Zealand Regions Research Articles

Association of postoperative opioid type with mortality and readmission rates: multicentre retrospective cohort study.

Opioid treatment in postoperative pain management is crucial, but the impact of administration practices on outcomes is unclear. The hypothesis was that prescription trends remained stable over recent years, and that no difference in mortality and readmission risks is associated with prescription strategies. Electronic health records of surgical episodes in the Capital and Zealand Regions of Denmark from 2017 to 2021 were analysed. All opioids administered during postoperative admission were converted to oral morphine equivalents (OMEQs) and an average daily dose per patient was calculated. The opioid administered in the highest OMEQ dosages is considered the primary opioid strategy for the surgical case. Administration trends were analysed through linear regression, and Cox regression was used to calculate hazard ratios to assess dominant opioid strategies' association with 90-day mortality and readmission rates while controlling for confounders. A total of 183 317 patients met the inclusion criteria. Prescription trends remained steady during the study period. Multivariable analysis revealed increased readmission risk (HR 1.18, P < 0.001) of tramadol and tapentadol compared to morphine. They exhibited decreased 90-day mortality risk (HR 0.63, P < 0.001). Oxycodone had similar readmission risk (HR 1.009, P = 0.24) but lower 90-day mortality risk (HR 0.68, P < 0.001). Postoperative in-hospital opioid administration remained stable from 2017 to 2021. Tramadol/tapentadol had a higher risk of readmission but lower mortality risk. Oxycodone had comparable readmission but reduced mortality risk. This study provides a framework for future clinical trials assessing this potential impact of opioids in a targeted manner.

Alemtuzumab-induced thyroid disease: A Danish cohort study

ObjectivesAlemtuzumab, a monoclonal antibody against the cluster of differentiation 52 (CD52) molecule, is used in the treatment of multiple sclerosis (MS). A side effect of the treatment is development of secondary autoimmune thyroid disease. The aim of this study was to evaluate the rate, type and course of thyroid disease in Danish patients with multiple sclerosis (MS) treated with alemtuzumab. MethodsWe conducted a retrospective cohort study of patients treated with a first series of alemtuzumab for MS in the Capital and Zealand regions of Denmark (population: 2.6 million) between 2014 and 2018 (n = 60 ResultsThe duration of follow-up was median 81 months (range 54–105). Thyroid disease occurred in 47 % of the patients with the following distribution: Graves’ disease (GD), thyrotropin (TSH) receptor antibody (TRAb) positive hyper- or hypothyroidism 35 %; multinodular goitre 5 %; silent thyroiditis, gestational transient thyrotoxicosis or unclassified hyperthyroidism 7 %. Of patients with GD, 14 % had an additional silent or postpartum thyroiditis before onset or after remission of GD. Unusual courses of GD occurred in 67 %, most commonly fluctuation from hypo- to hyperthyroidism or vice versa, mainly treated with antithyroid drug alone or thyroxine substitution regime but switched to concomitant block and replace treatment in 25 % and/or subsequent total thyroidectomy in less than 25 %. ConclusionData from the largest Danish MS center supports previous observations of unusual, long-lasting and unpredictable courses of alemtuzumab-induced GD. Thus, follow-up of these patients may require long lasting and more frequent biochemical measurements compared to other patients with GD. Also, concomitant block and replace treatment or definitive treatment, such as thyroidectomy, should be considered in a subgroup of patients.

