bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring patient safety in New Zealand public hospitals
Authors:   , Bowden Nicholas 
Published: November 2021

<p>In New Zealand the Ministry of Health recognises quality of care as an integral part of a high performing health system and identifies patient safety as one of the key dimensions of quality. Over recent years a greater emphasis has been placed on improving patient safety mostly as a result of increased awareness around the frequency of medical error and resulting economic cost. However tools used to measure patient safety are limited. In particular the use of hospital administrative data to measure patient safety is scarce and existing safety measures often ignore one of the major issues confronting comparative analyses of hospital safety, risk adjustment to control for the differences in populations hospitals serve. The objective of this research is to develop comparable measures of patient safety for New Zealand public hospitals. It uses risk adjustment strategies applied to the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) with New Zealand hospital administrative data, the National Minimum Dataset 2001 to 2009. The research employs econometric techniques to address risk adjustment of the PSIs, utilising existing AHRQ models but adapting and re-estimating them with New Zealand administrative data. The findings from the research indicate that to use the AHRQ PSIs as measures of hospital patient safety in New Zealand, risk adjustment should first be employed to ensure measures are comparable across hospitals and over time. Overall, although the impact of risk adjustment appears to be minor, it has relevance and this should be recognised. Relative hospital performance is affected by risk adjustment. In particular, it has the greatest impact on those hospitals with poor rankings. The research takes us a step closer to being able to confidently measure patient safety and quality of care in New Zealand public hospitals in an innovative way.</p>
Seagrass: A Dynamic System
Authors:   , Duncan Alison 
Published: November 2021

<p>Small herbivorous invertebrates consume algal epiphytes, reducing negative effects (e.g. shading) on seagrass. Much research to date has focused on crustacean grazers, and comparatively little on gastropods. The aim of this research was to 1) examine seasonal and spatial variation in seagrass and associated gastropods in a large, tidal estuary and 2) examine the response of seagrass and epiphytic algae to nutrient enrichment and grazing pressure in a laboratory experiment. Surveys were conducted in summer and winter of 2016 to assess the seasonal fluctuations in the associated gastropods and relationships with seagrass and epiphyte biomass within three sites in the Porirua Harbour. Seagrass, gastropods and epiphytic algae showed seasonal trends, including evidence of a loss of grazer control on epiphytes during winter. Potamopyrgus estuarinus, Notoacmea scapha, Diloma spp. and Micrelenchus spp. were the dominant gastropod grazers in the system in both seasons. The gastropod assemblage and seagrass characteristics differed between sites, likely in response to small scale differences in abiotic factors. Seagrass from Elsdon (a site with elevated nutrient levels) and Browns Bay (a relatively pristine site) were used to investigate the role of select grazers and nutrient enrichment on epiphyte and seagrass growth. Nutrient treatments represented nitrate and phosphate concentrations of Elsdon (High), a 20% increase (High+) and a control (no addition). Little evidence was found for epiphyte regulation by gastropods, nor did epiphyte loads increase with nutrient addition. Seagrass from Browns Bay responded more strongly to High+ treatments than that of Elsdon. The results suggest that seagrass from Elsdon is adapted to the site’s high nutrient loads, where seagrass from Browns Bay is not. The results of this thesis support prior research findings of high variation in seagrass over a small scale, and adds to the currently lacking information on the role of micro-grazers in New Zealand’s seagrass meadows.</p>
A builder's duty of care - When should it apply to the directors and employees of companies involved in the creation of defective buildings?
Authors:   , Brittain Grant 
Published: November 2021

