title: Using physical clocks for replication in MANETs

authors: Scholz, Manuel

subjects: computer science

abstract: When update-anywhere data replication is performed in a MANET, operations on replicated data are often executed concurrently. To achieve a global total ordering of all operations, we propose a hybrid timestamp mechanism that combines physical clocks and logical timestamps. Our approach overcomes the ordering problem that arises from imprecisely synchronized physical clocks. We overlay the timestamps of operations with a grid of time-slots. To order the operations, we use physical clocks for operations in different time-slots and logical clocks for operations within the same time-slot. We prove that our method guarantees a total ordering when using an appropriate grid width.

text: Using physical clocks for replication in MANETs When update-anywhere data replication is performed in a MANET, operations on replicated data are often executed concurrently. To achieve a global total ordering of all operations, we propose a hybrid timestamp mechanism that combines physical clocks and logical timestamps. Our approach overcomes the ordering problem that arises from imprecisely synchronized physical clocks. We overlay the timestamps of operations with a grid of time-slots. To order the operations, we use physical clocks for operations in different time-slots and logical clocks for operations within the same time-slot. We prove that our method guarantees a total ordering when using an appropriate grid width.

year: 2007

title: The experience of thriving at work in rotational physiotherapists in Aotearoa New Zealand

authors: Stephens, Fiona

subjects: Thriving at work

abstract: Aim: This thesis aims to identify what contributes to thriving at work by rotational physiotherapists employed at national public hospitals in Aotearoa New Zealand. It will do this by exploring what enables individuals to thrive at work and what organisations can do to better support their rotational therapy staff to thrive, recommendations will be created to promote thriving at work to better support the retention and recruitment of staff in both a local and national workforce. 
Background: Workforce retention and attrition is a major concern for all health professions, including physiotherapy. A workforce analysis undertaken for the New Zealand physiotherapy workforce highlights that whilst there are no issues with the supply of physiotherapists for graduate positions, the supply of experienced physiotherapists, i.e. over five years work experience, is less than demand.  This study builds on the literature using the thriving at work model in the nursing workforce. Research has highlighted the lack of a perceived career pathway as a major concern for physiotherapists and a contributing factor to the number of physiotherapists who leave the profession before the seven-year mark. Recommendations to date have emphasised consideration be given to the implications regarding the quality of leadership support and positive workplace practices on job satisfaction and turnover intention in the profession. 
Design: An exploratory sequential mixed methods design.
Method: Data were collected in 2021 via face to face focus groups at one hospital location in Aotearoa New Zealand with rotational physiotherapists. The focus groups data was coded using Nvivo and then used to generate a nation-wide survey for rotational physiotherapists using Qualtrics. Survey data was analysed using thematic analysis. 
Results: The survey respondents had low intention to leave the profession, and agreed they found themselves learning often in their roles. Seven themes were generated from the qualitative data; 1) professional support; 2) culture of well-being; 3) supported learning activities; 4) workload; 5) engaged leaders; 6) rotations which align to career aspirations; 7) culture of Aotearoa. The recommendations include: 1) senior staff need to be available to provide regular clinical support and coaching; 2) mentorship by physiotherapists working outside of the hospital environment who also have previous experience within the environment; 3) provide access to cultural supervision for staff of Māori ethnicity; 4) explore the nationwide use of clinical coaches with rotational physiotherapists as they would be additional resource that would free-up current senior staff to provide workload support to the rotational staff;  5) replication for Allied Health of the funding models that exist for ongoing learning for other health professionals ; 6) increase connectivity by senior management in the organisation as well as line managers; 7) implement forums for rotational therapist nationwide to provide opportunity for two-way communication without senior clinicians present to provide safe space for  open discussion; 8) rotation allocation processes need to include regional and cross-district placements; 9) Develop an allied health specific wellness group to promote wellbeing in the workplace with provision to implement the Good4work model within Allied Health.
Conclusion: Professional support, culture of wellbeing and supported learning activities play an important role in supporting early career physiotherapists to thrive at work. Being engaged in work that aligns with career aspirations also help rotational physiotherapist to thrive. The unique culture of Aotearoa New Zealand should be reflected in future health workforce research to embody the spirit of Te Tiriti o Waitangi.

