Zealand Population Research Articles

The natural history of elevated tetradecenoyl-L-carnitine detected by newborn screening in New Zealand: implications for very long chain acyl-CoA dehydrogenase deficiency screening and treatment.

Very long chain acyl-CoA dehydrogenase deficiency (VLCADD, OMIM #201475) has been increasingly diagnosed since the advent of expanded newborn screening (NBS). Elevated levels of tetradecenoyl-L-carnitine (C14:1) in newborn screening blood spot samples are particularly common in New Zealand, however this has not translated into increased VLCADD clinical presentations. A high proportion of screen-positive cases in NZ are of Maori or Pacific ethnicity and positive for the c.1226C > T (p.Thr409Met) ACADVL gene variant. We performed a retrospective, blinded, case-control study of 255 cases, born between 2006 and 2013, with elevated NBS C14:1 levels between 0.9 and 2.4μmol/L, below the NZ C14:1 notification cut-off of 2.5μmol/L. Coded healthcare records were audited for cases and age- and ethnicity- matched controls. The clinical records of those with possible VLCADD-related symptoms were reviewed. The follow-up period was 6months to 7years. Two of 247 cases (0.8%) had possible VLCADD-like symptoms while four of 247 controls (2%) had VLCADD-like symptoms (p = 0.81). Maori were overrepresented (68% of the cohort vs 15% of population). Targeted analysis of the c.1226 locus revealed the local increase in screening C14:1 levels is associated with the c.1226C > T variant (97/152 alleles tested), found predominantly in Maori and Pacific people. There was no increase in clinically significant childhood disease, irrespective of ethnicity. The study suggests that children with elevated C14:1, between 0.9-2.4μmol/L, on NBS are at very low risk of clinically significant childhood disease. A minimally interventional approach to managing these patients is indicated, at least in the New Zealand population.

Distinguishing autism from co-existing conditions: a behavioural profiling investigation

Purpose – Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition for which there is no known cure. The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. The paper aims to discuss this issue. Design/methodology/approach – A number of questionnaires and a computer-based task were used in the current study. The authors asked the participants about symptoms of ASD, attention deficit hyperactivity disorder (ADHD) and anxiety, as well as overall adaptive functioning. Findings – The results demonstrate that each condition, in its pure form, can be clearly differentiated from one another (and from neurotypical controls). Further analyses revealed that when ASD occurs together with anxiety, anxiety appears to be a separate condition. In contrast, there is no clear behavioural profile for when ASD and ADHD co-occur. Research limitations/implications – First, due to small sample sizes, some analyses performed were targeted to specific groups (i.e. comparing ADHD, ASD to comorbid ADHD+ASD). Larger sample sizes would have given the statistical power to perform a full scale comparative analysis of all experimental groups when split by their comorbid conditions. Second, males were over-represented in the ASD group and females were over-represented in the anxiety group, due to the uneven gender balance in the prevalence of these conditions. Lastly, the main profiling techniques used were questionnaires. Clinical interviews would have been preferable, as they give a more objective account of behavioural difficulties. Practical implications – The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. Social implications – This information will be important, not only to healthcare practitioners when administering a diagnosis, but also to therapists who need to apply evidence-based treatment to comorbid and stand-alone conditions. Originality/value – This study is the first to investigate the nature of co-existing conditions in ASD in a New Zealand population.

Why a hill country symposium?

Introduction When I was young the hill country was where the store lambs came from. But with the flatter and generally better land being lost to the likes of urban and dairy farming expansion, New Zealand's hill country is now the key breeding platform, and is increasingly being required to finish stock for the red meat sector - a sector that generates nearly $8 billion/year in export earnings for the country. Hill country farmers, their service providers and local communities face notable challenges including continuing pressure on profitability, rural depopulation and climate change, as well as environmental pressure around the 'right to farm' from the greater New Zealand population. However, there are also great success stories in terms of the improvements in productivity and environmental stewardship that have been made in the hill country. The Hill Country Symposium (HCS) will update relevant research and present some of the industry's successes. However, our main aim is as a group to answer two questions: What does a profitable and resilient future for our hill country farming look like? What do we, collectively

New Zealand needs a Practice Based Research Network.

