Zealand Background Research Articles

Midwifery practice arrangements which sustain caseloading Lead Maternity Carer midwives in New Zealand.

A Corresponding Author: andrea. gilkison@aut.nz B School of Midwifery, AUT University, New Zealand INTRODUCTION AND BACKGROUND Implementing caseload, continuity of care, midwifery models improves outcomes and has significant benefits for the woman and baby (National Health Service, 2014; Sandall, Devane, Soltani, Hatem, & Gates, 2010; Sandall, Soltani, Gates, Shennan, & Devane, 2013), and enhances women’s and midwives’ satisfaction (Collins, Fereday, Pincombe, Oster, & Turnbull, 2010; Ministry of Health, 2011). The New Zealand Nurses Amendment Act (1990) provided New Zealand midwives with the legal ability to practise as autonomous health professionals. Midwives in New Zealand are funded by the government to provide midwifery care throughout pregnancy, labour, birth and the postpartum period up to six weeks, for women who have chosen to book with them (Ministry of Health, 2007). To support this continuity of care for women, New Zealand midwives are able to work as a Lead Maternity Carer (LMC) and provide care to a caseload of women. The predominant choice as LMC is a midwife (Ministry of Health, 2012), however, a general practitioner or an obstetrician can fulfil this role; it is the woman who determines who her LMC will be. Providing LMC care to a caseload of women often means that the midwife needs to be available to her caseload at any time of the day or night – to provide care during labour or for any urgent or emergency issues (Ministry of Health, 2007). For some midwives this requirement is unsustainable and it has been argued may potentially increase burnout (Young, 2011), whilst for others it is enjoyable and satisfying (McAra-Couper et al., 2014). Our wider study aimed to explore what it is about working as a LMC midwife, providing continuity of care, which sustains midwives and supports them to continue to work in this role. A previous paper has described this study and the main themes summing up what sustained them in practice were identified as: the joy of working in partnership with women; having good collegial relationships with practice partners who are philosophically aligned; managing the unpredictability of being on-call; having clear boundaries; having good relationships with colleagues in maternity units; having supportive families and friends; and the way the practice was organised (McAra-Couper et al., 2014). This paper reviews the specifics of practice arrangements which contributed to sustainable midwifery practice for our participants. In 2013, 38.1% (1,118 midwives) of the New Zealand midwifery workforce reported caseloading as their main work situation, 86% of the caseloading midwives worked as self-employed LMCs (Midwifery Council of New Zealand, 2013). Midwives who work Background: The New Zealand Lead Maternity Carer (LMC) midwifery model has benefits for women and babies and is a satisfying way to work for midwives. Due to the need to be on-call for long periods of time, there have been questions raised about the sustainability of the model for midwives and the potential for burnout. Objective: This qualitative descriptive study explored what sustains on-call, caseloading Lead Maternity Carer (LMC) midwives in New Zealand. Methods: Eleven midwives with 12 to 20 years in practice were interviewed and thematic analysis used to identify themes which sustained these LMC midwives in practice. Findings: Overall, the study found that it was the joy of midwifery practice, managing the unpredictability of being on-call, having clear boundaries, having good relationships with colleagues, having supportive families and friends, and workable practice arrangements which sustain them in practice. This paper presents the findings from the theme: workable practice arrangements. The midwives interviewed explained that having regular time off, a manageable caseload size, working together as a practice, the financial arrangements, and the sharing of arrangements with women created a sustainable way to practice. Conclusion: This paper has identified aspects of sustainable practice which are congruent with the international research but also very specific to the New Zealand model of midwifery.

Transgenic Rabbits Expressing Ovine PrP Are Susceptible to Scrapie.

Transmissible spongiform encephalopathies (TSEs) are a group of neurodegenerative diseases affecting a wide range of mammalian species. They are caused by prions, a proteinaceous pathogen essentially composed of PrPSc, an abnormal isoform of the host encoded cellular prion protein PrPC. Constrained steric interactions between PrPSc and PrPC are thought to provide prions with species specificity, and to control cross-species transmission into other host populations, including humans. Transgenetic expression of foreign PrP genes has been successfully and widely used to overcome the recognized resistance of mouse to foreign TSE sources. Rabbit is one of the species that exhibit a pronounced resistance to TSEs. Most attempts to infect experimentally rabbit have failed, except after inoculation with cell-free generated rabbit prions. To gain insights on the molecular determinants of the relative resistance of rabbits to prions, we generated transgenic rabbits expressing the susceptible V136R154Q171 allele of the ovine PRNP gene on a rabbit wild type PRNP New Zealand background and assessed their experimental susceptibility to scrapie prions. All transgenic animals developed a typical TSE 6–8 months after intracerebral inoculation, whereas wild type rabbits remained healthy more than 700 days after inoculation. Despite the endogenous presence of rabbit PrPC, only ovine PrPSc was detectable in the brains of diseased animals. Collectively these data indicate that the low susceptibility of rabbits to prion infection is not enciphered within their non-PrP genetic background.

