title: Developing a recovery ethos for psychiatric  services in New Zealand

authors: Smith, Mark Andrew

subjects: Philosophy

abstract: This thesis is about developing a recovery ethos for psychiatric services in New Zealand. The argument of the thesis is that  currently a procedural ethos is dominant in psychiatric services in New Zealand, based on eclectic ways of facilitating recovery. Recovery from mental illness, is based on the criteria of symptom reduction and functioning and can be further refined to   have a client and professional perspective. Rather than using an eclectic approach to facilitating recovery the thesis argues for a pluralistic approach, where the virtues, the relationship with professionals, client narrative and the psychiatric community become central to decision making, rather than principle based procedures.
  The thesis is an argued, applied philosophical thesis in terms of methodology. The scope of the thesis is psychiatric services and the focus is broadly ethical decision making. There are three main divisions to the thesis. Part 1 is concerned with clarification of the main terms used in the thesis. This involves exploring the  historical background to the concept of recovery, clarifying the concept of recovery itself and providing an argument for giving greater prominence to the term mental illness over the term mental disorder. Part 2  identifies the main problem of the thesis, namely the procedural ethos, and the problems it is causing clients suffering from mental illness in facilitating their recovery. Part 3  shows what is involved in developing a recovery ethos for psychiatric services in New Zealand.

text: Developing a recovery ethos for psychiatric  services in New Zealand This thesis is about developing a recovery ethos for psychiatric services in New Zealand. The argument of the thesis is that  currently a procedural ethos is dominant in psychiatric services in New Zealand, based on eclectic ways of facilitating recovery. Recovery from mental illness, is based on the criteria of symptom reduction and functioning and can be further refined to   have a client and professional perspective. Rather than using an eclectic approach to facilitating recovery the thesis argues for a pluralistic approach, where the virtues, the relationship with professionals, client narrative and the psychiatric community become central to decision making, rather than principle based procedures.
  The thesis is an argued, applied philosophical thesis in terms of methodology. The scope of the thesis is psychiatric services and the focus is broadly ethical decision making. There are three main divisions to the thesis. Part 1 is concerned with clarification of the main terms used in the thesis. This involves exploring the  historical background to the concept of recovery, clarifying the concept of recovery itself and providing an argument for giving greater prominence to the term mental illness over the term mental disorder. Part 2  identifies the main problem of the thesis, namely the procedural ethos, and the problems it is causing clients suffering from mental illness in facilitating their recovery. Part 3  shows what is involved in developing a recovery ethos for psychiatric services in New Zealand.

year: 2007

title: Development of novel approaches for industrial fermentation of menaquinone-7