text: The experience of thriving at work in rotational physiotherapists in Aotearoa New Zealand Aim: This thesis aims to identify what contributes to thriving at work by rotational physiotherapists employed at national public hospitals in Aotearoa New Zealand. It will do this by exploring what enables individuals to thrive at work and what organisations can do to better support their rotational therapy staff to thrive, recommendations will be created to promote thriving at work to better support the retention and recruitment of staff in both a local and national workforce. 
Background: Workforce retention and attrition is a major concern for all health professions, including physiotherapy. A workforce analysis undertaken for the New Zealand physiotherapy workforce highlights that whilst there are no issues with the supply of physiotherapists for graduate positions, the supply of experienced physiotherapists, i.e. over five years work experience, is less than demand.  This study builds on the literature using the thriving at work model in the nursing workforce. Research has highlighted the lack of a perceived career pathway as a major concern for physiotherapists and a contributing factor to the number of physiotherapists who leave the profession before the seven-year mark. Recommendations to date have emphasised consideration be given to the implications regarding the quality of leadership support and positive workplace practices on job satisfaction and turnover intention in the profession. 
Design: An exploratory sequential mixed methods design.
Method: Data were collected in 2021 via face to face focus groups at one hospital location in Aotearoa New Zealand with rotational physiotherapists. The focus groups data was coded using Nvivo and then used to generate a nation-wide survey for rotational physiotherapists using Qualtrics. Survey data was analysed using thematic analysis. 
Results: The survey respondents had low intention to leave the profession, and agreed they found themselves learning often in their roles. Seven themes were generated from the qualitative data; 1) professional support; 2) culture of well-being; 3) supported learning activities; 4) workload; 5) engaged leaders; 6) rotations which align to career aspirations; 7) culture of Aotearoa. The recommendations include: 1) senior staff need to be available to provide regular clinical support and coaching; 2) mentorship by physiotherapists working outside of the hospital environment who also have previous experience within the environment; 3) provide access to cultural supervision for staff of Māori ethnicity; 4) explore the nationwide use of clinical coaches with rotational physiotherapists as they would be additional resource that would free-up current senior staff to provide workload support to the rotational staff;  5) replication for Allied Health of the funding models that exist for ongoing learning for other health professionals ; 6) increase connectivity by senior management in the organisation as well as line managers; 7) implement forums for rotational therapist nationwide to provide opportunity for two-way communication without senior clinicians present to provide safe space for  open discussion; 8) rotation allocation processes need to include regional and cross-district placements; 9) Develop an allied health specific wellness group to promote wellbeing in the workplace with provision to implement the Good4work model within Allied Health.
Conclusion: Professional support, culture of wellbeing and supported learning activities play an important role in supporting early career physiotherapists to thrive at work. Being engaged in work that aligns with career aspirations also help rotational physiotherapist to thrive. The unique culture of Aotearoa New Zealand should be reflected in future health workforce research to embody the spirit of Te Tiriti o Waitangi.

year: 2022

title: Mycobacterium tuberculosis strains in New Zealand: phylogeny and structural biology