Tu1622 Primary Anterograde EUS-Guided Biliary Interventions for Failed ERCP

Tu1622 Primary Anterograde EUS-Guided Biliary Interventions for Failed ERCP Frank Weilert* Department of Gastroenterology, Waikato Hospital, Hamilton, New Zealand Background: EUS-guided biliary drainage (EUS-BD) is technically challenging but an alternative method of therapeutic intervention when ERCP fails. Objective: Assess the feasibility, safety and risks of EUS-BD with intra-hepatic biliary access and anterograde interventions to increase flexibility of interventions, limit adverse events and improve procedural time. Design: Prospective observational cohort study Patients: 25 consecutive patients underwent EUS-BD drainage for failed ERCP. Main Outcome measures: Technical and clinical success rates with adverse event rate. Results: Patient recruitment from June 2011-Sep 2014; 25 patients with a mean age of 68.6 years, predominantly male (68%) with pancreatic cancer (48%), cholangiocarcinoma (20%), other malignant biliary obstruction (8%) and benign biliary obstruction (21.7%). Prior interventions included failed ERCP in 22/25 (88%) while 3/ 25 (12%) had primary EUS-BD. Anterograde cholangiogram was achieved in all patients. Technical success was achieved in 24/25 (96%) with clinical success was achieved in 23/25 (92%). Placement of access wire was across the ampulla in 13/24 (54.2%) and into CBD or contra-lateral IHD in 11/24 (44.8%). Tract dilatation was accomplished in 20/24 (83.3%) but required completion using intra-hepatic needle knife in 4/25 (16.7%). Anterograde interventions (table 1) were performed in 18/24 (75%) but crossover to rendezvous in 5/24 (20.8%) or choledochoduodenostomy 1/ 24 (4.2%). Three patients 3/25 (12%) also had endoscopic duodenal SEMS placement to relieve duodenal obstruction. Three patients (12%) had adverse event including post-procedural bile leak (1), pain (1) and subcapsular hematoma (1), respectively. Conclusion: Primary anterograde EUS-guided biliary drainage using the intra-hepatic access route has high technical and clinical success with low adverse rate. We would promote a simplified standardized algorithm (fig 1), which gives flexibility of direct anterograde interventions.

Predictors of responses and sexual function for women in the St George breast boost randomized trial (StGBBT)

s / The Breast 24 (2015) 302e307 304 Resonance Imaging (CEMRI) is currently the most sensitive imaging technique for breast cancer detection; however, it suffers from many drawbacks including high cost, timely accessibility, patient contraindications and low specificity. Previous studies have shown that contrast enhanced spectral mammography (CESM) may have similar diagnostic capability to CEMRI without these associated costs (2). Methods: The study included patients with biopsy proven breast cancer aged 21 years, fit for surgery, and excluded patients with contra-indications to intravenous contrast or CEMRI, candidates for neo-adjuvant chemotherapy, or who had pure in situ carcinoma. Participants underwent both CESM and CEMRI. Studies were independently double read and results benchmarked against the final surgical histopathology, core biopsy histology or one year follow-up imaging. CESM and CEMRI were compared for 1) detection of additional lesions 2) ability to size the index lesion 3) influence on surgical plan and 4) participant satisfaction. Results: A minimum of 19 participants was analysed for each study objective. For the detection of additional lesions (n1⁄421), the addition of CESM to conventional imaging increased sensitivity from 50% to 67% with specificity unchanged (47%). Addition of CEMRI to standard imaging increased sensitivity from 50% to 100% but with considerable reduction in specificity (47% to 7%). The geometric mean of index lesion size at pathology was similar for CESM and CEMRI (n1⁄424). For 19 patients, CESM and CEMRI had identical influence on the surgery plan. Participants preferred CESM to CEMRI (n1⁄434, p1⁄40.0005). Conclusions: Results so far suggest CESM has similar diagnostic capacity to CEMRI and is preferred by patients.

Multiple sessions of deep brain stimulation using TMS-like protocols reduce cue-induced relapse to cocaine in a rat model

