify impacts on non-addicted family members, their coping strategies and barriers to help seeking. METHODS: Literature and key stakeholder interviews informed the development of an interview schedule for 29 family participants recruited through health and social services. Interviews were recorded for analysis of central themes and critical elements that underpin those. Key stakeholders and informal informants were again consulted to discuss findings and interpretation. FINDINGS: Addiction has widespread effects on NZ families. The coping strategies described by the participants in this project lacked the positive connotations of resilience, namely positive adaptation under significant adversity. CONCLUSION: Family impacts of addiction are complex, and similar family problems arise regardless of the substance(s) involved. This small exploratory study indicates that the implications for NZ families deserve further investigation. Future research is also required to further characterise the impact of behavioural addictions on families, addiction in particular ethnic groupings and the implications of the findings for clinical practice, other social and health services, and for public health and social policy. KEYWORDS: Qualitative research; addiction; family resilience
Randomised controlled trial of informal team sports for cardirespiratory fitness and health benefit in Pacific Adults
Authors: Biddle Mark , Vincent Grace , McCambridge Alana , Britton Gabrielle , Dewes Ofa , Raina Elley C , Moyes Simon , Edge Johann
Published: November 2018

INTRODUCTION: Rates of obesity, Type 2 diabetes and cardiovascular disease are high among Pacific people in New Zealand. Physical activity is recommended in the prevention and management of these conditions. Community-based, ‘small-sided game’ group activities may be an effective and culturally appropriate way to promote physical activity within Pacific communities. AIM: To assess the effectiveness of small-sided games-based exercise on fitness and health parameters among Pacific adults over four weeks. METHODS: Twenty untrained (13 female) Pacific adults were randomised to intervention or control. Intervention participants were offered 45 minutes of small-sided games three times per week for four weeks. Control participants were offered one-month gym membership after the trial. Primary outcomes included cardiorespiratory fitness (VO2 peak) and leg strength (maximal concentric force of quadriceps at 60°/second) measured at baseline and four weeks. Secondary outcomes included glycaemia, lipid profile, blood pressure (BP), and inflammatory markers. Multivariable regression models were used to assess differences between groups, adjusting for baseline values, age and gender. RESULTS: At baseline, mean age was 34.8 years (SD 12.6), BMI 36.3 (6.7), systolic BP 127.7 mmHg (12.1), HbA1c 6.1% (1.9), VO2 peak 2.5 L/min (0.6) and leg strength 170.0 N.m (57.4). Sixteen participants completed the trial. Change in outcomes were greater in intervention than control participants in absolute VO2 peak (0.9 L/min (p=0.003)), leg strength (17.8 N.m (p=0.04)) and HDL (0.12 mmol/L (p=0.02)). There were no other significant differences. DISCUSSION: Small-sided games appear to be a promising means for improving the health and cardiorespiratory fitness and reducing the risk of diabetes and cardiovascular disease in Pacific adults. KEYWORDS: Exercise; diabetes mellitus, Type 2; Pacific Islands; randomized controlled trial; health promotion
The incidence of acute otitis media in New Zealand children under five years of age in the primary care setting
Authors: Gribben Barry , Salkeld Lesley , Hoare Simon , Jones Hannah
Published: November 2018

INTRODUCTION: Acute otitis media (AOM) is a common childhood infection. Baseline data are required to evaluate potential changes in the epidemiology of AOM with new public health measures. AIM: To estimate the incidence of AOM in children under five years of age in primary care in New Zealand. METHODS: Using a cohort study design, consultation notes from 1 November 2008 to 31 October 2009 from 63 primary care facilities were analysed for new and recurrent episodes of AOM, complications, antimicrobial use and outcome. RESULTS: There were 19 146 children in the sample. The raw incidence of AOM was 273 per 1000 children (27.3%; 95% CI 216330). Of the 3885 children, 2888 (74%) had one episode of AOM and 152 (4%) of these children developed recurrent AOM. Incidence declined with age. There was no difference in incidence between Maori, Pacific and Other ethnicities. Antibiotics were used to treat 2653 (51%) AOM episodes and 113 (4.3%) of these children re-presented within three days of antibiotic therapy for persistent symptoms. Tympanic membrane perforation was the only complication noted, observed in 62 (1%) episodes. DISCUSSION: These data indicate that AOM is an important and frequent childhood infection in New Zealand. The show a significant decline in the use of antibiotics to manage AOM in concordance with accepted best practice. The complication rate of AOM is likely under-represented. This study enables future research into the effectiveness of current and future immunisations and changing management practices in New Zealand. KEYWORDS: Otitis media; incidence; child, preschool; New Zealand, antibiotic
Evaluation of Tu Meke PHOs Wairua Tangata Programme: a primary mental health initiative for underserved communities
Authors: Abel Sally , Marshall Bob , Riki Donny , Luscombe Tania
Published: November 2018

