Bay Of Plenty Research Articles

Insect visitors to avocado flowers in the Bay of Plenty, New Zealand

Insect pollination is key to ensuring adequate fruit yields within avocado orchards. Various bee and non-bee insect species have been considered as potential pollinators of avocado worldwide, but in New Zealand there has been little research into which insect species visit avocado flowers. In the Bay of Plenty, an important avocado production area, flower visitor abundance and diversity data were obtained by conducting observational surveys in four orchards in November 2015. Honey bees were the dominant flower visitors in all orchards surveyed, representing 92.9% of all insects recorded, but there was high variation in numbers among sites. Other common insects observed included the beetle, Zorion guttigerum (3.4%), and bumblebees Bombus spp. (1.6%). A better understanding of the interaction between honey bee stocking rates and flower visitor abundances within orchards could assist in improving pollination recommendations.

Performance of Advance Gold budbreak enhancer on Gold3 kiwifruit in cold and warm seasons


 
 
 Advance Gold (AG) is a new agricultural compounds & veterinary medicines (ACVM)-registered budbreak enhancer for Gold3 kiwifruit. It contains salicylic acid as the active ingredient, and is used in conjunction with nitrogen and calcium salts. Gold3 kiwifruit blocks in the Bay of Plenty up to 1 ha in area were sprayed using convention air blast sprayers fitted with air inclusion nozzles in August of 2015 and 2016, and monitored for budbreak, flowering and components of yield. Following good winter chill in 2015, a block at near sea level produced about 2 king flowers per winter bud (KF/WB) without AG treatment and about 3 KF/WB following AG treatment. A site at 93 m above sea level produced a larger number of flowers unassisted and a modest increase following AG treatment. Minimal winter chill in 2016 resulted in very low flower numbers in untreated canes at both sites, with AG treatment producing an increase of approximately 1 KF/WB. The current budbreaker used by the kiwifruit industry, hydrogen cyanamide, produced comparable increases in flower numbers to AG in the four trials but gave a larger proportion of “star triples”, tightly clustered triple flowers. Components of yield are presented.
 
 

An investigation into the barriers and facilitators to acceptance, and use of Bay Navigator Pathways by general practitioners in the Western Bay of Plenty

Introduction : The New Zealand Government introduced The Primary Health Care Strategy, putting primary health central in health care delivery. Bay Navigator Pathways (BNP) was developed by multidisciplinary teams. Most care and investigations occur in general practice. When referral is indicated, BNP give clear guidelines to efficient acceptance and treatment in a timely manner. The project aims to explore reasons for variable uptake of the BNP among General Practitioners (GP). The project will identify barriers and facilitators in the use of the BNP and come up with suggestions regarding improved utility of BNP by GP users. Method : GPs were purposively sampled to include specific pre-determined criteria to cover a ranged of characteristics. GPs were interviewed using semi-structured qualitative interviews. Data saturation was reached after fifteen interviews. A Diffusion of innovation framework was used, as it addressed the research requirements well, and helped to thoroughly explore and address the nuances of the data collected. Results : Diffusion of innovation is the process through which an individual, over time, move from knowledge about an innovation, towards forming an attitude towards the innovation - resulting in either adopting or rejecting the innovation. Analysis of data was done according to this framework. Discussions : The meta-context of the New Zealand Health system and the information from the literature reviewed informed new insights obtained through research results. These aspects integrated distilled new knowledge and insights. New theory can inform practical application and health improvement activities. Conclusion : An understanding of the barriers and facilitators that influenced the acceptance and use of the local GP population was achieved. Unmet and unrealistic expectations were identified. Low centrality hindered the use and acceptance of the BNP. Issues with technology and incompatibility of different practice management systems were identified as a universal issue. The trialability period may lead to improved acceptance and use. Lessons learned should be taken into account to improve outcome of reinvention of BNP. Lessons learned : One of the most prominent realizations was the mountain of skills required by the GP within the changed practice milieu. Adequate support through ongoing education and development of skill should be high on the agenda for Health Workforce New Zealand. It is important to listen to the GP’s views, to enable them with knowledge and technical support to implement BNP, to give adequate feedback and allow redevelopment of weaker points to strengthen the BNP. Limitations : There were no obtainable data on the views of regional GPs regarding the BNP. This research study only focussed on the GP. Aspects not covered include the personality of the GP and how comfortable the GPs were with using technology. Suggestions for future research : Research about an innovation development and implementation process is difficult to do in a single timeframe. As this process is not linear, but can have repetitive phases, it does however gives (at least) some introductory insights. Repeated phases of a similar research may inform about paradigm shifts and failures or successes through interventions. The wider primary care health team should be included in future research.

