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Evolving Atrial Fibrillation (AF) Care in New Zealand (NZ): A Nurse Specialist-Led Clinic Aiming to Improve Standardisation, Equity, Cost-Effectiveness, and Lifestyle Modification in AF Management
(Elsevier, 2024-06) Hosking, A; Jameson, M; Stiles, M; Ryan, H; Joyson, P; Sugden, L; Tan, C
Aim This study assesses the efficacy of a nurse specialist-led AF clinic in a large regional centre in New Zealand. We look specifically at the standardisation of care, lifestyle management, the impact on health equity, and the cost-effectiveness of these strategies. Method A retrospective analysis of the first year of the clinic’s establishment was conducted reviewing the outcomes, attendance, and adherence to management guidelines. The clinic follows up those presenting to the Emergency Department with a primary diagnosis of AF. After discharge, appointments are available within 48–72 hours of presentation. Results Over the first year, 247 appointments were made (Median age 66, interquartile range 58–76, 48% male, 75% NZ European). 168 patients were established on a rhythm control strategy, with 20 referred for ablation, 26 receiving cardioversions, and the remainder established on anti-arrhythmic medication. Lifestyle modifications were addressed with majority of these patients. Demographic data also highlighted, a need to focus on equity with only 17.4% of appointments attended by Māori and Pacific patients, lower than would be expected given relative disease burden. Conclusion The Nurse Specialist-led AF clinic is a positive step forward in AF management in this region of NZ. This clinic brings international standards to a local stage and throws a focus on our unique healthcare needs and an emphasis on equitable delivery of care. This clinic is scalable, effective, and an inclusive approach to AF care.
Evolving atrial fibrillation (AF) care in New Zealand (NZ): a nurse specialist-led clinic aiming to improve standardisation, equity, cost-effectiveness, and lifestyle modification in AF management
(Oxford University Press (OUP), 2024-10-28) Hosking, A; Jameson, M; Stiles, M; Ryan, H; Sugden, L; Joyson, P; Tan, C
Background: Management of atrial fibrillation (AF) in NZ is challenging and variable between regions. NZ has a diverse population with Māori and Pacific ethnic groups, in particular, facing significant difficulties with access to care and inequity in treatment. The integration of nurse specialists into the care of patients with AF is increasingly recognised and discussed in AF management, including the European Society of Cardiology (ESC) guidelines. This approach also allows emphasis on managing lifestyle factors, pivotal contributing factors in disease burden Objective: This study assesses the efficacy of a nurse specialist-led AF clinic in a large regional centre in New Zealand. We look specifically at the standardisation of care, lifestyle management, the impact on health equity in managing AF, and the cost-effectiveness of these strategies. Methods: A retrospective analysis of the first year of the clinic’s establishment was conducted reviewing the outcomes, attendance, and adherence to management guidelines. The clinic is running three days per week to follow up those presenting to the Emergency Department with a primary diagnosis of AF. After discharge, appointments are available within 48-72 hours of presentation. The clinics efficacy and ability to serve wider NZ populations will also be presented alongside a recently-published, similar initiative in Christchurch, NZ. Results: Over the first year, 247 appointments were made (Median age 66, interquartile range 58-76, 48% male, 75% NZ European). 168 patients were established on a rhythm control strategy, with 20 directly referred for ablation, 26 receiving cardioversions, and the remainder established on anti-arrhythmic medication strategies. Lifestyle modifications were addressed with majority of these patients. Demographic data also highlighted once more, a need to focus on equity with only 17.4% of appointments attended by Māori and Pacific patients, lower than would be expected given population data and relative disease burden. Conclusions: The Nurse Specialist-led AF clinic shows promising outcomes and is a positive step forward in AF management in this region of NZ. Incorporating ESC guidelines with emphasis on lifestyle factors and including rhythm control strategies to good effect. This clinic brings international standards to a local stage and throws a focus on our unique healthcare needs and an emphasis on equitable delivery of care. This clinic is scalable, effective, and an inclusive approach to AF care.
