Tuwhera Research Repository

The Tuwhera Research Repository provides sustainable open access and archiving to a broad range of AUT produced research - theses, research outputs and datasets.

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Access status: Open Access ,
ULTRA-metrics: Delphi-derived Framework for Assessing Ultrasound Competency
(Wiley, 2025-10-07) Reid, Steve; Goffi, Alberto; Tsou, Ean; Pivetta, Emanuele; Pascoe, Suean; Solis-McCarthy, Jessica; Foster, Mark; Gelabert, Chris; Smith, Mike; Bell, Colin; Whalen, Erica Clarke; Latta, Hannah; Desy, Janeve; Hayward, Simon; Israel, Hayley; Leamon, Andrew; Peck, Marcus; Wong, Adrian; Wong, Tanping; Yap, Chris; Chung, Emma ML
OBJECTIVES: Ultrasound competency is critical in modern healthcare, yet no standardized framework currently supports ultrasound skill monitoring across diverse clinical settings and user types. Existing frameworks often lack generalizability, overemphasize exam counts, and fail to assess key skills such as interpretation, limiting ultrasound's safe and effective integration into clinical practice. The objective of this study is to develop a consensus-based, universal framework for monitoring ultrasound competency across clinical applications and disciplines. METHODS: A modified Delphi process was conducted with an international panel of Point-of-Care ultrasound experts. Panelists independently evaluated framework elements categorized by competency domains (experience, skills, autonomy), skill domains (indication, acquisition, interpretation, clinical integration), metrics (eg, exam counts, entrustability, interpretation accuracy, etc.), answer sets (score-based inputs used by assessors), and score criteria (requirements for each score). Consensus thresholds were defined as strong consensus at >84%, and weak consensus at 68-84%. Two Delphi rounds were completed. RESULTS: Nineteen experts participated across 2 Delphi rounds. Strong consensus was reached to include 3 competency domains (experience, skills, autonomy) and 4 skill domains (indication, acquisition, interpretation, and clinical integration). Optional components, including the use of acquisition skill trees and varied answer set granularity, were favored by some participants to allow ultrasound programs to tailor the framework to specific examinations, assessment scenarios, and job roles. CONCLUSION: The resulting modular framework provides a flexible, consensus-based approach to ultrasound competency assessment, enabling cross-program comparisons and evaluation of training methods. Validation across diverse settings is needed to support its use in global competency standards and ultrasound education expansion.
Access status: Open Access ,
Walking Patterns and Hormonal Cycles in Females
(Auckland University of Technology, 2026) Moganathas, Sarniya; Hume, Patria A.; Shaikh, Nusratnaaz; Zoellner, Anja
Concussion is a mild traumatic brain injury caused by direct or indirect biomechanical forces to the head or body, resulting in temporary disruption of brain function and a range of physical, cognitive, emotional, and sleep-related symptoms, often without structural abnormalities detectable on standard neuroimaging. Female athletes often experience prolonged symptoms and higher rates of secondary musculoskeletal (MSK) injuries following concussion compared to males, potentially due to hormonal fluctuations and physiological characteristics that influence neurological recovery and physical function. This thesis explores the relationship between menstrual cycle-related hormonal changes and gait alterations, and their potential implications for concussion outcomes, recurrent concussion, and secondary musculoskeletal injury susceptibility in females. Despite growing evidence linking concussion-related hormonal disruption, menstrual cycle changes, and post-concussion gait alterations, limited research has examined how these factors interact. To address this gap, a scoping review was conducted to evaluate current evidence on the influence of menstrual cycle related hormonal changes and gait alterations on concussion outcomes their potential implications for secondary musculoskeletal injury and recurrent concussion in females. The literature review highlighted that fluctuations in oestrogen and progesterone may affect symptom severity and recovery, with injuries sustained during the luteal phase often associated with more pronounced symptoms. In addition, gait-related studies demonstrated persistent post-concussion impairments, particularly during dual-task conditions, including reduced walking speed, altered cadence, and impaired stability, which may increase vulnerability to secondary MSK injuries. However, no studies directly investigated the combined relationship between menstrual cycle-related hormonal changes and gait alterations. To further explore this relationship, a prospective observational pilot case series study was conducted between 1 October 2025 and 15 March 2026. The study included 10 healthy female participants with no history of concussion or musculoskeletal injury, who attended multiple study visits (up to 12 sessions) over a three-month period. Participants completed questionnaires, performed single-task, dual-task, and head-turn walking assessments, and provided blood samples for hormonal analysis. Significant hormonal variations occurred across menstrual phases, particularly in oestradiol, progesterone, luteinising hormone, follicle-stimulating hormone, testosterone, thyroid-stimulating hormone, and dehydroepiandrosterone. However, no significant differences were identified in gait parameters across menstrual phases, with gait performance remaining stable despite hormonal fluctuations. The findings contribute new insights into the relationship between menstrual cycle-related hormonal changes and gait alterations, suggesting that hormonal fluctuations alone may not substantially influence gait in healthy females. Although limited by the small sample size and absence of concussed participants, this study provides important feasibility data and methodological guidance for future research investigating the relationship between menstrual cycle-related hormonal changes and gait alterations, and their potential implications for secondary musculoskeletal injury and recurrent concussion in females recovering from concussion.
