Zealand Community Research Articles

The Seismicity Rate Model for the 2022 Aotearoa New Zealand National Seismic Hazard Model

ABSTRACT A seismicity rate model (SRM) has been developed as part of the 2022 Aotearoa New Zealand National Seismic Hazard Model revision. The SRM consists of many component models, each of which falls into one of two classes: (1) inversion fault model (IFM); or (2) distributed seismicity model (DSM). Here we provide an overview of the SRM and a brief description of each of the component models. The upper plate IFM forecasts the occurrence rate for hundreds of thousands of potential ruptures derived from the New Zealand Community Fault Model version 1.0 and utilizing either geologic- or geodetic-based fault-slip rates. These ruptures are typically less than a couple of hundred kilometers long, but can exceed 1500 km and extend along most of the length of the country (albeit with very low probabilities of exceedance [PoE]). We have also applied the IFM method to the two subduction zones of New Zealand and forecast earthquake magnitudes of up to ∼Mw 9.4, again with very low PoE. The DSM combines a hybrid model developed using multiple datasets with a non-Poisson uniform rate zone model for lower seismicity regions of New Zealand. Forecasts for 100 yr are derived that account for overdispersion of the rate variability when compared with Poisson. Finally, the epistemic uncertainty has been modeled via the range of models and parameters implemented in an SRM logic tree. Results are presented, which indicate the sensitivity of hazard results to the logic tree branches and that were used to reduce the overall complexity of the logic tree.

New Zealand community pharmacists’ perspectives on supplying smoked tobacco as an endgame initiative: a qualitative analysis

IntroductionTobacco endgame strategies often include measures to reduce tobacco availability by decreasing retailer numbers. Recently, some US pharmacies have delisted tobacco, though overall retailer numbers have not reduced markedly. Paradoxically,...

New Zealand Fault-Rupture Depth Model v.1.0: A Provisional Estimate of the Maximum Depth of Seismic Rupture on New Zealand’s Active Faults

ABSTRACT We summarize estimates of the maximum rupture depth on New Zealand’s active faults (“New Zealand Fault-Rupture Depth Model v.1.0”), as used in the New Zealand Community Fault Model v1.0 and as a constraint for the latest revision of the New Zealand National Seismic Hazard Model (NZ NSHM 2022). Rupture depth estimates are based on a combination of two separate model approaches (using different methods and datasets). The first approach uses regional seismicity distribution from a relocated earthquake catalog to calculate the 90% seismicity cutoff depth (D90), representing the seismogenic depth limit. This is multiplied by an overshoot factor representing the dynamic propagation of rupture into the conditional stability zone, and accounting for the difference between regional seismicity depths and the frictional properties of a mature fault zone to arrive at a seismic estimate of the maximum rupture depth. The second approach uses surface heat flow and rock type to compute depths that correspond to the thermal limits of frictional instabilities on seismogenic faults. To arrive at a thermally-based maximum rupture depth, these thermal limits are also multiplied by an overshoot factor. Both the models have depth cutoffs at the Moho and/or subducting slabs. Results indicate the maximum rupture depths between 8 (Taupō volcanic zone) and >30 km (e.g., southwest North Island), strongly correlated with regional thermal gradients. The depths derived from the two methods show broad agreement for most of the North Island and some differences in the South Island. A combined model using weighting based on relative uncertainties is derived and validated using constraints from hypocenter and slip model depths from recent well-instrumented earthquakes. We discuss modifications to the maximum rupture depths estimated here that were undertaken for application within the NZ NSHM 2022. Our research demonstrates the utility of combining seismicity cutoff and thermal stability estimates to assess the down-dip dimensions of future earthquake ruptures.

Characterization of Focal Mechanisms for Upper Crustal Distributed Seismicity in Aotearoa New Zealand

AbstractApplying distributed seismicity models for seismic hazard analysis requires postulating the styles of faulting and nodal planes for anticipated earthquakes. Here, we present a model describing focal mechanisms, or more specifically, strike, dip, and rake angles, for the ruptures of shallow (hypocentral depth ≤40 km) crustal earthquakes in Aotearoa New Zealand. This model is based on delineations of neotectonic domains and analysis of pre-existing datasets, including an active fault database, geological map-based fault datasets, the New Zealand Community Fault Model, and a regional moment tensor catalog. We demonstrate that the focal mechanism model is broadly consistent with the regional moment tensor catalog, with respect to spatial distributions of P and T axes and in terms of the Kagan angle. This characterization of focal mechanisms complements the distributed seismicity component of the New Zealand National Seismic Hazard Model 2022.