Ensuring objectivity by applying the Mauri Model to assess the post-disaster affected environments of the 2011 MV Rena disaster in the Bay of Plenty, New Zealand

The 2011MV Rena grounding on Otāiti (Astrolabe reef) in the Bay of Plenty, New Zealand is considered to be New Zealand’s worst maritime environmental disaster and one of the most expensive shipwreck and oil spill salvage and recovery operations ever undertaken, with the clean-up currently costing in excess of $660 million (NZD) (Schiel et al., 2016; Beca, 2014). The resultant environmental impacts due to the fuel oil spilled and flotsam were also experienced anthropocentrically as economic, social and cultural impacts. The presence and consideration of impacts experienced by the indigenous groups of the impacted regions within the on-going recovery process is a major contributing factor to the uniqueness of this scenario internationally. The scale and complexity of impacts from this disaster is without precedent in New Zealand. The consideration of past and potential future impacts is especially significant in present times, with the resource consent application to leave the remnants of the wreck and associated debris in place on the reef and seabed, being granted on February 26 2016.The assessment builds on the methodology presented by Faaui et al. (2016) which established indicator sets for measuring impacts upon the mauri of the affected environments (post-Rena state) and assessing the state of the environment prior to the grounding (pre-Rena state). Using the sustainability indicator sets compiled previously by Faaui et al. (2016), the Mauri Model Decision Making Framework has been used to present a holistic assessment of the impacts of the disaster on the reef and surrounding ecosystems, from October 2011 (date of the grounding) to October 2015. These indicators have been expanded on, defining the threshold conditions for scoring the indicators within the Mauri Model. The impact assessment methodology has included a process that identifies the indicator scoring thresholds which ensures objectivity in the scoring of indicators, and therefore the impact assessment, allowing for repeatable and robust results.This assessment is the first use of the Mauri Model Decision Making Framework at this scale, providing a holistic assessment of the impacts experienced within the Rena affected regions in this post-Rena time period. This research leads directly into the post resource consent time period and the associated future impacts as a result of the consent and given consent conditions.

Capturing Compositional Variation in Denitrifying Communities: a Multiple-Primer Approach That Includes Epsilonproteobacteria.