s / Brain Stimulation 8 (2015) 412e427 423 University of Auckland, Clinical Neuroscience Laboratory, Department of Medicine, Auckland, New Zealand Background: External counterpulsation (ECP) enhances cerebral blood flow in patients with subacute ischemic stroke but whether it changes corticomotor excitability, which is a powerful prognostic predictor for motor recovery, remains unknown. Methods: We randomized 30 patients with subacute ischemic stroke within 4-21 days of onset (mean 6.23 days) in this sham-controlled clinical trial to either real ECP (n1⁄415) or sham ECP (n1⁄415). Treatment consisted of daily one hour sessions of ECP for ten days. Clinical measures included National Institutes of Health Stroke Scale (NIHSS); functional measures included Purdue Pegboard Test (PPT), Hand Grip (HG), Pinch Grip (PG); and cortical excitability measures included bilateral resting motor threshold (RMT) and motor evoked potential amplitude (MEP) at 130% of RMT. Measures were made at baseline, post-ECP day 1 (Post 1), and post-ECP day 30 (post 30). Results: There were no significant differences between groups at baseline. At post 30, there were significant differences between the real ECP group vs sham ECP group in normalized ipsilesional MEP amplitude (real: 2.35 vs sham: 1.08, P1⁄40.001) and ipsilesional RMT(real: 0.89 vs sham: 0.96, P1⁄40.039). The increase in HG and PPT were also significantly different between the groups at post 30 (HG: real 9.81 vs sham 4.83, P 1⁄4 0.027; PPT: real 4.73 vs sham 2.00, P 1⁄4 0.014 ), but no differences were found in the NIHSS and PG. No differences were found in the contralesional RMT or MEP amplitude. Conclusion: ECP enhances ipsilesional corticomotor excitability in subacute stroke patients. This proof-of-principle study provides a mechanism of motor recovery facilitated by ECP treatment in ischemic stroke patients. * Joint last authors 369 Multiple sessions of deep brain stimulation using TMS-like protocols reduce cue-induced relapse to cocaine in a rat model I. Goldenberg , R. Gal , S. Zibman , N. Barnea-Ygael , A. Zangen Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel A major hallmark of drug (and especially cocaine-) addiction is relapse to drug use following a period of abstinence. In humans and animal models, relapse can be reliably triggered by presenting cues previously associated with drug self-administration, a phenomenon termed cue-induced relapse (CIR). It has been suggested that changes in neuronal activity in the medial prefrontal cortex (mPFC) following repeated drug use may play a key role in CIR. Here we used a chronically-implanted bilateral linear microelectrode array (14 recording electrodes + 2 stimulating electrodes) to record local field potentials (LFPs) and induce subconvulsive electrical stimulations (SCES) in the mPFC of behaving rats. Following array implantation, rats were trained to self-administer cocaine by pressing a reinforcing lever, and each reinforcement was coupled with a light+tone cues. Thereafter, abstinence from drug-taking was induced using the ‘conflict model’. Next, mPFC-SCES (50 trains of 2.5 sec at 20 Hz every 15 sec, 0.2 ms pulse duration, 400 mAmp) was applied daily (15min/day) for two weeks, simulating a typical human TMS-based treatment. The rats then entered a 30 min CIR-test, during which the cues were non-contingently presented. Cue-induced mPFC-LFP activity was recorded throughout the experiment. Whereas 80% of the rats that did not receive SCES ’relapsed’ to lever-pressing, only 33% of the rats treated with SCES ’relapsed’. Additionally, during the CIR-tests, an increased power was observed in the alpha and beta frequency ranges in response to the cues, but this was attenuated in the ICES treated group. Finally, the electrophysiological response to stimulation was altered during treatment particularly in these bands. It therefore seems that repeated cocaine self-administration is associated with increased saliency of the drug-associated cues manifested, at least, as increased cue-induced alpha/beta mPFC activity, and that SCES treatment of the mPFC reduces relapse rates following abstinence.

Nosocomial bacteriuria in elderly inpatients may be leading to considerable antibiotic overuse: an audit of current management practice in a secondary level care hospital in New Zealand.

BackgroundBacteriuria in the form of symptomatic urinary tract infection (UTI) and asymptomatic bacteriuria (ASB) is common in the elderly. There is no clinical benefit obtained by treating elderly individuals with ASB. However, its high prevalence leads to the overdiagnosis of UTI and unnecessary antibiotic use, which can result in adverse events, including Clostridium difficile diarrhea and reinfection with antibiotic-resistant organisms.MethodsThis was a retrospective audit that assessed the management of nosocomial bacteriuria in elderly patients admitted to the over-65 years rehabilitation unit of a secondary level care hospital in New Zealand. Identified bacteriuria episodes had the timing of sample collection relative to admission, microbial etiology, antibiotic susceptibility profile, inflammatory marker level, and treatment determined. Episodes were classified into six different clinical groups based on the presence or absence of signs and symptoms, urinary catheter status, and systemic inflammatory response. The proportion of bacteriuria episodes by clinical grouping and the level of treatment by clinical group were determined, followed by assessment of the amount of overtreatment in terms of the number of unnecessary antibiotic courses and unnecessary antibiotic treatment days.ResultsSignificant bacteriuria was identified in 30% of patients, with 35% of urine samples collected in the immediate postadmission period. Fifty-four percent of the bacteriuria episodes were ASB or catheter-associated ASB (CA-ASB) without an inflammatory response, 24% were ASB or CA-ASB with raised inflammatory markers, and 22% were UTI or CA-UTI. The most common cause of bacteriuria was Escherichia coli, although the etiology was diverse, especially after prolonged hospitalization or in catheterized patients. A large proportion of organisms were resistant to one or more of the commonly used oral antibiotics. Treatment of ASB and CA-ASB accounted for 43% of all antibiotic courses received. Furthermore, treatment of ASB and CA-ASB combined with unnecessarily prolonged treatment days for clinically relevant infections accounted for 55% of all antibiotic treatment days received.ConclusionThe results suggest that inappropriate urine screening was occurring and that 43% of antibiotic courses and 55% of all antibiotic treatment days were unnecessary. Current practice is amenable to improvement by performing urine culture only when clinically indicated, focusing on clinical signs and symptoms to diagnose clinically significant UTI rather than a positive culture, and using, where possible, the ecologically least damaging antibiotic for the shortest duration required.