<p>This thesis considers the issue of when a tortious duty of care to prevent economic loss should be imposed on the company directors and employees who stand behind the complex structure of companies and contracts involved in the creation of a defective building. Set against the background of the leaky building crisis, and what are (it is argued) unfair litigation outcomes, the thesis traverses the emergence and development of the principles that underpin liability for negligence and negligent misstatement in respect of defective buildings. A review of the cases confirms that the concepts of control and general reliance are the basis of New Zealand law in this area. There follows a discussion of the difficult relationship between company law principles and negligence principles, and the role of assumption of responsibility in the law of negligence and negligent misstatement, including a discussion of developments in the leaky building litigation. The thesis advanced is that, in respect of the creation of defective buildings, the approach to the issue of whether to impose a duty of care on company directors and employees would benefit from placing significant weight on the factor of de facto control of the inputs that dictate the outcome of a building project, and on the lower level factor of a direct or indirect financial interest in the outcome of the project. It is argued that the approach to imposing a duty of care should be the same for directors and employees and in respect of statements and actions. In cases where the evidence establishes that the financial interest factor is not present, this should give rise to an inference that the company director or employee does not have control of the inputs that dictate the outcome of the project, so that no duty of care arises. This would enable a director or employee to exit litigation by way of an application for summary judgment. This is intended to discourage the practice of joining minor parties to litigation for the purpose of extracting a precautionary settlement. If control of the inputs that dictate the outcome of a project can be established by inference from the existence of the financial interest factor, or by the other evidence, then the two stage approach to the imposition of a duty of care would require a consideration of other factors that might negate the duty, such as the contractual matrix.</p>
River on Fire: The mache parapotamios and Ecological Crises in Greco-Roman Epic
Authors:   , Fairley Alice 
Published: November 2021

<p>The mache parapotamios, or river battle, briefly brings nature to the forefront of epic narrative and provides an insight into perceptions of the environment. This type scene, appearing in a number of extant epics including Homer’s Iliad, Silius Italicus’ Punica, and Statius’ Thebaid, demonstrates that these poems are aware of the importance of nature as divine and cosmological, and are concerned with its relationship to humankind. The mache parapotamios does not, however, communicate a ‘green’ message in which nature is considered, or cared for, as an entity unto itself. Destruction of the environment is frequently slated as sacrilegious, and it is often equated with cosmological disorder. What is more, the narrative promotes the consensual domestication of nature so that it will benefit humankind, recognising that undamaged and benevolent nature is better than its wild and aggressive counterpart. In this way, concern for the preservation of nature in epic is anthropocentric. Using a schema with which to analyse nature in epic, we can categorise aspects of nature into domesticated or undomesticated, and natural or non-natural. In the case of the mache parapotamios, this schema takes into account the personification of the river, as well as its relationship with humans. Alliances with humans demonstrate domestication, such as the Scamander’s cooperation with the Trojans, while enmity towards humans demonstrates a lack of domestication, as when the Trebia of the Punica assaults Scipio. Furthermore, a river is natural when it is in control of itself and acting according to its phusis, but an external force, such as pollution or obstruction, can cause a river to become non-natural. This frequently reflects negatively on the human perpetrators of the non-natural phenomena. Each of the three chapters discusses one of the texts above and analyses the mache parapotamios, as well as other scenes involving nature, using the proposed schema. While each text presents an altered version of the river battle in order to best suit the needs of the epic, the significance of the relationships between the gods, humans, and nature remains a constant across all three.</p>
Local Learnings from Local Voices: Exploring rural ni-Vanuatu perspectives of agricultural education and extension services in Santo, Vanuatu
Authors:   , Bird Andrew 
Published: November 2021

<p>Over the past 100 years, Vanuatu has seen the growth of a commercial agricultural sector through the influence of colonial interests. However, around 80 percent of the population still rely on semi-subsistence agriculture for their daily well-being. Agricultural education and extension resources operate across Vanuatu but are centralised around the Santo, the largest of Vanuatu’s 83 islands. However, their use by rural villages is limited despite growing recognition within rural communities that agricultural practices need to evolve in order to address issues such as climate change and food security. This led me to ask the questions: what are the ways in which villagers engage with these agricultural development resources; what influences whether they use these resources or not; and what would help improve engagement between villagers and resources? To answer these questions, I undertook this research using an indigenous Pacific research methodology which aligns the data collection approach and process with traditional practices of knowledge sharing and relationship building such as storytelling and open group discussions. This included living in three different villages, building relationship, conversing in Bislama, and conducting semi-structured group discussions in the traditional ni-Vanuatu format of storian. This research found an apparent disconnect between the rural village context and agricultural education and extension services on Santo. All three villages had minimal engagement with these resources, more regularly receiving agricultural information through other villagers. From the villagers’ perspective, in-village engagement is the most desirable and effective form of engagement. Perceptions of the present situation were dominantly negative with high travel costs, inconsistency in staff availability, past negative experiences with resources, education courses being too long and costly for many villages to attend and contextually misaligned information all influencing poor resource use. Villagers also highlighted the growing impact that climate change is having on food production, with changes to seasonal patterns, increasing weather extremes, and crop failures leading to dietary changes and growing food insecurity. However, villagers, in general, do recognise the potential benefits of agricultural development resources and do want greater engagement. Both past engagement examples and international examples offer options for a way forward and there are positive signs on the horizon. The need for more effective and community focused engagement is only going to increase due to climate change, growing urbanisation, and increasing food insecurity and greater recognition of the local perspective will be essential in order to address the challenges to come.</p>
The Role of Outer-Membrane Vesicles in Intercellular Communication in Pseudomonas Aeruginosa
Authors:   , Russell Euan 
Published: November 2021

