Quantifying Water Exchange Across the Blood-Brain Barrier Using Magnetic Resonance Imaging With Multi-Echo Arterial Spin Labelling

Cerebral capillaries are unique in their ability to restrict the exchange of substances between blood and tissue. This blood-brain barrier (BBB) prevents neurotoxic substances entering the brain. BBB dysfunction may play a role in a range of neurodegenerative diseases, and non-invasive means of assessing BBB function in vivo are sought. Multi-echo arterial spin labelling (ME-ASL) is a magnetic resonance imaging (MRI) technique designed to track the progress of water through the vasculature and tissue. A ME-ASL protocol was used to acquire images of cerebral water transport in participants with mild cognitive impairment (MCI), early Alzheimer’s disease (AD) and cognitively normal controls of a similar age. The aims of this thesis were to optimise the computation of water exchange rate (kw), and then apply it to this cohort. An image analysis pipeline was formulated to produce maps of BBB water exchange (kw) from the ME-ASL data using a two-compartment tracer kinetic model. A fit for kw in grey matter (GM) yielded implausible results, prompting further investigation. An estimate of the temporal signal-to-noise ratio (tSNR) in the data was derived, and a method for assessing identifiability and parameter sensitivity was demonstrated for two common ASL tracer kinetic models. Results show that the ME-ASL signal was relatively insensitive to kw, and low tSNR precluded fitting for kw voxelwise. Both tracer kinetic models were nonidentifiable unless certain parameter combinations were fixed. Accordingly, the analysis approach was adapted so that kw could be quantified in a whole GM region of interest, using an identifiable version of the selected model. Using this refined approach, GM kw was quantified in 46 participants with either MCI or early AD, and in 23 controls. The median kw in the combined MCI/AD group was 9 min−1 (range 0 - 37 min−1) and 14 min−1 in controls (range 0 - 36 min−1), although after adjusting for the participants’ age and sex, this difference was not significant. A weak negative correlation between age and kw was identified (median (95% interval): -2.8 (-5.4 - 0) min−1 per decade). Future work on ME-ASL protocol optimisation and model validation may yield more accurate and reproducible kw estimates

Fostering Social Cohesion in the School Physical Education Context

The need to focus on social cohesion comes to the fore in times of increasing social inequity, and during the current social changes and challenges that undermine the established social fabric of our societies such as large-scale immigration, increasingly nationalist governments, and the polarising perspectives on, as well as responses to, global pandemics. Chapter 7 makes the case that the nature of compulsory school physical education offers an ideal opportunity to rebuild relationships and inclusive social environments. Drawing on data from the EDUHEALTH project conducted in Sweden, Norway, and New Zealand, examples of teaching for social cohesion in physical education are provided through a focus on building teacher/student and student/student relationships, inclusiveness, culturally inclusive practices, planning and structuring activities that require students to work in heterogeneous teams and require interdependence between group members, and focusing on personal and social responsibility by encouraging adherence to the principles of fair play and democratically determined rules. The chapter concludes by discussing how social cohesion as a quest for – or precursor to – social justice must move students’ thinking beyond mere social integration to address the social conditions that privilege the values and beliefs of some communities, cultures, and religions whilst lessening others (minorities)

Charcoal Drawing

An Installation consisting of 10 large‐scale sculptural forms resembling three‐dimensional rock drawings, kowhaiwhai, waka and other forms of whakairo. The installation activated a space measuring 15 metres by 14 metres by 6 metre

Integrating social wellbeing into post-disaster decision-making, recovery, and infrastructure investment planning