Paleoseismic Earthquake Recurrence Interval Derivation for the 2022 Revision of the New Zealand National Seismic Hazard Model

Abstract Recurrence intervals of ground-surface rupturing earthquakes are one of numerous datasets used to constrain the rates of fault ruptures in the 2022 revision of the New Zealand National Seismic Hazard Model (NZ NSHM 2022). Paleoearthquake timing and single-event displacement (SED) data in the New Zealand Paleoseismic Site Database version 1.0 alongside geologic and geodetic slip rates from the New Zealand Community Fault Model version 1.0 and NZ NSHM 2022 Geodetic Deformation Model were used to estimate recurrence intervals on faults across New Zealand for inclusion in the NZ NSHM 2022. Past earthquake timings were fit with lognormal, exponential, and Brownian Passage Time recurrence models to derive probability density functions (PDFs) of mean recurrence interval (MRI) in a Bayesian framework. At some sites, SED and slip-rate (SR) data were used to estimate PDFs of MRI; and at sites where timings, slip rate, and displacement data are available, the timings-based and slip-based PDFs were combined to develop tighter constraints on MRI. Using these approaches, we produce a database of maximum-likelihood MRIs and their uncertainties for 80 sites across New Zealand. The resulting recurrence interval dataset is publicly available and is the largest such dataset in New Zealand to date. It provides a valuable resource for future seismic hazard modeling and highlights areas that would benefit from future study.

This is Not Us/This is Us: Dissensus Politics in the Wake of the Christchurch Terror Attacks

Abstract: On March 15th, 2019, a terrorist targeted two mosques in Christchurch, resulting in 51 deaths and many more injured. In the wake of these events, the Aotearoa New Zealand community struggled to make sense of what they meant for who “we” are. This article traces developments and tensions within the discourse that emerged in the two weeks following the attacks, identifying three significant framings: discourses of unity, innocence, and responsibility. Analyzing these discourses via Jacques Rancière’s theory of politics, we explore whether this marked a truly political moment wherein “the part that has no part”—the Muslim community of Aotearoa New Zealand—was actually heard.

The New Zealand Community Fault Model – version 1.0: an improved geological foundation for seismic hazard modelling

ABSTRACT The New Zealand Community Fault Model (NZ CFM) is a publicly available representation of New Zealand fault zones that have the potential to produce damaging earthquakes. Compiled through collaborative engagement between New Zealand earthquake-science experts, this first edition (version 1.0) of the NZ CFM builds upon previous compilations of earthquake-source active fault models with the addition of new and modified information. Developed primarily to support an update of the New Zealand National Seismic Hazard Model, the NZ CFM comprises two principal components. The first dataset is a two-dimensional map representation of the surface traces of 880 generalised fault zones. Each fault zone is assigned specific geometric and kinematic attributes, including uncertainties, supplemented with a subjective quality ranking focused primarily on the confidence in assigned slip rates. The second component is a three-dimensional representation of the fault zones as triangulated mesh surfaces that are projected down-dip from the two-dimensional mapped traces to a geophysically-defined maximum fault rupture depth. This article summarises the compilation and parameterisation of the NZ CFM, along with background on its relation to predecessor datasets, and forward applications to probabilistic seismic hazard assessment and physics-based earthquake models currently being developed for Aotearoa New Zealand.

What constitutes evidence for over-the-counter medicines? A cross-sectional study of community pharmacists’ knowledge, attitude, and practices