Practice Based Research Networks (PBRNs) are groups of general practices collaborating to produce research. Contemporary New Zealand health information technology systems are ideal for electronic data extraction for PBRN research. Stakeholders have a valuable, but typically underutilised, part to play in research. Development of an e-participation platform will facilitate stakeholder engagement. New Zealand is in a unique position to create an innovative, low cost, stakeholder-engaged PBRN. This type of PBRN would offer unparalleled research opportunities, and would strengthen New Zealand's general practice research capacity. The more research information we have based on our New Zealand population, the more appropriate care we can provide. Establishing a stakeholder-engaged PBRN in New Zealand will promote and support transformational change within our health system.

The spread of non-OIE-listed avian diseases through international trade of chicken meat: an assessment of the risks to New Zealand.

Twelve avian diseases are listed by the World Organisation for Animal Health (OIE), although more than 100 infectious diseases have been described in commercial poultry. This article summarises a recent assessment of the biosecurity risks posed by non-listed avian diseases associated with imports of chilled or frozen chicken meat and meat products into New Zealand. Following the guidelines described in Chapter 2.1 of the OIE Terrestrial Animal Health Code, avian adenovirus splenomegaly virus, avian paramyxovirus-2 (APMV-2), Bordetella avium, Mycoplasma spp., Ureaplasma spp., Ornithobacterium rhinotracheale, Riemerella anatipestifer, and Salmonella arizonae have been identified as hazards. However, of all the non-listed avian diseases discussed here, only APMV-2 and S. arizonae are assessed as being risks associated with the commercial import of chicken meat into New Zealand. Specific control measures may have to be implemented to mitigate such risks. This conclusion is likely to reflect both the high-health status of New Zealand poultry and the threat posed by these infectious agents to New Zealand's unique population of native psittacine species.

Comparative ultrastructure of spermatozoa from two regular and two irregular New Zealand echinoids

Spermatozoa from four species of echinoids found in New Zealand had morphological characteristics typical of other echinoids, including a conical sperm head with an acrosome-capped nucleus, a midpiece, and a single long flagellum. The spermatozoa of Fellaster zelandiae, Echinocardium cordatum, Evechinus chloroticus, and Centrostephanus rodgersii also showed statistically significant differences in species-specific morphological characteristics. Evechinus chloroticus showed the most variable sperm morphology. The irregular urchins (F. zelandiae and E. cordatum) had short, wide sperm heads (head length:width ratios 2.93:1 & 2.97:1, respectively) with a long acrosome complex, while the regular urchins (E. chloroticus and C. rodgersii) had longer, narrower heads with a short acrosome complex (ratios 5.29:1 & 3.37:1). Spermatozoa of E. cordatum from the New Zealand population shared more characteristics with those of conspecifics from the Sea of Japan than those of conspecifics from the Baltic, reflecting the membership of the former two populations in a distinct Pacific clade. Volumetric calculations showed no evidence of phylogenetic grouping. Mitochondria of E. chloroticus spermatozoa were less than half the volume of those of C. rodgersii and E. cordatum, and those of F. zelandiae were intermediate in volume. These volume measurements will be useful in physiological studies of sperm performance and quality.