Denitrifying Epsilonproteobacteria may dominate nitrogen loss processes in marine habitats with intense redox gradients, but assessment of their importance is limited by the currently available primers for nitrite reductase genes. Nine new primers targeting the nirS gene of denitrifying Epsilonproteobacteria were designed and tested for use in sequencing and quantitative PCR on two microbial mat samples (vent 2 and vent 4) from the Calypso hydrothermal vent field, Bay of Plenty, New Zealand. Commonly used nirS and nirK primer sets nirS1F/nirS6R, cd3aF/R3cd, nirK1F/nirK5R, and F1aCu/R3Cu were also tested to determine what may be missed by the common single-primer approach to assessing denitrifier diversity. The relative importance of Epsilonproteobacteria in these samples was evaluated by 16S rRNA gene sequencing. Epsilonproteobacteria represented up to 75.6% of 16S rRNA libraries, but nirS genes from this group were not found with commonly used primers. Pairing of the new primer EPSnirS511F with either EPSnirS1100R or EPSnirS1105R recovered nirS sequences from members of the genera Sulfurimonas, Sulfurovum, and Nitratifractor. The new quantitative PCR primers EPSnirS103F/EPSnirS530R showed dominance of denitrifying Epsilonproteobacteria in vent 4 compared to vent 2, which had greater representation by "standard" denitrifiers measured with the cd3aF/R3cd primers. Limited results from commonly used nirK primers suggest biased amplification between primers. Future application of multiple nirS and nirK primers, including the new epsilonproteobacterial nirS primers, will improve the detection of denitrifier diversity and the capability to identify changes in dominant denitrifying communities.IMPORTANCE Estimating the potential for increasing nitrogen limitation in the changing global ocean is reliant on understanding the microbial community that removes nitrogen through the process of denitrification. This process is favored under oxygen limitation, which is a growing global-ocean phenomenon. Current methods use the nitrite reductase genes nirS and nirK to assess denitrifier diversity and abundance using primers that target only a few known denitrifiers and systematically exclude denitrifying Epsilonproteobacteria, a group known to dominate in reducing environments, such as hydrothermal vents and anoxic basins. As oxygen depletion expands in the oceans, it is important to study denitrifier community dynamics within those areas to predict future global ocean changes. This study explores the design and testing of new primers that target epsilonproteobacterial nirS and reveals the varied success of existing primers, leading to the recommendation of a multiple-primer approach to assessing denitrifier diversity.

Vitamin D status of Māori and non-Māori octogenarians in New Zealand: a Cohort Study (LiLACS NZ).

This study assessed vitamin D status and its determinants in a cohort of octogenarians living within New Zealand's Bay of Plenty and Lakes Districts. Serum 25- hydroxyvitamin D [25(OH)D] concentration was measured in 209 Māori (aged 80-90 years) and 357 non-Māori (85 years), along with demographic, lifestyle, supplement use and other health data. Mean [95% CI] 25(OH)D concentration was 69 [67 to 72] nmol/L, with 15% >100 nmol/L and 6 individuals >150 nmol/L. Concentrations in Māori (59 [55 to 62] 4 nmol/L) were lower than in non-Māori (75 [72 to 78] nmol/L; p<0.001), a difference maintained when adjusted for day-of-year measured. Vitamin D supplementation was reported by 98 participants (18%): including a greater proportion of women (24%) than men (11%; p<0.001) and of non-Māori (24%) than Māori (7%; p<0.001). Of those taking vitamin D, 49% took high oral doses (>=25 μg/day or equivalent) and five individuals took >50 μg/day. Vitamin D supplement use strongly and independently predicted seasonally- adjusted 25(OH)D concentration and was associated with 28 nmol/L higher levels than non-use. Other predictors included Māori ethnicity (10 nmol/L lower concentration than for non-Māori), and female gender (11 nmol/L lower). Vitamin D status in New Zealand octogenarians appears higher than previously reported, particularly in non-Māori compared to Māori. Prescribed and non-prescribed oral vitamin D supplementation is prevalent in this group and a strong indicator of vitamin D status.

Magnetic mineral and sediment porosity distribution on a storm-dominated shelf investigated by benthic electromagnetic profiling (Bay of Plenty, New Zealand)