authors: Ranmadugala, Dinali Niluka Achala

subjects: Menaquinone-7

abstract: Vitamin K, an anti-haemorrhagic factor discovered by the Danish nutritional biochemist Henrik Carl Peter Dam in 1929, is capable of correcting dietary-induced bleeding disorders in chickens. It is essential for blood coagulation, and therefore must be supplied in the diet. Menaquinones (MK) together with phylloquinone (PK) fall under the common name ‘vitamin K’. Recent studies show that dietary intake of menaquinones results in more health benefits than phylloquinone. Menaquinone-7 (MK-7) plays an important role in maintaining human health in the liver, bone and arterial vessels with potential to prevent osteoporosis and cardiovascular diseases as well as cancer. Therefore, MK-7 can be taken as the obvious choice for the prevention of these health complications.
MK-7 is produced industrially by a fermentation process of Bacillus subtilis at low concentrations. To date, there have been several attempts to improve MK-7 yield via optimising the fermentation media, genetic mutation of Bacillus subtilis and reducing downstream processing steps. Despite this progress, industrial production of MK-7 has been difficult, mainly due to biofilm formation, low MK-7 production by Bacillus subtilis and the presence of so many tedious unit operations in the process. As a result, the price of MK-7 is currently US$5 million/kg. It appears worthwhile to develop novel strategies to address the current MK-7 production challenges. The main goal of the current research was, therefore, to develop a novel cost-effective fermentation process by eliminating biofilm formation while enhancing MK-7 production and reducing the fermentation process steps.
In combating biofilm formation in Bacillus subtilis fermentation, a major challenge was to adopt strategies which would maintain the viability of the bacterial cells as required by the fermentation process. In this regard, as a first step, a nanobiotechnological approach was taken in which superparamagnetic iron oxide nanoparticles (Fe3O4) were used to decorate Bacillus subtilis cells. In comparison to naked iron oxide nanoparticles, iron oxide nanoparticles coated with 3-aminopropyltriethoxysilane (IONs@APTES) significantly reduced the adherence and pellicle biofilm biomass of Bacillus subtilis in a concentration-dependent manner without affecting the growth and viability of Bacillus subtilis. Further, the research embodied in this thesis also addresses the low MK-7 production by immobilising Bacillus subtilis cells using IONs@APTES. Immobilisation of Bacillus subtilis cells with IONs@APTES significantly enhanced the MK-7 production, implying that binding of IONs@APTES to Bacillus subtilis cells might have changed the state or composition of the cell membranes resulting in enhanced production and secretion of MK-7 to the fermentation medium. In addition to a strategy that minimised bacterial cell attachment and subsequent biofilm formation, the effect of a biofilm detachment strategy was also investigated. As nutrient conditions in the medium can greatly influence biofilm detachment, nutrient components which would interfere with the structural integrity of biofilms and bring about biofilm detachment were investigated by supplementing the medium with salts and urea. In this study the optimum conditions to minimise biofilm formation while maximising MK-7 production was determined by response surface optimisation. These investigations finally led to an optimum fermentation medium for minimum biofilm formation and maximum MK-7 production which consists of 5% (w/v) yeast extract, 18.9% (w/v) soy peptone, 5% (w/v) glycerol, 0.05% (w/v) K₂HPO₄, 0.32% (w/v) CaCl₂, 0.10% (w/v) urea and 200 µg/mL IONs@APTES. A ~ 47% reduction in biofilm biomass and ~ 16% increase in MK-7 production was observed after 60 hours of fermentation when the medium was supplemented with 0.32% (w/v) CaCl₂, 0.10% (w/v) urea and 200 µg/mL IONs@APTES in comparison to the medium without added CaCl₂, urea and IONs@APTES. This was found  useful as a non-antibiotic antifouling strategy which would permit the growth and viability of bacterial cells in the fermentation process while minimising biofilm formation and maximising MK-7 production. Using this medium, the feasibility of designing a milking process for enhancing MK-7 productivity was assessed. Initial studies involved selecting biocompatible organic solvent/s for milking MK-7. Milking MK-7 with n-hexane proved to be an effective strategy to enhance the total MK-7 production by ~ 1.7-fold in subtilis fermentation without compromising the bacterial cell viability in comparison to non-milking conditions. Not only did the total MK-7 increase by ~ 1.7-fold, but the maximum total MK-7 production also reached earlier i.e. within 72 hoursin comparison to previously recorded liquid state fermentation studies for MK-7 production, which is important from a commercial point of view. In addition, a novel, accurate, reliable and high throughput MK-7 analysis protocol is also presented in the thesis. Hence, by examining and integrating a range of strategies, this thesis provides a feasible approach for industrial production and analysis of MK-7.

text: Development of novel approaches for industrial fermentation of menaquinone-7 Vitamin K, an anti-haemorrhagic factor discovered by the Danish nutritional biochemist Henrik Carl Peter Dam in 1929, is capable of correcting dietary-induced bleeding disorders in chickens. It is essential for blood coagulation, and therefore must be supplied in the diet. Menaquinones (MK) together with phylloquinone (PK) fall under the common name ‘vitamin K’. Recent studies show that dietary intake of menaquinones results in more health benefits than phylloquinone. Menaquinone-7 (MK-7) plays an important role in maintaining human health in the liver, bone and arterial vessels with potential to prevent osteoporosis and cardiovascular diseases as well as cancer. Therefore, MK-7 can be taken as the obvious choice for the prevention of these health complications.
MK-7 is produced industrially by a fermentation process of Bacillus subtilis at low concentrations. To date, there have been several attempts to improve MK-7 yield via optimising the fermentation media, genetic mutation of Bacillus subtilis and reducing downstream processing steps. Despite this progress, industrial production of MK-7 has been difficult, mainly due to biofilm formation, low MK-7 production by Bacillus subtilis and the presence of so many tedious unit operations in the process. As a result, the price of MK-7 is currently US$5 million/kg. It appears worthwhile to develop novel strategies to address the current MK-7 production challenges. The main goal of the current research was, therefore, to develop a novel cost-effective fermentation process by eliminating biofilm formation while enhancing MK-7 production and reducing the fermentation process steps.
In combating biofilm formation in Bacillus subtilis fermentation, a major challenge was to adopt strategies which would maintain the viability of the bacterial cells as required by the fermentation process. In this regard, as a first step, a nanobiotechnological approach was taken in which superparamagnetic iron oxide nanoparticles (Fe3O4) were used to decorate Bacillus subtilis cells. In comparison to naked iron oxide nanoparticles, iron oxide nanoparticles coated with 3-aminopropyltriethoxysilane (IONs@APTES) significantly reduced the adherence and pellicle biofilm biomass of Bacillus subtilis in a concentration-dependent manner without affecting the growth and viability of Bacillus subtilis. Further, the research embodied in this thesis also addresses the low MK-7 production by immobilising Bacillus subtilis cells using IONs@APTES. Immobilisation of Bacillus subtilis cells with IONs@APTES significantly enhanced the MK-7 production, implying that binding of IONs@APTES to Bacillus subtilis cells might have changed the state or composition of the cell membranes resulting in enhanced production and secretion of MK-7 to the fermentation medium. In addition to a strategy that minimised bacterial cell attachment and subsequent biofilm formation, the effect of a biofilm detachment strategy was also investigated. As nutrient conditions in the medium can greatly influence biofilm detachment, nutrient components which would interfere with the structural integrity of biofilms and bring about biofilm detachment were investigated by supplementing the medium with salts and urea. In this study the optimum conditions to minimise biofilm formation while maximising MK-7 production was determined by response surface optimisation. These investigations finally led to an optimum fermentation medium for minimum biofilm formation and maximum MK-7 production which consists of 5% (w/v) yeast extract, 18.9% (w/v) soy peptone, 5% (w/v) glycerol, 0.05% (w/v) K₂HPO₄, 0.32% (w/v) CaCl₂, 0.10% (w/v) urea and 200 µg/mL IONs@APTES. A ~ 47% reduction in biofilm biomass and ~ 16% increase in MK-7 production was observed after 60 hours of fermentation when the medium was supplemented with 0.32% (w/v) CaCl₂, 0.10% (w/v) urea and 200 µg/mL IONs@APTES in comparison to the medium without added CaCl₂, urea and IONs@APTES. This was found  useful as a non-antibiotic antifouling strategy which would permit the growth and viability of bacterial cells in the fermentation process while minimising biofilm formation and maximising MK-7 production. Using this medium, the feasibility of designing a milking process for enhancing MK-7 productivity was assessed. Initial studies involved selecting biocompatible organic solvent/s for milking MK-7. Milking MK-7 with n-hexane proved to be an effective strategy to enhance the total MK-7 production by ~ 1.7-fold in subtilis fermentation without compromising the bacterial cell viability in comparison to non-milking conditions. Not only did the total MK-7 increase by ~ 1.7-fold, but the maximum total MK-7 production also reached earlier i.e. within 72 hoursin comparison to previously recorded liquid state fermentation studies for MK-7 production, which is important from a commercial point of view. In addition, a novel, accurate, reliable and high throughput MK-7 analysis protocol is also presented in the thesis. Hence, by examining and integrating a range of strategies, this thesis provides a feasible approach for industrial production and analysis of MK-7.

