Kelly, Patrick; Wilson, Kati; Mowjood, Aqeela; Friedman, Joshua; Reed, Peter
To describe and evaluate a shaken baby prevention programme trialled in the Auckland District Health Board from January 2010, to December 2011. Development and implementation of the programme, telephone survey of a sample of caregivers and written survey of a sample of providers. At least 2,592 caregivers received the trial programme. 150 (6%) were surveyed by telephone a median of 6 weeks later. 128 (85%) remembered at least one key message, unprompted; most commonly "It's OK to walk away" (94/150, 63%). When asked, 92% had made a plan for what to do when frustrated and 63% had shared the information with others. Only 98/150 (65%) watched the programme DVD. Many said they already knew about the risks of shaking a baby, but still found the programme highly relevant. Thirty-one nurses were surveyed. There was a high degree of agreement that the programme was relevant. Barriers to programme delivery included time, workload and the documentation required. A shaken baby prevention programme adapted to New Zealand can be introduced in a District Health Board and is acceptable to caregivers and health professionals. Further research is needed to evaluate the content, mode of delivery and effectiveness of this programme.
Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew
In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.
Palmer, Celia; Bycroft, Janine; Healey, Kate; Field, Adrian; Ghafel, Mazin
Auckland District Health Board was one of four District Health Boards to trial the Breakthrough Series (BTS) methodology to improve the management of long-term conditions in New Zealand, with support from the Ministry of Health. To improve clinical outcomes, facilitate planned care and promote quality improvement within participating practices in Auckland. Implementation of the Collaborative followed the improvement model / Institute for Healthcare Improvement methodology. Three topic areas were selected: system redesign, cardio-vascular disease/diabetes, and self-management support. An expert advisory group and the Improvement Foundation Australia helped guide project development and implementation. Primary Health Organisation facilitators were trained in the methodology and 15 practice teams participated in the three learning workshops and action periods over 12 months. An independent evaluation study using both quantitative and qualitative methods was conducted. Improvements were recorded in cardiovascular disease risk assessment, practice-level systems of care, self-management systems and follow-up and coordination for patients. Qualitative research found improvements in coordination and teamwork, knowledge of practice populations and understanding of managing long-term conditions. The Collaborative process delivered some real improvements in the systems of care for people with long-term conditions and a change in culture among participating practices. The findings suggest that by strengthening facilitation processes, improving access to comprehensive population audit tools and lengthening the time frame, the process has the potential to make significant improvements in practice. Other organisations should consider this approach when investigating quality improvement programmes.
Hobbs, Mark; Moor, Catherine; Wansbrough, Tony; Calder, Lester
Approximately 1500 to 1800 applications for refugee status are made to the New Zealand Immigration Service each year. Approximately one third of these asylum seekers receive health screening from Auckland Public Health. We report here key findings from this screening programme for the period 1999 to 2000. The files of patients attending the Auckland Public Health Protection Asylum Seekers Screening Clinic at Green Lane Hospital were reviewed. Data on demographics, medical examination, diagnostic testing and referrals were analysed. Nine hundred people, mainly from Middle Eastern countries, received screening. Important findings were: symptoms of psychological illness (38.4%); Mantoux skin test positivity ( 36.4%); active tuberculosis (0.6%); TB infection requiring chemoprophylaxis (18%) or chest X-ray monitoring (15%); gut parasite infection; carrier state for alpha and beta thalassaemia and the heterozygous states for HbS and HbE; incomplete immunisation; and the need for referral to a secondary care service (32.6%). Immigrant communities in New Zealand have special healthcare needs, as well as experiencing language barriers, cultural differences and economic difficulties. Healthcare providers should be alert to these needs. Appropriate resources are required to address these issues in a timely fashion.
Munn, Stephen R; Evans, Helen M; Gane, Edward J
New Zealand is a geographically isolated country with 4.55 million inhabitants. It has endemic hepatitis B (HBV) infection that is especially evident in Maori and Pacific Island communities and impacts indications for liver transplantation. The country has a socialised medical system that allows for full coverage of the assessment for, and completion of liver transplants in suitable recipients. Between February 1998 and December 2014, the New Zealand Liver Transplant Unit (NZLTU) had performed 595 liver transplants in 568 patients, indicating a crude re-transplant rate of 4.8%. Overall 1, 5, and 10 year patient survival rates for all adult (96%, 89%, and 81%, respectively) and pediatric (93%, 92%, and 92%, respectively) recipients compare very favourably with international outcomes from Europe and the United States. Eligibility criteria could be modestly expanded if deceased donor rates improved from the current level of around 10 per million of population per year. This somewhat meagre supply of deceased donor organs, along with significant waiting list attrition, has necessitated the use of living donors, which have been used in more than 50 recipients to date. Despite these limitations, the NZLTU has contributed to improvements in the outcome of transplantation for HBV and hepatitis C through the development of effective antiviral prophylaxis regimes. Furthermore, innovative changes have been made to the manner in which pediatric patients are transitioned to the adult service.
Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick
To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.
Rocha, C M; McGuire, S; Whyman, R; Kruger, E; Tennant, M
Background: This study examined the spatial accessibility of the population of metropolitan Auckland, New Zealand to the bus network, to connect them to primary health providers, in this case doctors (GP) and dentists. Analysis of accessibility by ethnic identity and socio-economic status were also carried out, because of existing health inequalities along these dimensions. The underlying hypothesis was that most people would live within easy reach of primary health providers, or easy bus transport to such providers. An integrated geographic model of bus transport routes and stops, with population and primary health providers (medical. and dental practices) was developed and analysed. Although the network of buses in metropolitan Auckland is substantial and robust it was evident that many people live more than 150 metres from a stop. Improving the access to bus stops, particularly in areas of high primary health care need (doctors and dentists), would certainly be an opportunity to enhance spatial access in a growing metropolitan area.
Bukowski, Kate; Buetow, Stephen
Women and the concept of homelessness are weakly connected in the international discourses on health and housing. This PhotoVoice study gave a sample of homeless women in central Auckland a camera with which to photograph their lives in order to voice their felt health needs as advocates and agents for positive change. Interviews explored the meanings given to street lives captured in the photographs and reveal threats to the women's mental health and worsening addictions. Their tight-knit, resilient community, including dogs, was seen as 'family' who provide support and protection. The women perceived social services as helping them survive and support their health, but not ending their homelessness. Barriers to them getting and staying off the street included a shortage of affordable, secure housing, which has also tended to become overcrowded. They identified their own leaders who could link with state housing services to implement and evaluate new homelessness programmes, such as Housing First. Copyright © 2010 Elsevier Ltd. All rights reserved.
Reynolds, Gary E; Saunders, Helen; Matson, Angela; O'Kane, Fiona; Roberts, Sally A; Singh, Salvin K; Voss, Lesley M; Kiedrzynski, Tomasz
Global forced displacement has climbed to unprecedented levels due largely to regional conflict. Degraded public health services leave displaced people vulnerable to multiple environmental and infectious hazards including vaccine preventable disease. While diphtheria is rarely notified in New Zealand, a 2 person outbreak of cutaneous diphtheria occurred in refugees from Afghanistan in February 2015 at the refugee resettlement centre in Auckland. Both cases had uncertain immunisation status. The index case presented with a scalp lesion during routine health screen and toxigenic Corynebacterium diphtheriae was isolated. A secondary case of cutaneous diphtheria and an asymptomatic carrier were identified from skin and throat swabs. The 2 cases and 1 carrier were placed in consented restriction until antibiotic treatment and 2 clearance swabs were available. A total of 164 contacts were identified from within the same hostel accommodation as well as staff working in the refugee centre. All high risk contacts (n=101) were swabbed (throat, nasopharynx and open skin lesions) to assess C. diphtheriae carriage status. Chemoprophylaxis was administered (1 dose of intramuscular benzathine penicillin or 10 days of oral erythromycin) and diphtheria toxoid-containing vaccine offered regardless of immunisation status. Suspected cases were restricted on daily monitoring until swab clearance. A group of 49 low risk contacts were also offered vaccination. Results suggest a significant public health effort was required for a disease rarely seen in New Zealand. In light of increased worldwide forced displacement, similar outbreaks could occur and require a rigorous public health framework for management.
Daly, Barbara; Arroll, Bruce; Kenealy, Timothy; Sheridan, Nicolette; Scragg, Robert
The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (pmanagement on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes.
Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Stewart, Alistair; Scragg, Robert
To identify factors associated with patients receiving foot examinations by primary health care nurses. A cross-sectional survey of 287 randomly sampled primary health care nurses, from a total of 1091 in Auckland, completed a postal self-administered questionnaire and telephone interview. Biographical and diabetes management details were collected for 265 diabetes patients consulted by the nurses on a randomly selected day. A response rate of 86% was achieved. Nurses examined patient's feet in 46% of consultations. Controlling for demographic variables, foot examinations were associated with age, odds ratio (1.25, 95% CI 0.57-2.74) for patients aged 51-65 years and >66 years (2.50, 1.08-5.75) compared with those ≤50 years, consultations by district compared with practice nurses (14.23, 95% CI 3.82-53.05), special programme consultations compared with usual follow-up consults (8.81, 95% CI 2.99-25.93) and length of consultation (1.89, 0.72-4.97) for 15-30 min and (4.45, 95% CI 1.48-13.41) >30 min compared with consultations ≤15 min, or for wound care (2.58, 1.01-6.61). Diabetes foot examinations by primary health care nurses varies greatly, and are associated with characteristics of the patient (age, need for wound care) and the consultation (district nurses, diabetes programme and duration). Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Loeff, Stephanie; Saluja, Manmeet; Rice, Michael
To evaluate the incidence of acute symptomatic urolithiasis in the Auckland region. Associated epidemiological factors and stone characteristics were also studied and compared to previous research conducted in order to analyse trends. All patients that presented acutely with symptomatic urolithiasis to the Auckland District Health Board (AHDB) between July 2014 and June 2015 were studied. Clinical data was obtained from medical records and population data was based on estimates provided by the Ministry of Health. Two-tailed tests and the Pearson Chi-Square tests were used for analysis. Overall, 1,125 patients (1,328 events) presented with an incidence of 85 per 100,000 per year, which was lower than that reported in 2006. The highest incidence was found among the Middle Eastern ethnic subgroup (0.130 %), followed by Māori (0.102%), Asian (0.087%), European (0.084%) and Pacific (0.041%) ethnicity. Males were more likely to be affected than females. Urolithiasis was most common in the fifth decade of life (25%). Forty-seven percent of the study population presented with multiple stones and 64% had recurrent urolithiasis or were 'high risk' stone formers. Distal ureteric stones Auckland. This deviation could be attributed to the large influx of Asian immigrants observed in this period of time. A caucasian male, between 40-49 years, with a calculus <5mm in the distal ureter with a history of a previous urolithiasis has the highest chance to present with renal colic.
Immunization Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits coalitions statewide. Visit the AOPTF Website to learn more. Childhood Trauma Costs All Alaskans What we
Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert
Diabetes prevalence continues to increase, with most diabetes patients managed in primary care. This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand. Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006-2008. On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.
Han, Hahrie; Nicholas, Alexandra; Aimer, Margaret; Gray, Jonathon
To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert
To describe primary health care (practice and specialist) nurses involvement in the government-funded annual diabetes review 'Get Checked' programme and the division of care between nurses and general practitioners in Auckland, New Zealand. Of the total 911 practice and specialist nurses identified and working in the greater Auckland region, 276 (30%) were randomly selected and invited to undertake a self-administered questionnaire and telephone interview in 2006-8. An 86% response rate was achieved. Over 60% of practice nurses and over half of specialist nurses participate in 'Get Checked' reviews. Of those nurses, 40% of practice and 70% specialist nurses, reported completing over half of the total number of 'Get Checked' reviews at their practice. Of the nurses sampled who work in general practice (n=198), 38% reported that 'nurses mostly complete' the reviews, 45% stated that 'nurses and doctors equally complete' them and 17% reported that only 'doctors' did so. For the nurses who reported that 'nurses and doctors equally complete' the reviews (n=89), most nurses undertake blood pressure measurements (90%), weigh patients (88%), give lifestyle advice (87%), examine patient's feet (73%), and 44% carried out the complete review of the patients they consult. These findings show the 'Get Checked' programme was successful in engaging practice and community-based specialist nurses in the community management of diabetes and has revealed positive relationships between nurses and doctors, extended roles for nurses and the importance of engaging nurses in the design of health care programmes.
Medical Students and informed consent: A consensus statement prepared by the Faculties of Medical and Health Science of the Universities of Auckland and Otago, Chief Medical Officers of District Health Boards, New Zealand Medical Students' Association and the Medical Council of New Zealand.
Bagg, Warwick; Adams, John; Anderson, Lynley; Malpas, Phillipa; Pidgeon, Grant; Thorn, Michael; Tulloch, David; Zhong, Cathy; Merry, Alan F
To develop a national consensus statement to promote a pragmatic, appropriate and unified approach to seeking consent for medical student involvement in patient care. A modified Delphi technique was used to develop the consensus statement involving stakeholders. Feedback from consultation and each stakeholder helped to shape the final consensus statement. The consensus statement is a nationally-agreed statement concerning medical student involvement in patient care, which will be useful for medical students, health care professionals and patients.
Ticehurst, Rob; Thomast, Mark
We aimed to determine the level of antimicrobial consumption by adult inpatients at Auckland City Hospital (Auckland, New Zealand) and to compare our findings with those in other developed nations. We used the computerised records of the central Auckland District Health Board (ADHB) pharmacy to measure the amount of antimicrobials dispensed to inpatients (excluding psychiatric units, day stay units and outpatient clinics) during 2006 to 2009. The total weight of each antimicrobial dispensed was used to determine the number of defined daily doses (DDDs) dispensed. The Information Management and Technical Services department of ADHB provided data on the number of admissions and inpatient days, and these data, together with information from the 2006 census, were used to calculate antimicrobial consumption for adult inpatients measured in DDDs/100 admissions, DDDs/100 inpatient days and DDDs/1000 population. Total antimicrobial consumption by adult inpatients increased from 74 DDDs/100 inpatient days in 2006 to 80.3 DDDs/100 inpatient days in 2009. The level of consumption did not vary greatly with the season. The total level of consumption was very similar to that seen in adult inpatients in hospitals in Australia and Scandinavian countries. The level of consumption of fluoroquinolones, third or fourth generation cephalosporins, carbapenems and vancomycin (antimicrobial classes that are not available for unrestricted use in Auckland City Hospital) was comparable to or less than that seen in adult inpatients in hospitals in Australia or Scandinavian countries. Beta-lactamase susceptible penicillins (such as benzyl penicillin and phenoxymethylpenicillin) comprised a relatively small proportion of total penicillin use and beta-lactamase inhibitor combinations (predominantly amoxicillin/clavulanate) a relatively large proportion of total penicillin use, when compared with Scandinavian hospitals. The antimicrobial stewardship programme at Auckland City Hospital has
To briefly report on the large increase in cases of syphilis managed at Auckland Regional Sexual Health Service (ARSHS) in 2015. To raise awareness of syphilis as an emerging significant public health issue in Auckland. A search was conducted of the electronic patient management system at ARSHS for cases of syphilis diagnosed between 1st of January 2015 and 31st of December 2015. Those that fitted the Institute of Environmental Science and Research Ltd (ESR) case definitions for infectious syphilis were included and demographic, clinical and behavioural characteristics were described. One hundred and fifty-two cases of infectious syphilis were managed at ARSHS in 2015, which was a 78% increase from the previous year. The crude incidence rate was 9.5 cases per 100,000 head of population. As in previous years, the majority of cases were male (92%) and most of these were gay or bisexual men (GBM). Thirty-nine percent of cases were asymptomatic and 22% of cases were diagnosed with another STI. Twenty-eight percent of GBM were co-infected with HIV. While the overall number of heterosexual cases was small (n=35); there was a 3.8-fold increase from the numbers diagnosed in 2014 (n=9). The largest number of syphilis cases in recent decades was managed by the Auckland Regional Sexual Health Service in 2015. The increase in numbers is concerning as syphilis can enhance transmission and acquisition of HIV. Furthermore, other countries have noted increases in congenital syphilis cases when incidence in females has increased. It is important that all persons at risk of STI are tested for syphilis and that sexually active GBM in particular are tested regularly. Health professionals need to be made aware of who and when to test, and to refer or discuss any suspected cases with a specialist service as management of syphilis requires significant expertise.
Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas
To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland. Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey. Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'Alcohol & Drug Helpline' (4%); 'ambulance' (3%); 'A&E' (3%); and hospitalisation (3%). Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.
Paterson, Janis E; Gao, Wanzhen; Sundborn, Gerhard; Cartwright, Susan
To examine maternal and socio-demographic factors associated with oral health practices and experiences in six-year-old Pacific children. The longitudinal Pacific Islands Families (PIF) study is following a cohort of Pacific children born in Auckland, New Zealand in 2000. At approximately six years postpartum maternal reports (n = 1001) on child oral health practices and experiences of fillings and extractions were gathered. Forty-five per cent of mothers reported that their child had experienced fillings or extractions. After adjusting for confounding factors, we found that Tongan children were almost twice as likely to have their teeth filled or extracted than Samoan children (OR, 1.93; 95%, 1.34-2.77). Differences between Samoan children and children of other ethnic groups were not significant. Children of mothers who had secondary qualifications were significantly less likely to have their teeth filled or extracted compared to children of mothers who had postsecondary qualifications (OR, 0.634; 95%, 0.44-0.90). Prolonged duration of breastfeeding was associated with an increased likelihood of filling or extraction experience. In terms of maternal oral hygiene, maternal tooth brushing frequency of less that once a day was significantly associated with increased odds of fillings and/or extractions in their children (OR, 1.35; 95% CI, 1.02-1.79). Children who were sometimes supervised for tooth brushing were significantly more likely to have fillings or extractions than children who were not provided supervision. These findings highlight the role of cultural factors and maternal hygiene in child oral health outcomes and suggest that health promotion efforts should encompass the whole family and embrace a culturally appropriate approach. © 2010 John Wiley & Sons A/S.
Zaneta M. Thayer
Full Text Available Auckland, Aotearoa/New Zealand is a culturally and ethnically diverse city. Despite popular global conceptions regarding its utopian nature, the lived experience for many individuals in Auckland attests to the substantial social, economic, and health inequalities that exist there. In particular, rapidly rising home prices constrain housing decisions and force individuals to live in less desirable neighborhoods, with potential impacts on individual health. One of the pathways through which adverse neighborhood conditions could impact health is through alterations in the functioning of the hypothalamic pituitary adrenal (HPA-axis, which regulates the physiological stress response. This paper evaluates the relationship between perceived neighborhood safety, self-rated health, and cortisol, an end product of HPA-axis activation, among women in late pregnancy. Pregnant women living in neighborhoods where they were concerned about safety of their property had poorer self-rated health and elevated morning cortisol, even after adjusting for maternal age, material deprivation, and ethnicity. However, fear of personal safety was unrelated to self-rated health and cortisol. These results suggest that maternal health in pregnancy is sensitive to perceptions regarding neighborhood safety. Such findings are important since higher cortisol levels in pregnancy could not only influence maternal health, but also the health and development of women's children.
Thayer, Zaneta M
Auckland, Aotearoa /New Zealand is a culturally and ethnically diverse city. Despite popular global conceptions regarding its utopian nature, the lived experience for many individuals in Auckland attests to the substantial social, economic, and health inequalities that exist there. In particular, rapidly rising home prices constrain housing decisions and force individuals to live in less desirable neighborhoods, with potential impacts on individual health. One of the pathways through which adverse neighborhood conditions could impact health is through alterations in the functioning of the hypothalamic pituitary adrenal (HPA)-axis, which regulates the physiological stress response. This paper evaluates the relationship between perceived neighborhood safety, self-rated health, and cortisol, an end product of HPA-axis activation, among women in late pregnancy. Pregnant women living in neighborhoods where they were concerned about safety of their property had poorer self-rated health and elevated morning cortisol, even after adjusting for maternal age, material deprivation, and ethnicity. However, fear of personal safety was unrelated to self-rated health and cortisol. These results suggest that maternal health in pregnancy is sensitive to perceptions regarding neighborhood safety. Such findings are important since higher cortisol levels in pregnancy could not only influence maternal health, but also the health and development of women's children.
The emphases of the work of the Federal Board of Health is on drug control, consumer protection with regard to health, environmental hygiene, radiation hygiene, preventation and intervention as well as on special subjects, as for instance the control of animal experiments and the supervision of biological safety of genetic engineering. In addition, central services, systems of information and documentation, publications and courses for professional and advanced training are offered. (DG) [de
Hosking, Jamie; Ameratunga, Shanthi; Exeter, Daniel; Stewart, Joanna; Bell, Andrew
To describe ethnic, socioeconomic and geographical differences in road traffic injury (RTI) within Auckland, New Zealand's largest city. We analysed rates of RTI deaths and non-fatal hospital admissions using the New Zealand Mortality Collection and the National Minimum Data Set 2000-08. Poisson regression examined the association of age, gender, prioritised ethnicity and small area deprivation (New Zealand Index of Deprivation) with RTI rates, and RTI rates were mapped for 21 local board areas within the Auckland region. While RTI rates increased with levels of deprivation in all age groups, the gradient was steepest among children (9% increase/decile) and adults aged 25-64 years (11% increase/decile). In all age groups, RTI risk was highest among Māori. Pacific children had an elevated risk of RTI compared with the NZ European/Other group, but Pacific youth (15-24 years) and adults (25-64 years) had a lower risk. While RTI rates were generally higher for those living in rural local board areas, all but one local board in the southern Auckland urban area had among the highest rates. There are substantial ethnic, socioeconomic and geographic inequalities in RTI risk in the Auckland region, with high rates among Māori (all ages), Pacific children, people living in socioeconomically deprived neighbourhoods, the urban south and rural regions. To meet the vision of regional plans, road safety efforts must prioritise vulnerable communities at greatest risk of RTI, and implement and monitor the effectiveness of strategies that specifically include a focus on reducing inequalities in RTI rates. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.
Creamer, Gowan; Civil, Ian; Ng, Alex; Adams, David; Cacala, Shas; Koelmeyer, Timothy; Thompson, John
To investigate the role of Māori and Pacific ethnicity within the severe trauma and population demographics of Auckland, New Zealand. A population-based study utilising prospectively gathered trauma databases and coronial autopsy information. Population data was derived from Statistics New Zealand resident population projections for the year 2004. The geographic boundaries of the Auckland district health boards (Waitemata DHB, Auckland DHB and Counties-Manukau DHB). Severe injury was defined as death or injury severity score more than 15. Combining data from coronial autopsy and four hospital trauma databases provided age, gender, ethnicity, mechanism, mortality and hospitalisation information for severely injured Aucklanders. Māori and Pacific had increased risk of severe injury and injury-related mortality. A major gender difference is apparent: Māori female at increased risk and Pacific female at decreased risk compared to the remaining female population; both Māori and Pacific male have high severe injury rate than the remaining population. The relative risk for severe injury (and mortality) for Māori RR=2.38 (RR=2.80) and Pacific RR=1.49 (RR=1.59) is higher than the remaining population, the highest risk (and more statistically significant) is seen in the 15-29 age group (Māori RR=2.87, Pacific RR=2.57). Road traffic crashes account for the greatest proportion of injuries in all groups. Māori have relatively higher rates of hanging and assault-related injury and death; Pacific have relatively higher rates of falls and assault. Ethnicity is a factor in severe injury and mortality rates in Auckland. Age is an important influence on these rates. Although mechanism of injury varies between ethnic groups, no particular mechanism of injury accounts for the overall differences between groups.
Schluter, Philip J; Durward, Callum; Cartwright, Susan; Paterson, Janis
To report on the oral health risk in a disadvantaged group of 4-year-old Pacific children and their mothers living in South Auckland, New Zealand. The Pacific Islands Families study follows a cohort of Pacific infants born in 2000. Maternal self-report of mother and child's oral health practices and child's filling and extraction experience was undertaken at interview approximately 4 years postpartum. Overall, 1,048 mothers of children were interviewed. Children's reported oral health practices were generally poor, with 47 percent brushing Culturally appropriate and targeted strategies aimed at these modifiable practices need to be widely promoted so that the oral health burden carried by Pacific children can be reduced.
A total of 297 candidates from developing countries have attended the annual Geothermal Diploma Course at the University of Auckland between 1979 and 1989. Additional training in the form of post-graduate studies and short-term specialized courses has been given to 69 candidates from these countries between 1989 and 1989. In this paper performance indicators for the training are discussed, namely: demand, job retention rate, regional intake in relation to demand, and publication record of fellows
Neville, Stephen; Adams, Jeffery
Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex.
Neville, Stephen; Adams, Jeffery
Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex. PMID:27211584
Lin, Aaron; Oh, Timothy; Alawami, Mohammed; Webster, Mark; El-Jack, Seif; Scott, Douglas; Stewart, James; Ormiston, John; Armstrong, Guy; Khan, Ali; Kay, Patrick; Harrison, Wil; Kerr, Andrew; McGeorge, Alastair; Gamble, Greg; Ruygrok, Peter; Ellis, Chris J
Primary percutaneous coronary intervention (PCI) is the optimal management for ST segment elevation myocardial infarction (STEMI) patients. We reviewed the largest primary PCI regional service in New Zealand: the Auckland/Northland service based at Auckland City Hospital, to assess patient management, in particular the door to reperfusion times (DTRTs), and predictors of death in hospital. We obtained patient details from a comprehensive prospective database of all primary PCI patients admitted with STEMI from 1/1/12 to 31/12/12 to the Auckland City Hospital cardiac catheterisation laboratory. Of four District Health Boards (DHBs) within the region, two accessed this regional service at all times, and two accessed the Auckland City Hospital cardiac catheterisation laboratory 'after hours': all times except for 08:00 to 16:00 hours on Monday to Friday. A total of 401 adult patients underwent a primary PCI at the Auckland City Hospital Regional centre for a STEMI presentation, over the 12 months period. The median patient age was 61 years, 77% were male. Overall 183 (46%) (95% CI 41, 51) patients achieved a DTRT of Auckland/Northland primary PCI service delivers good outcomes consistent with current Australasian standards. Although geographical isolation complicates door to reperfusion times, these may potentially be improved by more focus on direct transfer to the cardiac catheterisation laboratory, especially directly from the community. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Hilton, Jackie; Azariah, Sunita; Reid, Murray
Previous studies have identified Mycoplasma genitalium as a cause of urethritis in men. As there is no New Zealand data, a case-control study was conducted to determine whether this organism is a significant cause of urethritis in men presenting to Auckland Sexual Health Service. Enrollment for the study commenced in March 2006 and finished in February 2008. Inclusion criteria for cases of non-gonococcal urethritis were onset of urethritis symptoms within one month confirmed by urethral Gram staining showing >or=10 polymorphonuclear leucocytes per high-powered field. Controls were men presenting during the same time period for asymptomatic sexual health screening. All participants were tested for Neisseria gonorrhoeae, M. genitalium, and Chlamydia trachomatis. Information regarding symptoms, sexual behaviour and treatment was collected using a standard questionnaire. We recruited 209 cases and 199 controls with a participation rate of 96%. The prevalence of C. trachomatis and M. genitalium in non-gonococcal urethritis cases was 33.5% and 10% respectively. Co-infection with these organisms was uncommon (1.9%). C. trachomatis and M. genitalium were diagnosed in 4% and 2% of controls, respectively, and both infections were detected significantly less often than in the cases (P urethritis was a significant predictor of current symptoms (P urethritis in men presenting to our service.
Duncan-Marr, Alison; Duckett, Stephen J
Board evaluation is a critical component of good governance in any organisation. This paper describes the board self-evaluation process used by Bayside Health, a public health service in Melbourne. The question of how governing boards can assess their performance has received increasing attention over the past decade. In particular, the increasing demand for accountability to shareholders and regulators experienced by corporate sector Boards has resulted in greater scrutiny of board performance, with the market and the balance sheet providing some basis for assessment. Performance evaluation of governing boards in the public sector has been more challenging. Performance evaluation is complex in a sector that is not simply driven by the bottom line, where the stakeholders involve both government and the broader community, and where access to, and the quality and safety of the services provided, are often the major public criteria by which performance may be judged. While some practices from the corporate sector can be applied successfully in the public sector, this is not always the case, and public sector boards such as the Board of Directors of Bayside Health have been developing ways to evaluate and improve their performance.
Swinburn, B A; Walter, L; Ricketts, H; Whitlock, G; Law, B; Norton, R; Jackson, R; MacMahon, S
The New Zealand diet is high in total and saturated fat and this is likely to be contributing to the increasing prevalence of obesity and relatively high rates of coronary heart disease in New Zealand. The identification of subgroups with a high-fat intake will enable nutrition-related public health strategies to be better targeted. Subjects from two surveys were included in the study: 7574 employees from a large multinational workforce survey and 2447 people aged 35-84 years selected from a stratified random sample of the electoral roll in central Auckland. Fat and saturated fat intake were assessed by short questionnaire which gave a dietary fat habits (DFH) score and supplemented by a six-item food frequency questionnaire. The DFH scores were higher in males than in females at all ages, and there was an inverse relationship with age which was stronger for males. Age-adjusted scores showed significantly higher DFH scores for Maori than for Europeans. Lower socioeconomic status was associated with higher DFH scores in males. Current smoking and heavy drinking (in males) were associated with significantly higher DFH scores after controlling for socioeconomic status. The results of the limited food frequency questionnaire supported the trends in DFH scores. The subgroups with high total and saturated fat intakes which should be a priority for public health action are young and middle-aged males, Maori and lower socioeconomic status males. The clustering of high-fat intake with smoking and heavy drinking should be considered when developing preventative strategies.
Made Asri Budisuari
Full Text Available Background: Islamic boarding school system has long story in indonesia, they covered as much 14.798 student whoare teenager between 9–15 year old. Problems encountered with adolescent sexuality and reproductive health. Methods:An explorative research implemented in 3 provinces ie East Java, Nusa Tenggara Barat (NTB, East Kalimantan and sixIslamic boarding schools. Data were collected through questionnaires about reproductive health. Results: It showed 48,5%of respondents didn’t have enough knowledge, attitudes and behavior about reproductive health, 40% of respondents knewvery little about puberty, menstruation and wet dream, 71% of respondents had little knowledge about the risk of pregnancy;49% of respondents had not enough knowledge about sexually transmited diseases. 88% respondents said that they hadfall in love, 76% of respondents had positive courtship behavior. Conclusion: The information about reproductive healthin islamic boarding school for adolescents is still in adequate and only refer to yellow book. Health worker did not provideadequqte information. We still found student who have sex while when they were engaged still datting. Suggestion: Theneed of additional and up to date reproductive health information and the risks of sexual intercourse marriage it maybedelivery on interesting media, such as one social networking. A health reproductive modules consist of scientic materialand some knowledge has to be developed and should be delivery health worker. Reproductive health syllabus and trainingfor trainers for teachers of boarding school is needed.
Moxon, Te Aro; Reed, Peter; Jelleyman, Timothy; Anderson, Philippa; Leversha, Alison; Jackson, Catherine; Lennon, Diana
To determine the most accurate data source for acute rheumatic fever (ARF) epidemiology in the Auckland region. To assess coverage of the Auckland Regional Rheumatic Fever Register (ARRFR), (1998-2010) for children Auckland at the time of illness, register, hospitalisation and notification data were compared. A consistent definition was applied to determine definite and probable cases of ARF using clinical records. (www.heartfoundation.org.nz) RESULTS: Of 559 confirmed (definite and probable) RF cases Auckland. This was significantly more accurate than medical officer of health notification and hospitalisation data.
Poole, Tracey; Goodyear-Smith, Felicity; Petousis-Harris, Helen; Desmond, Natalie; Exeter, Daniel; Pointon, Leah; Jayasinha, Ranmalie
The New Zealand HPV publicly funded immunisation programme commenced in September 2008. Delivery through a school based programme was anticipated to result in higher coverage rates and reduced inequalities compared to vaccination delivered through other settings. The programme provided for on-going vaccination of girls in year 8 with an initial catch-up programme through general practices for young women born after 1 January 1990 until the end of 2010. To assess the uptake of the funded HPV vaccine through school based vaccination programmes in secondary schools and general practices in 2009, and the factors associated with coverage by database matching. Retrospective quantitative analysis of secondary anonymised data School-Based Vaccination Service and National Immunisation Register databases of female students from secondary schools in Auckland District Health Board catchment area. Data included student and school demographic and other variables. Binary logistic regression was used to estimate odds ratios and significance for univariables. Multivariable logistic regression estimated strength of association between individual factors and initiation and completion, adjusted for all other factors. The programme achieved overall coverage of 71.5%, with Pacific girls highest at 88% and Maori at 78%. Girls higher socioeconomic status were more likely be vaccinated in general practice. School-based vaccination service targeted at ethic sub-populations provided equity for the Maori and Pacific student who achieved high levels of vaccination. Copyright © 2012 Elsevier Ltd. All rights reserved.
Obdeijn, M. C.; Tonkin, S.; Mitchell, E. A.
Aim. An audit of the sudden infant death syndrome (SIDS) prevention programme in the Auckland region. Methods. 107 health professionals working in antenatal classes, postnatal wards, domiciliary midwifery and the Plunket Society were interviewed. Results. Maternal smoking and infant sleeping
Jensen, Anker; Jepsen, Jørgen Riis
There is only limited knowledge of the exposure to vibrations of ships’ crews and their risk of vibration-induced health effects. Exposure to hand-arm vibrations from the use of vibrating tools at sea does not differ from that in the land-based trades. However, in contrast to most other work places...... of the health consequences of whole body vibrations in land-transportation, such exposure at sea may affect ships’ passengers and crews. While the relation of back disorders to high levels of whole body vibration has been demonstrated among e.g. tractor drivers, there are no reported epidemiological evidence...... for such relation among seafarers except for fishermen, who, however, are also exposed to additional recognised physical risk factors at work. The assessment and reduction of vibrations by naval architects relates to technical implications of this impact for the ships’ construction, but has limited value...
Dowling, P A
This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.
Tarin Cheer; Robin Kearns; Laurence Murphy
This paper explores the links between housing and other welfare policies, low income, and culture among Pacific peoples within Auckland, New Zealand. These migrant peoples occupy an ambiguous social space within Auckland: they represent the visible face of the world's largest Polynesian city, yet are occupants of some of the city's poorest and least health-promoting housing. Through considering the balance between choice and constraint, we examine how housing costs, poverty, and cultural prac...
Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B
Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.
Mason, Diana J; Keepnews, David; Holmberg, Jessica; Murray, Ellen
The Representation of Health Professionals on Governing Boards of Health Care Organizations in New York City. The heightened importance of processes and outcomes of care-including their impact on health care organizations' (HCOs) financial health-translate into greater accountability for clinical performance on the part of HCO leaders, including their boards, during an era of health care reform. Quality and safety of care are now fiduciary responsibilities of HCO board members. The participation of health professionals on HCO governing bodies may be an asset to HCO governing boards because of their deep knowledge of clinical problems, best practices, quality indicators, and other issues related to the safety and quality of care. And yet, the sparse data that exist indicate that physicians comprise more than 20 % of the governing board members of hospitals while less than 5 % are nurses and no data exist on other health professionals. The purpose of this two-phased study is to examine health professionals' representations on HCOs-specifically hospitals, home care agencies, nursing homes, and federally qualified health centers-in New York City. Through a survey of these organizations, phase 1 of the study found that 93 % of hospitals had physicians on their governing boards, compared with 26 % with nurses, 7 % with dentists, and 4 % with social workers or psychologists. The overrepresentation of physicians declined with the other HCOs. Only 38 % of home care agencies had physicians on their governing boards, 29 % had nurses, and 24 % had social workers. Phase 2 focused on the barriers to the appointment of health professionals to governing boards of HCOs and the strategies to address these barriers. Sixteen health care leaders in the region were interviewed in this qualitative study. Barriers included invisibility of health professionals other than physicians; concerns about "special interests"; lack of financial resources for donations to the organization
Greaves, Z; McCafferty, S
Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Corbett, Sarah; Chelimo, Carol; Okesene-Gafa, Kara
To identify barriers to early initiation of antenatal care amongst pregnant women in South Auckland, New Zealand. Women in late pregnancy (>37 weeks gestation) or who had recently delivered (18 weeks (late bookers). The ethnic composition of the sample was: 43% Pacific Peoples, 20% Maori, 14% Asian, and 21% European or other ethnicities. The multivariate analysis indicated that women were significantly more likely to book late for antenatal care if they had limited resources (OR=1.86; 95% CI=1.17-2.93), no tertiary education (OR=1.96; 95% CI=1.23-3.15), or were not living with a husband/partner (OR=2.34; 95% CI=1.48-3.71). In addition, the odds of late booking for antenatal care was almost six times higher among Maori (OR=5.70; 95% CI=2.57-12.64) and Pacific (OR=5.90; 95% CI=2.83-12.29) women compared to those of European and other ethnicities. Late booking for antenatal care in the Counties Manukau District Health Board area (South Auckland) is associated with sociodemographic factors, social deprivation, and inadequate social support.
Streat, S J; Donaldson, M L; Judson, J A
Data are presented on all 569 subjects who, as a result of trauma, either died or were admitted to hospital in Auckland over a four week period. Median age was 23 with an overall 3:2 male:female ratio. Median injury severity score (ISS) was five with 9% of subjects having an ISS of 16 or more (major trauma). Blunt trauma accounted for 84% of all injuries. Life threatening injuries were most commonly to the head, thorax and abdomen while the largest number of less severe injuries were to the extremities. Eight subjects died before admission to hospital and a further six in hospital. Definitive care was given to 98% of patients at Middlemore and Auckland hospitals (including the onsite Princess Mary paediatric facility) but 26% had presented first to other hospitals and 43% of all patients were transferred from one hospital to another. The 561 patients used 6380 hospital days (including 314 intensive care days) and the following services--operating room 63%, orthopaedic ward 45%, plastic surgical ward 17%, paediatric ward 15%, neurosurgical ward 10%, general surgical ward 5%, intensive care 5% and CT scanner 4%. Only one hospital death was judged potentially preventable. This study reveals areas where trauma care could be improved, demonstrates the large amount of hospital resources required to treat trauma and particularly highlights the urgent need for studies into strategies for trauma prevention in New Zealand.
New Zealand's 'district health board' (DHB) system has been under implementation since the 1999 general election. A key factor motivating the change to DHBs is the democratisation of health care governance. A majority of the new DHB members are popularly elected. Previously, hospital board members were government appointees. Inaugural DHB elections were held in October 2001. This article reports on the election results and the wider operating context for DHBs. It notes organisational issues to be considered for the next DHB elections in 2004, and questions the extent to which the elections and DHB governance structure will enhance health care democratisation in New Zealand.
Anand, Lanit; Sealey, Christopher
The purpose of this study was to review patient outcomes from surgical reconstruction of isolated orbital fractures, performed by the Auckland District Health Board (ADHB) Oral and Maxillofacial Surgery service (OMFS), from 2010 to 2015. In particular, we wished to assess titanium as an orbital reconstructive material and compare outcomes with the international literature. Hospital records for 103 adults (>18 years old) who underwent repair of isolated orbital fractures by the OMFS department at Middlemore Hospital, between 2010 and 2015, were reviewed. Information collected included patient characteristics, cause of injury, type of reconstruction material used and post-operative complications. Patients were then followed up by means of a verbal telephone questionnaire. The majority of patients were male in the 18-30 year age group, with interpersonal violence being the leading cause of injury. Titanium was the preferred choice of reconstructive material. Seven patients required return to theatre to resolve post-operative complications. Sixty-four patients could be contacted by telephone (12 months to six years follow-up). Thirty patients, who could not be contacted by telephone, did attend clinic follow-up and were assessed from their hospital records (minimum of one month follow-up). Ten patients could not be contacted by telephone and had not attended clinic follow-up. Problems with diplopia, paraesthesia and cosmesis were within complication rates reported in the literature. Patients with isolated orbital fractures, treated by the Oral and Maxillofacial Surgery Department in Auckland from 2010-2015, were reviewed. Titanium was the most commonly used reconstructive material and proved to be well tolerated. Complication rates were within international norms.
Lindsay, J.; Leonard, G.S.
In 2008 a multi-disciplinary research programme was launched, a GNS Science-University of Auckland collaboration with the aim of DEtermining VOlcanic Risk in Auckland (DEVORA). A major aspiration of DEVORA is development of a probabilistic hazard model for the Auckland Volcanic Field (AVF). This will be achieved by investigating past eruption magnitude-frequency relationships and comparing these with similar data from analogous volcanic fields. A key data set underpinning this is an age database for the AVF. To this end a comprehensive dating campaign is planned as part of DEVORA. This report, Age of the Auckland Volcanic Field, is a synthesis of all currently available age data for the AVF. It represents one of several reports carried out as part of the 'synthesis' phase of DEVORA, whereby existing data from all previous work is collated and summarised, so that gaps in current knowledge can be identified and addressed. (author). 60 refs., 7 figs., 31 tabs.
A number of members of our Health Insurance Scheme are currently experiencing difficulties getting reimbursement for consulting an acupuncture practitioner. The CHIS Board wishes to remind you that in order to be reimbursed, you must receive your acupuncture treatment from doctors recognised by the competent authorities of the country in which they have their medical practice. In Switzerland, these are people possessing the title of doctor of medicine recognised by the Swiss Medical Association (FMH). Treatment provided by medical auxiliaries must be prescribed beforehand by a recognised doctor. As the practitioner in question is currently not recognised as a doctor in Switzerland, his services are not reimbursed. In order to avoid any inconvenience, we advise you to contact uniqa before undergoing such treatment. You will find all details concerning reimbursement of complementary medicine (acupuncture, chiropractic, osteopathy and ethiopathy) in CHISbull’ No. 18 dated November 2004, which can ...
A number of members of our Health Insurance Scheme are currently experiencing difficulties getting reimbursement for consulting an acupuncture practitioner. The CHIS Board wishes to remind you that in order to be reimbursed, you must receive your acupuncture treatment from doctors recognised by the competent authorities of the country in which they have their medical practice. In Switzerland, these are people possessing the title of doctor of medicine recognised by the Swiss Medical Association (FMH). Treatment provided by medical auxiliaries must be prescribed beforehand by a recognised doctor. As the practitioner in question is currently not recognised as a doctor in Switzerland, his services are not reimbursed. In order to avoid any inconvenience, we advise you to contact uniqa before undergoing such treatment. You will find all details concerning reimbursement of complementary medicine (acupuncture, chiropractic, osteopathy and ethiopathy) in CHISbull' No. 18 dated November 2004, which can also be co...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... Disease Prevention and Health Promotion (NCCDPHP). [[Page 42449
Williamson, John; Paling, Richard; Staheli, Ramon; Waite, David
Agglomeration effects, or the productivity benefits that stem from high employment densities, are being achieved in Auckland's central business district (CBD). This provides support for Auckland's economic transformation. However, questions remain as to the nature of these effects, and whether other factors may help to explain the CBD's observed productivity premium. Using 2001 census area unit data, this paper examines to what extent the CBD's productivity advantages can be explained by sect...
... Hilton Washington Dulles Hotel, 13869 Park Center Road, Herndon, Virginia, 20171 FOR FURTHER INFORMATION... meeting registration are available online at the Defense Health Board (DHB) Web site: http://www.ha.osd... the Defense Health Board until the next open meeting. The Designated Federal Officer will review all...
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... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...
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Kruger, E; Whyman, R; Tennant, M
New Zealanders are one of the healthiest populations in the world, but significant inequalities in health and oral health remain. New Zealand suffers a possible shortage of medical and dental practitioners and an agreed mal-distribution of both. This study examines the distribution of dental and medical practices in New Zealand's largest city Auckland, using modem Geographic Information System tools. The aim of the study is to determine if medical and dental practices are similarly distributed across the city. The address for each dental and medical practice in Auckland was obtained and mapped over the census population data. A total of 442 medical and 256 dental practices were geo-coded in the study area. These practices overlaid the Auckland region, with a total population of 0.8 million, and an adult population (>9 years old) of 0.69 million. Auckland city was deemed, for this study, to be a region included in a 15km radius circle from a central reference point that was the General Post Office (GPO). The medical practice to total population ratio ranged from 1:1,500 for people 121/2-15km from the GPO, to 1:1,200 for those within 21/2km. Dental practice to population ratio ranged from 1:2,700 for people living 121/2-15km from the GPO to 1:1,300 for those within 21/2km. Medical practices were relatively evenly distributed, regardless of distance from the GPO, but the fairly dense distribution of dental practices in the city's inner 21/2km circle rapidly decreased in density as distance from the GPO increased. These results refute the hypothesis of this study in that there is a similar distribution of primary health practices (medical and dental) across the Auckland region.
Running Bear, Ursula; Croy, Calvin D; Kaufman, Carol E; Thayer, Zaneta M; Manson, Spero M
American Indian (AI) boarding school attendance is related to poor physical health status; however, little is known about how specific aspects of this experience contribute to poor health. Five experiences (age of first attendance, limited family visits, forced church attendance, prohibition on practicing AI culture and traditions, and punishment for use of AI language) may be independently associated with physical health status in adulthood. We expected the effect to be greater for those who began boarding school at older ages. Data on AI boarding school attenders (n = 771) came from the AI-Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project. Multiple linear regression models examined the association of these five experiences with physical health status. Additionally, we conducted a separate set of regressions to test for an interaction effect of age of first attendance. Each of the five experiences noted above were independently associated with poorer physical health status compared to those who did not have these experiences. An interaction effect for those punished for use of AI language and who were aged 8 or older was confirmed. Findings are consistent with reports that boarding school attendance is related to poor AI adult health. To inform AI health programs, the relationship of specific diseases and boarding school attendance should be considered.
Pondicherry, Ashwini; Martin, Richard; Meredith, Ineke; Rolfe, Jack; Emanuel, Patrick; Elwood, Mark
As the New Zealand Cancer Registry does not require mandatory reporting of non-melanoma skin cancers (NMSC), basal cell carcinomas (BCC) and squamous cell carcinomas (SCC), the clinical burden of these diseases is unknown. A retrospective review of all patients with histopathology performed allowed us to estimate invasive BCC and SCC in the Auckland region in 2008 (population 1.44 million). During this period, a total of 21 236 NMSC were diagnosed among 13 996 patients, consisting of 5611 SCC lesions (26%) and 15 525 (74%) BCC. The Auckland incidence rates per 100 000 were 425 for SCC and 1177 for BCC. The overall rate of NMSC per 100 000 was 1906.5 (standardised to the census data of Australia 2001); 1385 for BCC and 522 for SCC. Using published data on incidence trends and population growth, we estimate that 29 000-33 000 NMSC would have been excised in Auckland in 2016, and 78 000-87 000 in New Zealand. Auckland has the highest reported incidence of invasive NMSC in the world. We believe that high-risk cutaneous SCC and complex BCC should be recorded. Our study provides information for clinicians and health economists on the scale of the problem. © 2018 The Australasian College of Dermatologists.
The district health board (DHB) system is New Zealand's present structure for the governance and delivery of publicly-funded health care. An aim of the DHB system is to democratise health care governance, and a key element of DHBs is elected membership of their governing boards. This article focuses on the electoral component of DHBs. It reports on the first DHB elections of 2001 and recent 2004 elections. The article presents and discusses data regarding candidates, the electoral process, voter behaviour and election results. It suggests that the extent to which the DHB elections are contributing to aims of democratisation is questionable.
Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G
Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).
Barker, Carol; Crengle, Sue; Bramley, Dale; Bartholomew, Karen; Bolton, Patricia; Walsh, Michael; Wignall, Jean
Ambulatory Sensitive Hospitalisations (ASH) are a group of conditions potentially preventable through interventions delivered in the primary health care setting. ASH rates are consistently higher for Māori compared with non-Māori. This study aimed to establish Māori experience of factors driving the use of hospital services for ASH conditions, including barriers to accessing primary care. A telephone questionnaire exploring pathways to ASH was administered to Māori (n=150) admitted to Auckland and Waitemata District Health Board (DHB) hospitals with an ASH condition between January 1st-June 30th 2015. A cohort of 1,013 participants were identified; 842 (83.1%) were unable to be contacted. Of the 171 people contactable, 150 agreed to participate, giving an overall response rate of 14.8% and response rate of contactable patients of 87.7%. Results demonstrated high rates of self-reported enrolment, utilisation and preference for primary care. Many participants demonstrated appropriate health seeking behaviour and accurate recall of diagnoses. While financial barriers to accessing primary care were reported, non-financial barriers including lack of after-hours provision (12.6% adults, 37.7% children), appointment availability (7.4% adults, 17.0% children) and lack of transport (13.7% adults, 20.8% children) also featured in participant responses. Interventions to reduce Māori ASH include: timely access to primary care through electronic communications, increased appointment availability, extended opening hours, low cost after-hours care and consistent best management of ASH conditions in general practice through clinical pathways. Facilitated enrolment of ASH patients with no general practitioner could also reduce ASH. Research into transport barriers and enablers for Māori accessing primary care is required to support future interventions.