BACKGROUND AND CONTEXT: New Zealands primary mental health initiatives (PMHIs) have successfully filled a health service gap and shown good outcomes for many presenting with mild to moderate anxiety/depression in primary health care settings. Maori have higher rates of mental health disorders and complexity of social and mental health needs not matched by access to PMHIs. ASSESSMENT OF PROBLEM: The Wairua Tangata Programme (WTP), a Hawkes Bay PMHI, aimed to provide an integrated, flexible, holistic, tikanga Maoribased therapeutic service targeting underserved Maori, Pacific and Quintile 5 populations. External evaluation of the programme provided formative and outcome feedback. RESULTS: The WTP reported high engagement of Maori (particularly women), low non-attendance rates, good improvements in mental health assessment exit scores, strong stakeholder support and service user gratitude. GPs reported willingness to explore mental health issues in this high needs population. Challenges included engaging Pacific peoples and males and recruiting from scarce Maori, Pacific and male therapist workforces. STRATEGIES FOR IMPROVEMENT: Effectively meeting the target populations complex social and therapeutic needs required considerable programme flexibility, referral back into the programme and assistance with transitioning to other therapeutic or social support services. Referral criteria required adaptation to accommodate some sectors, especially youth. A group programme was developed specifically for males. LESSONS: A holistic PMHI programme delivered with considerable flexibility and a skilled, culturally fluent team working closely with primary care providers can successfully engage and benefit underserved Maori communities with complex social and mental health needs. Successful targeted programmes are integral to reducing mental health disparities. KEYWORDS: Primary health care; mental health; Maori; medically underserved areas; evaluation
Drug safety awareness in New Zealand: public knowledge and preferred sources for information
Authors: Brounéus Fredrik , Macleod Gregory , Maclennan Karyn , Parkin Lianne , Paul Charlotte
Published: November 2018

INTRODUCTION: To make informed choices about medical treatment options, patients and consumers need knowledge about the benefits and the risks of drugs. Little is known about levels of drug safety knowledge or preferred sources of drug safety information in general population samples. AIM: To explore drug safety knowledge, experience of adverse drug reactions (ADRs), and preferred sources for drug safety information in the New Zealand public. METHODS: We undertook a telephone survey of a random sample of adults (N=87) in the Dunedin area of New Zealand. RESULTS: Although 47% of those currently or recently using prescription or over-the-counter drugs (N=83) were unable to recall any safety information at all about the medicine they were taking, 84% felt confident they could use these medicines in a safe way. The experience of at least one ADR during the last five years was reported by 40%. The five most preferred sources for drug safety information among all participants were: doctor (92%), pharmacist (76%), information on/inside the medicine package (66%), nurse (57%), and the internet (41%). DISCUSSION: Our results add to findings from specific patient groups to show that there is a low level of drug safety knowledge in the general population. Primary health care practitioners have a recognised and vital part to play in promoting drug safety awareness. KEYWORDS: Consumer health information; drug safety; medicine information; patient education
Could the polypill improve adherence? The patient perspective
Authors: Bryant Linda , Martini Nataly , Chan Jacky , Chang Lisa , Marmoush Ahmed , Robinson Belinda , Yu Karen , Wong Many
Published: November 2018