Māori university graduates: indigenous participation in higher education

ABSTRACTMāori, the indigenous population of New Zealand, are gaining university qualifications in greater numbers. This article describes the history of Māori university graduates, their current situation and the implications for indigenous futures. Section one provides a brief overview of historical policies and practices that, similar to those used on other indigenous populations, resulted in the widespread exclusion of Māori from university education until the 1970s and 1980s. Section two describes findings for Māori university graduates (n = 626) from the Graduate Longitudinal Study New Zealand (GLSNZ). Results show that nearly half (48.4%) were the first member of their immediate family to attend university. Humanities/education (50.8%) was the most common domain of study followed by commerce (17.7%), science/engineering (15.4%), health sciences (10.9%), law (2.8%) and PhD study (2.4%). More Māori graduates were females (71%). One-third of graduates were parents, and being a parent was associated with a lower likelihood of studying science and engineering compared to those participants without children. The most common areas/fields that participants wished to work in post-graduation were education and training (28.3%), health care and medical (17.4%) and government (11.8%). Despite increases in higher education participation and completion, parity remains an issue. Similar to previous indigenous research findings, Māori are under-represented as graduates (7.1% of the total sample) and in particular as postgraduates (5.8%) considering that Māori constitute 14.9% of the New Zealand population. Contemporary indigenous graduates are critical for indigenous development. Over the next 10 years, the GLSNZ will follow graduates and provide insights into Māori graduate outcomes.

Susceptibility of New Zealand flora to Phytophthora kernoviae and its seasonal variability in the field

The oomycete Phytophthora kernoviae is known from the United Kingdom and the Republic of Ireland, where it is considered to be a recent invader, from Chile where it was only discovered in 2014, and New Zealand where records date back to 1953. As there is little information in New Zealand linking P. kernoviae with plant disease, it may have been present for much longer and may be indigenous. Seasonal activity of P. kernoviae in a site known to have infested soil was tested by isolation from soil and foliage of existing shrubs and the use of indicator plants. In greenhouse studies, the susceptibility of a range of indigenous plants to P. kernoviae was tested via stem and foliar inoculation. Soil, litter and understorey vegetation samples were collected for isolation of P. kernoviae at monthly intervals for a year. Plants of Rhododendron catawbiense, which is known to be susceptible to foliar and shoot infection, were placed in the stand as indicator species. In laboratory and greenhouse studies, stem and foliar inoculations of a selection of arborescent plants representing major groups within the New Zealand flora were carried out and compared with three exotic plants of known susceptibility. Phytophthora kernoviae was not isolated from foliage of understorey plants at the study site, but it was recovered from soil and litter from April to November (autumn through spring) inclusive. Little disease developed on the Rhododendron catawbiense indicator plants. All of the exotic, and most of the indigenous, species developed a lesion in response to stem inoculation. Stem lesions were more developed on exotic species than on indigenous hosts. In contrast, few species formed foliar symptoms. Phytophthora kernoviae was recovered from asymptomatic tissue, stems and foliage, of a number of species. Based on the results of the inoculations and the lack of historical records of disease of indigenous plants associated with P. kernoviae, this oomycete does not appear to be a damaging pathogen of New Zealand’s indigenous flora. Although presence in the soil or litter was demonstrated at the study site, little disease developed on the indicator plants suggesting that at least part of the New Zealand population is of low pathogenicity to R. catawbiense.

Native Joint Septic Arthritis: Epidemiology, Clinical Features, and Microbiological Causes in a New Zealand Population.

To determine the epidemiology, clinical features, and microbiology of adult native joint septic arthritis in Canterbury, New Zealand, over a 5-year period in individuals with and without an underlying rheumatic disorder. Patients with native joint septic arthritis were identified retrospectively and classified by Newman's criteria. The clinical characteristics were described and comparisons made between those with and without underlying rheumatic disease. Two hundred forty-eight cases of native joint septic arthritis (mean age 60, range 16-97 yrs) were identified with an overall incidence rate of 12.0/100,000/year (95% CI 10.6-13.6). Yearly incidence increased with age to a maximum of 73.4/100,000 in those > 90 years of age. Septic arthritis was iatrogenic in 16.9% of cases while 27% had an underlying inflammatory arthritis including gout (14.9%), calcium pyrophosphate disease (8.5%), and rheumatoid arthritis (4%). Few patients were taking immunosuppressant therapy, with just 1 taking a biological agent. Staphylococcus aureus was the most commonly identified organism. Those with underlying inflammatory arthritis were significantly older (73.6 yrs vs 55.6 yrs; p < 0.001), more likely to be female (55.2% vs 26.0%; p < 0.001), and to have septic polyarthritis (16.4% vs 4.4%; p = 0.002). The 30-day mortality was 2%, increasing to 6% at 90 days. The incidence of septic arthritis in Canterbury, New Zealand, is higher than in previous studies. Crystal arthropathy commonly coexisted with infection although autoimmune arthritis and immunosuppression was less of a factor than anticipated.