Disaster recovery is a common goal for any community that has suffered loss, regardless of the cause or location. This research looks at the potential link between infrastructure reconstruction within the built environment and improvements in different categories of social wellbeing. These relationships, if found, could provide important information for the prioritisation of post-disaster reconstruction programmes. Irrespective of the cause of disruption, modern societies tend to focus on rebuilding back to the pre-damaged state, rather than rebuilding to ensure the avoidance of future risk or to provide for any specific social benefit. Infrastructure engineers will focus on the rebuilding of physical infrastructure that is broken, while social welfare agencies will focus on the people in the community with particular attention on the vulnerable and directly impacted. Economists will focus on economic indicators, health professionals will focus on injuries or illnesses, and it could be argued that politicians focus on re-election. This research is born out of practical experience with different disasters, and a motivation to improve the recovery process. From experience, recovery always takes longer than anyone wants or expects, and is aided or hindered by the myriad of decisions that are made by the leaders of the recovery. Social deprivation and built environment are commonly the focus of separate efforts during disaster recovery, however this research employed datasets from both, with datasets from the Canterbury Earthquake sequence of 2010 used for spatial comparison and analysis. The relationships between social wellbeing and the built environment were not as expected. This research postulated that there is potential for better decision making during disaster recovery by more holistic consideration of mutually beneficial outcomes, or more transparent trade-offs between competing interests. Instead of finding numerous direct links between these spatial datasets, there was only limited statistical correlation. While there are clear changes within the built environment and social wellbeing, there is insufficient evidence to attribute the specific reasons. This research therefore provides an important contribution to the literature by exploring the possibilities of using disparate spatial datasets to aid the prioritisation of disaster recovery

Objectively measured wear time in children prescribed myopia control spectacles: a comparison of adherence between two lens designs

Importance: Myopia control spectacle lenses are widely used to control myopia progression in children. A dose-response relationship exists between the hours of daily spectacle wear (adherence) and lens efficacy. This study compares adherence between two lens designs using a frame-mounted sensor to objectively measure wear time. Aims: To compare spectacle wear adherence in children wearing Defocus Incorporated Multiple Segments (DIMS) and Highly Aspherical Lenslet Target (HALT) lens designs. To assess the influence of adherence on axial eye growth and explore the barriers to full-time wear. Hypothesis: Adherence to spectacle wear is similar between DIMS and HALT lens designs due to similarities in cosmesis and impact on visual function. Methods: This parallel randomised clinical trial included 32 myopic children aged 7-12 years allocated to wear either DIMS or HALT lenses for 12-months. Objective adherence was measured using a SpecsOn sensor over 21 days following 6-months of spectacle wear. Subjective adherence was obtained via online surveys every 3 months. Spherical equivalent refraction (SER) and axial eye length (AL) were measured at baseline, 6-months and 12-months. Barriers to spectacle wear were explored using questionnaires at 1-, 6- and 12-month visits. Results: The mean objective daily wear times were 12.9 ± 1.3 hours in the HALT group and 11.9 ± 1.8 hours in the DIMS group, which were not significantly different (p = 0.100). Across both groups, 60% of children wore their spectacles for more than the recommended 12 hours/day. In the HALT group, older baseline age was associated with longer wear time, and longer wear time was associated with slower axial elongation. These associations were not observed in the DIMS group. Across both groups, spectacle wear time decreased significantly on non-school days compared to school days. Sport was a commonly reported barrier among children with low myopia (-1.00 to -2.50D), and non-adherent children more commonly reported fear of injury or spectacle breakage as a barrier to spectacle wear. Conclusion: Adherence to myopia control spectacle wear in this study was lower than in previous RCTs. While most participants wore their spectacles for more than 12 hours/day, reduced adherence on non-school days and other lifestyle-related barriers underscore the importance of providing personalised guidance based on each child’s history, lifestyle and behaviours to optimise treatment

Ecological impacts of phosphite treatments on Phytophthora communities associated with declining Agathis australis (kauri)