Camburn, Anna E; Ingram, R Joan H; Holland, David; Read, Kerry; Taylor, Susan
To describe the current malaria situation in Auckland, New Zealand. We collected data on all cases of malaria diagnosed in Auckland from 1st October 2008 to 30th September 2009. Enhanced surveillance was arranged with all hospital and community haematology laboratories in the region. Laboratories notified us when a diagnosis of malaria was made. After obtaining informed consent the patient was asked about their travel, prophylaxis taken and symptoms. Laboratory results were collected. There were 36 cases of malaria in 34 patients. Consent could not be obtained from two patients so data is from 34 cases in 32 patients. (One patient had P.falciparum then later P.vivax, the other had P.vivax and relapsed.) There were 24 males and 8 females with a median age of 21 years (range 6 months to 75 years). Eleven of the 32 were New Zealand residents. 8 of these 11 had travelled to visit friends or relatives (VFR) while 3 were missionaries. In this group 6 had P.falciparum, 4 P.vivax and one had both. Twenty-one of the 32 were new arrivals to New Zealand: 11 refugees and 10 migrants. Malaria in Auckland is seen in new arrivals and VFR travellers, not in tourist travellers.
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on August 28-30, 2012, at the Boston Omni Parker...
Deane, Frank P.; Tweedie, Rosemarie; van der Weyden, Chantelle; Cowlin, Feona
Unlicensed boarding houses provide low cost accommodation for many people who have mental health and/or alcohol or other drug problems. The present study explored the needs and experiences of owners and managers of unlicensed boarding houses who have residents with MH and AOD problems. Twenty-three boarding house managers (BHMs) from Illawarra and…
Slišković, Ana; Penezić, Zvjezdan
Seafaring is characterized by specific stressors and health risks. The purpose of this article was to compare the prevalence of various lifestyle factors between the shipping and home environments, and in addition to test the relations between lifestyle factors, perceived stress on board, and health in seafarers. A total of 530 Croatian seafarers participated in an on-line survey. The questionnaire contained requests for demographic data and a set of questions relating to lifestyle, stress on board, physical health symptoms, and mental health. The data showed higher sleep deprivation, higher levels of smoking and unhealthier diet at sea than at home, with prevalence of alcohol consumption and physical exercise being more favourable for the shipping environment. Sleep deprivation, unhealthy diet, lack of physical exercise, and smoking are shown as negative correlates of various measures of health. Stress on board was associated with sleep deprivation and unhealthy diet, and with more unfavourable physical and mental health. The results give practical implications for promoting health in seafarers. Some of the lifestyle factors tested, such as alcohol use, smoking and physical exercise, fall rather under individual control, but others, such as a healthy, balanced diet on board and sleeping hygiene at sea, should be improved by shipping management.
Bloom, Joseph D
Psychiatric boarding is a term derived from emergency medicine that describes the holding of patients deemed in need of hospitalization in emergency departments for extended periods because psychiatric beds are not available. Such boarding has occurred for many years in the shadows of mental health care as both inpatient beds and community services have decreased. This article focuses on a 2014 Washington State Supreme Court decision that examined the interpretation of certain sections of the Washington state civil commitment statute that had been used to justify the extended boarding of detained psychiatric patients in general hospital emergency departments. The impact of this decision on the state of Washington should be significant and could spark a national debate about the negative impacts of psychiatric boarding on patients and on the nation's general hospital emergency services. © 2015 American Academy of Psychiatry and the Law.
... briefings regarding military health needs and priorities including, a vote on Supraglottic Airways... Groups Ad Hoc Work Group, and Military Health Systems Governance Updates. Pursuant to 5 U.S.C. 552b, as... DHB. Special Accommodations If special accommodations are required to attend (sign language...
... Academia; Health Care Finance/Economics; Health Care Policy/Executive Leadership; and Patient Care. The... at least one of the following disciplines: Clergy, DoD leadership, Human Research Protection... formal bioethics or medical ethics training or experience. The Subcommittee, when tasked according to DoD...
Staveley, Aimee; Soosay, Ian; O'Brien, Anthony J
To audit New Zealand district health boards' (DHBs) metabolic monitoring policies in relation to consumers prescribed second-generation antipsychotic medications using a best practice guideline. Metabolic monitoring policies from DHBs and one private clinic were analysed in relation to a best practice standard developed from the current literature and published guidelines relevant to metabolic syndrome. Fourteen of New Zealand's 20 DHBs currently have metabolic monitoring policies for consumers prescribed antipsychotic medication. Two of those policies are consistent with the literature-based guideline. Eight policies include actions to be taken when consumers meet criteria for metabolic syndrome. Four DHBs have systems for measuring their rates of metabolic monitoring. There is no consensus on who is clinically responsible for metabolic monitoring. Metabolic monitoring by mental health services in New Zealand reflects international experience that current levels of monitoring are low and policies are not always in place. Collaboration across the mental health and primary care sectors together with the adoption of a consensus guideline is needed to improve rates of monitoring and reduce current rates of physical health morbidities.
Compares Auckland (New Zealand) with San Francisco (California) in terms of topographical structure, geographic location, and urban development. Both cities contain striking similarities. Maintains that Auckland can become a world-class city renowned for its beauty if developers and government work in tandem. (MJP)
Mukherjee, Dhrubodhi; Saxon, Verletta
This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.
At the end of 2006, the Management of Clinique La Colline canceled its 2005 tariff agreement with the health insurance schemes of international organizations (CERN, ILO-ITU, WHO, UNOG). The proposed 2007 tariffs were unacceptable to these schemes as they included an average increase of 12%. No agreement was found and therefore this clinic is no longer approved by the CHIS, according to the definition given in the Rules of the CERN Health Insurance Scheme. Our Administrator, UNIQA, will no longer act as paying third party for any hospitalisation which has not already been planned and agreed. More information will appear in the next issue of the CHISBull'. Tel.74484
... Colorado Springs Marriott hotel, 5580 Tech Center Drive, Colorado Springs, CO 80919. Written statements may.... Additional information, agenda updates, and meeting registration are available online at the Defense Health... will review all timely submissions with the Department of Defense Task Force on the Prevention of...
... meeting will be held at the Doubletree Hotel Cocoa Beach, 2080 North Atlantic Avenue, Cocoa Beach, Florida.... Additional information, agenda updates, and meeting registration are available online at the Defense Health... next open meeting. The Designated Federal Officer will review all timely submissions with the Defense...
... August 8, 2011, the DHB will receive briefings regarding military health needs and priorities. The DHB... briefings about the DoD Institutional Review Board, the Military Infectious Diseases Research Program, and... (sign language, wheelchair accessibility) please contact Ms. Lisa Jarrett at (703) 681- 8448 Ext. 1280...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... below. All requests must contain the name, address, telephone number, and organizational affiliation of...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... name, address, telephone number, and organizational affiliation of the presenter. Written comments...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... contain the name, address, telephone number, and organizational affiliation of the presenter. Written...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and..., and organizational affiliation of the presenter. Written comments should not exceed five single-spaced...
..., diagnosis, treatment, control, and prevention of physical and mental diseases and other impairments; (2... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of.... L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting of...
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... Research and Development Service Scientific Merit Review Board will meet on February 13-14, 2013, at the... research. Applications are reviewed for scientific and technical merit. Recommendations regarding funding...
The Supreme Court's determination on Montgomery (AP) (Appellant) v Lanarkshire Health Board (Respondent) (Scotland)  clarified UK law on consent. It is for the informed patient to determine which intervention, if any, they will undergo. All doctors must meet this standard and may need to reassess their practice to do so.
Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems. [Cukurova Med J 2016; 41(2.000: 253-258
Leonard B. Lerer. Annual reports of the Kimberley Board of Health, established in 1883. provide rich insight into public hearth discourse on infant mortality. Commentaries on the determinants of infant mortality, especially prior to 1950, largely focus on poverty and interracial disparities, issues relevant to current heatth policy.
... Disorders; HCR 2--Substance Use Disorders; HCR 3--Rehabilitation/Rural; HCR 4--Women's Health; HCR 5--Pain... Development Service Scientific Merit Review Board will meet on March 6-8, 2012, at the Hilton New Orleans... to the Chief Research and Development Officer. On March 6, the subcommittee on Nursing Research...
Chin, Seung Joon; Zeng, Irene S L; Morton, Randall P
Estimate the incidence rate and provide basic descriptive epidemiologic characteristics of plunging ranulas in a multi-ethnic population. Case series with chart review. The study group comprised all Counties Manukau Health (CMH, Manukau City, Auckland, New Zealand) patients presenting to the CMH Department of Otolaryngology with a diagnosis of plunging ranula from January 2001 to December 2013, as recorded in the departmental case register. Non-CMH domicile patients were excluded. South Auckland comprised the base population, as serviced by CMH. The 2006 New Zealand census data was used for population demographics. A total of 134 cases of plunging ranula were identified. The overall annual crude incidence rate was 2.4 per 100,000 person-years. The gender specific incidence rate for males was 3.2 per 100,000 (95% confidence interval [CI]: 2.5. 3.9) and for females was 2.0 per 100,000 (95% CI: 1.5, 2.6). The overall age-adjusted annual incidence rate was 2.6 per 100,000 (95% CI: 2.1, 3.0). The age-adjusted incidence was highest among Maori (6.7 per 100,000, 95% CI 4.9, 8.4), followed by Pacific Island (4.4 per 100,000, 95% CI 3.2, 5.6), Asian (0.7 per 100,000, 95% CI 0.2, 1.2), and European population (0.6 per 100,000, 95% CI 0.3, 0.8). We have quantified for the first time the age-specific and age-adjusted incidence rates for plunging ranula by gender and ethnicity. The results show a likely underlying genetic predisposition for this condition, possibly with a superimposed environmental acquired factor relating to external, minor blunt trauma to the neck. 4. Laryngoscope, 126:2739-2743, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Gorenflo, Grace G; Klater, David M; Mason, Marlene; Russo, Pamela; Rivera, Lillian
The nationally known Malcolm Baldrige Award for Excellence ("Baldrige program") recognizes outstanding performance management and is specifically cited by the Public Health Accreditation Board (PHAB) as a potential framework for PHAB's requisite performance management system. The authors developed a crosswalk that identifies alignments between the 2 programs and is a highlight of the Quest for Exceptional Performance tool that is intended to help health departments capitalize on the connections between the 2 programs. To provide deeper insight into the most robust connections between the 2 programs. The authors developed a crosswalk by listing the PHAB measures, identifying corresponding Baldrige areas to address, and assigning a rating regarding the strength of the alignment. Subsequently, they generated a matrix with numerical scores reflecting the strength of the PHAB-Baldrige alignments that were then analyzed for frequency and strength of alignment by PHAB domain and by Baldrige category. The tool developers and 3 public health leaders with experience in the Baldrige program contributed to both the design and the analyses. The measures used reflected both the frequency and strength of alignments. Of the 123 alignments identified in the crosswalk, 39 were rated as high, 40 as medium, and 44 as low. The strongest connections were in the areas of performance management, quality improvement, strategic planning, workforce development, assessment and analysis, and customer service. While the areas with the most frequent and strongest connections provide the most useful basis for health departments pursuing Baldrige recognition or using Baldrige criteria as a framework for performance management, all alignments could be considered for both purposes.
... provided to the contact person below in advance of the meeting. Background: The Advisory Board was... President on a variety of policy and technical functions required to implement and effectively manage the new compensation program. Key functions of the Advisory Board include providing advice on the...
Following a long series of discussions with the Administration of the La Tour Hospital, a tariff agreement has been concluded between the Hospital and the CERN Health Insurance Scheme. In the case of hospitalisations, this new agreement will apply to admissions on or after 1st September 2004 and will result, in particular, in the reintroduction of the third-party payer system. In the case of out-patient treatment, billing will be according to the Swiss medical tariff system TARMED and Uniqa will act as third-party guarantor. Further details will be published in the next issue of the CHISBull'. Tel.74484
Rocha, C M; Kruger, E; Whyman, R; Tennant, M
To model the geographic distribution of current (and treated) dental decay on a high-resolution geographic basis for the Auckland region of New Zealand. The application of matrix-based mathematics to modelling adult dental disease-based on known population risk profiles to provide a detailed map of the dental caries distribution for the greater Auckland region. Of the 29 million teeth in adults in the region some 1.2 million (4%) are suffering decay whilst 7.2 million (25%) have previously suffered decay and are now restored. The model provides a high-resolution picture of where the disease burden lies geographically and presents to health planners a method for developing future service plans.
Forsyth, M B; Morris, A J; Sinclair, D A; Pritchard, C P
Investigation was undertaken to assess the occurrence of zoonotic infection among staff at Auckland Zoological Park, New Zealand, in 1991, 2002 and 2010. Serial cross-sectional health surveys in 1991, 2002 and 2010 comprising a health questionnaire, and serological, immunological and microbiological analysis for a range of potential zoonotic infections were performed. Laboratory results for zoo animals were also reviewed for 2004-2010 to assess the occurrence of potential zoonotic infections. Veterinary clinic, animal handler, grounds, maintenance and administrative staff participated in the surveys, with 49, 42 and 46 participants in the 1991, 2002 and 2010 surveys, respectively (29% of total zoo staff in 2010). A small number of staff reported work-related infections, including erysipelas (1), giardiasis (1) and campylobacteriosis (1). The seroprevalence of antibodies to hepatitis A virus and Toxoplasma gondii closely reflected those in the Auckland community. No carriage of hepatitis B virus (HBV) was detected, and most of those with anti-HBV antibodies had been vaccinated. Few staff had serological evidence of past leptospiral infection. Three veterinary clinic staff had raised Chlamydophila psittaci antibodies, all Auckland Zoo, this was uncommon and risks appear to be adequately managed under current policies and procedures. Nevertheless, ongoing assessment of risk factors is needed as environmental, human and animal disease and management factors change. Policies and procedures should be reviewed periodically in conjunction with disease monitoring results for both animals and staff to minimise zoonotic transmission. © 2012 Blackwell Verlag GmbH.
Shirzadi, Shayesteh; Asghari Jafarabadi, Mohammad; Nadrian, Haidar; Mahmoodi, Hassan
Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p<0.05). Perceived benefits, perceived barriers and cues to action were predictors of physical puberty health behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.
... President on a variety of policy and technical functions required to implement and effectively manage the... Responses to Public Comments from the September 2012 Advisory Board Meeting; Subcommittee and Work Group..., Management Analysis and Services Office, has been delegated the authority to sign Federal Register notices...
... a variety of policy and technical functions required to implement and effectively manage the new... Facility Records Search Methods; NIOSH Office of Compensation Analysis and Support Analysis of SEC Class Definitions; Board Subcommittee and Work Group Updates; and, OCAS SEC Petition Evaluations Update for May 2010...
... President on a variety of policy and technical functions required to implement and effectively manage the...); Subcommittee and Work Group Updates; SEC Petition Evaluations Update for the December 2012 Advisory Board....gov . The Director, Management Analysis and Services Office, has been delegated the authority to sign...
Sundean, Lisa J; Polifroni, E Carol; Libal, Kathryn; McGrath, Jacqueline M
Nurses are key change agents in health care; yet, nurses have not been sufficiently engaged on boards to shape decision making. Without an equal voice in the boardroom, nurses cannot fulfill their professional obligation to society. The purpose of this study was to understand the progression in research focus and recommendations over time about nurses on boards (NOB), identify research gaps, and make research/practice recommendations. An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (2009) for data evaluation and analysis. Eleven studies (six quantitative, three qualitative, and two quasi-mixed methods) were included in the review. The focus/recommendations of research about NOB have changed from passive observation to action-oriented inquiry that considers nurse expertise and value but lacks a coordinated approach to advance board appointments for nurses. A systematic approach to the research is needed to advance NOB as key agents in health care transformation and social justice. Copyright © 2017 Elsevier Inc. All rights reserved.
Downey, Laura E; Mehndiratta, Abha; Grover, Ashoo; Gauba, Vijay; Sheikh, Kabir; Prinja, Shankar; Singh, Ravinder; Cluzeau, Francoise A; Dabak, Saudamini; Teerawattananon, Yot; Kumar, Sanjiv; Swaminathan, Soumya
India is at crossroads with a commitment by the government to universal health coverage (UHC), driving efficiency and tackling waste across the public healthcare sector. Health technology assessment (HTA) is an important policy reform that can assist policy-makers to tackle inequities and inefficiencies by improving the way in which health resources are allocated towards cost-effective, appropriate and feasible interventions. The equitable and efficient distribution of health budget resources, as well as timely uptake of good value technologies, are critical to strengthen the Indian healthcare system. The government of India is set to establish a Medical Technology Assessment Board to evaluate existing and new health technologies in India, assist choices between comparable technologies for adoption by the healthcare system and improve the way in which priorities for health are set. This initiative aims to introduce a more transparent, inclusive, fair and evidence-based process by which decisions regarding the allocation of health resources are made in India towards the ultimate goal of UHC. In this analysis article, we report on plans and progress of the government of India for the institutionalisation of HTA in the country. Where India is home to one-sixth of the global population, improving the health services that the population receives will have a resounding impact not only for India but also for global health.
... Science Advisory Board; Exposure and Human Health Committee AGENCY: Environmental Protection Agency (EPA... Office announces a public teleconference of the SAB Exposure and Human Health Committee to discuss its... hereby given that the SAB Exposure and Human Health Committee (EHHC) will hold a public teleconference to...
Warin, Briar; Exeter, Daniel J; Zhao, Jinfeng; Kenealy, Timothy; Wells, Susan
To determine whether the prevalence of diagnosed diabetes in the greater Auckland Region varies by General Electoral District (GED). Using encrypted National Health Identifiers and record linkage of routine health datasets, we identified a regional cohort of people with diagnosed diabetes in 2011 from inpatient records and medication dispensing. The geographical unit of a person's residence (meshblock) was used to determine the GED of residence. We calculated prevalence estimates and 95% confidence intervals and used binary logistic regression to map geographical variations in diabetes. An estimated 63,014 people had diagnosed diabetes in Auckland in 2011, a prevalence of 8.5% of the adult population ≥30 years of age. We found significant variation in diabetes prevalence by age, gender, ethnicity and GED. There was a more than five-fold difference in the unadjusted prevalence of diabetes by GED, ranging from 3.2% (3.1 to 3.4%) in the North Shore to 17.3% (16.8 to 17.7%) in Mangere. Such variations remained after binary logistic regression adjusting for socio-demographic variables. Compared to New Zealand Europeans, Indian people had the highest odds of having diabetes at 3.85 (3.73 to 3.97), while the odds of people living in the most deprived areas having diabetes was nearly twice that of those living in least deprived areas (OR 1.93, [1.87 to 1.99]). Geographic variations in diabetes remained after adjusting for socio-demographic circumstances: people living in GEDs in south-west Auckland were at least 60% more likely than people living in the North Shore GED to have diabetes. There is significant variation in the prevalence of diabetes by GED in Auckland that persists across strata of age group, gender and ethnicity, and persists after controlling for these same variables. These inequities should prompt action by politicians, policymakers, funders, health providers and communities for interventions aimed at reducing such inequities. Geography and its
Evans-Campbell, Teresa; Walters, Karina L; Pearson, Cynthia R; Campbell, Christopher D
Systematic efforts of assimilation removed many Native children from their tribal communities and placed in non-Indian-run residential schools. To explore substance use and mental health concerns among a community-based sample of 447 urban two-spirit American Indian/Alaska Native adults who had attended boarding school as children and/or who were raised by someone who attended boarding school. Eighty-two respondents who had attended Indian boarding school as children were compared to respondents with no history of boarding school with respect to mental health and substance use. Former boarding school attendees reported higher rates of current illicit drug use and living with alcohol use disorder, and were significantly more likely to have attempted suicide and experienced suicidal thoughts in their lifetime compared to non-attendees. About 39% of the sample had been raised by someone who attended boarding school. People raised by boarding school attendees were significantly more likely to have a general anxiety disorder, experience posttraumatic stress disorder symptoms, and have suicidal thoughts in their lifetime compared to others.
A Longitudinal Study into Indicators of Mental Health, Strengths and Difficulties Reported by Boarding Students as They Transition from Primary School to Secondary Boarding Schools in Perth, Western Australia
Mander, David J.; Lester, Leanne
This study examined indicators of mental health, as well as strengths and difficulties, as reported by same-age boarding and non-boarding students spanning four time points over a 2-year period as they transitioned from primary to boarding school in Western Australia (i.e., at the end of Grade 7, beginning of Grade 8, end of Grade 8, and end of…
Silvestre, Anthony J.; Quinn, Sandra J.; Rinaldo, Charles R.
Conducting health research often requires a partnership between marginalized communities and researchers. Community organizers can broker this partnership in a way that not only produces important scientific discoveries but also brings needed resources to the communities. This article is a description of a community advisory board established in 1984 to advise researchers on a longitudinal study of the natural history of AIDS among gay men. The Board successfully guided the recruitment of more than 3,000 gay and bisexual male volunteers and, at the same time worked as a powerful change agent. An analysis of minutes from all Board meetings between 1984-2006 indicates that significant social change as well as important research findings resulted from Board actions. Community organizers who work to create a mutually beneficial partnership between communities and researchers may find new opportunities to support community growth and social justice. PMID:20523763
The Thorotrast Commmitte appointed by the National Board of Health evaluated the medical consequences of thorotrast use as x-ray contrast until 1947. Based on the available statistical data of thorotrast carcinogenic effects there is given a prognosis for the 100 Danish thorotrast patients. The risk of developing cancer, particularly liver cancer and leukemia is treble compared to a control group of the same age (average 70). There is a high probability of 29 developing some form of liver cancer or cirrhosis. With regard to their advanced age surgical methods (resection) are rarely succesful. About five cases of leukemia in various forms and as many of bone marrow diseases are probable. There is some promising progress in treatment of these diseases, but at present the committee does not find semiannual screenings helpful for therapeutic purposes. (EB) 52 refs
...: January 20, 2010. Mark E. Brown, Chief Financial Officer, Office of Oceanic and Atmospheric Research... decide to entertain: (1) What are NOAA's unique and important scientific roles in addressing ocean health...
Forster, Rose; Ng, Diana; Upton, Arlo; Franklin, Rick; Thomas, Mark
The relentless emergence and spread of strains of Neisseria gonorrhoeae that are resistant to many antimicrobial agents has led to frequent changes in treatment guidelines, with a consequent risk that prescribers may not be aware of current guidelines. To determine the proportion of patients with gonorrhoea who were treated with a regimen consistent with the New Zealand Sexual Health Society (NZSHS) guidelines. We audited the treatment given to adult patients with laboratory-proven gonorrhoea in Auckland, New Zealand, during the first 6 months of 2015. Treatment compliant with the current NZSHS guidelines was administered in only 65% (458/706) episodes overall. Guideline-compliant treatment was much more likely to be prescribed for patients who presented to a sexual health clinic (89%) than for patients who presented to either a general practice or other community clinic (52%) or to a hospital (56%) (P Auckland region. Improved compliance with treatment guidelines, particularly in patients who present either to general practice or to hospitals, is necessary to maintain the efficacy of current treatment regimens. © 2017 Royal Australasian College of Physicians.
Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter
The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
U.S. Department of Health & Human Services — Decisions issued by the Chair and Board Members of the Departmental Appeals Board concerning determinations in discretionary, project grant programs, including...
Chong, Chee Foong; McGhee, Charles N J; Dai, Shuan
Childhood visual impairment has significant individual and socioeconomic costs with global differences in etiology and prevalence. This study aimed to determine prevalence, etiology, and avoidable causes of childhood visual impairment in New Zealand. Retrospective data analysis from a national referral center, the Blind and Low Vision Education Network New Zealand, Auckland. The World Health Organization Program for Prevention of Blindness eye examination records for visually impaired children, 16 years or younger, registered with the Auckland Visual Resource Centre, were included. Data analyzed included demographics, etiology, visual acuity, visual fields, educational setting, and rehabilitation plan. Charts of 340 children were examined, of which 267 children (144 blind, 123 low vision) were included in the analysis, whereas the remaining 73 charts of children with no visual impairment were excluded. The calculated prevalence of blindness and low vision was 0.05% and 0.04%, respectively, in the Auckland region. Principal causes of blindness affecting 91 children (63.9%) were cerebral visual impairment in 61 children (42.4%), optic nerve atrophy in 18 children (12.5%), and retinal dystrophy in 13 children (9.0%). The main potentially avoidable causes of blindness in 27 children (19%) were neonatal trauma, asphyxia in 9 children (33%), and nonaccidental injury 6 children (22%). This first report of prevalence for childhood blindness and low vision in New Zealand is similar to data from Established Market Economy countries. The leading causes of blindness are also comparable to other high-income countries; however, proportions of avoidable causes differ significantly.
Full Text Available Aims • To explore organ donation and transplantation knowledge and attitudes among medical students at the University of Auckland. • To understand students' perception of the extent of training received prior to and during the medical program. Method A validated web-based questionnaire consisting of 42 questions in five categories was anonymously administered to all enrolled medical students at the Faculty of Medical and Health Sciences, University of Auckland, in September 2012. Results In all, 419 out of 989 (42% Year 2–6 students responded. A total of 99.3% of medical students supported organ donation, but knowledge was limited (mean score 7.54/15±2.26. A total of 38% of students reported having participated in organ donation learning. A total of 96% of students believed that organ donation information should be available in primary care settings. A total of 69% of students reported that if a patient asked a question about organ donation that they did not know the answer to, they also would not know where to source the correct information from. Conclusion This study demonstrates that although medical students support organ donation, they lack the knowledge required to facilitate informative discussions with patients. Enhanced organ donation education in medical programs may enable students to develop skills and knowledge allowing them to better discuss donation with patients.
Bailey, David John
This study investigates maternal and perinatal outcomes for women with low-risk pregnancies laboring in free-standing birth centers compared with laboring in a hospital maternity unit in a large New Zealand health district. The study used observational data from 47 381 births to women with low-risk pregnancies in South Auckland maternity facilities 2003-2010. Adjusted odds ratios with 95% confidence intervals were calculated for instrumental delivery, cesarean section, blood transfusion, neonatal unit admission, and perinatal mortality. Labor in birth centers was associated with significantly lower rates of instrumental delivery, cesarean section and blood transfusion compared with labor in hospital. Neonatal unit admission rates were lower for infants of nulliparous women laboring in birth centers. Intrapartum and neonatal mortality rates for birth centers were low and were not significantly different from the hospital population. Transfers to hospital for labor and postnatal complications occurred in 39% of nulliparous and 9% of multiparous labors. Risk factors identified for transfer were nulliparity, advanced maternal age, and prolonged pregnancy ≥41 weeks' gestation. Labor in South Auckland free-standing birth centers was associated with significantly lower maternal intervention and complication rates than labor in the hospital maternity unit and was not associated with increased perinatal morbidity. © 2017 Wiley Periodicals, Inc.
... studies relating to the causes, diagnosis, treatment, control, and prevention of physical and mental... DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) Centers for Disease Control and Prevention Board of... Climate Control; a discussion of ATSDR Funded State Reports; an update on Amyotrophic Lateral Sclerosis...
... Actuaries; Notice of Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting notice. SUMMARY: Under... Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 2, 2013, from 10:00 a.m. to... Activity, DoD Office of the Actuary, 4800 Mark Center Drive, STE 06J25-01, Alexandria, VA 22350-4000. Phone...
... Retiree Health Care Board of Actuaries AGENCY: Department of Defense (DoD). ACTION: Meeting notice... Actuaries will meet on August 18, 2010. Subject to the availability of space, the meeting is open to the...: Margot Kaplan at the DoD Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203...
Full Text Available The article examines women’s local government representation following amalgamation to form a super-sized city authority, Auckland, which covers a third of New Zealand’s population. Using a gender perspective, it analyses the promise implicit in amalgamation rhetoric that democratic gaps in representation, including the gender gap, would diminish. It examines the question of whether size has made a difference. Prior to local government amalgamation, women’s representation had not significantly increased over a period of seven election cycles. Women’s descriptive and substantive representation are examined at national and city levels and the gendered implications of local government reform are considered from the perspectives of female elected representatives at councillor and local board levels. Evidence shows that local government reform has yet to be the catalyst for improving women’s descriptive and substantive representation, although there are tentative signs of entry-level improvement at community board level which raise the prospect of a pipeline effect. Interviews with elected female representatives after amalgamation show that while they do not identify themselves as speaking for women, they see themselves as women speaking for their communities and doing it better than men. The results suggest the influence of gender backlash politics and also confirm the need to think about the performance of elected women as more than ‘articulated’ representation.
Full Text Available Public library services in New Zealand are being re-examined in light of the developments in ICT and an increasinglymulticultural population. The research question investigated was “Can an internet portal on a public library website beused to meet the information needs of new Chinese Mandarin immigrants to the Auckland region of New Zealand?” In anattempt to effectively answer the research question and sub-questions a literature survey was carried out focusing on twoaspects relevant to the study: immigration theory and information behaviour (IB. Thirty Chinese Mandarin speakingrecent migrants to the Auckland region of New Zealand were interviewed in-depth to determine their IB and resourcesused. The findings indicate that respondents were in need of everyday survival information. The findings suggest that amore coordinated approach to information provision, for example through a library web portal, will assist respondents intheir search for information relating to their initial settlement.
Anderson, N.E. [Auckland Hospital, Auckland, (New Zealand); Bonita, R.; Broad, J.B. [University of Auckland, Auckland, (New Zealand). Faculty of Medicine and Health Science
Studies of acute stroke management in stroke units and tertiary referral hospitals may not accurately reflect practice within the population. Reliable information on the management of stroke within a population is sparse. The aims of this study was to compare clinical practice in acute stroke management in Auckland with guidelines for the management and treatment of stroke in other countries; to provide a baseline measure against which future changes in management can be evaluated. All new stroke events in Auckland residents in 12 months were traced through multiple case finding sources. For each patient, a record of investigations and treatment during the first week of hospital admission was kept. One thousand eight hundred and three stroke events (including subarachnoid haemorrhages) occurred in 1761 patients in one year. Twenty-seven per cent of all events were managed outside hospital and 73% of the stroke events were treated in an acute hospital. Of the 1242 stroke events admitted to an acute hospital in the first week, only 6% were managed on the neurology and neurosurgery ward, 83% were managed by a general physician or geriatrician and 42% had computed tomography (CT). Of 376 validated ischaemic strokes, 44% were treated with aspirin and 12% with intravenous heparin. Of the 690 unspecified strokes (no CT or autopsy), 38% received aspirin and 0.5% heparin. The 28 day in-hospital case fatality for all stroke events admitted to an acute hospital during the first week was 25%. It was concluded that in Auckland, management of acute stroke differed from clinical guidelines in the high proportion of patients managed in the community, the low rate of neurological consultation, and the low frequency of CT scanning. Despite these deficiencies in management, the 28 day hospital case fatality in Auckland was similar to other comparable studies which had a high proportion of cases evaluated by a neurologist and CT. (authors). 34 refs., 4 tabs., 2 figs.
Anderson, N.E.; Bonita, R.; Broad, J.B.
Studies of acute stroke management in stroke units and tertiary referral hospitals may not accurately reflect practice within the population. Reliable information on the management of stroke within a population is sparse. The aims of this study was to compare clinical practice in acute stroke management in Auckland with guidelines for the management and treatment of stroke in other countries; to provide a baseline measure against which future changes in management can be evaluated. All new stroke events in Auckland residents in 12 months were traced through multiple case finding sources. For each patient, a record of investigations and treatment during the first week of hospital admission was kept. One thousand eight hundred and three stroke events (including subarachnoid haemorrhages) occurred in 1761 patients in one year. Twenty-seven per cent of all events were managed outside hospital and 73% of the stroke events were treated in an acute hospital. Of the 1242 stroke events admitted to an acute hospital in the first week, only 6% were managed on the neurology and neurosurgery ward, 83% were managed by a general physician or geriatrician and 42% had computed tomography (CT). Of 376 validated ischaemic strokes, 44% were treated with aspirin and 12% with intravenous heparin. Of the 690 unspecified strokes (no CT or autopsy), 38% received aspirin and 0.5% heparin. The 28 day in-hospital case fatality for all stroke events admitted to an acute hospital during the first week was 25%. It was concluded that in Auckland, management of acute stroke differed from clinical guidelines in the high proportion of patients managed in the community, the low rate of neurological consultation, and the low frequency of CT scanning. Despite these deficiencies in management, the 28 day hospital case fatality in Auckland was similar to other comparable studies which had a high proportion of cases evaluated by a neurologist and CT. (authors)
Braatvedt, Geoffrey; Wilkinson, Susan; Scott, Marilyn; Mitchell, Paul; Harris, Roger
This study describes in detail the burden of caring for patients aged ≥ 50 years seen in one year with a fragility fracture in a large urban environment and shows that these fractures result in a long length of stay and significant mortality. Intervention to prevent further fracture was poorly done. To examine the epidemiology of fragility fracture in patients over age 50 years and record the number who received appropriate secondary prevention treatment. All patients aged ≥ 50 years presenting with a fracture during the 12 months following July 1 st 2011, to Auckland City Hospital or residing in central Auckland at the time of their fracture, were identified from hospital and Accident Compensation Corporation records. A random sample of 55% of these patient's records were reviewed to establish the type of fracture, prior fracture and falls history, and use of bisphosphonates in the 12 months before presentation. Their length of stay (LOS) by type of fracture was recorded. The use of bisphosphonate drugs in the following 12 months was obtained from centralised national records of prescriptions. 2729 patients aged ≥ 50 years presented with a fragility fracture in the central Auckland region in one year. Fifty-six percent of these patients were seen at Auckland Hospital and of these, 82% patients required admission with a mean LOS of 20 days (SD ± 24 days).The remaining 44% of patients were looked after in the private outpatient sector. Approximately 30% of the admissions were for hip fracture. Sixty-four percent of patients with a fragility fracture did not receive a potent bisphosphonate, 12% were considered not appropriate for treatment, and 24% received a potent bisphosphonate during their admission or in the next 12 months. Approximately 1 in 18 people aged ≥ 50 years presented in one year with a fragility fracture.Secondary prevention strategies were poorly implemented. Additional resources for identifying and initiating secondary fracture prevention
Smith, I.E.M.; McGee, L.E.; Lindsay, J.M.
Research has long shown that the petrology of suites of volcanic rock can be used to define and understand the fundamental parameters of the magmatic systems that feed volcanoes. The geochemistry of volcanic rocks provides information about the nature of the source rocks, depths and amounts of melting, the processes that act on magmas as they rise to the surface and, most importantly, the rates of these processes. In turn, the answers to fundamental petrological questions can provide input to important questions concerning volcano hazard scenarios and hazard mitigation challenges. The multi-disciplinary DEVORA research programme, launched in 2008, is a GNS Science-University of Auckland collaboration with the aim of DEtermining VOlcanic Risk in Auckland. One of its main themes is the development of an integrated geological model for the Auckland Volcanic Field (AVF) by investigating the physical controls on magma generation, ascent and eruption though detailed structural and petrological investigations. A key data set underpinning this theme is a comprehensive geochemical database for the rocks of the AVF. This report, Review of the Petrology of the Auckland Volcanic Field, is a synthesis and commentary of all petrological and geochemical data currently available for the AVF. It represents one of several reports carried out as part of the 'synthesis' phase of DEVORA, whereby existing data from previous work is collated and summarised, so that gaps in current knowledge can be appropriately addressed. In this report we utilise published and unpublished sources to summarise the petrological data available up to May 2009, and identify where new data and approaches will improve our understanding of the magmatic system which feeds the field. (author). 53 refs., 7 figs., 2 tabs.
Marasini, S.; Swift, S.; Dean, S. J.; Ormonde, S. E.; Craig, J. P.
Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laborato...
Mochizuki, Nobutatsu; Tsunakawa, Hideo; Shibuya, Hidetoshi; Tagami, Takahiro; Ozawa, Ayako; Cassidy, John; Smith, E.M.
K-Ar age determinations were made on two monogenetic volcanoes in the Auckland volcanic field, New Zealand, which have recorded the Auckland geomagnetic excursions. For the Wiri volcano with the north-down intermediate paleomagnetic direction, five samples gave a weighted mean age of 27±5 (1σ) ka. For the Hampton Park volcano with the west-up intermediate direction, three samples gave a weighted mean of 55±5(1σ) ka. Since these two K-Ar ages are distinguished at 2σ level, it is inferred that at least two geomagnetic excursions can be recognized in Auckland. The age of the Hampton Park is barely distinguished from the established age range of the Laschamp excursion (39-45 ka) at 2σ level. The age of the Wiri coincides with the age of c. 30 ka in which excursions have been found from sedimentary and volcanic records. The reported excursions from volcanic rocks show a VGP cluster in the central to northern Pacific region which is distinct from the VGP paths or clusters during polarity reversals. (author)
Thornley, Simon; Marshall, Roger; Reynolds, Gary; Koopu, Pauline; Sundborn, Gerhard; Schofield, Grant
The study assessed whether a healthy food policy implemented in one school, Yendarra Primary, situated in a socio-economically deprived area of South Auckland, had improved student oral health by comparing dental caries levels with students of similar schools in the same region with no such policy. Records of caries of the primary and adult teeth were obtained between 2007 and 2014 for children attending Yendarra, and were compared to those of eight other public schools in the area, with a similar demographic profile. Children were selected between the ages of 8 and 11 years. Linear regression models were used to estimate the strength of association between attending Yendarra school and dental caries. During the study period, 3813 records were obtained of children who attended dental examinations and the schools of interest. In a linear model, mean number of carious primary and adult teeth were 0.37 lower (95% confidence interval: 0.09-0.65) in Yendarra school children, compared to those in other schools, after adjustment for confounders. Pacific students had higher numbers of carious teeth (adjusted β coefficient: 0.25; 95% confidence interval: 0.03-0.46) than Māori. This nutrition policy, implemented in a school in the poorest region of South Auckland, which restricted sugary food and drink availability, was associated with a marked positive effect on the oral health of students, compared to students in surrounding schools. We recommend that such policies are a useful means of improving child oral health. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Sharma, Anjali; Zodpey, Sanjay; Batra, Bipin
A trained and adequate heath workforce forms the crux in designing, implementing and monitoring health programs and delivering quality health services. Education is recognized as a critical instrument for creating such trained health professionals who can effectively address the 21 st century health challenges. At present, the Public Health Education in India is offered through medical colleges and also outside the corridors of medical colleges which was not the scenario earlier. Traditionally, Public Health Education has been a domain of medical colleges and was open for medical graduates only. In order to standardize the Postgraduate Medical Education in India, the National Board of Examinations (NBE) was set up as an independent autonomous body of its kind in the country in the field of medical sciences with the prime objective of improving the quality of the medical education. NBE has also played a significant role in enhancing Public Health Education in India through its Diplomat of National Board (DNB) Programs in Social and Preventive Medicine, Health and Hospital Administration, Maternal and Child Health, Family Medicine and Field Epidemiology. It envisions creating a cadre of skilled and motivated public health professionals and also developing a roadmap for postgraduate career pathways. However, there still exists gamut of opportunities for it to engage in expanding the scope of Public Health Education. It can play a key role in accreditation of public health programs and institutions which can transform the present landscape of education of health professionals. It also needs to revisit and re-initiate programs like DNB in Tropical Medicine and Occupational Health which were discontinued. The time is imperative for NBE to seize these opportunities and take necessary actions in strengthening and expanding the scope of Public Health Education in India.
... strategies and goals for the programs and research within OPHPR, monitoring the overall strategic direction...; improving critical information sharing across CDC; biosecurity risk evaluation software; measuring operational readiness; (2) BSC liaison representative updates to the Board highlighting organizational...
Samaranayake, Chinthaka B; Fernando, Antonio T
The aim of this study was to assess the satisfaction with life among undergraduate medical and other students in Auckland and identify associations with depression and anxiety disorders. The study was conducted at The University of Auckland, New Zealand in 2008 and 2009. The sample population was derived from five undergraduate classes in four courses (medicine (two classes), nursing, health science and architecture). A battery of questionnaires including the Satisfaction with Life Scale (SWLS), Patient Health Questionnaire (PHQ) for depression and Generalised Anxiety Disorder Questionnaire (GAD) were administered to the cohort. Subgroup analysis between medical and other students were also carried out. A total of 778 students were eligible, and 594 (76.4%) students (255 medical, 208 health science, 36 nursing and 95 architecture) completed the questionnaire. The median age was 20 years (range 17-45) and women represented 67.2% (n=399) of the total group. The mean SWLS score for the total group was 24.9 (SD 6.4), with medical students on average having higher satisfaction with life compared to other students. The rate of depression (PHQ = 10) and anxiety (GAD score = 8) among medical students was 16.9% (95% CI 12.2-21.5) and 13.7% (95%CI 9.5-18.0) respectively. Female students had higher rates of depression and anxiety compared to males. A statistically significant moderate correlation between SWLS score and PHQ score [r = -0.37 (pstudents are more satisfied with life compared to other students. A significant proportion of students surveyed in this study have clinically significant depression and anxiety. Promoting positive wellbeing and improving satisfaction with life may enhance the quality of life as well as the social and academic performance of university students.
Akiyama, Takeshi; Win, Thar; Maung, Cynthia; Ray, Paw; Sakisaka, Kayako; Tanabe, Aya; Kobayashi, Jun; Jimba, Masamine
In Tak province of Thailand, a number of adolescent students who migrated from Burma have resided in the boarding houses of migrant schools. This study investigated mental health status and its relationship with perceived social support among such students. This cross-sectional study surveyed 428 students, aged 12-18 years, who lived in boarding houses. The Hopkins Symptom Checklist (HSCL)-37 A, Stressful Life Events (SLE) and Reactions of Adolescents to Traumatic Stress (RATS) questionnaires were used to assess participants' mental health status and experience of traumatic events. The Medical Outcome Study (MOS) Social Support Survey Scale was used to measure their perceived level of social support. Descriptive analysis was conducted to examine the distribution of sociodemographic characteristics, trauma experiences, and mental health status. Further, multivariate linear regression analysis was used to examine the association between such characteristics and participants' mental health status. In total, 771 students were invited to participate in the study and 428 students chose to take part. Of these students, 304 completed the questionnaire. A large proportion (62.8%) indicated that both of their parents lived in Myanmar, while only 11.8% answered that both of their parents lived in Thailand. The mean total number of traumatic events experienced was 5.7 (standard deviation [SD] 2.9), mean total score on the HSCL-37A was 63.1 (SD 11.4), and mean total score on the RATS was 41.4 (SD 9.9). Multivariate linear regression analysis revealed that higher number of traumatic events was associated with more mental health problems. Many students residing in boarding houses suffered from poor mental health in Thailand's Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status. Rather than making a generalized assumption on the mental health status of
Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard
Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants
Slišković, Ana; Penezić, Zvjezdan
The aim of this study was to test for associations between different aspects of contract and on-board internet access and seafarers' satisfaction and health. Altogether 298 Croatian seafarers, all officers, employed on cargo ships, with a minimum work experience of two years with their current shipping company, participated in an online survey. The questionnaire included sociodemographic items, questions relating to their employment contract and internet access, and measures of job satisfaction, life satisfaction, mental health, and gastrointestinal and cardiovascular symptoms. Their job- and lifesatisfaction levels were higher for shorter duration on board, favourable ratio of work to non-work days, and compliance with the employment contract regarding the changes to work and non-work days. Mental health differed likewise but only in relation to two aspects of the contract: on-board duration and compliance with the contract. The level of gastrointestinal symptoms was lower in cases of shorter on-board duration and compliance with the contract, and in seafarers who have free, unlimited internet access on board. Lower level of cardiovascular symptoms was found in seafarers with free, unlimited internet access on board. Our findings suggest that in promoting satisfaction and health in seafaring, attention should be given to reducing on-board duration, compliance with the contract, and internet accessibility on board.
Brabazon, E D
Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a
Lo, Sum Sum; Johnston, Richard; Al Sameraaii, Ahmed; Metcalf, Patricia A; Rice, Michael L; Masters, Jonathan G
Symptom prevalence (retrospective cohort) Level of Evidence 2b. To determine the incidence of acute presentation of urinary calculi (UC) in Auckland, New Zealand, during the period 1999-2007, and whether there was any significant seasonal variation. The details of all UC within the population presenting acutely to public hospitals in Auckland between 1999 and 2007 were collected using clinical coding searches International Classification of Disease 10th revision (Australian Modification) N132 and N20. Climatic variables for the Auckland region were obtained from the National Institute of Water and Atmospheric Research, New Zealand. The mean atmospheric temperature, hours of sunshine and humidity data were calculated monthly for this period. During the study there were 7668 acute presentations of UC in the Auckland region. A Poisson regression model showed that the number of presentations was significantly related to temperature (P Auckland, New Zealand, varies significantly with temperature and hours of sunshine. Humidity was not a significant factor.
Barber, P Alan; Krishnamurthi, Rita; Parag, Varsha; Anderson, Neil E; Ranta, Annemarei; Kilfoyle, Dean; Wong, Edward; Green, Geoff; Arroll, Bruce; Bennett, Derrick A; Witt, Emma; Rush, Elaine; Minsun Suh, Flora; Theadom, Alice; Rathnasabapathy, Yogini; Te Ao, Braden; Parmar, Priyakumari; Feigin, Valery L
There have been few recent population-based studies reporting the incidence (first ever) and attack rates (incident and recurrent) of transient ischemic attack (TIA). The fourth Auckland Regional Community Stroke study (ARCOS IV) used multiple overlapping case ascertainment methods to identify all hospitalized and nonhospitalized cases of TIA that occurred in people ≥16 years of age usually resident in Auckland (population ≥16 years of age is 1.12 million), during the 12 months from March 1, 2011. All first-ever and recurrent new TIAs (any new TIA 28 days after the index event) during the study period were recorded. There were 785 people with TIA (402 [51.2%] women, mean [SD] age 71.5 [13.8] years); 614 (78%) of European origin, 84 (11%) Māori/Pacific, and 75 (10%) Asian/Other. The annual incidence of TIA was 40 (95% confidence interval, 36-43), and attack rate was 63 (95% confidence interval, 59-68), per 100 000 people, age standardized to the World Health Organization world population. Approximately two thirds of people were known to be hypertensive or were being treated with blood pressure-lowering agents, half were taking antiplatelet agents and just under half were taking lipid-lowering therapy before the index TIA. Two hundred ten (27%) people were known to have atrial fibrillation at the time of the TIA, of whom only 61 (29%) were taking anticoagulant therapy, suggesting a failure to identify or treat atrial fibrillation. This study describes the burden of TIA in an era of aggressive primary and secondary vascular risk factor management. Education programs for medical practitioners and patients around the identification and management of atrial fibrillation are required. © 2016 American Heart Association, Inc.
Pavletic, Adria C.; Dukes, Thomas; Greene, Jamelle Gardine; Taylor, Jennifer; Gilpin, Louise B.
Adolescents who attend high school as preparatory boarding students are growing up and learning to care for themselves in a very different set of circumstances than those who live at home with their families. Although this choice may present myriad opportunities for personal growth and academic advantages, nurturance and support from caring adults…
... Board will be held March 2-3, 2011, at the Hilton San Francisco Financial District, 750 Kearny Street... management, and nursing research. Applications are reviewed for scientific and technical merit... subcommittee on Nursing Research Initiatives will convene from 8 a.m. to 2 p.m.; the subcommittee for pilot...
Social media sites, such as message boards and blogs, provide innovative data sources for researchers as these sites feature people sharing advice and discussing issues in a public arena. Research has found the online context can encourage people to reveal more information than do such traditional methods as interviews or focus groups. However,…
... thinking in disaster management; assessing CDC's Emergency Management Program through accreditation; (2) BSC liaison representative updates to the Board highlighting organizational activities relevant to the...) no later than 12:00 noon (EDT) on Tuesday, October 8, 2013: Full Name, Organizational Affiliation...
..., VA 22204. The June 9 meeting will be held at the Industrial College of the Armed Forces, Fort McNair... to the Board: Department of Defense Task Force on the Prevention of Suicide by Members of the Armed.... 552b, as amended, and 41 CFR 102-3.155, in the interest of national security, the Department of Defense...
Abbott, Max W; Wong, Sai; Giles, Lynne C; Wong, Sue; Young, Wilson; Au, Ming
This study was conducted to identify risk factors for depressive symptomatology among older Chinese migrants. One hundred and sixty-two Chinese migrants aged 55 years or older, living in the community and recruited via Chinese community organizations and general practitioners, were interviewed using a Chinese version of the Geriatric Depression Scale and measures of stressful life events, morbid conditions, self-rated health, acculturation, social support and service utilization. Twenty-six percent of participants met the criteria for depressive symptomatology. No recent migrants showed symptoms of depression. Multiple logistic regression analysis showed that lower emotional support, greater number of visits to a doctor, difficulties in accessing health services and low New Zealand cultural orientation increased the risk of showing symptoms of depression. Significant numbers of older Chinese migrants appear to be depressed or at risk for depression and, while participants with depressive symptoms consulted general practitioners more than their counterparts without such symptoms, they reported greater difficulty in accessing health services. The findings point to the need for further epidemiological study of this growing sector of the population and investigation of the nature of its engagement with health services. Social support and aspects of acculturation may play a significant role in preventing depression. This also requires further investigation.