Preface

Against the backdrop of the rapidly evolving global energy transition, power, grid and energy storage technology are receiving unprecedented attention as key forces in promoting cleaner, smarter and more efficient energy sources. The Proceedings of the 2024 2nd International Conference on Power, Grid and Energy Storage (PGES 2024) brings together the latest research results and cutting-edge explorations of experts and scholars in the field of power energy from all over the world, demonstrating the vigorous vitality and unlimited potential of this field. The PGES 2024 took place virtually in Kunming, China from June 21st to 23rd, 2024. The conference was organized in order to provide an international academic forum for promoting research and other academic activities as well as developing research cooperation in field of power, grid and energy. It is worth mentioning that the number of international participants in this conference hit a record high. Experts and scholars from Canada, Malaysia, Italy, New Zealand, China, and many other countries and regions gathered together to contribute to the development of power, grid and energy. They brought cutting-edge technologies and research results in their respective fields, injecting new vitality and momentum into the conference. The conference fully demonstrated the characteristics of globalized exchanges. Participants from different countries and regions promoted international academic exchanges and cooperation by sharing their research achievements and experiences. At the same time, the conference also invited a number of internationally renowned experts and scholars to give keynote speeches, bringing participants cutting-edge academic views and profound insights. The keynote speakers include Hossam A. Gabbar (full Professor of Ontario Tech University, Canada), Tao Lin (Professor of Wuhan University, China), M A Hannan (Professor of Sunway University, Malaysia), Pierluigi Siano (Full Professor of University of Salerno, Italy), Udaya Madawala (Professor of The University of Auckland, New Zealand), as well as Guobing Zhou (Professor of North China Electric Power University, China). In addition, the conference also organized oral and poster presentations, which provided participants with more opportunities for in-depth exchanges and discussions. These activities not only helped to enhance the friendship and cooperation among the attendees, but also laid a solid foundation for promoting international exchanges and cooperation in the field of information education and artificial intelligence. The topics of papers collected and undergone rigorous peer review in the Proceedings of PGES 2024 can be classified as follows: Power Systems and Automation, Energy Storage Equipment and Systems, Smart Grid Information Engineering, Electrical Power Generation Technology, Power Transmission and Distribution, Communication and Control in The Power System, etc. We would like to express our sincere thanks and gratitude to all the keynote speakers, authors, committee members and other colleagues for the success of PGES 2024, which has given rise to this present volume of selected papers. We would also like to acknowledge the staff of Journal of Physics: Conference Series for their effective work to make this Proceedings published. The Committee of PGES 2024 List of Committee Member is available in this Pdf.

Dysphagia and tracheostomy management in New Zealand intensive care units

ABSTRACT Background: Speech-language therapists (SLTs) hold an important multidisciplinary team (MDT) role in managing swallowing, communication and tracheostomy weaning in intensive care units (ICUs). Yet, many ICUs do not have dedicated SLT time. In this study, we explored New Zealand ICU’s current practices to support benchmarking across the country and against international evidence-based practice. Methods: In part 1, we extracted New Zealand data representing 11 ICU MDTs across all regions from an international survey of 746 ICUs (26 countries). MDTs were asked about their dysphagia practice. In part 2, we conducted a national survey exploring tracheostomy practice in New Zealand. SLTs were asked about perceived roles, knowledge, skills and confidence in tracheostomy. Thirty-five SLTs responded to the survey, again, representing all New Zealand regions. Results: All ICUs had access to a SLT but none had dedicated SLT hours. ICU teams had variable awareness of evidence-based practice in dysphagia care. Swallowing rehabilitation was infrequent. The top two perceived barriers to standardized management of dysphagia were lack of access to SLT and flexible endoscopic evaluation of swallowing (FEES) equipment. In part 2, SLTs were experienced and confident but standardized protocols were infrequent and not all practices met current international evidence-based practice. SLTs’ reported barriers to best practice were MDT understanding of role, insufficient ICU-dedicated SLTs, training of nursing, and access to otolaryngology. Conclusions: Skilled, ICU-dedicated SLTs are needed in New Zealand ICUs to support more consistent and evidence-based practice. Access to FEES and time for rehabilitation and MDT education are needed.

