Faculty of Health and Environmental Sciences (Te Ara Hauora A Pūtaiao)

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The frequency and incidence of low-back-pain/sciatica in an urban-population
(New Zealand Medical Association, 1991-10-09) Laslett, M; Crothers, C; Beattie, P; Cregten, L; Moses, A
The frequency, incidence and severity of low back pain was assessed by a random telephone survey of 314 urban New Zealanders. Relationships between the severity and frequency of low back pain and referred lower extremity pain and other variables such as occupation, recreation, age, sex and predominant working posture was analysed.Point incidence was 17.5%, weekly incidence 33.4%, yearly incidence 63.7% and total incidence 79%. Some 28.3% get frequent minor episodes and 6.4% get frequent severe episodes of low back pain. Nearly 50% suffer the initial episode before the age of 30 years.Of those suffering low back pain within the last seven days, 14.3% experience reference below the knee and the total incidence of below knee pain was 13.7%. Over half (51.6%) have pain that has lasted seven days or less, but a third have had pain for longer than seven weeks. No correlation between the incidence of low back pain and referred pain and occupational posture was found.In conclusion, this telephone survey established that the incidence of low back pain in New Zealand is similar to that reported in overseas studies. The survey could not establish differences in low back pain characteristics across different social groupings, nor could a relationship between occupational posture and low back pain be established.
New nematode species and genera (Chromadorida, Microlaimidae) from the deep sea of the eastern tropical South Pacific
(Natural History Museum Vienna, 1999) Bussau, C; Vopel, K
Six new nematode species are described from the sediment of a manganese nodule area of the abyssal eastern South Pacific: Aponema nympha sp.n., Caligocanna mirabilis gen.n. sp.n., Microlaimus discolensis sp.n., M. clancularius sp.n., M. porosus sp.n., and Bathynox clavata gen.n. sp.n.. The new genera Caligocanna and Bathynox are considered to belong to the Microlaimidae MICOLETZKY, 1922. The genus Caligocanna gen.n. differs from all other genera of the family Microlaimidae in combining the following characters: The six cephalic setae of the second circlet longer than the four cephalic setae of the third circlet. Annulated cuticle; annules with numerous longitudinal bars. Monospiral amphids turn ventrally. The genus Bathynox gen.n. differs from all other genera of the family Microlaimidae in having projecting, club-shaped corpora gelata and somatic setae positioned on peduncles.
Self-organising Maps to Study the Effects of Urbanisation at Long Bay in New Zealand
(Knowledge Engineering Lab, the University of Otago, 2001) Shanmuganathan, S; Sallis, P; Buckeridge, JS
Biologically inspired Artificial Neural Network (ANN) modelling methods provide a means of problem solving that incorporates heuristics with conventional algorithmic processing Over the last few decades, nell' techniques for neuron relationship modelling and network architecture algorithms have been introduced to solve a ll'ide range of problems across many fields. This paper looks into the aspects of using SOMs to a biological example to permit understanding of a complex environmental process. The preliminmy research results to study the effects of urbanisation on marine life at the Long Bay-Okura Marine Reserve, situated in northern Nell' Zealand is discussed in detail. This was the count1y 's first urban, marine resen1e to be established (1995), and resulted from groll'ing concern of environmental groups and general public of the area. Since then many institutions have conducted research to find the cause for the observed environmental change. All these data sets are fused and analysed collectively to study the patterns in them. The use of SOMs to industrial process monitoring has been ve1y successful in many areas and is applied here to study the process dynamics in environmental process modelling with SOM trajectories. The analyses show the relationships found in the data sets from different sources in easily perceivable formats without having to model the complex physical process.