Moore, Michael N; Depledge, Michael H; Fleming, Lora; Hess, Philipp; Lees, David; Leonard, Paul; Madsen, Lise; Owen, Richard; Pirlet, Hans; Seys, Jan; Vasconcelos, Vitor; Viarengo, Aldo
will impact adversely on efforts to alleviate poverty, sustain the availability of environmental goods and services and improve health and social and economic stability; and thus, will impinge on many policy decisions, both nationally and internationally. Knowledge exchange (KE) will be a key element of any ensuing research. KE will facilitate the integration of biological, medical, epidemiological, social and economic disciplines, as well as the emergence of synergies between seemingly unconnected areas of science and socio-economic issues, and will help to leverage knowledge transfer across the European Union (EU) and beyond. An integrated interdisciplinary systems approach is an effective way to bring together the appropriate groups of scientists, social scientists, economists, industry and other stakeholders with the policy formulators in order to address the complexities of interfacial problems in the area of environment and human health. The Marine Board of the European Science Foundation Working Group on "Oceans and Human Health" has been charged with developing a position paper on this topic with a view to identifying the scientific, social and economic challenges and making recommendations to the EU on policy-relevant research and development activities in this arena. This paper includes the background to health-related issues linked to the coastal environment and highlights the main arguments for an ecosystem-based whole systems approach.
Crawford, Alexandra Z; McKelvie, James; Craig, Jennifer P; McGhee, Charles N J; Patel, Dipika V
To analyze characteristics and indications for corneal transplantation in patients undergoing penetrating, lamellar, and endothelial keratoplasty in Auckland, New Zealand (NZ). Corneal transplantation data from the NZ National Eye Bank and hospital records of corneal transplant recipients in the Auckland region from January 1, 2000, to December 31, 2009, were collated. Patient demographics, preoperative diagnosis, indication, ocular and medical history, visual acuity, deprivation index, and access to transplantation surgery were analyzed. A total of 941 corneal transplants involving 770 patients were included for analysis. Mean age was 46 years. Age and ethnicity varied according to the transplant indication. A male preponderance and disproportionally high rates of Māori and Pacific ethnicity with a mean age of 30 years were observed in transplants for keratoconus. A total of 67.2% of corneal transplants were completed in the public health system and were associated with higher levels of deprivation than those completed in private facilities. Preoperative visual acuity varied according to the transplant type and indication. The most common clinical indication for corneal transplantation was keratoconus (41.3%), followed by repeat transplantation (21.0%). There was no significant change in the relative proportion of transplant indications in any year over the duration of this study (P = 0.41). A contralateral corneal transplant was present in 24.4% and glaucoma in 12.8% of penetrating keratoplasty recipients. Keratoconus is the leading indication for corneal transplantation in Auckland, NZ, and involves a disproportionately high rate of Māori and Pacific transplant recipients with a male preponderance and comparatively low mean age at the time of surgery.
Craven, R; Blinkhorn, A S; Schou, L
A dental health promotion campaign was developed by Forth Valley Health Board in conjunction with the Scottish Health Education Group and the Department of Marketing at Strathclyde University. The aim was to encourage dental attendance among early school leavers. The emphasis was on the contribut...
Wimalasena, Bodhi; Harris, Roger
The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013. Ninety-one patients were audited; mean age was 83 years, 68% were female. Both inpatient and 30-day mortality was 5%. 120-day mortality was 15%. Seventy-six percent of patients were admitted from ED within the national health target prescribed period of 6 hours. Only one patient was treated non-surgically. Eighty-six percent had surgery within 48 hours of admission. Eighty-two percent of patients had rehabilitation and treatment by Older People's Health. Of those living at home pre-fracture, 76% returned home on discharge. Thirty-seven percent of patients were able to walk unaided prior to hip fracture, but only 1% on discharge. Average overall length of stay was 22 days. Bisphosphonates were prescribed for 56% of patients. Compared to 2007, Auckland City Hospital has demonstrated a significant improvement in the rate of provision of timely surgery for hip fracture patients. Most patients are receiving the guideline recommended fracture-specific surgical interventions. The assessment and treatment of osteoporosis needs further attention.
Exeter, Daniel J; Sabel, Clive E; Hanham, Grant; Lee, Arier C; Wells, Susan
The association between area-level disadvantage and health and social outcomes is unequivocal. However, less is known about the health impact of residential mobility, particularly at intra-urban scales. We used an encrypted National Health Index (eNHI) number to link individual-level data recorded in routine national health databases to construct a cohort of 641,532 participants aged 30+ years to investigate the association between moving and CVD hospitalisations in Auckland, New Zealand. Residential mobility was measured for participants according to changes in the census Meshblock of usual residence, obtained from the Primary Health Organisation (PHO) database for every calendar quarter between 1/1/2006 and 31/12/2012. The NZDep2006 area deprivation score at the start and end of a participant's inclusion in the study was used to measure deprivation mobility. We investigated the relative risk of movers being hospitalised for CVD relative to stayers using multi-variable binomial regression models, controlling for age, gender, deprivation and ethnicity. Considered together, movers were 1.22 (1.19-1.26) times more likely than stayers to be hospitalised for CVD. Using the 5×5 deprivation origin-destination matrix to model a patient's risk of CVD based on upward, downward or sideways deprivation mobility, movers within the least deprived (NZDep2006 Quintile 1) areas were 10% less likely than stayers to be hospitalised for CVD, while movers within the most deprived (NZDep2006 Q5) areas were 45% more likely than stayers to have had their first CVD hospitalisation in 2006-2012 (RR: 1.45 [1.35-1.55]). Participants who moved upward also had higher relative risks of having a CVD event, although their risk was less than those observed for participants experiencing downward deprivation mobility. This research suggests that residential mobility is an important determinant of CVD in Auckland. Further investigation is required to determine the impact moving has on the risk of
Tan, Lee; Carr, Julia; Reidy, Johanna
This paper provides New Zealand evidence on the effectiveness of primary care investment, measured through the Capital and Coast District Health Board's (DHB) Primary Health Care Framework. The Framework was developed in 2002/2003 to guide funding decisions at a DHB level, and to provide a transparent basis for evaluation of the implementation of the Primary Health Care Strategy in this district. The Framework used a mixed method approach; analysis was based on quantitative and qualitative data. This article demonstrates the link between investment in primary health care, increased access to primary care for high-need populations, workforce redistribution, and improved health outcomes. Over the study period, ambulatory sensitive hospitalisations and emergency department use reduced for enrolled populations and the District's immunisation coverage improved markedly. Funding and contracting which enhanced both 'mainstream' and 'niche' providers combined with community-based health initiatives resulted in a measurable impact on a range of health indicators and inequalities. Maori primary care providers improved access for Maori but also for their enrolled populations of Pacific and Other ethnicity. Growth and redistribution of primary care workforce was observed, improving the availability of general practitioners, nurses, and community workers in poorer communities.
Symptom presentations and other characteristics of colorectal cancer patients and the diagnostic performance of the Auckland Regional Grading Criteria for Suspected Colorectal Cancer in the South Auckland population.
Hsiang, John C; Bai, Wayne; Lal, Dinesh
This study reviews the presenting symptoms of colorectal cancer in the ethnically diverse Middlemore Hospital referral population of South Auckland, New Zealand. The performance of the newly introduced Auckland Regional Grading Criteria as prediction tool for selecting colorectal cancer cases referred from primary care was evaluated in this group. Retrospective review of all colorectal cancer (CRC) cases diagnosed between January 2006 and January 2011. Information extracted from case note review was used to grade patients using the Auckland Regional Grading Criteria. A total of 799 patients were included. The commonest symptoms were: rectal bleeding (25.5-42.3%) and change in bowel habit (20.6-26.8%). Low-risk symptoms including abdominal pain (16.3-46.8%) and weight loss (18.4-26.1%) were not uncommon. 64.4% of Maori and 64.9% of Pacific patients had stage III or IV cancers. Pacific patients had more stage IV disease, 37.7% (pAuckland Regional Grading Criteria would miss 24.7% of the patients with CRC in the referral population. While rectal bleeding and change in bowel habit are frequent presenting symptoms, low-risk atypical symptoms including constipation, weight loss and abdominal pain were not uncommon. Significant proportion of Pacific patients present with late-stage disease. The current Auckland Regional grading criteria would miss significant proportion of our study population with colorectal cancer.
Bozeman, Barry; Slade, Catherine; Hirsch, Paul
Research involving human participants continues to grow dramatically, fueled by advances in medical technology, globalization of research, and financial and professional incentives. This creates increasing opportunities for ethical errors with devastating effects. The typical professional and policy response to calamities involving human participants in research is to layer on more ethical guidelines or strictures. We used a recent case-the Johns Hopkins University/Kennedy Kreiger Institute Lead Paint Study-to examine lessons learned since the Tuskegee Syphilis Study about the role of institutionalized science ethics in the protection of human participants in research. We address the role of the institutional review board as the focal point for policy attention.
von Hurst, Pamela R; Stonehouse, Welma; Coad, Jane
To determine the vitamin D status of women of South Asian origin living in Auckland, New Zealand, and to investigate their attitudes and behaviours with regard to sun exposure. Cross-sectional study. Auckland, New Zealand. Women of South Asian origin (n 235) aged 20 years and older were tested for serum 25(OH)D, and 228 were included in these analyses. Of these, 140 completed a questionnaire about attitudes and behaviours to sun exposure, and health motivation. Exclusion criteria included high dose (>1000 IU/d) supplementation with 25(OH)D3, or any supplementation with 1,25(OH)2D3. As serum vitamin D concentrations were not normally distributed, data are reported as median (25th, 75th percentile). Median serum 25(OH)D3 was 27.5 (18.0, 41.0) nmol/l. Adequate concentrations (>50 nmol/l) were observed in only 16 % of the subjects. Concern about skin cancer and the strength of the New Zealand sun were the most prevalent reasons given for sun avoidance, with 65 % saying they did avoid the sun. However, a seasonal variation was observed, with concentrations reducing significantly (P < 0.001) from summer through to early spring by 19.5 nmol/l. The results of the present study suggest that South Asian women are at high risk of hypovitaminosis D, due, in part, to deliberate sun avoidance and an indoor lifestyle, and that they are especially vulnerable in winter and spring.
... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned..., NCHS; discussion of vital statistics; future program reviews; National Health Interview Survey 2017...
... University of the Health Sciences AGENCY: Department of Defense, Uniformed Services University of the Health... Uniformed Services University of the Health Sciences. DATES: Tuesday, October 25, 2011, from 8:30 a.m. to 11... FURTHER INFORMATION CONTACT: Janet S. Taylor, Designated Federal Officer, 4301 Jones Bridge Road, Bethesda...
Full Text Available The traditional diet in Greenland consists to a large extent of meat and organs of seal and other marine mammals, which is polluted by POPs and mercury. These substances are present in the blood of Greenlanders in concentrations well above international guidelines, and as these contaminants are suspected of having negative impacts on health, some action should be taken. On the other hand, traditional food is also an important source of health promoting micronutrients that are not provided by imported food in sufficient quantities, for example vitamin D, long chain n-3 fatty acids, and selenium, not to mention the traditional diet's function as a social glue that is perceived as important for Inuit identity in Greenland. The proportion of the total diet that comes from marine mammals is on a constant decrease, and especially children and young adults consume rather little seal and whale. The traditional food items are consequently being replaced by imported food, and among the imported food items several rather unhealthy items are popular, that is carbonated soft drinks with sugar, sweets, chips and farmed (red meat with a high content of saturated fat. Together with a decrease in physical activity, this dietary transition has resulted in a severe epidemic of overweight and diabetes. In giving advice to the public, the Greenland Board of Nutrition was therefore faced with the challenge to retain the benefits of the traditional diet while minimizing the contaminant exposure, and at the same time to counteract the effects of poor quality imported food. The Board tried to balance the known and suspected positive and negative aspects of the total diet in relation not only to physical health but to general wellbeing, and decided on 10 simple recommendations. As the consumption of traditional food becomes less prominent and as the consumption of food rich in empty calories increases, the guidelines are continuously revised and updated.
Bjerregaard, Peter; Mulvad, Gert
The traditional diet in Greenland consists to a large extent of meat and organs of seal and other marine mammals, which is polluted by POPs and mercury. These substances are present in the blood of Greenlanders in concentrations well above international guidelines, and as these contaminants are suspected of having negative impacts on health, some action should be taken. On the other hand, traditional food is also an important source of health promoting micronutrients that are not provided by imported food in sufficient quantities, for example vitamin D, long chain n-3 fatty acids, and selenium, not to mention the traditional diet's function as a social glue that is perceived as important for Inuit identity in Greenland. The proportion of the total diet that comes from marine mammals is on a constant decrease, and especially children and young adults consume rather little seal and whale. The traditional food items are consequently being replaced by imported food, and among the imported food items several rather unhealthy items are popular, that is carbonated soft drinks with sugar, sweets, chips and farmed (red) meat with a high content of saturated fat. Together with a decrease in physical activity, this dietary transition has resulted in a severe epidemic of overweight and diabetes. In giving advice to the public, the Greenland Board of Nutrition was therefore faced with the challenge to retain the benefits of the traditional diet while minimizing the contaminant exposure, and at the same time to counteract the effects of poor quality imported food. The Board tried to balance the known and suspected positive and negative aspects of the total diet in relation not only to physical health but to general wellbeing, and decided on 10 simple recommendations. As the consumption of traditional food becomes less prominent and as the consumption of food rich in empty calories increases, the guidelines are continuously revised and updated.
Martini, Nataly; Basdew, Kamlika; Kammona, Ala; Shen, Amy; Taylor, Caragh; McIntosh, Timothy R; Barnes, Joanne
To explore the views of New Zealand pharmacists on bowel cancer screening, particularly with regards to faecal occult blood testing (FOBT) kits, self-perceived knowledge on FOBT kits and barriers, motivators and experiences with selling and counselling consumers with respect to FOBT kits. Semi-structured interviews were conducted face to face or by telephone with 20 community pharmacists in the Auckland region. Interviews were recorded and transcribed verbatim and data were coded and analysed using NVivo software to identify key themes. Participant pharmacists believed that they were well placed to provide advice on FOBT kits to consumers. Barriers to selling the kits included cost and perceived lack of test sensitivity of the kits, poor consumer demand, pharmacists' lack of training and information, and a belief that selling FOBT kits was outside the pharmacists' scope of practice. Motivators to selling the kits included customer convenience, ease of use, confidence in the kits and embracing new roles for pharmacists. Pharmacists were concerned that use of the kits may increase the burden on the public health system through customer anxiety over test results; however, they agreed that there was a need for bowel cancer screening and awareness and that people concerned about bowel cancer should make visiting their general practitioner a priority. Pharmacists' views were mixed. Pharmacists' training and competence with respect to the provision of bowel cancer kits, and how a bowel cancer screening service can be developed to optimise public health outcomes, need to be addressed. © 2013 Royal Pharmaceutical Society.
Tupai-Firestone, Ridvan; Tuisano, Hana; Manukia, Moana; Kaholokula, Keawe'aimoku; Foliaki, Sunia; Kingi, Te Kani; Kruger, Rozanne; Breier, Bernhard; O'Connell, Angelique; Kruger, Rozanne; Borman, Barry; Ellison-Loschmann, Lis
In New Zealand, the burden of obesity is greatest among Pacific people, especially in children and adolescents. We investigated the factors of the obesogenic environment that were indigenous to Pasifika youths' social-cultural context, their food purchasing behaviours, and associated anthropometric measures. An exploratory study of 30 Pasifika youth aged 16-24 years in Wellington and Auckland, New Zealand. A large proportion of the participants were obese (mean body mass index: 31.0kg/m2; waistto-hip ratio: 0.84; waist-to-height ratio: 0.6), suggesting that the future health and wellbeing trajectory of the studied Pasifika youth is poor. Purchasing behaviours of food and snacks over a 7-day period provided meaningful insights that could be a useful future research tool to examine the role of their physical environment on food access and availability. From this exploratory study, we highlight the following: (i) the future health trajectory of Pasifika youth is poor. Developing the youths' healthy lifestyle knowledge may lend itself to developing culturally relevant intervention programmes; (ii) identifying the enablers and barriers within the Pasifika ontext of an obesogenic environment can provide very useful information; (iii) use of spatial analysis using purchased food receipts adds to the current knowledge base of obesity-related research, although this was an exploratory investigation. We need to address these highlights if we are to reverse the trend of obesity for this population.
Franco, Natália M; Medeiros, Gabriel F; Silva, Edson A; Murta, Angela S; Machado, Aydano P; Fidalgo, Robson N
This work presents a Modeling Language and its technological infrastructure to customize the vocabulary of Communication Boards (CB), which are important tools to provide more humanization of health care. Using a technological infrastructure based on Model-Driven Development (MDD) approach, our Modelin Language (ML) creates an abstraction layer between users (e.g., health professionals such as an audiologist or speech therapist) and application code. Moreover, the use of a metamodel enables a syntactic corrector for preventing creation of wrong models. Our ML and metamodel enable more autonomy for health professionals in creating customized CB because it abstracts complexities and permits them to deal only with the domain concepts (e.g., vocabulary and patient needs). Additionally, our infrastructure provides a configuration file that can be used to share and reuse models. This way, the vocabulary modelling effort will decrease our time since people share vocabulary models. Our study provides an infrastructure that aims to abstract the complexity of CB vocabulary customization, giving more autonomy to health professionals when they need customizing, sharing and reusing vocabularies for CB.
... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned...; review of the ambulatory and hospital care statistics program; a discussion of the NHANES genetics...
... on the future course for health communications and marketing at CDC; and a discussion of focus areas... Scientific Counselors, National Center for Health Marketing (BSC, NCHM) In accordance with section 10(a)(2..., goals and organizational structure of the new Office of Communications; discussions on program...
Balmukhanov, S.B.; Raisova, G.K.; Balmukhanov, T.S.; Voronin, A.M.; Sandybaev, M.N.
It is performed the detailed investigation the health status of Semipalatinsk region population affected by constant radioactive irradiation during 40 years. The special attention attached to such pathologies as cancer, congenial defects of development and pathologies of cardio-vascular and nervous systems. It is also characterized the children health status. (author)
... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service, Scientific Merit... management, and nursing research. Applications are reviewed for scientific and technical merit, mission... Advisory Committee Act, 5 U.S.C. App. 2, that the Health Services Research and Development Service (HSR&D...
..., and prevention of physical and mental diseases and other impairments; (2) assist states and their... Health Effects; presentation on NCEH/ ATSDR Internal Clearance and External Peer Review Policies and...
Full text: A retrospective review of Yttrium 90 synovectomies carried out from June 1997 to February 1999 in Auckland Hospital to determine outcome from the procedure. Methods: Patients were sent a questionnaire for each treated knee The principal outcome measures assessed in the month prior and the 6 months after the Y90 were pain, swelling, walking distance and overall disability score. Referring doctors were sent a questionnaire to provide information on duration of synovitis and treatment. Outcomes measured were presence of effusion 6 months after the Y90, requirement for intra-articular steroid in the 12 months prior to and after the yttrium and change of therapy due lo ongoing symptoms in the treated knee. Results: 29 patients and 40 knees had Y90 during the study period 86% patients with 87.5% knees responded. Referring doctors for 86% patients accounting for 87.5% knees responded. The procedure was well tolerated with the majority of patients reporting nil-mild discomfort during and in the 24 hours after Y90. 86% knees treated reported improvement with a reduction in pain and swelling Patient global assessment reduced from 3.8 to 2.0 while physician global assessment reduced from 3.9 to 3.0. There was an improvement in walking distance 6 months after Y90 with the number of knees able to walk >1km increasing from 2 to 17 14 of 25 patients required a change in treatment because of ongoing problems in the treated knee and one patient has undergone knee joint replacement One further patient is waiting knee joint replacement The need for intra-articular steroid was reduced with 83%, knees having an average of 2.4 steroid injections in the 12 months prior to Y90 compared to 38% knees having an average of 0.7 steroid injections in the 12 months after Y90. Of the 30 knees reporting Improvement 24 knees are at least 12 months post Y90. Of these 50% were Improved at 12 months. As a result of this audit we continue to offer this procedure in the Auckland area, and
A board game comprises a board, a number of counters and two dice. The board is marked to provide a central area, representing the nucleus of an atom, and six or more annular rings extending concentrically around the central area, the rings being divided into 2,8,18,32,48 and 72 squares. Each ring represents an electron shell, and some of the squares are numbered, the number representing the atomic number of different elements. (author)
Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert
To quantify and compare knowledge of diabetes including risk factors for diabetes-related complications among the three main groups of primary health care nurses. In a cross-sectional survey of practice, district and specialist nurses (n=1091) in Auckland, New Zealand, 31% were randomly sampled to complete a self-administered questionnaire and telephone interview, designed to ascertain nurses' knowledge of diabetes and best practice, in 2006-2008. All 287 nurses (response rate 86%) completed the telephone interview and 284 the self-administered questionnaire. Major risk factors identified by nurses were excess body weight for type 2 diabetes (96%) and elevated plasma glucose levels or glycosylated haemoglobin (86%) for diabetes-related complications. In contrast, major cardiovascular risk factors were less well identified, particularly smoking, although by more specialist nurses (43%) than practice (14%) and district (12%) nurses (p=0.0005). Cardiovascular complications, particularly stroke, were less well known than microvascular complications, and by significantly fewer practice (13%) and district (8%) nurses than specialist nurses (36%, p=0.002). In general, nurses had better knowledge of overweight as a risk factor for type 2 diabetes mellitus and elevated plasma glucose levels as a risk factor for diabetes-related complications compared with knowledge of cardiovascular risk factors, particularly smoking. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Silva, Martha; Clinton, Janet; Appleton, Sarah; Flanagan, Pat
Self-management education programs seek to help patients realize that they are their own principal caregivers and that health care professionals are consultants who support them in this role. The aim of this study was to evaluate a diabetes self-management education program implemented as part of a district-wide approach in South Auckland, New Zealand, which has some of the highest prevalence rates for diabetes and is one of the most ethnically diverse and deprived regions of New Zealand. Self-management attitudes and behaviors were monitored with the use of questionnaires before and after program implementation. Clinical outcomes such as hemoglobin A1c, body mass index, and blood pressure were also tracked before the program began and 3 months after the program ended. Participant focus groups and facilitator interviews were conducted to explore perceptions of the program. Participants showed improvement in attitudes toward their own ability to manage their diabetes; in diet, physical activity, and foot care; and in hemoglobin A1c levels 3 months after the end of participation. Participants also reduced their sense of isolation when dealing with their diabetes. However, catering to the needs of a multiethnic community is extremely resource-intensive because of the need to provide adequate language and cultural interpretation. Self-management education can work in multiethnic, high-needs communities in New Zealand. Programs must ensure they enable the appropriate mechanisms and have appropriate resources to support the community's needs.
... (from 7 a.m. to 2 p.m.). ADDRESSES: The meeting will be held at the Thayer Hotel, 674 Thayer Road, West...: Additional information, agenda updates, and meeting registration are available online at the Defense Health... casualties requiring transfusion, and the Joint Theater Trauma System, as well as the review of the...
Dr. A.L. van Staa; Dr. H.A. van der Stege; Dr. S.R. Hilberink; MSc E.J.M. Bakker
The aim of the study was to gain insight into use of a new board game (SeCZ TaLK) to facilitate discussing sexual health with adolescents with chronic conditions in healthcare and special education, and to establish impeding and facilitating factors for using the game.
Full Text Available A state-of-health (SOH estimation method for electric vehicles (EVs is presented with three main advantages: (1 it provides joint estimation of cell’s aging states in terms of power and energy (i.e., SOHP and SOHE—because the determination of SOHP and SOHE can be reduced to the estimation of the ohmic resistance increase and capacity loss, respectively, the ohmic resistance at nominal temperature will be taken as a health indicator, and the capacity loss is estimated based on a mechanistic model that is developed to describe the correlation between resistance increase and capacity loss; (2 it has wide applicability to various ambient temperatures—to eliminate the effects of temperature on the resistance, another mechanistic model about the resistance against temperature is presented, which can normalize the resistance at various temperatures to its standard value at the nominal temperature; and (3 it needs low computational efforts for on-board application—based on a linear equation of cell’s dynamic behaviors, the recursive least-squares (RLS algorithm is used for the resistance estimation. Based on the designed performance and validation experiments, respectively, the coefficients of the models are determined and the accuracy of the proposed method is verified. The results at different aging states and temperatures show good accuracy and reliability.
Yu, Yan; Zhou, Yaping; Zhao, Xuefeng; Li, Dongsheng; Ou, Jinping
As an important part of new information technology, the Internet of Things(IoT) is based on intelligent perception, recognition technology, ubiquitous computing, ubiquitous network integration, and it is known as the third wave of the development of information industry in the world after the computer and the Internet. And Smart Phones are the general term for a class of mobile phones with a separate operating system and operational memory, in which the third-party service programs including software, games, navigation, et.al, can be installed. Smart Phones, with not only sensors but also actuators, are widely used in the IoT world. As the current hot issues in the engineering area, Structural health monitoring (SHM) is also facing new problems about design ideas in the IoT environment. The development of IoT, wireless sensor network and mobile communication technology, provides a good technical platform for SHM. Based on these facts, this paper introduces a kind of new idea for Structural Health Monitoring using Smart Phones Technique. The system is described in detail, and the external sensor board based on Bluetooth interface is designed, the test based on Smart Phones is finished to validate the implementation and feasibility. The research is preliminary and more tests need to be carried out before it can be of practical use.
Gyani, Girdhar J; Krishnamurthy, B
Quality in health care is important as it is directly linked with patient safety. Quality as we know is driven either by regulation or by market demand. Regulation in most developing countries has not been effective, as there is shortage of health care providers and governments have to be flexible. In such circumstances, quality has taken a back seat. Accreditation symbolizes the framework for quality governance of a hospital and is based on optimum standards. Not only is India establishing numerous state of the art hospitals, but they are also experiencing an increase in demand for quality as well as medical tourism. India launched its own accreditation system in 2006, conforming to standards accredited by ISQua. This article shows the journey to accreditation in India and describes the problems encountered by hospitals as well as the benefits it has generated for the industry and patients.
Full Text Available Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%, followed by Pseudomonas (21.3%. Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p≤0.05. Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%, cefuroxime (33.3%, and chloramphenicol (94.7% showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51% and ciprofloxacin (98.8% showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres.
Kulasegaran, Suheelan; Cribb, Benjamin; Vandal, Alain C; McBride, Stephen; Holland, David; MacCormick, Andrew D
The aims of this paper were to review our experience with necrotizing fasciitis at Middlemore Hospital and to define the trends in incidence, inpatient mortality and microbiological profile. A computerized search of the electronic medical records was undertaken to identify adult patients with a diagnosis of necrotizing fasciitis between January 2000 and December 2010. A retrospective review of the clinical records was performed. Of the 138 patients with necrotizing fasciitis identified, 129 had their diagnosis confirmed at operation. The mortality at 30 days was 20.3% (95% confidence interval (CI) 13.9%-28.0%). There was a significant reduction in hospital mortality in each successive year of the study period with an odds ratio of 0.84 (95% CI 0.71-0.98, P = 0.03). A pattern of increasing incidence was noted until February 2004 (95% CI September 2002-July 2005). This was followed by a significant decrease in incidence. The empirical antibiotic regime of clindamycin, gentamicin and penicillin provides satisfactory cover against 95% of the causative pathogens. This represents the largest single-centre published case series in New Zealand. Despite concerns of increasing incidence and mortality associated with necrotizing fasciitis in New Zealand, the experience in South Auckland shows a decrease in incidence of necrotizing fasciitis since 2004 and a statistically significant decreasing trend in hospital mortality. © 2015 Royal Australasian College of Surgeons.
Marasini, S; Swift, S; Dean, S J; Ormonde, S E; Craig, J P
Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%), followed by Pseudomonas (21.3%). Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p ≤ 0.05). Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%), cefuroxime (33.3%), and chloramphenicol (94.7%) showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51%) and ciprofloxacin (98.8%) showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres.
Bebbington, Mark S.
The idea of a volcanic field `boundary' is prevalent in the literature, but ill-defined at best. We use the elliptically constrained vents in the Auckland Volcanic Field to examine how spatial intensity models can be tested to assess whether they are consistent with such features. A means of modifying the anisotropic Gaussian kernel density estimate to reflect the existence of a `hard' boundary is then suggested, and the result shown to reproduce the observed elliptical distribution. A new idea, that of a spatio-volumetric model, is introduced as being more relevant to hazard in a monogenetic volcanic field than the spatiotemporal hazard model due to the low temporal rates in volcanic fields. Significant dependencies between the locations and erupted volumes of the observed centres are deduced, and expressed in the form of a spatially-varying probability density. In the future, larger volumes are to be expected in the `gaps' between existing centres, with the location of the greatest forecast volume lying in the shipping channel between Rangitoto and Castor Bay. The results argue for tectonic control over location and magmatic control over erupted volume. The spatio-volumetric model is consistent with the hypothesis of a flat elliptical area in the mantle where tensional stresses, related to the local tectonics and geology, allow decompressional melting.
Braatvedt, Geoffrey; Tekiteki, Amelia; Britton, Holly; Wallace, John; Khanolkar, Manish
To examine the length of stay and need for intensive care of people admitted with diabetic ketoacidosis (DKA) to a single centre between 1988 and 2011. Patients aged ≥15 years admitted for the first time with DKA (plasma glucose ≥ 10mmol/L and a bicarbonate concentration ≤15mmol/L and a pH Auckland City Hospital from 1988-2011 were identified retrospectively. The patients were divided into four cohorts (1988-1996; 1997-2001; 2002-2006; 2007-2011). Over this time period there was no significant change to the insulin infusion protocol. There were 576 admissions with DKA in 388 people over the 23 years. The mean age of the patients and glucose concentration at presentation to hospital fell significantly over time. The admission pH and bicarbonate concentration was higher in more recent cohorts. The length of stay and need for intensive care admission fell significantly over time, but the number of patients subsequently readmitted with DKA remained high. In-hospital mortality remained low. DKA remains an important reason for admission to this hospital, but the severity of DKA at presentation has reduced over time. The need for intensive care admission and length of stay has fallen dramatically.
Swift, S.; Dean, S. J.; Ormonde, S. E.
Background. The bacteria isolated from severe cases of keratitis and their antibiotic sensitivity are recognised to vary geographically and over time. Objectives. To identify the most commonly isolated bacteria in keratitis cases admitted over a 24-month period to a public hospital in Auckland, New Zealand, and to investigate in vitro sensitivity to antibiotics. Methods. Hospital admissions for culture-proven bacterial keratitis between January 2013 and December 2014 were identified. Laboratory records of 89 culture positive cases were retrospectively reviewed and antibiotic sensitivity patterns compared with previous studies from other NZ centres. Results. From 126 positive cultures, 35 species were identified. Staphylococcus was identified to be the most common isolate (38.2%), followed by Pseudomonas (21.3%). Over the last decade, infection due to Pseudomonas species, in the same setting, has increased (p ≤ 0.05). Aminoglycosides, cefazolin, ceftazidime, erythromycin, tetracycline, and doxycycline were 100% effective against tested isolates in vitro. Amoxicillin (41.6%), cefuroxime (33.3%), and chloramphenicol (94.7%) showed reduced efficacy against Gram-negative bacteria, whereas penicillin (51%) and ciprofloxacin (98.8%) showed reduced efficacy against Gram-positive bacteria. Conclusions. Despite a shift in the spectrum of bacterial keratitis isolates, antibiotic sensitivity patterns have generally remained stable and show comparability to results within the last decade from NZ centres. PMID:27213052
Ofsted inspects and regulates services that care for children and young people, including boarding facilities. Medication management is an integral part of caring for children in boarding schools, and robust systems must be in place to pass inspection. These systems must cover how medicines are dispensed, administered and stored at the facility, risk assessments, identifying which pupils can manage their own medicines and the individual health needs of boarders, so that care plans can be put in place for children with specific needs.
Striewski, B.; Shulmeister, J.; Augustinus, P. C.; Soderholm, J.
Spectral analyses of quasi-annual organo-diatomaceous laminae couplets in an Auckland maar lake indicate brief (sub-decadal scale) episodes with strong spectral power and long periods of weak to no spectral power between c. 1700 to c. 550 cal. yr BP. Laminae couplet thickness appears to be a function of changes in wind flow over the basin, with enhanced wind flow deepening the mixing zone and providing additional nutrients for laminae formation. Aeolian dust from Australia amplifies the wind signal. Spectral signals in the high power episodes are focused in Auckland climate whereby strongly negative (positive) ENSO are associated with enhanced (diminished) SW airflow over Auckland. ENSO events interact in the modern climate and the spectral results indicate that this is the case when spectral power is strong in the laminae. These results highlight strong but intermittent ENSO activity between 600 and 1400 cal. yr BP.
Haas, Rachel M; Hannam, Jacqueline A; Sames, Christopher; Schmidt, Robert; Tyson, Andrew; Francombe, Marion; Richardson, Drew; Mitchell, Simon J
The treatment of divers for decompression illness (DCI) in Auckland, New Zealand, has not been described since 1996, and subsequent trends in patient numbers and demographics are unmeasured. This was a retrospective audit of DCI cases requiring recompression in Auckland between 01 January 1996 and 31 December 2012. Data describing patient demographics, dive characteristics, presentation of DCI and outcomes were extracted from case notes and facility databases. Trends in annual case numbers were evaluated using Spearman's correlation coefficients (ρ) and compared with trends in entry-level diver certifications. Trends in patient demographics and delay between diving and recompression were evaluated using regression analyses. There were 520 DCI cases. Annual caseload decreased over the study period (ρ = 0.813, P Auckland have declined significantly over the last 17 years. The most plausible explanation is declining diving activity but improvements in diving safety cannot be excluded. The delay between diving and recompression has reduced.
Williamson, Deborah A; Moreland, Nicole J; Carter, Philip; Upton, Arlo; Morgan, Julie; Proft, Thomas; Lennon, Diana; Baker, Michael G; Dunbar, Rod; Fraser, John D
To describe the molecular epidemiology of emm types associated with circulating pharyngeal group A streptococcus (GAS) isolates in Auckland, New Zealand. GAS isolates were collected over a 10-day period from a community pathology provider in Auckland. PCR analysis and sequencing of the emm gene was performed at the Institute of Environmental Science and Research. A total of 52 emm types were identified from 278 GAS isolates. The three most common emm types were emm1, emm89 and emm12. Overall, the experimental 30-valent GAS M protein vaccine covered 19 / 52 (37%) of emm types in our study. Our study provides baseline data on the circulating pharyngeal GAS emm types in Auckland. Future clinical and molecular surveillance of GAS pharyngitis is essential in the context of ongoing GAS vaccine development.
Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert
There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006-2008. Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access.
Weary, D M; Huzzey, J M; von Keyserlingk, M A G
We review recent research in one of the oldest and most important applications of ethology: evaluating animal health. Traditionally, such evaluations have been based on subjective assessments of debilitative signs; animals are judged ill when they appear depressed or off feed. Such assessments are prone to error but can be dramatically improved with training using well-defined clinical criteria. The availability of new technology to automatically record behaviors allows for increased use of objective measures; automated measures of feeding behavior and intake are increasingly available in commercial agriculture, and recent work has shown these to be valuable indicators of illness. Research has also identified behaviors indicative of risk of disease or injury. For example, the time spent standing on wet, concrete surfaces can be used to predict susceptibility to hoof injuries in dairy cattle, and time spent nuzzling the udder of the sow can predict the risk of crushing in piglets. One conceptual advance has been to view decreased exploration, feeding, social, sexual, and other behaviors as a coordinated response that helps afflicted individuals recover from illness. We argue that the sickness behaviors most likely to decline are those that provide longer-term fitness benefits (such as play), as animals divert resources to those functions of critical short-term value such as maintaining body temperature. We urge future research assessing the strength of motivation to express sickness behaviors, allowing for quantitative estimates of how sick an animal feels. Finally, we call for new theoretical and empirical work on behaviors that may act to signal health status, including behaviors that have evolved as honest (i.e., reliable) signals of condition for offspring-parent, inter- and intra-sexual, and predator-prey communication.
Steel, Allison; Erhardt, Robert; Phelps, Richard; Upham, Peter
We analyzed data from 65 schools that are U.S. members of The Association of Boarding Schools (TABS) to estimate how TABS member school graduates who enter college compare with college entrants from non-boarding schools on several long-term quality-of-life estimates. Although TABS students are more likely to graduate college than the population of…
Background Escherichia coli is a major human pathogen, both in community and healthcare settings. To date however, relatively few studies have defined the population burden of E. coli bloodstream infections. Such information is important in informing strategies around treatment and prevention of these serious infections. Against this background, we performed a retrospective, population-based observational study of all cases of E. coli bacteremia in patients presenting to our hospital between January 2005 and December 2011. Methods Auckland District Health Board is a tertiary-level, university-affiliated institution serving a population of approximately 500,000, within a larger metropolitan population of 1.4 million. We identified all patients with an episode of bloodstream infection due to E. coli over the study period. A unique episode was defined as the first positive E. coli blood culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated E. coli bacteremia. Demographic information was obtained for all patients, including: age; gender; ethnicity; length of stay (days); requirement for intensive care admission and all-cause, in-patient mortality. Results A total of 1507 patients had a unique episode of E. coli bacteremia over the study period. The overall average annual incidence of E. coli bacteremia was 52 per 100,000 population, and was highest in the under one year and over 65-year age groups. When stratified by ethnicity, rates were highest in Pacific Peoples and Māori (83 and 62 per 100,000 population respectively). The incidence of community-onset E. coli bacteremia increased significantly over the study period. The overall in-hospital mortality rate was 9% (135/1507), and was significantly higher in patients who had a hospital-onset E. coli bacteremia. Conclusions Our work provides valuable baseline data on the incidence of E. coli bacteremia in our locale
Williamson, Deborah A; Lim, Alwin; Wiles, Siouxsie; Roberts, Sally A; Freeman, Joshua T
Escherichia coli is a major human pathogen, both in community and healthcare settings. To date however, relatively few studies have defined the population burden of E. coli bloodstream infections. Such information is important in informing strategies around treatment and prevention of these serious infections. Against this background, we performed a retrospective, population-based observational study of all cases of E. coli bacteremia in patients presenting to our hospital between January 2005 and December 2011. Auckland District Health Board is a tertiary-level, university-affiliated institution serving a population of approximately 500,000, within a larger metropolitan population of 1.4 million. We identified all patients with an episode of bloodstream infection due to E. coli over the study period. A unique episode was defined as the first positive E. coli blood culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated E. coli bacteremia. Demographic information was obtained for all patients, including: age; gender; ethnicity; length of stay (days); requirement for intensive care admission and all-cause, in-patient mortality. A total of 1507 patients had a unique episode of E. coli bacteremia over the study period. The overall average annual incidence of E. coli bacteremia was 52 per 100,000 population, and was highest in the under one year and over 65-year age groups. When stratified by ethnicity, rates were highest in Pacific Peoples and Māori (83 and 62 per 100,000 population respectively). The incidence of community-onset E. coli bacteremia increased significantly over the study period. The overall in-hospital mortality rate was 9% (135/1507), and was significantly higher in patients who had a hospital-onset E. coli bacteremia. Our work provides valuable baseline data on the incidence of E. coli bacteremia in our locale. The incidence was higher that that
Schumann, Johann; Rozier, Kristin Y.; Reinbacher, Thomas; Mengshoel, Ole J.; Mbaya, Timmy; Ippolito, Corey
Unmanned aerial systems (UASs) can only be deployed if they can effectively complete their missions and respond to failures and uncertain environmental conditions while maintaining safety with respect to other aircraft as well as humans and property on the ground. In this paper, we design a real-time, on-board system health management (SHM) capability to continuously monitor sensors, software, and hardware components for detection and diagnosis of failures and violations of safety or performance rules during the flight of a UAS. Our approach to SHM is three-pronged, providing: (1) real-time monitoring of sensor and/or software signals; (2) signal analysis, preprocessing, and advanced on the- fly temporal and Bayesian probabilistic fault diagnosis; (3) an unobtrusive, lightweight, read-only, low-power realization using Field Programmable Gate Arrays (FPGAs) that avoids overburdening limited computing resources or costly re-certification of flight software due to instrumentation. Our implementation provides a novel approach of combining modular building blocks, integrating responsive runtime monitoring of temporal logic system safety requirements with model-based diagnosis and Bayesian network-based probabilistic analysis. We demonstrate this approach using actual data from the NASA Swift UAS, an experimental all-electric aircraft.
Brabazon, E D
This study aimed to compare trends in both hospital admissions and notifications of viral meningitis in the North Eastern Health Board (NEHB). Hospital admissions from 1997 to 2001, involving NEHB residents with an infectious disease diagnosis, were examined and viral meningitis cases were analyzed. During this period 265 NEHB residents were admitted to hospital with viral meningitis--an increase of 429% between 1997 and 2001 with the bulk of this increase during 2000 and 2001. A total of 1,234 bed days were taken up by this cohort and the mean length of stay was 4.5 days (95% CI 4.2 - 4.9). The number of viral meningitis notifications in the NEHB was 38 (ranging from 4 in 1997 to 11 in 2001). This number is much lower than expected given the corresponding number of hospital admissions for the same period. Thus, most cases were not notified which means that current surveillance systems under-estimate the disease burden of viral meningitis. Such under-reporting has implications for infectious disease policy in Ireland.
Sjardin, Natalia; Reed, Peter; Albert, Ben; Mouat, Fran; Carter, Phillipa J; Hofman, Paul; Cutfield, Wayne; Gunn, Alistair; Jefferies, Craig
It is important to understand whether type 2 diabetes mellitus (T2DM) is increasing in childhood for health-care planning and clinical management. The aim of this study is to examine the incidence of T2DM in New Zealand children, aged Auckland, New Zealand. Retrospective analysis of prospectively collected data from a population-based referral cohort from 1995 to 2015. Hundred and four children presented with T2DM over the 21-year period. The female:male ratio was 1.8:1, at mean (standard deviation) age 12.9 (1.9) years, body mass index standard deviation score +2.3 (0.5), blood sugar 15.3 (8.5) mmol/L, HbA1c 76 (28) mmol/mol. At diagnosis, 90% had acanthosis nigricans and 48% were symptomatic. In all, 33% were Maori, 46% Pacific Island, 15% Asian/Middle Eastern and 6% European. There was a progressive secular increase of 5% year on year in incidence. The overall annual incidence of T2DM <15 years of age was 1.5/100 000 (1.2-1.9) (95% confidence interval), with higher rates in Pacific Island (5.9/100 000) and Maori (4.1/100 000). The incidence of T2DM in children <15 years of age in New Zealand has increased progressively at 5%/year over the last 21 years. The risk was disproportionately associated with girls and children from high-risk ethnic groups. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Rush, E; Oliver, M; Plank, L D; Taylor, S; Iusitini, L; Jalili-Moghaddam, S; Savila, F; Paterson, J; Tautolo, E
Purpose This article profiles a birth cohort of Pacific children participating in an observational prospective study and describes the study protocol used at ages 14–15 years to investigate how food and activity patterns, metabolic risk and family and built environment are related to rates of physical growth of Pacific children. Participants From 2000 to 2015, the Pacific Islands Families Study has followed, from birth, the growth and development of over 1000 Pacific children born in Auckland, New Zealand. In 2014, 931 (66%) of the original cohort had field measures of body composition, blood pressure and glycated haemoglobin. A nested subsample (n=204) was drawn by randomly selecting 10 males and 10 females from each decile of body weight. These participants had measurement of body composition by dual-energy X-ray absorptiometry, food frequency, 6 min walk test and accelerometer-determined physical activity and sedentary behaviours, and blood biomarkers for metabolic disease such as diabetes. Built environment variables were generated from individual addresses. Findings to date Compared to the Centres for Disease Control and Prevention (CDC) reference population with mean SD scores (SDS) of 0, this cohort of 931 14-year-olds was taller, weighed more and had a higher body mass index (BMI) (mean SDS height >0.6, weight >1.6 and BMI >1.4). 7 of 10 youth were overweight or obese. The nested-sampling frame achieved an even distribution by body weight. Future plans Cross-sectional relationships between body size, fatness and growth rate, food patterns, activity patterns, pubertal development, risks for diabetes and hypertension and the family and wider environment will be examined. In addition, analyses will investigate relationships with data collected earlier in the life course and measures of the cohort in the future. Understanding past and present influences on child growth and health will inform timely interventions to optimise future health and reduce
OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence
Examines the Chinese immigrant community in Auckland, New Zealand and how they address the question of first language maintenance in their largely new English-speaking environment. Shows that language maintenance, especially the written language is going to be an uphill struggle. (Author/VWL)
Bolton, Patricia; Dirks, Kim; Neuwelt, Pat
Community engagement in natural hazard preparedness is crucial to ensure sustainable initiatives. Children are important members of communities, and can actively contribute to community preparedness. This article presents research undertaken with 11- to 12-year-old students from a school in Auckland, New Zealand, and leaders associated with the…
Gascoyne, Alexandra; Beyene, Kebede; Stewart, Joanna; Aspden, Trudi; Sheridan, Janie
The practice of medication sharing, the lending (giving) or borrowing (taking) of prescription medicines, has been reported increasingly in the literature. This study aimed to investigate prescription medication sharing practices among adults in Auckland, New Zealand. Community pharmacies in Auckland. A cross-sectional survey was conducted in ten community pharmacies in Auckland during March, 2012. Clients were invited to complete an anonymous questionnaire to assess their medication sharing practices. Proportion of respondents reporting lending or borrowing; information provided or received. Of all participants (N = 642), 25.5% reported borrowing, and 24.1% reported lending prescribed medicines in the past year. Furthermore, 14.8% of participants reported ever giving a child's prescribed medicine to another child in their care, and 49.8% reported having leftover prescription medicines at home. Of those who borrowed medicines (n = 164), 56.1% received written medication instructions from the lender, and of the lenders (n = 155), 47.1% provided verbal instructions with the lent medicines. The sharing of prescription medicines in Auckland appears to be similar to that reported in other developed countries, and it is now clear that information provision while sharing does not always occur. Approaches to reduce harm resulting from sharing medicines should be explored.
Leung, Bonnie; Taylor, Susan; Drinkovic, Dragana; Roberts, Sally; Carter, Phil; Best, Emma
To characterise Haemophilus influenzae type b (Hib) invasive disease in the era of Hib vaccination, in children of the greater Auckland region of New Zealand. Identification of sterile site culture positive Hib via the Auckland hospital laboratories databases and national laboratory surveillance database in the time period; 1995 to 2009. There were a total of 26 cases in the Auckland Region. Over the 15-year period, the annual incidence of invasive Hib disease was 0.61 per 100,000 (95% CI: 0.4-0.9) for children aged under 15 years and 1.65 per 100,000 (95% CI: 1.1-2.5) for children aged under 5 years. Ninety-two percent were under 5 years and 54% were under 1 year. Sixty percent of the children were of Maori and Pacific ethnicity. The predominant diagnosis was meningitis, accounting for 15 cases (60%). There were no fatalities. Forty-eight percent of affected children were completely unimmunised with the Hib vaccine which has been fully funded on the National Immunisation Schedule since 1994. Since the introduction of the Hib vaccine, the disease rates have greatly reduced in the Auckland region. Although ethnic disparities have improved amongst the cases that occur, immunisation rates in cases are low and infants remain most at risk. Current emphasis on intensifying immunisation programmes to achieve higher vaccination rates and timeliness of delivery will help in efforts to achieve elimination of the disease in New Zealand.
The following article asks about the speeches, practices, representations and experiences on health, hygiene and illnes in boarding schools early last century, taking for instance the School of Arts and Crafts of the Salesian Congregation, with the intention of revisiting the dialogue between medicine, hygiene and school in the context of development of the social question, the result of accelerated modernization process experienced by the city of Córdoba.
Smid, E. R.; McGee, L. E.; Smith, I. E.; Lindsay, J. M.