Body-contouring surgery following bariatric surgery: do we need to provide this service?

Bariatric surgery is well established as a treatment for obese patients with hypertension and type 2 diabetes. Over one-third of the adults in New Zealand population are overweight and one-fourth are obese.1 Following massive weight loss, patients are often left with hanging and excessive soft tissue. Anecdotally, we know that patients often request removal of this tissue and the most common procedures they seek are abdominoplasty, brachioplasty and medial thigh lift. Given the incidence of obesity and the increasing number of bariatric procedures, it is important to better characterize the number of patients who may benefit from body-contouring surgery and to identify what those benefits are. At our regional service based at Middlemore Hospital, the General Surgery Department has been providing government-funded bariatric surgery since 2007. We have a large cohort of patients who are now over 2 years post-bariatric surgery and from whom we can ask their experience with excess soft tissue and the effect on their lives. We sent questionnaires out to 200 patients who were 2 years post-bariatric surgery and 50 matched controls who had laparoscopic cholecystectomies over the same time period. The response rate was just over 50% for the bariatric surgery patients and only 4% for the control group. Using a Likert scale to assess degrees of concern, we asked about excess abdominal skin, arm skin and thigh skin and how these areas affected the ability to do activities of daily living, social interactions and soft-tissue infections. Of the responses, 97% strongly/agree they had excess skin over the abdomen with 83 and 86% for upper legs and arms, respectively. We also found that 55% had weekly infections from oversized pannus and 21% had yearly infections. The excess skin also caused 42% to agree that abdominal skin limits their ability to exercise, similarly in 61% in those with upper leg and 64% with upper arm excess. The information from this study suggested that there are significant quality-of-life issues related to having this excess soft tissue both psychosocial and physical for patients at a stable weight post-massive weight loss. There is evidence to demonstrate the improvement in quality of life provided by body-contouring surgery following massive weight loss.2, 3 Klassen et al. interviewed 43 patients and found the main concerns precontouring were physical, cosmetic, psychological, sexual and social.4 Overall cosmesis improved but some concerns were raised over scarring. Most reported an improvement in sexual life and a ‘huge difference’ in psychological health. van der Beek et al. also completed quality-of-life questionnaires and showed an improvement,5 as did Araco et al.6 There is additional evidence that weight loss is not only maintained post-body contouring surgery but there is increased weight loss over and above the weight of the tissue removed at the time of surgery.7 The financial cost of body-contouring surgery is significant with a straight forward abdominoplasty requiring 3 h or longer of surgery time with a two-night hospital stay. In our publicly funded institution, the calculated value for this treatment is between NZ$15 000 and $25 000. Post-operative complications may increase this cost. Our impression is that there would be significant demand for body-contouring surgery following bariatric surgery if there was funding available for these procedures. In our department, we currently perform some body-contouring procedures but these are on a case-by-case basis and need to be approved by a group of clinicians who prioritize these ‘restricted procedures’. We believe there is clear evidence for clinicians to demonstrate to the funders of surgery that the benefits from body-contouring surgery are significant enough to warrant allocation of resource to these patients for these procedures.

Quantifying and Adjusting for Disease Misclassification Due to Loss to Follow-Up in Historical Cohort Mortality Studies.