<p>Gram-negative bacteria produce outer-membrane vesicles (OMVs) that have biological roles ranging from biofilm formation, modulation of host-cell interactions & delivery of virulence factors. Several studies have shown a role for OMVs to act as intracellular signals to co-ordinate the behaviour of bacteria. This study showed OMVs generated at sub-lethal ciprofloxacin concentrations were capable of programming naïve P. aeruginosa cultures resulting in premature entry into stationary-phase and a significantly lower final culture density reached after 14 hrs. Pyoverdine production was also initiated after 6 hrs in cultures treated with OMVs. Heat-inactivation of OMVs failed to impede OMV-mediated growth inhibition & pyoverdine production. Chloroform-disruption of OMVs prevented OMV-mediated growth inhibition but did not inhibit OMV-induced pyoverdine production. It is likely that these effects are mediated by multiple signals as opposed to a single mechanism. This suggests that a protein is not responsible for OMV-mediated growth inhibition and an intact OMV lipid bilayer is required. Induction of pyoverdine production is likely due to a lipid (such as a homo-serine lactone) or small molecule present within OMVs. Preincubation with OMVs for 2-4 hrs resulted in a substantial decrease in the final culture density from cultures that were exposed to OMVs during the course of growth. This suggests that OMV fusion is capable of programming naïve bacteria to set a predetermined division limit on subsequent daughter cells. We coin this as the ‘Dayflick’ limit due to the similarities of the Hayflick limit in eukaryotic cells. This shows that OMVs act as intercellular messaging vehicles between bacteria that communicate and program naïve bacteria to adapt to the environment under which they were generated in, aiding survival in harsh environments. Further study is needed to determine what OMV components are responsible for initiating these responses and to determine how long the programming is stable.</p>
“At least I have a house to live in”: Māori and Pacific young people’s hopes and fears about the future
Authors:   , Funaki Hine 
Published: November 2021

<p>Young people are often represented as the leaders of the next generation and much attention is given to the need for them to become more active participants in shaping the nation’s future. Over the years, education policy makers, health officials, government representatives in the criminal justice and welfare systems have sought ways of involving New Zealand’s youth more closely in civic society as they grapple with a daunting range of problems, many of which are likely to significantly worsen in the coming years. Despite these efforts, the views of some of the most economically and politically marginalised indigenous and/or racialized young people continue to be elusive and as a result a less nuanced understanding is available about how young people think about their lives in times ahead. This study explores the hopes and fears that marginalised urban Māori and Pacific youth hold about the future and how they establish a sometimes fragile sense of belonging in precarious and uncertain times. In this project, Māori and Pacific young people were invited to discuss their aspirations and anxieties about the future and how these ideas are influenced by their everyday local ‘places’ in the present. Two participant groups were involved in the project; one included Māori youth in an urban centre where there were few opportunities for unemployed young people while the other group included Pacific youth living in a city area where many families experience high levels of economic hardship. The research tracks their views about who they are now as young people growing up in a complex and increasingly divided society and who they might become in the years ahead. Taking a place-based approach, focus groups and walk-along interviews were conducted in two New Zealand cities. As the study progressed, the participants began to talk about the significance of hope, and lack of hope, in their everyday lives. Drawing on the work of Paulo Freire, it is argued that informed hope can be a powerful humanizing force in young people’s lives and the study suggests that when youth have a strong foundation of hope and belonging, they are often capable of becoming active agents of social change.</p>
Training for volunteers - A multiple case study investigating the relationship between volunteer motivations and required training programmes
Authors:   , Daly Philip Ronald 
Published: November 2021

