title: Performance of a fast-track pathway for giant cell arteritis in Waikato, Aotearoa New Zealand

authors: van Dantzig, Philippa

subjects: Data analytics

abstract: Giant cell arteritis (GCA) is the most common primary vasculitis in adults over 50 years of age. To facilitate early diagnosis and reduce harms from corticosteroids and temporal artery biopsies, fast-track pathways have been established. We review the benefits of the fast-track pathway set up in Waikato, Aotearoa New Zealand.  methods: Patients were collected prospectively as part of the fast-track pathway from 2014 to 2022. Their records were then reviewed retrospectively to collect data on clinical features, investigations and treatment.  results: There were 648 individual patients over the study period who had a colour Doppler ultrasound (CDUS) of the temporal arteries. There were 17 true positive CDUS, giving a sensitivity of 10.3% (95% confidence interval [CI] 6.3–15.5%) and specificity of 99.8% (95% CI 99.1–100%). Patients with GCA and a positive scan had significantly fewer steroids than those with GCA and a negative scan (p=0.0037). There were 376 patients discharged after a CDUS who did not have a diagnosis of GCA, resulting in reduced corticosteroid and temporal artery biopsy exposure.  conclusions: This is a real-life study that reflects the benefits of fast-track pathways in Aotearoa New Zealand to patients and healthcare systems. It also shows the effect of corticosteroids on positive CDUS, an important consideration when setting up an fast-track pathway.

text: Performance of a fast-track pathway for giant cell arteritis in Waikato, Aotearoa New Zealand Giant cell arteritis (GCA) is the most common primary vasculitis in adults over 50 years of age. To facilitate early diagnosis and reduce harms from corticosteroids and temporal artery biopsies, fast-track pathways have been established. We review the benefits of the fast-track pathway set up in Waikato, Aotearoa New Zealand.  methods: Patients were collected prospectively as part of the fast-track pathway from 2014 to 2022. Their records were then reviewed retrospectively to collect data on clinical features, investigations and treatment.  results: There were 648 individual patients over the study period who had a colour Doppler ultrasound (CDUS) of the temporal arteries. There were 17 true positive CDUS, giving a sensitivity of 10.3% (95% confidence interval [CI] 6.3–15.5%) and specificity of 99.8% (95% CI 99.1–100%). Patients with GCA and a positive scan had significantly fewer steroids than those with GCA and a negative scan (p=0.0037). There were 376 patients discharged after a CDUS who did not have a diagnosis of GCA, resulting in reduced corticosteroid and temporal artery biopsy exposure.  conclusions: This is a real-life study that reflects the benefits of fast-track pathways in Aotearoa New Zealand to patients and healthcare systems. It also shows the effect of corticosteroids on positive CDUS, an important consideration when setting up an fast-track pathway.

year: 2024-03-22

title: Analytical solutions of fractional diffusion-advection equation for solar cosmic-ray transport

authors: Litvinenko, Yuri E.

abstract: Motivated by recent applications of superdiffusive transport models to shock-accelerated particle distributions in the heliosphere, we analytically solve a one-dimensional fractional diffusion-advection equation for the particle density. We derive an exact Fourier transform solution, simplify it in a weak diffusion approximation, and compare the new solution with previously available analytical results and with a semi-numerical solution based on a Fourier series expansion. We apply the results to the problem of describing the transport of energetic particles, accelerated at a traveling heliospheric shock. Our analysis shows that significant errors may result from assuming an infinite initial distance between the shock and the observer. We argue that the shock travel time should be a parameter of a realistic superdiffusive transport model.

text: Analytical solutions of fractional diffusion-advection equation for solar cosmic-ray transport Motivated by recent applications of superdiffusive transport models to shock-accelerated particle distributions in the heliosphere, we analytically solve a one-dimensional fractional diffusion-advection equation for the particle density. We derive an exact Fourier transform solution, simplify it in a weak diffusion approximation, and compare the new solution with previously available analytical results and with a semi-numerical solution based on a Fourier series expansion. We apply the results to the problem of describing the transport of energetic particles, accelerated at a traveling heliospheric shock. Our analysis shows that significant errors may result from assuming an infinite initial distance between the shock and the observer. We argue that the shock travel time should be a parameter of a realistic superdiffusive transport model.