Access status: Embargo ,
Paramedic Echocardiography in Pulseless Electrical Activity Cardiac Arrest: An Education and Simulation Study
(Wiley, 2025-12-22) Latta, Hannah; Swain, Andrew; Garrett, Nick; Tunnage, Bronwyn
BACKGROUND: Patients presenting with pulseless electrical activity (PEA) in out-of-hospital cardiac arrest (OHCA) may receive inappropriate care if a manual pulse check is relied upon to determine pulselessness. This study aimed to investigate whether ultrasound-naïve paramedics could acquire an ultrasound image within a 10-s pause during a pulse check in a simulated cardiac arrest environment and interpret ultrasound-detectable pathology. Secondary aims focus on the quality of ultrasound image acquisition and the retention of learned knowledge. METHOD: Thirty paramedics participated in three sequential phases. Phase I involved a self-directed e-learning program covering an overview of ultrasound applications, including cultural considerations for indigenous New Zealand Māori in cardiac arrest. Phase II included face-to-face education, simulation assessments, and a knowledge quiz. Phase III included simulation assessments and a knowledge quiz. Ultrasound images were scored against the cardiac ultrasound structural assessment score (CUSAS) for quality. RESULTS: During simulated cardiac arrest scenarios, the mean time to acquire an ultrasound scan was 9.6 s (SD = 2.9, 95% CI [9.3, 10.0]). Forty-seven per cent of study scans were captured within the 10-s pulse check pause. Of the acquired images, 73% (95% CI [67.8, 79.4]) of scans scored a CUSAS of ≥ 3, demonstrating adequate image quality. Participants correctly interpreted 91% (95% CI [88.5, 94.5]) of 243 pathological scans during the simulations. In Phase II, 83 of 87 interpretations were correct (95%, 95% CI [91.0, 99.7]), while in Phase III, 140 of 156 interpretations were correct (90%, 95% CI [84.9, 94.4]). CONCLUSIONS: During cardiac arrest simulations, paramedics on average took 9.6 s to acquire an ultrasound scan, with 47% of scans completed within the 10-s pulse-check pause. RESEARCH AIMS: To determine if paramedics can acquire an ultrasound image within the 10-s pulse check pause in simulated pulseless electrical activity (PEA) cardiac arrest. Secondary aims focus on the quality of ultrasound image acquisition, interpretation and retention of learned knowledge.
Access status: Open Access ,
Authenticity and Change: A Framework for Examining Post-Earthquake Outcomes for the Christchurch Cathedral in Aotearoa New Zealand
(Informa UK Limited, 2026-08-25) Vallis, Stacy; Ingham, Jason; Gatley, Julia
The Canterbury earthquake sequence (2010–2011) resulted in damage to historic unreinforced masonry cathedral and church precincts in Christchurch, Aotearoa New Zealand, where significant schemes of post-earthquake remediation have taken place. Public and church communities, government authorities, and conservation experts constitute decision-making stakeholders who are often, but not always, collectively motivated to retain historic architectural characteristics and religious traditions. International theories for conserving authenticity offer specialist guidance; however, there is a critical gap between institutional discourse and actual heritage outcomes shaped by the local decision-making. Using archival materials, local history records, and conservation planning documentation, we explore the construction of the city’s Anglican cathedral, known as Christ Church Cathedral, and post-earthquake proposals and interventions from the 19th century to the present day. The novelty of this study lies in investigating tensions between heritage values, material conservation, community engagement, and financial constraints, as demonstrated by the production of post-earthquake design responses, ranging from ruination and preservation through to reconstruction and complete redesign, presented using a thematic assessment framework. Analysing the site’s history of construction and conservation reveals a multidimensional authenticity, evolving from a focus on retaining materiality to a greater acceptance of change to heritage sites, consistent with global and local trends.
Access status: Open Access ,
AI Slop’s Carnival of (Im)possibilities: The Trial of ‘Genuine’ Versus ‘Generated’ Visualities
(International Council for Adult Education, 2026-08-20) Westbrook, Fiona
Images generated by artificial intelligence (AI) are flooding online and offline spaces with ‘AI Slop', hyperreal and often grotesque and absurdist visualities. Framed predominantly as an existential threat, AI Slop is charged with killing the internet, distorting reality, and accelerating social collapse. Such charges reflect what Mikhail Epstein terms horrology, a civilisation's fear of destruction by its own technological creations, evoked anew with engineered, technical advancements. This article turns such horror on its head by employing Mikhail Bakhtin's carnivalesque alongside Epstein's possibilism, contemplating how AI Slop jestingly inverts the ‘genuine' versus ‘generated' consumption of an image's ‘truth'. When equal parts hyperreal and absurd, how visualities have always, to some degree, been generated by the technologies of seeing is signalled by this inversion. The possible implications of AI Slop's proliferation, within and beyond education, are therefore greater discussions and consideration of the codified ‘generated' ideologies of visualities, which visual scholars have long lamented. In addition to the implication that AI Slop could overturn the recevied ‘truth' that an image can capture a ‘genuine' representation, fostering critical visual literacies within public discourse. This article pairs this dialogue with a series of visualities that operate together to prompt the reader into a visual feast of jesting truth games.