A major step in the continental Moho and its geodynamic consequences: The Taranaki-Ruapehu line, New Zealand

Receiver function analysis reveals a 7 km step-like change in crustal thickness across the Taranaki-Ruapehu Line (TR-line) of North Island, New Zealand. The TR-line runs east-west between the active andesite volcanoes of Mt Taranaki and Ruapehu and mark

Seismic Response to Injection Well Stimulation in a High-Temperature, High-Permeability Reservoir

Fluid injection into the Earth's crust can induce seismic events that cause damage to local infrastructure but also offer valuable insight into seismogenesis. The factors that influence the magnitude, location, and number of induced events remain poorly understood but include injection flow rate and pressure as well as reservoir temperature and permeability. The relationship between injection parameters and injection-induced seismicity in high-temperature, high-permeability reservoirs has not been extensively studied. Here we focus on the Ngatamariki geothermal field in the central Taupō Volcanic Zone, New Zealand, where three stimulation/injection tests have occurred since 2012. We present a catalog of seismicity from 2012 to 2015 created using a matched-filter detection technique. We analyze the stress state in the reservoir during the injection tests from first motion-derived focal mechanisms, yielding an average direction of maximum horizontal compressive stress (SHmax) consistent with the regional NE-SW trend. However, there is significant variation in the direction of maximum compressive stress (σ1), which may reflect geological differences between wells. We use the ratio of injection flow rate to overpressure, referred to as injectivity index, as a proxy for near-well permeability and compare changes in injectivity index to spatiotemporal characteristics of seismicity accompanying each test. Observed increases in injectivity index are generally poorly correlated with seismicity, suggesting that the locations of microearthquakes are not coincident with the zone of stimulation (i.e., increased permeability). Our findings augment a growing body of work suggesting that aseismic opening or slip, rather than seismic shear, is the active process driving well stimulation in many environments

S-wave splitting in the offshore South Island, New Zealand : insights into plate-boundary deformation

Author Posting. © American Geophysical Union, 2015. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry, Geophysics, Geosystems 16 (2015): 2829–2847, doi:10.1002/2015GC005882.Local and regional S-wave splitting in the offshore South Island of the New Zealand plate-boundary zone provides constraints on the spatial and depth extent of the anisotropic structure with an enhanced resolution relative to land-based and SKS studies. The combined analysis of offshore and land measurements using splitting tomography suggests plate-boundary shear dominates in the central and northern South Island. The width of this shear zone in the central South Island is about 200 km, but is complicated by stress-controlled anisotropy at shallow levels. In northern South Island, a broader (>200 km) zone of plate-boundary parallel anisotropy is associated with the transitional faulting between the Alpine fault and Hikurangi subduction and the Hikurangi subduction zone itself. These results suggest S-phases of deep events (∼90 km) in the central South Island are sensitive to plate-boundary derived NE-SW aligned anisotropic media in the upper-lithosphere, supporting a “thin viscous sheet” deformation model.United States National Ocean Bottom Seismograph Instrumentation Pool2016-02-2

Upper mantle seismic anisotropy at a strike-slip boundary: South Island, New Zealand

New shear wave splitting measurements made from stations onshore and offshore the South Island of New Zealand show a zone of anisotropy 100–200 km wide. Measurements in central South Island and up to approximately 100 km offshore from the west coast yield orientations of the fast quasi-shear wave nearly parallel to relative plate motion, with increased obliquity to this orientation observed farther from shore. On the eastern side of the island, fast orientations rotate counterclockwise to become nearly perpendicular to the orientation of relative plate motion approximately 200 km off the east coast. Uniform delay times between the fast and slow quasi-shear waves of nearly 2.0 s onshore continue to stations approximately 100 km off the west coast, after which they decrease to ~1 s at 200 km. Stations more than ~300 km from the west coast show little to no splitting. East coast stations have delay times around 1 s. Simple strain fields calculated from a thin viscous sheet model (representing distributed lithospheric deformation) with strain rates decreasing exponentially to both the northwest and southeast with e-folding dimensions of 25–35 km (approximately 75% of the deformation within a zone 100–140 km wide) match orientations and amounts of observed splitting. A model of deformation localized in the lithosphere and then spreading out in the asthenosphere also yields predictions consistent with observed splitting if, at depths of 100–130 km below the lithosphere, typical grain sizes are ~ 6–7 mm.New Zealand. Ministry of Research, Science, and TechnologyNational Science Foundation (U.S.). Continental Dynamics Program (Grant EAR-0409564)National Science Foundation (U.S.). Continental Dynamics Program (Grant EAR-0409609)National Science Foundation (U.S.). Continental Dynamics Program (Grant EAR-0409835