INTRODUCTION: Multiple medications are recommended for the management of ischaemic heart disease. Unfortunately, increasing the number of medicines reduces adherence to medicines therapy. The concept of a polypill with a fixed dose combination of the common cardiovascular medicines (aspirin, statin, two blood pressurelowering medicines) has been promoted. Patient perceptions about this concept have not been explored. METHODS: People taking at least three cardiovascular medicines were interviewed using a semi-structured interview about their views on a polypill that could reduce the number of tablets they would need to take. FINDINGS: The participants considered that the polypill would be very convenient, especially when travelling and would reduce the pill burden. If the polypill was subsidised by the government, they would have reduced dispensing fee costs. There were concerns around the inflexibility of dosing of individual components of the polypill, and some concerns about safety and efficacy. Medical practitioners were identified as having an important role in influencing participants about the acceptability of the polypill. CONCLUSION: Generally the concept of the polypill was acceptable to participants, primarily because of the convenience and reduced number of tablets required daily. There were concerns about whether the polypill would be as effective and safe as the individual medicines. KEYWORDS: Cardiovascular diseases; medication adherence; prevention
General practitioners can offer effective nutrition care to patients with lifestyle-related chronic disease
Authors: Ball Lauren , Johnson Cristina , Desbrow Ben , Leveritt Michael
Published: November 2018

INTRODUCTION: Nutrition is a key priority for the management of lifestyle-related chronic disease, and the demand on general practitioners (GPs) to provide nutrition care is increasing. AIM: The aim of this systematic review was to investigate the effectiveness of nutrition care provided by GPs in improving the nutrition-related behaviour and subsequent health outcomes of individuals with lifestyle-related chronic disease. METHODS: A systematic literature review was conducted using the Cochrane Library, MEDLINE and ISI Web of Knowledge databases. Randomised controlled trials that investigated a nutrition care intervention feasible within general practice consultations, and that utilised outcome measures relevant to nutritionrelated behaviour or indicators of health, were included in the review. RESULTS: Of the 131 articles screened for inclusion, nine studies, totalling 9564 participants, were included in the review. Five interventions observed improvements in the nutrition behaviour of participants, such as a reduction of energy consumption, reduction of meat consumption, increase in fruit and vegetable intake, increase in fish intake and increase in fibre intake. Seven interventions observed improvements in risk factors, including in weight, serum lipid levels and blood pressure. Some inconsistencies in findings were observed in the reviewed studies. DISCUSSION: This systematic review demonstrates that GPs have the potential to provide nutrition care that improves the nutrition behaviour and risk factors in individuals with lifestyle-related chronic disease. However, the consistency and clinical significance of the intervention outcomes are unclear. Further investigation regarding the development of nutrition care protocols and the attributes of nutrition care that result in improved outcomes are required. KEYWORDS: Chronic disease; general practice; general practitioners; nutritional management
Understanding barriers to glycaemic control from the patients perspective
Authors: Janes Ron , Titchener Janet , Pere Joseph , Pere Rose , Senior Joy
Published: November 2018

INTRODUCTION: To better understand barriers to glycaemic control from the patients perspective. METHODS: An interpretative phenomenological approach was used to study the experiences of 15 adults with Type 2 diabetes. Participants each gave a semi-structured interview of their experiences of living with diabetes. Interviews were transcribed, and themes extracted and organised using a patient-centred framework. FINDINGS: Participants stories confirmed many of the barriers in the literature, particularly those related to context, such as family, finances, work. Barriers also related to negative emotional reactions to diabetes: fear of new events (diagnosis, starting pills/insulin); guilt about getting diabetes and not controlling it; and shame about having diabetes. Barriers also related to unscientific beliefs and personal beliefs. There were additional barriers related to poor clinicianpatient relationships. Overall, participants had a poor understanding of diabetes, and complained that their clinician simply told them what to do. CONCLUSION: Using a patient-centred approach, this study identified many barriers to glycaemic control. We suggest that a key barrier is clinician ignorance of their patients fears, beliefs, expectations, context; of what constitutes a positive therapeutic relationship; and of the limitations of a biomedical approach to patient non-adherence. Faced with both a worsening diabetes epidemic and increasing health care workforce shortages, clinicians urgently need to understand that it is they, not their patients, who must change their approach if diabetes care is to be improved. KEYWORDS: Communication barriers; diabetes mellitus, type 2; medication adherence; patient-centered care
Influences on final year medical students attitudes to general practice as a career
Authors: Parker Johanna , Hudson Ben , Wilkinson Tim
Published: November 2018

INTRODUCTION: General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. METHODS: This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. FINDINGS: General practitioners (GPs) play a key role in influencing medical students attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. CONCLUSION: GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements. KEYWORDS: Career choice; general practice; general practitioners; medical education; students, medical