The Auckland Volcanic Field (AVF) is a nephelinitic to subalkali basaltic monogenetic field centered on the city of Auckland, New Zealand. Lavas are olivine-phyric, and the deposits of several volcanoes in the field contain olivine crystals with chrome spinel (Cr-spinel) inclusions. Microprobe analyses show at least two populations of olivine, categorised by their Mg# and their spinel inclusion compositions: the first has olivines that are euhedral, have compositions slightly less forsteritic than expected for whole rock Mg#, and have Cr-spinel inclusions with relatively low Cr2O3 contents of ~20%. These are interpreted as antecrysts inherited from the mantle source that yielded their host magma. The second population is characterised by olivines that are sub- to euhedral, are significantly more forsteritic than expected from their host whole rock Mg#, and have Cr-spinel inclusons with relatively high Cr2O3 contents of ~50%. These are interpreted as xenocrysts. The composition of these high Cr2O3 spinels very closely resembles the composition of spinels within olivines in dunite sampled from the Dun Mountain Ophiolite on the South Island of New Zealand. The northward extension of the Dun Mountain complex beneath the North Island is defined by the Junction Magnetic Anomaly, marking a crustal terrane boundary that underlies the Auckland Volcanic Field. These data indicate that the magmas that have risen to produce the volcanoes of the Auckland Volcanic Field have carried crystals from an underlying ultramafic crust as well as from their asthenospheric source. Euhedral olivine crystals which do not contain Cr-spinel are also present in AVF lavas and these are interpreted as true phenocrysts that crystallised directly from their host magmas. The lack of reaction textures at crystal margins suggests rapid ascent rates. A crustal origin for the xenocrysts not only has large implications for ascent rate modelling of olivines, but also for the crustal structure of the
Umbdenstock, R J
The governing board's role in health care is not changing, but new competitive forces necessitate a refinement of the board's approach to fulfilling its role. In a free-standing, community, not-for-profit hospital, the board functions as though it were the "owner." Although it does not truly own the facility in the legal sense, the board does have legal, fiduciary, and financial responsibilities conferred on it by the state. In a religious-sponsored facility, the board fulfills these same obligations on behalf of the sponsoring institute, subject to the institute's reserved powers. In multi-institutional systems, the hospital board's power and authority depend on the role granted it by the system. Boards in all types of facilities are currently faced with the following challenges: Fulfilling their basic responsibilities, such as legal requirements, financial duties, and obligations for the quality of care. Encouraging management and the board itself to "think strategically" in attacking new competitive market forces while protecting the organization's traditional mission and values. Assessing recommended strategies in light of consequences if constituencies think the organization is abandoning its commitments. Boards can take several steps to match their mode of operation with the challenges of the new environment. Boards must rededicate themselves to the hospital's mission. Trustees must expand their understanding of health care trends and issues and their effect on the organization. Boards must evaluate and help strengthen management's performance, rather than acting as a "watchdog" in an adversarial position. Boards must think strategically, rather than focusing solely on operational details. Boards must evaluate the methods they use for conducting business.
Full Text Available Background and Objectives: Problems caused by menstruation are common among women. Focus group discussions are a method of data collection in which a small group of participants discuss a specified topic or issue. This study mainly aimed to determine the effects of health education based on focus group discussions on the promotion of health behaviors of female adolescents residing boarding centers of the Welfare Organization (Tehran, Iran during their menstruation periods. Materials and Methods: This quasi-experimental interventional study recruited all eligible 12-19-year-old female residents (n=61 of the boarding centers affiliated to the Welfare Organization, Tehran, Iran. The data collection tool was a questionnaire including demographic information and puberty health behaviors (health behaviors during the menstruation period. The questionnaires were completed through interviews before and one month after training. The educational intervention lasted for three months. Data were analyzed using paired t and Kolmogorov-Smirnov tests in SPSS16. Results: The mean scores of performance increased from 12.11±4.43 before the intervention to 16.50±2.79 after the intervention (P<0.001. Conclusion: Since the educational intervention based on focus group discussions had positive effects on the participants’ puberty health, such discussions are recommended to educate adolescent girls about puberty issues.
Sydney and Auckland have similar climates, cultures and urban form. However, methods for reducing carbon emissions and energy use are completely different. Auckland has low carbon buildings due to the large proportion of renewable energy in the electricity supply. However, it is a car dependent city and lacks resilience in transport energy. Sydney has high carbon buildings due to the large proportion of coal used to generate electricity. However, its public transport system is more resilient ...
Enggaard, Helle; Moselund, Lene
Projekt ’BuddyBoard’ er kommet i stand via et samarbejde mellem Frederikshavn kommune, Bunker43 og Lab. X. Afdeling en ’Havly’ på Sæby Ældrecenter fungerer som living lab, hvilket betyder, at det udgør et levende laboratorium for udvikling og afprøvning af teknologi (Schultz, 2013). Projektet er....... Bunker43 har udviklet en teknologi (BuddyBoard) til hurtig formidling af billeder fra pårørende og personale til beboere på institutioner. Pårørende og personale uploader billeder via en APP eller en hjemmeside og har mulighed for at tilføje en kort forklarende tekst til hvert billede. Beboeren ser...... billederne via en tablet. Systemet bygger på et simpelt og brugervenligt design, så ældre med kognitive og/eller fysiske funktionsnedsættelser kan anvende teknologien. BuddyBoard fungerer via internettet, og billederne gemmes på en sikret server hos udbyderen, som er Bunker43. Intentionerne med BuddyBoard er...
Pautet, P. D.; Ma, J.; Taylor, M. J.; Bossert, K.; Doyle, J. D.; Eckermann, S. D.; Williams, B. P.; Fritts, D. C.
The DEEPWAVE project recently took place in New Zealand during the months of June and July 2014. This international program focused on investigating the generation and deep propagation of atmospheric gravity waves. A series of instruments was operated at several ground-based locations and on-board the NSF Gulfstream V aircraft. 26 research flights were performed to explore possible wave sources and their effects on the middle and upper atmosphere. On July 14th, a research flight was conducted over the Auckland Islands, a small sub Antarctic archipelago located ~450km south of New Zealand. Moderate southwesterly tropospheric wind (~25m/s) was blowing over the rugged topography of the islands, generating mountain wave signature at the flight altitude. Spectacular small-scale gravity waves were simultaneously observed at the mesopause level using the USU Advanced Mesospheric Temperature Mapper (AMTM). Their similarity with the model-predicted waves was striking. This presentation will describe this remarkable case of deep wave propagation and compare the measurements obtained with the instruments on-board the aircraft with forecasting and wave propagation models.
Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.
Rush, E; Oliver, M; Plank, L D; Taylor, S; Iusitini, L; Jalili-Moghaddam, S; Savila, F; Paterson, J; Tautolo, E
This article profiles a birth cohort of Pacific children participating in an observational prospective study and describes the study protocol used at ages 14-15 years to investigate how food and activity patterns, metabolic risk and family and built environment are related to rates of physical growth of Pacific children. From 2000 to 2015, the Pacific Islands Families Study has followed, from birth, the growth and development of over 1000 Pacific children born in Auckland, New Zealand. In 2014, 931 (66%) of the original cohort had field measures of body composition, blood pressure and glycated haemoglobin. A nested subsample (n=204) was drawn by randomly selecting 10 males and 10 females from each decile of body weight. These participants had measurement of body composition by dual-energy X-ray absorptiometry, food frequency, 6 min walk test and accelerometer-determined physical activity and sedentary behaviours, and blood biomarkers for metabolic disease such as diabetes. Built environment variables were generated from individual addresses. Compared to the Centres for Disease Control and Prevention (CDC) reference population with mean SD scores (SDS) of 0, this cohort of 931 14-year-olds was taller, weighed more and had a higher body mass index (BMI) (mean SDS height >0.6, weight >1.6 and BMI >1.4). 7 of 10 youth were overweight or obese. The nested-sampling frame achieved an even distribution by body weight. Cross-sectional relationships between body size, fatness and growth rate, food patterns, activity patterns, pubertal development, risks for diabetes and hypertension and the family and wider environment will be examined. In addition, analyses will investigate relationships with data collected earlier in the life course and measures of the cohort in the future. Understanding past and present influences on child growth and health will inform timely interventions to optimise future health and reduce inequalities for Pacific people. Published by the BMJ
Hill, Philip C; Hicking, John; Bennett, Jennifer M; Mohammed, Azeem; Stewart, Joanna M; Simmons, Greg
To investigate simultaneous outbreaks of Shigella sonnei gastroenteritis occurring in February 2001 at a health camp for socially deprived children and an elderly care facility. Those with symptoms were interviewed using a standardised questionnaire. Cases were defined as having at least three loose stools over a 24 hour period and stool samples requested. A case-control study investigating routes of transmission was performed at the health camp. Environmental investigations of food safety and hygiene were conducted at each facility. At the camp, 15 (37%) students and 15 (28%) staff met case criteria. Contact with human faeces (OR 4.0; 95% confidence interval 1.0-16.3; p = 0.05) and, for staff, eating camp food (OR 6.9; 1.0-5.0; p = 0.06) were shown to be independent risk factors for illness. At the elderly care facility, four (19%) residents and four (25%) staff met case criteria. Molecular subtyping confirmed that the outbreaks were related to each other and to other cases in travellers returning from Samoa to Auckland and other New Zealand cities over a four month period. Molecular subtyping is of considerable use in communicable disease investigation, providing strong evidence for links between outbreaks. With expanded technological capability, New Zealand could perform routine molecular subtyping of selected organisms to improve the detection and the investigation of regional and inter-regional outbreaks of infection.
Exam papers have always been a heavily used resource in University of Auckland libraries. Prior to 2001 the library provided hard copies of exam papers in all its 15 libraries. These were heavily used at all times of the year, especially in the weeks leading up to exams. In 1996 the University Library first began to explore the possibility of providing past exam papers electronically to University students and staff. In 2001 a trial pilot project was carried out, which was successful result...
Raeburn, J M; Dubignon, J M; Grant, V J; Richmond, D E
This paper provides an overview of developments in the Auckland Medical School behavioural science programme. From 1984 to 1987, an entirely new five year course was phased in, its design based on a survey of 165 clinical teachers. This course has eight topic streams oriented towards producing a behaviourally knowledgeable and skilled clinician. Evaluation of the course shows good acceptance by students. Recent and planned modifications to the course are described.
Spoonley, P.; Meares, C.; Peace, R.; Cain, T.
New Zealand’s post-1987 business and skill-focussed immigrant recruitment policies have had several consequences for Auckland, including the transformation of numerous public spaces. One manifestation of this process of change has been the co-location of immigrant-dominated retailing in ethnic business precincts, which provides both economic and social network spaces for immigrant interaction with co-ethnics, and a zone of contact between immigrants and others. This paper describes the exampl...
Rush, E; Oliver, M; Plank, L D; Taylor, S; Iusitini, L; Jalili-Moghaddam, S; Savila, F; Paterson, J; Tautolo, E
Purpose This article profiles a birth cohort of Pacific children participating in an observational prospective study and describes the study protocol used at ages 14?15?years to investigate how food and activity patterns, metabolic risk and family and built environment are related to rates of physical growth of Pacific children. Participants From 2000 to 2015, the Pacific Islands Families Study has followed, from birth, the growth and development of over 1000 Pacific children born in Auckland...
Place matters in innovation. New ideas – and the capability to translate them into innovative goods, services, processes or markets – rely on the sharing of knowledge and resources by a diverse range of players, including firms, suppliers, employees, universities and government research institutes. For this paper, a review was undertaken to examine the extent to which Auckland has all the actors, linkages, inputs and framework conditions required for innovation. A regional innovation system a...
Moy, C. M.; Vandergoes, M.; Gilmer, G. J.; Nichols, J. E.; Dagg, B. J.; Wilson, G. S.; Browne, I. M.; Curtin, L. G.; Aebig, C.; McGlone, M.
The strength and latitudinal position of the Southern Hemisphere westerly winds (SHWW) play a fundamental role in influencing mid latitude climate and carbon dioxide exchange between the Southern Ocean and the atmosphere. Despite their importance, our understanding of past changes in the SHWW is limited by few paleoclimate records from the modern wind maximum that are often not in agreement. The New Zealand subantarctic Auckland Islands are located within the core of the modern wind belt (50°S) where the ocean-atmospheric linkages between the Antarctic and middle latitudes are strong. In contrast to other subantarctic islands on the Campbell Plateau, the Auckland Islands have protected fjord sub-basins, deep lakes, and peatlands that are advantageous for the development of high-resolution paleoclimate records. We will present ongoing work towards the establishment of multi-proxy and multi-site reconstructions of past SHWW variability from the Auckland Islands. Modern process and paleoclimate results from two research cruises in 2014 and 2015 suggest that in lacustrine and fjord settings, the degree of water column mixing, the stable isotopic composition of n-alkanes and benthic foraminifera, the influx of terrestrial organic matter are good indicators of wind-induced mixing of the water column or precipitation-driven erosion within catchments. In ombrotrophic peatlands, hydrogen isotope ratios of specific organic molecules allow reconstructions of the hydrogen isotope ratios of precipitation, which is related to precipitation source area and the latitudinal position of the SHWW. Using macrofossil counts paired with abundances of leaf wax biomarkers, we are able to estimate the moisture balance at peatland coring sites. Early results indicate an overall strengthening of the SHWW at the Auckland Islands through the Holocene. We will discuss these results within the context of complimentary records developed from New Zealand and southern South America to ultimately
Babar, Zaheer-Ud-Din; Stewart, Joanna; Reddy, Shiwangni; Alzaher, Woroud; Vareed, Prateeka; Yacoub, Nineweh; Dhroptee, Bandhana; Rew, Anne
The aim of this project was to evaluate the perceptions, knowledge and attitudes regarding generic medicines. A cross-sectional study, with self administered questionnaires, was conducted to survey consumers visiting pharmacies in four regions of Auckland (North Shore, Waitakere, Central Auckland and South Auckland). Through stratified random sampling, approximately 10% of pharmacies from each region were selected, which turn out to be 30 pharmacies. Every alternate customer coming to the pharmacy, who was eligible to participate in the study, was asked by the researchers to complete the questionnaire. A total of 441 questionnaires were included in the analysis. Different response rates were obtained in different regions of Auckland. Of all respondents, 51.6% had previous knowledge of generic medicines. Pharmacists were the main source of information regarding generic medicines followed by doctors and media. A higher level of education had a direct relationship with having correct knowledge of generics (P = .002). Attitude of participants toward the use of generic medicines was determined by their knowledge of generics, whether it was recommended by a pharmacist and their type of illness. Participants were more prepared to change to a generic for a minor illness (79%) than for a major illness (58.7%). Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness (P = .001) as well as minor illness (P < .0001). Previous positive experiences with generics also determined consumers' willingness to use generics. Many consumers have misconceptions regarding generic medicines. Having knowledge about generics and the advice by doctors and pharmacists are key indicators to improve the quality use of generic medicines.
Lai, Foon Yin; Wilkins, Chris; Thai, Phong; Mueller, Jochen F
New Zealand is considered to have unusual drug use patterns by international standards. However, this understanding has largely been obtained from social surveys where respondents self-report use. The aim of this paper is to conduct the first wastewater study of drug use in Auckland. Wastewater sampling was completed from 2 May to 18 July 2014 at 2 Auckland wastewater treatment plants which service 1.3 million people. Samples were analysed for 17 drug residues by using liquid chromatography-tandem mass spectrometry. Consumption of methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), cocaine, codeine and methadone (mg/day/1000 people) was estimated by using a back-calculation formula. Methamphetamine, codeine, morphine and methadone were detected with high frequency (80-100%), followed by amphetamine (~60%), MDMA (~7%, i.e. 8 occasions) and methylone (3 occasions). An overall mean of 360 mg of methamphetamine and 60 mg of MDMA was estimated to have been consumed per day per 1000 people. Methamphetamine consumption was found at similar levels in both catchments (377 and 351 mg/day/1000 people). Cocaine was only detected in 1 catchment and on only 8 occasions. JWH-018 was detected in 1 catchment and only on 1 occasion. Methamphetamine, codeine and other opioids were detected at a consistent level throughout the week. 3,4-Methylenedioxymethamphetamine and methylone were detected only during the weekends. Wastewater analysis confirms that methamphetamine was one of the most commonly detected illegal drugs in Auckland and was detected consistently throughout the week. In contrast, cocaine and MDMA were rarely detected, with detection limited to weekends. [Lai FY, Wilkins C, Thai P, Mueller JF. An exploratory wastewater analysis study of drug use in Auckland, New Zealand. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Hale, Michael J.; Baker, Michael G.
Entry screening for influenza A(H1N1)pdm09 at Auckland International Airport, New Zealand, detected 4 cases, which were later confirmed, among 456,518 passengers arriving April 27–June 22, 2009. On the basis of national influenza surveillance data, which suggest that ≈69 infected travelers passed through the airport, sensitivity for screening was only 5.8%. PMID:22516105
Lane, R J; Holland, D; McBride, S; Perera, S; Zeng, I; Wilson, M; Read, K; Jelleyman, T; Ingram, R J H
There are limited clinical data on enteric fever in the Pacific and New Zealand (NZ) compared with the Indian subcontinent (ISC) and South-East Asia (SEA). Our objective was to describe enteric fever in Auckland - a large Pacific city, focusing on disease acquired in these regions. We reviewed enteric fever cases hospitalised in Auckland from January 2005 to December 2010. Microbiologically confirmed EF was identified in 162 patients. Travel regions: Pacific, 40 cases (25%) (Samoa, 38; Fiji, two), ISC, 72 (44%), SEA, seven (4%), other, three (2%), no travel, 40 (25%). Enteric fever rates for Auckland resident travellers were: India 50.3/100 000; Samoa 19.7/100 000.All Pacific cases were Salmonella Typhi. Of local isolates (without travel history), 38 were S. Typhi (36 fully susceptible, one multi-drug resistant (MDR) + nalidixic acid resistant (NAR), one unknown) and two S. Paratyphi (both NAR). Of non-Pacific travel, 56/82 (69%) isolates were S. Typhi, the remainder S. Paratyphi (15 isolates were fully susceptible, only 1% were MDR). Significant associations of serotype and antibiotic resistance with different travel regions and similarity of phage types (local and Pacific) were observed. Headache, vomiting and acute kidney injuries were more frequent with Pacific travel, while abdominal distension and cholecystitis with local disease. Shorter duration of treatment in the Pacific group was seen despite length of stay in hospital not being reduced. Local cases were associated with longer hospital admissions. One half of cases in Auckland are acquired either from Pacific or locally. Similarities mean that disease acquired locally is likely of Pacific origin. © 2014 Royal Australasian College of Physicians.
Ritchie, Stephen R; Fraser, John D; Libby, Eric; Morris, Arthur J; Rainey, Paul B; Thomas, Mark G
To estimate the burden of skin and soft tissue infection caused by Staphylococcus aureus (S. aureus), and to determine the effects of ethnicity and age on the rate of skin and soft tissue due to MRSA in the Auckland community. We reviewed the culture and susceptibility results of all wound swabs processed by Auckland's only community microbiology laboratory in 2007. Demographic data for a random sample of 1000 people who had a wound swab collected and for all people from whom a methicillin-resistant S. aureus (MRSA) strain was isolated were obtained and compared to demographic data for the total population of Auckland. S. aureus was isolated from 23853/47047 (51%) wound swab cultures performed in 2007; the estimated annual incidence of S. aureus isolation from a wound swab was 1847/100,000 people; and the estimated annual incidence of MRSA isolation from a wound swab was 145/100,000 people. Maori and Pacific people had higher rates of non-multiresistant MRSA infection compared with New Zealand European and Asian people; elderly New Zealand European people had much higher rates of multiresistant MRSA infections compared with people from other ethnic groups. S. aureus is a very common cause of disease in the community and the incidence of infection with MRSA subtypes varies with ethnicity.
Patel, Dipika V; Rayner, Sandra; McGhee, Charles N J
To investigate the presentation, clinical characteristics and outcomes of Acanthamoeba keratitis (AK) in Auckland, New Zealand over a 7-year period. Retrospective analysis of all cases of AK treated by the tertiary corneal service at Auckland City Hospital/ University of Auckland Department of Ophthalmology (August 2001 to May 2008). Data were collected regarding age, gender, contact lens history, presenting signs and symptoms, diagnosis at first presentation, time to final diagnosis, identifiable risk factors, presenting and final visual acuity, results of microbiological testing, medical treatment, surgical interventions, recurrence of disease and length of follow up. All photographs and in vivo confocal microscopy images were reviewed. Twenty-five eyes of 25 patients were identified with a diagnosis of AK (mean age 40 +/- 13 years). Ninety-six per cent were contact lens wearers. Mean time to diagnosis was 41 +/- 49 days (range 0-181 days, median 21 days). Fourteen patients (56%) had been treated with topical corticosteroids prior to the diagnosis. Early diagnosis of AK (New Zealand in the current decade. This study highlights the fundamental importance of early diagnosis and appropriate management in ensuring favourable outcomes. Practitioners should maintain a clinical suspicion of AK, especially as 96% of the subjects in this study were contact lens wearers.
Hopgood, Timothy; Percival, Teuila; Stewart, Joanna; Ameratunga, Shanthi
The school journey is a common context for child pedestrian injuries in New Zealand, with children from low socioeconomic, Maori or Pacific families being at increased risk. The extent to which evidence-based environmental strategies that can address this problem are equitably implemented is unclear. To determine if there is a difference in the distribution of traffic-calming modifications around schools in areas of high and low socioeconomic deprivation in Auckland and Manukau Cities, New Zealand. From a list of the most and least socioeconomically deprived schools in Auckland and Manukau Cities, 40 of each were randomly selected. The number of modifications within a 1 km radius of these schools was recorded in December 2009 or January 2010. The association of deprivation and region with the numbers of traffic-calming modifications was examined using a general linear model. Socioeconomically least deprived schools had more traffic-calming interventions than the most deprived schools (least square mean (LSM): 25 versus 18; p=0.05), and Auckland schools had more interventions than Manukau schools (LSM: 27 versus 16; p=0.001). Traffic-calming measures were observed more commonly in less deprived areas where the risks of child pedestrian injuries are generally lower. This apparent paradox could result in increasing socioeconomic inequities in the distribution of child pedestrian injuries.
Shelker, William; Poole, Phillippa; Bagg, Warwick; Wood, Ian; Glue, Paul
Auckland and Otago medical programmes have different methods for selecting students. This study compared postgraduate retention in New Zealand (NZ) of medical graduates from the two medical programmes, to assess whether different selection methods influenced retention. Other variables assessed included entrance category and age at graduation. Anonymised databases were created of all graduates from the Otago Faculty of Medicine (1999-2011) and the Auckland medical programme (2000-2012). Demographic and entry category data were recorded. Retention was defined as presence on the NZ Medical Register in December 2012. Risk differences (RD) were calculated to compare retention between the two medical programmes using the Mantel-Haenszel method. The influence of medical programme entrance category on retention was also tested. The influence of covariates on retaining graduates on the register was evaluated using a multiple logistic regression model. The postgraduate retention of graduates of the two medical programmes over 13 years was identical (Auckland 74.9%, Otago 73.6%, P=0.48). Retention of graduate and non-graduate entry students from both medical programmes was similar by 6 years after graduation. Age during medical school did not affect retention. University of attendance had no effect on postgraduation retention of students on the NZ Medical Register, suggesting that retention is not influenced by the different student selection methods at each programme. The data presented shows that New Zealand graduates regardless of programme completed show a similar profile in terms of retention.
O'Grady, G; Fitzjohn, J
To determine the debt level that current Auckland medical students expect to graduate with, and evaluate this debt in the context of their career aspirations and intended place of practice. Simple check-box and fill-in-the-blank surveys were distributed to Auckland University medical students in Years 1 through to 5 during their second week of scheduled lectures in March 2000. Students were asked to provide demographic details, then complete sections on debt and career aspirations. 70% of Auckland medical students participated. Average expected debt was between $60000 to $70000. Predicted size of graduation debt was significantly related with plans to practice medicine overseas, and this trend was especially strong among females. In addition, Maori and Polynesian students bear a disproportionate level of the student debt burden compared to Pakeha and Asian groups. 77% of students indicated a preference for working in private or hospital specialty work. Student debt will have major effects on the composition of the New Zealand medical workforce over coming years. More attention must be paid to the national picture of medical student indebtedness if adequate workforce planning is to be possible.
Adams, Jeffery; Neville, Stephen
To identify ways Chinese and South Asian gay and bisexual men living in Auckland talk about issues related to sexuality and experiences of living 'gay social lives.' Results will be available to inform health policy and practice. A qualitative design with individual interviews and thematic analysis was used. Semi-structured digitally recorded interviews were undertaken with 27 Chinese and 17 South Asian gay and bisexual men living in Auckland. Four themes in the data related to talk about sexuality and living gay social lives are reported: (a) 'Happy in my skin': Being gay is Ok! (b) 'To come out or not': Managing sexual identity, (c) 'Places to go, people to see': Connecting with others, and (d) 'What's wrong with being Asian': Tolerating discrimination. There are many similarities in the ways these men talked about their identity and sexuality that can be usefully considered by health policy makers and service planners. The concept of gay (and bisexual) sexuality had some salience for the men interviewed, despite the adoption and acknowledgement of same-sex identity being a relatively new phenomenon in some Asian countries. This supports the use of these terms in local health interventions. However, as these men closely managed their gay identity and typically had not disclosed their sexuality to others, including healthcare professionals, interventions to address the skills and comfort of healthcare providers in addressing sexuality in clinical settings appear warranted to facilitate optimal healthcare. These men are not well connected with others and this has implications for HIV health promotion that is based on creating cultural norms among networks to encourage safe sex. Discrimination results in many Chinese and South Asian gay and bisexual men disengaging from connecting with others and should be addressed.
Cronin, Robin S; Chelimo, Carol; Mitchell, Edwin A; Okesene-Gafa, Kara; Thompson, John M D; Taylor, Rennae S; Hutchison, B Lynne; McCowan, Lesley M E
The Auckland Stillbirth study demonstrated a two-fold increased risk of late stillbirth for women who did not go to sleep on their left side. Two further studies have confirmed an increased risk of late stillbirth with supine sleep position. As sleep position is modifiable, we surveyed self-reported late pregnancy sleep position, knowledge about sleep position, and views about changing going-to-sleep position. Participants in this 2014 survey were pregnant women (n = 377) in their third trimester from South Auckland, New Zealand, a multi-ethnic and predominantly low socio-economic population. An ethnically-representative sample was obtained using random sampling. Multivariable logistic regression was performed to identify factors independently associated with non-left sided going-to-sleep position in late pregnancy. Respondents were 28 to 42 weeks' gestation. Reported going-to-sleep position in the last week was left side (30%), right side (22%), supine (3%), either side (39%) and other (6%). Two thirds (68%) reported they had received advice about sleep position. Non-left sleepers were asked if they would be able to change to their left side if it was better for their baby; 87% reported they would have little or no difficulty changing. Women who reported a non-left going-to-sleep position were more likely to be of Maori (aOR 2.64 95% CI 1.23-5.66) or Pacific (aOR 2.91 95% CI 1.46-5.78) ethnicity; had a lower body mass index (BMI) (aOR 0.93 95% CI 0.89-0.96); and were less likely to sleep on the left-hand side of the bed (aOR 3.29 95% CI 2.03-5.32). Maternal going-to-sleep position in the last week was side-lying in 91% of participants. The majority had received advice to sleep on their side or avoid supine sleep position. Sleeping on the left-hand side of the bed was associated with going-to-sleep on the left side. Most non-left sleepers reported their sleeping position could be modified to the left side suggesting a public health intervention about sleep
Castinel, A; Duignan, P J; Pomroy, W E; López-Villalobos, N; Gibbs, N J; Chilvers, B L; Wilkinson, I S
As part of a health survey of New Zealand sea lions (Phocarctos hookeri) on Enderby Island, Auckland Islands (50 degrees 30'S, 166 degrees 17'E), neonatal mortality was closely monitored at the Sandy Bay colony for seven consecutive years. Throughout the breeding seasons 1998-99 to 2004-05, more than 400 postmortem examinations were performed on pups found dead at this site. The primary causes of death were categorized as trauma (35%), bacterial infections (24%), hookworm infection (13%), starvation (13%), and stillbirth (4%). For most pups, more than one diagnosis was recorded. Every year, two distinct peaks of trauma were observed: the first associated with mature bulls fighting within the harem and the second with subadult males abducting pups. In 2001-02 and 2002-03, epidemics caused by Klebsiella pneumoniae increased mortality by three times the mean in nonepidemic years (10.2%). The increased mortality was attributed directly to acute suppurative infection due to the bacterium and also to an increase in traumatic deaths of debilitated pups. Parasitic infection with the hookworm Uncinaria spp. was a common finding in all pups older than three weeks of age and debilitation by the parasite may have contributed to increased susceptibility to other pathogens such as Klebsiella sp. or Salmonella sp. This study provides valuable quantitative data on the natural causes of neonatal mortality in New Zealand sea lions that can be used in demographic models for management of threatened species.
Exeter, Daniel J; Moss, Lauren; Zhao, Jinfeng; Kyle, Cam; Riddell, Tania; Jackson, Rod; Wells, Susan
National cardiovascular disease (CVD) guidelines recommend that adults have cholesterol levels monitored regularly. However, little is known about the extent and equity of cholesterol testing in New Zealand. To investigate the distribution and frequency of blood lipid testing by sociodemographic status in Auckland, New Zealand. We anonymously linked five national health datasets (primary care enrolment, laboratory tests, pharmaceuticals, hospitalisations and mortality) to identify adults aged ≥25 years without CVD or diabetes who had their lipids tested in 2006-2010, by age, gender, ethnicity and area of residence and deprivation. Multivariate logistic regression was used to estimate the likelihood of testing associated with these factors. Of the 627 907 eligible adults, 66.3% had at least one test between 2006 and 2010. Annual testing increased from 24.7% in 2006 to 35.1% in 2010. Testing increased with age similarly for men and women. Indian people were 87% more likely than New Zealand European and Others (NZEO) to be tested, Pacific people 8% more likely, but rates for Maori were similar to NZEO. There was marked variation within the region, with residents of the most deprived areas less likely to be tested than residents in least deprived areas. Understanding differences within and between population groups supports the development of targeted strategies for better service utilisation. While lipid testing has increased, sociodemographic variations persist by place of residence, and deprivation. Of the high CVD risk populations, lipid testing for Maori and Pacific is not being conducted according to need.
Deligne, N. I.; Leonard, G.; King, A.; Wilson, G.; Wilson, T.; Lindsay, J. M.
Auckland city, home to a third of New Zealand's population, is situated on top of the Auckland Volcanic Field (AVF), which last erupted roughly 500 years ago. Since 2008, the Determining Volcanic Risk in Auckland (DEVORA) program has investigated the geologic context of the AVF, improved timing constraints of past eruptions, explored possible tempo-spatial-volume eruption trends, and identified likely styles and hazards of future eruptions. DEVORA is now moving into development of risk and societal models for Auckland. The volcanic module of RiskScape, a multi-hazard risk assessment tool developed by Crown Research Institutes GNS Science and NIWA, will be expanded and used to model risk and impact to the built environment and population caused by a future AVF eruption. RiskScape models casualties, damage and disruption caused by various hazards, the resulting reduced functionality of assets, and associated clean up costs. A strength of RiskScape is that the effect of various mitigation strategies can be explored by strengthening asset attributes and examining resulting changes in the output risk evaluation. We present our framework for building a volcano hazard exposure module for RiskScape along with our approach for assessing asset vulnerability through the development of fragility functions. We also present the framework for engagement with regional Auckland stakeholders, including representatives of local and regional governments and utility companies, to identify complementary needs to ensure that final risk products are relevant and useable by end users.
Austin, J Matthew; Demski, Renee; Callender, Tiffany; Lee, K H Ken; Hoffman, Ann; Allen, Lisa; Radke, Deborah A; Kim, Yungjin; Werthman, Ronald J; Peterson, Ronald R; Pronovost, Peter J
As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety. The four components implemented by Johns Hopkins Medicine were governance, accountability, reporting of consolidated quality performance statements, and auditing. Governance is provided by the health system's Patient Safety and Quality Board Committee, which reviews goals and strategy for patient safety and quality, reviews quarterly performance for each entity, and holds organizational leaders accountable for performance. An accountability plan includes escalating levels of review corresponding to the number of months an entity misses the defined performance target for a measure. A consolidated quality statement helps inform the Patient Safety and Quality Board Committee and leadership on key quality and safety issues. An audit evaluates the efficiency and effectiveness of processes for data collection, validation, and storage, as to ensure the accuracy and completeness of quality measure reporting. If hospitals and health systems truly want to prioritize improvements in safety and quality, they will need to create a performance management system that ensures data validity and supports performance accountability. Without valid data, it is difficult to know whether a performance gap is due to data quality or clinical quality. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.
Minichilli, Alessandro; Zattoni, Alessandro; Nielsen, Sabina
identify three board processes as micro-level determinants of board effectiveness. Specifically, we focus on effort norms, cognitive conflicts and the use of knowledge and skills as determinants of board control and advisory task performance. Further, we consider how two different institutional settings....... The findings show that: (i) Board processes have a larger potential than demographic variables to explain board task performance; (ii) board task performance differs significantly between boards operating in different contexts; and (iii) national context moderates the relationships between board processes...... and board task performance....
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Clancy, Gerard P
Many urban areas struggle with significant health disparities. In Tulsa, Oklahoma, there is a 14-year difference in life expectancy between the predominantly African American population in north Tulsa and the predominantly Caucasian population in south Tulsa. The roots of Tulsa's health disparities can be linked, in part, to a long history of racial mistrust stemming from the 1921 Tulsa Race Riot, arguably one of the worst race riots in U.S. history. In 2011, the author served as both a university campus president and chairman of the board of the Tulsa region's chamber of commerce. Through his work with the chamber, he discovered the business community's substantial resources and advocacy abilities. He also found that regional business leaders strongly supported health equity, diversity, and inclusion initiatives, both as moral obligations and regional economic development imperatives. After sharing the lessons he learned from working closely with business leaders, the author encourages other academic health centers (AHCs) to reach out to their business communities, which are likely willing and able to help them undertake similar initiatives. In doing so, AHCs and businesses can work together to improve the economic vitality of their regions.
Pautet, P.-D.; Taylor, M. J.; Fritts, D. C.; Bossert, K.; Williams, B. P.; Broutman, D.; Ma, J.; Eckermann, S. D.; Doyle, J. D.
The Deep Propagating Gravity Wave Experiment (DEEPWAVE) project was conducted over New Zealand and the surrounding regions during June and July 2014, to more fully understand the generation, propagation, and effects of atmospheric gravity waves. A large suite of instruments collected data from the ground to the upper atmosphere (~100 km), with several new remote-sensing instruments operating on board the NSF Gulfstream V (GV) research aircraft, which was the central measurement platform of the project. On 14 July, during one of the research flights (research flight 23), a spectacular event was observed as the GV flew in the lee of the sub-Antarctic Auckland Islands (50.7°S). An apparent "ship wave" pattern was imaged in the OH layer (at ~83.5 km) by the Utah State University Advanced Mesospheric Temperature Mapper and evolved significantly over four successive passes spanning more than 4 h. The waves were associated with orographic forcing generated by relatively strong (15-20 m/s) near-surface wind flowing over the rugged island topography. The mountain wave had an amplitude T' ~ 10 K, a dominant horizontal wavelength ~40 km, achieved a momentum flux exceeding 300 m2 s-2, and eventually exhibited instability and breaking at the OH altitude. This case of deep mountain wave propagation demonstrates the potential for strong responses in the mesosphere arising from a small source under suitable propagation conditions and suggests that such cases may be more common than previously believed.
Zito, Sarah; Vigeant, Shalsee; Dale, Arnja
Simple Summary It is generally accepted that stray cats need to be managed to minimise the associated negative impacts and there is a need for effective and humane management tools. One such potential tool is trap-neuter-return (TNR), which anecdotally has been used in New Zealand to manage stray cats, but no concerted and targeted implementation of this technique has been reported, nor any formal assessments conducted. A targeted TNR (TTNR) programme for urban stray cats was implemented and assessed in one Auckland suburb. Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray feline, underage euthanasia, and unsocialised stray cat euthanasia numbers all reduced for the targeted suburb when these outcome measures were compared for the years before and after the programme. These outcome measures had a greater reduction in the targeted suburb compared to the other Auckland suburbs not targeted by the TTNR programme, although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable humane cat management tool in urban New Zealand, and further assessment is warranted. Abstract There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned
The 1965-66 excavations at the South Auckland site of Maioro were described and interpreted by Aileen Fox and R.C. Green in the previous volume. Their report indicated that six radiocarbon samples had been submitted for age determination, and would be reported when available. The results are now to hand and provide a 13th century A.D. estimation as the age for the initial settlement occupation of the site, and a 15th century date as the time for its major use as a stockaded pa
... of physical and mental diseases and other impairments; (2) assist States and their political... Health Effects; and presentations by EHHE Branches. Agenda items are tentative and subject to change...
Lovell, Sarah; Kearns, Robin A; Friesen, Wardlow
Cervical screening has been subject to intense media scrutiny in New Zealand in recent years prompted by a series of health system failings through which a number of women developed cervical cancer despite undergoing regular smears. This paper considers why underscreening persists in a country where cervical screening has a high profile. It explores how the promotion of cervical screening has impacted on the decisions of women to undergo a smear test. Ideas of risk and the new public health are deployed to develop a context for thinking about screening as a form of governing the body. Qualitative interviews with 17 women who were overdue for a cervical smear were undertaken in 2001-2002, yielding understandings of their knowledge of screening and their reasons for postponement. Nine providers of screening services were also interviewed. Concurrent with socioeconomic limitations, concerns over exposing one's body loomed large in women's reasons for delaying being screened. In particular, feelings of shyness and embarrassment were encountered among Maori and Pacific women for whom exposing bodies in the process of smear taking compromises cultural beliefs about sacredness. We conclude that medicalization of the body has, paradoxically, assisted many women in dealing with the intrusion of screening. For others, compliance with the exhortations to be screened brings a high emotional and cultural cost which should at least be considered in health policy debates.
Full Text Available Along with many Pacific Rim cities in Australia and North America, Auckland, New Zealand has enacted an urban growth management strategy premised on two concepts: “liveability” and a “quality compact city”. The effective implementation of this strategy will, in part, require higher density housing typologies to be developed within the existing suburban fabric. The urban amenities in a neighbourhood play an important role in providing a sense of liveability for residents. This paper examines these issues by evaluating and reporting on key outcomes from 57 face-to-face qualitative interviews with residents who currently live in medium density housing in four Auckland suburbs; Takapuna, Kingsland, Botany Downs, and Te Atatu Peninsula. Findings consider the trade-offs residents make when choosing to live in medium density housing typologies, how they value the urban amenities in their neighbourhood and the role they think these amenities play in their location satisfaction. Conclusions are drawn around how the resident-derived information may inform the market on the supply side of housing, and comment is made about how these preferences may, or may not, respond to the objectives of the underlying urban management strategies involved.
Norrie, M W; Lane, M R
A retrospective review of patients being treated by percutaneous endoscopic gastrostomy (PEG) at Auckland Hospital from 1993-4 was undertaken in order to determine patient characteristics, clinical outcome and to compare these results with published series. The case notes of all patients having PEGs performed in the Auckland Hospital gastroenterology unit during the defined period were reviewed. Demographic details, indications, morbidity and mortality data were obtained. Data were supplemented with information obtained from the general practitioner. Fifty procedures (18 in 1993, 32 in 1994) were performed on 41 patients (29 male 12 female), with a mean age of 61 years. Neurological disorders represented the most common clinical indication (25) followed by head and neck malignancy (9). Three patients (7) died within 30 days of the procedure and 13 (32) had early complications (less than 30 days) with four (10) having late complications. Significant pain requiring narcotics occurred in 18. Results were in general comparable to published series apart from a higher early complication rate (32% vs 16%). Pain may be significant post procedure and should be anticipated. The increasing use of this procedure in our hospital reflects its acceptability to patients, relatives and staff as a means of providing nutritional support to the patient with disorders of swallowing.
Power, H. C.; de Freitas, C. R.; Hay, J. E.
Atmospheric lead levels were examined to assess the consequences of the 46 percent reduction in the lead content of premium grade petrol in New Zealand. Since this change was implemented in July 1986 observed levels of atmospheric lead decreased by 38 percent, but all or part of this reduction may have been due to factors other than fluctuations in lead emissions, notably variations in climate. Analysis of detailed atmospheric lead, meteorological and traffic data measured contemporaneously provided insight into the atmospheric processes influencing lead levels in Auckland and formed the basis of a statistical model capable of predicting monthly lead concentrations. The model was used to predict lead levels in Auckland for the period July 1986 through to July 1989 in the absence of any reduction in the lead content of petrol. Comparison with values observed for the same period showed that all of the reduction in atmospheric lead levels since July 1986 can be attributed to the reduction in the lead content of petrol. Policy planning implications of such a finding are considered.
Nichols, J. E.; Moy, C. M.; Peteet, D. M.; Weiss, A.; Curtin, L. G.
The strength and position of the Southern Hemisphere Westerly Wind belt plays an important role in our understanding of the global carbon cycle and glacial-interglacial climate change. We present a paleoclimate record that is primarily influenced by the strength and latitudinal position of the Southern Hemisphere Westerly Winds from a late Holocene lake sediment core and a peat core that spans the last 13,000 years, both obtained from New Zealand's subantarctic Auckland Islands (50°S, 166°E). Several proxy indicators contribute to our reconstruction. Hydrogen isotope ratios of specific organic molecules allow us to reconstruct the hydrogen isotope ratios of precipitation. Using macrofossil counts and the abundances of leaf wax biomarkers, we are able to estimate the moisture balance at our sites. Model simulations of the Westerlies and the rate and isotope ratios of precipitation allow us to interpret our proxy data as changes in the strength and position of the Westerly Winds. In our lacustrine sediment, we found that the Westerlies have been shifting southward since the Little Ice Age, consistent with modern observations of a southward shift. In the peatland sediment, we found a multi-millennial northward shift in the Westerlies during the middle Holocene. We will present further ongoing work that strengthens the chronology of Auckland Islands environmental change and integrates these results with vegetation shifts identified in pollen and macrofossil data.
Eggleton, Kyle; Goodyear-Smith, Felicity; Henning, Marcus; Jones, Rhys; Shulruf, Boaz
The aim of this study was to develop an instrument (University of Auckland General Practice Report of Educational Environment: UAGREE) with robust psychometric properties that measured the educational environment of undergraduate primary care. The questions were designed to incorporate measurements of the teaching of cultural competence. Following a structured consensus process and an initial pilot, a list of 55 questions was developed. All Year 5 and 6 students completing a primary care attachment at Auckland University were invited to complete the questionnaire. The results were analysed using exploratory factor analysis and confirmatory factor analysis resulting in a 16-item instrument. Three factors were identified explaining 53% of the variance. The items' reliability within the factors were high (Learning: 0.894; Teaching: 0.871; Cultural competence: 0.857). Multiple groups analysis by gender; and separately across ethnic groups did not find significant differences between groups. UAGREE is a specific instrument measuring the undergraduate primary care educational environment. Its questions fit within established theoretical educational environment frameworks and the incorporation of cultural competence questions reflects the importance of teaching cultural competence within medicine. The psychometric properties of UAGREE suggest that it is a reliable and valid measure of the primary care education environment.
Zito, Sarah; Aguilar, Glenn; Vigeant, Shalsee; Dale, Arnja
There is a need for effective and humane management tools to manage urban stray cats and minimise negative impacts associated with stray cats. One such tool is targeted trap-neuter-return (TTNR), but no concerted implementation of this technique or formal assessments have been reported. To address this deficit, a TTNR programme was implemented and assessed in one Auckland suburb from May 2015 to June 2016; the programme sterilised and returned 348 cats (4.2 cats/1000 residents). Assessment was based on the number of incoming felines; stray, unsocialised cats euthanased; unsocialised, unowned cats sterilised and returned (independently of the TTNR programme); and neonatal/underage euthanasias. Incoming stray felines, underage euthanasias, and unsocialised stray cat euthanasias were all reduced for the targeted suburb when compared for the years before and after the programme (the percentage reduction in these parameters was −39, −17, −34, −7, and −47, respectively). These outcome measures had a greater reduction in the targeted suburb compared to the Auckland suburbs not targeted by the TTNR programme ( p < 0.01), although causation cannot be inferred, as a variety of reasons could have contributed to the changes. This pilot programme suggests that TTNR could be a valuable, humane cat management tool in urban New Zealand, and further assessment is warranted.
Upton, Arlo; McEwan, M; Williamson, Deborah
Urinalysis for microscopy and culture is one of the most frequently requested tests for microbiology laboratories, particularly from elderly patients. This study sought to describe the clinical appropriateness of urinalysis from community-dwelling elderly patients and subsequent antibiotic prescription. Demographic, laboratory, and antibiotic prescription data were collected on all samples submitted from patients ≥ 70 years during August 2014 to Labtests Auckland. In addition, clinical data were collected by questionnaire from a subgroup of 200 patients. During August 2014, approximately 7% of the Auckland population aged ≥ 70 years had urinalysis submitted. Urine dipstick was not routinely performed before specimen submission, particularly from patients living at home rather than a long-term care facility, and nearly 50% of samples were not cultured due to absence of pyuria. Escherichia coli was isolated from 23% of female and 7% of male specimens. E. coli isolates from our cohort were less susceptible to all antibiotics tested against compared with all E. coli isolated from all urines in 2014. Clinical indications were absent in 40% of the subgroup of patients. Antibiotic prescription within 7 days of urinalysis was common (36%). This study highlights the frequency of urinalysis testing among the elderly residing in the community. Clinical indications are often absent, and treatment of asymptomatic bacteriuria is likely to be contributing to excessive antibiotic prescription in this group of patients.
Horrocks, M.; Augustinus, P.; Deng, Y.; Shane, P.; Andersson, S.
Lake Pupuke provides a near-complete, high-resolution environmental record of the Holocene from northern New Zealand. Tephra beds constrain the timing of a range of proxy indicators of environmental change, and demonstrate errors in a radiocarbon chronology. Agathis australis forest progressively increases from c. 7000 yr BP and, in conjunction with indicators of reduced biomass productivity, support a model of long-term climate change to drier conditions over the Holocene. However, except for Agathis, conifer-hardwood forest dominated mainly by Dacrydium cupressinum shows little change throughout the pre-human Holocene, suggesting environmental stability. Dramatic vegetation change occurred only within the last millennium as a result of large-scale Polynesian deforestation by fire. This happened a short time before the local eruption of c. 638 cal. yr BP Rangitoto Tephra. The identification of two eruptions of tephra from Rangitoto volcano has implications for future hazard planning in the Auckland region, because the volcanoes were previously considered single event centres. Changes in atmospheric circulation since the Late Glacial, possibly causing lower frequency of distal ashfall in Auckland during the Holocene, complicates the use of long-term records in hazard frequency assessment. (author). 39 refs., 7 figs., 2 tabs
Matthews, Christina; Bagg, Warwick; Yielder, Jill; Mogol, Vernon; Poole, Phillippa
Relative shortages of rural doctors persist. In 2008 the University of Auckland medical programme introduced a Year 5 regional and rural immersion programme, Pukawakawa, based in Northland, New Zealand (NZ). This study evaluates the early workforce outcomes of graduates of this programme. During 2013 we surveyed Auckland medical graduates who were in the 2008-2011 Pukawakawa cohorts. Questions were asked regarding recent and current place of work, future intentions for place of work, and career preference with reasons why. Qualitative analysis was undertaken to analyse free text responses about experiences of Pukawakawa on this choice. Of the 72 Pukawakawa participants, 45 completed the survey, for a response rate of 63%. In 2013, 62% were working in rural or regional areas, with 31% in the Northland DHB. The great majority intend to work rurally or regionally, with 35.6% intending to return to Northland DHB. Of the respondents, 68% listed general practice in their top three future career intentions. In the early postgraduate years, medical graduates who participated in Pukawakawa are very likely to be working in rural and regional areas. These graduates also show an intention to work in general practice and rural medicine.
Yoon, Jinny J; Misra, Stuti L; McGhee, Charles Nj; Patel, Dipika V
The aim is to investigate ethnic variation, in presentation and biometric parameters, within the population undergoing cataract surgery in Auckland. The design is a retrospective study. Four thousand nine hundred thirty-one eyes of 3524 consecutive patients undergoing cataract surgery in Auckland Public Hospital over 18 months were included in the study. Analysis of preoperative medical records was performed. Age, gender, self-reported ethnicity, keratometry, anterior chamber depth, axial length and intraocular lens (IOL) power data were collected. Māori (4.7%) were under-represented compared with the proportion of Māori attending the eye clinic (5.5%) and in the major patient catchment area (8.2%). People of Māori, Pacific and Indian ethnicities presented at a significantly younger age (66.4, 65.9 and 67.9 years, respectively) than those of Caucasian and Asian ethnicities (76.4 and 71.3 years, respectively, P biometric parameters. These data may help identify potential biometric refinements and those at risk of developing ocular morbidities known to be associated with these parameters. © 2015 Royal Australian and New Zealand College of Ophthalmologists.
Inspired by a new teaching initiative that involved a redesign of conventional classroom spaces at the University of Auckland's Epsom Campus, this article considers the relationship between architecture, the built environment and education. It characterises the teaching space of the Epsom Campus as the embodiment of educational policy following…
... most impact if it provides specific scientific or technical information or analysis for SAB committees... the SAB Exposure and Human Health Committee to develop a work plan for advancing the EPA's application... independent scientific and technical advice to the EPA Administrator on the technical basis for EPA actions...
Our health insurance system falls into the 'private' category and fees for the same medical treatment from different doctors can vary enormously. However, over the last few months, information has been compiled which will be a useful tool to curb rising health care costs. We urge you to use it! AUSTRIA has drawn up a table of fees charged for a whole series of standard consultations over the last few months to learn more about average rates and facilitate comparisons. The result is a list of Geneva doctors known to charge members of the CERN health insurance the same rates as their patients covered by the Geneva health funds. The list is available for consultation at the CERN AUSTRIA office or at the Social Affairs office. You will appreciate that this list cannot be published or distributed.If you would like to know if your doctor is on the list or if you are looking for a new doctor, be it a general practitioner or a specialist - please come and have a look - it's worth taking the time to get more informati...