Sheep models of Alzheimer's Disease
(2023-11-11) Mckean, Natasha; McMurray, Cara; Zetterberg, Henrik; Handley, Renee; Rudiger, Skye R; Mclaughlin, Clive; Bawden, Simon C; Verma, Paul J; Kelly, Jennifer M; Faull, Richard; Waldvogel, Henry; Reid, Suzanne; Pearson, John F; Hardy, John; Gusella, James F; Owen, Michael; Snell, Russell G
Navigating the places we now inhabit: Stories of migrant learning designers
(2024-12-23) Schwenger, Bettina; Nguyen, Nhung; Carvalho, Lucila; Cochrane, T; Narayan, V; Bone, E
Learning design involves creating educational opportunities that are engaging and effective. In many countries, this process must attune to indigenous ways of being and knowing. In the context of Aotearoa New Zealand, the learning design process requires the ability to create culturally inclusive learning opportunities that are respectful of Māori culture, but also beneficial to all learners - a process that calls for deeper reflection and understanding of tikanga Māori (Māori customs and practices). This paper highlights the experiences of migrant learning designers and teachers in Aotearoa New Zealand, who work at the intersection of Māori knowledge and Western educational practices. As non-indigenous immigrants, learning designers, teachers, and educational researchers, the authors drew on autoethnography as the methodology, to analyse and reflect on their role as allies of Māori, the indigenous people of Aotearoa New Zealand. This research aims to find and share ways of reconciling principles of learning design with different ways of knowing, whilst honouring the Māori culture. The paper contributes to wider debates in education that discuss how indigenous knowledge systems can enrich modern educational practices.
Spatial patterns of heat exposure and child hospital admissions in Aotearoa New Zealand
(Environmental Health Perspectives, 2024-08-15) Lai, Hakkan; Lee, Jeong Eun; Hales, Simon; Health Research Council Grant Project Team
BACKGROUND AND AIM: The influence of global climate change on temperature-related health outcomes, particularly among vulnerable populations, has been widely acknowledged. The spatial dimensions of these effects, related to population sensitivity by socio-demographic and environmental factors, remain underexplored. METHOD: We analysed data from 686,900 children under five years old, admitted to public hospitals between 2000 and 2019. We investigated associations between daily maximum temperatures (-6 to 40°C) and counts of child admissions, stratified by 2185 statistical areas, day-of-week and month of the year. We modelled temperature effect with a fixed effects quasi-Poisson distributed lag model with lag window of 0–21 days. Long term trends were modelled with a cubic spline of year with 2 degrees of freedom. We examined the modifying impact of socio-economic deprivation, housing factors, and ethnicities on the temperature-morbidity association. RESULTS: Preliminary findings suggest a non-linear exposure-response relationship. Significant elevations in relative risks (RR) were observed for temperatures below and above the 23°C threshold, with RRs ranging from 1.014 [95%CI: 1.011-1.017] to 1.423 [1.362-1.487] at lower temperatures and 1.004 [1.001-1.007] to 9.551 [7.393-12.340] at higher temperatures. Although the overall pattern of the exposure-response curve was consistent across different levels of deprivation and housing factors, there were significant disparities in RR below the reference temperature, with higher RR observed in more deprived areas compared to less deprived areas, and in areas with fewer homeowners compared to areas with more homeowners. Additionally, ethnic disparities in RR were evident above the reference temperature, with higher RR observed among Pacific Island, Asian and Māori children compared to European children. CONCLUSIONS: The findings suggest that child morbidity in Aotearoa New Zealand is highly sensitive to elevated temperatures. Further analyses are exploring the impact of interactions between urban heat islands and additional factors, with the goal of mapping the population attributable fractions under present and future climate conditions.