year: 2018

title: Māori child rearing and infant sleep practices

authors: Jones, Horiana Majorie

abstract: Sleep is important to a healthy lifestyle for parents and children, and having effective ways of putting a child to sleep contributes significantly to mental and physical wellbeing. Cultural groups around the world have developed a variety of approaches to this task, for example, rocking, co-sleeping, bed-sharing, breastfeeding to sleep, and encouraging infants to self soothe through various methods of infant sleep training. In New Zealand the continuation of traditional Māori approaches to infant sleep, e.g. co-sleeping, bed-sharing, responsivity to infant cues have been over-shadowed by its negative association with sudden infant death syndrome (SIDS) and dependence on parent interaction when initiating infant sleep. In this study, we were interested in the approaches Māori parents used to put their pēpi (child, 2 months-2 years of age) to sleep and the various factors that have influenced these approaches. Data were collected through online surveys (n =58) and face-to-face interviews (n =10) with Māori parents. Survey results indicated that being held and breast or bottle fed to sleep were the most practiced techniques by Māori parents. Parent assisted approaches, e.g., rocking, feeding, lying with baby until they go to sleep, were the most practiced. Many parents planned for their babies to sleep separately but very few actually persisted with self-soothing approaches due to a number of factors, such as discomfort with listening to their babies cry, culture, whānau (extended families) influences safety, and convenience. The majority of participants expressed a desire for separate sleep; however, few within the interview group actually successfully practiced separate sleep regularly.

text: Māori child rearing and infant sleep practices Sleep is important to a healthy lifestyle for parents and children, and having effective ways of putting a child to sleep contributes significantly to mental and physical wellbeing. Cultural groups around the world have developed a variety of approaches to this task, for example, rocking, co-sleeping, bed-sharing, breastfeeding to sleep, and encouraging infants to self soothe through various methods of infant sleep training. In New Zealand the continuation of traditional Māori approaches to infant sleep, e.g. co-sleeping, bed-sharing, responsivity to infant cues have been over-shadowed by its negative association with sudden infant death syndrome (SIDS) and dependence on parent interaction when initiating infant sleep. In this study, we were interested in the approaches Māori parents used to put their pēpi (child, 2 months-2 years of age) to sleep and the various factors that have influenced these approaches. Data were collected through online surveys (n =58) and face-to-face interviews (n =10) with Māori parents. Survey results indicated that being held and breast or bottle fed to sleep were the most practiced techniques by Māori parents. Parent assisted approaches, e.g., rocking, feeding, lying with baby until they go to sleep, were the most practiced. Many parents planned for their babies to sleep separately but very few actually persisted with self-soothing approaches due to a number of factors, such as discomfort with listening to their babies cry, culture, whānau (extended families) influences safety, and convenience. The majority of participants expressed a desire for separate sleep; however, few within the interview group actually successfully practiced separate sleep regularly.

year: 2017