The purpose of this analysis was to quantify and adjust for disease misclassification from loss to follow-up in a historical cohort mortality study of workers where exposure was categorized as a multi-level variable. Disease classification parameters were defined using 2008 mortality data for the New Zealand population and the proportions of known deaths observed for the cohort. The probability distributions for each classification parameter were constructed to account for potential differences in mortality due to exposure status, gender, and ethnicity. Probabilistic uncertainty analysis (bias analysis), which uses Monte Carlo techniques, was then used to sample each parameter distribution 50,000 times, calculating adjusted odds ratios (ORDM-LTF) that compared the mortality of workers with the highest cumulative exposure to those that were considered never-exposed. The geometric mean ORDM-LTF ranged between 1.65 (certainty interval (CI): 0.50–3.88) and 3.33 (CI: 1.21–10.48), and the geometric mean of the disease-misclassification error factor (εDM-LTF), which is the ratio of the observed odds ratio to the adjusted odds ratio, had a range of 0.91 (CI: 0.29–2.52) to 1.85 (CI: 0.78–6.07). Only when workers in the highest exposure category were more likely than those never-exposed to be misclassified as non-cases did the ORDM-LTF frequency distributions shift further away from the null. The application of uncertainty analysis to historical cohort mortality studies with multi-level exposures can provide valuable insight into the magnitude and direction of study error resulting from losses to follow-up.

Changing importances of professional practice competencies over an engineering career

The profession depends on its practitioners developing management and leadership skills to achieve good client outcomes and robust, reliable products or services, delivered by profitable, ethically run engineering businesses. The difficulty is determining what those skills are, and where in the career they are needed. The New Zealand population of professional engineers was surveyed to rate the importance of a list of management and leadership topics. Results show the relative importance of various topics and how their importance is perceived differently with years of experience. The results also help differentiate the roles of teaching institutions and ongoing in-career professional development.

Pediatric Acute Hematogenous Osteomyelitis.

Osteomyelitis continues to be a significant problem among the New Zealand pediatric population. We present a large series of acute hematogenous osteomyelitis (AHO) cases, with the aim to identify any changing trends and guide successful management of the disease. A 10-year retrospective review was performed of clinical records of children with AHO at the 2 children's orthopaedic departments in the Auckland region. Cases were identified from Starship Children's Hospital between 1997 and 2007 and Middlemore's Kidz First Hospital between 1998 and 2008. A total of 813 cases of pediatric AHO were identified. The incidence was 1:4000, which was decreasing over the 10-year period. There was a male predominance and New Zealand (NZ) Maori and Pacific Islanders were overrepresented. The diagnosis was made clinically in 27%, radiographically in 66%, and surgically in 7%. The most common pathogen was Staphylococcus aureus and the incidence of methicillin-resistant S. aureus was low (2%). The average length of antibiotic treatment was 44 days and 44% required surgery. This produced a recurrence rate of only 7% and a 15% treatment-related complication rate. In the New Zealand population, the incidence of AHO remains high with NZ Maori and Pacific Islanders overrepresented. The predominant pathogen remains S. aureus and our population has a very low incidence of methicillin-resistant S. aureus; flucloxacillin remains a good choice for empiric treatment in our population. Our rate of relapse and subsequent chronic osteomyelitis is low. This could be explained by traditionally longer antibiotic courses; however, this may also lead to increased treatment-related complications. Through prompt and accurate diagnosis with the aid of laboratory and radiologic tests and effective treatment with appropriate antibiotics (guided by local pathogen sensitivities) and surgical treatment when indicated, AHO can be well managed with minimal severe complications. Level IV-retrospective case series.