Microclimate of the brown alga Feldmannia caespitula interstitium under zero-flow conditions
(Inter Research, 2001) Pohn, M; Vopel, K; Grunberger, E; Ott, J
The microclimate of the brown alga Feldmannia caespitula (J. Agardh) Knoepffler-Peguy interstitium was studied using microelectrode techniques. Zero water flow and irradiances of 170 and 1500 mu mol photons m(-2) s(-1) cause steep O-2 gradients peaking 3 to 4 mm below the outer surface of the tufts at 310 and 506% atmospheric saturation, respectively. The mean fluxes of O-2 from the interstitium to the surrounding bulk water were 87 +/- 21 and 262 +/- 68 nmol cm(-2) h(-1) at low and high quantum flux density. Except for the outer 2 to 4 mm thick margin, the alga interstitium became anoxic within 52 min after abrupt darkening. The rate of dark oxygen uptake was 52 +/- 5 nmol cm(-2) h(-1). The tufts were populated by 9 metazoan taxa: nematodes, harpacticoid copepods, ostracods, gastropods, bivalves, polychaetes, amphipods, isopods and halacarids. Our results suggest that the interstitium of fine-textured algal thalli is a microhabitat of variable water chemistry with temporary anoxia and hyperoxia in an otherwise relatively stable water column. Although the tufts are attractive for meiofauna by providing food and protection from currents and predators, rapid fluctuations in oxygen concentration probably cue temporal emigration of the algal infauna.
The use of evidence-based practice in the physiotherapy management of the uncomplicated coronary artery bypass graft patient in the United Kingdom
(Australian Physiotherapy Association, 2001) Reeve, JC; Ewan, S,
Ciliate-generated advective seawater transport supplies chemoautotrophic ectosymbionts
(Inter-Research, 2001-01-26) Vopel, K; Pohn, M; Sorgo, A; Ott, J
Variations of [O2] and [H2S] in seawater surrounding laboratory reared sessile ciliates with ectosymbiotic chemoautotrophic bacteria were studied at high spatial and temporal resolutions using amperometric microsensors. We show how suspension feeding by the colonial Zoothamnium niveum and the solitary Vorticella sp. in the chemocline (O2/H2S-interface) of near-natural and artificial H2S-releasing substrates generates the physico-chemical microenvironment for the ectobiotic bacteria. Continuous recordings revealed a steep increase of [O2] and decrease of [H2S] in the proximal region of Z. niveum colonies during rapid stalk contraction. Hydrogen sulphide concentrations 2.5 mm above the substrate (upper end of the fully extended colony) increased when the contracted colony extended, followed by a decrease after the colony attained the fully upright position. Multiple contractions without complete extension successively transported sulphidic seawater upwards. The solitary Vorticella sp. maintained high ambient [O2] and low [H2S] 350 μm above the H2S-releasing membrane by generating a vertical flow field that drew seawater from above toward the ciliate. Oxygen concentration at the proximal part of Vorticella sp. did not increase during contraction, whereas during slow extension deoxygenated seawater was transported upwards and rapidly mixed with the surrounding oxygenated seawater when the ciliate started to beat its cilia. In both species rapid stalk contraction and subsequent slow extension enhanced the mixing of oxygenated and deoxygenated, H2S-containing seawater; the feeding currents (toroidal vortices) drew the surrounding seawater within reach of the zooid’s external surface at high speed. It is suggested that this advective fluid transport supplies the ectobiotic bacteria with O2 and H2S simultaneously. The high fluid velocity may cause a decrease in cell boundary layer thickness, thereby enhancing rates of nutrient uptake by the ectobiotic bacteria.
