The effect of pre-information on clinical inference and nursing actions : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

A study to examine the effects of pre-information (what a nurse learns about a patient before they meet) on clinical inference and nursing actions, in a simulated nurse-patient situation. It was hypothesised that the nature of the pre-information will influence the way the patient is perceived, and the resulting nursing actions. The research was conducted in an obstetrical setting. There were 55 subjects within three groups. Two groups comprised student midwives, and the third group was of second year comprehensive nursing students near the completion of clinical experience in maternal and child health nursing. A five minute videotape sequence of a role-played post-natal patient was made for use in the research. All subjects were given the same initial pre-information, viewed the videotape and gave written descriptions of what they saw on the videotape and their response (as the nurse in the situation). This data provided a base-line for each subject. Subjects were then given additional pre-information concerning the patient's physical condition, her baby's condition, or formed part of the control group (receiving no additional pre-information). The procedure was repeated. These responses were then compared with the base-line for each subject. Responses were coded by means of content analysis. Group data was analysed using a multivariate one way analysis of variance graphical display. The results indicated support of the hypothesis that the nature of the pre-information does influence the way in which a nurse perceives a patient, and resulting nursing actions. Implications of these findings for nursing are discussed

The synthesis of triglyceride and other non-polar acyl lipids by protoplasts and chloroplasts from barley leaf : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science with Honours in Biochemistry at Massey University

Protoplasts, isolated from barley leaf, were incubated with H¹⁴CO₃ and (1-¹⁴C) acetate. The radioactivity was found incorporated into the lipids sulpholipid, phosphatidyl choline, phosphatidyl ethanolamine, phosphatidyl glycerol, and monogalactosyl diglyceride as identified by thin layer chromatography. Large quantities were found in an unidentified region referred to in this thesis as USF (Unknowns near the solvent front) . ThisUSF was much less polar than the phospholipids and galactolipids and ran in the same region as plant pigments. USF, by using TLC with several solvent systems, was identified as consisting of acyl lipids; the major proportion was triglyceride (approximately 55%) with diglyceride, free fatty acid and monoglyceride also present. The radioactivity in the triglyceride was found, by GLC of methylated esters, to be contained in the fatty acids; mainly in linoleate (18:2)and palmitate (16:0) and in lesser concentrations in stearate (18:0) and oleate (18:1). Endogenous levels of triglyceride were found to be very low - only 14.8 nmoles /g of fresh tissue. The results of experiments with sections of tissue of different maturity suggested that the high level of incorporation into acyl lipids was related to tissue immaturity. Chloroplasts were isolated by a traditional blending method and by bursting prepared protoplasts. The latter technique produced chloroplasts of a higher quality. Examination of the incubation products when chloroplasts were incubated with (1-¹⁴C) acetate showed once more the appearance of acyl lipids. Triglyceride made up 35% of the USF from chloroplasts incubations. The label accumulated mainly in palmitate (16:0) on the triglyceride. These results suggest that at least part of the triglyceride synthesis in the plant cell is occurring within the chloroplast, contrary to the findings represented in the literature

Eosinophilic Asthma Response to Therapy: 129Xe Magnetic Resonance Imaging and Computed Tomography

Novel biologic therapies, such as anti-interleukin-5 receptor α (anti-IL-5Rα) or benralizumab, have been developed to treat patients with severe eosinophilic asthma who experience frequent exacerbations, poor quality of life and increased risk of mortality. Whether this therapy results in disease modifying activity, specifically in the asthmatic airways and pulmonary vasculature, is still poorly understood. Pulmonary structure and function may be evaluated using computed tomography (CT) and hyperpolarized noble gas magnetic resonance imaging (MRI), respectively. Computed tomography has previously been utilized to measure airway dimensions, mucus occlusions and pulmonary blood volumes. In contrast, hyperpolarized gas MRI allows for the in vivo visualization and quantification of ventilation abnormalities, which are thought to reflect airway abnormalities such as airway inflammation and mucus plugging. Therefore, CT and MRI are poised to non-invasively evaluate the pulmonary structural and functional changes in eosinophilic asthma patients initiated on anti-IL-5Rα therapy. The overarching objective of this thesis was to use hyperpolarized 129Xe MRI and chest CT to evaluate pulmonary function and structure following continuous anti-IL-5Rα therapy and to compare with pre-treatment measurements to better our understanding of the mechanisms responsible for improved asthma control and airflow obstruction. We first determined the upper limit of normal and minimal clinically important difference for 129Xe MRI ventilation defect percent (VDP) and showed that the upper limit of normal varied with age and the minimal clinically important difference was 2%. Next, we measured 129Xe MRI VDP after a single dose of anti-IL-5Rα and showed that VDP improvements were influenced by baseline CT mucus plugs. We evaluated a subset of these same participants after 2.5-years of continuous treatment and revealed that early 129Xe MRI VDP improvements were sustained and that there was a near complete resolution of CT mucus plugs. Finally, we measured pulmonary blood volumes following 2.5-years of therapy and showed that there was a normalization and redistribution of blood from the larger to smaller vessels in eosinophilic asthma. Together, these results point towards mechanisms that may be responsible for improvements in airflow obstruction and asthma control and suggest that anti-IL-5Rα results in disease-modifying activity in patients with eosinophilic asthma