Development of a text message intervention aimed at reducing alcohol-related harm in patients admitted to hospital as a result of injury

BackgroundScreening for alcohol misuse and brief interventions (BIs) for harm in trauma care settings are known to reduce alcohol intake and injury recidivism, but are rarely implemented. We created the content for a mobile phone text message BI service to reduce harmful drinking among patients admitted to hospital following an injury who screen positive for hazardous alcohol use. The aim of this study was to pre-test and refine the text message content using a robust contextualisation process ahead of its formal evaluation in a randomised controlled trial.MethodsPre-testing was conducted in two phases. First, in-depth interviews were conducted with 14 trauma inpatients (16–60 years) at Auckland City Hospital and five key informants. Participants were interviewed face-to-face using a semi-structured interview guide. Topics explored included: opinions on text message ideas and wording, which messages did or did not work well and why, interactivity of the intervention, cultural relevance of messages, and tone of the content. In a second phase, consultation was undertaken with Māori (New Zealand’s indigenous population) and Pacific groups to explore the relevance and appropriateness of the text message content for Māori and Pacific audiences.ResultsFactors identified as important for ensuring the text message content was engaging, relevant, and useful for recipients were: reducing the complexity of message content and structure; increasing the interactive functionality of the text message programme; ensuring an empowering tone to text messages; and optimising the appropriateness and relevance of text messages for Māori and Pacific people. The final version of the intervention (named ‘YourCall™’) had three pathways for people to choose between: 1) text messages in English with Te Reo (Māori language) words of welcome and encouragement, 2) text messages in Te Reo Māori, and 3) text messages in English (with an option to receive a greeting in Samoan, Tongan, Cook Island Māori, Niuean, Tokelauan, Tuvaluan, or Fijian).ConclusionsWe have developed a text message intervention underpinned by established BI evidence and behaviour change theory and refined based on feedback and consultation. The next step is evaluation of the intervention in a randomised-controlled trial.

Identification of seven novel HLA class I alleles in New Zealand.

Seven new HLA class I alleles have been identified in the New Zealand population in the process of routine HLA typing and they are described here. Unusual bead positivity in Luminex typing identified potential new alleles in a bone marrow registry donor (B*40:285) and two HIV patients prior to abacavir prescription (B*14:02:09, B*41:29). In addition, four new class I alleles were identified through class I sequencing-based typing (SBT) outside of exons 2 and 3. One mutation was identified in exon 4 (new allele C*12:125) and three have been found in exon 5, an exon rarely sequenced. Two stem cell transplant recipients (B*07:02:45, C*03:279) had novel mutations in exon 5 and one was found in exon 5 of a potentially matched unrelated donor from DKMS, previously thought to be B*40:02:01 (B*40:303).