The transformation of the utero-placental interface in early pregnancy: Functional insights from computational modeling

The transformation of the utero-placental interface in early pregnancy: Functional insights from computational modeling

A cardiac sparing technique for breast cancer radiation treatment

s / The Breast 23 (2014) S1eS6 S2 A CARDIAC SPARING TECHNIQUE FOR BREAST CANCER RADIATION TREATMENT Christopher Kelly, Kirsten Stuart, Tim Wang, Drew Latty, Verity Ahern. Crown Princess Mary Cancer Centre (CPMCC), and Breast Cancer Institute NSW, Westmead Hospital, Australia Background: Historically left-sided breast cancer radiation treatment has been associatedwith an excess risk of cardiac deaths1, and every additional 1Gy mean cardiac dose results in a relative increase in cardiac events of 7.4%2. Methods: A deep inspiratory breath hold (DIBH) techniquewas introduced as a method of reducing the volume of heart in breast / chest wall tangential radiation treatment at CPMCC in 2010, one of the few centres using this technique in Australia. This study evaluates the impact of DIBH on cardiac radiation dose. Results: A total of 51 patients underwent an attempt at radiation treatment simulation by DIBH as well as the conventional ‘free breathing’ (FB) approach between December 2010 and April 2013. Thirty eight patients proceeded to treatment delivery by DIBH. Thirteen patients did not undergo treatment by DIBH, either because DIBH did not reduce the cardiac dose (6 patients) or because they were not able to follow instructions for DIBH (7 patients). For the 38 patients who underwent DIBH, the simulated size of the heart measured as a volume varied between FB and DIBH by 72% 115%. The mean irradiated heart dose calculated by simulation was 6.2Gy by the DIBH technique and higher by the FB technique for all 38 patients .It was a mean of 7.0Gy for the 13 patients treated by FB .Six of 38 patients underwent fluoroscopic imaging of one radiation field during treatment on at least two occasions. For the six patients as a group, the heart moved between 1 and 6mm during the fluoroscopic imaging. Conclusions: DIBH is a suitable technique to reduce the cardiac volume irradiated for some patients with left sided breast cancer. We are now exploring the best method of measuring cardiac position during treatment, and how we can help more women cope with this procedure.

Factors predicting the nodal involvement in early breast cancer

s / The Breast 23 (2014) S1eS6 S5 FACTORS PREDICTING THE NODAL INVOLVEMENT IN EARLY BREAST CANCER A. Elmadahm, P. Gill , G. Farshid , V. Gebski , M. Bilous , S. Lord , L. Chee , N. Wetzig . University of Adelaide, North Terrace, Adelaide, SA, Australia; NHRMC Clinical trial Centre, University of Sydney, Sydney, NSW, Australia; 3 Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Wesley Medical Centre, Brisbane, QLd, Australia Background: The nodal status is an important prognostic factor in early breast cancer. This study assessed association between clinicopathological factors and involvement of Sentinel Lymph Node (SLN) and Non Sentinel Lymph Node (NSLN) in the SNAC 1 trial. Accurate statistical models can assist surgical counselling and potentially avoid axillary surgery in selected cases. Method: This is a retrospective analysis of 1088 patients. Lymphoscintigraphy, blue dye injection and gamma probe were used for SLN mapping and retrieved nodes were examined with HE 16:266-75. TREATMENT DELAY FOR M AORI WOMEN WITH BREAST CANCER IN NEW ZEALAND S.A. Seneviratne, I.D. Campbell, N. Scott, R. Lawrenson. Waikato Clinical School, University of Auckland, New Zealand Background: Delays in diagnosis and treatment of breast cancer are associated with lower survival rates 1. Indigenous M aori women have 60% higher overall and 32% higher stage adjusted breast cancer mortality compared to European women in New Zealand (NZ) 2. We sought to evaluate factors associated with delays of >31 and >90 days for surgical treatment of breast cancer among NZ womenwith newly diagnosed breast cancer. Methods: A retrospective analysis of prospectively collected data included in the Waikato Breast Cancer Register from 01/01/2005 through 31/12/ 2010 was performed. Results: 1449 (out of 1510, 96%) breast cancers diagnosed within Waikato, over the study period were included. Out of women undergoing primary surgery (n1⁄41264), 59.6% and 98.2% underwent surgery within 31 and 90 days of diagnosis respectively. Compared with NZ European women (mean 30.4 days), significantly longer delays for surgical treatment were observed among M aori (mean 36.9, p with NZ European women, higher proportions of M aori and Pacific Island women (statistically non-significant) experienced delays longer than 31 days (40.2% vs. 47.8% and 52.1%, P>0.05) and 90 days (1.6% vs. 2.7% and 4.3%, p>0.05). Multivariate analysis identified public sector treatment (OR 5.93 and 8.14), DCIS (OR 1.53 and 3.17), mastectomy as treatment (OR 1.75 and 6.60) and earlier year of diagnosis (1.21 and 1.03) as factors significantly associated with delays longer than 31 and 90 days. Conclusions: A high proportion of women not initiating surgical treat- ment of breast cancer within the stipulated guideline limit of 31 days and significantly longer delays experienced by ethnic minority women were highlighted in this study. Urgent steps are needed to improve performance and to shorten treatment delays in public sector to minimize delays overall, and to reduce ethnic inequities in breast cancer treatment in NZ.

Recruitment evaluation of a preschooler obesity-prevention intervention

The aim of this paper was to compare the recruitment strategies of two recent studies that focused on the parental influences on childhood obesity during the preschool years. The first study was a randomised controlled trial (RCT) of the Mind, Exercise, Nutrition … Do It! 2–4 obesity prevention programme and the second was a longitudinal cohort study. For both studies, the desired population were families with preschool children at risk of developing overweight or obesity. Hence, families from diverse ethnic and socio-economic backgrounds were sought. Funding for the RCT provided the resources to adopt a targeted approach to recruitment whereas for the longitudinal study, recruitment was random and opportunistic, rather than specific and targeted. The RCT reported higher child body mass index-for-age z scores, more families not from an Australian or New Zealand background, and more families in the lowest income bracket, suggesting that strategically targeted approaches to recruitment are more likely to achieve the desired sample.