Flow microenvironment of two marine peritrich ciliates with ectobiotic chemoautotrophic bacteria
(Inter-Research, 2002-09-03) Vopel, K; Reick, CH; Arlt, G; Pohn, M; Ott, JA
The flow microenvironment of 2 marine peritrich ciliates, Vorticella sp. and Zoothamnium niveum, with ectobiotic sulfur bacteria was studied with frame-by-frame analyses of video sequences and a microsensor for fluid velocity. Both species populate the chemocline above H2Sreleasing mangrove peat. Vorticella sp. moves the surrounding seawater up to a horizontal and vertical distance of at least 400 μm with a maximum flow velocity of 18 mm s–1 close to its peristomial edge. The feather-shaped colonies of Z. niveum generate a unidirectional flow of seawater passing the colony perpendicular to the stalk; the convex side of the feather faces upstream. The flow velocity increased exponentially towards the colony, up to 11 mm s–1 at a distance of 100 μm. Contraction of the stalk forces the zooids of Vorticella sp. and Z. niveum towards the substrate at a high velocity of 71 and 520 mm s–1, respectively. During contraction of Vorticella sp., only little seawater is dragged along towards the surface to which the ciliates are attached whereas the contraction of Z. niveum resulted in a clear increase in the velocity of the seawater both surrounding the colony and above the substrate. Extension of the species proceeds 700 to 1000 times more slowly than contraction, and the surrounding seawater sticks to the cells and therefore is dragged along. The measurements given here support our earlier data indicating the importance of the feeding current for the bacteria-ciliate association, i.e. the cilia beat drives H2S- and O2-containing seawater toward the zooid at high velocity and thus, supports the growth of the ectobiotic sulfide-oxidizing bacteria. Rapid movement, shrinkage (Vorticella sp.) and bunching (Z. niveum) of the zooids during stalk contraction apparently cause sufficient shear stress to abrade ectobiotic bacteria that, once suspended, could enter the feeding currents.
A survey of physiotherapy on-call and emergency duty services in New Zealand
(New Zealand Society of Physiotherapists, 2003) Reeve, JC
Physiotherapists working in hospitals are commonly required to undertake emergency on-call duties. Concerns from within the profession about the quality of on-call services have been expressed. The aims of this study were to audit oncall practice in New Zealand, identify variations in service provision and ascertain physiotherapists’ concerns in providing these services. A postal questionnaire was distributed to senior physiotherapists in all New Zealand hospitals expected to provide physiotherapy emergency on-call duties (n = 38). A response rate of 97.4% (n=37) was obtained of which 33 respondents provided on-call physiotherapy. Assessment of competency to undertake on-call duties, agreed standards of practice, the use of protocols, training and support provided were ascertained. Respondents were asked to highlight their most important concerns in the provision of their on-call service. These were found to be maintenance of competency, service provision, training and resource issues. This study demonstrates wide variations in the practice and provision of on-call duties by physiotherapists and highlights common concerns in the provision of these services. Strategies to diminish these concerns require further consideration at both national and local levels.
Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests
(Australian Physiotherapy Association, 2003) Laslett, M; Young, SB; Aprill, CN; McDonald, B
Research suggests that clinical examination of the lumbar spine and pelvis is unable to predict the results of diagnostic injections used as reference standards. The purpose of this study was to assess the diagnostic accuracy of a clinical examination in identifying symptomatic and asymptomatic sacroiliac joints using double diagnostic injections as the reference standard. In a blinded concurrent criterion-related validity design study, 48 patients with chronic lumbopelvic pain referred for diagnostic spinal injection procedures were examined using a specific clinical examination and received diagnostic intraarticular sacroiliac joint injections. The centralisation and peripheralisation phenomena were used to identify possible discogenic pain and the results from provocation sacroiliac joint tests were used as part of the clinical reasoning process. Eleven patients had sacroiliac joint pain confirmed by double diagnostic injection. Ten of the 11 sacroiliac joint patients met clinical examination criteria for having sacroiliac joint pain. In the primary subset analysis of 34 patients, sensitivity, specificity and positive likelihood ratio (95% confidence intervals) of the clinical evaluation were 91% (62 to 98), 83% (68 to 96) and 6.97 (2.70 to 20.27) respectively. The diagnostic accuracy of the clinical examination and clinical reasoning process was superior to the sacroiliac joint pain provocation tests alone. A specific clinical examination and reasoning process can differentiate between symptomatic and asymptomatic sacroiliac joints.