year: 2014

title: Just take a second to breathe: Empowering youth through mindfulness at Atawhai 2019

authors: McAllister, Suzanne Maree

subjects: Mindfulness

abstract: This research was an evaluation of The Kindness Institute’s 2019 Atawhai programme. It examined the effects that exposure to mindfulness-based skills, Māori cultural practices, mentoring, and the creative arts had on a cohort of marginalised youth. Specifically, the research aimed to determine (1) if learning mindfulness-based skills helped the youth to positively deal with challenges, (2) what effect learning mindfulness-based skills has on their positive and negative emotions and (3) were youth empowered to share the skills they learned within their homes, families and communities to enable a wider benefit from the mindfulness-based skills. Participants included 12 youth who attended the Atawhai programme during 2019. They all completed shortened versions of the Five Facet Mindfulness Questionnaire (FFMQ), Adolescent Self-Regulatory Inventory (ASRI), The Oxford Happiness Questionnaire (OHQ), Revised Children’s Anxiety and Depression Scale (RCADS) and Self-Compassion Scale (SCS) at seven stages over a nine-month period from March 2019 to December 2019. Self-report debrief questionnaires and researcher observations were recorded during the October 2019 residential intensive of 5 days. Inferential statistics (repeated measures ANOVA and post-hoc paired t-tests) indicated a statistically significant increase in positive emotions (p<0.01) with a large effect 1.07 over the duration of the evaluation period from March 2019 to December 2019; the October 2019 intensive, p<0.01, d=1.37; and the April 2019 intensive, p<0.01, d=1.89. Statistically significant decreases in anxiety (p<0.01) with a large effect d=1.99 were indicated over the duration of the evaluation period from March 2019 to December 2019; the October 2019 intensive, p=0.07, d=0.57; and the April 2019 intensive, p≤0.01, d=1.19. Self-report measures indicated the youth; found the mindfulness-based skills beneficial, preferred a particular skill over others, and found their mentors supportive in helping them incorporate the skills into their daily lives. Youth reported they had continued their mindfulness-based practice outside Atawhai and were regularly sharing the skills within their homes, families and communities including their schools. These findings suggest the Atawhai programme has a profound and significant positive effect on the wellbeing of the young people it serves.

text: Just take a second to breathe: Empowering youth through mindfulness at Atawhai 2019 This research was an evaluation of The Kindness Institute’s 2019 Atawhai programme. It examined the effects that exposure to mindfulness-based skills, Māori cultural practices, mentoring, and the creative arts had on a cohort of marginalised youth. Specifically, the research aimed to determine (1) if learning mindfulness-based skills helped the youth to positively deal with challenges, (2) what effect learning mindfulness-based skills has on their positive and negative emotions and (3) were youth empowered to share the skills they learned within their homes, families and communities to enable a wider benefit from the mindfulness-based skills. Participants included 12 youth who attended the Atawhai programme during 2019. They all completed shortened versions of the Five Facet Mindfulness Questionnaire (FFMQ), Adolescent Self-Regulatory Inventory (ASRI), The Oxford Happiness Questionnaire (OHQ), Revised Children’s Anxiety and Depression Scale (RCADS) and Self-Compassion Scale (SCS) at seven stages over a nine-month period from March 2019 to December 2019. Self-report debrief questionnaires and researcher observations were recorded during the October 2019 residential intensive of 5 days. Inferential statistics (repeated measures ANOVA and post-hoc paired t-tests) indicated a statistically significant increase in positive emotions (p<0.01) with a large effect 1.07 over the duration of the evaluation period from March 2019 to December 2019; the October 2019 intensive, p<0.01, d=1.37; and the April 2019 intensive, p<0.01, d=1.89. Statistically significant decreases in anxiety (p<0.01) with a large effect d=1.99 were indicated over the duration of the evaluation period from March 2019 to December 2019; the October 2019 intensive, p=0.07, d=0.57; and the April 2019 intensive, p≤0.01, d=1.19. Self-report measures indicated the youth; found the mindfulness-based skills beneficial, preferred a particular skill over others, and found their mentors supportive in helping them incorporate the skills into their daily lives. Youth reported they had continued their mindfulness-based practice outside Atawhai and were regularly sharing the skills within their homes, families and communities including their schools. These findings suggest the Atawhai programme has a profound and significant positive effect on the wellbeing of the young people it serves.

year: 2020