Climbing up from the abyss of problem gambling: a story of an international student in New Zealand

Correspondence: john.wong@pgfnz. org.nz Asian Family Services at the Problem Gambling Foundation of New Zealand, Auckland, New Zealand Background I was born in China. I came to Auckland, New Zealand to study English when I was 22 years old. Obtaining a tertiary degree in business and marketing was my ultimate goal. During the initial few months, I enjoyed the New Zealand life style very much. I loved the fresh air, the delicious Eastern and Asian food, the kiwi culture, and the beautiful waterfront and beaches. I made new friends who came from everywhere around the world. I was greatly amazed with this new life experience!

Variation in the gene coding for BDNF influences the integrity of white matter tracts within recognition memory circuits.

Event Abstract Back to Event Variation in the gene coding for BDNF influences the integrity of white matter tracts within recognition memory circuits. Nicole Mckay1* and Ian J. Kirk1 1 University of Auckland, New Zealand Background: Recognition memory allows for the discrimination of stimuli that have been previously encountered from those that have not. Previous research has suggested that performance on recognition memory tasks is influenced by a single nucleotide polymorphism (SNP) observed within the gene that codes for brain derived neurotrophic factor (BDNF). This SNP is known to affect the functional activity of BDNF and carriers of the BDNF Met allele have shown impaired performance on recognition memory tasks as well as reduced hippocampal volume compared to Val homozygotes. It is of interest to us to determine whether observed behavioural differences between Met allele carriers and Val homozygotes might be underpinned by white matter connectivity differences. Methods: 30 healthy participants completed two behavioural tasks that were designed to examine familiarity and recollection based recognition memory performance. Diffusion weighted images were also collected for each participant and probabilistic tractography was used to trace out thalamo-cortical pathways of interest. Results: Connectivity of thalamo-cortical pathways differed between the two genotype groups. Carriers of the Met allele were found to have reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in tracts seeded from the anterior and medial dorsal thalamic nuclei compared to Val homozygotes. Behavioural results showed no difference in accuracy between the two groups, however, connectivity measures were found to account for 60% of the variance in the recognition scores of our participants and therefore might indicate problems with the sensitivity of our behavioural tasks. Discussion: We have found that across thalamo-cortical pathways implicated in recognition memory circuits, carriers of the BDNF Met allele have reduced connectivity as measured by FA and MD. This was particularly apparent in pathways seeded from the anterior thalamic nuclei, which is thought to be a critical component of the neural circuit for recollection-based recognition memory. These results are consistent with previous findings that Met allele carriers perform worse on recognition memory tasks. Our findings indicate that BDNF genotype influences white matter microstructure and we therefore propose that in Met allele carriers, this results in a loss of tract integrity and may underpin the decrease in recognition memory performance observed in previous studies. Keywords: BDNF, Diffusion Tensor Imaging, Probabilistic Tractography, imaging genetics, Thalamus, thalamocortical projections, recognition memory, connectivity Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Oral Topic: Memory Citation: Mckay N and Kirk IJ (2013). Variation in the gene coding for BDNF influences the integrity of white matter tracts within recognition memory circuits.. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00112 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 23 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Ms. Nicole Mckay, University of Auckland, Auckland, New Zealand, nicole.mckay@auckland.ac.nz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Nicole Mckay Ian J Kirk Google Nicole Mckay Ian J Kirk Google Scholar Nicole Mckay Ian J Kirk PubMed Nicole Mckay Ian J Kirk Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Global motion detection, stereopsis, and motor development are related at the age of 2-years