Finding multiple Phytophthora species causing disease in forests and often within the same foundation tree host has become increasingly common. The chemical phosphite is one of the only treatments consistently shown to provide some protection to natural ecosystems from Phytophthora diseases. In New Zealand, kauri (Agathis australis) is under threat from P. agathidicida, and phosphite injections are used to manage the disease. The principal aim of this research was to understand the extent of the Phytophthora community in the kauri rhizosphere and the impacts of phosphite treatments on that community. I explored global Phytophthora surveys (n = 187) in a review that informed my methodology for subsequent Phytophthora surveys within kauri forests. The Phytophthora community associated with kauri was relatively small compared to published studies from other forest systems. Four species were detected with soil baiting (P. agathidicida, P. cinnamomi, P. multivora, and P. pseudocryptogea/P. cryptogea) and an additional three species with eDNA metabarcoding (P. kernoviae, P. cactorum/P. aleatoria and a P. europaea-like species). Phytophthora agathidicida presence was strongly correlated with declining canopy health, confirming its role as the main driver of kauri dieback. Despite phosphite being a key management tool to protect kauri, it was unclear if phosphite affects the Phytophthora species assemblages or abundance in the rhizosphere. I quantified P. agathidicida inoculum changes using qPCR of soil DNA following a field phosphite treatment and showed a reduction in inoculum abundance 18 months after treatment. This has a direct impact on the epidemiology of the disease by reducing inoculum load around treated trees, indicating phosphite treatments should be an effective way to protect uninfected areas and minimise the spread of inoculum from infested zones. Phosphite trunk injections are systemically translocated and can inhibit colonisation and reduce sporulation of Phytophthora; however, they have no effect on the external inoculum present in the environment. Due to compliance restraints of working with P. agathidicida, I tested the ability of P. multivora to survive in and be dispersed from soil substrates when introduced as zoospores. Zoospore cysts of P. multivora were dispersed for 49 days and survived for 76 days in potting mix, raising concerns about cryptic dispersal from infected soil. I also explored the concept of preventative treatments to create a phosphite barrier with Eucalyptus sieberi and P. multivora, but under the glasshouse conditions, it was not a suitable model system. More work is needed to quantitatively test the barrier hypothesis though I did show that a preventative foliar phosphite treatment applied to kauri protected the plants from P. agathidicida more effectively than a curative treatment. The final aspect of my thesis was to test the efficacy of phosphite when applied as a foliar spray to kauri because phosphite trunk injections can be time-consuming and labour-intensive and present the risk of spreading soilborne Phytophthora inoculum. Glasshouse trials showed foliar-applied phosphite prevented the colonisation of P. agathidicida and was translocated to the roots with minimal phytotoxicity impacts. Overall, the findings of this research suggest that phosphite is an effective tool to aid in the management of Phytophthora diseases in forests. There does not appear to be a large population of native Phytophthora associated with kauri, though a wider sampling of co-habiting plants is necessary to conclude this for kauri forests. Further investigation trialling foliar phosphite sprays in field trials, testing the phosphite barrier approach along a disease front and temporal co-inoculation studies to better understand the roles of P. cinnamomi and P. multivora in kauri forest health is needed

Genetic differentiation and population connectivity of humpback whales migrating through Aotearoa New Zealand waters

Context Historically, humpback whales migrating past Aotearoa New Zealand (NZ) were linked to western South Pacific wintering grounds and Antarctic feeding grounds. As populations have recovered, research has focused on contemporary connectivity patterns throughout the South Pacific. Aims To determine the contemporary connectivity of winter breeding grounds for humpback whales on their northern and southern migrations past NZ, and those at the Kermadec Islands (Rangitāhua) migratory stopover. Methods We generated DNA profiles (mitochondrial DNA (mtDNA) haplotypes, genetic sex and microsatellite genotypes) using skin samples collected from whales between 1998 and 2021. We used comparisons of DNA profiles and a mixed-stock analysis of mtDNA haplotypes to determine the most likely wintering grounds of genetically identified individuals. Key results DNA profiles of 350 individual whales from NZ were compared to profiles from Oceania (n > 2000), Central and South America (n = 452) and East Australia (n = 809). This comparison revealed 35 genotype matches, mainly to New Caledonia and East Australia. The mixed-stock analysis showed that northbound whales (n = 145) had approximately equal assignment proportions to East Australia and New Caledonia whereas southbound whales (n = 74) showed a two-fold higher assignment to East Australia. In contrast, whales passing Rangitāhua (n = 112) assigned to New Caledonia and other Pacific wintering grounds but not to East Australia. Conclusions Humpback whales passing mainland NZ on their north and southbound migrations are strongly associated with East Australia and New Caledonia wintering grounds. Those migrating south past Rangitāhua have a broader range of wintering ground destinations, including a connection to Central America

Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care

BackgroundDespite evidence supporting interventions that improve outcomes for patients with stroke, their implementation remains suboptimal. Facilitation can support implementation of research into clinical practice by helping people develop the strategies to implement change. However, variability in the amount (dose) and type of facilitation activities/facilitator roles that make up the facilitation strategies (content), may affect the effectiveness of facilitation. This review aimed to determine if, and how, facilitation dose is measured or reported and the type of facilitation strategies used to support adoption of stroke interventions in hospitals and subacute settings. We also assessed whether the included studies had reporting checklists or guidelines.MethodsThe scoping review was based on Arksey and O'Malley's framework. Cochrane, CINAHL and MEDLINE databases were searched to identify randomised trials and quasi-experimental studies of stroke interventions published between January 2017 and July 2023. Accompanying publications (quantitative, qualitative, mixed methods or process evaluation papers) from eligible studies were also included. Narrative data synthesis was undertaken.ResultsTen studies (23 papers) from 649 full-text papers met the inclusion criteria. Only two studies reported the total facilitation dose, measured as the frequency and duration of facilitation encounters. Authors of the remaining eight studies reported only the frequency and/or duration of varying facilitation activities but not the total dose. The facilitation activities included remote external facilitator support via ongoing telecommunication (phone calls, emails, teleconferences), continuous engagement from on-site internal facilitators, face-to-face workshops and/or education sessions from external or internal facilitators. Facilitator roles were broad: site-specific briefing, action planning and/or goal setting; identifying enablers and barriers to change; coaching, training, education or feedback; and network support. Only two studies included reporting checklists/guidelines to support researchers to describe interventions and implementation studies in sufficient detail to enable replication.ConclusionsThere is a paucity of information on the measurement of facilitation dose and reporting on specific details of facilitation activities in stroke implementation studies. Detailed reporting of dose and content is needed to improve the scientific basis of facilitation as strategic support to enable improvements to stroke care. Development of a standardised measurement approach for facilitation dose would inform future research and translation of findings

NIH Toolbox for assessment of neurocognitive, motor and emotional-behavioral function in childhood: A systematic review

The NIH Toolbox is used extensively in various research settings, including clinical trials, observational studies, and longitudinal studies. Its validity and reliability have been systematically appraised only in adults. The current study systematically evaluated the validity and reliability of the NIH Toolbox for assessing neurocognitive, motor and emotional-behavioral functioning in children. Based on 22 studies including over 60,000 participants, sufficient evidence was found for the validity and reliability of most tests in the Cognition Battery and Motor Battery. However, there was insufficient evidence to assess the validity and reliability of the Emotion Battery. Thus, this review supports the use of the NIH Toolbox Cognition and Motor Batteries in assessing neurocognitive functioning in 3–17-year-olds

Emotional Impact of Architectural Spaces -- An Analysis of Therapeutic Environments for Psychological Effect on Architectural Design Principles

The intricate relationship between architectural design and emotional well-being has emerged as a significant area of inquiry within architectural psychology. This thesis explores how various architectural elements, such as lighting, colour schemes, textures, materials, and the application of Chinese Feng Shui principles, affect the emotional states of occupants. The primary objective is to investigate how these design elements can be strategically utilised to create therapeutic environments that support individuals with psychological disorders and contribute to the overall mental well-being of the general population. Employing a mixed-methods approach, this research integrates a comprehensive literature review, case studies, and experimental design to assess the emotional impact of key architectural features. Specifically, the study examines the psychological effects of open versus enclosed spaces, natural versus artificial lighting, and the role of colours, textures, and materials in shaping emotional responses. Additionally, it evaluates the impact of Biophilic design and Chinese Feng Shui principles in fostering therapeutic and psychologically harmonious environments. The anticipated outcomes of this study include a deeper understanding of the emotional implications of architectural design, insights into the efficacy of Feng Shui principles in therapeutic settings, and the identification of key architectural elements that enhance mental health. Furthermore, this research aims to develop evidence-based design guidelines for architects and designers to create spaces that actively support emotional well-being and help mitigate psychological distress. Through this interdisciplinary exploration, the thesis seeks to bridge the gap between architecture and psychology, offering valuable insights into the creation of environments that enhance both the emotional and mental health of occupants. While exploring therapeutic potential, this study remains cautious of over-attributing psychological agency to spatial form