Background Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children's mental health.Objective The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health.Methods A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken.Results A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F<sub>1,39</sub>=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F<sub>1,39</sub>=2.9, P=.099), parenting self-efficacy (F<sub>1,39</sub>=0.1, P=.805), family cohesion (F<sub>1,39</sub>=0.4, P=.538), or parenting sense of confidence (F<sub>1,40</sub>=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing.Conclusions Kākano is an app co-designed with parents to help manage their children's mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted.Trial registration Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women
This thesis investigates life-safety risk in earthquakes. The first component of the thesis utilises a dataset of earthquake injuries and deaths from recent earthquakes in New Zealand to identify cause, context, and risk factors of injury and death in the 2011 MW6.3 Christchurch earthquake and 2016 MW7.8 Kaikōura earthquake. Results show that nearly all deaths occurred from being hit by structural elements from buildings, while most injuries were caused by falls, strains and being hit by contents or non-structural elements. Statistical analysis of injured cases compared to an uninjured control group found that age, gender, building damage, shaking intensity, and behaviour during shaking were the most significant risk factors for injury during these earthquakes. The second part of the thesis uses the empirical findings from the first section to develop two tools for managing life-safety risk in earthquakes. The first tool is a casualty estimation model for health system and emergency response planning. An existing casualty model used in New Zealand was validated against observed data from the 2011 Christchurch earthquake and found to underestimate moderate and severe injuries by an order of magnitude. The model was then updated to include human behaviour such as protective actions, falls and strain type injuries that are dependent on shaking intensity, as well as injuries and deaths outside buildings. These improvements resulted in a closer fit to observed casualties for the 2011 Christchurch earthquake. The second tool that was developed is a framework to set seismic loading standards for design based on fatality risk targets. The proposed framework extends the risk-targeted hazard method, by moving beyond collapse risk targets, to fatality risk targets for individuals in buildings and societal risk in cities. The framework also includes treatment of epistemic uncertainty in seismic hazard to allow this uncertainty to be used in risk-based decision making. The framework is demonstrated by showing how the current New Zealand loading standards could be revised to achieve uniform life-safety risk across the country and how the introduction of a new loading factor can reduce risk aggregation in cities Not on Alma, moved and emailed. 1/02/2023 ce
It is well known that buildings constructed using unreinforced masonry (URM) are susceptible to damage from earthquake induced lateral forces that may result in partial or full building collapse. The 2010/2011 Canterbury earthquakes are the most recent New Zealand example of destructive earthquakes, which have drawn people's attention to the inherent seismic weaknesses of URM buildings and anchored masonry veneer systems in New Zealand. A brief review of the data collected following the 2010 Darfield earthquake and more comprehensive documentation of data that was collected following the 2011 Christchurch earthquake is presented, along with the findings from subsequent data interrogation. Large stocks of earthquake prone vintage URM buildings that remain in New Zealand and in other seismically active parts of the world result in the need for minimally invasive and cost effective seismic retrofit techniques. The principal objective of the doctoral research reported herein was to investigate the applicability of near surface mounted (NSM) carbon fibre reinforced polymer (CFRP) strips as a seismic improvement technique. A comprehensive experimental program consisting of 53 pull tests is presented and is used to assess the accuracy of existing FRP-to-masonry bond models, with a modified model being proposed. The strength characteristics of vintage clay brick URM wall panels from two existing URM buildings was established and used as a benchmark when manufacturing replica clay brick test assemblages. The applicability of using NSM CFRP strips as a retrofitting technique for improving the shear strength and the ductility capacity of multi-leaf URM walls constructed using solid clay brick masonry is investigated by varying CFRP reinforcement ratios. Lastly, an experimental program was undertaken to validate the proposed design methodology for improving the strength capacity of URM walls. The program involved testing full-scale walls in a laboratory setting and testing full-scale walls in-situ in existing vintage URM buildings. Experimental test results illustrated that the NSM CFRP technique is an effective method to seismically strengthen URM buildings
Eccentrically Braced Frames (EBFs) are a widely used seismic resisting structural steel system. Since their inception in the late 1970s, they have been a viable option with an available stiffness that is between simple braced systems and moment resisting systems. A similar concept, the linked column frame (LCF), uses shear links between two closely spaced columns. In both cases, the key component is the active link or the shear link, and this component is the objective of this study. The performance of high rise EBF buildings in the 2010 and 2011 Christchurch earthquakes was beyond that which was expected, especially considering the very high accelerations recorded. As the concrete high-rises were torn down, two EBF buildings remained standing and only required some structural repair. These events prompted a renewed interest in bolted shear links, as well as their performance. While some research into replaceable shear links had already been done (Mansour, 2011), the objectives of this study were to improve on the shear link itself, with the consideration that links built in the future are likely to be bolted. The main components of this study were to: 1. Reduce or eliminate the requirements for intermediate web stiffeners, as they were suspected of being detrimental to performance. Furthermore, any reduction in stiffening requirements is a direct fabrication cost saving. Links with low web aspect ratios were found to achieve exceptional ductilities when no stiffeners were included, prompting new design equations. 2. Ensure that the stresses in the ends of links are adequately transferred into the endplates without causing fractures. Although most of the experimental links had web doubler plates included, four had varied lengths of such doubler plates from 0.0 in. to 8.0 in. The link without any doubler plates performed to a similar level to its peers, and thus it is likely that links with quality end details may not need web doubler plates at all. 3. Evaluate the performance of a link with double sided stiffeners without the use of web welds, as opposed to conventional single sided, welded stiffeners. This link performed well, and web-weld-less double sided stiffeners may be an economical alternative to conventional stiffeners for deeper sections of links. 4. Evaluate the performance of a link with thin endplates that are made efficient with the use of gusset plates. This link performed to an acceptable level and provides evidence for a cost effective alternative to thick endplates, especially considering the high overstrength end moments in links, typically requiring 16-bolt connections. 5. Examine the potential use of an alternative EBF arrangement where the collector beam is over sized, and the link section is formed by cutting out parts of the beam's web. After running a series of finite element models each with a unique variation, a number of approximate design rules were derived such that future research could develop this idea further experimentally. 6. Ensure that during testing, the secondary elements (members that are not the shear link), do not yield and are not close to yielding. None of the instrumented elements experienced any unexpected yielding, however the concerns for high stresses in the collector beam panel zone during design were warranted. The use of an existing New Zealand design equation is recommended as an extra check for design codes worldwide. The above objectives were mainly conducted experimentally, except: the data set for item 1 was greatly expanded through the use of a calibrated numerical model which was then used in an extensive parametric study; item 5 was purely finite element based; and, a small parametric study was included for item 3 in an attempt to expand on the trends found there