Event Abstract Back to Event Global motion detection, stereopsis, and motor development are related at the age of 2-years Tzu-Ying (. Yu1*, Judith Ansell2, Nicola Anstice1, Robert Jacobs1, Nabin Paudel1, Trecia Wouldes3, Jane Harding2 and Benjamin Thompson1 1 The University of Auckland, Optometry and Vision Science, New Zealand 2 The University of Auckland, Liggins Institute, New Zealand 3 The University of Auckland, Psychological Medicine, New Zealand Background: The dorsal cortical processing stream is thought to support global motion processing, stereopsis and visuo-motor coordination. Deficits in global motion processing have been reported in groups of children with or at risk of abnormal neurodevelopment which has led to the dorsal stream vulnerability hypothesis. However, it is unclear whether the development of global motion processing is associated with the development of other abilities that may rely on the dorsal stream. The purpose of this study was to assess the relationship between global motion detection, stereopsis and motor development in a group of 2-year old children born at risk of abnormal neurodevelopment. Methods: Children born with risk factors for neonatal hypoglycaemia (n=403) were assessed at 24±1 months corrected age. Global motion coherence thresholds were measured using the method of constant stimuli by presenting random-dot-kinematograms and recording the optokinetic reflex. Stereopsis was measured using LANG I&II and Frisby stereotests. Motor functions were measured using the Bayley Scales of Infant Development III (BSID-III). Data were analysed using Spearman’s Rho and multiple comparisons were accounted for using the Bonferroni correction. Results: Global motion coherence thresholds, successfully measured in 334 children, were significantly correlated with BSID-III composite motor (r=-0.19, p=0.001), fine motor (r=-0.16, p=0.004), and gross motor (r=-0.17, p=0.002) scores, with poorer global motion coherence thresholds associated with poorer motor scores. Stereopsis was successfully measured in 333 children using the LANG I&II stereotest and in 222 children using the Frisby stereotest. Both LANG I&II and Frisby stereopsis results correlated with composite motor (r=-0.17, p=0.002 and r=-0.19, p=0.004) and fine motor (r=-0.22, p less than 0.001 and r=-0.20, p=0.002) scores as well as global motion coherence thresholds (r=0.28, p less than 0.001 and r=0.18, p=0.013). However, stereopsis was not significantly correlated with gross motor scores (r=-0.08, p=0.135 and r=-0.065, p=0.337). Discussion: Global motion detection, stereopsis, and motor function were correlated in 2-year-old children. The results are consistent with the hypothesis that the dorsal processing stream contributes to both visual and motor development. Acknowledgements This abstract was prepared on behalf of the CHYLD Study Team, Liggins Institute, Univeristy of Auckland. The research is supported by funding from: National Institutes of Health (US) Health Research Council (NZ) Faculty Research Development Fund (University of Auckland) Waikato Medical Research Foundation (NZ) New Zealand Association of Optometrists (NZ) Keywords: dorsal stream, Motor development, Visual development, global motion, random dot kinematic displays, optokinetic reflex, infant neurodevelopment Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Oral or poster presentation Topic: Motor Citation: Yu T(, Ansell J, Anstice N, Jacobs R, Paudel N, Wouldes T, Harding J and Thompson B (2013). Global motion detection, stereopsis, and motor development are related at the age of 2-years. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00186 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 15 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Ms. Tzu-Ying ( Yu, The University of Auckland, Optometry and Vision Science, Auckland, New Zealand, sandy.yu@auckland.ac.nz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Tzu-Ying ( Yu Judith Ansell Nicola Anstice Robert Jacobs Nabin Paudel Trecia Wouldes Jane Harding Benjamin Thompson Google Tzu-Ying ( Yu Judith Ansell Nicola Anstice Robert Jacobs Nabin Paudel Trecia Wouldes Jane Harding Benjamin Thompson Google Scholar Tzu-Ying ( Yu Judith Ansell Nicola Anstice Robert Jacobs Nabin Paudel Trecia Wouldes Jane Harding Benjamin Thompson PubMed Tzu-Ying ( Yu Judith Ansell Nicola Anstice Robert Jacobs Nabin Paudel Trecia Wouldes Jane Harding Benjamin Thompson Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Evidence of Hyperplasticity in adults with Autism Spectrum Disorder

• 1 University of Auckland, School of Psychology, New Zealand Background: Long-term potentiation (LTP) is a form of synaptic plasticity involved in learning and memory. Abnormal levels of LTP have been suggested to contribute to symptoms in a number of disorders, and here we examined the extent to which LTP may be affected in autism spectrum disorders (ASD). While animal models of ASD have suggested LTP may be atypical, the results have been inconsistent in terms of the direction of abnormality. Methods: An EEG paradigm for non-invasively eliciting LTP in humans was applied to a group of adults with ASD and matched neurotypical (NT) controls. This paradigm uses high frequency visual stimulation as the LTP inducing stimulus, and the increase in amplitude of the visually-elicited N1b component of the visual evoked potential (VEP) is taken as the index of LTP. Results: It was found that the ASD group had a significantly larger LTP effect relative to the neurotypical control group. Discussion: These results provide support for the “Intense World” theory, in which hyper-plasticity is thought to underlie cognitive symptoms in ASD. This non-invasive paradigm for eliciting LTP has potential to be applied in a clinical setting as a neural marker for ASD.

Enhanced lateralization in expert musicians: an fMRI investigation of visuospatial processing

Event Abstract Back to Event Enhanced lateralization in expert musicians: an fMRI investigation of visuospatial processing Laura Ewens1*, Lynette J. Tippett1 and Donna R. Addis1 1 The University of Auckland, New Zealand Background: Expert musicians are regarded as an excellent model of neuroplasticity due to their early and intensive musical training. Cross-sectional research consistently identifies behavioural and neural differences between musicians and non-musicians, across a range of cognitive domains and brain regions. Previous behavioural and electrophysiological research has indicated musicians have an enhanced ability to direct visual attention to both sides of space, however to date this has not been explored with functional magnetic resonance imaging (fMRI). This study sought to identify differences in the lateralization of activation during two visuospatial attention tasks, with musicians expected to have more bilateral, and non-musicians more right-sided activation. Method: Visuospatial processing and its neural correlates were assessed in 14 adult musicians and 13 non-musicians using fMRI. Two tests of visuospatial processing were employed: the Landmark task (a variant of a line bisection task) and a visual search task. Laterality index (LI) scores were calculated to assess lateralization in parietal and occipital ROIs. Results: Preliminary behavioural data suggests that musicians were more accurate in the two tasks. The LI scores indicate that, contrary to predictions, musicians appeared to be more strongly right-lateralised than non-musicians on the Landmark task. On the Visual Search task, LI scores in both groups indicated bilateral activation with no significant group difference. Discussion: Musicians were more accurate than non-musicians with comparable reaction times. This is in line with previous research indicating enhanced visuospatial processing in musically trained individuals. Against predictions, musicians were more right-lateralised on the Landmark task. This suggests that previous behavioural research finding more symmetric visual attention in musicians is a result of enhanced processing in right-hemispheric visuospatial regions. Keywords: visuospatial processing, visuospatial attention, musicians, fMRI, plasticity Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Poster Topic: Sensation and Perception Citation: Ewens L, Tippett LJ and Addis DR (2013). Enhanced lateralization in expert musicians: an fMRI investigation of visuospatial processing. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00140 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 17 Sep 2013; Published Online: 25 Nov 2013. * Correspondence: Miss. Laura Ewens, The University of Auckland, Auckland, New Zealand, lauraewens@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Laura Ewens Lynette J Tippett Donna R Addis Google Laura Ewens Lynette J Tippett Donna R Addis Google Scholar Laura Ewens Lynette J Tippett Donna R Addis PubMed Laura Ewens Lynette J Tippett Donna R Addis Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Melody and gamma oscillations: processing of contour and interval in musicians and non-musicians