Briggs, R.M.; Okada, T.; Itaya, T.; Shibuya, H.; Smith, I.E.M.
The South Auckland volcanic field is one of the Pliocene-Quaternary intraplate basaltic fields in northern North Island. It consists of at least 97 monogenetic volcanic centres covering an area of c. 300 km 2 , 38 km south of Auckland. Fifty-nine of the volcanic centres are characterised by mainly magmatic or effusive activity that constructed scoria cones and lava flows, while 38 are mainly phreatomagmatic or explosive that produced tuff rings and maars. Rock types consist of basanites, hawaiites, nepheline hawaiites, transitional basalts, and ol-tholeiitic basalts, with relatively minor amounts of nephelinites, alkali basalts, Q-tholeiitic basalts, and nepheline mugearites. Forty-three new K-Ar ages are presented, which range from 0.51 to 1.59 Ma, and show two peaks of activity at 0.6 and 1.3 Ma. Paleomagnetic determinations at 26 selected sites agree well with the paleomagnetic reversal time scale and support the K-Ar age data. Age data from each of the volcanic fields of Okete, Ngatutura, South Auckland, and Auckland, which constitute the Auckland intraplate basaltic province, show that they have developed within a time span of 0.3-1.1 Ma. After activity ceased in any particular field, a new field then developed 35-38 km to the north. These consistent time/space patterns indicate the possibility of a mantle source migrating northwards at c. 5 cm/yr. There is no correlation of rock composition with time, which is consistent with observations in the Northland intraplate province, but is not consistent with the formerly invoked rising diapir model. (author). 30 refs., 8 figs., 3 tabs
Moy, C. M.; Gilmer, G.; Nichols, J. E.; Browne, I. M.; Curtin, L.; Vandergoes, M.; Aebig, C.; Wilson, G. S.
The strength and latitudinal position of the Southern Hemisphere westerly winds (SHWW) play a fundamental role in influencing mid-latitude climate and CO2 exchange between the Southern Ocean and the atmosphere along seasonal to glaicial-interglacial timescales. Despite their importance, our understanding of past SHWW change is limited by the small number of paleoclimate records from the modern wind maximum, which are often not in agreement. The New Zealand subantarctic Auckland Islands are located within the core of the modern wind belt (50°S), a key latitude where ocean-atmospheric linkages between the Antarctic and mid-latitudes are strong. In contrast to other subantarctic islands on the Campbell Plateau, the Auckland Islands have multiple protected fjord sub-basins, deep lakes, and peatlands that are advantageous for the development of high-resolution paleoclimate records. We will present ongoing work towards the establishment of multi-proxy and multi-site reconstructions of past SHWW variability from the Auckland Islands. Modern process and paleoclimate studies suggest that in lacustrine and fjord settings, the degree of water column mixing, the stable isotopic composition of n-alkanes and benthic foraminifera, and the influx of terrestrial organic matter are good indicators of wind-induced mixing of the water column or precipitation-driven erosion within catchments. During the Late Glacial and early Holocene (15 to 9 ka), elevated long-chain n-alkane δD values from ombrotrophic peatlands and an increase in the concentration of redox-sensitive elements in fjord sediment cores, signal weakening of the SHWW that appears to be coincident with periods of rapid deglacial warming of West Antarctica. Since 5.5 ka, we interpret declining n-alkane δD values to indicate enhanced westerly flow. These interpretations are in broad agreement with terrestrial paleoclimate records developed from southern South America and argue for a symmetrical response of the SHWW during
Organization of accident medical service in emergency situations in the system of Federal administration board for medical-biological and emergency problems at the Ministry of public health and medical industry of Russia
Federal Administration Board for medical-biological problems at the Ministry of Public Health and Medical Industry of Russia, in accordance with the entrusted functions, provides medical-sanitary service for the workers of the branches of industry with especially dangerous labour conditions. For these purpose, there is functioning in its system a network of therapeutic-prophylactic, sanitary, scientific-research, educational and other establishments. A high degree of accident danger of the attended industrial plants determines the state policy of organizations and administrations as well as scientific-practical establishments of the Federal Administration Board in respect of elaboration and introduction of a complex of measures which would enable to guarantee the safe functioning of the plants. All sub-administration establishments have the necessary structures, settle the questions of liquidation of medical-sanitary after-effects of accidents at the attended plants, and are regarded to be the organizations of specialized emergency medical aid of the Federal Administration Board
Miceli, Teresa S; Colson, Kathleen; Faiman, Beth M; Miller, Kena; Tariman, Joseph D
About 90% of individuals with multiple myeloma will develop osteolytic bone lesions from increased osteoclastic and decreased osteoblastic activity. Severe morbidities from pathologic fractures and other skeletal events can lead to poor circulation, blood clots, muscle wasting, compromised performance status, and overall poor survival. Supportive care targeting bone disease is an essential adjunct to antimyeloma therapy. In addition, the maintenance of bone health in patients with multiple myeloma can significantly improve quality of life. Oncology nurses and other healthcare providers play a central role in the management of bone disease and maintenance throughout the course of treatment. Safe administration of bisphosphonates, promotion of exercise, maintenance of adequate nutrition, vitamin and mineral supplementation, scheduled radiographic examinations, and monitoring of bone complications are among the important functions that oncology nurses and healthcare providers perform in clinical practice.
Health is a personal matter so it is up to each one of us to find our own ways to curb costs. But here are a few suggestions that you may find useful.For non-urgent cases, try asking for estimates from hospitals and clinics and compare them before committing yourself to extensive treatment; makedoctors realise - whether they are general practitioners or specialists - that you are concerned that your treatment should be at a reasonable cost;ask to have the various treatments available explained to you;if you are surprised by the size of your bill, insist that the items are explained to you and if necessary contact AUSTRIA;avoid long hospital stays for convenience sake;apart from the doctor's personal notes, medical files belong to the patient. You are also entitled to your x-rays and lab test results. Keep them thereby avoiding unnecessary repeat tests.These tips show that savings can be made without undermining the quality of care. We hope they will be helpful.
Derraik, José G. B.; Reed, Peter W.; Jefferies, Craig; Cutfield, Samuel W.; Hofman, Paul L.; Cutfield, Wayne S.
Background We aimed to evaluate the incidence of type 1 diabetes mellitus in children Auckland region (New Zealand) over 20 years (1990–2009). Methods We performed a retrospective review of all patients Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10–14 yr. There was little change in BMI SDS in this population, providing no support for the ‘accelerator hypothesis’. PMID:22389717
Monath, Thomas P; Caldwell, Joseph R; Mundt, Wolfgang; Fusco, Joan; Johnson, Casey S; Buller, Mark; Liu, Jian; Gardner, Bridget; Downing, Greg; Blum, Paul S; Kemp, Tracy; Nichols, Richard; Weltzin, Richard
The threat of smallpox as a biological weapon has spurred efforts to create stockpiles of vaccine for emergency preparedness. In lieu of preparing vaccine in animal skin (the original method), we cloned vaccinia virus (New York City Board of Health strain, Dryvax by plaque purification and amplified the clone in cell culture. The overarching goal was to produce a modern vaccine that was equivalent to the currently licensed Dryvax in its preclinical and clinical properties, and could thus reliably protect humans against smallpox. A variety of clones were evaluated, and many were unacceptably virulent in animal models. One clonal virus (ACAM1000) was selected and produced at clinical grade in MRC-5 human diploid cells. ACAM1000 was comparable to Dryvax in immunogenicity and protective activity but was less neurovirulent for mice and nonhuman primates. To meet requirements for large quantities of vaccine after the events of September 11th 2001, the ACAM1000 master virus seed was used to prepare vaccine (designated ACAM2000) at large scale in Vero cells under serum-free conditions. The genomes of ACAM1000 and ACAM2000 had identical nucleotide sequences, and the vaccines had comparable biological phenotypes. ACAM1000 and ACAM2000 were evaluated in three Phase 1 clinical trials. The vaccines produced major cutaneous reactions and evoked neutralizing antibody and cell-mediated immune responses in the vast majority of subjects and had a reactogenicity profile similar to that of Dryvax.
Full Text Available The rapid diversification of immigration to New Zealand post-1987 has made Auckland, as the nation’s key gateway city, both culturally and demographically superdiverse, and the location of considerable immigrant business development. We focus here on the development of ethnic precincts as the manifestation of this transformation of the cityscape. The neo-liberalism of the 1980s continues to prevail in the unwillingness of central and local government to recognise the ethnic/immigrant nature of such developments and there has been little in terms of either policy or resourcing to support or brand these precincts. As a consequence of this laissez-faire attitude, immigrants’ relational embeddedness tends to be privileged and ethnic-specific networks dictate the nature and location of ethnic precincts within a policy environment that stresses the importance of market processes and encourages small business development.
Mochizuki, N.; Tsunakawa, H.; Shibuya, H.; Cassidy, J.; Smith, I. E.
Shibuya et al. (1992) reported the Auckland excursion from several basaltic lava flows of monogenetic volcanic centers (Auckland Volcanic Field, New Zealand. The Auckland excursion was recorded in five centers in three intermediate direction groups of north-down, west and south. We carried out paleointensity and rock-magnetic studies in order to obtain the absolute paleointensities associated with three intermediate geomagnetic fields. Thermomagnetic analyses indicated typical Curie temperatures of 150-200, 450-500 and/or 550-580 oC. The Day plot (Day et al., 1977) showed a linear trend in the pseudo-single-domain range of magnetic carriers. Those results, combined with the reflection microscope observations, identified the magnetic carriers as titanomagnetites with wide variation in titanium content and grain size. First, the Coe's version of the Thellier method (Coe, 1967) was applied to the samples. Several samples seemed to give paleointensities ranging from 3.2 to 6.4 μ T (Shibuya and Cassidy, 1995 AGU fall meeting), but they were often affected by thermal alteration in the furnace even from fairly low temperature steps like 200oC. We were forced to introduce correction for thermal alterations in laboratory heating, using low temperature part of the Arai plot. We, therefore, applied the double heating technique (DHT) of Shaw method (Tsunakawa and Shaw, 1994), which was capable of detecting inappropriate results by the ARM correction, to the samples. The low temperature demagnetization (LTD) was combined with DHT (Yamamoto et al., submitted) before AF demagnetization and samples were heated in a vacuum of 10-100 Pa. Sixty-one samples from the five lava flows were subjected to the LTD-DHT Shaw method. Twenty-three of these samples yielded successful results passing the selection criteria. Five out of six paleointensities from the Crater Hill lava were consistent with each other. A mean paleointensity was given to be 10.9+/- 1.9 μ T (N=5) for the Crater Hill
Horrocks, M.; O'Loan, A.; Wallace, R.
Two sediment sequences from Pukekawa crater, Auckland Domain, contain silty clay underlain by fibrous peat. The peat contains a pollen flora and wood indicating the presence of a warm-temperate, conifer-hardwood forest with Metrosideros, Agathis, Prumnopitystaxifolia, P. ferruginea, and especially Dacrydium. Radiocarbon dates indicate that the peat was deposited before the Last Glacial Maximum (LGM). Absence of tephras and small amounts of Fuscospora pollen indicate probable non-preservation of the LGM. The pollen flora of most of the clay contains Metrosideros, Ascarina, and ferns, indicating post-LGM warmer, wetter conditions. The two uppermost samples contain exotic pollen, indicating that they are post-European in origin. Excavation and levelling to form sports fields and parkland appears to have curtailed and mixed the Holocene record. (author). 24 refs., 4 figs., 1 tab.
Davis, Robert E; Dougherty, Erin; McArthur, Colin; Huang, Qiu Sue; Baker, Michael G
The relationship between weather and influenza and pneumonia mortality was examined retrospectively using daily data from 1980 to 2009 in Auckland, New Zealand, a humid, subtropical location. Mortality events, defined when mortality exceeded 0·95 standard deviation above the mean, followed periods of anomalously cold air (ta.m. = -4·1, P < 0·01; tp.m. = -4·2, P < 0·01) and/or anomalously dry air (ta.m. = -4·1, P < 0·01; tp.m. = -3·8, P < 0·01) by up to 19 days. These results suggest that respiratory infection is enhanced during unusually cold conditions and during conditions with unusually low humidity, even in a subtropical location where humidity is typically high. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.
National Oceanic and Atmospheric Administration, Department of Commerce — Pilot boarding areas are locations at sea where pilots familiar with local waters board incoming vessels to navigate their passage to a destination port. Pilotage is...
Wheeler, Amanda; Moyle, Stuart; Jansen, Carol; Robinson, Elizabeth; Vanderpyl, Jane
This paper describes a follow-up of acute psychiatric hospital contact in Auckland, New Zealand for an admission cohort in the 5-years past an index admission (published in the NZMJ in 2005). A 5-year follow-up study of hospital psychiatric service utilisation by 924 patients admitted (index admission) in Auckland during 2000. Hospital admissions within New Zealand for this population were extracted from electronic records. Relevant demographic information (gender, age and ethnicity) and clinical data (primary diagnosis at index admission and admission history) were included for each person. Descriptive analysis of inpatient data and negative binomial regression models were conducted. Of 924 patients, 38.5% had no readmissions anywhere in New Zealand in the 5-years following index discharge. 41.0% were readmitted within 12 months and 61.4% were readmitted within 5 years of index discharge. Only 5.6% experienced an admission every year for the 5-years post index admission. Readmission was least likely for those with index discharge diagnosis of depression. A history of admissions prior to index admission and Maori ethnicity were characteristics associated with higher numbers of readmission. Those who were younger, or a diagnosis of schizophrenia/schizoaffective disorder or previous admissions tended to have longer total length of stay over the 5-years. More than a third of patients had no further hospital contact and the two factors associated with readmission were a history of previous admissions and Maori ethnicity. Reliable community-based data needs to be a priority to enable exploration of community service utilisation and impact of service alternatives to hospital for acute care.
Shane, P. A. R.; Linnell, T.; Lindsay, J. M.; Smith, I. E.; Augustinus, P. M.; Cronin, S. J.
Rangitoto is a small basaltic shield volcano representing the most recent and most voluminous episode of volcanism in the Auckland Volcanic Field, New Zealand. Auckland City is built on the field, and hence, Rangitoto's importance in hazard-risk modelling. The symmetrical edifice, ~6 km wide and 260 m high, has volume of 1.78 km3. It comprises summit scoria cones and a lava field. However, the lack of deep erosion dissection has prevented the development of an eruptive stratigraphy. Previous studies suggested construction in a relatively short interval at 550-500 yrs BP. However, microscopic tephra have been interpreted as evidence of intermittent activity from 1498 +/- 140 to 504 +/- 6 yrs BP, a longevity of 1000 years. A 150-m-deep hole was drilled through the edifice in February 2014 to obtain a continuous core record. The result is an unparalleled stratigraphy of the evolution of a small shield volcano. The upper 128 m of core comprises at least 27 lava flows with thicknesses in the range 0.3-15 m, representing the main shield-building phase. Underlying marine sediments are interbedded with 8 m of pyroclastic lapilli, and a thin lava flow, representing the explosive phreatomagmatic birth of the volcano. Preliminary geochemical analyses reveal suite of relatively uniform transitional basalts (MgO = 8.1 to 9.7 wt %). However, 4 compositional groups are distinguished that were erupted in sequential order. High-MgO magmas were erupted first, followed by a two more heterogeneous groups displaying differentiation trends with time. Finally, distinct low-MgO basalts were erupted. Each magma type appears to represent a new magma batch. The core places the magma types in a time series, which can be correlated to the surface lava field. Hence, allowing a geometrical reconstruction of the shield growth. Additional petrologic investigations are providing insight to magmatic ascent processes, while radiocarbon and paleomagnetic secular variation studies will reveal the
Kawabata, Emily; Bebbington, Mark S.; Cronin, Shane J.; Wang, Ting
In monogenetic volcanic fields, where each eruption forms a new volcano, focusing and migration of activity over time is a very real possibility. In order for hazard estimates to reflect future, rather than past, behavior, it is vital to assemble as much reliable age data as possible on past eruptions. Multiple swamp/lake records have been extracted from the Auckland Volcanic Field, underlying the 1.4 million-population city of Auckland. We examine here the problem of matching these dated deposits to the volcanoes that produced them. The simplest issue is separation in time, which is handled by simulating prior volcano age sequences from direct dates where known, thinned via ordering constraints between the volcanoes. The subproblem of varying deposition thicknesses (which may be zero) at five locations of known distance and azimuth is quantified using a statistical attenuation model for the volcanic ash thickness. These elements are combined with other constraints, from widespread fingerprinted ash layers that separate eruptions and time-censoring of the records, into a likelihood that was optimized via linear programming. A second linear program was used to optimize over the Monte-Carlo simulated set of prior age profiles to determine the best overall match and consequent volcano age assignments. Considering all 20 matches, and the multiple factors of age, direction, and size/distance simultaneously, results in some non-intuitive assignments which would not be produced by single factor analyses. Compared with earlier work, the results provide better age control on a number of smaller centers such as Little Rangitoto, Otuataua, Taylors Hill, Wiri Mountain, Green Hill, Otara Hill, Hampton Park and Mt Cambria. Spatio-temporal hazard estimates are updated on the basis of the new ordering, which suggest that the scale of the 'flare-up' around 30 ka, while still highly significant, was less than previously thought.
Gilmer, G.; Moy, C. M.; Vandergoes, M.; Gadd, P.; Riesselman, C. R.; Jacobsen, G. E.; Wilson, G. S.; Visinand, C.
Situated within the core of the Southern Hemisphere westerly winds, and between the subtropical and subantarctic fronts, the New Zealand subantarctic islands are uniquely positioned to evaluate past ocean and atmospheric change in the middle to high southern latitudes. We collected a series of sediment cores from Auckland Island fjords to produce a high-resolution record of climate change following the Last Glacial Maximum. Physical property and organic geochemical data, Itrax XRF, and visual core descriptions indicate the cores capture several phases of sedimentation. From these studies, we identify four primary sedimentary facies: 1) a deglacial facies exhibiting mm-scale laminae defined by magnetic susceptibility and density contrasts and high counts of elements associated with terrigenous sources; 2) a lacustrine facies defined by very low density, high organic carbon concentrations and low counts of lithophilic elements; 3) a marine transgression facies with moderate density, moderate bioturbation and alternating marine and lacustrine sedimentary components; 4) a marine facies that contains biogenic carbonate. Radiocarbon results indicate deglacial sedimentation was underway in the basin by approximately 19,000 cal yr BP. Lacustrine deposition in ice-free conditions began around 15,600 cal yr BP and continued until marine transgression at approximately 9,500 cal yr BP. During the early Holocene between 11 and 9.5 ka, we observe elevated n-alkane δD values and an overall increase in redox-sensitive elements that signal a combination of warmer atmospheric temperatures and reduced westerly wind strength that drives fjord stratification. Poleward-shifted westerlies south of the Auckland Islands could accommodate these results, but there are few records to corroborate this interpretation. We will discuss these results within the context of developing New Zealand and subantarctic paleoclimate records in order to provide a more comprehensive record of past change.
Holland, DJ; Cooper, B; Garner, J; Ellis-Pegler, R; Mee, E
Notes were reviewed for 68 patients with brain abscess diagnosed at Auckland Hospital, Auckland, New Zealand between 1978 and 1988. Mean age was 30 years (range one week to 74 years). There were 48 men and 40% were Maori or Pacific Island Polynesians. Seventy-two per cent of patients had headache, 54% had fever and 72% had lateralizing neurological signs. Thirty-one per cent of abscesses were associated with contiguous infection (otic, sinus, dental). Forty-four per cent were in the frontal lobe. Two abscesses were sterile; 197 bacterial isolates were cultured from the remainder. Fifty-four per cent contained obligate anaerobes, which were the only isolates in 22%. Streptococcus anginosus was the single most common isolate present in 22% of the abscesses. Amoxycillin plus metronidazole provided cover for approximately 95% of the total isolates on the basis of sensitivity testing. Treatment was with surgery and antibiotics in all but three patients, who were cured with antibiotics alone. Sixty per cent had a definitive regimen of penicillin (or ampicillin/amoxycillin) and/or metronidazole, always intravenous initially but subsequently often orally. Median duration of antibiotic treatment was 57 days (range 28 to 206). Seventy-five per cent had initial aspiration, 9% open drainage and 7% were excised initially. Seventy-one per cent had a good functional outcome. Mortality was 8.8%. Factors associated with a poor outcome were trauma as a cause, and delays after admission of more than seven days to diagnosis and/or operation. PMID:22346451
Beig, Junaid; Khanolkar, Manish; Cundy, Tim
Type 2 diabetes (T2D) in young adults is associated with a high risk of diabetes complications. To investigated the demography and the emergence of complications of young adults with T2D in the central Auckland region where there has been substantial immigration. In total, 310 young adults with T2D (Auckland Diabetes Centre in 2015. We documented demographic, anthropometric and metabolic variables and prevalence and the emergence of complications. Three demographic groups accounted for 243 participants (78%): 135 (44%) were migrants of Asian or Pacific Island origin, diagnosed a median 9 years after migration at a mean age of 28 ± 6 years; 88 (29%) were New Zealand-born Pāsifika descent, with a high prevalence of morbid obesity and 37 (12%) had major mental illness or intellectual disability. At diagnosis, the median HbA1c was 80 mmol/mol, and in 28%, it was ≥100 mmol/mol. A median 6 years after diagnosis, 56% had some degree of retinopathy, with the prevalence related both to the duration of diabetes and glycaemic control (P = 0.001). Forty-four percent of subjects had abnormal albuminuria at diagnosis (12% with macroalbuminuria). Increased albuminuria was strongly associated with obesity (P = 0.002). The development of CKD stages 4-5 was related both to the severity of retinopathy and degree of albuminuria at diagnosis (P = 0.0001). Major cardiovascular events were related to the severity of retinopathy at diagnosis (P = 0.0001). New migrants, New Zealand-born Pāsifika and patients with mental illness or an intellectual disability comprise the bulk of young onset T2D. The disease is aggressive, and by the age of 40, patients are already developing advanced complications. © 2017 Royal Australasian College of Physicians.
B. Visser (Bauke); S. Dominguez Martinez (Silvia); O.H. Swank (Otto)
textabstractIt is often assumed that bad corporate performance means a bad CEO. The task of a board of directors is then simple: dismiss the executive. If it fails to do so, the board is said to be indolent. We take a kinder approach to observed board behaviour and point to the problems even
Curran, Connie R
Health care reform will result in significant changes in reimbursement with much greater emphasis put on primary care, home care, and other types of non-acute care. The changes in reimbursement will necessitate significant changes in organizational structure and operations. It is essential board members keep current in their knowledge of health care finance so they can execute their responsibilities for the financial health of the organization. The board must ensure that the budget is aligned with the organization's financial objectives and monitor the financial performance. It is essential the chief nursing officer (CNO) contributes to the board's understanding of the financial health of the organization. The board of trustees will more effectively execute their financial responsibilities with the input of nurse trustees and the CNO.
The article analyses the legal consequences of the choice now available to Danish public limited companies, which can now opt for a two-tier management structure, in which the management board undertakes both the day-to-day and the overall management, while a supervisory board exercises control...... over the management board, including its appointment and dismissal. The article considers which companies a two-tier structure may be relevant for, and reviews the consequences for the composition, election and functioning of the company organs....
Sundean, Lisa J; Polifroni, E Carol
Nurses' knowledge, skills, and expertise uniquely situate them to contribute to health care transformation as equal partners in organizational board governance. The Institute of Medicine, the 10,000 Nurses on Boards Coalition, and a growing number of nurse and health care scholars advocate nurse board leadership; however, nurses are rarely appointed as voting board members. When no room is made for nurses to take a seat at the table, the opportunity is lost to harness the power of nursing knowledge for health care transformation and social justice. No philosophical framework underpins the emerging focus on nurse board leadership. The purpose of this article is to add to the extant nursing literature by suggesting feminism as a philosophical framework for nurses on boards. Feminism contributes to the knowledge base of nursing as it relates to the expanding roles of nurses in health care transformation, policy, and social justice. Furthermore, a feminist philosophical framework for nurses on boards sets the foundation for new theory development and validates ongoing advancement of the nursing profession. Copyright © 2016 Elsevier Inc. All rights reserved.
Valery L Feigin
Full Text Available Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ over 30-years.Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years of Auckland NZ in 1981-1982, 1991-1992, 2002-2003 and 2011-2012. All used standard World Health Organization (WHO diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard annual incidence and mortality with corresponding 95% confidence intervals (CI were calculated per 100,000 people, assuming a Poisson distribution.5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31% and 62% (95% CI 36%-86%, respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively compared with NZ/Europeans (mean age 75 years. There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17% across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in
Feigin, Valery L; Krishnamurthi, Rita V; Barker-Collo, Suzanne; McPherson, Kathryn M; Barber, P Alan; Parag, Varsha; Arroll, Bruce; Bennett, Derrick A; Tobias, Martin; Jones, Amy; Witt, Emma; Brown, Paul; Abbott, Max; Bhattacharjee, Rohit; Rush, Elaine; Suh, Flora Minsun; Theadom, Alice; Rathnasabapathy, Yogini; Te Ao, Braden; Parmar, Priya G; Anderson, Craig; Bonita, Ruth
Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years. Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years) of Auckland NZ in 1981-1982, 1991-1992, 2002-2003 and 2011-2012. All used standard World Health Organization (WHO) diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard) annual incidence and mortality with corresponding 95% confidence intervals (CI) were calculated per 100,000 people, assuming a Poisson distribution. 5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31%) and 62% (95% CI 36%-86%), respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively) compared with NZ/Europeans (mean age 75 years). There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17%) across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in frequency
Feigin, Valery L.; Krishnamurthi, Rita V.; Barker-Collo, Suzanne; McPherson, Kathryn M.; Barber, P. Alan; Parag, Varsha; Arroll, Bruce; Bennett, Derrick A.; Tobias, Martin; Jones, Amy; Witt, Emma; Brown, Paul; Abbott, Max; Bhattacharjee, Rohit; Rush, Elaine; Suh, Flora Minsun; Theadom, Alice; Rathnasabapathy, Yogini; Te Ao, Braden; Parmar, Priya G.; Anderson, Craig; Bonita, Ruth
Background Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years. Methods Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years) of Auckland NZ in 1981–1982, 1991–1992, 2002–2003 and 2011–2012. All used standard World Health Organization (WHO) diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard) annual incidence and mortality with corresponding 95% confidence intervals (CI) were calculated per 100,000 people, assuming a Poisson distribution. Results 5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31%) and 62% (95% CI 36%-86%), respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively) compared with NZ/Europeans (mean age 75 years). There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17%) across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes
A. Visser; Dr. H.A. van der Stege; Dr. S.R. Hilberink; Dr. A.L. van Staa
This study evaluated the feasibility and appreciation of a new educational board game (SeCZ TaLK) that stimulates communication on sexuality and intimate relationships in youth with chronic conditions.
Bergin, Peter; Jayabal, Jayaganth; Walker, Elizabeth; Davis, Suzanne; Jones, Peter; Dalziel, Stuart; Yates, Kim; Thornton, Vanessa; Bennett, Patricia; Wilson, Kaisa; Roberts, Lynair; Litchfield, Rhonda; Te Ao, Braden; Parmer, Priya; Feigin, Valery; Jost, Jeremy; Beghi, Ettore; Rossetti, Andrea O
The EpiNet project has been established to facilitate investigator-initiated clinical research in epilepsy, to undertake epidemiological studies, and to simultaneously improve the care of patients who have records created within the EpiNet database. The EpiNet database has recently been adapted to collect detailed information regarding status epilepticus. An incidence study is now underway in Auckland, New Zealand in which the incidence of status epilepticus in the greater Auckland area (population: 1.5 million) will be calculated. The form that has been developed for this study can be used in the future to collect information for randomized controlled trials in status epilepticus. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.
Horrocks, M.; Deng, Y.; Nichol, S.L.; Shane, P.A.; Ogden, J.
A multi-proxy analysis of a sediment core from Waiatarua, Auckland Isthmus, adds to an environmental history from the local wetland spanning the Late Glacial to modern times. Several distal tephra were recorded in the core: 8.5 ka Rotoma (reworked), 6.1 ka Tuhua (primary and reworked), most likely the 1.8 ka Taupo (the latter is previously unreported for the Auckland Isthmus), and one unidentified, possibly 665 yr BP Kaharoa. Pollen and diatom analyses of the core show that during the period c. 6000-c. 4800 yr BP, the site was a lake fringed with Cyperaceae/Leptospermum swamp. The lake became progressively shallower after c. 4800 yr BP, probably due to hydroseral infilling. Surrounding the lake was forest dominated by Dacrydium, Prumnopitys, Metrosideros, and Nestegis. Transition to the Polynesian era appears unclear because the site probably endured a hiatus due to destruction of peat by burning in European times. (author). 39 refs., 4 figs., 2 tabs
McAuliffe, Gary N; Taylor, Susan L; Drinković, Dragana; Roberts, Sally A; Wilson, Elizabeth M; Best, Emma J
In July 2014, New Zealand introduced universal infant vaccination with RotaTeq (Merk & Co.) administered as 3 doses at 6 weeks, 3 and 5 months of age. We sought to assess the impact of rotavirus vaccination on gastroenteritis (GE) hospitalizations in the greater Auckland region and analyze changes in rotavirus testing in the period around vaccine introduction. Hospitalizations, laboratory testing rates and methods were compared between the pre-vaccine period (2009-2013), post-vaccine period (January 2015 to December 2015) and year of vaccine introduction (2014). There was a 68% decline in rotavirus hospitalizations of children Auckland region. However, continued rotavirus testing at pre-vaccine rates risks generating false positive results. Laboratories and clinicians should consider reviewing their testing algorithms before vaccine introduction.
Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L
In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.
Walton, AnnMarie; Lake, Donna; Mullinix, Connie; Allen, Deborah; Mooney, Kathi
Nurses need to be full partners in shaping health care and health care policy. One way to do this is to be present and active on boards at all levels. The purpose of this study is to examine the orientation experiences of nurses to boards and their preparation to influence health care and health care policy. A Web-based survey about the efficacy of board orientation was sent to members of three local boards made up exclusively of nurses. Liabilities and fiduciary duties were least likely to be addressed in board orientation for nurses. Board members requested more training in finance and a more formal/structured orientation process. Standardizing orientation elements for nurses serving on boards would best prepare them to serve on interprofessional hospital boards and work in the health policy arena. The orientation experience on local- and state-level nursing boards is fundamental to nurses beginning board service. Copyright © 2015 Elsevier Inc. All rights reserved.
Mazot, Agnès; Smid, Elaine R.; Schwendenmann, Luitgard; Delgado-Granados, Hugo; Lindsay, Jan
The Auckland Volcanic Field (AVF) is a dormant monogenetic basaltic field located in Auckland, New Zealand. Though soil gas CO2 fluxes are routinely used to monitor volcanic regions, there have been no published studies of soil CO2 flux or soil gas CO2 concentrations in the AVF to date or many other monogenetic fields worldwide. We measured soil gas CO2 fluxes and soil gas CO2 concentrations in 2010 and 2012 in varying settings, seasons, and times of day to establish a baseline soil CO2 flux and to determine the major sources of and controlling influences on Auckland's soil CO2 flux. Soil CO2 flux measurements varied from 0 to 203 g m-2 day-1, with an average of 27.1 g m-2 day-1. Higher fluxes were attributed to varying land use properties (e.g., landfill). Using a graphical statistical approach, two populations of CO2 fluxes were identified. Isotope analyses of δ13CO2 confirmed that the source of CO2 in the AVF is biogenic with no volcanic component. These data may be used to assist with eruption forecasting in the event of precursory activity in the AVF, and highlight the importance of knowing land use history when assessing soil gas CO2 fluxes in urban environments.
Fernando, Ruchira S W; Muthu, Carl
To assess the effectiveness of adopting endovenous laser treatment (EVLT) as the primary treatment modality for varicose veins at Auckland City Hospital (Auckland, New Zealand). The outcomes of 354 consecutive EVLT procedures performed between 2007 and 2013 were reviewed. Data was collected from a prospectively maintained procedural database and by retrospective chart review. Of the 319 patients who had an ultrasound, at 1 month post-procedure there was a saphenous vein occlusion rate of 96%. Side effects were minimal with no cases of DVT or skin burns and one case of self-limiting neuralgia. The procedure was well tolerated with a median pain score of 3. Since the adoption of EVLT there has been a large increase in the number of patients treated for varicose veins (28 in 2007 compared to 176 in 2013). EVLT is a safe and effective treatment for varicose veins and its adoption has allowed a large increase in the number of varicose vein patients treated at Auckland City Hospital.
Hawken, Susan J; Huggard, Peter; Alley, Patrick; Clark, Angela; Moir, Fiona
This article presents a consensus statement that arose from the views of participants that attended the multidisciplinary conference "The Health of the Health Professional", in Auckland in November 2011. A healthy workforce is the key to improving the health of all New Zealanders. Yet health practitioners' health is of concern, and despite the evidence of real problems little has been done to constructively and systematically address these issues. This consensus statement provides some potential ways to move forward.
Torrecillas Nunez, C.; Miguel-rodriguez, A.
As a collaborative project between the Faculties of Engineering of the University of Sinaloa, Mexico and the University of Auckland, an inter-disciplinary team researched historical information, monitoring results and modelling completed over the last ten years to establish the cause-effect relationship of development and human impacts in the watershed and recommend strategies to offset them .The research program analyzed the performance of the Twin Streams watershed over time with modelling of floods, hydrological disturbance indicators, analysis of water quality and ecological information, cost / benefit, harbor modelling and contaminant loads. The watershed is located in the west of Auckland and comprises 10,356 hectare: 8.19% ecologically protected area, 29.70% buffer zone, 6.67% peri-urban, 30.98% urban, 16.04% parks, and 8.42% other; average impermeability is 19.1%. Current population is 129,475 (2011) forecast to grow to 212,798 by 2051. The watershed includes 317.5 km of streams that drain to the Waitemata Harbor. The human impact can be traced back to the 1850s when the colonial settlers logged the native forests, dammed streams and altered the channel hydro-ecology resulting in significant erosion, sediment and changes to flows. In the early 1900s native vegetation started to regenerate in the headwaters, while agriculture and horticulture become established in rest of the watershed leading to the use of quite often very harmful pesticides and insecticides, such as DDT which is still detected in current environmental monitoring programs, and more erosion and channel alterations. As land become unproductive in the 1950s it stared to be urbanized, followed by more intensive urban development in the 1990s. Curiously there was no regulatory regime to control land use in the early stages and consequently over 400 houses were built in the floodplains, as well there were no legislation to control environmental impacts until 1991. Consequently today there is a
Brand, B. D.; Gravley, D.; Clarke, A. B.; Bloomberg, S. H.
The most dangerous phenomena associated with phreatomagmatic eruptions are dilute pyroclastic density currents (PDCs). These are turbulent, ground-hugging sediment gravity currents that travel radially away from the explosive center at up to 100 m/s. The Auckland Volcanic Field (AVF), New Zealand, consists of approximately 50 eruptive centers, at least 39 of which have had explosive phreatomagmatic behaviour. A primary concern for future AVF eruptions is the impact of dilute PDCs in and around the Auckland area. We combine field observations from the Maungataketake tuff ring, which has one of the best exposures of dilute PDC deposits in the AVF, with a quantitative model for flow of and sedimentation from a radially-spreading, steady-state, depth-averaged dilute PDC (modified from Bursik and Woods, 1996 Bull Volcanol 58:175-193). The model allows us to explore the depositional mechanisms, macroscale current dynamics, and potential impact on societal infrastructure of dilute PDCs from a future AVF eruption. The lower portion of the Maungataketake tuff ring pyroclastic deposits contains trunks, limbs and fragments of Podocarp trees (strength of the wood, we calculate that dynamic pressures (Pdyn) of 10-75 kPa are necessary to topple trees of this size and composition. Thus the two main criteria for model success based on the field evidence include (a) Pdyn must be >10 kPa nearer than 0.9 km to the vent, and 35 kPa can be expected within 3 km from source, ensuring complete destruction of the area; Pdyn > 15 kPa up to 5 km from source, resulting in heavy structural damage to most buildings and near destruction of weaker buildings; and Pdyn <10 kPa at ~6 km from source, resulting in severe damage to weaker structures at least up to this distance. This exercise illustrates our ability to combine field measurements with numerical techniques to explore controlling parameters of dilute PDC dynamics. These tools can be used to understand and estimate the damage potential and
Agustín-Flores, Javier; Németh, Károly; Cronin, Shane J.; Lindsay, Jan M.; Kereszturi, Gábor; Brand, Brittany D.; Smith, Ian E. M.
Maungataketake is a monogenetic basaltic volcano formed at ~ 85-89 ka in the southern part of the Auckland Volcanic Field (AVF), New Zealand. It comprises a basal 1100-m diameter tuff ring, with a central scoria/spatter cone and lava flows. The tuff ring was formed under hydrogeological and geographic conditions very similar to the present. The tuff records numerous density stratified, wet base surges that radiated outward up to 1 km, decelerating rapidly and becoming less turbulent with distance. The pyroclastic units dominantly comprise fine-grained expelled grains from various sedimentary deposits beneath the volcano mixed with a minor component of juvenile pyroclasts (~ 35 vol.%). Subtle lateral changes relate to deceleration with distance and vertical transformations are minor, pointing to stable explosion depths and conditions, with gradual transitions between units and no evidence for eruptive pauses. This volcano formed within and on ~ 60 m-thick Plio/Pleistocene, poorly consolidated, highly permeable shelly sands and silts (Kaawa Formation) capped by near-impermeable, water-saturated muds (Tauranga Group). These sediments rest on moderately consolidated Miocene-aged permeable turbiditic sandstones and siltstones (Waitemata Group). Magma-water fuelled thermohydraulic explosions remained in the shallow sedimentary layers, excavating fine-grained sediments without brittle fragmentation required. On the whole, the resulting cool, wet pyroclastic density currents were of low energy. The unconsolidated shallow sediments deformed to accommodate rapidly rising magma, leading to development of complex sill-like bodies and a range of magma-water contact conditions at any time. The weak saturated sediments were also readily liquefied to provide an enduring supply of water and fine sediment to the explosion loci. Changes in magma flux and/or subsequent stabilisation of the conduit area by a lava ring-barrier led to ensuing Strombolian and fire-fountaining eruption
Holm Pedersen, T
The purpose of this report is, through a limited literature study, to elucidate the direct and probable indirect health effects due to wind turbine noise / vibrations / shadow effect. It is shown that the wind turbine noise's character is not substantially different from many other sources of noise in our daily lives. The sound levels are rather low, seen in relation to the sound impacts that we normally are exposed to, and that also includes low-frequency noise. Audible infrasound does not occur. Noise annoyance is the most significant effect of noise from wind turbines. The noise annoyance from wind turbines is greater than from road traffic at the same level of noise. At the noise limit of 39 dB for noise-sensitive land use one must expect that for wind turbines about 10% is highly annoying. Sleep disorders can occur. There is a sharp increase in the percentage of sleep disorders just above the noise limits. There was not found a direct correlation between stress and noise. By contrast, significant correlations between stress symptoms and noise nuisance are found. Existing studies show no significant correlations to chronic diseases, diabetes, high blood pressure and cardiovascular diseases. The literature reports on phenomenon called vibro-acoustic diseases and wind turbine syndrome, without, however, a proven causal dose-response relationship or without conducted studies where it is compared to control groups. These phenomena are not considered real for wind turbines. On the present basis, there are no demonstrated direct health effects due to wind turbine noise, though there are observed correlation between noise and stress symptoms Shadows from the rotating blades are annoying, but cannot induce epileptic attacks. (LN)
Holm Pedersen, T.
The purpose of this report is, through a limited literature study, to elucidate the direct and probable indirect health effects due to wind turbine noise / vibrations / shadow effect. It is shown that the wind turbine noise's character is not substantially different from many other sources of noise in our daily lives. The sound levels are rather low, seen in relation to the sound impacts that we normally are exposed to, and that also includes low-frequency noise. Audible infrasound does not occur. Noise annoyance is the most significant effect of noise from wind turbines. The noise annoyance from wind turbines is greater than from road traffic at the same level of noise. At the noise limit of 39 dB for noise-sensitive land use one must expect that for wind turbines about 10% is highly annoying. Sleep disorders can occur. There is a sharp increase in the percentage of sleep disorders just above the noise limits. There was not found a direct correlation between stress and noise. By contrast, significant correlations between stress symptoms and noise nuisance are found. Existing studies show no significant correlations to chronic diseases, diabetes, high blood pressure and cardiovascular diseases. The literature reports on phenomenon called vibro-acoustic diseases and wind turbine syndrome, without, however, a proven causal dose-response relationship or without conducted studies where it is compared to control groups. These phenomena are not considered real for wind turbines. On the present basis, there are no demonstrated direct health effects due to wind turbine noise, though there are observed correlation between noise and stress symptoms Shadows from the rotating blades are annoying, but cannot induce epileptic attacks. (LN)
Wing, D. R.; Austin, G. L.
The University of Auckland Global Mars Mesoscale Meteorological Model (GM4) is a numerical weather prediction model of the Martian atmosphere that has been developed through the conversion of the Penn State University / National Center for Atmospheric Research fifth generation mesoscale model (MM5). The global aspect of this model is self consistent, overlapping, and forms a continuous domain around the entire planet, removing the need to provide boundary conditions other than at initialisation, yielding independence from the constraint of a Mars general circulation model. The brief overview of the model will be given, outlining the key physical processes and setup of the model. Comparison between data collected from Mars Pathfinder during its 1997 mission and simulated conditions using GM4 have been performed. Diurnal temperature variation as predicted by the model shows very good correspondence with the surface truth data, to within 5 K for the majority of the diurnal cycle. Mars Viking Data is also compared with the model, with good agreement. As a further means of validation for the model, various seasonal comparisons of surface and vertical atmospheric structure are conducted with the European Space Agency AOPP/LMD Mars Climate Database. Selected simulations over regions of interest will also be presented.
Gentschew, Liljana; Bishop, Karen S; Han, Dug Yeo; Morgan, Angharad R; Fraser, Alan G; Lam, Wen Jiun; Karunasinghe, Nishi; Campbell, Bobbi; Ferguson, Lynnette R
New Zealand has one of the highest incidence rates of Crohn's Disease (CD), whilst the serum selenium status of New Zealanders is amongst the lowest in the world. A prospective case-control study in Auckland, New Zealand considered serum selenium as a potential CD risk factor. Serum selenium levels were significantly lower in CD patients compared to controls (101.8 ± 1.02 vs. 111.1 ± 1.01 ng/mL) (p = 5.91 × 10(-8)). Recent detailed studies in the United Kingdom have suggested an optimal serum level around 122 ng/mL, making the average CD patient in New Zealand selenium deficient. Of the 29 single nucleotide polymorphisms (SNPs) tested, 13 were found to significantly interact with serum selenium on CD. After adjustment for multiple testing, a significant interaction with serum selenium on CD was found for three SNPs, namely rs17529609 and rs7901303 in the gene SEPHS1, and rs1553153 in the gene SEPSECS. These three SNPs have not been reported elsewhere as being significantly associated with selenium or CD. It is unclear as to whether lower selenium levels are a cause or an effect of the disease.
Ergler, Christina R; Kearns, Robin; Witten, Karen
Studies of seasonal barriers for outdoor activities seldom view families' play practices as grounded in the everyday experience of the natural elements. This paper brings 20 families' mundane outdoor play experiences in Auckland's temperate climate to the fore. Through drawings and interviews, families residing in both suburban detached houses and central city apartments revealed locally constituted beliefs about appropriate play spaces (e.g. garden, park). While the majority of participants retreated to indoor activities during winter, some children and their parents viewed the outdoors as the only opportunity for 'real fun'. We advocate the importance of a better understanding of children's seasonal outdoor play. In particular, we argue that in order to promote year-round healthy levels of outdoor activities it is necessary to understand variations in societal, neighbourhood and family values attributed to outdoor activities. Further, to develop a more nuanced understanding of the locational complexities of outdoor play it is important to understand the meanings of, and practices associated with, seasonal and weather conditions in different international locations. Copyright © 2016 Elsevier Ltd. All rights reserved.
Waite, David W; Dsouza, Melissa; Biswas, Kristi; Ward, Darren F; Deines, Peter; Taylor, Michael W
The endemic New Zealand weta is an enigmatic insect. Although the insect is well known by its distinctive name, considerable size, and morphology, many basic aspects of weta biology remain unknown. Here, we employed cultivation-independent enumeration techniques and rRNA gene sequencing to investigate the gut microbiota of the Auckland tree weta (Hemideina thoracica). Fluorescence in situ hybridisation performed on different sections of the gut revealed a bacterial community of fluctuating density, while rRNA gene-targeted amplicon pyrosequencing revealed the presence of a microbial community containing high bacterial diversity, but an apparent absence of archaea. Bacteria were further studied using full-length 16S rRNA gene sequences, with statistical testing of bacterial community membership against publicly available termite- and cockroach-derived sequences, revealing that the weta gut microbiota is similar to that of cockroaches. These data represent the first analysis of the weta microbiota and provide initial insights into the potential function of these microorganisms.
Gow, N; Briggs, S; Nisbet, M
New Zealand, which has a low incidence of tuberculosis (TB), has historically taken a risk-based approach to screening for latent tuberculous infection (LTBI) in adult people living with the human immunodeficiency virus infection (PLHIV). To evaluate LTBI screening, treatment and outcomes in an adult PLHIV population. This was a retrospective clinical record review of an initial cohort of adult PLHIV attending the Auckland City Hospital HIV clinic in 2011, and a second cohort of adult PLHIV newly attending the clinic in 2014. We analysed high-risk (born in or acquiring HIV in a high TB incidence country) and low-risk patients using descriptive statistical methods. Of the 752 patients from the initial cohort, 416 (55%) had documentation of LTBI screening, which was positive in 74 (10%): 19/461 (4%) low-risk and 55/291 (19%) high-risk patients. LTBI treatment was received in 13 low-risk and 44 high-risk patients. Of 73 patients in the second cohort, 68 (93%) were screened. LTBI screening was incomplete in our clinic, but improved between 2011 and 2014. A significant number of patients with LTBI did not originate from a high TB incidence country.
Horrocks, M.; Nichol, S.L.; D'Costa, D.M.; Shane, P.; Prior, C.
A 2.34 m sediment profile from the base of the crater of Mt St John volcano (a small basaltic cone on Auckland Isthmus) provides a partial environmental record of the Late Quaternary. The record highlights potential age control problems with sediment cores taken directly from archaeological sites. Two distal tephras were recorded: 9.5 ka Rotoma and 7 ka Tuhua. A date of 16 309 ± 90 14 C yr BP from the basal scoria of the profile provides a minimum date for the eruption of Mt St John. Pollen was present only in the upper 0.33 m of the profile, in a layer of peat and soil which caps highly weathered silts and clays eroded from the crater walls. In early Polynesian times (most likely after c. 800 14 C yr BP), vegetation of the crater swamp was dominated by Cyperaceae sedges and Paesia ground fern. Dacrycarpus trees were also present. Podocarp-hardwood forest, dominated by Metrosideros, grew on the rim and inner slopes of the crater. Elaeocarpus, Griselinia, and Cyathea were also present. A decline in Dacrycarpus pollen and an accelerated erosion rate mark Polynesian forest clearance within the crater. Typha became a major component of the swamp vegetation during the Late Polynesian-European era. (author). 30 refs., 5 figs., 2 tabs
Andajani-Sutjahjo, Sari; Liew, Theresa C H; Smith, John F; Esekielu, Iutita; Mason, Gabrielle; Tariu, Imele
This article discusses the experiences of community volunteers' participation in a community-based participatory research project in Tāmaki, a low socio-economic and ethnically diverse suburban community within greater Auckland City, New Zealand. In the Tāmaki Community Action Research project, community volunteers were recruited and trained to conduct random household surveys (RHS) and asset mapping commissioned by community groups and government agencies in that area. The volunteers were involved in planning, coordination and ongoing governance of the project and ∼70 residents and local university students participated at different stages of the 2-year project. Over 600 RHS were completed and the volunteers' experiences were recorded in field notes, informal group discussions, daily team meetings and individual interviews and form the basis of this article. Only their experiences are discussed here, not the survey results which will be presented elsewhere. The project reflected the inherent asset-rich nature of the community via examples of individual volunteer empowerment and collective social/community capacity building. Volunteers increased their interpersonal and organizational skills, their understanding of the complexity of their community's logistics and cultural diversity, and gained an increased sense of community purpose and commitment. There was very strong endorsement of culturally sensitive research practice to recognize cultural differences and to engage productively within their richly ethnically diverse community. Full community volunteer participation in the project's governance (i.e. through design, training, implementation and ongoing consultation/management phases) was considered key to sustaining the life of project.