<p>This thesis reports on a multiple case study exploring the impact of required training programmes upon the motivations of new volunteers. The core research question is: How are the primary motivations of volunteers affected by the initial training that they are required to complete? Previous research has investigated the motivations of volunteers, and sought to measure the efficacy of volunteer training programmes. However there is little research investigating how volunteer motivations and volunteer training programmes influence each other. Volunteers from two contrasting volunteer organisations were interviewed about their motivations to volunteer, experiences of the volunteer training, and any subsequent changes in motivation. Prior to these interviews the volunteers were given the Volunteers Function Inventory (VFI) questionnaire which measures volunteer motivations. The interview data was analysed using a six phase process of thematic analysis, and the motivational themes from this analysis were checked against the results of the VFI Questionnaire. The study found little difference in the overall motivations of volunteers between the two organisations, though there were differences in how these motivations were expressed within each organisation. Both sets of volunteers displayed high levels of altruistic and knowledge-based motivations, with the career motivation being the most variable, and age and stage of life appearing as a key moderator for the motivations. Volunteers appreciated training that they perceived as being relevant, and that utilised peer-learning, but both training programmes lacked the flexibility required to have a high level of relevance to a wide range of learning needs and motivations. Ultimately the motivations of the volunteers were improved by the training when they found that it either helped them to be more effective in their volunteer roles, or related well to their motivations for volunteering.</p>
Programme evaluation and educational policy development : an exploration
Authors:   , Jackman Patricia Helen 
Published: November 2021

<p>Programme evaluation in education began as a form of public inquiry and has developed into a tool for informing policy development. This process has accompanied the government's focus on outcomes rather than outputs and the current global demand for accountability. In recent years there has been an increase in the letting of contracts by the New Zealand Ministry of Education for the production of evidence to support educational policy and this has included the evaluation of programmes designed to improve teaching and raise student achievement. The study reports the historical development of programme evaluation and the different schools of thought which have evolved. It outlines the management of formative programme evaluation within the Ministry of Education's Research Division and describes Rist's approach to policy making, used in the Numeracy Development Project. Two large-scale programmes, the Strengthening Education in Mangere/Otara (SEMO) Project and the Numeracy Development Project, are discussed as examples of initiatives involving programme evaluation. The results of both have informed policy and have been extended more widely. The relationship between research and programme evaluation is discussed with reference to the Performance-Based Research Fund.</p>
The Clinical Utility of Genetic Risk Scores Following Myocardial Infarction
Authors:   , Northcott Hadley 
Published: November 2021

<p>Current risk assessment for the development of coronary artery disease (CAD) in an individual relies on a combination of clinical characteristics. These well-established CAD risk factors include consideration of age, gender, hypertension, dyslipidemia, diabetes, smoking and obesity. However there are a proportion of patients that experience an acute coronary syndrome (ACS) event despite being deemed as low risk based on the current New Zealand risk model. These patients present with an absence of the traditional risk factors, or they fall below the age threshold where CAD screening is initiated. The lack of association with disease development and presence of the traditional risk factors in these patients has led to the hypothesis that genetics play a significant role in the etiology of their disease. The conduction of family-based hereditary studies has supported the hypothesis that CAD risk is associated with genetic markers. A method of analyzing this genetic risk has been developed in the form of calculating a genetic risk score (GRS). The GRS is comprised of a panel of single nucleotide polymorphisms (SNPs) discovered through genome wide association studies in CAD patients. Currently, there is controversy in the clinical utility of different GRS calculation methods, and as yet, there has been no research conducted on the potential benefits of a GRS in a New Zealand setting. Our study measured genetic risk through a weighted GRS calculated from a 27 SNP panel in 420 patients in a New Zealand based population. In looking at whether we could determine a difference in GRS values between premature (young) MI patients and older control patients, we found that the mean GRS was not significantly elevated in the premature MI cohort (p = 0.156). However, in assessing GRS differences between ethnicities and in relation to specific risk factors we saw that mean GRS was higher in patients with a family history of coronary disease (p = 0.003), in Māori patients (p = 0.013) and in patients with fewer than 2 traditional risk features (p = 0.001). GRS was not associated with individual traditional risk factors, including dyslipidaemia, hypertension, diabetes, obesity or gender. Our results showed that genetic risk for CAD is identifiable with this GRS, and indicates that further research into ethnic differences and identifying genetic risk in young CAD patients with low traditional risk would provide interesting insights.</p>