Effect of the brittle star Amphiura filiformis (Amphiuridae, Echinodermata) on oxygen flux into the sediment
(American Society of Limnology and Oceanography (ASLO) - Blue Policies in RoMEO, 2003-09-01) Vopel, K; Thistle, D; Rosenberg, R
O-2 plays a key role in early sedimentary diagenetic processes, but the effect of most macrofaunal species on the pathways and rates of supply of O-2 into the seabed are not well known. We investigated the effect of the ophiuroid Amphiura filiformis, one of the dominant macrobenthic species on soft bottoms in the northeast Atlantic, at depths of similar to15-100 m, in a laboratory environment. We determined how the presence of the ophiuroid changed the total O-2 uptake of macrofauna-free sediment by combining measurements from a microcosm approach and an approach that uses microelectrodes and a flushed aquarium. We suggest that natural populations of A. filiformis can account for 80% of the total flux of O-2 into the soft bottom. At least 67% of this portion is due to the diffusion of O-2 across additional sediment-water interfaces excavated by the brittle star.
Inter-tester reliability of a new diagnostic classification system for patients with non-specific low back pain
(Australian Physiotherapy Association, 2004) Petersen, T; Olsen, S; Laslett, M; Thorsen, H; Manniche, C; Ekdahl, C; Jacobsen, S
Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying patients with non-specific low back pain into 12 different syndromes and three subcategories based on history and physical examination. The purpose of this study was to estimate the inter-tester reliability of clinical tests used as criteria for classifying patients. Ninety patients with chronic low back pain were each examined by two physiotherapists. A total of four physiotherapists conducted the assessments, Examination findings were recorded independently by the two examiners. Percentage of agreement and kappa coefficients were calculated for each category. The overall rate of agreement was 72% and the kappa coefficient was 0.62 for the mutually exclusive syndromes in the classification system. Agreement rates for each of the syndromes ranged from 74% to 100% and kappa coefficients ranged from 0.44 to 1.00. The findings suggest the inter-tester reliability of the system is acceptable. The relatively modest level of total agreement (39%) for the system as a whole might indicate that the utility of the system for general screening purposes is limited, compared with the utility in identification of particular syndromes. Due to low prevalence of positive findings in some of the syndromes, future work should focus on testing reliability on a larger sample of patients, and testing of validity and feasibility of the system.
Preventative Strategies for Exercised-Induced Muscle Damage
(Begell House Inc., 2004) Weerapong, P; Hume, PA; Kolt, GS
Eccentric exercise is part of regular rehabilitation and sports training. Unaccustomed eccentric exercise causes muscle damage that presents as delayed soreness, strength and range of motion loss, swelling, and increased passive stiffness. These symptoms reduce the ability to exercise and might be harmful if further exercise is continued. Several interventions such as warm-up, stretching, massage, acupuncture, anti-inflammatory drugs, and estrogen supplements have been researched in order to find interventions that successfully alleviate the severity of muscle damage. The results are controversial due mainly to the variety of exercise-induced muscle damage protocols, the types of intervention protocols, and the doses of application. From a practical point of view prevention strategies are preferred by practitioners because they reduce time lost from training, reduce the cost of treatment, and reduce the risk of further injury. For that reason, this article emphasizes the mechanism of initial events and the factors involving the severity of muscle damage. Research on the prevention of eccentric exercise-induced muscle damage is reviewed and discussed. Appropriate preventative strategies for muscle damage from eccentric exercise are suggested.
Stretching: Mechanisms and Benefits for Sport Performance and Injury Prevention
(Taylor & Francis, 2004) Weerapong, P; Hume, P; Kolt, GS
Stretching is usually performed before exercise in an attempt to enhance performance and reduce the risk of injury. Most stretching techniques (static, ballistic, and proprioceptive neuromuscular facilitation) are effective in increasing static flexibility as measured by joint range of motion, but the results for dynamic flexibility as measured by active and passive stiffness, are inconclusive. The mechanisms of various stretching techniques in terms of biomechanics and neurology, the effectiveness of the combination of stretching with other therapies such as heat and cold, and the effectiveness of stretching for performance and injury prevention are reviewed. The possible mechanisms responsible for the detrimental effects of stretching on performance and the minimal effects on injury prevention are considered, with the emphasis on muscle dynamic flexibility. Further research is recommended to explore the mechanisms and effects of alternative stretching techniques on dynamic flexibility, muscle soreness, sport performance, and rate of injury.