Obtaining the Weyl tensor from the Bel-Robinson tensor

The algebraic study of the Bel-Robinson tensor proposed and initiated in a previous work (Gen. Relativ. Gravit. {\bf 41}, see ref [11]) is achieved. The canonical form of the different algebraic types is obtained in terms of Bel-Robinson eigen-tensors. An algorithmic determination of the Weyl tensor from the Bel-Robinson tensor is presented.Comment: 21 page

Vacuum type I spacetimes and aligned Papapetrou fields: symmetries

We analyze type I vacuum solutions admitting an isometry whose Killing 2--form is aligned with a principal bivector of the Weyl tensor, and we show that these solutions belong to a family of type I metrics which admit a group $G_3$ of isometries. We give a classification of this family and we study the Bianchi type for each class. The classes compatible with an aligned Killing 2--form are also determined. The Szekeres-Brans theorem is extended to non vacuum spacetimes with vanishing Cotton tensor.Comment: 19 pages; a reference adde

On the classification of type D spacetimes

We give a classification of the type D spacetimes based on the invariant differential properties of the Weyl principal structure. Our classification is established using tensorial invariants of the Weyl tensor and, consequently, besides its intrinsic nature, it is valid for the whole set of the type D metrics and it applies on both, vacuum and non-vacuum solutions. We consider the Cotton-zero type D metrics and we study the classes that are compatible with this condition. The subfamily of spacetimes with constant argument of the Weyl eigenvalue is analyzed in more detail by offering a canonical expression for the metric tensor and by giving a generalization of some results about the non-existence of purely magnetic solutions. The usefulness of these results is illustrated in characterizing and classifying a family of Einstein-Maxwell solutions. Our approach permits us to give intrinsic and explicit conditions that label every metric, obtaining in this way an operational algorithm to detect them. In particular a characterization of the Reissner-Nordstr\"{o}m metric is accomplished.Comment: 29 pages, 0 figure

The behaviors and experiences of the community pharmacy team on the provision of multi-compartment compliance aids.

Background - Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines. Acknowledging the lack of evidence that MCAs improve adherence or clinical outcomes, the Royal Pharmaceutical Society has expressed concern that MCAs have 'become regarded as a panacea for medicines use'. Objectives - To determine the behaviors and experiences of the community pharmacy team around MCA provision. Methods - A cross-sectional survey was conducted in 26 community pharmacies in the north east of Scotland. Survey items were grouped into: current activities in the provision of MCAs; potential influences on these activities; reports of patient experiences; and demographics. Data were analysed using descriptive and inferential statistics, and content analysis of responses to open questions. Principal component analysis (PCA) was performed on the items of potential influences on activities. Results - Data were collected from 136 community team members (median 4, range1-10 per pharmacy; 32.3% pharmacists). All were involved in some aspect of MCA provision and within the same pharmacy, several different staff positions were commonly involved in the same activity. PCA gave seven components; the lowest scores were obtained for the component of 'others expecting me to provide MCAs'. Participants agreed that GPs, patients and their families, and carers expected them to provide MCAs. Positive experiences of MCA provision were in themes of promoting patient adherence, reducing patient stress and enhancing patient monitoring. Further negative experiences were in of lack of shared patient decision making, worsening adherence and generation of medicines waste, and dealing with changing medicines. MCAs were not always considered to be the most appropriate solution. Conclusion - While community pharmacy teams value MCAs, there may be issues around staff assignment to particular roles, expectations from others and reports of negative patient experiences. A systematic approach to MCA provision and monitoring involving the multidisciplinary health and social care team is warranted

Meta-Analysis of the Structural Equation Models' Parameters for the Estimation of Brain Connectivity with fMRI.

Structural Equation Models (SEM) is among of the most extensively applied statistical techniques in the study of human behavior in the fields of Neuroscience and Cognitive Neuroscience. This paper reviews the application of SEM to estimate functional and effective connectivity models in work published since 2001. The articles analyzed were compiled from Journal Citation Reports, PsycInfo, Pubmed, and Scopus, after searching with the following keywords: fMRI, SEMs, and Connectivity. Results: A 100 papers were found, of which 25 were rejected due to a lack of sufficient data on basic aspects of the construction of SEM. The other 75 were included and contained a total of 160 models to analyze, since most papers included more than one model. The analysis of the explained variance (R2) of each model yields an effect of the type of design used, the type of population studied, the type of study, the existence of recursive effects in the model, and the number of paths defined in the model. Along with these comments, a series of recommendations are included for the use of SEM to estimate of functional and effective connectivity models