Multi-Wave Structures of Traveling Ionospheric Disturbances Associated with the 2022 Tonga Volcanic Eruptions in the New Zealand and Australia Regions

Using dense global navigation satellite system data and brightness temperature data across the New Zealand and Australia regions, we tracked the propagation of traveling ionospheric disturbances (TIDs) associated with the 15 January 2022 Tonga volcanic eruptions. We identified two shock wave-related TIDs and two Lamb wave-related TIDs following the eruptions. The two shock wave-related TIDs, propagating with velocities of 724–750 and 445–471 m/s, respectively, were observed around New Zealand and Australia within a distance of 3500–6500 km from the eruptive center. These shock wave-related TIDs suffered severe attenuation during the propagation and disappeared more than 6500 km from the eruptive center. Based on the TEC data from the nearest ground-based receivers, we estimated the onset times of two main volcanic explosions at 04:20:54 UT ± 116 s and 04:24:37 UT ± 141 s, respectively. The two shock wave-related TIDs were most likely generated by these two main volcanic eruptions. The two Lamb wave-related TIDs propagated with velocities of 300–370 and 250 m/s in the near-field region. The Lamb wave-related TIDs experienced minimal attenuation during their long-distance propagation, with only a 0.17% decrease observed in the relative amplitudes of the Lamb wave-related TIDs from the near-field to far-field regions.

Biogeographical comparison of Lagarosiphon major between native South Africa and invaded New Zealand: A natural enemy release case study?

The Enemy Release Hypothesis (ERH) suggests that the absence of natural enemies (herbivores, parasites, and diseases) in non-native environments allow exotic plants to allocate more resources towards growth and reproduction, resulting in increased invasiveness. This study uses the submerged macrophyte Lagarosiphon major (Ridl.) Moss ex Wager (Hydrocharitaceae), native to Southern Africa, as a case study of this hypothesis. This species is invasive in many parts of the world, including Ireland, the United Kingdom and New Zealand. Here, we investigate the applicability of the ERH in explaining the invasiveness of L. major in New Zealand. This was achieved by comparing L. major biomass and cover, and plant species richness between L. major’s native range in South Africa and its invaded range in New Zealand, where specialist natural enemies were presumed to be lacking. The findings revealed significantly higher L. major biomass (∼100 % increase), cover (∼28 % increase) and shoot production (∼91 % increase) in the invaded range compared to the native range. Additionally, overall species richness and abundance was negatively correlated with L. major abundance in the invaded range. Plants in the native range were associated with more natural enemies and experienced higher levels of damage relative to the invaded sites. Overall, these observations align with the ERH, but should be interpreted with caution as other influential factors such as competition were not measured. Nevertheless, this suggests that L. major could benefit from the integration of biological control measures with the existing methods of control. Two natural enemies, Polypedilum tuburcinatum Andersen (Diptera: Chironomidae) and Hydrellia lagarosiphon Deeming (Diptera: Ephydridae) have already been identified as promising candidates, for biological control of L. major in New Zealand and other regions invaded by this weed.

Does landscape composition influence the diets of feral cats in agroecosystems?

Habitat fragmentation can influence the diet of mammalian predators, potentially increasing their impact on prey species. Agroecosystems are fragmented landscapes that often have high densities of invasive mammalian predators. Feral cats are generalist predators that have successfully adapted to living in agricultural landscapes. Feral cats are known to eat rabbits, rodents, and birds, but it is unclear how landscape characteristics affect prey consumption. Here, we tested whether feral cat diet in New Zealand agroecosystems was affected by landscape composition and spatial configuration. We examined the contents of 112 feral cat gastrointestinal tracts collected from agroecosystems in different New Zealand regions over a 3-year period. We related prey richness and composition to the landscape composition and spatial configuration in a 500-ha area within which each cat was caught. Dietary analysis showed that feral cats were consuming invertebrates, birds, rodents, and rabbits, and that there were some regional and seasonal effects. No significant differences in prey richness or composition of the diet were associated with variation in landscape composition or spatial configuration. This study confirms feral cats as generalist predators that feed on a wide range of prey types in New Zealand agroecosystems, including some native species. Our study highlights the importance of further research for understanding how current conservation interventions in New Zealand, which include revegetation and rodent control, interact with feral cat populations and behaviours to impact on future biodiversity outcomes.