Cultural responsiveness and the family partnership model

IntroductionCultural responsiveness is contingent on the relationships developed between nurses and clients, and is necessary for the clients' and whanau (extended family) cultural needs to be incorporated into care delivery. The health and wellbeing of Maori children and their whanau is an ongoing concern for the delivery of health and social services in New Zealand. The Royal New Zealand Plunket Society (known as Plunket) provides well child services to 90% of children and their families nationwide, and to 65% of Maori children born in 2010 (Royal New Zealand Plunket Society, 2012). Plunket is committed to the Family Partnership Model, developed in the United Kingdom (Davis, Day, & Bidmead, 2002). The Family Partnership Model is based on establishing relationships and communication for working with others, and informs a programme to develop knowledge, skills and techniques for those working with children and their families. Plunket nurses undertake a 10-session Family Partnership Model training that aims to enhance their communication and ability to establish partnerships with families. However, it is not clear if the Family Partnership Model supports culturally responsive nursing practice. In this article we report the findings of a study investigating whether the Family Partnership Model influenced culturally responsive practice for nurses working with Maori whanau.BackgroundMaori, indigenous peoples of New Zealand, experience persistent inequities in health status and outcomes, similar to other Indigenous peoples who have histories of colonisation. They comprise 14.9% of the New Zealand population (Statistics New Zealand, 2013). Ninety percent of Maori live in households with other family members, and of these, 42.9% are couples with children, 26.5% are single adults with children and 11.5% in multi-family households (Te Puni Kokiri, 2011). Many Maori women have children at a younger age than other women living in New Zealand, are disconnected from their iwi and lack wider whanau support (Ritchie, 2007). Consequently, Maori whanau and children are often deemed at risk and vulnerable. For example, Maori children suffer health disparities and inequities at higher rates than other children living in New Zealand (Ministry of Health, 2012a, 2012b).Health inequities occur within a complex context that includes being indigenous; experiencing discrimination, poverty and unemployment; and having low levels of education. Many Maori children live in areas of high deprivation, with 41% of Maori whanau living in neighbourhoods with high deprivation (NZDep 2006 deciles 9 and 10) compared with 15% of non-Maori, while 73% of Maori live in deciles 6 to 10 neighbourhoods compared with 44% of non-Maori (Ministry of Health, 2010). There is a high likelihood that Maori children will live in poverty, an adverse experience that impacts lifelong health and social outcomes (Marie, Fergusson, & Boden, 2008; Poulton et al., 2002). The health system has a role to manage improvement in the poor health status of children (Tipene-Leach, 2012). Yet, despite Maori reporting good health in the 2012/13 New Zealand Health Survey, ongoing health inequities for parents and their children are evident, such as unmet health needs (Ministry of Health, 2012b).Providing culturally safe and responsive care is crucial for reducing health disparities and inequities for Maori (Robson & Harris, 2007; Wilson & Barton, 2012). Cultural responsiveness is grounded in worldviews, relationships, cultural contexts, and connecting in 'culturally-normed' ways of functioning (WerkmeisterRozas & Klein, 2009). Werkmeister-Rozas and Klein go further, stating cultural responsiveness is a cocreated reality between worker and client (p.6). This concept defies the adoption of universal or one-size-fits-all approaches. In addition to practitioners' awareness of their own cultural positions, cultural responsiveness is informed by a critical analysis of Maori whanau realities in terms of equity, social justice, rights, intersectionality, and complex interactions that impact their daily lives (Anderson et al. …

Phylogeographic Structure in Penguin Ticks across an Ocean Basin Indicates Allopatric Divergence and Rare Trans-Oceanic Dispersal.

The association of ticks (Acarina) and seabirds provides an intriguing system for assessing the influence of long-distance dispersal on the evolution of parasitic species. Recent research has focused on host-parasite evolutionary relationships and dispersal capacity of ticks parasitising flighted seabirds. Evolutionary research on the ticks of non-flighted seabirds is, in contrast, scarce. We conducted the first phylogeographic investigation of a hard tick species (Ixodes eudyptidis) that parasitises the Little Blue Penguin (Eudyptula minor). Using one nuclear (28S) and two mitochondrial (COI and 16S) markers, we assessed genetic diversity among several populations in Australia and a single population on the South Island of New Zealand. Our results reveal two deeply divergent lineages, possibly representing different species: one comprising all New Zealand samples and some from Australia, and the other representing all other samples from Australian sites. No significant population differentiation was observed among any Australian sites from within each major clade, even those separated by hundreds of kilometres of coastline. In contrast, the New Zealand population was significantly different to all samples from Australia. Our phylogenetic results suggest that the New Zealand and Australian populations are effectively isolated from each other; although rare long-distance dispersal events must occur, these are insufficient to maintain trans-Tasman gene flow. Despite the evidence for limited dispersal of penguin ticks between Australia and New Zealand, we found no evidence to suggest that ticks are unable to disperse shorter distances at sea with their hosts, with no pattern of population differentiation found among Australian sites. Our results suggest that terrestrial seabird parasites may be quite capable of short-distance movements, but only sporadic longer-distance (trans-oceanic) dispersal.

Sodium in commonly consumed fast foods in New Zealand: a public health opportunity.