Unlocking The Potential of Pre-Eclampsia Self-Management System: Analysing Benefits, Challenges and Gaps
(2025-01-06) Chung, Claris; Sreeprakash, Ashitha
Pre-eclampsia is a severe hypertension condition that complicates approximately up to 10% of pregnancies. Timely diagnosis and treatment are essential since this condition poses serious threats to the health of the mother and fetus. Selfmanagement of blood pressure (SMBP) has become a viable approach to improving health outcomes and early diagnosis. Through a systematic literature review using PRISMA and applying the Technology Acceptance Model (TAM) as a lens, this research identifies key functionalities for developing Preeclampsia Self-Management Systems. Patients and health providers experienced improved patientprovider communication, real-time alerts, and integration with electronic health records as beneficial functionalities. However, they also expressed challenges such as financial barriers, technical literacy, and data privacy concerns. The results show the need for specialized functions to manage pre-eclampsia and emphasize the importance of considering the specific needs of patients and providers.
Numerical simulation of two large spheres moving in vertical turbulent pipe flow
(2024-12-02) Sun, Deping; MacDonald, Michael; Liu, Haixiao
This study investigates the dynamics of two large spheres in a vertical turbulent pipe flow using Reynolds-Averaged Navier–Stokes (RANS) simulations. We focus on axial, radial, and tangential velocities and the effects of initial separation distances between the spheres. The simulation domain features a 13-meter-long pipe with a 200 mm diameter. The model's validation against experimental data shows an average systematic error of 6.6%. The results reveal that the initial distance between two spheres has a minimal impact on their axial velocities but significantly affects radial velocities, particularly for smaller separations. The spheres reach terminal velocities similar to a single sphere, although interactions between the two spheres lead to increased energy dissipation, resulting in lower velocities. The study also shows that in upward turbulent flow, the axial distance between spheres generally increases over time, with higher mean fluid velocities leading to faster separation due to more pronounced wake effects. The typical "drafting, kissing, and tumbling" (DKT) behaviour is not observed, as the bottom sphere can act as a "windbreak", reducing the direct influence of the wake from the upper one. Radial velocities exhibit significant initial fluctuations due to strong interactions, which dissipate quickly at higher mean velocities. Tangential movements appear to be minimal.
Experimental Investigation on the Near-ground Flow Structure of Buoyancy Induced Vortices
(2024-12-02) Wang, Dominic; Hawkes, NA; MacDonald, Michael; Cater, John E; Flay, Richard GJ
This research focuses on the lower near-ground flow structure of buoyancy-induced vortices at laboratory scale for various swirl vane angles. The time-averaged velocity components are measured from both horizontal cross-sections and vertical planes above the ground plane using Particle Image Velocimetry (PIV) for one-cell, one to two-cell transition, and two-cell type vortices. The vortex wandering effect and a force balance analysis are also carried out based on the timeaveraged Navier-Stokes equations for different types of vortex structures. The results show that centripetal acceleration and radial pressure gradient are the primary contributors to the force balance near the ground. The results also reveal that vortices developed with 45° vane angle have the minimum wandering, corresponding to the minimum unsteady forces in both the radial and vertical directions.
Direct Numerical Simulation of Turbulent Radiation Fog
(2024-12-02) Liu, Deng; Cater, John; Dunker, Christina; MacDonald, Michael
This study investigates the interplay between turbulent and radiative effects in fog formation using Direct Numerical Simulation (DNS). The simulation is conducted in an open channel with a fixed total amount of cooling at a friction Reynolds Number of Re∗ = 590. Three cases are compared: GC, which only has a constant ground cooling, and GCR, which also incorporates radiative cooling effects with varying absorption coefficients of 100,000 and 600,000. The results reveal that turbulence promotes early fog growth by enhancing water vapour aggregation, while higher radiative absorption by fog results in more uniform liquid water potential temperature distributions. Both turbulence and radiation contribute to increased liquid water accumulation, revealing complex interactions in fog dynamics and offering insights into fog formation under different conditions.