Magnetic susceptibility and electric conductivity within the uppermost meter of the seafloor were measured with high resolution along 33 coast-normal profiles in the Bay of Plenty (New Zealand), using the recently developed electromagnetic benthic profiler MARUM NERIDIS III. These parameters are used to determine magnetic mineral concentration and porosity of mostly volcanoclastic sediments between 2 and 35m water depth to investigate distribution and formation of magnetic mineral enrichments on a storm-dominated shelf.In general, magnetic mineral concentration (susceptibility) is inversely correlated to porosity (conductivity). Along profiles, susceptibility maxima and conductivity minima were commonly found on bathymetrical elevations such as dune and ripple crests. Cores and grab samples show the highest degree of enrichment in the uppermost 20cm of the seafloor. Complementing petromagnetic analysis indicates a spectrum of FeTi-oxides in the sediment, ranging from magnetite and hematite over titanomagnetite (TM40 and TM60) to titanohematite (likely TH80 and TH95).Three distinct zones of magnetic mineral enrichment could be identified: a coast-parallel structure with low porosity in recent fine sand between 5 and 20m water depth, a widespread structure with low porosity in older, transgressionally reworked, coarse sand in up to 30m water depth, and third structure coarse sand with high porosity located mostly below 30m. While the fine sand structure is interpreted as the result of an active process, the other two appear to be relics. Sorting by grain size selective entrainment appears to be the major formation mechanism.This study demonstrates how electromagnetic benthic profiling, in combination with environmental magnetic laboratory analysis, provides reliable, highly interpretable data that allow insight into sorting processes within the boundaries of established lithofacies that are difficult to detect using a classical sedimentological approach.

Investigating trade-offs between water quality and agricultural productivity using the Land Utilisation and Capability Indicator (LUCI)–A New Zealand application

Concern for the impacts of rural land-use intensification on ecosystem services is growing world-wide, especially with regard to water quality management. The Land Utilisation & Capability Indicator (LUCI) is a GIS framework that considers impacts of land use on multiple ecosystem services in a holistic and spatially explicit manner. Due to its fine spatial scale and focus on the rural environment, LUCI is well-placed to help both farm and catchment managers to explore and quantify spatially explicit solutions to improve water quality while also maintaining or enhancing other ecosystem service outcomes.LUCI water quality and agricultural productivity models were applied to a catchment in the Bay of Plenty, New Zealand. Nitrogen (N) and phosphorus (P) sources, sinks and pathways in the landscape were identified and trade-offs and synergies between water quality and agricultural productivity were investigated. Results indicate that interventions to improve water quality are likely to come at the expense of agriculturally productive land. Nonetheless, loss of agriculturally productive land can be minimised by using LUCI to identify, at a fine spatial scale, the most appropriate locations for nutrient intervention. Spatially targeted and strategic nutrient source management and pathway interception can improve water quality, while minimising negative financial impacts on farms. Our results provide spatially explicit solutions to optimize agricultural productivity and water quality, which will inform better farm, land and catchment management as well as national and international policy.

Māori and the natural environment from an occupational justice perspective

ABSTRACTThis paper posits a broader agenda for occupational science by exploring tribal ideology and practices in relation to the natural environment. Tapuika, a tribe located in the Bay of Plenty, Aotearoa New Zealand, share with other tribes and many other indigenous people, a traditional world-view that is holistic and all encompassing. The Māori world begins with the creation narratives. In traditional Māori thought, the entire universe is personified and both spiritually and physically defined. The progenitors of life, the primeval parents Ranginui (sky) and Papatūānuku (earth), are perceived to be ātua (gods). The spiritual and physical aspects of the natural environment can provide a platform to explore the concept of inclusion and participation from a Māori perspective. The mauri (life force) of this relationship is maintained through everyday occupations. While this suggests a positive engagement with the natural environment, the colonial experience alienated tribal people from their estates. However, recent Treaty Settlements have provided a means for tribes to access ancestral lands, much of which was previously alienated from tribal ownership or control. Tribes also are able to exercise a sense of traditional kaitiakitanga (guardianship) over these lands.

Differences in meiofauna communities with sediment depth are greater than habitat effects on the New Zealand continental margin: implications for vulnerability to anthropogenic disturbance.