Safar, Atheer; Stewart, Joanna; Trenholme, Adrian; Drinkovic, Dragana; Peat, Briar; Taylor, Susan; Read, Kerry; Roberts, Sally; Voss, Lesley
We aimed to assess the effect of invasive group A streptococcal (GAS) infection and the potential effects of a multivalent GAS vaccine in New Zealand. During January 2005–December 2006, we conducted prospective population-based laboratory surveillance of Auckland residents admitted to all public hospitals with isolation of GAS from normally sterile sites. Using emm typing, we identified 225 persons with confirmed invasive GAS infection (median 53 years of age; range 0–97 years). Overall incidence was 8.1 cases per 100,00 persons per year (20.4/100,000/year for Maori and Pacific Islanders; 24.4/100,000/year for persons >65 years of age; 33/100,000/year for infants Auckland’s lowest socioeconomic quintile. Twenty-two persons died, for an overall case-fatality rate of 10% (63% for toxic shock syndrome). Seventy-four percent of patients who died had an underlying condition. To the population in our study, the proposed 26-valent vaccine would provide limited benefit. PMID:21749758
Three chronostratigraphic units based on accumulative deposits and their respective soils are proposed for late Holocene coastal deposits between Auckland and Dunedin, New Zealand: Tamatean Chronozone (c. 1,800 to 450 years BP), Ohuan Chronozone (c. 450 to 150 years BP), and Hoatan Chronozone (c. 150 years to present day). The chronozones represent depositional episodes each consisting of two phases: a high rate of deposition (unstable phase), followed by a low rate of deposition and soil formation (stable phase). Vegetation on soils formed during the stable phases is inferred principally from landsnails recovered from archaeological sites. Forest on Tamatean soil (600 to 450 years BP) advanced almost to the coast in the Manawatu, the southeast Wairarapa, and on the East Coast. Sediment thickness measured at sections along the eastern North Island coast show that rates of deposition during unstable phases have decreased during the last 650 years. The depositional episodes appear to be unrelated to sea level changes, tectonic activity, volcanic eruptions or cultural influence. Unstable phases appear to correlate with times of high temperatures, and stable phases with time of low temperatures; it is suggested that the episodes may be related to changes in the frequency of tropical and extratropical cyclones. Inferred climate during unstable phases is windy and dry, and during stable phases, less windy and moist
Blackman, N.S.; Gummer, W.K.
This paper has been prepared to provide an overview of the responsibilities and activities of the Atomic Energy Control Board. It is designed to address questions that are often asked concerning the establishment of the Atomic Energy Control Board, its enabling legislation, licensing and compliance activities, federal-provincial relationships, international obligations, and communications with the public
Giles, Rebecca M.; Shaw, Edward L.
SMART Board is a technology that combines the functionality of a whiteboard, computer, and projector into a single system. The interactive nature of the SMART Board offers many practical uses for providing an introduction to or review of material, while the large work area invites collaboration through social interaction and communication. As a…
The Board on Chemical Sciences and Technology organizes and provides direction for standing and ad-hoc committees charged with addressing specific issues relevant to the continued health of the chemical sciences and technology community. Studies currently under the oversight of the BCST include a major survey of the chemical sciences, a complementary survey of chemical engineering, an examination of the problems of biohazards in the laboratory, and an analysis of the roots and magnitude of the problem of obsolescent facilities for research and teaching in departments in the chemical sciences and engineering. The Board continues to respond to specific agency requests for program assessments and advice. BCST members are designated to serve as liaison with major federal agencies or departments that support research in order to help identify ways for the Board to assist these organizations. The BCST maintains close contact with professional societies and non-governmental organizations that share the Board's concern for the health of chemical sciences and technology. Individual Board members are assigned responsibility for liaison with the American Chemical Society, the American Institute of Chemical Engineers, the American Society of Biological Chemists, the Council for Chemical Research, the NAS Chemistry and Biochemistry Sections, and the National Academy of Engineering. In the past few years, the Board has served as a focus and a forum for a variety of issues that relate specifically to the health of chemistry
... FARM CREDIT SYSTEM INSURANCE CORPORATION Board Meeting AGENCY: Farm Credit System Insurance Corporation Board; Regular Meeting. SUMMARY: Notice is hereby given of the regular meeting of the Farm Credit System Insurance Corporation Board (Board). DATE AND TIME: The meeting of the Board will be held at the...
Vicente, J. de; Castilla, J.; Martinez, G.
Decamp (Dark Energy Survey Camera) is a new instrument designed to explore the universe aiming to reveal the nature of Dark Energy. The camera consists of 72 CCDs and 520 Mpixels. The readout electronics of DECam is based on the Monsoon system. Monsoon is a new image acquisition system developed by the NOAO (National Optical Astronomical Observatory) for the new generation of astronomical cameras. The Monsoon system uses three types of boards inserted in a Eurocard format based crate: master control board, acquisition board and clock board. The direct use of the Monsoon system for DECam readout electronics requires nine crates mainly due to the high number of clock boards needed. Unfortunately, the available space for DECam electronics is constrained to four crates at maximum. The major drawback to achieve such desired compaction degree resides in the clock board signal density. This document describes the changes performed at CIEMAT on the programmable logic of the Monsoon clock board aiming to meet such restricted space constraints. (Author) 5 refs
Vicente, J. de; Castilla, J.; Martinez, G.
Decamp (Dark Energy Survey Camera) is a new instrument designed to explore the universe aiming to reveal the nature of Dark Energy. The camera consists of 72 CCDs and 520 Mpixels. The readout electronics of DECam is based on the Monsoon system. Monsoon is a new image acquisition system developed by the NOAO (National Optical Astronomical Observatory) for the new generation of astronomical cameras. The Monsoon system uses three types of boards inserted in a Eurocard format based crate: master control board, acquisition board and clock board. The direct use of the Monsoon system for DECam readout electronics requires nine crates mainly due to the high number of clock boards needed. Unfortunately, the available space for DECam electronics is constrained to four crates at maximum. The major drawback to achieve such desired compaction degree resides in the clock board signal density. This document describes the changes performed at CIEMAT on the programmable logic of the Monsoon clock board aiming to meet such restricted space constraints. (Author) 5 refs.
Broad, Joanna B; Boyd, Michal; Kerse, Ngaire; Whitehead, Noeline; Chelimo, Carol; Lay-Yee, Roy; von Randow, Martin; Foster, Susan; Connolly, Martin J
in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.
Kereszturi, Gábor; Németh, Károly
Scoria cones are a common type of basaltic to andesitic small-volume volcanoes (e.g. 10- 1-10- 5 km3) that results from gas-bubble driven explosive eruptive styles. Although they are small in volume, they can produce complex eruptions, involving multiple eruptive styles. Eight scoria cones from the Quaternary Auckland Volcanic Field in New Zealand were selected to define the eruptive style variability from their volcanic facies architecture. The reconstruction of their eruptive and pyroclastic transport mechanisms was established on the basis of study of their volcanic sedimentology, stratigraphy, and measurement of their pyroclast density, porosity, Scanning Electron Microscopy, 2D particle morphology analysis and Visible and Near Visible Infrared Spectroscopy. Collection of these data allowed defining three end-member types of scoria cones inferred to be constructed from lava-fountaining, transitional fountaining and Strombolian type, and explosive Strombolian type. Using the physical and field-based characteristics of scoriaceous samples a simple generalised facies model of basaltic scoria cones for the AVF is developed that can be extended to other scoria cones elsewhere. The typical AVF scoria cone has an initial phreatomagmatic phases that might reduce the volume of magma available for subsequent scoria cone forming eruptions. This inferred to have the main reason to have decreased cone volumes recognised from Auckland in comparison to other volcanic fields evolved dominantly in dry eruptive condition (e.g. no external water influence). It suggests that such subtle eruptive style variations through a scoria cone evolution need to be integrated into the hazard assessment of a potentially active volcanic field such as that in Auckland.
Jefferies, Craig; Cutfield, Samuel W; Derraik, José G B; Bhagvandas, Jignal; Albert, Benjamin B; Hofman, Paul L; Gunn, Alistair J; Cutfield, Wayne S
We assessed the incidence of diabetic ketoacidosis (DKA) in children aged Auckland Region (New Zealand) in 1999-2013, in a retrospective review of a complete regional cohort. DKA and its severity were classified according to ISPAD 2014 guidelines. Of 730 children presenting with new-onset T1DM over the 15-year time period, 195 cases had DKA of any severity (27%). There was no change in the incidence of DKA or the proportion of children with severe DKA at presentation. The incidence of DKA among children aged Auckland Region over time. Thus, it is important to explore ways to reduce DKA risk.
Jefferies, Craig; Cutfield, Samuel W.; Derraik, José G. B.; Bhagvandas, Jignal; Albert, Benjamin B.; Hofman, Paul L.; Gunn, Alistair J.; Cutfield, Wayne S.
We assessed the incidence of diabetic ketoacidosis (DKA) in children aged Auckland Region (New Zealand) in 1999–2013, in a retrospective review of a complete regional cohort. DKA and its severity were classified according to ISPAD 2014 guidelines. Of 730 children presenting with new-onset T1DM over the 15-year time period, 195 cases had DKA of any severity (27%). There was no change in the incidence of DKA or the proportion of children with severe DKA at presentation. The incidence of DKA among children aged Auckland Region over time. Thus, it is important to explore ways to reduce DKA risk. PMID:25989414
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Luc Vos with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 14 to 28 June 2002. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Poul Frandsen concerning his assimilation into the new career structure. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 13 to 24 January 2003. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joào Bento with regard to residential category. As the appellant has not objected, the recommendations of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article RÊVIÊ1.20 of the Staff Regulations.The relevant documents will therefore be posted on the notice boards of the Administration Building (N¡ 60) from 29 October to 12 November 1999.Personnel DivisionTel. 74128
The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to advancement. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (No. 60) from 24 March to 10 April 2006. Human Resources Department Tel. 74128
The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. The relevant documents will therefore be posted on the notice board of the Main building (Bldg. 60) from 24 September to 7 October 2007. Human Resources Department
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Olivier Francis Martin with regard to indefinite contract. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 8 to 25 June 2001.
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Jack Blanchard with regard to 'non recognition of specific functions'. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 12th to 26th April 2002. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Judith Igo-Kemenes concerning the application of procedures foreseen by Administrative Circular N§ 26 (Rev. 3). As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 6 to 20 June 2003. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mrs Maria DIMOU with regard to a periodic one-step increase. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 30 April to 14 May 2004. Human Resources Department Tel. 74128
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joël Lahaye with regard to non-resident allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 18 May to 1st June 2001.
The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to award him a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (Bldg. 500) from 17 March to 30 March 2008. Human Resources Department Tel. 73911
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Bertrand Nicquevert with regard to the non-resident allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 29 November to 13 December 2002. Human Resources Division Tel. 74128
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Antonio Millich with regard to advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 27 September to 11 October 2002. Human Resources Division Tel. 74128
Human Resources Department
The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to a periodic one-step increase. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 1 to 15 April 2005. Human Resources Department Tel. 74128
The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Gert Jan Bossen with regard to dependent child allowance. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 1st to 15 March 2002. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 26 May to 6 June 2008. Human Resources Department (73911)
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Serge Peraire with regard to exceptional advancement. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 17 to 31 May 2002. Human Resources Division Tel. 74128
The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. These documents will therefore be posted on the notice board of the Main Building (Bldg. 60) from 21 January to 3 February 2008. Human Resources Department (73911)
Step-by-step instructions for making your own PCBs at home. Making your own printed circuit board (PCB) might seem a daunting task, but once you master the steps, it's easy to attain professional-looking results. Printed circuit boards, which connect chips and other components, are what make almost all modern electronic devices possible. PCBs are made from sheets of fiberglass clad with copper, usually in multiplelayers. Cut a computer motherboard in two, for instance, and you'll often see five or more differently patterned layers. Making boards at home is relatively easy
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Aloïs Girardoz with regard to classification and advancement. As the appellant has not objected, the Board's report and the Director-General's decision will be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 15 to 29 August 2003. Human Resources Division Tel. 74128
Kereszturi, Gábor; Németh, Károly; Cronin, Shane J.; Agustín-Flores, Javier; Smith, Ian E. M.; Lindsay, Jan
Monogenetic basaltic volcanism is characterised by a complex array of behaviours in the spatial distribution of magma output and also temporal variability in magma flux and eruptive frequency. Investigating this in detail is hindered by the difficulty in evaluating ages of volcanic events as well as volumes erupted in each volcano. Eruptive volumes are an important input parameter for volcanic hazard assessment and may control eruptive scenarios, especially transitions between explosive and effusive behaviour and the length of eruptions. Erosion, superposition and lack of exposure limit the accuracy of volume determination, even for very young volcanoes. In this study, a systematic volume estimation model is developed and applied to the Auckland Volcanic Field in New Zealand. In this model, a basaltic monogenetic volcano is categorised in six parts. Subsurface portions of volcanoes, such as diatremes beneath phreatomagmatic volcanoes, or crater infills, are approximated by geometrical considerations, based on exposed analogue volcanoes. Positive volcanic landforms, such as scoria/spatter cones, tephras rings and lava flow, were defined by using a Light Detection and Ranging (LiDAR) survey-based Digital Surface Model (DSM). Finally, the distal tephra associated with explosive eruptions was approximated using published relationships that relate original crater size to ejecta volumes. Considering only those parts with high reliability, the overall magma output (converted to Dense Rock Equivalent) for the post-250 ka active Auckland Volcanic Field in New Zealand is a minimum of 1.704 km3. This is made up of 1.329 km3 in lava flows, 0.067 km3 in phreatomagmatic crater lava infills, 0.090 km3 within tephra/tuff rings, 0.112 km3 inside crater lava infills, and 0.104 km3 within scoria cones. Using the minimum eruptive volumes, the spatial and temporal magma fluxes are estimated at 0.005 km3/km2 and 0.007 km3/ka. The temporal-volumetric evolution of Auckland is
Browne, I. M.; Moy, C. M.; Wilson, G. S.; Neil, H.; Riesselman, C. R.
The Southern Hemisphere Westerly Winds (SHWW) and the associated oceanic fronts have a major influence on atmospheric and oceanic circulation in the Southern Hemisphere. Sediment cores recovered from fjords along the eastern margin of the sub-Antarctic Auckland Islands (51°S, 166°E) are ideally located to sensitively record changes in the strength and position of the SHWW throughout the Holocene. A 5.75m core from Hanfield Inlet preserves both marine and terrestrial environmental components, which we use to develop a multiproxy record of past climatic conditions. This core, composed entirely of brown marine mud and silt, was recovered from a depth of 44m. Based on the entrance sill depth of the fjord (10mbsl) and our knowledge of regional sea level rise, we infer that the base of the core will be early Holocene in age, which will be confirmed using radiocarbon age dating. Benthic foraminiferal assemblages (125-500μm fraction) in surface and downcore samples are dominated by three taxa, Nonionellina flemingi, Cassidulina carinata and Quinqueloculina seminula. These species are either shallow infaunal or infaunal. We will use stable carbon (δ¹³C) and oxygen (δ¹⁸O) isotope geochemistry of the benthic foraminifera Nonionellina flemingi, Bolivina cf. earlandi, Trifarina angulosa, Bulimina marginata f. marginata and Cibicides species (all identified from Rose Bengal stained box-core samples) to reconstruct water column fluctuations associated with frontal migration. These results will compliment bulk sediment C and N concentration and isotope reconstructions of terrestrial organic matter delivery to fjord sub-basins over the past 12,000 years.
Full Text Available Several studies have documented benefits of prefabrication system (prefab compared to the traditional building system (TBS. However, the documented benefits have been anecdotal or fragmented with reports of isolated case study projects. Few studies have looked at the objectively quantified benefits from statistical significance point of view and across building types in New Zealand. This study contributes to filling this knowledge gap by analyzing cost and time-savings, and productivity improvement achievable by the use of prefab in place of the TBS. Records of completion times and final contract values of 66 building projects implemented using prefab in Auckland were collected. The building types included commercial, houses, apartments, educational, and community buildings. The project details included final contract sums, completion dates, gross floor areas, and number of floors. Based on these details, the equivalent completion times and the final cost estimates for similar buildings implemented using the TBS were obtained from the Rawlinsons construction data handbook and feedback from some designers and contractors. Marginal productivity outcome for each building project was computed as the product of the cost and time-savings achieved using the prefab. Results showed that the use of prefab in place of TBS resulted in 34% and 19% average reductions in the completion times and costs, respectively. This also translated to overall 7% average improvement in the productivity outcomes in the building projects. Univariate ANOVA-based hypothesis test results showed that ‘building type’ had no significant effects on the cost and productivity improvement outcomes, but had significant effect on the time savings analyzed in the case study projects. The greatest productivity gain of 11% was achieved in house projects. These evidence-based results could guide optimized use of prefab for specific building application. The hypothesis-testing outcome
Neilly, P; Neill, M E; Hill, G L
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become an established operation for patients with ulcerative colitis and familial adenomatous polyposis (FAP). The results of a 15-year experience with IPAA are reported. Between September 1982 and June 1997, 203 patients had IPAA surgery. From a review of the charts, data were collected on the surgical procedure, the diagnosis and early and late complications. Pouch function was assessed by means of a postal questionnaire. Of the 201 patients (median age of 32 years; 89 women) with complete records, 122 had J pouches, 65 had W pouches and 14 S pouches were constructed. The pre-operative diagnosis in 88% was ulcerative colitis and in 10% it was FAP. During a median follow-up time of 6.1 years the diagnoses were changed for 8% of the patients; in 4% the diagnosis was changed to Crohn's disease. The overall mortality was 1.5% (early = 2, late = 1). The overall morbidity was 62% (early = 17%, late = 52%). The pouch was removed or was non-functional in 9%. All patients with a final diagnosis of Crohn's disease have had their pouch excised. The median stool frequency was 4.0 (range 1.3-8.7) during the day, and 0.7 (range 0-2.1) during the night. The fewer night-time stools (J = 1.0+/-0.6; W = 0.4+/-0.5 P requirement of the W-pouch patients for anti-diarrhoeals (P = 0.004) were offset by the need for two W-pouch patients to pass a catheter to empty their pouches. The type of patients who present for IPAA surgery and the outcomes observed in this series of Auckland patients are similar to those reported from major centres elsewhere.
Satterthwaite, P; Pritchard, K; Floyd, D; Law, B
To identify major risk factors for Yersinia enterocolitica (YE) and identify measures to reduce YE infections. A prospective case control study, group age matched, using 186 cases of YE identified by community pathology laboratories and 379 randomly selected controls. Conducted between April 1995 and June 1996 in Auckland, New Zealand. Face-to-face interviews used a standardised questionnaire examining exposures to factors potentially associated with YE infections including untreated water, unreticulated sewerage, consumption of selected foods, selected food handling practices and socio-demographic factors. Multivariate logistic regression was used to calculate adjusted odds ratios for the potential risk factors. Population attributable risk (PAR) was calculated for significant exposures. Having more than two people living in the home was more common among cases than controls (OR = 2.2). Town supply water (OR = 0.2), reticulated sewerage (OR = 0.34) and looking after a young child (OR = 0.51) were significantly less common. Of the meats, only pork (OR = 1.34) had a higher consumption rate, while bacon (OR = 0.75) and smallgoods (OR = 0.73) were consumed less frequently by cases than controls. Eating food from a sandwich bar was more frequent among cases (OR = 1.18). Fruit and vegetable consumption was marginally less (OR = 0.98). The population attributable risk of these factors was 0.89, implying that 89% of YE would be eliminated if adverse exposures were removed. The risk of YE illness is increased by contact with untreated water, unreticulated sewerage and consumption of pork. Investigation of non-town water supply, informal sewerage systems and methods of preparation and consumption of pork are recommended to determine how YE enters the human food chain.
Stacey, Tomasina; Thompson, John M D; Mitchell, Edwin A; Ekeroma, Alec; Zuccollo, Jane; McCowan, Lesley M E
Maternal perception of decreased fetal movements has been associated with adverse pregnancy outcomes, including stillbirth. Little is known about other aspects of perceived fetal activity. The objective of this study was to explore the relationship between maternal perception of fetal activity and late stillbirth (≥28 wk gestation) risk. Participants were women with a singleton, late stillbirth without congenital abnormality, born between July 2006 and June 2009 in Auckland, New Zealand. Two control women with ongoing pregnancies were randomly selected at the same gestation at which the stillbirth occurred. Detailed demographic and fetal movement data were collected by way of interview in the first few weeks after the stillbirth, or at the equivalent gestation for control women. A total of 155/215 (72%) women who experienced a stillbirth and 310/429 (72%) control group women consented to participate in the study. Maternal perception of increased strength and frequency of fetal movements, fetal hiccups, and frequent vigorous fetal activity were all associated with a reduced risk of late stillbirth. In contrast, perception of decreased strength of fetal movement was associated with a more than twofold increased risk of late stillbirth (aOR: 2.37; 95% CI: 1.29-4.35). A single episode of vigorous fetal activity was associated with an almost sevenfold increase in late stillbirth risk (aOR: 6.81; 95% CI: 3.01-15.41) compared with no unusually vigorous activity. Our study suggests that maternal perception of increasing fetal activity throughout the last 3 months of pregnancy is a sign of fetal well-being, whereas perception of reduced fetal movements is associated with increased risk of late stillbirth. © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.
Boyd, Michal; Broad, Joanna B; Zhang, Tony Xian; Kerse, Ngaire; Gott, Merryn; Connolly, Martin J
global population projections forecast large growth in demand for long-term care (LTC) and acute hospital services for older people. Few studies report changes in hospitalisation rates before and after entry into LTC. This study compares hospitalisation rates 1 year before and after LTC entry. the Older Persons' Ability Level (OPAL) study was a 2008 census-type survey of LTC facilities in Auckland, New Zealand. OPAL resident hospital admissions and deaths were obtained from routinely collected national databases. all 2,244 residents (66% = female) who entered LTC within 12 months prior to OPAL were included. There were 3,363 hospitalisations, 2,424 in 12 months before and 939 in 12 months after entry, and 364 deaths. In the 6 to 12 months before LTC entry, the hospitalisation rate/100 person-years was 67.3 (95% confidence interval [CI] 62.5-72.1). Weekly rates then rose steeply to over 450/100 person-years in the 6 months immediately before LTC entry. In the 6 months after LTC entry, the rate fell to 49.1 (CI 44.9-53.3; RR 0.73 (CI 0.65-0.82, P < 0.0001)) and decreased further 6 to 12 months after entry to 41.1 (CI 37.1-45.1; rate ratio [RR] 0.61 (CI 0.54-0.69, P < 0.0001)). increased hospitalisations a few months before LTC entry suggest functional and medical instability precipitates LTC entry. New residents utilise hospital beds less frequently than when at home before that unstable period. Further research is needed to determine effective interventions to avoid some hospitalisations and possibly also LTC entry. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: email@example.com.
Hamm, Lisa M; Yeoman, Janice P; Anstice, Nicola; Dakin, Steven C
When measuring recognition acuity in a research setting, the most widely used symbols are the Early Treatment of Diabetic Retinopathy Study (ETDRS) set of 10 Sloan letters. However, the symbols are not appropriate for patients unfamiliar with letters, and acuity for individual letters is variable. Alternative pictogram sets are available, but are generally comprised of fewer items. We set out to develop an open-access set of 10 pictograms that would elicit more consistent estimates of acuity across items than the ETDRS letters from visually normal adults. We measured monocular acuity for individual uncrowded optotypes within a newly designed set (The Auckland Optotype [TAO]), the ETDRS set, and Landolt Cs. Eleven visually normal adults were assessed on regular and vanishing formats of each set. Inter-optotype reliability and ability to detect subtle differences between participants were assessed using intraclass correlations (ICC) and fractional rank precision (FRP). The TAO vanishing set showed the strongest performance (ICC = 0.97, FRP = 0.90), followed by the other vanishing sets (Sloan ICC = 0.88, FRP = 0.74; Landolt ICC = 0.86, FRP = 0.80). Within the regular format, TAO again outperformed the existing sets (TAO ICC = 0.77, FRP = 0.75; Sloan ICC = 0.65, FRP = 0.64; Landolt ICC = 0.48, FRP = 0.63). For adults with normal visual acuity, the new optotypes (in both regular and vanishing formats) are more equally legible and sensitive to subtle individual differences than their Sloan counterparts. As this set does not require observers to be able to name Roman letters, and is freely available to use and modify, it may have wide application for measurement of acuity.
Acland, George; Zargar-Shoshtari, Kamran; Rice, Michael
The aim of the study is to assess the contemporary patterns of utilization of various therapeutic options for the management of nephrolithiasis in our tertiary referral institution in Auckland, New Zealand. A retrospective audit was conducted for all urinary stone procedures between January 2007 and December 2013. Procedure-related information was collected for each year. All elective and emergency procedures were included. Data were collected on the elective waiting lists for each procedure. A total of 5512 stone-related cases were performed during the study period. Six hundred and fifty-three cases were performed in 2007 compared with 945 in 2013. Total number of percutaneous nephrolithotomy (PCNLs) performed, as well as the proportion of PCNL cases, demonstrated a significant decline from 84 (12.9%) in 2007 to 67 (7.1%) in 2013. While the annual numbers of extracorporeal shock wave lithotripsy (ESWLs) have increased, the percentage of ESWLs performed relative to total stone procedures has declined from 33% to 23% over the last 4 years of this audit. There has been a significant rise in the numbers of rigid and flexible ureteroscopies, with these now being the most utilized procedure. The number of patients awaiting elective procedures declined over the duration of this audit, with an associated improvement in meeting annual demand for treatment of nephrolithiasis from 78% in 2007 to 91% in 2013. A proportional decline in PCNL and ESWL utilization with a significant increase in flexible and rigid ureteroscopic procedures has been observed over this time and this pattern has been associated with improved adherence to surgical targets despite an increasing number of cases. © 2015 Royal Australasian College of Surgeons.
Capelle, Lisa; Brooks, Susan; Stevens, Wendy
This review was performed to describe the patient pathway and timelines involved in the treatment of FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IVA cervical cancer in a New Zealand cancer centre. Retrospective audit of women with a new diagnosis of FIGO Stage IB1–IVA cervical cancer in the Auckland/Northland regions between 2003 and 2007. Two hundred and seven patients were identified. Median time from referral to first specialist assessment (FSA) was 10 days, from FSA to decision to treat (DTT) 50 days and from DTT to start of treatment 26 days. Overall median time from referral to start of treatment was 97 days. There was no difference in median time from referral to DTT for patients treated with primary surgery (48 days) or radiotherapy (47 days). On univariate analysis, factors associated with reduced time from referral to start of treatment were less socioeconomic deprivation (P = 0.001), shorter time to completion of radiological investigations (P < 0.0005) and private FSA (P < 0.0005). Only private FSA remained significant on multivariate analysis. The greatest delay in the pathway was between FSA and DTT, encompassing presentation at multidisciplinary meeting, examination under anaesthetic and obtaining radiological investigations. Median overall treatment time (OTT) for patients treated with definitive radiotherapy was 56 days and was increased by a median of 3 days where there were delays accessing operating theatre time for brachytherapy insertions. Overall patient pathway and radiotherapy OTT were longer than optimal, and areas of delay potentially amenable to modification were identified.
Kim, Bia Z; Patel, Dipika V; Sherwin, Trevor; McGhee, Charles N J
To evaluate 2 preoperative risk stratification systems for assessing the risk of complications in phacoemulsification cataract surgery, performed by residents, fellows, and attending physicians in a public teaching hospital. Cohort study. One observer assessed the clinical data of 500 consecutive cases, prior to phacoemulsification cataract surgery performed between April and June 2015 at Greenlane Clinical Centre, Auckland, New Zealand. Preoperatively 2 risk scores were calculated for each case using the Muhtaseb and Buckinghamshire risk stratification systems. Complications, intraoperative and postoperative, and visual outcomes were analyzed in relation to these risk scores. Intraoperative complication rates increased with higher risk scores using the Muhtaseb or Buckinghamshire stratification system (P = .001 and P = .003, respectively, n = 500). The odds ratios for residents and fellows were not significantly different from attending physicians after case-mix adjustment according to risk scores (P > .05). Postoperative complication rates increased with higher Buckinghamshire risk scores but not with Muhtaseb scores (P = .014 and P = .094, respectively, n = 476). Postoperative corrected-distance visual acuity was poorer with higher risk scores (P < .001 for both, n = 476). This study confirms that the risk of intraoperative complications increases with higher preoperative risk scores. Furthermore, higher risk scores correlate with poorer postoperative visual acuity and the Buckinghamshire risk score also correlates with postoperative complications. Therefore, preoperative assessment using such risk stratification systems could assist individual informed consent, preoperative surgical planning, safe allocation of cases to trainees, and more meaningful analyses of outcomes for individual surgeons and institutions. Copyright © 2016 Elsevier Inc. All rights reserved.
Presented in three volumes; 'Boat Boarding Ladder Placement,' which explores safety considerations including potential for human contact with a rotating propeller; 'Boat Handhold Placement,' which explores essential principles and methods of fall con...
An 'Interactive Printed Circuit Board Design System' has been developed by a company in a Member-State. Printed circuits are now produced at the SB's surface treatment workshop using a digitized photo-plotter.
Open Access Publication Policy ATLAS had recently issued a short statement in support of open access publishing. The mood of the discussions in the December CMS Collaboration Board had appeared to be in favour and so it was being proposed that CMS issue the same statement as that made by ATLAS (the statement is attached to the agenda of this meeting). The Collaboration Board agreed. Election of the Chair of the Collaboration Board Following the agreement to shorten the terms of both the Spokesperson and the Collaboration Board Chair, and to introduce a longer overlap period between the election and the start of the term, the election for the next Collaboration Board Chair was due in December 2007. If the old standard schedule specified in the Constitution were adapted to this date, then the Board should be informed at the present meeting that the election was being prepared. However, it was felt that the experience of the previous year's election of the Spokesperson had shown that it would be desirable to...
..., manufacturing, nonprofit, education, and health care industries. The Board includes members familiar with the..., small businesses, health care providers, and educational institutions. Members are also chosen who have...
Reynolds, Gary; Dias, Cassandra; Thornley, Simon; King, Ronald; Morrison, Anne; Matson, Angela; Hoskins, Richard
To analyse the epidemiology, serology and vaccine effectiveness in a recent New Zealand measles outbreak that started in Auckland, from December, 2013 to June, 2014, to guide further preventive measures. Cases had a clinically compatible illness, which was either confirmed by PCR or serology, or were linked to a laboratory confirmed case. A total of 113 cases with 3,113 contacts were traced and managed in the Auckland region. Thirteen overseas acquired cases, produced a total of 98 locally acquired secondary cases, (plus two cases with unknown travel history). The majority of cases occurred in adolescents and young adults; 68/113 cases (60.1%) were aged 10 to 19 years. Among cases, 38.9% (44/113) were unimmunised, and 31.8% (36/113) had unknown immunisation status. A further 15.0% (17/113) of cases had received one or two doses of measles, mumps, rubella (MMR) vaccine. Of the contacts who underwent serological testing for immunity (n=735), the lowest levels of serological immunity were observed in people aged 10 to 24 years. Vaccine effectiveness was calculated for the 15-24 year age cohort at 92% (95%CI; 82-97). Results suggest that an adolescent catch-up immunisation programme would prevent further outbreaks of imported measles.
Wu, Sylvia S Y; Wang, Tom Kai Ming; Nand, Parma; Ramanathan, Tharumenthiran; Webster, Mark; Stewart, Jim
Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in high-risk patients. We report the initial TAVI experience at Auckland City Hospital. The records of patients undergoing TAVI between 2011 and 2015 at Auckland City Hospital were reviewed. We report the procedural success and outcome, including major adverse events (death, stroke, myocardial infarction, bleeding, vascular complications and rehospitalisations), degree of aortic regurgitation and symptom status up to 1-year follow-up. Mean age was 80.7 years and mean Euroscore II and Society of Thoracic Surgeons' scores were 8.2% and 6.3% respectively; 50% had undergone previous cardiac surgery. Successful deployment of the valve was achieved in all patients. The cumulative mortality rates at 30 days, 6 months and 1 year were 2.4%, 6.1% and 12.2% and cumulative stroke rates 1.2%, 3% and 8.2% respectively. Severe aortic regurgitation occurred in 2.3% TAVI is available in the New Zealand public hospital system for patients who are high-risk candidates for AVR. Early results are excellent and indicate that the technology is being used appropriately, according to current access criteria. If the early cost effectiveness data are confirmed, the indications for TAVI may widen.
Green, Rebecca M.; Bebbington, Mark S.; Cronin, Shane J.; Jones, Geoff
Detailed tephrochronologies are built to underpin probabilistic volcanic hazard forecasting, and to understand the dynamics and history of diverse geomorphic, climatic, soil-forming and environmental processes. Complicating factors include highly variable tephra distribution over time; difficulty in correlating tephras from site to site based on physical and chemical properties; and uncertain age determinations. Multiple sites permit construction of more accurate composite tephra records, but correctly merging individual site records by recognizing common events and site-specific gaps is complex. We present an automated procedure for matching tephra sequences between multiple deposition sites using stochastic local optimization techniques. If individual tephra age determinations are not significantly different between sites, they are matched and a more precise age is assigned. Known stratigraphy and mineralogical or geochemical compositions are used to constrain tephra matches. We apply this method to match tephra records from five long sediment cores (≤ 75 cal ka BP) in Auckland, New Zealand. Sediments at these sites preserve basaltic tephras from local eruptions of the Auckland Volcanic Field as well as distal rhyolitic and andesitic tephras from Okataina, Taupo, Egmont, Tongariro, and Tuhua (Mayor Island) volcanic centers. The new correlated record compiled is statistically more likely than previously published arrangements from this area.
Crowley, Susan L.; Lichtenberg, James W.; Pollard, Jeffrey W.
Although specialty board certification by the American Board of Professional Psychology (ABPP) has been a valued standard for decades, the vast majority of counseling psychologists do not pursue board certification in the specialty. The present article provides a brief history of board certification in general and some historical information about…
... FARM CREDIT SYSTEM INSURANCE CORPORATION Board Meeting AGENCY: Farm Credit System Insurance Corporation. SUMMARY: Notice is hereby given of the regular meeting of the Farm Credit System Insurance Corporation Board (Board). DATE AND TIME: The meeting of the Board will be held at the offices of the Farm...
... FARM CREDIT SYSTEM INSURANCE CORPORATION Board Meeting AGENCY: Farm Credit System Insurance Corporation. ACTION: Regular meeting. SUMMARY: Notice is hereby given of the regular meeting of the Farm Credit System Insurance Corporation Board (Board). Date and Time: The meeting of the Board will be held...
Gray, Josephine; Nosa, Vili
The aim of this paper is to explore the binge drinking behaviours and attitudes of nine New Zealand born Niuean women aged 18 to 45 plus years living in Auckland who are heavy binge drinkers. Taped interviews were conducted individually with nine Niuean participants, utilising a semi-structured interviewing schedule in both Niuean and English languages. This study argues that excessive drinking style of binge drinking commonly practised with the younger generation of Niuean women. The study highlighted the important role of supportive friends and women within a drinking circle compared to the cultural and gender restrictions when drinking with males. NZ born Niuean women outlined there were fewer limitations on alcohol use and behaviour associated with drunkenness; the reason for drinking was to reach a level of intoxication. Alcohol consumption was seen as a way of socialising, having fun, being happy and feeling safe primarily when drinking with other women, even though participants experienced negative behaviour when safety was threatened. The Niuean community needs to address alcohol related issues affecting Niuean women through education awareness within social and cultural gatherings. This study is not a representative study and it cannot be generalised to all New Zealand born Niuean women because the sampling size is too small. The aim of this paper is to look at the binge drinking behaviours of nine New Zealand born Niuean women living in Auckland. A qualitative research methodology offace to face interviews was used to interview NZ born Niuean women and their alcohol consumption. Participants were recruited by using a snow ball methodology. Participants were also approached throughout the community on the telephone and via email/internet about the research. Participants were also from Niuean gatherings such as Niuean cultural workshops, weaving groups, church groups, and sports groups, Niuean websites. A semi-structured interview format was used making it
Manley, D.J.; Johnston, Ron; Jones, Kelvyn
There has been a growing appreciation that the processes generating urban residential segregation operate at multiple scales, stimulating innovations into the measurement of their outcomes. This paper applies a multi‐level modelling approach to that issue to the situation in Auckland, where multiple
... and Orders; Milk), DEPARTMENT OF AGRICULTURE FLUID MILK PROMOTION PROGRAM Fluid Milk Promotion Order Definitions § 1160.105 Board. Board means the National Processor Advertising and Promotion Board established... Promotion Board or Board). ...
Zastocki, Deborah K
Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the
Gunn, Eleanor R; Albert, Benjamin B; Hofman, Paul L; Cutfield, Wayne S; Gunn, Alistair J; Jefferies, Craig A
There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. To assess potentially modifiable antecedents of DKA in children Auckland (New Zealand) from 2010 to 2014. DKA and severity were defined according to the ISPAD 2014 guidelines. A total of 263 children presented with new onset T1DM during the 5-year study period at 9.0 years of age (range 1.0-14.7), of whom 61% were NZ-European, 14% Maori, 13% Pacifica, and 11% other. A total of 71 patients (27%) were in DKA, including 31 mild, 20 moderate, and 20 severe DKA. DKA was associated with no family history of T1DM, higher glycated hemoglobin (HbA1c) values at presentation, self-presenting to secondary care, health care professional contacts in the 4 weeks before final presentation, and greater deprivation. Although a delay in referral from primary care for laboratory testing was common (81/216), only delay for more than 48 hours was associated with increased risk of DKA (11/22 > 48 h vs 12/59 referred at <48 h, P = .013). These data suggest that in addition to lack of family awareness potentially modifiable risk factors for new onset DKA include prolonged delay for laboratory testing and a low index of medical suspicion for T1DM leading to delayed diagnosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hornung, Rosalie J; Reed, Peter W; Mouat, Fran; Jefferies, Craig; Gunn, Alistair J; Hofman, Paul L
To review indications and use of angiotensin-converting enzyme-inhibitor (ACEI) therapy for the treatment of persistent microalbuminuria (MA) and/or hypertension (HTN) in adolescents with type 1 diabetes mellitus (T1DM). Retrospective chart review of adolescent patients with T1DM seen within the paediatric diabetes service in Auckland, New Zealand, from 2006 to 2016. MA, HTN, patient demographic characteristics and ACEI prescribing and monitoring indices were examined. Five hundred adolescents with T1DM were included. There were 26 patients (5%) with MA and/or HTN. MA alone was present in 16, HTN alone in 3 and both HTN and MA in 7. The 5-year MA/HTN-free rate was 98%, and the 10-year MA/HTN-free rate was 93%. Longer disease duration and earlier diagnosis were predictors of MA/HTN. There was no significant difference in standard clinical indices between study patients and others. ACEI was prescribed for 17 of 26 patients for either HTN or MA. Within 6 weeks of ACEI commencement, less than half of the subjects had repeat serum creatinine and MA screens and no record of repeat blood pressure measurement. Despite this, all patients had 3-monthly reviews within outpatient clinics where adjustments of ACEI doses were made. In our regional adolescent population with T1DM, there were low rates of both MA and/or HTN. In those who required treatment with ACEI, clinical monitoring post-commencement of therapy was inconsistent. Local consensus guidelines for the management of persistent MA in children and adolescents with diabetes mellitus were developed in response to this study. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Castinel, Aurélie; Grinberg, Alex; Pattison, Rebecca; Duignan, Pádraig; Pomroy, Bill; Rogers, Lynn; Wilkinson, Ian
The 2001/2002 and 2002/2003 breeding seasons of New Zealand sea lions (NZSLs) on the Auckland Islands were marked by a high pup mortality caused by acute bacterial infections. As part of a health survey from 1998/1999 to 2004/2005, tissues and swabs of lesions had been collected at necropsy to identify the bacteria associated with pup mortality. Klebsiella pneumoniae was grown in pure culture from 83% of various organs and lesions in 2001/2002 and 76% in 2002/2003, and less frequently in the following seasons (56% in 2003/2004 and 49% in 2004/2005). Pup isolates of K. pneumoniae showed identical minimal inhibitory concentrations (MIC) of cefuroxime, neomycin, cephalotin, cephalexin and dihydrostreptomycin, suggesting clonal aetiology of the pathogen. Isolates also tested negative for production of extended-spectrum beta-lactamases (ESBLs), which was not in favour of an anthropogenetic origin of the epidemic strain. Pulsed-field gel electrophoresis (PFGE) of XbaI DNA macrorestriction fragments was performed on isolates of K. pneumoniae and Klebsiella oxytoca from 35 pups, thee NZSL adult females, and from three human patients for comparison. PFGE showed that pup isolates of K. pneumoniae were genetically indistinguishable but were neither related to K. pneumoniae from humans and from NZSL adults, nor to K. oxytoca from NZSLs. It is concluded that the 2001/2002 and 2002/2003 epidemics at Sandy Bay rookery were caused by a single K. pneumoniae clonal lineage, genetically different from the strain carried by adult NZSLs. An anthropogenic origin of the K. pneumoniae clone could not be confirmed, but further investigations are required to rule-out such occurrence.
Reyes, A.G.; Trompetter, W.J.
During magmatic differentiation processes B preferentially partitions into the glassy mesostasis of rhyolite and andesite. The behaviour of Li, on the other hand, varies with the silica content of the rock. Lithium, B, Cl and water contents increase proportionally with the silica concentration of the volcanic rocks. Their relative proportions in andesites of the Taupo Volcanic Zone (TVZ) appear to reflect the nature of the underlying crust, the dip of the subducting slab and hence the depth and temperature of magma generation. The B/Li ratios of rhyolites associated with the northern Rotorua and Okataina eruptive centres yield lower B/Li ratios than those from Maroa and Taupo centres in the south, where the slab subducts at a shallower angle. Apparently, volcanics associated with a younger subduction event as in the TVZ, contain and retain more Cl, yielding lower Li/Cl ratios for the TVZ than Northland-Auckland basalts. The B/Li ratio of greywackes from the Torlesse terrane ( 1.4). In geothermal wells in Ngawha, hydrothermal alteration yields higher B/Li ratios of >2.8 for Waipapa terrane sedimentary rocks. The Li/Cl ratios for average South and North Island greywackes are similar and may reflect similar degrees of metamorphism. In general, the relative Li, B and Cl contents in greywackes are dictated by the composition of the detrital fragments, the clay fraction, the type of clays and the metamorphic grade. During hydrothermal alteration of rhyolite in the TVZ, Cl always partitions into solution while Li and B have an affinity for the rock. However, more Li remains in the rock than B at any given temperature. The distribution coefficients of Li and B between water and rock increase with increasing temperature. The partitioning of Li between rock and solution in TVZ hydrothermal systems is mainly dictated by temperature, whereas the mass distribution coefficient for B is related to the tectonic setting. An increase in relative Li of the rock is associated with the
Human Resources Division
The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Neil Calder, Mrs Sudeshna Datta Cockerill, Mrs Andrée Fontbonne, Mrs Moniek Laurent and Mr Ulrich Liptow with regard to membership in the Pension Fund under the period with a Paid Associate contract, appeals dealt with on a collective basis. As the appellants have not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 10 to 31 August 2001.
Note The CERN pension scheme is based on the principle of defined benefits, so beneficiaries continue to receive the benefits to which they are entitled in accordance with the Rules of the Pension Fund. This means that pension entitlements under the Rules are not directly affected by the financial crisis and the current economic situation. However, the adjustment of pensions to the cost of living is not automatic and, under the method applied since 2006, must take into account the Fund’s financial position. Meeting of the Pension Fund Governing Board The Pension Fund Governing Board held its eighth meeting at ESO in Garching, Germany (near Munich) on 24 October 2008. Before starting its work, the Governing Board had the privilege of hearing an opening address by Professor Tim de Zeeuw, the Director General of ESO. Professor de Zeeuw described the mission of ESO and the ambitious projects of his organisation, which performs astronomy observations using telescopes located in...
Mulder, John C.; Schwartz, Moses Daniel; Berg, Michael J.; Van Houten, Jonathan Roger; Urrea, Jorge Mario; King, Michael Aaron; Clements, Abraham Anthony; Jacob, Joshua A.
Critical infrastructures, such as electrical power plants and oil refineries, rely on programmable logic controllers (PLCs) to control essential processes. State of the art security cannot detect attacks on PLCs at the hardware or firmware level. This renders critical infrastructure control systems vulnerable to costly and dangerous attacks. WeaselBoard is a PLC backplane analysis system that connects directly to the PLC backplane to capture backplane communications between modules. WeaselBoard forwards inter-module traffic to an external analysis system that detects changes to process control settings, sensor values, module configuration information, firmware updates, and process control program (logic) updates. WeaselBoard provides zero-day exploit detection for PLCs by detecting changes in the PLC and the process. This approach to PLC monitoring is protected under U.S. Patent Application 13/947,887.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and Emergency Response; Notice of..., 1972, that the Board of Scientific Counselors, Coordinating Office for Terrorism Preparedness and...
The Joint Advisory Appeals Board has examined the internal appeal lodged by a former member of the personnel, a beneficiary of the CERN Pension Fund, against the calculation of his pension in the framework of the Progressive Retirement Programme. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be available from 26 July to 11 August 2013 at the following link. HR Department Head Office
On Monday 14 October, the Service Status Board for GS and IT will change. The new Status Board will be integrated with the CERN Service Portal and with the CERN Service Catalogue. As of today, the SSB will display “Service Incidents”, “Planned Interventions” and “Service Changes”. References valid from 14 October: CERN SSB at https://cern.ch/ssb Computing SSB (previously IT SSB) at https://cern.ch/itssb Nicole Cremel, IT and GS Service Management Support
... DEPARTMENT OF VETERANS AFFAIRS Disciplinary Appeals Board Panel AGENCY: Department of Veterans... Affairs Health Care Personnel Act of 1991 (Pub. L. 102-40), dated May 7, 1991, revised the disciplinary grievance and appeal procedures for employees appointed under 38 U.S.C. 7401(1). It also required the...
... DEPARTMENT OF VETERANS AFFAIRS Disciplinary Appeals Board Panel AGENCY: Department of Veterans... Affairs Health Care Personnel Act of 1991 (Pub. L. 102-40), dated May 7, 1991, revised the disciplinary grievance and appeal procedures for employees appointed under 38 U.S.C. 7401(1). It also required the...
Rose, Caspar; Munch-Madsen, Peter; Funch, Maja
We study the impact of female board representation as well as citizenship on corporate performance based on a sample of the largest listed firms in the Nordic countries as well as Germany. We also seek to determine the variation of board structures using factor analysis. We find no support for any...... performance impact relating to female board representation. However, we find an impact of board citizenship on performance showing that board members with a background from common law have a significant positive influence on corporate performance measured as ROA, ROE and ROCE. Consistent with other studies we...... also document that large boards impact corporate performance negatively. Moreover we also show that data set on boards can be explained by four underlying factors. This article adds insight to board determinants of corporate performance as well as the classification of board variation. Specifically...
... 29 Labor 7 2010-07-01 2010-07-01 false Responsibilities of the Board; voting. 1922.4 Section 1922.4 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... WORKERS' COMPENSATION ACT § 1922.4 Responsibilities of the Board; voting. (a) Determinations and...
... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) INVESTIGATIONAL HEARINGS UNDER SECTION 41 OF THE LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT § 1922.3 Composition of the Board. The Board shall be composed of three members appointed by the...
... board. The Academy will charge room and board to all persons staying at the Academy, except MSHA personnel, persons attending the Academy under a program supported through an MSHA State grant, and persons..., supervision, or management of a function or activity under the Federal Mine Safety and Health Act of 1977 or a...