Abstract Objectives To assess the knowledge, attitude and practices of evidence-based medicine (EBM) with regard to over-the-counter (OTC) medicines among New Zealand community pharmacists. Methods A pre-piloted, self-administered online questionnaire was disseminated through email to 2788 registered community pharmacists. The questionnaire covered the aspects of knowledge, attitude and barriers towards EBM, and factors influencing pharmacists’ product recommendations. Responses were collected over 4 weeks in January 2021. Data were analysed using SPSS (version 26). Key findings A total of 326 responses were collected (11.7% response rate). Participants had an average knowledge score of 15.6 (out of 33). More than 50% had a favourable attitude towards EBM. Insufficient time (20.2%) and a lack of resources (16.4%) were reported as the major barriers to practicing EBM. The majority (72.8%) of participants believed that guideline recommendations were important for OTC recommendations; however, 44.9% would always use their own judgement. Recent graduates (P = 0.048) and pharmacists with a higher level of education (P = 0.00) scored significantly higher for knowledge. A higher knowledge score predicted ‘more favourable’ attitude towards EBM. Conclusions Deficiencies exist in community pharmacists’ EBM-related knowledge, attitude and practices. An educational intervention targeting older pharmacists is required since the relevant knowledge was found to be deteriorating with age.

Knowledge, attitudes, and practices towards fetal alcohol spectrum disorder in the New Zealand social and community sector: An online survey.

Background: Fetal Alcohol Spectrum Disorder (FASD) is a common neurodevelopmental disorder but may be underrecognized and misunderstood by people who provide health and social support services. The aim of the research is to understand the FASD knowledge, attitudes, and practices among people employed by the social and community sector in New Zealand. Methods: We conducted an online survey of people working in the New Zealand social and community sector (i.e., social workers, support workers). The survey focused on the following areas: awareness of FASD; knowledge and beliefs about FASD; the impact of FASD on professional practice; and training needs. Results: Most participants reported a basic understanding of FASD, however only 5% felt very well prepared to support someone with FASD. A large majority of participants believed that FASD diagnosis may be stigmatising for individuals or families. Conclusion: There is a need to improve training, professional development, and workplace support for social and community workers in New Zealand to support people with FASD.

Rurality and latent precarity: Growing older in a small rural New Zealand town

Behind rural lives lurk several forms of latent precarity that are unique to rural dwellers and rural contexts. Latent precarities may never become actualised or experienced, and the expression of latent precarity can be mitigated by both individual and community resources. For older rural dwellers, the latent precarities associated with rural life intersect with those associated with ageing and when experienced or actualised, can impact on an individual's ability to successfully ‘age in place’ within their rural community. We interviewed adults across the lifespan who lived in a small rural southern New Zealand community, and this article explores the latent precarities of rurality and ageing that they identified. If community assets dwindle or become unavailable, and health capabilities decline, latent precarities may multiply, or become actual/experienced precarities. The experience of ageing well in rural places can be improved and older adults better supported through the identification of, and attention to, forms of latent precarity within these rural places.

Extended-spectrum β-lactamase- and AmpC β-lactamase-producing Enterobacterales associated with urinary tract infections in the New Zealand community: a case-control study

ObjectivesTo assess whether having a pet in the home is a risk factor for community-acquired urinary tract infections associated with extended-spectrum β-lactamase (ESBL)- or AmpC β-lactamase (ACBL)- producing Enterobacterales. MethodsAn unmatched case-control study was conducted between August 2015 and September 2017. Cases (n = 141) were people with community-acquired urinary tract infection (UTI) caused by ESBL- or ACBL-producing Enterobacterales. Controls (n = 525) were recruited from the community. A telephone questionnaire on pet ownership and other factors was administered, and associations were assessed using logistic regression. ResultsPet ownership was not associated with ESBL- or ACBL-producing Enterobacterales-related human UTIs. A positive association was observed for recent antimicrobial treatment, travel to Asia in the previous year, and a doctor's visit in the last 6 months. Among isolates with an ESBL-/ACBL-producing phenotype, 126/134 (94%) were Escherichia coli, with sequence type 131 being the most common (47/126). ConclusionsCompanion animals in the home were not found to be associated with ESBL- or ACBL-producing Enterobacterales-related community-acquired UTIs in New Zealand. Risk factors included overseas travel, recent antibiotic use, and doctor visits.

Community Houses to Increase Access to Home Dialysis.

Community Houses to Increase Access to Home Dialysis.