Studies of deep-sea benthic communities have largely focused on particular (macro) habitats in isolation, with few studies considering multiple habitats simultaneously in a comparable manner. Compared to mega-epifauna and macrofauna, much less is known about habitat-related variation in meiofaunal community attributes (abundance, diversity and community structure). Here, we investigated meiofaunal community attributes in slope, canyon, seamount, and seep habitats in two regions on the continental slope of New Zealand (Hikurangi Margin and Bay of Plenty) at four water depths (700, 1,000, 1,200 and 1,500 m). We found that patterns were not the same for each community attribute. Significant differences in abundance were consistent across regions, habitats, water and sediment depths, while diversity and community structure only differed between sediment depths. Abundance was higher in canyon and seep habitats compared with other habitats, while between sediment layer, abundance and diversity were higher at the sediment surface. Our findings suggest that meiofaunal community attributes are affected by environmental factors that operate on micro- (cm) to meso- (0.1–10 km), and regional scales (> 100 km). We also found a weak, but significant, correlation between trawling intensity and surface sediment diversity. Overall, our results indicate that variability in meiofaunal communities was greater at small scale than at habitat or regional scale. These findings provide new insights into the factors controlling meiofauna in these deep-sea habitats and their potential vulnerability to anthropogenic activities.

Effects of including forage herbs in grass–legume mixtures on persistence of intensively managed pastures sampled across three age categories and five regions

ABSTRACTTo test the hypothesis that the inclusion of the forage herbs chicory (Cichorium intybus L.) or plantain (Plantago lanceolata L.) or both in a grass–legume pasture mix improves persistence of sown vegetation and reduces weed and invertebrate pest ingress, a study was undertaken in 31–44 intensively managed pastures in each of five regions in New Zealand (Northland, Waikato, Bay of Plenty, Taranaki and Canterbury). The regions were stratified according to farm type (dairy or sheep and beef), pasture type (sown with grasses, legumes and herbs or grasses and legumes) and pasture age (young: 1–2 years old; medium: 3–4 years old; and old: 5+ years since sowing, n = 171). Sown species ground cover and emergence from the soil seed bank was greater, and unsown species ground cover and emergence lower, in sheep and beef pastures sown with herbs than without herbs (78% vs 68% ground cover, respectively, averaged over all pasture ages), but there was no difference between pasture types on dairy farms. Invertebrate predator and parasitoid abundance was 65% greater under pastures sown with herbs than without herbs. The number and % dry matter contribution of sown species decreased, and that of unsown species increased, as pastures aged. Unsown species comprised 90% (sheep and beef) and 98% (dairy) of total seedling emergence. The inclusion of forage herbs increased persistence of sown species and reduced weed ingress, but only on sheep and beef farms.

What do we know about the nutritional status of the very old? Insights from three cohorts of advanced age from the UK and New Zealand.

Very old people (referred to as those aged 85 years and over) are the fastest growing age segment of many Western societies owing to the steady rise of life expectancy and decrease in later life mortality. In the UK, there are now more than 1·5 million very old people (2·5 % of total population) and the number is projected to rise to 3·3 million or 5 % over the next 20 years. Reduced mobility and independence, financial constraints, higher rates of hospitalisation, chronic diseases and disabilities, changes in body composition, taste perception, digestion and absorption of food all potentially influence either nutrient intake or needs at this stage of life. The nutritional needs of the very old have been identified as a research priority by the British Nutrition Foundation's Task Force report, Healthy Ageing: The Role of Nutrition and Lifestyle. However, very little is known about the dietary habits and nutritional status of the very old. The Newcastle 85+ study, a cohort of more than 1000 85-year olds from the North East of England and the Life and Living in Advanced Age study (New Zealand), a bicultural cohort study of advanced ageing of more than 900 participants from the Bay of Plenty and Rotorua regions of New Zealand are two unique cohort studies of ageing, which aim to assess the spectrum of health in the very old as well as examine the associations of health trajectories and outcomes with biological, clinical and social factors as each cohort ages. The nutrition domain included in both studies will help to fill the evidence gap by identifying eating patterns, and measures of nutritional status associated with better, or worse, health and wellbeing. This review will explore some of this ongoing work.