(i) To determine the Na content of commonly consumed fast foods in New Zealand and (ii) to estimate Na intake from savoury fast foods for the New Zealand adult population. Commonly consumed fast foods were identified from the 2008/09 New Zealand Adult Nutrition Survey. Na values from all savoury fast foods from chain restaurants (n 471) were obtained from nutrition information on company websites, while the twelve most popular fast-food types from independent outlets (n 52) were determined using laboratory analysis. Results were compared with the UK Food Standards Agency 2012 sodium targets. Nutrient analysis was completed to estimate Na intake from savoury fast foods for the New Zealand population using the 2008/09 New Zealand Adult Nutrition Survey. New Zealand. Adults aged 15 years and above. From chain restaurants, sauces/salad dressings and fried chicken had the highest Na content (per 100 g) and from independent outlets, sausage rolls, battered hotdogs and mince and cheese pies were highest in Na (per 100 g). The majority of fast foods exceeded the UK Food Standards Agency 2012 sodium targets. The mean daily Na intake from savoury fast foods was 283 mg/d for the total adult population and 1229 mg/d for fast-food consumers. Taking into account the Na content and frequency of consumption, potato dishes, filled rolls, hamburgers and battered fish contributed substantially to Na intake for fast-food consumers in New Zealand. These foods should be targeted for Na reduction reformulation.

Measuring accessible journeys: a tool to enable participation

This study set out to demonstrate the feasibility and usefulness of a series of pedestrian counts, including counting the subset of pedestrians who use visibly identifiable mobility aids. The resulting proportion of mobility aid users can then be used as a proxy measure of relative accessibility for each count site. The study acknowledges the diversity of disability, and the count is not intended to capture all people who identify as having disability of any kind. It was estimated from Statistics New Zealand data that approximately 3% of New Zealand's adult population uses a mobility aid for travel at any particular time. This figure includes those identifying as having permanent disability, as well as an estimate to account for those not included in this figure, namely children, people who do not identify as having a disability but nevertheless use a mobility aid, and those with temporary disability requiring use of a mobility aid. The study identified opportunities to use the tool to remove gaps in the delivery of accessible transportation, across all parts of its system from policy and planning, through design, construction and monitoring. Its widespread promotion will support more objective measurement of inclusion, to inform best-practice infrastructure investment for all.

Analgesic Medicine Utilization in Older People in New Zealand from 2005 to 2013.

BackgroundOlder people (aged 65 years and above) consume more analgesics compared with other age groups. Because of the aging of the New Zealand population, it is important to ascertain the trends of analgesic use at a population-level.ObjectiveThe aim of this population-based study was to describe and characterize the utilization of analgesic medicines in older people in New Zealand from 2005 to 2013.MethodsRepeated cross-sectional analysis of population-level dispensing data was conducted from 2005 to 2013. Dispensing data were obtained from Pharmaceutical Claims Data Mart (Pharms), Ministry of Health, extracted using encrypted national health index numbers as unique identifiers and categorized by the World Health Organization Collaborating Centre for Drug Statistics Methodology (WHOCC) Anatomical Therapeutic Chemical (ATC) classification system. Utilization of analgesics was measured in defined daily dose (DDD) per 1000 older people per day (TOPD).ResultsOverall, analgesic medicine utilization increased by 5.44 % from 2005 to 2013. Analgesic utilization increased from 233.66 to 246.36 DDD/TOPD. The increased utilization was mainly driven by analgesics and antipyretics. An increased utilization of analgesics was seen in the 85+ age group. Females consumed more analgesics compared with males. Differences in analgesic utilization across the District Health Boards (DHBs) persisted over the 9-year period. Utilization of anti-migraines was stable over the 9-year period.ConclusionsThis population-level utilization study showed a 5.44 % increase in utilization of analgesic medicines in older people in New Zealand from 2005 to 2013. Important findings were that (1) females utilized more analgesics compared with males; (2) non-steroidal anti-inflammatory drug (NSAID) utilization decreased over the years; and (3) the highest utilization was reported in the 85+ group. Further research is warranted to examine the drivers influencing analgesic use in New Zealand.