Interprofessional education in a New Zealand Community Polytechnic: A mixed-method pilot study

INTRODUCTION: Interprofessional collaboration leads to better patient care, enhanced teamwork skills, better communication, and enhanced understandings of each other’s professional roles. METHODS: The objective of the study was to trial an interprofessional education (IPE) simulation activity with students (nine) from three health and social service disciplines in one community polytechnic. A pre-test/post-test design was used to gather data on the students’ perspectives of the IPE simulation and what the students learned from it. A simple Likert Scale questionnaire and two focus groups (with five and four participants, respectively) were conducted. A thematic analysis of the focus group data was undertaken while survey responses are presented in percentages for ease of readability. FINDINGS: The participants enjoyed the simulation, had greater confidence with interprofessional communication post-participation and increased knowledge of each other’s scope of practice. The participants welcomed the opportunity to practise handover, which was an area of concern for all. IMPLICATIONS: IPE is an invaluable tool for preparing students for their future careers as members of an interdisciplinary health team.

An assessment of the potential impact of the Omicron variant of SARS-CoV-2 in Aotearoa New Zealand.

New Zealand delayed the introduction of the Omicron variant of SARS-CoV-2 into the community by the continued use of strict border controls through to January 2022. This allowed time for vaccination rates to increase and the roll out of third doses of the vaccine (boosters) to begin. It also meant more data on the characteristics of Omicron became available prior to the first cases of community transmission. Here we present a mathematical model of an Omicron epidemic, incorporating the effects of the booster roll out and waning of vaccine-induced immunity, and based on estimates of vaccine effectiveness and disease severity from international data. The model considers differing levels of immunity against infection, severe illness and death, and ignores waning of infection-induced immunity. This model was used to provide an assessment of the potential impact of an Omicron wave in the New Zealand population, which helped inform government preparedness and response. At the time the modelling was carried out, the date of introduction of Omicron into the New Zealand community was unknown. We therefore simulated outbreaks with different start dates, as well as investigating different levels of booster uptake. We found that an outbreak starting on 1 February or 1 March led to a lower health burden than an outbreak starting on 1 January because of increased booster coverage, particularly in older age groups. We also found that outbreaks starting later in the year led to worse health outcomes than an outbreak starting on 1 March. This is because waning immunity in older groups started to outweigh the increased protection from higher booster coverage in younger groups. For an outbreak starting on 1 February and with high booster uptake, the number of occupied hospital beds in the model peaked between 800 and 3,300 depending on assumed transmission rates. We conclude that combining an accelerated booster programme with public health measures to flatten the curve are key to avoid overwhelming the healthcare system.

Electronic transmission of prescriptions in primary care: transformation, timing and teamwork.

INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy. AIM The purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy. METHODS Semi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants' perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach. RESULTS Four themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs). DISCUSSION Both general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners.

Out of the closet and into the museum: The costumes of Mika Haka

The Auckland Museum recently acquired a significant collection of costume and related material from New Zealand entertainer and community leader Mika Haka. Mika has collected material for over thirty years and it was always his intention that his material would become part of a museum collection. Mika’s motivations to offer material to the Auckland Museum included the positive experiences he had with the Museum and that these objects would speak for takatāpui / LGBT+ communities who are underrepresented in museum collections. The process of selecting material for the museum was a challenge due to the size and variety of the collection. The costumes that represent Mika’s life and are now preserved in the Auckland Museum have wide ranging research and display potential and

Statin adherence is lower in primary than secondary prevention: A national follow-up study of new users.

Maintaining adherence to statins reduces the risk of an initial cardiovascular disease (CVD) event in high-risk individuals (primary prevention) and additional CVD events following the first event (secondary prevention). The effectiveness of statin therapy is limited by the level of adherence maintained by the patient. We undertook a nationwide study to compare adherence and discontinuation in primary and secondary prevention patients. Dispensing data from New Zealand community pharmacies were used to identify patients who received their first statin dispensing between 2006 and 2011. The Medication Possession Ratio (MPR) and proportion who discontinued statin medication was calculated for the year following first statin dispensing for patients with a minimum of two dispensings. Adherence was defined as an MPR ≥ 0.8. Previous CVD was identified using hospital discharge records. Multivariable logistic regression was used to control for demographic and statin characteristics. Between 2006 and 2011 289,666 new statin users were identified with 238,855 (82.5%) receiving the statin for primary prevention compared to 50,811 (17.5%) who received it for secondary prevention. The secondary prevention group was 1.55 (95% CI 1.51-1.59) times as likely to be adherent and 0.67 (95% CI 0.65-0.69) times as likely to discontinue statin treatment than the primary prevention group. An early gap in statin coverage increased the odds of discontinuing statin treatment. Adherence to statin medication is higher in secondary prevention than primary prevention. Within each group, a range of demographic and treatment factors further influences adherence.