The timing of benthic copepod emergence
(American Society of Limnology and Oceanography (ASLO), 2004-05-01) Teasdale, M; Vopel, K; Thistle, D
We investigated emergence of marine benthic harpacticoid and cyclopoid copepods from subtidal sediment into the bottom water. Previous studies that used traps in the field found that copepods emerged from the sediment within 2 h of dusk. We examined emergence in 20-min sampling periods over 13 h from 1200 to 0100 h in a laboratory flume under conditions of constant flow speed. The light intensity was adjusted to field conditions every 20 min. We observed a peak in emergence during the 20-min sampling period after the onset of darkness, greatly increasing the accuracy with which the timing of emergence is known. This result will help to set the stage for studies of emergence cues.
Zygapophysial joint blocks in chronic low back pain: a test of Revel's model as a screening test
(BioMed Central Ltd, 2004-11-16) Laslett, M; Oberg, B; Aprill, CN; McDonald, B
Background: Only controlled blocks are capable of confirming the zygapophysial joints (ZJ) as the pain generator in LBP patients. However, previous workers have found that a cluster of clinical signs ("Revel's criteria"), may be valuable in predicting the results of an initial screening ZJ block. It was suggested that these clinical findings are unsuitable for diagnosis, but may be of value in selecting patients for diagnostic blocks of the lumbar ZJ's. To constitute evidence in favour of a clinical management strategy, these results need confirmation. This study evaluates the utility of 'Revel's criteria' as a screening tool for selection of chronic low back pain patients for controlled ZJ diagnostic blocks.Methods: This study utilized a prospective blinded concurrent reference standard related validity design. Consecutive chronic LBP patients completed pain drawings, psychosocial distress and disability questionnaires, received a clinical examination and lumbar zygapophysial blocks. Two reference standards were evaluated simultaneously: 1.75% reduction of pain on a visual analogue scale (replication of previous work), and 2. abolition of the dominant or primary pain. Using "Revel's criteria" as predictors, logistic regression analyses were used to test the model. Estimates of sensitivity, specificity, predictive values and likelihood ratios for selected variables were calculated for the two proposed clinical strategies.Results: Earlier results were not replicated. Sensitivity of "Revel's criteria" was low sensitivity (<17%), and specificity high (approximately 90%). Absence of pain with cough or sneeze just reached significance (p=0.05) within one model.Conclusions: "Revel's criteria" are unsuitable as a clinical screening test to select chronic LBP patients for initial ZJ blocks. However, the criteria may have use in identifying a small subset (11%) of patients likely to respond to the initial block (specificity 93%).
The physiotherapy management of the coronary artery bypass graft patient
(Association of charted physiotherapists in respiratory care, 2005) Reeve, JC; Ewan, S
This study investigated the current physiotherapy management of the patient undergoing routine coronary artery bypass graft. A postal questionnaire was sent to the senior physiotherapists in all (n=52) cardiothoracic units in the United Kingdom. Respondents were asked to identify assessment and treatment programmes in both the preoperative and postoperative management of these patients and the basis on which these programmes were implemented. An indication of current research awareness was also ascertained. A response rate of 80% (n = 40) was obtained.