Coming out of the closet: From single-cell classrooms to innovative learning environments

The New Zealand Ministry of Education encourages schools to update to flexible learning spaces and activate teaching approaches that augment such physical settings. Many schools have embraced the concept of innovative learning environments (ILE) and team teaching, motivating a trend fast gaining popularity in New Zealand primary schools. However, apart from positive self-reporting documentaries from enthusiastic schools, there is a dearth of New Zealand-based information available to assist prospective schools to consider the complexities of adopting this trend. As they venture ‘out of the single-classroom closet’ into a collaborative ‘community of learners’, the staff of one primary school in the Bay of Plenty has been researching their own ILE practices and processes through inquiry, regular appraisal and self-review monitoring. While the school’s experience is contextual and unique to its own specific situation and community, it provides a representation of some affordances and constraints that other schools might contemplate when they similarly venture into ILEs

Habitat suitability and requirements for a threatened New Zealand amphibian

Habitat modification is one of the largest threats to global terrestrial biodiversity, yet management tools such as translocations often fail because of insufficient knowledge about species' habitat suitability and requirements in release areas. Resource selection is a useful technique that can address this issue. In 2014, we investigated resource selection of Hochstetter's frogs (Leiopelma hochstetteri) in mature (>30 year) exotic pine (Pinus radiata) plantations and regenerating native broadleaf forests in Torere Forest (Bay of Plenty, North Island), New Zealand, where harvesting of pines threatens this population. We then determined whether key habitats were present at the proposed target translocation site, Orokonui Ecosanctuary (Dunedin, South Island), New Zealand. In Torere Forest, we conducted daytime searches for frogs along streams and recorded microhabitats (e.g., cobbles) in used and random available plots. In Orokonui, we recorded microhabitats in randomly distributed plots because Hochstetters's frogs are presently absent. We used averaged mixed (binomial) models to identify important resources in pine plantations and native forests and to compare resource use between habitats. Finally, we predicted habitat use in Orokonui and Torere Forest to gain an indication of habitat suitability. Frogs predominantly selected cobble microhabitats in pine plantations and native forests but also partially decayed logs ≥15 cm in diameter within pine plantations. In contrast, high gravel cover and sand-silt were avoided by frogs. In response to limited cobble cover in pine plantations, frogs were more generalized in selecting resources (primarily logs) than in native forests. Habitat suitability was slightly lower in pine plantations compared to native forests, but mature pine plantations do provide suitable habitat for Hochstetter's frogs, at least in the short term prior to pine harvesting. Our study suggests that Orokonui provides suitable habitat for the proposed translocation of Hochstetter's frogs. © 2016 The Wildlife Society.

The MV Rena shipwreck: time-critical scientific response and environmental legacies

ABSTRACTThe sinking of the MV Rena on Astrolabe Reef (Otaiti) in the Bay of Plenty, New Zealand, resulted in the release of oil and ship debris, including dangerous goods carried as cargo. Two key questions of concern to the public and environmental managers were posed immediately: what was the impact of the Rena oil spill and how long would it take for the marine environment to recover? The research that began immediately after the ship grounded provided answers, as documented in this special issue.

Effects of the MV Rena oil spill on intertidal rocky reefs in the Bay of Plenty, New Zealand

In the weeks following the 2011 Rena oil spill, a series of surveys was initiated on eight rocky intertidal reefs to describe the distribution of oil and to assess the impacts of oil on ecological communities. Consistent but relatively low cover of oil occurred at two sites (Mt Maunganui and Moturiki). The area covered by oil had decreased by c. 90% after 5 months due to natural weathering processes. There were immediate effects of oil fouling on the mussel Limnoperna pulex and its associated fauna, with reductions in the number of mussels and infaunal taxonomic richness. However, no ecological effects on any of the communities were detectable after 1 month. Overall, the ecological effects of the Rena oil spill on rocky shore intertidal communities were small and not long-lasting, but we stress that this does not consider potential sublethal effects and their consequences on organisms.