Assessing the utility of natural language processing for detecting postoperative complications from free medical text.

Postoperative complication rates are often assessed through administrative data, although this method has proven to be imprecise. Recently, new developments in natural language processing have shown promise in detecting specific phenotypes from free medical text. Using the clinical challenge of extracting four specific and frequently undercoded postoperative complications (pneumonia, urinary tract infection, sepsis, and septic shock), it was hypothesized that natural language processing would capture postoperative complications on a par with human-level curation from electronic health record free medical text. Electronic health record data were extracted for surgical cases (across 11 surgical sub-specialties) from 18 hospitals in the Capital and Zealand regions of Denmark that were performed between May 2016 and November 2021. The data set was split into training/validation/test sets (30.0%/48.0%/22.0%). Model performance was compared with administrative data and manual extraction of the test data set. Data were obtained for 17 486 surgical cases. Natural language processing achieved a receiver operating characteristic area under the curve of 0.989 for urinary tract infection, 0.993 for pneumonia, 0.992 for sepsis, and 0.998 for septic shock, whereas administrative data achieved a receiver operating characteristic area under the curve of 0.595 for urinary tract infection, 0.624 for pneumonia, 0.571 for sepsis, and 0.625 for septic shock. The natural language processing approach was able to capture complications with acceptable performance, which was superior to administrative data. In addition, the model performance approached that of manual curation and thereby offers a potential pathway for complete real-time coverage of postoperative complications across surgical procedures based on natural language processing assessment of electronic health record free medical text.

Aviation Pollution, Tourism, and Economic Development: A Study of the EKC Hypothesis at the Regional Level

The study aims to revisit the relationship between aviation pollution, tourism, and economic development through the lens of the Environmental Kuznets Curve (EKC), particularly at the regional level, using New Zealand as a case study. We are the first to estimate aviation pollution at regional airports in New Zealand and use them as proxy for the regional pollution in an EKC setting. Our findings provide evidence of an EKC at New Zealand regions, indicating that tourism and economic development contribute to the long-term regional environment improvement. This highlights the necessity for environment policy to be tailored at a regional level, rather than solely at the national scale. Additionally, our research introduces a novel approach to EKC studies by incorporating new pollution estimations, which enhances the understanding of regional environmental dynamics. Among others, we discovered that that the sustainable tourism policy has, and will, work well in New Zealand. This study underscores the importance of considering regional factors in environmental policymaking and offers insights that could inform future strategies for balancing economic growth with environmental sustainability.

Financial Comparison of Afforestation Using Redwood and Radiata Pine within New Zealand for Regimes That Derive Value from Timber and Carbon

Carbon sequestration has become an important source of supplementary revenue from forest plantations. Although there are many financial comparisons of species based on timber revenue, there have been few regional comparisons that integrate revenue from carbon. Within New Zealand, radiata pine is the most widely planted species, but there has been a recent upsurge in planting rates for coast redwood. Under New Zealand’s Emissions Trading Scheme, areas that are newly afforested under clear-fell rotational forestry receive carbon payments up to a set age, intended to represent the long-term average under successive rotations. Using growth models for both species, the objectives of this research were to regionally quantify (i) how the rotation length and the carbon averaging age influenced the profitability of growing redwood and (ii) compare carbon, timber yields, and profitability between radiata pine and redwood. The results showed the legislated carbon averaging age of 22 years for redwood underestimated the actual mid-points of carbon accumulation, which averaged 26, 28, and 31 years across rotation lengths of 40, 45, and 50 years, respectively. The optimal rotation length for redwood varied markedly by region and carbon price but was most often 40 years, increasing to 50 years at higher carbon prices, particularly for southern regions. Under regimes where revenue was only derived from timber, the redwood internal rate of return (IRR) exceeded that of radiata pine for eight of the nine New Zealand regions. When revenue was received from carbon and timber, redwood had a higher IRR than radiata pine up to carbon prices ranging from 29 to 50 NZD/tonne CO2 for the North Island and 23 to 34 NZD/tonne CO2 in all South Island regions apart from Otago. The IRR of radiata pine exceeded that of redwood at carbon prices above these values for the eight regions and at all carbon prices within the cold, dry Otago region.