The Board on Chemical Sciences and Technology organizes and provides direction for standing and ad hoc committees charged with addressing specific issues relevant to the continued health of the chemical sciences and technology community. Studies currently under the oversight of the BCST include a major survey of chemical engineering, an examination of the problems of biohazards in the laboratory, and an analysis of the roots and magnitude of the problem of obsolescent facilities for research and teaching in departments in the chemical sciences and engineering. The Board continues to respond to specific agency requests for program assessments and advice. BCST members are designated to serve as liaison with major federal agencies or departments that support research in order to help identify ways for the board to assist the these organizations. The BCST also maintains close contact with professional societies and nongovernmental organizations that share the Board's concern for the health of chemical sciences and technology. Individual Board members are assigned responsibility for liaison with the American Chemical Society, the American Institute of Chemical Engineers, the American Society of Biological Chemists, the Council for Chemical Research, the Chemistry and Biochemistry Sections of the National Academy of Sciences (NAS), and the National Academy of Engineering (NAE). In the past few years, the Board has served as a focus and a forum for a variety of issues that relate specifically to the health of chemistry. A sampling of these concerns include: industry-university cooperation; basic research funding in DOD, DOE, NIH, and NSF; basic research in the chemistry of life processes; basic research in biochemical engineering; basic research in the science and technology of new materials; and undergraduate education in chemistry and chemical engineering
Nosa, Vili; Ofanoa, Malakai
Kava consumption is a very popular practise amongst Pacific people especially amongst the Tongan communities. The purpose of this paper is to identify some of the key cultural, social and medicinal elements of kava use amongst Tongan men. Twelve face to face interviews in this study were undertaken. The paper argues that kava drinking is strongly linked to many of the ceremonial, social and cultural obligations that are deeply embedded within the Tongan culture. The positive uses of kava include medicinal purposes, male bonding, alternative to alcohol consumption, reaffirming and establishing relationships amongst other Tongan men, The men also stated negative uses of kava such as it made them lazy, tired so they were not able to go to work, a lack of sexual activities by being too tired have sex with their partners, and very expensive to buy in New Zealand. The aim of this paper is to discuss and examine the social, cultural and medicinal kava use amongst twelve Tongan born men living in Auckland, New Zealand. The study used qualitative methods, specifically individual interviews were conducted in Tongan or English. Participants were recruited through community networks in Auckland. A number of Tongan churches, Tongan medical clinics such as Langimailie, and kava clubs were approached to recruit participants. The open ended interview schedule covered themes such as access, quantity, frequency, and problems associated with kava use. The interviews were conducted by a Tongan researcher either in English or Tongan. All interviews were translated and transcribed into English. A thematic analysis based on multiple readings of the transcripts was used The analysis identified commonalities and differences. The study was granted ethical approval by the University of Auckland Human Subjects Ethics Committee in December 2004. Interviews were conducted at the beginning of 2005. Interviews were undertaken in a place where the participants felt comfortable. Interview times
Samaranayake, Chinthaka B; Arroll, Bruce; Fernando, Antonio T
Sleep symptoms, depression and anxiety often coexist and tertiary students are a population group that are increasingly recognised to be at risk. However the rates of these conditions in the New Zealand population are poorly understood. The aim of this study was to determine the rates of sleep disorders, depression and anxiety, and identify correlations between satisfactions with life among university students in Auckland. Auckland Sleep Questionnaire (ASQ) was administered to undergraduate students from six schools of The University of Auckland. The different types of sleep disorders were calculated for the students who reported a significant sleep problem lasting more than 1 month. The rate of depression, anxiety and substance use as well as the satisfaction with life scale scores were also calculated for the whole cohort. A total of 1933 students were invited to participate and 66.8% completed the questionnaire. The median age was 20 years (range 16-38) and women represented 63.9% of the total group. A total of 39.4% of the students surveyed reported having significant sleep symptoms lasting longer than 1 month. The most prevalent causes for sleep symptoms were depression and anxiety. Delayed sleep phase disorder was found in 24.9% of students and parasomnias were reported by 12.4%. Depression and anxiety were present in 17.3% and 19.7% of the total group respectively, and 7.3% of students had thoughts of "being better off dead" or self-harm. A total of 15.5% students were found to have a CAGE score greater than or equal to 2 and 9.3% reported using recreational drugs in the last 3 months. Moderate negative correlations between SWLS scores and depression and anxiety were found (r=-0.45 and r=-0.37 respectively). A large number of university students are suffering from significant sleep symptoms. Mood disorders, substance use, and circadian rhythm disorders can greatly contribute to sleep difficulties in this population group. The study also showed that harmful
Bibby, Rebecca L.; Webster-Brown, Jenny G.
Suspended particulate matter (SPM) is an important transport agent for metal contaminants in streams, particularly during high flow periods such as storm events. For highly contaminated urban catchments in the greater Auckland (New Zealand) area, trace metal partitioning between the dissolved phase and SPM was determined, and SPM characterised in terms of its Si, Al, Fe, Mn, Zn, Cu, Pb, TOC, TON and PO 4 concentrations, as well as particle size, abundance, type and surface area. This data was compared to similar data from representative non-urban catchments in the Auckland region, the Kaipara River and Waikato River catchments, to identify any significant differences in the SPM and its potential trace metal adsorption capacity. Trace metal partitioning was assessed by way of a distribution coefficient: K D =[Me SPM ]/[Me DISS ]. Auckland urban SPM comprises quartz, feldspars and clay minerals, with Fe-oxides and minor Mn-oxides. No particles of anthropogenic origin, other than glass shards, were observed. No change in urban SPM particle size or SSA was observed with seasonal change in temperature, but the nature of the SPM was observed to change with flow regime. The abundance of finer particles, SSA and Al content of the SPM increased under moderate flow conditions; however, Si/Al ratios remained constant, confirming the importance of aluminosilicate detrital minerals in surface run-off. The SPM Fe content was observed to decrease with increased flow and was attributed to dilution of SPM Fe-oxide of groundwater origin. The Kaipara River SPM was found to be mineralogically, chemically and biologically similar to the urban SPM. However, major differences between urban catchment SPM and SPM from the much larger (non-urban) Waikato River were observed, and attributed to a higher abundance of diatoms. The Fe content of the Waikato River SPM was consistently lower (<5%), and the Si/Al ratio and Mn content was higher. Such differences observed between urban and non
Estevez Radio, H.; Fernandez Arenal, C.A.
Here, the calculation of the magnetic field on board ships is performed, using matrix calculus, in a similar way as when the magnetic field in matter is studied. Thus the final formulas are written in a more compact form and they are obtained through a simpler way, more suitable for the university education. (Author)
Nolan, Jason M; Fee, Christopher; Cooper, Bruce A; Rankin, Sally H; Blegen, Mary A
Boarding, especially among psychiatric patients, has been characterized as a significant cause of ED crowding, but no quantitative analysis has described boarding nationally. This study determines the incidence, duration, and factors associated with ED boarding in the United States. 2008 National Hospital Ambulatory Medical Care Survey ED data were stratified by visit type (psychiatric vs. non-psychiatric), boarding status, and patient and hospital characteristics. Boarding was defined as a visit with an ED length of stay >6 hours, and boarding time as ED length of stay minus 6 hours. Pearson's chi-square tests describe hospital and patient characteristics stratified by boarding status. Multilevel multivariable logistic and linear regressions determine associations with boarding and boarding time. While 11% of all ED patients boarded, 21.5% of all psychiatric ED patients boarded. Boarding was also more prolonged for psychiatric ED patients. Controlling for confounders, odds of boarding for psychiatric patients were 4.78 (2.63-8.66) times higher than non-psychiatric, and psychiatric patients boarded 2.78 (1.91-3.64) hours longer than non-psychiatric. US EDs experienced high proportions and durations of boarding with psychiatric patients disproportionately affected. Additional research concerning mental health care services and legislation may be required to address ED psychiatric patient boarding. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
Full Text Available This paper examines the effects of board affiliation on the corporate pay gap. Using a sample of Chinese listed firms from 2005 to 2011, we find that boards with a greater presence of directors appointed by block shareholders have lower pay gaps. Furthermore, the governance effects of board affiliation with and without pay are distinguished. The empirical results show that board affiliation without pay is negatively related to the pay gap, while board affiliation with pay is positively related to the pay gap. Overall, the results shed light on how block shareholders affect their companies’ pay gaps through board affiliation.
The SVX Sequencer boards are 9U by 280mm circuit boards that reside in slots 2 through 21 of each of eight Eurocard crates in the D0 Detector Platform. The basic purpose is to control the SVX chips for data acquisition and when a trigger occurs, to gather the SVX data and relay the data to the VRB boards in the Movable Counting House. Functions and features are as follows: (1) Initialization of eight SVX chip strings using the MIL-STD-1553 data bus; (2) Real time manipulation of the SVX control lines to effect data acquisition, digitization, and readout based on the NRZ/Clock signals from the Controller; (3) Conversion of 8-bit electrical SVX readout data to an optical signal operating at 1.062 Gbit/sec, sent to the VRB. Eight HDIs will be serviced per board; (4) Built-in logic analyzer which can record the most important control and data lines during a data acquisition cycle and put this recorded information onto the 1553 bus; (5) Identification header and end of data trailer tacked onto data stream; (6) 1553 register which can read the current values of the control and data lines; (7) 1553 register which can test the optical link; (8) 1553 registers for crossing pulse width, calibration pulse voltage, and calibration pipeline select; (9) 1553 register for reading the optical drivers status link; (10) 1553 register for power control of SVX chips and ignoring bad SVX strings; (11) Front panel displays and LEDs show the board status at a glance; (12) In-system programmable EPLDs are programmed via 1553 or Altera's 'Bitblaster'; (13) Automatic readout abort after 45us; (14) Supplies BUSY signal back to Trigger Framework; (15) Supports a heartbeat system to prevent excessive SVX current draw; and (16) Supports a SVX power trip feature if heartbeat failure occurs.
Richard Le Heron
Full Text Available Surprisingly little theoretical or empirical research is available on Auckland’s actual functional and geographic connectivity, including developments relating to closer economic relations with Australia. This paper draws on the geography of accumulation literatures to argue that close attention must be given to developments in the three circuits of capital (trade, production and finance if the changing character and contributions of globalising firm networks are to be discerned and understood. The empirical investigations show that for Australian owned firms globalising rather than purely Australasian networks are the norm, network complexity is considerable and that it makes sense to think of Auckland’s economy in globalising terms. A globalising networks perspective means that estimates of the magnitude and assessments of the character of employment contributions of Australian owned firms to the Auckland economy reflects these interdependencies.
Suepaul, R B; Alley, M R; van Rensburg, M Jansen
Three Blue Penguins (Eudyptula minor) were rescued between July 2006 and January 2007 off the east coast of Auckland, New Zealand. They were taken to a rehabilitation center, where they subsequently died in May 2007 and were submitted for necropsy. There was unilateral enlargement of the salt glands with disseminated small, pale, and firm foci in all birds. Histologic examination of the affected glands demonstrated the presence of multifocal granulomas and areas of severe squamous metaplasia of the collecting ducts. The remaining gland had areas of hyperplasia, dysplasia, and necrosis with a severe granulomatous inflammatory reaction. Intralesional gram-negative bacteria were detected, but, unfortunately, bacterial culture was unrewarding. No further cases were observed in penguins in the subsequent year, and the primary cause of the salt gland adenitis remains uncertain.
Barry, Lorelle; Coleborne, Catharine
This article examines Māori patients at the Auckland Mental Hospital between 1860 and 1900.We argue that the patient case notes reveal 'European' categories in which Māori were situated, and demonstrate the extent to which the authorities at the hospital grappled with their appearance, their language and their culture, all of which were elements of their ethnicity. We argue that the use of institutional case records is highly suggestive of some of the historical meanings of insanity for Māori, including the lack of detailed or sustained collection of information about patients' tribal affiliations, the interest shown in their rights to land in maintenance payment inquiries, the experiences of cultural alienation or mate Māori, and the sad outcomes for Māori.
Jefferies, Craig; Carter, Philippa; Reed, Peter W; Cutfield, Wayne; Mouat, Fran; Hofman, Paul L; Gunn, Alistair Jan
The incidence of type 2 diabetes mellitus (T2DM) is increasing in adolescents in most western countries. The time-course of glycemic control and impact of early treatment remain poorly understood. To determine the change in incidence of T2DM, and the time-course of glycemic control in a regional pediatric cohort with T2DM. Retrospective analysis of prospectively collected data on 52 patients with T2DM from a population-based treatment referral cohort from 1 January 1995 to 31 December 2007. The annual incidence of new cases of T2DM in children Auckland region of New Zealand from 1995 [0.5/100,000; 95% confidence interval (CI) 0.0–2.2] to 2007 (2.5/100,000; 95% CI 1.0–5.5). The average annual incidence per 100,000 over the entire period was 1.3 (95% CI 1.0–1.8) overall, 0.1 (0.0–0.4) in Europeans, and 3.4 in both Maori (2.0–5.3) and Pacifica (2.2–5.0). Fifty-seven percent of children were symptomatic at presentation. Fifty-eight percent of patients were treated with insulin from diagnosis, most of whom were symptomatic (p = 0.003). Follow-up data were available for 48 patients with a mean of 2.4 yr. Although insulin therapy was associated with a greater fall in HbA1c values in the first 12 months of treatment (to a nadir of 7.1 vs. 8.1%, p 9% in both groups. Therapy did not affect body mass index standard deviation score (BMI SDS). The incidence of T2DM in childhood or adolescence increased markedly over a 13-yr period in the Auckland region. Long-
Menozzi, Anna; Fraquelli, Giovanni; Novara, Jolanda de
The paper deals with diversity as a key factor to improve the board of directors’ decision process in family firms. The empirical literature about board diversity points at the positive impact of diversity on board functioning and firm performance. The paper uses a statistical diversity index to capture the heterogeneity of board of directors and put it in relation with firm performance, as measured by firm profitability. The empirical analysis is based on a newly collected panel of 327 famil...
The International Programme on the Health Effects of the Chernobyl Accident (IPHECA) have been initiated in mid-1991 following its endorsement by the Forty-fourth World Health Assembly in resolution WHA44.36. This report by the Director General outlines the progress made in the implementation of the Programme, and summarises the scientific information obtained to date on the health effects and planned future activities. The major projects under the programme include Thyroid project, Hematology project, Dosimetry and Communication Support Services, Brain Damage in utero project and Epidemiological Registry project
Schlechty, Phillip C.; Cole, Robert W.
Claiming that individual school board members act in selfish ways, proposes electing entire school board as a slate. Board would collectively be held responsible for performance of the school system and all of its employees. State legislation would be required to specify how interested groups would select a slate and create a charter, which is the…
Full Text Available The aim of this pocket-book size manual is to assist Institutional Review Board (IRB members and chairs conduct ethics review by balancing the two major morally relevant considerations in health research
Full Text Available Board members may well be responsible for dissension between themselves and shareholders since they are simultaneously the setters and receivers of both board remuneration and dividends. They may act out of their own personal interests at the expense of external shareholders. We investigate the impact of ownership structure, board structure and control deviation on payment asymmetry, where excessively high remuneration is paid to board members but considerably lower dividends are distributed to shareholders. We find strong evidence confirming that the smaller the shareholdings of board members and outside blockholders are, the more asymmetric the payments are. With controlling family members on the board and a higher percentage of seats held by independent board members, there is a slight reduction in the likelihood and severity of payment asymmetry. In addition, it is abundantly clear that the larger the board seat-control deviation is, the greater is the likelihood and severity of payment asymmetry. While prior research has primarily focused on board-manager agency issues, the board-shareholder perspective could be even more important in that it is the board that is the most directly delegated agent of shareholders, not the managers
Note The CERN pension scheme is based on the principle of defined benefits, so beneficiaries continue to receive the benefits to which they are entitled in accordance with the Rules of the Pension Fund. This means that pension entitlements under the Rules are not directly affected by the financial crisis and the current economic situation. However, the adjustment of pensions to the cost of living is not automatic and, under the method applied since 2006, must take into account the Fund’s financial position. Meeting of the Pension Fund Governing Board The Pension Fund Governing Board held its eighth meeting at ESO in Garching (near Munich), Germany on 24 October 2008. Before starting its work, the Governing Board had the privilege of hearing an opening address by Professor Tim de Zeeuw, the Director General of ESO. Professor de Zeeuw described the mission of ESO and the ambitious projects of his organisation, which performs astronomy observations using telescopes located in Chile. The Director-General receiv...
Kuntz, Ludwig; Pulm, Jannis; Wittland, Michael
Dynamic and complex transformations in the hospital market increase the relevance of good corporate governance. However, hospital performance and the characteristics of supervisory boards differ depending on ownership. The question therefore arises whether hospital owners can influence performance by addressing supervisory board characteristics. The objective of this study is to explain differences in the financial performance of hospitals with regard to ownership by studying the size and composition of supervisory boards. The AMADEUS database was used to collect information on hospital financial performance in 2009 and 2010. Business and quality reports, hospital websites, and data from health insurer were used to obtain information on hospital and board characteristics. The resulting sample consisted of 175 German hospital corporations. We utilized ANOVA and regression analysis to test a mediation hypothesis that investigated whether decisions regarding board size and composition were associated with financial performance and could explain performance differences. Financial performance and board size and composition depend on ownership. An increase in board size and greater politician participation were negatively associated with all five tested measures of financial performance. Furthermore, an increase in physician participation was positively associated with one dimension of financial performance, whereas one negative relationship was identified for nurse and economist participation. For clerics, no associations were found. Decisions concerning board size and composition are important as they relate to hospital financial performance. We contribute to existing research by showing that, in addition to board size and physician participation, the participation of other professionals can also influence financial performance.
Manchikanti, Laxmaiah; Falco, Frank J E; Singh, Vijay; Benyamin, Ramsin M; Hirsch, Joshua A
The Independent Payment Advisory Board (IPAB) is a vastly powerful component of the president's health care reform law, with authority to issue recommendations to reduce the growth in Medicare spending, providing recommendations to be considered by Congress and implemented by the administration on a fast track basis. Ever since its inception, IPAB has been one of the most controversial issues of the Patient Protection and Affordable Care Act (ACA), even though the powers of IPAB are restricted and multiple sectors of health care have been protected in the law. IPAB works by recommending policies to Congress to help Medicare provide better care at a lower cost, which would include ideas on coordinating care, getting rid of waste in the system, providing incentives for best practices, and prioritizing primary care. Congress then has the power to accept or reject these recommendations. However, Congress faces extreme limitations, either to enact policies that achieve equivalent savings, or let the Secretary of Health and Human Services (HHS) follow IPAB's recommendations. IPAB has strong supporters and opponents, leading to arguments in favor of or against to the extreme of introducing legislation to repeal IPAB. The origins of IPAB are found in the ideology of the National Institute for Health and Clinical Excellence (NICE) and the impetus of exploring health care costs, even though IPAB's authority seems to be limited to Medicare only. The structure and operation of IPAB differs from Medicare and has been called the Medicare Payment Advisory Commission (MedPAC) on steroids. The board membership consists of 15 full-time members appointed by the president and confirmed by the Senate with options for recess appointments. The IPAB statute sets target growth rates for Medicare spending. The applicable percent for maximum savings appears to be 0.5% for year 2015, 1% for 2016, 1.25% for 2017, and 1.5% for 2018 and later. The IPAB Medicare proposal process involves
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Establishment of the Advisory Board on Elder Abuse...: Notice. Authority: The Advisory Board on Elder Abuse, Neglect, and Exploitation is authorized under... Services announces establishment of the Advisory Board on Elder Abuse, Neglect, and Exploitation, as...
Keating, Nancy L; Landrum, Mary Beth; Lamont, Elizabeth B; Bozeman, Samuel R; Shulman, Lawrence N; McNeil, Barbara J
Despite the widespread use of tumor boards, few data on their effects on cancer care exist. We assessed whether the presence of a tumor board, either general or cancer specific, was associated with recommended cancer care, outcomes, or use in the Veterans Affairs (VA) health system. We surveyed 138 VA medical centers about the presence of tumor boards and linked cancer registry and administrative data to assess receipt of stage-specific recommended care, survival, or use for patients with colorectal, lung, prostate, hematologic, and breast cancers diagnosed in the period from 2001 to 2004 and followed through 2005. We used multivariable logistic regression to assess associations of tumor boards with the measures, adjusting for patient sociodemographic and clinical characteristics. All statistical tests were two-sided. Most facilities (75%) had at least one tumor board, and many had several cancer-specific tumor boards. Presence of a tumor board was associated with only seven of 27 measures assessed (all P < .05), and several associations were not in expected directions. Rates of some recommended care (eg, white blood cell growth factors with cyclophosphamide, adriamycin, vincristine, and prednisone in diffuse large B-cell lymphoma) were lower in centers with hematologic-specialized tumor boards (39.4%) than in centers with general tumor boards (61.3%) or no tumor boards (56.4%; P = .002). Only one of 27 measures was statistically significantly associated with tumor boards after applying a Bonferroni correction for multiple comparisons. We observed little association of multidisciplinary tumor boards with measures of use, quality, or survival. This may reflect no effect or an effect that varies by structural and functional components and participants' expertise.
Agustín-Flores, Javier; Németh, Károly; Cronin, Shane J.; Lindsay, Jan M.; Kereszturi, Gábor
The Auckland Volcanic Field (AVF) comprises at least 52 monogenetic eruption centres dispersed over ˜360 km2. Eruptions have occurred sporadically since 250 ka, predominantly when glacio-eustatic sea levels were lower than today. Now that around 35 % of the field is covered by shallow water (up to 30 m depth), any eruption occurring in the present or near future within this area may display Surtseyan dynamics. The North Head tuff cone evidences eruptive dynamics caused by magma interaction with seawater. The first stages of the eruption comprise a phreatomagmatic phase that built a 48-m-high tuff cone. North Head tuff deposits contain few lithic fragments (Auckland area was at least 10-12 m above the pre-eruptive surface. The hazards associated with this type of eruption pose a risk to the densely populated coastal residential zones and the activities of one of the busiest harbours in New Zealand.
Viccellio, Peter; Zito, Joseph A; Sayage, Valerie; Chohan, Jasmine; Garra, Gregory; Santora, Carolyn; Singer, Adam J
Boarding of admitted patients in the emergency department (ED) is a major cause of crowding. One alternative to boarding in the ED, a full-capacity protocol where boarded patients are redeployed to inpatient units, can reduce crowding and improve overall flow. Our aim was to compare patient satisfaction with boarding in the ED vs. inpatient hallways. We performed a structured telephone survey regarding patient experiences and preferences for boarding among admitted ED patients who experienced boarding in the ED hallway and then were subsequently transferred to inpatient hallways. Demographic and clinical characteristics, as well as patient preferences, including items related to patient comfort and safety using a 5-point scale, were recorded and descriptive statistics were used to summarize the data. Of 110 patients contacted, 105 consented to participate. Mean age was 57 ± 16 years and 52% were female. All patients were initially boarded in the ED in a hallway before their transfer to an inpatient hallway bed. The overall preferred location after admission was the inpatient hallway in 85% (95% confidence interval 75-90) of respondents. In comparing ED vs. inpatient hallway boarding, the following percentages of respondents preferred inpatient boarding with regard to the following 8 items: rest, 85%; safety, 83%; confidentiality, 82%; treatment, 78%; comfort, 79%; quiet, 84%; staff availability, 84%; and privacy, 84%. For no item was there a preference for boarding in the ED. Patients overwhelmingly preferred the inpatient hallway rather than the ED hallway when admitted to the hospital. Copyright © 2013 Elsevier Inc. All rights reserved.
Samin, Oliver A.; Civil, Ian D.
Retrospectively calculated NISS was compared with the prospectively calculated ISS from data derived from the trauma registry of the Trauma Services of the Auckland Hospital as to which test is a better predictor of patient outcome, which is defined as the likelihood of death. The area under the curve (AUC) for ISS and NISS were computed using the non-parametric approach. AUC for ISS = 0.95835, and AUC for NISS = 0.97350, p
... TRANSPORTATION GENERAL RULES AND REGULATIONS BOARD ORGANIZATION; DELEGATIONS OF AUTHORITY § 1011.2 The Board. (a... submitted for decision except those assigned to an individual Board Member or employee or an employee board...) The Board may bring before it any matter assigned to an individual Board Member or employee or...
Krishnamurthi, Rita; Jones, Amy; Barber, P Alan; Barker-Collo, Suzanne; McPherson, Kathryn; Bennett, Derrick; Rush, Elaine; Suh, Flora; Starkey, Nicola; Theadom, Alice; Parag, Varsha; Rathnasabapathy, Yogini; Feigin, Valery L
Stroke is a leading cause of death and disability worldwide. Stroke burden is immense as it leads to premature deaths, leaves survivors with ongoing disabilities, and has a major financial impact on the individual, their families, and the community. Reliable, high-quality evidence is needed on stroke risk factors, incidence, and outcomes to provide information on how best to reduce this burden. Population-based studies are regarded as the 'gold-standard' of measuring disease burden but are not common due to the logistical and financial challenges they present. The Auckland Regional Community Stroke Studies are among a few in the world that have been carried out at a population level and at regular intervals. The aim of the fourth Auckland Regional Community Stroke Studies IV is to examine the current measures of stroke incidence, prevalence, and outcomes as well the trends over four decades. This article describes the methodology of the Auckland Regional Community Stroke Studies IV with stroke and transient ischemic attacks cases registered over a 12-month period from March 1, 2011 to February 29, 2012. The methodology described may be used as a guide in order to design similar population-based stroke incidence and outcome studies in other countries and populations, thus facilitating the collection of most consistent and accurate stroke epidemiological data. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.
Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk
One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.
Sonnenfeld, Jeffrey A
In the wake of meltdowns at WorldCom, Tyco, and Enron, enormous attention has been focused on the companies' boards. It seems inconceivable that business disasters of such magnitude could happen without gross or even criminal negligence on the part of board members. And yet a close examination of those boards reveals no broad pattern of incompetence or corruption. In fact, they followed most of the accepted standards for board operations: Members showed up for meetings; they had money invested in the company; audit committees, compensation committees, and codes of ethics were in place; the boards weren't too small or too big, nor were they dominated by insiders. In other words, they passed the tests that would normally be applied to determine whether a board of directors was likely to do a good job. And that's precisely what's so scary, according to corporate governance expert Jeffrey Sonnenfeld, who suggests that it's time for some new thinking about how corporate boards operate and are evaluated. He proposes thinking not only about how to structure the board's work but also about how to manage it as a social system. Good boards are, very simply, high-functioning work groups. They're distinguished by a climate of respect, trust, and candor among board members and between the board and management. Information is shared openly and on time; emergent political factions are quickly eliminated. Members feel free to challenge one another's assumptions and conclusions, and management encourages lively discussion of strategic issues. Directors feel a responsibility to contribute meaningfully to the board's performance. In addition, good boards assess their own performance, both collectively and individually.
Progress is reported on the following: nuclear materials, nuclear power, application of radioisotopes and radiation, health and safety and fundamental studies undertaken in physics, chemistry, metallurgy, medicine and geology during 1975. The technical activities on the site are summarized as well as the external negotiations untertaken. The staff organization and finance is given. The report also contains a list of publications published during 1975 by staff members and bursars of the Board
Dyall, Lorna; Carter, Kristie; Bonita, Ruth; Anderson, Craig; Feigin, Valery; Kerse, Ngaire; Brown, Paul
Although women have a greater lifetime risk of stroke than men, along with other gender differences in stroke, there is lack of reliable data on long-term trends in stroke in women. This paper presents the results of three population-based registers in Auckland (1981-1982, 1991-1992, and 2002-2003) which aimed to determine the trends in the incidence of stroke in New Zealand. This paper reports on the burden of stroke in women across different ethnic groups over the study period from 1981 to 2003. Three studies using similar methodology and overlapping case finding methods have been conducted in New Zealand to estimate trends in the incidence and outcome of stroke. The studies are recognised as meeting the 'ideal' criteria for stroke incidence and identify all first-ever and recurrent strokes in residents (aged greater than and equal to 15 years) the population of Auckland, New Zealand in the 12-month periods from 1981-1982, 1991-1992, and 2002-2003. There were totals of 307,578 strokes among women in 1981, 372,642 in 1991, and 470,727 in 2001, according to each Census representing over 50% of the population at each period (51%-54%). The WHO standard world population was used for direct age standardisation of annual rates (per 100,000 population), reported with 95% confidence intervals (CI). The proportion of women who have experienced a stroke did not change markedly over the study period but there were ethnic differences emerging which were related to population changes within the New Zealand population. Standardised stroke incidence in women was relatively stable across the three study periods (1981-1982), 133 [95% CI 118-151]; (1991-1992), 143 [95% CI 116-241]; and (2002-2003), 124 [95% CI 115-134]). However, a significant decline of 14% (95% CI 2%-29%) in rates of first-ever stroke was found between 1991-1992 and 2002-2003 in women. In contrast to the significant declines in event rates in European women over two decades (Rate ratio 0.84, 95% CI 0
The advice is accompanied by a letter dated July 1979 to the Health and Safety Commission on the acceptability of the dose limits contained within the draft Euratom Directive (Document 5020/78). There are comments on a reduction of the dose limits, the imposition of a dose limit for occupational exposure of 30 mSv (3 rem) in a quarter, and guidance in the use of derived limits and secondary standards. The NRPB strongly recommends that the UK legislation should be framed so as to allow a similar flexibility to that of the Directive. (UK)
Atish R. Ghosh
The growing integration of world capital markets has made it fashionable to argue that only extreme exchange rate regimes are sustainable. Short of adopting a common currency, currency board arrangements represent the most extreme form of exchange rate peg. This paper compares the macroeconomic performance of countries with currency boards to those with other forms of pegged exchange rate regime. Currency boards are indeed associated with better inflation performance, even allowing for potent...
I. M. Browne
Full Text Available The Southern Hemisphere westerly winds (SHWWs play a major role in controlling wind-driven upwelling of Circumpolar Deep Water (CDW and outgassing of CO2 in the Southern Ocean, on interannual to glacial–interglacial timescales. Despite their significance in the global carbon cycle, our understanding of millennial- and centennial-scale changes in the strength and latitudinal position of the westerlies during the Holocene (especially since 5000 yr BP is limited by a scarcity of palaeoclimate records from comparable latitudes. Here, we reconstruct middle to late Holocene SHWW variability using a fjord sediment core collected from the subantarctic Auckland Islands (51° S, 166° E, located in the modern centre of the westerly wind belt. Changes in drainage basin response to variability in the strength of the SHWW at this latitude are interpreted from downcore variations in magnetic susceptibility (MS and bulk organic δ13C and atomic C ∕ N, which monitor influxes of lithogenous and terrestrial vs. marine organic matter, respectively. The fjord water column response to SHWW variability is evaluated using benthic foraminifer δ18O and δ13C, both of which are influenced by the isotopic composition of shelf water masses entering the fjord. Using these data, we provide marine and terrestrial-based evidence for increased wind strength from ∼ 1600 to 900 yr BP at subantarctic latitudes that is broadly consistent with previous studies of climate-driven vegetation change at the Auckland Islands. Comparison with a SHWW reconstruction using similar proxies from Fiordland suggests a northward migration of the SHWW over New Zealand during the first half of the last millennium. Comparison with palaeoclimate and palaeoceanographic records from southern South America and West Antarctica indicates a late Holocene strengthening of the SHWW after ∼ 1600 yr BP that appears to be broadly symmetrical across the Pacific Basin
Brook, Martin; Liu, Shanshan; Richards, Nick; Bevan, David; Prebble, Warwick
Landslides pose significant risks to communities and infrastructure particularly in urban areas, and mitigating these risks relies on understanding landslide triggering processes that may cause reactivation. Previous work has shown that landslides are often complex, multiphase processes where gradual deterioration of shear strength within the subsurface precedes slope failure and the appearance of surface morphological features. Here, we combine a suite of remote sensing and direct invasive testing techniques to assess reactivation of the Pourewa Landslide Zone (PLZ), located in Auckland, New Zealand. The PLZ is located on the inner wall of the north-eastern flank of the Orakei volcano, 4 km east of Auckland CBD. The landslide zone occupies slopes above the east bank of the tidal Pourewa Creek, which lies within a residential area. Four landslides are located within the PLZ (from west to east): Ngapipi Road Landslide, Kepa Road Landslide, St Josephs Landslide, and Pourewa Landslide. Inward collapse of the crater walls since the initial eruption (>85 ka) has enlarged the crater to c. 1000 m diameter, with some slopes prone to ongoing mass movements. Indeed, reactivation during the 20th century led to the realignment of Kepa Road, and surface cracking of roads in the vicinity is ongoing. LiDAR imagery was used to develop high resolution geomorphological maps, and this data was compared with more recent Structure-from-Motion (SfM) photogrammetry, obtained from an unmanned aerial vehicle (UAV). The digital surface models and derived cross-sections developed from these data allow both the initial failure, and subsequent reactivations to be assessed in detail. Geophysical surveys included Electromagnetic Induction (EMI), augmented by information relating to lithological, moisture and strength variation with depth, allowing initial interpretation of zones likely to be prone to reactivation. Ongoing slope deformation includes shallow, retrogressive failure on the upper
Okesene-Gafa, Karaponi; Chelimo, Carol; Chua, Shireen; Henning, Marcus; McCowan, Lesley
Approximately 60% of women in South Auckland, a culturally diverse region in New Zealand, become pregnant with a high body mass index. However, little is known about these women's knowledge of nutrition and physical activity during pregnancy. To assess knowledge of nutrition and physical activity during pregnancy, factors influencing eating habits and the willingness to participate in a nutritional intervention. A total of 422 women completed the survey in late pregnancy between September and December 2013. Multivariable logistic regression investigated factors associated with infrequent healthy eating, adjusting for ethnicity and gestation at questionnaire completion. Ethnicity of participants was Māori (24.2%), Pacific (40.5%), Asian (12.8%) and European/Others (21.8%). Most (95.0%) reported receiving information about healthy eating while pregnant and 61% reported eating healthy frequently or very frequently. Forty-four point three per cent reported eating more in pregnancy; the commonest reasons were cravings and 'eating for two'. The adjusted odd ratios (aORs) indicated that the self-reported factors associated with infrequent healthy eating in this sample were Māori (aOR 17.66; 95% CI 8.49-36.77) and Pacific ethnicity (aOR 14.54; 95% CI 7.32-28.88); parity ≥3 (aOR 2.09; 95%CI 1.26-3.48); obesity (aOR 2.84; 95% CI 1.35-5.97); unplanned pregnancy (aOR 1.95; 95%CI 1.18-3.22); and eating takeaways ≥3 times/week (aOR 4.46; 95%CI 1.88-10.56). Of women sampled, 83.4% would likely/very likely participate in a nutritional intervention. Self-reported factors associated with infrequent healthy eating in pregnancy were identified in this sample. Our findings will assist development of a nutritional intervention for pregnant women in South Auckland. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Browne, Imogen M.; Moy, Christopher M.; Riesselman, Christina R.; Neil, Helen L.; Curtin, Lorelei G.; Gorman, Andrew R.; Wilson, Gary S.
The Southern Hemisphere westerly winds (SHWWs) play a major role in controlling wind-driven upwelling of Circumpolar Deep Water (CDW) and outgassing of CO2 in the Southern Ocean, on interannual to glacial-interglacial timescales. Despite their significance in the global carbon cycle, our understanding of millennial- and centennial-scale changes in the strength and latitudinal position of the westerlies during the Holocene (especially since 5000 yr BP) is limited by a scarcity of palaeoclimate records from comparable latitudes. Here, we reconstruct middle to late Holocene SHWW variability using a fjord sediment core collected from the subantarctic Auckland Islands (51° S, 166° E), located in the modern centre of the westerly wind belt. Changes in drainage basin response to variability in the strength of the SHWW at this latitude are interpreted from downcore variations in magnetic susceptibility (MS) and bulk organic δ13C and atomic C / N, which monitor influxes of lithogenous and terrestrial vs. marine organic matter, respectively. The fjord water column response to SHWW variability is evaluated using benthic foraminifer δ18O and δ13C, both of which are influenced by the isotopic composition of shelf water masses entering the fjord. Using these data, we provide marine and terrestrial-based evidence for increased wind strength from ˜ 1600 to 900 yr BP at subantarctic latitudes that is broadly consistent with previous studies of climate-driven vegetation change at the Auckland Islands. Comparison with a SHWW reconstruction using similar proxies from Fiordland suggests a northward migration of the SHWW over New Zealand during the first half of the last millennium. Comparison with palaeoclimate and palaeoceanographic records from southern South America and West Antarctica indicates a late Holocene strengthening of the SHWW after ˜ 1600 yr BP that appears to be broadly symmetrical across the Pacific Basin. Contemporaneous increases in SHWW at localities on either
Hopkins, Jenni L.; Wilson, Colin J. N.; Millet, Marc-Alban; Leonard, Graham S.; Timm, Christian; McGee, Lucy E.; Smith, Ian E. M.; Smith, Euan G. C.
Linking tephras back to their source centre(s) in volcanic fields is crucial not only to reconstruct the eruptive history of the volcanic field but also to understand tephra dispersal patterns and thus the potential hazards posed by a future eruption. Here we present a multi-disciplinary approach to correlate distal basaltic tephra deposits from the Auckland Volcanic Field (AVF) to their source centres using proximal whole-rock geochemical signatures. In order to achieve these correlations, major and trace element tephra-derived glass compositions are compared with published and newly obtained whole-rock geochemical data for the entire field. The results show that incompatible trace element ratios (e.g. (Gd/Yb)N, (La/Yb)N, (Zr/Yb)N) vary widely across the AVF (e.g. (La/Yb)N = 5 to 40) but show a more restricted range within samples from a single volcanic centre (e.g. (La/Yb)N = 5 to 10). These ratios are also the least affected by fractional crystallisation and are therefore the most appropriate geochemical tools for correlation between tephra and whole-rock samples. However, findings for the AVF suggest that each volcanic centre does not have a unique geochemical signature in the field as a whole, thus preventing unambiguous correlation of tephras to source centre using geochemistry alone. A number of additional criteria are therefore combined to further constrain the source centres of the distal tephras including age, eruption scale, and location (of centres, and sites where tephra were sampled). The combination of tephrostratigraphy, 40Ar/39Ar dating and morphostratigraphic constraints allow, for the first time, the relative and absolute ordering of 48 of 53 volcanic centres of the Auckland Volcanic Field to be resolved. Eruption frequencies are shown to vary between 0.13 and 1.5 eruptions/kyr and repose periods between individual eruptions vary from <0.1 to 13 kyr, with 23 of the 48 centres shown to have pre-eruptive repose periods of <1000 years. No spatial
Carter, J M; Irving, A C; Bridges, J P; Jones, B R
To provide an estimate of the prevalence of ocular lesions associated with hypertension in geriatric cats in Auckland, New Zealand and to evaluate the importance of examination of the ocular fundi of cats over eight years of age. A total of 105 cats ≥8 years of age were examined and clinical signs recorded. Blood was collected for the laboratory measurement of the concentrations of blood urea nitrogen (BUN), glucose and creatinine in serum, urine was collected for determination of urine specific gravity (USG), and blood pressure (BP) was measured using high definition oscillometry equipment. A cat was determined to have systemic hypertension with a systolic BP ≥160 mm Hg and a diastolic BP ≥100 mm Hg. Each animal had an ocular fundic examination using a retinal camera to diagnose ocular lesions associated with hypertension, including retinopathies, choroidopathies and optic neuropathies. Blood pressure was successfully recorded in 73 cats. Of these, 37 (51%) had no hypertensive ocular lesions and no underlying disease diagnosed, 24 (33%) had no hypertensive ocular lesions detected, but underlying disease such as chronic kidney disease, hyperthyroidism or diabetes mellitus was diagnosed, and 12 (16%) cats had evidence of hypertensive ocular lesions. Ten of the cats with hypertensive ocular lesions were hypertensive at the time of the first visit and two were normotensive. One additional cat had hypertensive ocular lesions, but it was not possible to obtain consistent BP readings in this animal. Chronic kidney disease was the most commonly diagnosed concurrent disease in cats with hypertensive ocular lesions (n=6). Mean systolic BP for cats with hypertensive ocular lesions (168.0 (SE 6.29) mm Hg) was higher than for those with no ocular lesions (144.7 (SE 3.11) mm Hg) or those with no lesions but with underlying disease (146.0 (SE 4.97) mm Hg) (p=0.001). Ocular fundic examination of cats over eight years of age allows identification of cats with
Ionising radiations. Joint consultative document. Supplementary proposals for provision on radiological protection and draft advice from the National Radiological Protection Board to the Health and Safety Commission
The consultative document is in two parts. Part 1 indicates the amendments to the first consultative document which would be required in order to implement (in the United Kingdom) the 1978 Draft Euratom Directive (on Basic Safety Standards for the health protection of the general public and workers against the dangers of ionising radiations). Part 2 deals with the system of dose limitation contained within the Euratom Directive. This aspect is discussed, in relation to the Articles of the Directive, under the following headings: limitation of doses for controllable exposures, limits of doses for exposed workers, limitation of doses for apprentices and students, planned special exposures, dose limits for members of the public. The Commission of the European Communities proposals for a draft Directive on Radiological Protection are reproduced as an Appendix, without Annexes. (U.K.)
Teschke, K.; Netten, C. van; Kennedy, S. [British Columbia Univ., Vancouver, BC (Canada)
The University of British Columbia was asked by the Safety and Health in Arts Production and Entertainment to assist in investigating a number of issues concerning the safety of theatrical smokes and fogs. Specifically, the study strove to answer the following: (1) what products and equipment are used in the British Columbia (BC) entertainment industry, the chemicals that are used, and does the composition of the chemicals change once they are heated during use?, (2) what measuring equipment can be used for on-site monitoring by production staff?, (3) what levels of smokes and fogs are present in the air, the sizes of the airborne fog droplets, the type of exposure of employees?, (4) and are employees suffering ill health effects as a result of exposure? In the course of the study, 23 members of the International Alliance of Theatrical Stage Employees (IATSE) Local 891 were interviewed concerning their jobs, including the materials and equipment they use to create atmospheric effects. In addition, laboratory investigations of the constituents of the glycol fluids and their potential for pyrolysis under normal operating conditions were performed, as well as field tests of measurement methods to allow industry personnel to check exposure levels easily. The authors also performed a cross-sectional study of exposures to theatrical employees in the industry. The results showed that several technicians formulated their own fluids. Bulk samples were obtained of 15 glycol-based fluids and were found to have the same proportions of specific glycols as specified on their Material Safety Data Sheets. Three commercially available real-time direct-reading monitors were evaluated as simple monitoring methods. The preferred method was found to be the DataRAM which is easy to use, can be worn as a personal monitor and is silent. The drawback is the price (8000 dollars). Several recommendations were made. refs., tabs., figs.
On 16 March and 7 May, the Pension Fund Governing Board (PFGB) held its fourth and fifth meetings The first of these meetings was primarily dedicated to the examination of the strategic asset allocation. The PFGB reaffirmed the main goal of the new strategic asset allocation: to improve the Pension Fund’s position with regard to risk by lowering overall portfolio volatility through suitable investments in less volatile asset classes such as real estate and absolute return strategies, where the return does not depend on market trends and negative growth is extremely unlikely. The finalised document will be presented to the Finance Committee and the Council at their June meetings for approval, in accordance with the provisions of the Levaux report. The PFGB also took note of the Internal Audit’s report on Pension Fund operations and decided to refer it to Working Group I as a working document for establishing a control and internal monitoring system for Pension Fund oper...
McKay, Stacey A; Farnworth, Mark J; Waran, Natalie K
This study distributed a questionnaire to cat or dog caregivers (owners) throughout Auckland, New Zealand, to investigate the attitudes of human companions toward the sterilization of their cats and dogs and the degree to which this occurs relative to demographic information gathered. A total of 276 recipients returned questionnaires with data pertinent to 477 cats and dogs. Female owners were more likely than were males to sterilize cats or dogs: 90.2% sterilization rate compared with 80%. Statistical trends also suggested that owners with a postschool education had a higher percentage of sterilized nonhuman animals than owners with no postschool or only school-age education. Cats were more likely than dogs to be neutered: 91.7% versus 78.5%. Companion animals not annually vaccinated were more likely to be sterilized than animals who were vaccinated annually: 93.6% and 85.4%. The study also showed gender bias and age differences in owner attitudes toward a number of the statements regarding sterilization, with male owners more likely to be concerned about the effect of neutering or spaying on the sexuality or masculinity of the animal.
Full Text Available New Zealand state housing includes a significant portion of problematic buildings constructed after the public housing scheme launched in 1936. Most of these houses are still uninsulated, thus, cold, draughty, mouldy, and progressively decaying; however, as they are fundamental elements of the country’s culture, society, and environment, and are built with good quality materials and sound construction, they are suitable candidates for effective energy upgrades. This paper presents findings of a study on problems and opportunities of retrofitting the state houses built between 1940 and 1960 in the Auckland region. It advocates strategic national policies and initiatives for retrofitting, based on more challenging performance thresholds. The research defines and virtually implements an incremental intervention strategy including different retrofit packages for a typical 1950s stand-alone house. Indoor and outdoor environmental parameters were monitored over a year, and data used to establish a base case for thermal simulation. The upgrade packages were then modelled to assess their impact on the house’s thermal performance, comparing heating requirements and comfort of various insulation and ventilation options. The paper reports on effective ways of preserving the integrity of such a house, while improving its thermal performance to the EnerPHit standard, and discusses the benefits of introducing this holistic approach into New Zealand retrofit practice.
Morgan Angharad R
Full Text Available Abstract Background Individuals born small for gestational age (SGA are at increased risk of rapid postnatal weight gain, later obesity and diseases in adulthood such as type 2 diabetes, hypertension and cardiovascular diseases. Environmental risk factors for SGA are well established and include smoking, low pregnancy weight, maternal short stature, maternal diet, ethnic origin of mother and hypertension. However, in a large proportion of SGA, no underlying cause is evident, and these individuals may have a larger genetic contribution. Methods In this study we tested the association between SGA and polymorphisms in genes that have previously been associated with obesity and/or diabetes. We undertook analysis of 54 single nucleotide polymorphisms (SNPs in 546 samples from the Auckland Birthweight Collaborative (ABC study. 227 children were born small for gestational age (SGA and 319 were appropriate for gestational age (AGA. Results and Conclusion The results demonstrated that genetic variation in KCNJ11, BDNF, PFKP, PTER and SEC16B were associated with SGA and support the concept that genetic factors associated with obesity and/or type 2 diabetes are more prevalent in those born SGA compared to those born AGA. We have previously determined that environmental factors are associated with differences in birthweight in the ABC study and now we have demonstrated a significant genetic contribution, suggesting that the interaction between genetics and the environment are important.
Abrahim, Ghada M. S.; Parker, Robin J.; Horrocks, Mark
Tamaki Estuary is an arm of the Hauraki Gulf situated on the eastern side of central Auckland. Over the last 100 years, Tamaki catchment has evolved from a nearly rural landscape to an urbanised and industrialised area. Pollen, 14C and glass shards analyses, were carried out on three cores collected along the estuary with the aim to reconstruct the estuary's history over the last ˜8000 years and trace natural and anthropogenic effects recorded in the sediments. Glass shard analysis was used to establish key tephra time markers such as the peralkaline eruption of Mayor Island, ˜6000 years BP. During the pre-Polynesian period (since at least 8000 years BP), regional vegetation was podocarp/hardwood forest dominated by Dacrydium cupressinun, Prumnopits taxifolia, and Metrosideros. Major Polynesian settler impact (commencing ˜700 yr BP) was associated with forest clearance as indicated by a sharp decline in forest pollen types. This coincided with an increase in bracken (Pteridium esculentum) spores and grass pollen. Continuing landscape disturbance during European settlement (commencing after 1840 AD) was accompanied by the distinctive appearance of exotic pollen taxa such as Pinus.
Background Individuals born small for gestational age (SGA) are at increased risk of rapid postnatal weight gain, later obesity and diseases in adulthood such as type 2 diabetes, hypertension and cardiovascular diseases. Environmental risk factors for SGA are well established and include smoking, low pregnancy weight, maternal short stature, maternal diet, ethnic origin of mother and hypertension. However, in a large proportion of SGA, no underlying cause is evident, and these individuals may have a larger genetic contribution. Methods In this study we tested the association between SGA and polymorphisms in genes that have previously been associated with obesity and/or diabetes. We undertook analysis of 54 single nucleotide polymorphisms (SNPs) in 546 samples from the Auckland Birthweight Collaborative (ABC) study. 227 children were born small for gestational age (SGA) and 319 were appropriate for gestational age (AGA). Results and Conclusion The results demonstrated that genetic variation in KCNJ11, BDNF, PFKP, PTER and SEC16B were associated with SGA and support the concept that genetic factors associated with obesity and/or type 2 diabetes are more prevalent in those born SGA compared to those born AGA. We have previously determined that environmental factors are associated with differences in birthweight in the ABC study and now we have demonstrated a significant genetic contribution, suggesting that the interaction between genetics and the environment are important. PMID:20712903
Gentschew, Liljana; Bishop, Karen S.; Han, Dug Yeo; Morgan, Angharad R.; Fraser, Alan G.; Lam, Wen Jiun; Karunasinghe, Nishi; Campbell, Bobbi; Ferguson, Lynnette R.
New Zealand has one of the highest incidence rates of Crohn’s Disease (CD), whilst the serum selenium status of New Zealanders is amongst the lowest in the world. A prospective case-control study in Auckland, New Zealand considered serum selenium as a potential CD risk factor. Serum selenium levels were significantly lower in CD patients compared to controls (101.8 ± 1.02 vs. 111.1 ± 1.01 ng/mL) (p = 5.91 × 10−8). Recent detailed studies in the United Kingdom have suggested an optimal serum level around 122 ng/mL, making the average CD patient in New Zealand selenium deficient. Of the 29 single nucleotide polymorphisms (SNPs) tested, 13 were found to significantly interact with serum selenium on CD. After adjustment for multiple testing, a significant interaction with serum selenium on CD was found for three SNPs, namely rs17529609 and rs7901303 in the gene SEPHS1, and rs1553153 in the gene SEPSECS. These three SNPs have not been reported elsewhere as being significantly associated with selenium or CD. It is unclear as to whether lower selenium levels are a cause or an effect of the disease. PMID:23112913
Full Text Available Background Progress testing is a method of assessing longitudinal progress of students using a single best answer format pitched at the standard of a newly graduated doctor. Aim To evaluate the results of the first year of summative progress testing at the University of Auckland for Years 2 and 4 in 2013. SUBJECTS: Two cohorts of medical students from Years 2 and 4 of the Medical Program. Methods A survey was administered to all involved students. Open text feedback was also sought. Psychometric data were collected on test performance, and indices of reliability and validity were calculated. Results The three tests showed increased mean scores over time. Reliability of the assessments was uniformly high. There was good concurrent validity. Students believe that progress testing assists in integrating science with clinical knowledge and improve learning. Year 4 students reported improved knowledge retention and deeper understanding. Conclusion Progress testing has been successfully introduced into the Faculty for two separate year cohorts and results have met expectations. Other year cohorts will be added incrementally. Recommendation Key success factors for introducing progress testing are partnership with an experienced university, multiple and iterative briefings with staff and students as well as demonstrating the usefulness of progress testing by providing students with detailed feedback on performance.