Community Pharmacists' Views and Experiences with ADR Reporting for Complementary Medicines: A Qualitative Study in New Zealand.

Detecting signals of safety concerns associated with complementary medicines (CMs) relies on spontaneous reports submitted by health professionals and patients/consumers. Community pharmacists are well placed to identify and report suspected adverse drug reactions (ADRs) associated with CMs, but pharmacists submit few CMs ADR reports. The aim of this study was to explore New Zealand community pharmacists' views and experiences with ADR reporting for CMs. Qualitative, in-depth, semi-structured interviews were undertaken with 27 practising community pharmacists identified through purposive and convenience sampling. Data were analysed using a general inductive approach. Participants were familiar with systems for reporting ADRs, believed ADR reporting for CMs important, and that pharmacists should contribute. However, few submitted reports of CMs ADRs and none encouraged patients/consumers to do so. Participants explained this was because they had never been informed by patients about ADRs associated with CMs. Participants said they would report serious ADRs; time pressures, lack of certainty around causality, lack of awareness of mechanisms for reporting CMs ADRs, and lack of remuneration were deterrents to reporting. Participants were aware of intensive-monitoring studies for prescription medicines, understood the rationale for considering this approach for CMs and recognised there would be potential practical difficulties. Participants used their knowledge of CMs safety concerns to minimise risk of harms to consumers from CMs use, but most had a passive approach to identifying and reporting ADRs for CMs. There is substantial potential for pharmacists to adopt proactive strategies in pharmacovigilance for CMs, particularly in recognising and reporting ADRs, and empowering CMs users to do the same.

Prostate cancer survivorship essentials framework: guidelines for practitioners.

ObjectiveTo develop contemporary and inclusive prostate cancer survivorship guidelines for the Australian setting.Participants and MethodsA four‐round iterative policy Delphi was used, with a 47‐member expert panel that included leaders from key Australian and New Zealand clinical and community groups and consumers from diverse backgrounds, including LGBTQIA people and those from regional, rural and urban settings. The first three rounds were undertaken using an online survey (94–96% response) followed by a fourth final face‐to‐face panel meeting. Descriptors for men’s current prostate cancer survivorship experience were generated, along with survivorship elements that were assessed for importance and feasibility. From these, survivorship domains were generated for consideration.ResultsSix key descriptors for men’s current prostate cancer survivorship experience that emerged were: dealing with side effects; challenging; medically focused; uncoordinated; unmet needs; and anxious. In all, 26 survivorship elements were identified within six domains: health promotion and advocacy; shared management; vigilance; personal agency; care coordination; and evidence‐based survivorship interventions. Consensus was high for all domains as being essential. All elements were rated high on importance but consensus was mixed for feasibility. Seven priorities were derived for immediate action.ConclusionThe policy Delphi allowed a uniquely inclusive expert clinical and community group to develop prostate cancer survivorship domains that extend beyond traditional healthcare parameters. These domains provide guidance for policymakers, clinicians, community and consumers on what is essential for step change in prostate cancer survivorship outcomes.

New Zealand community mental healthcare provider experience in schizophrenia management with 3-monthly paliperidone palmitate.

Objectives:To understand the impact of 3-monthly treatment with paliperidone palmitate on patient management, including non-adherence and relapse, from a psychiatrist and nurse perspective for 73 patients enrolled in a patient familiarisation programme (PFP) in New Zealand.Methods:An online questionnaire was sent to clinicians with at least 6 months of regular interaction with PFP patients. Questions addressed treatment effectiveness and patient management changes. Analyses are descriptive only and do not represent patient or carer perspectives.Results:Seven psychiatrists, representing 58 of 73 (79.5%) of patients, and 17 nurses responded to the survey. Psychiatrists were satisfied with efficacy and tolerability and relapse prevention. Treatment goals were either ‘met’ (2/7; 28.6%) or ‘exceeded’ (5/7; 71.4%). The focus on adherence issues decreased and the focus on life areas and recovery goals increased.Conclusions:From the clinician perspective, 3-monthly paliperidone palmitate offers patients the potential to remain adherent and improve social functioning.