Environmental effects of the MV Rena shipwreck: cross-disciplinary investigations of oil and debris impacts on a coastal ecosystem

ABSTRACTThe 2011 wreck of the MV Rena off the northeast coast of New Zealand, and subsequent impacts, has been called New Zealand's worst ever maritime environmental disaster. It is certainly one of the world's most complex as it involved a pollutant combination of oil and dangerous goods debris in a dynamic oceanic environment adjacent to a pristine coastline. Heavy fuel oil, shipping containers loaded with cargo, and a wide range of wreck debris and contaminants were spread along hundreds of kilometres of coastline of the Bay of Plenty. Much of this landed on sandy beaches and rocky shores. Broken containers released often toxic substances, and the wreck itself slid down the pinnacle of the wreck site at Astrolabe Reef (Otaiti). The reef remains heavily contaminated, with substantial remnants of the ship and its cargo present, and chemical effects still evident in some species. Here we present the background and timeline of events that unfolded after the grounding. The following articles contain the results of the ensuing chemical, toxicological and ecological studies of contamination and environmental recovery. At the time of writing, numerous legacy issues remain.

Acute sublethal toxicity of MV Rena contaminants (heavy fuel oil, oil dispersant and cryolite) to finfish and rock lobster

ABSTRACTThe wreck of the MV Rena in October 2011 discharged large quantities of potentially toxic materials in the coastal marine environment of the Bay of Plenty, New Zealand. We evaluated sublethal effects of the water soluble fractions of physically and chemically dispersed heavy fuel oil (HFO) and the water soluble fraction of cryolite on the haematology of subadult or adult snapper (Chrysophrys auratus), spotted wrasse (Notolabrus celidotus) and red rock lobster (Jasus edwardsii). Small but transient effects occurred, the most significant of which were changes in circulating immune cell populations in fish and lobster that recovered by the conclusion of a 96-h exposure period. No post-exposure effects were observed during a 10-day recovery in toxicant-free seawater. Corexit 9500 oil dispersant increased polycyclic aromatic hydrocarbon (PAH) uptake from HFO in fish and lobster by around two-fold and four-fold, respectively, and caused a larger change in immune cell abundance in snapper than exposure to HFO alone. While depuration of PAHs was more rapid in fish than lobster, significantly elevated PAH levels were still evident after 10 days of depuration.

Catch Me if You Can!

Background: Holter monitoring (HM) is a common request with considerable impact on waiting lists and service. At BOPDHB ∼75-100 HM are performed monthly and the number of requests is steadily increasing. This audit was performed to determine the diagnostic utility of HM to guide resource utilisation. Methods: In this retrospective audit we analysed HM performed between 01/01/2015 to 30/06/2015 at BOPDHB. Request details and reports were reviewed. Children <15yrs, HM <20 hrs duration, equipment failure were excluded. Arrhythmia was categorised as atrial fibrillation or flutter (AF), atrial or ventricular ectopy >5%, any ectopy associated with symptoms, 2nd and 3rd degree AV block, ventricular tachycardia or fibrillation. Results: During the 6-month study period 485 HM were performed at Tauranga and Whakatane hospitals, 455 reports met inclusion criteria. Referral source: direct GP referral 52%, cardiology 26%, hospital physician 20%, other 2%. Indication: palpitations 46%, dizziness 26%, suspicion for AF 9%, post AF ablation 8%. HM was of diagnostic utility in 62% of patients. Symptoms correlating with arrhythmia occurred in 18%, asymptomatic arrhythmia occurred in 24% and symptoms with no arrhythmia occurred in 20%. HM was of no diagnostic value in 38% because no arrhythmia or symptoms occurred. Detection of AF in community referrals was 4%. Conclusion: HM in the Bay of Plenty is a limited yield diagnostic test, particularly for community referral for unspecified palpitations and for suspected AF. Possible solutions: Revision of the referral form and acceptance criteria for community referrals. In patients with high clinical suspicion for atrial fibrillation, consider longer or repeated monitoring periods, or reveal device implantation.

Acute Coronary Syndrome (ACS) Outcomes in the Very Elderly in the Bay of Plenty

Acute Coronary Syndrome (ACS) Outcomes in the Very Elderly in the Bay of Plenty