Development of an Automated and Integrated Budgeting System

Alpine Health currently uses Microsoft Excel to produce consolidated budget statements each year. These Excel templates have become extremely cumbersome to the accounting department since they must cut and paste all of the templates (over 20) into a master schedule that consolidates the reports into a view that the executives make decisions from. Often times these templates are too large to email back and forth. They are hard to track since several versions of the same budget are sent during the process. Each time a new entity or hospital is added, the accounting department must update several different tabs on the master schedule to make sure it consolidates correctly. The company needs a seamless budget system that would put into place a budget process/workflow as well as a software package to incorporate the consolidation easily

When treatment success is not as black and white as a radiograph: the bio/psycho/social impact of chronic osteomyelitis

This case report is from Malawi Beit CURE international Hospital (BCIH), a center of excellence for the  management of chronic osteomyelitis (COM) in children. Currently minimal evidence based data exists on the long term outcomes for treatment of bone defects following COM. Few studies evaluating outcomes are based solely on clinical parameters. This case study highlights the often-debilitating outcome after treatment and hence the need for further research to find the most effective treatment to create treatment guidelines. It particularly demonstrates the importance of the bio/psycho/social impact of long-term morbidity and disability, which must be considered alongside clinical outcomes in evaluation.Key words: Osteomyelitis, bone deformity, disability, Malaw

Celebrating Undergraduate Students’ Research at York University

This article analyses the information literacy (IL) competencies of high-achieving undergraduate students through the lens of undergraduate research celebrations in a North American University. This article focuses on York University’s Undergraduate Research Fair, and shares findings from an analysis of students’ IL award submissions including lower-year (first and second year of university) and upper-year (third and fourth year of university) applicants. Submissions are analysed using a qualitative content analysis approach. The study’s findings point to the positive value of both IL and reference help in building high-achieving undergraduate students’ IL skills. Results indicate important future directions for IL instruction, such as the role of the flipped classroom, and the critical importance of embracing the Association of College and Research Libraries’ (ACRL) Framework for Information Literacy for Higher Education to engage undergraduates with high-order IL concepts

Systematic prey preference by introduced mice exhausts the ecosystem on Antipodes Island

For assistance collecting samples in the field the authors thank David Thompson, Erica Sommer, David Boyle and Mark Fraser in summer 2011, Helen Nathan, Terry Greene and Graeme Elliott in winter 2013, Fin Cox in autumn 2016 and Jose Luis Herrera in winter 2016. Thanks to the Department of Conservation, Murihiku, for logistical support, and Hank Haazen and crew of the Tiama for transport. Funding was provided for the summer 2011 expedition by NIWA and winter 2013 expedition by the National Geographic Society (Grant No. 9322-13). Thanks to Stephen Thorpe, Robert Hoare, and John Marris for taxonomic identification of invertebrate samples. Thanks to Surrya Khanam for laboratory sorting, Julie Brown and Anna Kilimnik for stable isotope laboratory analyses and Wendy Nelson for macroalgae identification. JCR is currently funded by the Royal Society of New Zealand Rutherford Discovery Fellowship (Grant No. RDF-UOA1404). TWB is currently funded by the European Union's Horizon 2020 research and innovation programme Marie Skłodowska-Curie Fellowship (Grant No. 747120). Thanks to Katherine Russell and two anonymous reviewers for feedback on the manuscript. This research was conducted under DOC entry (SO-29716-LND 1011/35) and research (SO-29140-FAU 1011/20) permits, and University of Auckland Animal Ethics Committee approval (R845).Peer reviewedPublisher PD

Visual art-making as a resource for living positively with arthritis: An interpretative phenomenological analysis of older women’s accounts

This is the post-print version of the final paper published in Journal of Aging Studies. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2010 Elsevier B.V.This study explored whether and how visual art-making, as a leisure activity, provided a coping resource for older women affected by arthritis. Twelve older women (aged 62–81) were interviewed. They had lived with arthritis for many years, and engaged in arts and crafts regularly. Transcripts were explored through Interpretative Phenomenological Analysis. Three main themes were identified. Firstly, most participants experienced art-making as a powerful means of controlling arthritis pain, through deep concentration, and through use of color and imagery. Secondly, participants experienced art-making as encouraging sustained attention to the outside world, offering psychological escape from the confines of the body and home. Thirdly, art-making protected and promoted identity, for example, through integrating current and former selves, enabling participants to express and re-experience certain valued memories, and engage in personal development. Some participants felt able to celebrate positive difference from others, on the basis of their art rather than their illness

Too Close for Comfort? Isotopic Niche Segregation in New Zealand’s Odontocetes

Species occurring in sympatry and relying on similar and limited resources may partition resource use to avoid overlap and interspecific competition. Aotearoa, New Zealand hosts an extraordinarily rich marine megafauna, including 50% of the world’s cetacean species. In this study, we used carbon and nitrogen stable isotopes as ecological tracers to investigate isotopic niche overlap between 21 odontocete (toothed whale) species inhabiting neritic, mesopelagic, and bathypelagic waters. Results showed a clear niche separation for the bathypelagic Gray’s beaked whales (Mesoplodon grayi) and sperm whales (Physeter macrocephalus), but high isotopic niche overlap and potential interspecific competition for neritic and mesopelagic species. For these species, competition could be reduced via temporal or finer-scale spatial segregation or differences in foraging behaviour. This study represents the first insights into the coexistence of odontocetes in a biodiverse hotspot. The data presented here provide a critical baseline to a system already ongoing ecosystem change via ocean warming and subsequent effects on prey abundance and distributions