Event Abstract Back to Event Melody and gamma oscillations: processing of contour and interval in musicians and non-musicians Rohan King1, 2*, Ian J. Kirk1, 2 and Chris King3 1 The University of Auckland, School of Psychology, New Zealand 2 The University of Auckland, New Zealand 3 The University of Auckland, New Zealand Background: Current thinking is that melody is processed as interval and contour information separately. Musical training also impacts musical processing, and musicians have an increased and differing response to contours and intervals. Musicians also show greater synchrony of gamma oscillations with music. This study investigated gamma processing of interval and contour in musicians and non-musicians. Methods: Sixteen adults (10 musicians and 6 non-musicians) were presented with two melodies and versions of those melodies with interval or contour violations at various note points, with EEG activity measured at 1000Hz. Continuous wavelet transforms (CWTs) of the data were computed over 30-60Hz and averaged. Regions of interest were selected from the average CWTs using a Monte Carlo searching algorithm. A Monte Carlo approximation of the permutation test was used to assess the significance of gamma power within selected regions of interest. The cluster mass test was used in the permutation test. Results: Several significant regions of interest were found. For interval in musicians electrode 101 (right posterior temporal) had activity at 341-376ms after the violation, E64 (left posterior temporal) at 798ms, E87 (right parietal) at 699ms and E62 (central parietal) at 765ms. For interval in non-musicians there was activity at 660ms in E103 (right temporoparietal) and at 629-676ms in E105 (right central). For contour in musicians E50 (left posterior temporal) had activity at 273-315ms and E108 (right inferior temporal) at 680ms. For contour in non-musicians there was activity at 357ms in E81 (central) and at 675-709ms in E32 (central). Discussion: Similar to previous research, musicians had greater activity, interval generally showed more pronounced activity, and a pattern of early and late activity was observed. Musicians in particular had significant activity in temporal electrodes, with an interesting timing difference between interval (right then left) and contour (left then right). Activity in parietal electrodes was also congruent with previous research, suggesting parietal processing may be important for forming auditory gestalts. These results support a role of gamma oscillations in the processing of melody. Keywords: music cognition, melody processing, gamma oscillations, musicians, EEG, wavelets, wavelet analysis, Monte Carlo method Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Poster Topic: Other Citation: King R, Kirk IJ and King C (2013). Melody and gamma oscillations: processing of contour and interval in musicians and non-musicians. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00053 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 15 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Mr. Rohan King, The University of Auckland, School of Psychology, Auckland, New Zealand, r.king@auckland.ac.nz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Rohan King Ian J Kirk Chris King Google Rohan King Ian J Kirk Chris King Google Scholar Rohan King Ian J Kirk Chris King PubMed Rohan King Ian J Kirk Chris King Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Behavioural and neural correlates of autobiographical memory and future thinking in depression

Event Abstract Back to Event Behavioural and neural correlates of autobiographical memory and future thinking in depression Donna Rose Addis1*, Sylvia Hach1 and Lynette J. Tippett1 1 The University of Auckland, School of Psychology, New Zealand Background: Major depressive disorder (MDD) is associated with a decrease in the specificity of past and future events: When engaged in autobiographical memory (AM) or future thinking (FT) tasks, patients with a history of MDD generate more generic events compared to non-depressed individuals. The CaRFAX model proposes that reduced event specificity results from a combination of rumination, functional avoidance as well as executive dysfunction. In this study, we tested the contribution of CaRFAX model components to the specificity of past and future events in MDD. Moreover, we explored whether there are differences in the neural correlates of AM and FT during the generation of specific events from the past and future. Methods: In Session 1, participants (17 MDD, 16 controls) completed measures of rumination, avoidance and executive function (working memory, inhibition, set-shifting and strategy use). In Session 2 (fMRI), participants generated past and future events in response to cues (e.g., getting/losing a pet). Events were scored for specificity during a post-scan interview. For the fMRI analysis (using spatiotemporal task Partial Least Squares), behaviour was matched across groups by only analysing trials on which specific events were generated. Results: The MDD group were more ruminative and avoidant than controls, and generated fewer specific events during the AM and FT task. However, there were no group differences in executive function. Regressions revealed that strategy use (as indexed by CVLT semantic clustering) was associated with specificity over and above depression severity, rumination and avoidance. fMRI analyses showed that both groups engaged regions typically associated with AM and FT. However, the MDD group showed reduced activity in temporal regions (hippocampus, temporal pole) and increased recruitment of frontal regions (e.g., inferior frontal gyrus). Discussion: Our results suggest that strategic abilities and neural changes both play an important role in the generation of specific past and future events in MDD. Strategic ability predicts event specificity over and above measures of rumination and avoidance. Although the MDD group was able to engage the same network as controls, they did exhibit reductions in key regions, such as the hippocampus, consistent with reports of hippocampal atrophy in MDD. However, prefrontal regions were over-activated in MDD, which may reflect greater executive demands and/or compensatory activation. Acknowledgements This work was funded by a Rutherford Discovery Fellowship (DRA). Keywords: Depression, autobiographical memory, Future thinking, fMRI, Executive Function Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Oral Topic: Memory Citation: Addis D, Hach S and Tippett LJ (2013). Behavioural and neural correlates of autobiographical memory and future thinking in depression. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00191 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 15 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Dr. Donna Rose Addis, The University of Auckland, School of Psychology, Auckland, New Zealand, d.addis@auckland.ac.nz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Donna Rose Addis Sylvia Hach Lynette J Tippett Google Donna Rose Addis Sylvia Hach Lynette J Tippett Google Scholar Donna Rose Addis Sylvia Hach Lynette J Tippett PubMed Donna Rose Addis Sylvia Hach Lynette J Tippett Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