Predicting facial eczema risks in a changing New Zealand climate

Facial eczema is a major concern for New Zealand farmers due to its economic impact and animal welfare implications. The disease occurs when animals ingest sporidesmin, a mycotoxin produced by spores of the fungus Pseudopithomyces chartarum. Spore production is related to weather conditions; thus the incidence and severity of facial eczema varies between years, with thedisease commonly occurring from late summer through autumn in the North Island. We developed a simple model to estimate climatic suitability for P. chartarum sporulation and ran it using climate data for 2008-2021 to compare its estimates with spore counts from the same years. Model climatic suitability estimates had significant linear correlations with an index of exposure to spores derived from spore counts at both national and local scales. Model results were also consistent with a documented outbreak of facial eczema. Using predicted future climate data from the Hadley Centre Global Environment Model version 2 and two emissionsscenarios, the model suggested climatic suitability for P. chartarum sporulation will increase with time in many New Zealand regions, particularly in the southern North Island and eastern parts of the South Island. However, it could remain relatively static in some other areas, thus the degree of change in climatic suitability for P. chartarum sporulation is predicted to vary between New Zealand regions.

Designing for health equity: A mixed method study exploring community experiences and perceptions of pharmacists' role in minor ailment care.

Minor ailments are self-limiting, easily diagnosable and treatable conditions. Funded pharmacist minor ailments services (PMAS) have been posited to improve medicines access equity and, despite ethnic minorities across the globe experiencing reduced access to medicines and health care, PMAS internationally have not explicitly centered ethnic equity in service design or outcome measurement. To explore Māori experiences of minor ailments care and perceptions of the pharmacists' role. This mixed methods study collected data through facilitated wānanga (collaborative knowledge-sharing group discussions). Eligible participants (Māori, 18 years plus, obtained medicine from pharmacy in last 3 years) were recruited through local pharmacist networks using convenience sampling. Wānanga included qualitative data collection through discussion using a topic guide and a quantitative questionnaire. Indigenous theory was applied within a general inductive approach to thematic development to analyze qualitative data. Quantitative data was reported using simple descriptive statistics. Thirteen wānanga (3 in-person, 10 online) were conducted from September 2021-February 2022 with 62 participants from seven New Zealand regions. The minor ailments that participants were most likely to seek treatment from pharmacy first, instead of a doctor, were eczema (87.2%), coughs and colds (85.7%), headlice (85.7%), insect bites (83.9%), and hayfever (83.9%). Four themes were generated from the qualitative data: designing the right environment for minor ailment care; clinically and culturally safe care; moving from stigmatizing to strengths-based services; the benefits of PMAS. Participant-informed ideas for PMAS service development centered on Māori aspirations included: developing clinically and culturally safe pharmacy environments, enabling medicine supply outside of the physical pharmacy setting, avoiding stigmatizing language when promoting PMAS availability, and collaborative practice with other health providers. This study provides important recommendations when developing PMAS to increase the likelihood of delivering equitable care, and has international application across multiple pharmacy and health service settings.

Experiences of the COVID-19 Lockdown and Telehealth in Aotearoa New Zealand: Lessons and Insights from Mental Health Clinicians

The COVID-19 pandemic rapidly changed health service delivery and daily life. There is limited research exploring health professional experiences with these changes. This research explores mental health clinicians' experiences over the first COVID-19 lockdown in New Zealand to inform future pandemic responses and improve usual business practices. Thirty-three outpatient mental health clinicians in three Aotearoa New Zealand regions took part in semi-structured interviews. Interviews were analysed thematically applying an interpretive description methodology. Three key themes emerged: (1) life in lockdown, (2) collegial support, and (3) maintaining well-being. Clinicians, fearful of contracting COVID-19, struggled to adapt to working from home while maintaining their well-being, due to a lack of resources, inadequate pandemic planning, and poor communication between management and clinicians. They were uncomfortable bringing clients notionally into their own homes, and found it difficult to separate home and work spheres. Māori clinicians reported feeling displaced from their clients and community. Rapid changes in service delivery negatively impacted clinician well-being. This impact is not lessened by a return to normal work conditions. Additional support is required to improve clinician work conditions and ensure adequate resourcing and supervision to enable clinicians to work effectively within a pandemic context.