Inner-layer turbulence of a vertical buoyancy layer
(2024-12-01) Maryada, KR; Armfield, SW; MacDonald, M; Dhopade, P; Norris, Stuart
Policing the polycrisis: Liberal democratic state terror and other contradictions
(2024-11-12) Rakete, Emmy
The pleasant daydream of capitalist social democracy has now ended, taking with it the possibility of a negotiated class detente. Capitalism has spent the last 50 years repeatedly colliding with external limits, which it has had to convert into merely internal barriers to avert terminal crisis. The stagflation crisis, the global financial crisis, and the crisis of social reproduction are just a few of the potential apocalypses warded off by the ruling class. This process of deferral has saved capitalism’s skin so far, but only by introducing new internal contradictions into capitalism that it must again defer, resolve, or be killed by. For the duration of the neoliberal period, the bourgeoisie has increasingly relied upon the repressive state apparatus to manage these contradictions. Cops, courts, and cages provide the capitalist state with both the directly repressive violence and the indirectly ideological violence that it depends upon for its continued existence. The qualitative transformation of the prison systems of social democracy into the mass incarceration of neoliberalism is one index by which we can register the increasing illiberalism of liberalism. Capitalism must both immiserate on a massive scale and imprison anyone who behaves miserably. Activists and organisers who threaten this intolerable system, like the student Palestine solidarity encampments, are met with police terror. Far from banishing crisis, this dependence upon the ‘justice’ system to incapacitate opposition constitutes a new potentially fatal internal contradiction. Capitalism can live now only so long as it continues to incarcerate, and by so doing it creates an enormous wasteful, futile, loathsome prison regime that teeters constantly on the brink of collapse and on which its whole legitimacy is now staked. The struggle against mass incarceration should be an immediate tactical priority for the communist movement.
Is assessment for learning really assessment?
(2024-11-30) Brown, Gavin
Test Item Analysis: Removing bad items before score estimation
(2024-11-26) Brown, Gavin
Analysis of test questions before score creation is a key psychometric process to ensure that the score best estimates a person’s ability. Classical test theory (CTT) creates test scores based on the block of items in a test. CTT usually removes items with too high or too low difficulty and removes items with zero or negative discrimination to create total scores. Item response theory (IRT) estimates item characteristics on a latent ability scale independent of which combination of items are in a test. IRT estimates item difficulty, item discrimination, so poorly performing items can be removed. There are three main IRT models, so the differences between the Rasch, 2PL, and 3PL models will be discussed. This workshop demonstrates how to obtain CTT and IRT values for any dichotomously score test containing MCQ or short answer questions. We will also look at using the AIC index to evaluate which model best fits the data. The workshop uses the free software R and the free RStudio interface. You will need your own device with R and R Studio. Please install the following packages before the workshop (psych, ltm, mirt).
Teacher assessment literacy in digital environments
(2024-10-17) Brown, Gavin
Teacher assessment literacy in practice
(2024-10-09) Brown, Gavin
STSPL-SSC: Semi-Supervised Few-Shot Short Text Clustering with Semantic text similarity Optimized Pseudo-Labels
(Association for Computational Linguistics, 2024) Nie, Wenhua; Deng, Lin; Liu, Chang-Bo; JialingWei, JialingWei; Han, Ruitong; Zheng, Haoran
This study introduces the Semantic Textual Similarity Pseudo-Label Semi-Supervised Clustering (STSPL-SSC) framework. The STSPL-SSC framework is designed to tackle the prevalent issue of scarce labeled data by combining a Semantic Textual Similarity Pseudo-Label Generation process with a Robust Contrastive Learning module. The process begins with employing k-means clustering on embeddings for initial pseudo-Label allocation. Then we use a Semantic Text Similarity-enhanced module to supervise the secondary clustering of pseudo-labels using labeled data to better align with the real clustering centers. Subsequently, an Adaptive Optimal Transport (AOT) approach fine-tunes the pseudo-labels. Finally, a Robust Contrastive Learning module is employed to foster the learning of classification and instance-level distinctions, aiding clusters to better separate. Experiments conducted on multiple real-world datasets demonstrate that with just one label per class, clustering performance can be significantly improved, outperforming state-of-the-art models with an increase of 1-6% in both accuracy and normalized mutual information, approaching the results of fully-labeled classification.