Breathing sediments: microbes, waves, and hidden animal pumps
(NIWA, 2005) Funnell, G; Vopel, K
Kay Vopel and Greig Funnell look into the mechanisms and creatures that help maintain the seabed’s life-support system. Aquatic sediment provides an important ecosystem service: the decomposition of organic matter and the associated regeneration of nutrients for algae and plants. In coastal marine ecosystems, more than half of the nutrients available for primary production in the water column and at the sediment surface can be supplied by the sedimentary processes of aerobic and anerobic decomposition. The most important (and abundant) players in this service are aerobic and anaerobic bacteria, which transform organic into inorganic matter using oxidants such as oxygen and nitrate. 49710 Fluid-dynamic animal pumps on the sediment surface of Mahurangi Harbour. (Click for enlargement and details)(Photos: K. Vopel) 49711 Kay Vopel uses a microelectrode mounted onto a micromanipulator to measure oxygen concentrations in the sediment immediately surrounding a buried echinoderm. (Photo: G. Funnell) To supply the bacteria with oxidants, the sediment breathes, just like we do to supply our cells. When we breathe, we transport oxygen into our lungs and from there into the bloodstream by air flow and molecular diffusion. We draw our diaphragm down to inhale air and up to exhale. This maintains an oxygen concentration in the alveoli of our lungs that is sufficiently high to let oxygen molecules diffuse from the alveoli into our blood. A similar principle applies to aquatic sediment.
More than just a crab hole
(NIWA, 2005) Vopel, K; Hancock, N
Mangrove trees trap fine sediment brought in by rivers and the tide. This sediment is the home of various bacteria, algae, protozoa, and invertebrates (such as marine worms) that cope well with the challenges of an intertidal mudflat, including the risk of desiccation, overheating, oxygen deficiency, and regular exposure to air and hydrogen sulphide. These organisms modify their environment and interact with other organisms by exchanging materials in the form of food, waste material, and respiratory gases. However, some larger species are especially important in the ecosystem. Going beyond these relatively straightforward transactions, they alter the nature of the sediment in ways that affect organisms other than their direct competitors, predators, or prey. Ecologists call such species 'ecosystem engineers' because they create new habitats and change the availability of nutrients to other species.
Wave-induced H2S flux sustains a chemoautotrophic symbiosis
(American Society of Limnology and Oceanography (ASLO), 2005-01-01) Vopel, K; Thistle, D; Ott, J; Bright, M; Roy, H
Symbioses involving sulfur-oxidizing bacteria and invertebrate hosts require a source of reduced sulfur, a source of O-2, and transport mechanisms that ensure them a supply of both. We investigated these mechanisms using the symbiosis between the sessile ciliate Zoothamnium niveum (Hemprich and Ehrenberg 1831) and bacteria living on its surface. The stalked colonies of Z niveum grow on peat walls around the openings of centimeter-scale conduits created when mangrove rootlets decompose. Using in situ, time-series measurements with fast-responding amper-ometric microelectrodes, we found that the conduits were charged with H2S by diffusion from the decaying rootlets during periods of low boundary-layer flow speed. During these times, the feeding current of the zooids transported oxygenated seawater from outside the peat wall toward the ectobiotic bacteria. During periods of high flow speed, H2S-rich seawater from the conduits was drawn along the colonies and over the bacteria. We conclude that this symbiosis exploits a combination of two transport mechanisms: (1) venting of H2S-rich seawater due to pulsating boundary-layer current over ciliate groups and (2) the continuous and rapid feeding current generated by the host's cilia. This discovery raises the possibility that other systems in which pockets of decay are exposed to pulsating flow could support similar symbioses.
Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain
(Biomed Central Ltd, 2005-06-09) Laslett, M; McDonald, B; Tropp, H; Aprill, CN; Oberg, B
Background: The tissue origin of low back pain (LBP) or referred lower extremity symptoms (LES) may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards.Methods: We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC) statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses.Results: In a sample of chronic LBP patients (n=216) with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement (PCC) was estimated at 13%. "Exact" agreement between clinical and reference standard diagnoses was 32% and "clinical agreement" 51%. For six pathoanatomic categories (disc, facet joint, sacroiliac joint, hip joint, nerve root and spinal stenosis), PCC was 33% with actual agreement 56%. There was no overlap of 95% confidence intervals on any comparison. Diagnostic agreement on the six most common patho-anatomic categories produced a kappa of 0.31.Conclusion: Clinical diagnoses agree with reference standards diagnoses more often than chance. Using available reference standards, most patients can have a tissue source of pain identified.

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