The COMT Val158Met polymorphism: Individual differences in visual N1 and error-related negativity

Event Abstract Back to Event The COMT Val158Met polymorphism: Individual differences in visual N1 and error-related negativity Jennifer Y. Lai1*, Melissa E. Pauling1 and Ian J. Kirk1 1 The University of Auckland, School of Psychology, New Zealand Background: The catechol-O-methyltransferase (COMT) Val158Met polymorphism is a commonly occurring genetic variation that affects catecholamine neurotransmitter levels in the human brain, which most notably includes frontal dopamine. In recent years, researchers have associated COMT Val158Met with inter-individual differences in cognitive control, and susceptibility to psychopathology. COMT Met/Met carriers are hypothesized to have high synaptic dopamine activity and poorer cognitive flexibility relative to Val/Val carriers. The aim of the current study is to investigate how the COMT Val158Met polymorphism may influence the event-related potentials (ERPs) linked to fear processing and conflict monitoring. Methods: A sample of young adults living in New Zealand was genotyped for the COMT Val158Met polymorphism. A novel Faces Go/No-Go task, which featured neutral and angry faces as the visual stimuli, was used to examine the global field power peak amplitude for the N1 visual potential and the error-related negativity (ERN). Results: Emerging trends in the data indicate that COMT Met/Met individuals tended to have larger N1 amplitudes to the visual processing of angry faces, and conversely, they tended to have smaller ERN amplitudes after committing task errors compared to the two other groups. Discussion: The present study contributes to the understanding of the COMT Val158Met polymorphism as it affects frontal control mechanisms. Thus far, our findings support the existing hypotheses that the COMT Met/Met variant relates to poorer cognitive flexibility and greater susceptibility to social anxiety. However, replication with a larger sample will be needed to determine if the trends can reach statistical significance. Keywords: COMT Val158Met polymorphism, Dopamine, error-related negativity (ERN), visual N1, conflict monitoring Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Poster Topic: Executive Processes Citation: Lai JY, Pauling ME and Kirk IJ (2013). The COMT Val158Met polymorphism: Individual differences in visual N1 and error-related negativity. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00107 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 24 Sep 2013; Published Online: 25 Nov 2013. * Correspondence: Miss. Jennifer Y Lai, The University of Auckland, School of Psychology, Auckland, New Zealand, jenniferlai224@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Jennifer Y Lai Melissa E Pauling Ian J Kirk Google Jennifer Y Lai Melissa E Pauling Ian J Kirk Google Scholar Jennifer Y Lai Melissa E Pauling Ian J Kirk PubMed Jennifer Y Lai Melissa E Pauling Ian J Kirk Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Early Prevent Pilot: Towards the Systemic Use of Dispensing Records to Prevent Treatment Gaps Early After Acute Coronary Syndromes-Proof of Concept

Early Prevent Pilot: Towards the Systemic Use of Dispensing Records to Prevent Treatment Gaps Early After Acute Coronary Syndromes-Proof of Concept

Predictors of Intervention in Acute Coronary Syndrome Patients with pre-Existing Bypass Grafts

Predictors of Intervention in Acute Coronary Syndrome Patients with pre-Existing Bypass Grafts T.A.C. Snow ∗, T. Watson, P.N. Ruygrok, M.W. Webster, J.T. Stewart Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand Background: The majority of patients who present to hospital with an acute coronary syndrome (ACS) undergo angiography with a view to revascularisation. However a large proportion of those with pre-existing coronary artery bypass grafts (CABG) have little scope for further intervention and are consequently treated medically. We investigated predictors of ability to offer percutaneous coronary intervention (PCI) in this cohort of patients. Methods: Case notes for all patients with previous CABG who presented to our unit with an ACS between May 2010 and February 2012 were reviewed. Clinical predictors for repeat revascularisationwere establishedusing binary logistic regression analysis. Results: 160 patients (mean age 70.2± 9.3 years, 82.5% male)were identified. Themeanduration sinceCABGwas 12.1± 6.6 years. The median number of grafts was three (range1–7)perpatient (90.6%hada left internalmammary, 80.3% had one or more saphenous venous and 26.3% had one or more radial artery grafts). Following angiography, PCI was undertaken in 66 (41.3%), 33 (50%) to the native c n