Demography and ecology of southern right whales Eubalaena australis wintering at sub-Antarctic Campbell Island, New Zealand

Since the decimation of the southern right whale Eubalaena australis population in New Zealand by whaling, research on its recovery has focused on the wintering ground at the Auckland Islands, neglecting potentially important wintering habitat at Campbell Island. For the first time in 20 years we conducted an expedition to sub-Antarctic Campbell Island to document and describe E. australis occupying this wintering habitat. We used a variety of methods including photo-identification, genetic and stable isotope analyses of tissue samples, and visual surveys of abundance and distribution, to provide details on the demography, population connectivity and ecology of E. australis wintering at Campbell Island. Our primary findings include (1) a lack of calves observed at Campbell Island, (2) an age-class bias toward sub-adults encountered at Campbell Island, (3) nine photo-identification matches between individuals observed at Campbell Island and previously documented elsewhere in New Zealand, (4) no genetic differentiation between E. australis at Campbell Island and the broader New Zealand population, (5) increased abundance estimates of E. australis at Campbell Island over the last 20 years, and (6) indications that E. australis forage within the sub-Antarctic region based on stable isotope analyses. Our results confirm that the Auckland Islands are currently the only significant calving area for E. australis in New Zealand, and therefore previous abundance estimates based on demographic data from the Auckland Islands are applicable to the entire New Zealand population of E. australis. However, future periodic surveys to Campbell Island are recommended to monitor population recovery and expansion.PostprintPeer reviewe

Women’s experiences of receiving care for pelvic organ prolapse: a qualitative study

Background Pelvic organ prolapse is a common urogenital condition affecting 41–50% of women over the age of 40. To achieve early diagnosis and appropriate treatment, it is important that care is sensitive to and meets women’s needs, throughout their patient journey. This study explored women’s experiences of seeking diagnosis and treatment for prolapse and their needs and priorities for improving person-centred care. Methods Twenty-two women receiving prolapse care through urogynaecology services across three purposefully selected NHS UK sites took part in three focus groups and four telephone interviews. A topic guide facilitated discussions about women’s experiences of prolapse, diagnosis, treatment, follow-up, interactions with healthcare professionals, overall service delivery, and ideals for future services to meet their needs. Data were analysed thematically. Results Three themes emerged relating to women’s experiences of a) Evaluating what is normal b) Hobson’s choice of treatment decisions, and c) The trial and error of treatment and technique. Women often delayed seeking help for their symptoms due to lack of awareness, embarrassment and stigma. When presented to GPs, their symptoms were often dismissed and unaddressed until they became more severe. Women reported receiving little or no choice in treatment decisions. Choices were often influenced by health professionals’ preferences which were subtly reflected through the framing of the offer. Women’s embodied knowledge of their condition and treatment was largely unheeded, resulting in decisions that were inconsistent with women’s preferences and needs. Physiotherapy based interventions were reported as helping women regain control over their symptoms and life. A need for greater awareness of prolapse and physiotherapy interventions among women, GPs and consultants was identified alongside greater focus on prevention, early diagnosis and regular follow-up. Greater choice and involvement in treatment decision making was desired. Conclusions As prolapse treatment options expand to include more conservative choices, greater awareness and education is needed among women and professionals about these as a first line treatment and preventive measure, alongside a multi-professional team approach to treatment decision making. Women presenting with prolapse symptoms need to be listened to by the health care team, offered better information about treatment choices, and supported to make a decision that is right for them

Wiggle-match radiocarbon dating of the Taupo eruption

The Taupo eruption deposit is an isochronous marker bed that spans much of New Zealand’s North Island and pre-dates human arrival. Holdaway et al. (2018, Nature Comms 9, 4110) propose that the current Taupo eruption date is inaccurate and that the eruption occurred “…decades to two centuries…” after the published wiggle-match estimate of 232 ± 10 CE (2 s.d.) derived from a tanekaha (Phyllocladus trichomanoides) tree at the Pureora buried forest site (Hogg et al. 2012, The Holocene 22, 439-449). Holdaway et al. (2018) propose that trees growing at Pureora (and other near-source areas) that were killed and buried by the climactic ignimbrite event were affected by ¹⁴C-depleted (magmatic) CO₂. Holdaway et al.'s (2018) proposal utilises a wide range of published ¹⁴C data, but their work results in assertions that are implausible. Four parts to their hypothesis are considered here

Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care

<p>Abstract</p> <p>Background</p> <p>Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched 'controls' and to develop and pilot test a valid study instrument.</p> <p>Methods</p> <p>A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status.</p> <p>Results</p> <p>Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation.</p> <p>Conclusion</p> <p>Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words)</p