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

Expert by Experience involvement in Mental Health Nursing Education: The co-production of standards between Experts by Experience and Academics in Mental Health Nursing

Introduction: Involving people with lived experience of mental distress in mental health nursing education has gained considerable traction yet broader implementation remains ad-hoc and tokenistic. Effective involvement requires curricula be informed by lived experience of service use. Aim: To develop standards to underpin expert by experience involvement in mental health nursing education based on lived experience of service use. Methods: Phase one used qualitative descriptive methods, involving focus groups with service users (n=50) from six countries to explore perceptions of service user involvement in mental health nursing education. Phase two utilised these findings through consensus building to co-produce standards to support Experts by Experience involvement in mental health nursing education. Results: Three themes emerged in Phase one: enablers and barriers, practical and informational support, and emotional and appraisal support. These themes underpinned development of the standards, which reflect nine processes: induction and orientation, external supervision, supportive teamwork, preparation for teaching and assessing, 'intervision', mutual mentorship, pre and post debriefing, role clarity and equitable payment. Conclusions: These standards form the framework entitled; Standards for Co-production of Education (Mental Health Nursing) (SCo-PE [MHN]). Implications for Practice The standards aim to support implementation of Expert by Experience roles in mental health nursing education

Outcome of paediatric intensive care survivors

The development of paediatric intensive care has contributed to the improved survival of critically ill children. Physical and psychological sequelae and consequences for quality of life (QoL) in survivors might be significant, as has been determined in adult intensive care unit (ICU) survivors. Awareness of sequelae due to the original illness and its treatment may result in changes in treatment and support during and after the acute phase. To determine the current knowledge on physical and psychological sequelae and the quality of life in survivors of paediatric intensive care, we undertook a computerised comprehensive search of online databases for studies reporting sequelae in survivors of paediatric intensive care. Studies reporting sequelae in paediatric survivors of cardiothoracic surgery and trauma were excluded, as were studies reporting only mortality. All other studies reporting aspects of physical and psychological sequelae were analysed. Twenty-seven studies consisting of 3,444 survivors met the selection criteria. Distinct physical and psychological sequelae in patients have been determined and seemed to interfere with quality of life. Psychological sequelae in parents seem to be common. Small numbers, methodological limitations and quantitative and qualitative heterogeneity hamper the interpretation of data. We conclude that paediatric intensive care survivors and their parents have physical and psychological sequelae affecting quality of life. Further well-designed prospective studies evaluating sequelae of the original illness and its treatment are warranted

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Bedrock geology of DFDP-2B, central Alpine Fault, New Zealand

<p>During the second phase of the Alpine Fault, Deep Fault Drilling Project (DFDP) in the Whataroa River, South Westland, New Zealand, bedrock was encountered in the DFDP-2B borehole from 238.5–893.2 m Measured Depth (MD). Continuous sampling and meso- to microscale characterisation of whole rock cuttings established that, in sequence, the borehole sampled amphibolite facies, Torlesse Composite Terrane-derived schists, protomylonites and mylonites, terminating 200–400 m above an Alpine Fault Principal Slip Zone (PSZ) with a maximum dip of 62°. The most diagnostic structural features of increasing PSZ proximity were the occurrence of shear bands and reduction in mean quartz grain sizes. A change in composition to greater mica:quartz + feldspar, most markedly below c. 700 m MD, is inferred to result from either heterogeneous sampling or a change in lithology related to alteration. Major oxide variations suggest the fault-proximal Alpine Fault alteration zone, as previously defined in DFDP-1 core, was not sampled.</p