Investigating Ethical Learning Approaches in Higher Education Students
(2024-11-04) Henning, Marcus
This presentation reviews 11 journal articles, co-written by the presenter, on students’ self-reported ethical learning practices in Africa, Asia, and New Zealand. Using self-report questionnaires, ethical dilemma assessments, and qualitative commentaries, the studies identified five key areas: rationale for engagement, incidence and typologies, acceptability, consequences, and strategies. The implications of these findings will be discussed.
Lake microbial communities are not resistant or resilient to repeated large-scale natural pulse disturbances
(Copernicus Publications, 2021-03-04) Brasell, Katie; Howarth, Jamie; Pearman, John; Fitzsimons, Sean; Pochon, Xavier; Zaiko, Anastasija; Simon, Kevin; Vandergoes, Marcus; Wood, Susanna
Opportunities to study and understand community level responses to extreme natural pulse disturbances in unaltered ecosystems are rare. Lake sediment records that span thousands of years can contain well resolved sediment pulses, triggered by earthquakes. These paleo-records provide a means to study repeated pulse disturbance and the processes of resistance (insensitivity to disturbance) and ecological resilience (capacity to regain structure, function and process). In this study, DNA preserved in lake sediment layers was extracted from a sediment core from a lake in a near-natural catchment. Metabarcoding and inferred functions were used to assess the lake microbial community over the past 1,100 years – a period that included four major earthquakes. Microbial community composition and function differed significantly between highly perturbed (postseismic, c. 50 yrs) phases directly after the earthquakes and more stable (interseismic, c. 260 yr) phases, indicating a lack of community resistance to natural pulse disturbances. A decoupling between community structure and function in successive postseismic phases suggest potential functional redundancy in the community. Significant differences in composition and function in successive interseismic phases demonstrates the communities are not resilient to large scale natural pulse disturbances. The clear difference in structure and function, and high number of indicator taxa in the fourth interseismic phase likely represents a regime shift, possibly due to the two-fold increase in sediment and terrestrial biospheric organic carbon fluxes recorded following the fourth earthquake. Large pulse disturbances that enhance sediment inputs into lake systems may produce an underappreciated mechanism that destabilises lake ecosystem processes.
Developing a hybrid-built pre-hardened alloy steel for injection moulding tools using the laser powder bed fusion process
(Elsevier, 2024-10) Chan, Yuk Lun Simon; Xu, Xun; Diegel, Olaf
Hybrid additive-subtractive manufacturing has been adopted as a cost-effective alternative for manufacturing plastic injection moulding tools with conformal-cooled inserts created by fusing powder and wrought material. This article reports the development of a hybrid power-wrought pre-hardened alloy steel to supplement the current material choice for fabricating injection mould inserts using this advanced manufacturing strategy. In this study, MS1 (maraging 300) steel powder was additively deposited onto pre-machined wrought Nimax steel to form a hybrid alloy material. The mechanical and microstructural properties of the fusion-bonded interface were examined. Microstructural observation revealed a 280 μm thick interfacial region consisting of a homogenous mixing of powder and substrate materials. As a result of solid solution strengthening within the region, tensile tests established robust powder-substrate bonding with tensile ruptures occurring well away from the interface. The as-built hybrid-alloy steel possessed excellent mechanical properties, with 1200 MPa in ultimate tensile strength, 12.4 % in elongation at fracture and 39 HRC (Nimax)/42 HRC (MS1) in hardness. The overall results suggested that hybrid MS1-wrought Nimax steel is a suitable pre-hardened material for manufacturing durable and high-performance injection mould inserts as part of a cost-effective hybrid additive-subtractive manufacturing strategy.
Atmospheric turbulence as seen by a moving object
(2024-09-04) Richards, Peter; Kay, Nicholas; Norris, Stuart

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