authors: Claire Vignette, Mulholland

subjects: tuberculosis

abstract: Mycobacterium tuberculosis is an obligate human pathogen and is the primary causative agent of tuberculosis. New Zealand has a relatively low incidence of tuberculosis disease, however, Māori (the indigenous people of New Zealand) and Pacific People are disproportionally affected. Molecular typing shows that approximately two-thirds of M. tuberculosis isolates from New Zealand-born patients can be assigned to clusters of related strains. The largest M. tuberculosis cluster in New Zealand is known as the ‘Rangipo’ cluster and is predominantly found in Māori. This strain has been the source of several tuberculosis outbreaks over the last 30 years and anecdotal evidence suggests it may be particularly virulent. Two other large clusters, known as the ‘Southern Cross’ and ‘Otara’ clusters, most commonly occur in Pacific People.
Here, whole genome sequencing, phylogenetics and structural biology were used to investigate evolutionary origins and functional consequences of genomic diversity in New Zealand M. tuberculosis clusters, with a particular focus on the Rangipo strain. Analysis of Rangipo strain non-synonymous single nucleotide polymorphisms (nsSNPs) identified bacterial genetic factors that may contribute to the high transmissibility of this strain. The F420-dependent oxidoreductase Rv2893 harbours a Rangipo-specific G72S mutation encoded by a nsSNP. H37Rv and Rangipo Rv2893 structures were solved and show the effect of this G72S mutation. Binding of the F420 cofactor was confirmed and characterised. SNP analyses also guided the optimisation of a diagnostic assay for rapid Rangipo strain classification at low cost and with high discriminatory power. Phylogenetic analyses revealed the Rangipo and Otara clusters belong to a larger M.tuberculosis clade of French/European origin that is also prevalent in indigenous populations in Canada. Molecular dating indicates dispersal of this clade to the South Pacific was driven by expanding European trade networks in the early 19th century and identifies host factors that have contributed to the dispersal and expansion of the Rangipo and Otara strains.
Overall, these results show that relatively recent changes in host ecology have likely played a crucial role in driving the success of the Rangipo strain in New Zealand and point to bacterial genetic factors that may influence its virulence and thereby also contribute to its prevalence.

text: Mycobacterium tuberculosis strains in New Zealand: phylogeny and structural biology Mycobacterium tuberculosis is an obligate human pathogen and is the primary causative agent of tuberculosis. New Zealand has a relatively low incidence of tuberculosis disease, however, Māori (the indigenous people of New Zealand) and Pacific People are disproportionally affected. Molecular typing shows that approximately two-thirds of M. tuberculosis isolates from New Zealand-born patients can be assigned to clusters of related strains. The largest M. tuberculosis cluster in New Zealand is known as the ‘Rangipo’ cluster and is predominantly found in Māori. This strain has been the source of several tuberculosis outbreaks over the last 30 years and anecdotal evidence suggests it may be particularly virulent. Two other large clusters, known as the ‘Southern Cross’ and ‘Otara’ clusters, most commonly occur in Pacific People.
Here, whole genome sequencing, phylogenetics and structural biology were used to investigate evolutionary origins and functional consequences of genomic diversity in New Zealand M. tuberculosis clusters, with a particular focus on the Rangipo strain. Analysis of Rangipo strain non-synonymous single nucleotide polymorphisms (nsSNPs) identified bacterial genetic factors that may contribute to the high transmissibility of this strain. The F420-dependent oxidoreductase Rv2893 harbours a Rangipo-specific G72S mutation encoded by a nsSNP. H37Rv and Rangipo Rv2893 structures were solved and show the effect of this G72S mutation. Binding of the F420 cofactor was confirmed and characterised. SNP analyses also guided the optimisation of a diagnostic assay for rapid Rangipo strain classification at low cost and with high discriminatory power. Phylogenetic analyses revealed the Rangipo and Otara clusters belong to a larger M.tuberculosis clade of French/European origin that is also prevalent in indigenous populations in Canada. Molecular dating indicates dispersal of this clade to the South Pacific was driven by expanding European trade networks in the early 19th century and identifies host factors that have contributed to the dispersal and expansion of the Rangipo and Otara strains.
Overall, these results show that relatively recent changes in host ecology have likely played a crucial role in driving the success of the Rangipo strain in New Zealand and point to bacterial genetic factors that may influence its virulence and thereby also contribute to its prevalence.

year: 2019