A new and some interesting species of ptyctimous mites (Acari, Oribatida) from different countries of the all worldly zoogeographical regions

In the paper, we presented ptyctimous mites collected from Nearctic (Canada, USA), Neotropical (Dominicana), Palaearctic (Scotland, Italy, Russia, Nepal, Egypt), Afrotropical (Ethiopia, Gabon, Congo, Mozambique, Madagascar, Réunion), South Africa, Oriental (Maldives, Vietnam, Malaysia, Indonesia, China) and Australasian (Papua New Guinea, Australia, New Zealand) regions. Information of Mesoplophora (Parplophora) flavida Niedbała, 1985 and M. (P.) polita Niedbała, 1985 phoretic on different insects (Coleoptera: Passalidae) are presented. A new species Atropacarus (Hoplophorella) additus Niedbała sp. nov., is described from Madagascar. Supplementary descriptions and some remarks of ten species from six genera are given (including two paratypes of previously synonymous species). Information on the distribution and location of 85 species of 18 genera is also presented. Fifty-three species were found for the first time in the zoogeographical region or given country.

New Zealand pharmacists' views regarding the current prescribing courses: questionnaire survey.

Introduction New Zealand pharmacists must complete a joint prescribing course offered by Otago and Auckland universities only, to be qualified as pharmacist prescribers. Aim To identify knowledge and perceptions of New Zealand registered pharmacists, who are not pharmacist prescribers, on: pharmacist prescribing roles, courses and perceived barriers and facilitators to course uptake. Methods Participants comprised registered practising New Zealand pharmacists (n = 4025), across all New Zealand regions. Invitations to participate in a questionnaire survey were sent in March 2021. Data were analysed using thematic analysis and descriptive statistics. Results The response rate was 12% (482/4025), with 94% community pharmacists. Almost two-thirds (65%) had over 10 years of working experience. Nearly all (95%) agreed that pharmacist prescribing would improve healthcare delivery in New Zealand. Most reported that barriers to pharmacist prescribing course uptake were funding, lack of institutional support, up-to-date pharmacological/pharmaceutical knowledge, and 2 years of experience in collaborative health team prerequisites for enrolment, finding medical supervisors, and lack of remuneration for prescribing roles. Discussion Pharmacist prescribing in New Zealand is still in its growing phase. Optimising uptake of prescribing courses and role requires a multi-level approach including all stakeholders. Government/policymakers should consider pharmacist prescribing training and remuneration in their funding plans. Employing institutions should provide required time and human resources (staff backfills). Training providers should consider methods of course delivery and assessment that are suitable for trainees in full-time employment.

Airport subsidies impact on wellbeing of smaller regions: A systemic examination in New Zealand

This study investigated the inter-relationships among airport subsidies, air transport activity, and regional wellbeing by applying a three-stage least squares structural model using a panel dataset of New Zealand's regions from 2010 to 2019. By investigating these inter-relationships, the study provides empirical evidence of the necessity of implementing regional airport subsidies in New Zealand, and contributes to the regional aviation literature. The empirical findings reveal that implementing airport subsidies significantly increased scheduled flight seat capacity and helped unprofitable regional airports to increase their regional air transport activity. This study also shows that increases in airport subsidies can facilitate economic growth and employment in the region in which the airport is located. More importantly, this study empirically finds that regional air transport activity, economic growth, and environmental sustainability should be critical considerations when determining airport subsidies. These findings have profound implications for regional policymakers and airport stakeholders.

