University of Auckland

About: University of Auckland is a education organization based out in Auckland, New Zealand. It is known for research contribution in the topics: Population & Context (language use). The organization has 28049 authors who have published 77706 publications receiving 2689366 citations. The organization is also known as: The University of Auckland & Auckland University College.

Using thematic analysis in counselling and psychotherapy research: A critical reflection

Abstract: © 2018 British Association for Counselling and Psychotherapy In this brief commentary, we critically reflect on the use of thematic analysis, and particularly the approach to thematic analysis we have outlined, in counselling and psychotherapy research. We identify the distinct characteristics of our thematic analysis approach, and highlight some common areas of confusion and poor practice in published thematic analysis research in counselling and psychotherapy.

Nicotine replacement therapy versus control for smoking cessation

Abstract: © 2018 The Cochrane Collaboration. Background: Nicotine replacement therapy (NRT) aims to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. Objectives: To determine the effectiveness and safety of nicotine replacement therapy (NRT), including gum, transdermal patch, intranasal spray and inhaled and oral preparations, for achieving long-term smoking cessation, compared to placebo or 'no NRT' interventions. Search methods: We searched the Cochrane Tobacco Addiction Group trials register for papers mentioning 'NRT' or any type of nicotine replacement therapy in the title, abstract or keywords. Date of most recent search is July 2017. Selection criteria: Randomized trials in people motivated to quit which compared NRT to placebo or to no treatment. We excluded trials that did not report cessation rates, and those with follow-up of less than six months, except for those in pregnancy (where less than six months, these were excluded from the main analysis). We recorded adverse events from included and excluded studies that compared NRT with placebo. Studies comparing different types, durations, and doses of NRT, and studies comparing NRT to other pharmacotherapies, are covered in separate reviews. Data collection and analysis: Screening, data extraction and 'Risk of bias' assessment followed standard Cochrane methods. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. Main results: We identified 136 studies; 133 with 64,640 participants contributed to the primary comparison between any type of NRT and a placebo or non-NRT control group. The majority of studies were conducted in adults and had similar numbers of men and women. People enrolled in the studies typically smoked at least 15 cigarettes a day at the start of the studies. We judged the evidence to be of high quality; we judged most studies to be at high or unclear risk of bias but restricting the analysis to only those studies at low risk of bias did not significantly alter the result. The RR of abstinence for any form of NRT relative to control was 1.55 (95% confidence interval (CI) 1.49 to 1.61). The pooled RRs for each type were 1.49 (95% CI 1.40 to 1.60, 56 trials, 22,581 participants) for nicotine gum; 1.64 (95% CI 1.53 to 1.75, 51 trials, 25,754 participants) for nicotine patch; 1.52 (95% CI 1.32 to 1.74, 8 trials, 4439 participants) for oral tablets/lozenges; 1.90 (95% CI 1.36 to 2.67, 4 trials, 976 participants) for nicotine inhalator; and 2.02 (95% CI 1.49 to 2.73, 4 trials, 887 participants) for nicotine nasal spray. The effects were largely independent of the definition of abstinence, the intensity of additional support provided or the setting in which the NRT was offered. A subset of six trials conducted in pregnant women found a statistically significant benefit of NRT on abstinence close to the time of delivery (RR 1.32, 95% CI 1.04 to 1.69; 2129 participants); in the four trials that followed up participants post-partum the result was no longer statistically significant (RR 1.29, 95% CI 0.90 to 1.86; 1675 participants). Adverse events from using NRT were related to the type of product, and include skin irritation from patches and irritation to the inside of the mouth from gum and tablets. Attempts to quantitatively synthesize the incidence of various adverse effects were hindered by extensive variation in reporting the nature, timing and duration of symptoms. The odds ratio (OR) of chest pains or palpitations for any form of NRT relative to control was 1.88 (95% CI 1.37 to 2.57, 15 included and excluded trials, 11,074 participants). However, chest pains and palpitations were rare in both groups and serious adverse events were extremely rare. Authors' conclusions: There is high-quality evidence that all of the licensed forms of NRT (gum, transdermal patch, nasal spray, inhalator and sublingual tablets/lozenges) can help people who make a quit attempt to increase their chances of successfully stopping smoking. NRTs increase the rate of quitting by 50% to 60%, regardless of setting, and further research is very unlikely to change our confidence in the estimate of the effect. The relative effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the individual. Provision of more intense levels of support, although beneficial in facilitating the likelihood of quitting, is not essential to the success of NRT. NRT often causes minor irritation of the site through which it is administered, and in rare cases can cause non-ischaemic chest pain and palpitations.

Continuing trophic cascade effects after 25 years of no-take marine reserve protection

Abstract: Between 1978 and 1996 benthic communities in the Leigh Marine Reserve shifted from being dominated by sea urchins to being dominated by macroalgae. This was a result of a trophic cas- cade thought to be an indirect effect of increased predator abundance. We assessed further changes in communities from 1996 to 2000, differences in benthic communities between reserve and adjacent unprotected sites, and the stability of these patterns from 1999 to 2001. Since 1996, densities of sea urchins Evechinus chloroticus have continued to decline in shallow areas of the reserve (<8 m), and all sites classified as urchin barrens in 1978 are now dominated by large brown algae. Comparisons between reserve and non-reserve sites revealed differences consistent with a trophic cascade at reserve sites. The greatest differences in algal communities between reserve and non-reserve sites occurred at depths where E. chloroticus was most abundant (4 to 6 m). Reserve sites had lower urchin densities and reduced extent of urchin barrens habitat with higher biomass of the 2 dominant algal species (Ecklonia radiata and Carpophyllum maschalocarpum). At reserve sites densities of exposed E. chloroticus (openly grazing the substratum) declined so that urchin barrens were completely ab- sent by 2001. Lower density of the limpet Cellana stellifera and higher densities of the turbinid gas- tropod Cookia sulcata at reserve sites are thought to be responses to changes in habitat structure, representing additional indirect effects of increased predators. The overall difference in community types between reserve and non-reserve sites remained stable between 1999 and 2001. Localised urchin mortality events due to an unknown agent were recorded at some sites adjacent to the marine reserve. Only at 1 of these sites did exposed urchins decline below the critical density of 1 m -2 , which resulted in the total replacement of urchin barrens with macroalgae-dominated habitats. At other sites urchin barrens have remained stable. Declines in the limpet C. stellifera occurred across all sites between 1999 and 2001 and may be indirectly associated with urchin declines. Long-term changes in benthic communities in the Leigh reserve and the stability of differences between reserve and non- reserve sites over time are consistent with gradual declines in urchin densities due to increased pre- dation on urchins, thus providing further evidence for a trophic cascade in this system. The rapid de- clines in urchin numbers at some unprotected sites, however, demonstrate how short-term disturbances, such as disease, may result in shifts in community types over much shorter time frames.