Pūao-te-Ata-tū and dissenting voices of change at New Zealand’s oldest school of social work

INTRODUCTION: The Ministerial Advisory Committee Report on a Māori Perspective for the New Zealand Department of Social Welfare (1986) offers an historic reference point from which to examine education and training reforms initiated at Aotearoa New Zealand’s oldest school of social work and designed to better address the needs and aspirations of Māori and those working with Māori. Pūao-te-Ata-tū is an internationally unique example of social research facilitated by distinguished Māori leaders and senior government officials using indigenous methods. The Vice Chancellor of Victoria University was approached in 1986 along with its new Professor of Social Work about becoming drivers of Pūao-te-Ata-tū Recommendation 10(c) to “assess the extent to which tertiary social work courses are meeting cultural needs for those public servants seconded as students to the courses”. The early passing of alumnus- Elder John Rangihau, shortly after Pūao-te-Ata-tū was published, left a legacy—acknowledged posthumously by the Council of Victoria University in 1989—when a senior Te Rangihau Scholar teaching and research position was established with Ngāi Tūhoe. A decade of reform in social work education and research at Victoria University saw important movement towards supporting and promoting Māori perspectives in the delivery of community social services in three New Zealand regions. IMPLICATIONS: Five lessons learned about partnerships from the Victoria University experience are highlighted as issues that promote cultural responsiveness in support of Māori whānau, tamariki and rangatahi. The Wellington programme closed at the start of the new millennium without addressing the VUW Council relationship with Ngāi Tūhoe, highlighting broken promises.

Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN

ObjectiveColorectal cancer (CRC) is the third most common cancer worldwide. The geographical and temporal burden of this cancer provides insights into risk factor prevalence and progress in cancer control strategies....

The relationship between population attributes of the mud snail Amphibola crenata and sediment contamination: A multi-estuary assessment

This study assessed the potential of the New Zealand mud snail Amphibola crenata to act as a bioindicator of contaminated estuarine sediment. Seventeen sites with varying contaminant burdens were identified within six New Zealand regions. Attributes (population density, individual length distribution and individual dry weight condition index) were measured for field-collected A. crenata, and related to measurements of sediment trace metals and nutrients. Population density of the mud snail was relatively high in sites with elevated nutrients and organic matter. The length distribution of A. crenata showed significant regional and site-specific variations. Minimum, mean, and median shell length of A. crenata were positively correlated with sediment cadmium and zinc concentration. Overall, the sites were able to be distinguished by A. crenata population attributes and the sediment metal and nutrient content. These results suggest that A. crenata population information has potential value for assessing estuarine sediment metal and nutrient contamination.

COVID-19 and hospice community palliative care in New Zealand: A qualitative study.

Within the context of an ageing population and the added challenges posed by COVID‐19, the need to optimise palliative care management in the community – the setting where a significant proportion of people prefer to die – cannot be underestimated. To date, there has been a dearth of research exploring community palliative care delivery during the pandemic. This study aimed to explore the impact of and response to COVID‐19 for hospice community services in Aotearoa/New Zealand. Eighteen structured interviews were conducted (10 February–18 August 2021) with healthcare professionals from sixteen purposively sampled community hospices from New Zealand regions according to the number of COVID‐19‐positive patients per 100,000 inhabitants (low, medium and high) with oversampling of high prevalence areas. Two overarching themes emerged ‘challenges’ and 'adaptations’. Each theme had several subthemes related to service delivery in communication, visiting, allied health team collaboration and volunteer services. Adaptations involved adjusting official health advice to the local context, increased use of telehealth, reducing infection risk during in‐home visits through triaging of cases, division of the workforce into teams and repurposing volunteers' services. Despite these adaptations, challenges remained, including increased workload pressures for staff and an absence of the human touch for patients and families. Implications for hospice practice and recommendations for future research are discussed. Governments must acknowledge the essential contribution of hospice to the COVID‐19 pandemic and ensure that these services are incorporated into the healthcare system response.