Broutman, Dave; Eckermann, Stephen D.; Knight, Harold; Ma, Jun
A relatively general stationary phase solution is derived for mountain waves from localized topography. It applies to hydrostatic, nonhydrostatic, or anelastic dispersion relations, to arbitrary localized topography, and to arbitrary smooth vertically varying background temperature and vector wind profiles. A simple method is introduced to compute the ray Jacobian that quantifies the effects of horizontal geometrical spreading in the stationary phase solution. The stationary phase solution is applied to mesospheric mountain waves generated by Auckland Island during the Deep Propagating Gravity Wave Experiment. The results are compared to a Fourier solution. The emphasis is on interpretations involving horizontal geometrical spreading. The results show larger horizontal geometrical spreading for nonhydrostatic waves than for hydrostatic waves in the region directly above the island; the dominant effect of horizontal geometrical spreading in the lower ˜30 km of the atmosphere, compared to the effects of refraction and background density variation; and the enhanced geometrical spreading due to directional wind in the approach to a critical layer in the mesosphere.
Gaw, S.K.; Wilkins, A.L.; Kim, N.D.; Palmer, G.T.; Robinson, P.
The long-term routine use of agrichemicals can result in elevated levels of trace elements and persistent organic pollutants in soils. Trace element concentrations and ΣDDT levels were measured in soil (0-7.5 cm) samples collected from horticultural and grazing properties in 3 regions of New Zealand (Auckland, Tasman and Waikato). Elevated levels of arsenic ( -1 ), cadmium ( -1 ), copper (5 to 523 mg kg -1 ), lead (5 to 243 mg kg -1 ) and ΣDDT ( -1 ) were detected in soils from all 3 regions. With the exception of cadmium and zinc, significantly higher levels of contaminants were generally detected in horticultural soils than in grazing soils. Our results have implications for the on-going use of agrichemicals as concentrations of cadmium, copper, tin and zinc in some samples exceeded ecotoxicity based soil criteria. The p,p'-DDE : DDT ratios indicate that the degradation of DDT in NZ horticultural soils may be inhibited by the co-contamination with trace elements
Mastrangelo, G; Carassai, Patrizia; Carletti, Claudia; Cattani, F; De Zorzi, Lia; Di Loreto, G; Dini, M; Mattioni, G; Mundo, Antonietta; Noceta, R; Ortolani, G; Piccioni, M; Sartori, Angela; Sereno, Antonella; Priolo, G; Scoizzato, L; Marangi, G; Marchiori, L
A decreasing time trend for occupational injuries and sickness absence would be the effect of the new legislation (D.Lgs. 626/94 and successive laws) on prevention in occupational settings. Conversely, the reduction of INPS disability would reflect a health improvement due to non-occupational causes. The aim of the study was to investigate the efficacy of the new legislation among employees in industry (where the law was mainly applied), via the time trend of three standardized rates in the Veneto Region. The numerator for the rate of occupational accidents (cases occurring in industry workers in the Veneto Region, broken down for sex, age and calendar years) was supplied by INAIL. The denominator for the above rate, as well as numerators and denominators for disability and sickness absence were supplied by INPS. Data were available from 1994 to 2002 for accidents and disability, and from 1997 to 2002 for sickness absence. In every year from 1994 to 2002, the rates were standardized for age and sex with the direct method, using an internal "standard" population. The time trend of year-specific standardized rates was analyzed by Joinpoint regression software. Among industrial workers in the Veneto Region, occupational accidents increased by 0.4% yearly, while disability decreased by 2.56% from 1994 to 2002. Sick absence increased up to 1999, then decreased. This epidemiological pattern is difficult to explain. The increase in accidents could be due to the increase of non-European Union workers and/or to the fact that accidents on the way to or from work were recognized as occupational accidents by INAIL starting from 2000. Both these phenomena could have contributed to increase the rate that was otherwise diminishing. On the other hand, this same situation could be due to insufficient efficacy of the legislation (D.Lgs. 626/94 and successive laws) for preventing occupational accidents and diseases.
Peacekeeping strategies for school-board meetings include developing a code of conduct that spells out guidelines for behavior and then enforcing it; bringing in a neutral observer to help board members work through what is really worrying them; and concentrating on policy. (MLF)
Robertson, Perry J.; Witzke, Edward L.
A general purpose accelerator board and acceleration method comprising use of: one or more programmable logic devices; a plurality of memory blocks; bus interface for communicating data between the memory blocks and devices external to the board; and dynamic programming capabilities for providing logic to the programmable logic device to be executed on data in the memory blocks.
Board structure is an important component of the individual governance of firms, and the appropriateness of the various models is one of the most debated issues in corporate governance today. A comparison of the Nordic and German approaches to the structure of corporate boards reveals stark...... conceptual differences, as emphasized by the 2014 Lekvall Report on the Nordic Corporate Governance Model. This article provides a conceptual comparison between the two approaches to board structure and confirms the fundamental divergence between both models. However, relying on a number of recent legal...... changes and developments in business practice, the article argues that board practices in the two systems effectively blur the structural distinction, and that board organization is converging in practice. It thereby contributes to the broader debates on functionality and comparative corporate law...
... 49 Transportation 8 2010-10-01 2010-10-01 false Employee boards. 1011.5 Section 1011.5... OF TRANSPORTATION GENERAL RULES AND REGULATIONS BOARD ORGANIZATION; DELEGATIONS OF AUTHORITY § 1011.5 Employee boards. This section covers matters assigned to the Accounting Board, a board of employees of the...
Through the Atomic Energy Act, Congress made is possible for the public to get a full and fair hearing on civilian nuclear matters. Individuals who are directly affected by any licensing action involving a facility producing or utilizing nuclear materials may participate in a formal hearing, on the record, before independent judges on the Atomic Safety and Licensing Board Panel (ASLBP or Panel). Frequently, in deciding whether a license, permit, amendment, or extension should be granted to a particular applicant, the Panel members must be more than mere umpires. If appropriate, they are authorized to go beyond the issues the parties place before them in order to identify, explore, and resolve significant questions involving threats to the public health and safety that come to a board's attention during the proceedings. This brochure explains the purpose of the panel. Also addressed are: type of hearing handled; method of public participation; formality of hearings; high-level waste; other panel responsibilities and litigation technology
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... website of the Association of Regulatory Boards of Optometry (ARBO). ARBO's web site is designed to provide resources to regulatory boards of optometry throughout the world. State/Provincial/Territorial Boards of ...
... DEPARTMENT OF ENERGY Environmental Management Advisory Board AGENCY: Department of Energy. ACTION: Notice of call for nominations for appointment to the Environmental Management Advisory Board. SUMMARY... Environmental Management Advisory Board. DATES: Nominations will be accepted through May 13, 2011. ADDRESSES...
... MERIT SYSTEMS PROTECTION BOARD Membership of the Merit Systems Protection Board's Performance Review Board AGENCY: Merit Systems Protection Board. ACTION: Notice. SUMMARY: Notice is hereby given of the members of the Merit Systems Protection Board's Performance Review Board. DATES: November 5, 2013...
Muttaiyah, S.; Coombs, G.; Pandey, S.; Reed, P.; Ritchie, S.; Lennon, D.; Roberts, S.
Panton-Valentine leukocidin (PVL) has been linked to invasive community-acquired methicillin-resistant Staphylococcus aureus infections. However, the association between disease and PVL-positive methicillin-susceptible Staphylococcus aureus (MSSA) has not been widely reported. We aimed to examine the epidemiology of PVL in clinical MSSA isolates from patients presenting to Auckland City Hospital. Four hundred eleven MSSA clinical isolates and 93 nasal carriage isolates were collected and tested for the presence of the lukSF-PV genes using PCR. The results were examined in light of host and disease factors. Multilocus sequence typing (MLST) was performed on a random subset of isolates to ensure that there was no single PVL-positive MSSA clone responsible for disease in Auckland. The prevalence of the lukSF-PV genes in MSSA isolates associated with disease (124/335; 37%) was not significantly different from the prevalence of the lukSF-PV genes in MSSA nasal carriage isolates (29/93; 31% [P = 0.33]). PVL-positive MSSA isolates in Auckland are genetically diverse and come from a number of different clonal complexes. PVL-positive infections peaked at between 10 and 20 years of age, with a subsequent decline. Pacific ethnicity, age, diagnosis of skin and soft tissue infection (SSTI), community-onset infection, and the need for surgical intervention were found by multivariate analysis to be independently associated with PVL-positive MSSA infection. More than one-third of MSSA infections in our patient population are caused by PVL-positive strains. Those patients with PVL-positive MSSA infection were more likely to be of Pacific ethnicity, be younger in age, have community-onset infection, have SSTI, and need surgical intervention. PMID:20686081
Lowe, Michele; Handy, Rupert; Ingram, Joan; Nisbet, Mitzi; Ritchie, Stephen; Thomas, Mark; Briggs, Simon
Current guidelines recommend that women with HIV infection receive annual cervical smears. We evaluated the uptake of annual cervical smears by women with HIV infection under the care of the Infectious Disease Service at Auckland City Hospital. In an attempt to identify potential barriers to regularly receiving an annual cervical smear, we invited the women to complete a questionnaire. The responses from women who had regularly received an annual cervical smear were compared with those who had not. The proportion of women who had received a cervical smear increased from 44% in 2001, to 73% in 2010 (p=0.001). Ninety-three women (76%) completed the study questionnaire. No statistically significant differences were found in the questionnaire responses between the women who had regularly received an annual cervical smear and those who had not. The proportion of women in this cohort who received a cervical smear in 2010 is comparable with other studies of women with HIV infection in New Zealand and overseas. We have not been able to identify barriers that prevent women with HIV infection in Auckland regularly receiving an annual cervical smear. We plan to encourage women who have not received a cervical smear in the previous 2-year period to have a cervical smear performed when they attend the Infectious Disease Clinic, and will continue to notify the National Cervical Screening Programme that all women who are newly diagnosed with HIV infection should have an annual recall code attached to future cervical smear reports. We expect that these interventions will further increase the proportion of women with HIV infection in Auckland who receive an annual cervical smear.
McDonald, Garry W.; Smith, Nicola J.; Kim, Joon-hwan; Cronin, Shane J.; Proctor, Jon N.
Volcanic risk assessment has historically concentrated on quantifying the frequency, magnitude, and potential diversity of physical processes of eruptions and their consequent impacts on life and property. A realistic socio-economic assessment of volcanic impact must however take into account dynamic properties of businesses and extend beyond only measuring direct infrastructure/property loss. The inoperability input-output model, heralded as one of the 10 most important accomplishments in risk analysis over the last 30 years (Kujawaski Syst Eng. 9:281-295, 2006), has become prominent over the last decade in the economic impact assessment of business disruptions. We develop a dynamic inoperability input-output model to assess the economic impacts of a hypothetical volcanic event occurring at each of 7270 unique spatial locations throughout the Auckland Volcanic Field, New Zealand. This field of at least 53 volcanoes underlies the country's largest urban area, the Auckland region, which is home to 1.4 million people and responsible for 35.3% (NZ201481.2 billion) of the nation's GDP (Statistics New Zealand 2015). We apply volcanic event characteristics for a small-medium-scale volcanic eruption scenario and assess the economic impacts of an `average' eruption in the Auckland region. Economic losses are quantified both with, and without, business mitigation and intervention responses in place. We combine this information with a recent spatial hazard probability map (Bebbington and Cronin Bull Volcanol. 73(1):55-72, 2011) to produce novel spatial economic activity `at risk' maps. Our approach demonstrates how business inoperability losses sit alongside potential life and property damage assessment in enhancing our understanding of volcanic risk mitigation.
Samin, Oliver A.; Civil, Ian D.
Retrospectively calculated NISS was compared with the prospectively calculated ISS from data derived from the trauma registry of the Trauma Services of the Auckland Hospital as to which test is a better predictor of patient outcome, which is defined as the likelihood of death. The area under the curve (AUC) for ISS and NISS were computed using the non-parametric approach. AUC for ISS = 0.95835, and AUC for NISS = 0.97350, p <0.012. Misclassification rate for ISS was 2.77% and the value for NISS was 2.43%.
Lindsay, Jan; Marzocchi, Warner; Jolly, Gill; Constantinescu, Robert; Selva, Jacopo; Sandri, Laura
The Auckland Volcanic Field (AVF) is a young basaltic field that lies beneath the urban area of Auckland, New Zealand’s largest city. Over the past 250,000 years the AVF has produced at least 49 basaltic centers; the last eruption was only 600 years ago. In recognition of the high risk associated with a possible future eruption in Auckland, the New Zealand government ran Exercise Ruaumoko in March 2008, a test of New Zealand’s nation-wide preparedness for responding to a major disaster resulting from a volcanic eruption in Auckland City. The exercise scenario was developed in secret, and covered the period of precursory activity up until the eruption. During Exercise Ruaumoko we adapted a recently developed statistical code for eruption forecasting, namely BET_EF (Bayesian Event Tree for Eruption Forecasting), to independently track the unrest evolution and to forecast the most likely onset time, location and style of the initial phase of the simulated eruption. The code was set up before the start of the exercise by entering reliable information on the past history of the AVF as well as the monitoring signals expected in the event of magmatic unrest and an impending eruption. The average probabilities calculated by BET_EF during Exercise Ruaumoko corresponded well to the probabilities subjectively (and independently) estimated by the advising scientists (differences of few percentage units), and provided a sound forecast of the timing (before the event, the eruption probability reached 90%) and location of the eruption. This application of BET_EF to a volcanic field that has experienced no historical activity and for which otherwise limited prior information is available shows its versatility and potential usefulness as a tool to aid decision-making for a wide range of volcano types. Our near real-time application of BET_EF during Exercise Ruaumoko highlighted its potential to clarify and possibly optimize decision-making procedures in a future AVF eruption
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Toxicology Program... announces the next meeting of the National Toxicology Program (NTP) Board of Scientific Counselors (BSC... authorities knowledgeable in fields such as toxicology, pharmacology, pathology, biochemistry, epidemiology...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Toxicology Program... announces the next meeting of the National Toxicology Program (NTP) Board of Scientific Counselors (BSC... such as toxicology, pharmacology, pathology, biochemistry, epidemiology, risk assessment...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Science Advisory Board for Biosecurity Meeting; Office of Biotechnology Activities, Office of Science Policy, Office of.... Contact Person: Ronna Hill, NSABB Program Assistant, NIH Office of Biotechnology Activities, 6705...
Turner, Nikki; Pierse, Nevil; Bissielo, Ange; Huang, Q Sue; Baker, Michael G; Widdowson, Marc-Alain; Kelly, Heath
Few studies report the effectiveness of trivalent inactivated influenza vaccine (TIV) in preventing hospitalisation for influenza-confirmed respiratory infections. Using a prospective surveillance platform, this study reports the first such estimate from a well-defined ethnically diverse population in New Zealand (NZ). A case test-negative design was used to estimate propensity adjusted vaccine effectiveness. Patients with a severe acute respiratory infection (SARI), defined as a patient of any age requiring hospitalisation with a history of a fever or a measured temperature ≥38°C and cough and onset within the past 7 days, admitted to public hospitals in South and Central Auckland were eligible for inclusion in the study. Cases were SARI patients who tested positive for influenza, while non-cases (controls) were SARI patients who tested negative. Results were adjusted for the propensity to be vaccinated and the timing of the influenza season. The propensity and season adjusted vaccine effectiveness (VE) was estimated as 39% (95% CI 16;56). The VE point estimate against influenza A (H1N1) was lower than for influenza B or influenza A (H3N2) but confidence intervals were wide and overlapping. Estimated VE was 59% (95% CI 26;77) in patients aged 45-64 years but only 8% (-78;53) in those aged 65 years and above. Prospective surveillance for SARI has been successfully established in NZ. This study for the first year, the 2012 influenza season, has shown low to moderate protection by TIV against influenza positive hospitalisation. Copyright © 2014 Elsevier Ltd. All rights reserved.
Rebello, Caraliese; Thomson, Maree; Bassett-Clarke, Deborah; Martini, Nataly
INTRODUCTION Treatment of gout, specifically with colchicine, varies globally. Colchicine can be fatal due to its narrow therapeutic index and potential for interactions. In New Zealand, cases of intentional and unintentional colchicine overdose have been documented. AIMS To explore patients' knowledge on the use of gout medicines, and in particular their awareness of the maximum dose of colchicine, the dangers of colchicine overdose, and their opinions on restricting colchicine dispensing. The study also investigates where patients receive gout information. METHODS Thirty people with gout presenting to their regular gout clinic in Auckland currently or previously taking colchicine were invited to participate in a 30-min semi-structured interview. Data were analysed using a general inductive thematic approach. FINDINGS Overall, participants had a lack of knowledge regarding colchicine and used variable doses during an acute gout attack. Participants were unsure of the maximum dose of colchicine and several took more than prescribed. The prophylactic use of colchicine and allopurinol varied from 3 weeks to 15 years. Mixed views were reported on restricting colchicine supply. Most participants received gout information from their general practitioner (GP). CONCLUSION Poor understanding of colchicine contributed to inappropriate use and highlights the need for targeted patient education. Considerable inter-patient variability exists in the use of colchicine for acute gout, suggesting the efficacy of low dose regimens be explored. The length of adjunctive colchicine use, as part of a prophylaxis regimen, needs to be regularly reviewed and tailored to each patient. Further research is required on limiting the amount of colchicine dispensed.
Kim, Bia Z; Patel, Dipika V; McKelvie, James; Sherwin, Trevor; McGhee, Charles N J
To assess the effect of preoperative risk stratification for phacoemulsification surgery on intraoperative complications in a teaching hospital. Prospective cohort study. Prospective assessment of consecutive phacoemulsification cases (N = 500) enabled calculation of a risk score (M-score of 0-8) using a risk stratification system. M-scores of >3 were allocated to senior surgeons. All surgeries were performed in a public teaching hospital setting, Auckland, New Zealand, in early 2016. Postoperatively, data were reviewed for complications and corrected distance visual acuity (CDVA). Results were compared to a prospective study (N = 500, phase 1) performed prior to formal introduction of risk stratification. Intraoperative complications increased with increasing M-scores (P = .044). Median M-score for complicated cases was higher (P = .022). Odds ratio (OR) for a complication increased 1.269 per unit increase in M-score (95% confidence interval [CI] 1.007-1.599, P = .043). Overall rate of any intraoperative complication was 5.0%. Intraoperative complication rates decreased from 8.4% to 5.0% (OR = 0.576, P = .043) comparing phase 1 and phase 2 (formal introduction of risk stratification). The severity of complications also reduced. A significant decrease in complications for M = 0 (ie, minimal risk cases) was also identified comparing the current study (3.1%) to phase 1 (7.2%), P = .034. There was no change in postoperative complication risks (OR 0.812, P = .434) or in mean postoperative CDVA (20/30, P = .484) comparing current with phase 1 outcomes. A simple preoperative risk stratification system, based on standard patient information gathered at preoperative consultation, appears to reduce intraoperative complications and support safer surgical training by appropriate allocation of higher-risk cases. Copyright © 2017 Elsevier Inc. All rights reserved.
Turner, Nikki; Pierse, Nevil; Bissielo, Ange; Huang, Q Sue; Baker, Michael; Widdowson, Marc-Alain; Kelly, Heath
Background Few studies report the effectiveness of trivalent inactivated influenza vaccine (TIV) in preventing hospitalisation for influenza-confirmed respiratory infections. Using a prospective surveillance platform, this study reports the first such estimate from a well-defined ethnically diverse population in New Zealand (NZ). Methods A case test-negative study was used to estimate propensity adjusted vaccine effectiveness. Patients with a severe acute respiratory infection (SARI), defined as a patient of any age requiring hospitalization with a history of a fever or a measured temperature ≥38°C and cough and onset within the past 7 days, admitted to public hospitals in Central, South and East Auckland were eligible for inclusion in the study. Cases were SARI patients who tested positive for influenza, while non-cases (controls) were SARI patients who tested negative. Results were adjusted for the propensity to be vaccinated and the timing of the influenza season Results The propensity and season adjusted vaccine effectiveness (VE) was estimated as 37% (95% CI 18;51). The VE point estimate against influenza A (H1N1) was higher than for influenza B or influenza A (H3N2) but confidence intervals were wide and overlapping. Estimated VE was 51% (95% CI 28;67) in patients aged 18-64 years but only 6% (95% CI -51;42) in those aged 65 years and above. Conclusion Prospective surveillance for SARI has been successfully established in NZ . This study for the first year, the 2012 influenza season, has shown low to moderate protection by TIV against hospitalisation for laboratory-confirmed influenza. PMID:24768730
Brown, Matthew B G J; Gemmill, Chrissen E C; Miller, Steven; Wehi, Priscilla M
Insects are important but overlooked components of forest ecosystems in New Zealand. For many insect species, information on foraging patterns and trophic relationships is lacking. We examined diet composition and selectivity in a large-bodied insect, the Auckland tree wētā Hemideina thoracica , in three habitat zones in a lowland New Zealand forest. We asked whether H. thoracica selectively forage from available plant food sources, and whether these choices were lipid-rich compared to nonpreferred available plants. We also identified the proportion of invertebrates in their frass as a proxy for omnivory. From reconnaissance plot sampling, together with fecal fragment analysis, we report that more than 93% of individual tree wētā had eaten invertebrates before capture. Additionally, wētā in the highest elevation hillslope habitat zone consumed significantly fewer species of plants on average than wētā on the low-elevation terrace habitat. Upper hillslope wētā also had the highest average number of invertebrate fragments in their frass, significantly more than wētā in the low-elevation terrace habitat zone. Wētā showed high variability in the consumption of fruit and seeds across all habitat zones. Generally, we did not observe diet differences between the sexes (although it appears that male wētā in the mid-hillslope habitat ate fruits and seeds more voraciously than females), suggesting that the sexes have similar niche breadths and display similar degrees of omnivorous behavior. Extraction of leaf lipids demonstrated a range of lipid content values in available plants, and Ivlev's Electivity Index indicated that plant species which demonstrated high electivity tended to have higher concentrations of lipids in their leaves. Our findings indicate that H. thoracica forage omnivorously and selectively, and hence play multiple roles in native ecosystems and food webs.
Kereszturi, Gábor; Németh, Károly; Cronin, Shane J.; Procter, Jonathan; Agustín-Flores, Javier
Monogenetic basaltic volcanism is characterised by a complex array of eruptive behaviours, reflecting spatial and temporal variability of the magmatic properties (e.g. composition, eruptive volume, magma flux) as well as environmental factors at the vent site (e.g. availability of water, country rock geology, faulting). These combine to produce changes in eruption style over brief periods (minutes to days) in many eruption episodes. Monogenetic eruptions in some volcanic fields often start with a phreatomagmatic vent-opening phase that later transforms into "dry" magmatic explosive or effusive activity, with a strong variation in the duration and importance of this first phase. Such an eruption sequence pattern occurred in 83% of the known eruption in the 0.25 My-old Auckland Volcanic Field (AVF), New Zealand. In this investigation, the eruptive volumes were compared with the sequences of eruption styles preserved in the pyroclastic record at each volcano of the AVF, as well as environmental influencing factors, such as distribution and thickness of water-saturated semi- to unconsolidated sediments, topographic position, distances from known fault lines. The AVF showed that there is no correlation between ejecta ring volumes and environmental influencing factors that is valid for the entire AVF. In contrary, using a set of comparisons of single volcanoes with well-known and documented sequences, resultant eruption sequences could be explained by predominant patterns of the environment in which these volcanoes were erupted. Based on the spatial variability of these environmental factors, a first-order susceptibility hazard map was constructed for the AVF that forecasts areas of largest likelihood for phreatomagmatic eruptions by overlaying topographical and shallow geological information. Combining detailed phase-by-phase breakdowns of eruptive volumes and the event sequences of the AVF, along with the new susceptibility map, more realistic eruption scenarios can be
Kattel, G.R.; Augustinus, P.C.
Subfossil cladocerans have rarely been used for paleoenvironmental reconstruction from New Zealand lake sediments, and here we detail the first examination of the response of cladocerans to past environments from an Auckland maar paleolake. Cladoceran remains were examined in the upper 230 cm of the lacustrine sediments spanning c. 9-31 cal. ka BP from Onepoto maar during which time the lake underwent significant changes. Lake level was relatively high during the Last Glacial Coldest Period (c. 28-18 cal. ka BP), with limited forest in the catchment, shoreline vegetation and low water temperature indicated by the presence of a planktonic taxon, Bosmina meridionalis, and a cold tolerant chydorid cladoceran Alona sp. (affinis type). However, the climate during the last glacial termination after c. 17.9 cal. ka BP changed abruptly, perhaps becoming extremely dry and windy, resulting in increased production of cladoceran resting eggs. Between c. 17.6 and 14.1 cal. ka BP, a gradually ameliorating climate with sustained windiness and dryness might have been unfavourable for hatching of chydorid cladoceran eggs and their recolonisation. After c. 14.1 cal. ka BP, continued climatic amelioration was accompanied by reduced lake levels inferred from high cladoceran littoral: planktonic ratios as well as increased cladoceran diversity and abundance of less cold tolerant chydorid taxa: Alona guttata, Alona sp. (intermedia type) and Alonella excisa. At c. 9 cal. ka BP, the maar crater rim was breached by the marine waters commensurate with postglacial sea-level rise, resulting in degraded water quality and production of a large number of cladoceran ephippia in the sediments. (author). 67 refs., 3 figs., 2 tabs.
Full Text Available Scholarly investigations on the board of directors, although intense from the mid-1990s onward, did not lead to entirely convincing results. This study proposes discussion on building a multidisciplinary and integrated theoretical framework able to capture the complexity and distinctive dimensions of the board as a group decision-making process. This is achieved through an essay developed from analytical and descriptive review of the literature. A synthesis on board research is presented, aiming to understand theoretical models lenses used to study corporate governance issues. The strengths and weaknesses of these models are pointed out, and their influence on board investigation is observed. This essay concludes by proposing a research agenda that considers the addition of psychological and sociological approaches to economic models of the analysis of group decision-making
... or large groups of speech-language pathologists. Speech-language pathologists who are Board Certified Specialists in Fluency may be found on this website by searching name, city(location) or zip code. ...
Fischer, Paul E.; Gramlich, Jeffrey D.; Miller, Brian P.
This paper provides evidence that uncontested director elections provide informative polls of investor perceptions regarding board performance. We find that higher (lower) vote approval is associated with lower (higher) stock price reactions to subsequent announcements of management turnovers. In...
... a Public Meeting of the Science Advisory Board Exposure and Human Health Committee (EHHC) AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Science Advisory Board (SAB) Staff... Science Advisory Board can be found on the SAB Web site at http://www.epa.gov/sab . SUPPLEMENTARY...
Kasanen, I H E; Inhilä, K J; Vainio, O M
adrenaline and noradrenaline content than the diet board animals. No gastric ulcers were found in any of the animals at necropsy. The diet board thus appears to cause a stress reaction when compared with AL-fed rats, but no apparent pathology was associated with this reaction. The diet board could help...... the stress physiology of diet board fed animals with that of AL-fed animals. Diet board feeding was associated with higher serum corticosterone levels and lower faecal secretion of IgA, suggesting the diet board causes a stress reaction. However, the AL-fed group had larger adrenal glands with higher...... to solve the health problems associated with AL feeding, while allowing the rats to be group-housed and to maintain their normal diurnal eating rhythms. The diet board can also be seen as a functional cage furniture item, dividing the cage into compartments and thus increasing the structural complexity...
Khushboo Nalband; Priyanka Jadhav; Geetanjali Salunke
On boarding, also known as organizational socialization, plays a vital role in building the initial relationship between an organization and an employee. It also contributes to an employees’ satisfaction, better performance and greater organizational commitment thus increasing an employees’ effectiveness and productivity in his/her role. Therefore, it is essential that on boarding process of an organization is efficient and effective to improve new employees’ retention. Generally this on boar...
Ana Luiza d'Ávila Viana
Full Text Available O atraso na implementação da estratégia da regionalização e a fragilidade de iniciativas combinadas de descentralização e regionalização no Brasil requerem explicação. O artigo levanta algumas hipóteses para elucidar essa intricada questão e analisa os condicionantes estruturais do processo de regionalização em curso nos estados. Para isso, elabora uma tipologia nacional das regiões de saúde que as diferenciam segundo graus de desenvolvimento econômico, social e características da rede de saúde, dos municípios que compõem os Colegiados de Gestão Regional (CGR formalmente implantados até janeiro de 2010. Para a construção da tipologia, adotaram-se os modelos de análise fatorial e de análise de agrupamentos (cluster analysis. Foram identificados cinco grandes grupos socioeconômicos de CGR, descritos de acordo com sua distribuição regional, população, despesa em saúde, perfil da oferta (incluindo mix público e privado e cobertura de serviços de saúde. Os resultados encontrados servem como norteadores da constituição de redes de atenção à saúde e de novas iniciativas no campo regional, de forma a aprimorar a política de regionalização e favorecer a construção de instrumentos de regulação diversificados, flexíveis e, sobretudo, mais ajustados às realidades regionais.An explanation is required for the delay in implementing the regionalization strategy and the fragile nature of the combined decentralization and regionalization initiatives in Brazil. The article raises some hypotheses to clarify this intricate issue and reviews the structural conditioning factors of the regionalization process ongoing in the states. A national typology of the health care regions is prepared, differentiating them according to the degree of socio-economic development and the characteristics of the health care network and of the municipalities that form the Regional Management Boards (CGR, formally implanted by January
Mannion, Russell; Davies, Huw; Freeman, Tim; Millar, Ross; Jacobs, Rowena; Kasteridis, Panos
To contribute towards an understanding of hospital board composition and to explore board oversight of patient safety and health care quality in the English NHS. We reviewed the theory related to hospital board governance and undertook two national surveys about board management in NHS acute and specialist hospital trusts in England. The first survey was issued to 150 trusts in 2011/2012 and was completed online via a dedicated web tool. A total 145 replies were received (97% response rate). The second online survey was undertaken in 2012/2013 and targeted individual board members, using a previously validated standard instrument on board members' attitudes and competencies (the Board Self-Assessment Questionnaire). A total of 334 responses were received from 165 executive and 169 non-executive board members, providing at least one response from 95 of the 144 NHS trusts then in existence (66% response rate). Over 90% of the English NHS trust boards had 10-15 members. We found no significant difference in board size between trusts of different types (e.g. Foundation Trusts versus non-Foundation Trusts and Teaching Hospital Trusts versus non-Teaching Hospital Trusts). Clinical representation on boards was limited: around 62% had three or fewer members with clinical backgrounds. For about two-thirds of the trusts (63%), board members with a clinical background comprised less than 30% of the members. Boards were using a wide range and mix of quantitative performance metrics and soft intelligence (e.g. walk-arounds, patient stories) to monitor their organisations with regard to patient safety. The Board Self-Assessment Questionnaire data showed generally high or very high levels of agreement with desirable statements of practice in each of its six dimensions. Aggregate levels of agreement within each dimension ranged from 73% (for the dimension addressing interpersonal issues) to 85% (on the political). English NHS boards largely hold a wide range of attitudes and
Association of Governing Boards of Universities and Colleges, 2012
The selection of a president is a governing board's most important responsibility, and the search process is the board's best opportunity to help guide its institution into a successful new era. This guide outlines the leadership roles during a search (those of the board, the board chair, the search committee, and others), briefs board…
The author's advice for for a school board superintendent is to assume incompetence instead of malevolence. Board members who behave inappropriately are a minority, and those with malicious intent are extremely rare. Most misbehaving board members act out of frustration. They may not understand the appropriate role of a board member.…
... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Board staff. 902.3 Section 902.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD ORGANIZATION § 902.3 Board staff. The chairperson shall select the Board's executive secretary and other staff provided for in the Act. The executive secretary and staff...
Meeder, Hans; Pawlowski, Brett
Interest has been growing in how to build or manage an effective business advisory board. Developing an advisory board is crucial to keeping CTE programs relevant and viable by engaging the support of business and industry. This article delves into how to build and manage a board, and how to re-energize boards that already exist but may be lacking.
Gaw, S.K.; Palmer, G.; Kim, N.D.; Wilkins, A.L.
Studies in New Zealand orchard soils indicate that elevated Cu concentrations have reduced the ability of the indigenous soil microbial community to degrade DDT to DDE. - Orchards (n=13) were sampled as part of a larger survey investigating agrichemical residues (pesticides and trace elements) in cropping soils in the Auckland region, New Zealand. ΣDDT concentrations in orchard soils ranged from -1 . DDT (o,p'- and p,p'-) comprised at least 40% of the ΣDDT residues in 67% of orchards in which DDT residues were detected. There was a highly significant negative correlation (-0.924, P -1 ) and the ratio of DDE:DDT (0.4-5.2) in pip and stonefruit orchard soils. In further investigations involving five pip and stone fruit orchard sites and one grazing paddock it was found that soil respiration and the ratio of soil microbial carbon to soil carbon (%C mic /Org-C) in orchard soils decreased with increasing copper concentration. These findings are consistent with the conclusion that elevated soil copper concentrations in pip and stone fruit orchard soils in the Auckland region may have reduced the ability of the indigenous soil microbial community to degrade DDT to DDE
Derraik, José G B; Reed, Peter W; Jefferies, Craig; Cutfield, Samuel W; Hofman, Paul L; Cutfield, Wayne S
We aimed to evaluate the incidence of type 1 diabetes mellitus in children Auckland region (New Zealand) over 20 years (1990-2009). We performed a retrospective review of all patients new cases of type 1 diabetes, and age at diagnosis rose from 7.6 yr in 1990/1 to 8.9 yr in 2008/9 (r(2) = 0.31, p = 0.009). There was a progressive increase in type 1 diabetes incidence among children new cases of type 1 diabetes was highest in New Zealand Europeans throughout the study period in all age groups (pNew Zealand Europeans and Non-Europeans. Type 1 diabetes incidence and average annual increase were similar in both sexes. There was no change in BMI SDS shortly after diagnosis, and no association between BMI SDS and age at diagnosis. There has been a steady increase in type 1 diabetes incidence among children Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10-14 yr. There was little change in BMI SDS in this population, providing no support for the 'accelerator hypothesis'.
Prebble, Warwick M.; Williams, Ann L.
Block slides have developed on extremely weak, thin clay seams of tectonic origin, parallel to bedding in gently dipping sandstones and mudstones of Tertiary age. Two areas of noted instability are investigated at Auckland and the Rangitikei valley. Dimensions range from 100 m across × 100 m long for short displacement block slides up to 4 km across × 3 km long for large landslide complexes in which block slides are a major component. Displacements of blocks range from incipient (cm) through short (30 m) to 2 or 3 km for large slides. Many of the Auckland slides are dormant but likely to move in a 2000 year return period earthquake or 100 year high intensity rain storm. At Rangitikei there are many active, younger slides. Sliding rates for active failures vary from a few cm/year to 50 m in 30 min. Host rocks are weak to very weak clayey sandstones and sandy mudstones. The seams are rich in smectite. They have polished and crushed walls, may have slickensides and some contain rounded rock fragments. Laboratory shear strength of the seams is 13 kPa cohesion and 13° friction, with a lower bound of 8° at zero cohesion. Strength is increased at the field scale by waviness, steps and splays. Continuity can be demonstrated over distances of hundreds of metres. Key investigation methods were mapping, shafts and trenches. Tectonic uplift, folding and faulting of the weak Tertiary strata and river down-cutting are perpetuating block slide development.
d'Young, A I; Young, L; Ockelford, P A; Brasser, M; Slavin, K; Manson, L; Preston, S
Many adult patients diagnosed with phenotypically moderate and severe haemophilia living in the Auckland region of New Zealand do not report bleeding episodes within a timeframe that allows for optimal assessment and management. This can result in poor clinical outcomes for patients and poor oversight of the use of expensive clotting factor concentrates. Our goal was to improve both the number and speed at which bleeding episodes were reported to our centre, improving access to care and clinical oversight of the use of expensive factor concentrates and aiding the development of a care partnership with patients. We worked with 70 adult PWH living in the Auckland region of New Zealand with moderate and severe haemophilia A and B. Over a 5-month period between March and July 2013 we used a co-design model to develop and implement a range of strategies to improve the timing and frequency of bleed reporting. Mean bleed reporting time was reduced threefold, with a threefold increase in the number of bleeds reported per month. We reduced the number of bleeding episodes reported outside of a prespecified 48-h time limit by 68%. We significantly improved bleed reporting and time to report, indicating improved access to our services, improved clinical oversight and improved accountability to our national funder. We have achieved a care partnership and a reduction in factor consumption for the study population without compromising the quality of care they receive. © 2013 John Wiley & Sons Ltd.
Curtis, Elana; Wikaire, Erena; Jiang, Yannan; McMillan, Louise; Loto, Rob; Airini,; Reid, Papaarangi
Introduction Achieving health equity for indigenous and ethnic minority populations requires the development of an ethnically diverse health workforce. This study explores a tertiary admission programme targeting M?ori and Pacific applicants to nursing, pharmacy and health sciences (a precursor to medicine) at the University of Auckland (UoA), Aotearoa New Zealand (NZ). Application of cognitive and non-cognitive selection tools, including a Multiple Mini Interview (MMI), are examined. Methods...
Alloway, B.V.; Westgate, J.; Pillans, B.; Pearce, N.; Newnham, R.; Byrami, M.; Aarburg, S.
Coastal sections in the Auckland region reveal highly carbonaceous and/or highly weathered clay-dominated cover-bed successions with numerous discrete distal volcanic ash (tephra) layers, fluvially reworked siliciclastic (tephric) deposits, and two widely distributed pyroclastic density current (PDC) deposits generated from explosive silicic volcanism within the Taupo Volcanic Zone (TVZ). The younger of the two PDC deposits (informally named Waiuku tephra) is glass-isothermal plateau fission-track (ITPFT) dated at 1.00 ± 0.03 Ma and occurs in a normal polarity interval interpreted as the Jaramillo Subchron. Waiuku tephra is correlated with Unit E sourced from the Mangakino Volcanic Centre of the TVZ. Waiuku tephra can be subdivided into two distinctive units enabling unequivocal field correlation: a lower stratified unit (dominantly pyroclastic surge with fall component) and an upper massive to weakly stratified unit (pyroclastic flow). At many sites in south Auckland, Waiuku tephra retains basal 'surge-like' beds (<1.4 m thickness). This provides clear evidence for primary emplacement and is an exceptional feature considering the c. 200 km this PDC has travelled from its TVZ source area. However, at many other Auckland sites, Waiuku tephra displays transitional sedimentary characteristics indicating lateral transformation from hot, gas-supported flow/surge into water-supported mass flow and hyperconcentrated flow (HCF) deposits. The older PDC deposit is dated at 1.21 ± 0.09 Ma, is enveloped by tephras that are ITPFT-dated at 1.14 ± 0.06 Ma (above) and 1.21 ± 0.06 Ma (below), respectively, and occurs below a short normal polarity interval (Cobb Mountain Subchron) at c. 1.19 Ma. This PDC deposit, correlated with Ongatiti Ignimbrite sourced from the Mangakino Volcanic Centre of TVZ, has laterally transformed from a gas-supported, fine-grained pyroclastic flow deposit at Oruarangi, Port Waikato, into a water-supported volcaniclastic mass flow deposit farther north
This new publication informs readers about what the Alberta Energy and Utilities Board (EUB) did in the past year, including important regulatory issues, trends and initiatives. The EUB is an agency of the provincial government, established to regulate Alberta`s energy resource and utility sectors. It is part of the Alberta Ministry of Energy. The four main functions of the Board are regulatory initiatives, license applications, enforcement and information. This publication summarized the EUB`s position regarding flaring (both solution gas flaring and well test flaring), and Board activities in the areas of animal health concerns, the gas over bitumen controversy, the deregulation of the electric industry and what it means to the EUB, improvements in data quality as a result of improved industry compliance in reporting, and a variety of issues related to the oil sands and the negotiated settlement process. Also, the Board has been proactive in the area of oilfield waste management guidelines, proliferation policies for gas processing facilities, sulphur recovery guidelines, and the expansion of the orphan well program to include facilities and pipelines. As a measure of the success of the EUB, a recent survey of 19 randomly selected focus groups praised EUB for its impartiality, fair and equitable enforcement and independence. It was also praised for its technically competent and experienced staff, its access to quality information and the clarity of its mandate, regulatory requirements and processes. The Board`s efforts in the area of timely stakeholder consultation was highlighted. tabs., figs.
Mathematics Education in the South Pacific. Proceedings of the Annual Conference of the Mathematics Education Research Group of Australasia Incorporated (25th, Auckland, New Zealand, July 7-10, 2002). Volume I [and] Volume II.
Barton, Bill, Ed.; Irwin, Kathryn C., Ed.; Pfannkuch, Maxine, Ed.; Thomas, Michael O. J., Ed.
This document contains the proceedings of the 25th annual conference of the Mathematics Education Research Group of Australia (MERGA) held at the University of Auckland, New Zealand. The focus of this meeting is mathematics education in the South Pacific. Presentations are centered around the topic of numeracy in primary or elementary school.…
Full text: Miss Blanche Margaret Meagher was elected chairman of the IAEA Board of Governors for 1964-65, after the new Board had been constituted at the Eighth Session of the General Conference in September. Since 1962 Miss Meagher has been Canadian Ambassador to Austria, and Canadian Governor of the Agency. Miss Meagher joined the Canadian Department of External Affairs in 1942, and has held a number of foreign diplomatic appointments; she has also served on Canadian delegations to the UN Educational, Scientific and Cultural Organization, the International Telecommunication Union, the Economic and Social Council of UN and the UN Disarmament Sub-Committee. The Vice-Chairmen of the Board are Mr. Wilhelm Billig (Poland) and Mr. Hassan M. Tohamy (UAR). Mr. Billig is Chairman of the State Council for Atomic Energy, and High Commissioner for Peaceful Uses of Atomic Energy. Mr. Tohamy is Ambassador to Austria, and Resident Representative to the Agency. Of the twelve elected members of the Board, five were chosen by the General Conference in 1964 for two years, viz. Argentina, Chile, Netherlands, Thailand and the United Arab Republic. Seven were elected in 1963: Afghanistan, China, Congo (Leopoldville), Morocco, Romania, Switzerland and Uruguay. The remaining thirteen members have been designated by the Board: Australia, Belgium, Brazil, Canada, Finland, France, India, Japan, Poland, South Africa, USSR, United Kingdom and United States. (author)
Ladur, Alice Norah; van Teijlingen, Edwin; Hundley, Vanora
Men can play a significant role in reducing maternal morbidity and mortality in low-income countries. Maternal health programmes are increasingly looking for innovative interventions to engage men to help improve health outcomes for pregnant women. Educational board games offer a unique approach to present health information where learning is reinforced through group discussions supporting peer-to-peer interactions. A qualitative study with men from Uganda currently living in the UK on their views of an educational board game. Men were purposively sampled to play a board game and participate in a focus group discussion. The pilot study explored perceptions on whether a board game was relevant as a health promotional tool in maternal health prior to implementation in Uganda. The results of the pilot study were promising; participants reported the use of visual aids and messages were easy to understand and enhanced change in perspective. Men in this study were receptive on the use of board games as a health promotional tool and recommended its use in rural Uganda. This study provides preliminary data on the relevancy and efficacy of using board games in maternal health. Key messages from the focus group appeared to be that the board game is more than acceptable to fathers and that it needs to be adapted to the local context to make it suitable for men in rural Uganda.
This paper addresses several aspects of implementing a control system for electronics boards in order to perform remote Field Programmable Gate Array (FPGA) programming, hardware configuration, register control, and monitoring, as well as interfacing it to an expert system. The paper presents an implementation, using the Distributed Information Management (DIM) package and the industrial SCADA system PVSS II from ETM, in which the access mechanisms to the board resources are completely generic and in which the device prescription and the handling of mapping between functional parameters and physical registers follow a common structure independent of the board type. The control system also incorporates mechanisms by which it may be controlled from a finite state machine based expert system. Finally the paper suggests an improvement in which the mapping between logical parameters and physical registers is represented by descriptors in the device description such that the translation can be handled by a common m...
Benito, J G; Vidales, A M; Ippolito, I
This work deals with a numerical study of the problem of separation of particles with different elastic properties. The separation procedure uses a Galton Board which consist in a bidimensional system of obstacles arranged in a triangular lattice. Disks of equal diameters but different elastic properties are launched from the top of the device. The Galton Board is commonly used for mixing particles, but here, we intend to find special conditions under which one can use it as a segregating device. We introduce a mixture of particles and generate, through simulations, different conditions to favor the segregation process based on the different elastic coefficients of the particles. We inspect which is the best configuration of size, density of obstacles and wall separation to favor the separations of particles. Our results prove that the Galton Board can be used as a segregation device under certain conditions.
Chen, Victor Zitian; Hobdari, Bersant; Sun, Pei
We argue that corporate boards are a dynamic repository of human- and social capital in response to external institutional evolution. Theoretically, integrating institutional economics, agency theory and resource dependence theory, we explain that evolution of market-, legal- and political......, since the board changes are typically proposed by the block shareholders, whose motivation for doing so is closely associated with a corporation’s financial performance, we further argue that financial performance is a key moderator of the relationships between institutional evolution and changes...... institutions restructures the particular context in which board members play their two primary roles: monitoring the CEO on behalf of the shareholders, suggested by the agency theory, and supporting the CEO by providing resources, knowledge and information, suggested by the resource dependence theory...
Saxton Peter JW
Full Text Available Abstract Background The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. Methods The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%, 1049 provided a matched specimen (provision rate 80.4%. Results HIV prevalence was 6.5% (95% CI: 5.1-8.1. After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9% of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. Conclusions This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics
Sathyendran, V; McAuliffe, G N; Swager, T; Freeman, J T; Taylor, S L; Roberts, S A
We aimed to determine the incidence of Clostridium difficile infection (CDI), the molecular epidemiology of circulating C. difficile strains and risk factors for CDI among hospitalised children in the Auckland region. A cross-sectional study was undertaken of hospitalised children <15 years of age in two hospitals investigated for healthcare-associated diarrhoea between November 2011 and June 2012. Stool specimens were analysed for the presence of C. difficile using a two-step testing algorithm including polymerase chain reaction (PCR). C. difficile was cultured and PCR ribotyping performed. Demographic data, illness characteristics and risk factors were compared between children with and without CDI. Non-duplicate stool specimens were collected from 320 children with a median age of 1.2 years (range 3 days to 15 years). Forty-six patients (14 %) tested met the definition for CDI. The overall incidence of CDI was 2.0 per 10,000 bed days. The percentage of positive tests among neonates was only 2.6 %. PCR ribotyping showed a range of strains, with ribotype 014 being the most common. Significant risk factors for CDI were treatment with proton pump inhibitors [risk ratio (RR) 1.74, 95 % confidence interval (CI) 1.09-5.59; p = 0.002], presence of underlying malignancy (RR 2.71, 95 % CI 1.65-4.62; p = 0.001), receiving chemotherapy (RR 2.70, 95 % CI 1.41-4.83; p = 0.003) and exposure to antibiotics (RR 1.17, 95 % CI 0.99-1.17; p = 0.03). C. difficile is an important cause of healthcare-associated diarrhoea in this paediatric population. The notion that neonatal populations will always have high rates of colonisation with C. difficile may not be correct. Several risk factors associated with CDI among adults were also found to be significant.
Saxton, Peter J W; Dickson, Nigel P; Griffiths, Richard; Hughes, Anthony J; Rowden, John
The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%), 1049 provided a matched specimen (provision rate 80.4%). HIV prevalence was 6.5% (95% CI: 5.1-8.1). After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9%) of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics, HIV prevalence was elevated in subgroups of MSM based on
Thompson, A M; Sachdev, N; Wong, T; Riley, A F; Grupcheva, C N; McGhee, C N
Aim: To assess clinical, visual, computerised corneal topographic, and subjective satisfaction with visual acuity, in a cohort of subjects 2 years after phacoemulsification surgery in a public hospital in New Zealand. Methods: Prospective study of a representative sample of 97 subjects (20%) randomly selected from 480 subjects in the original Auckland Cataract Study (ACS) cohort. The clinical assessment protocol was identical to the ACS and included an extensive questionnaire to enable direct comparisons to be made between the two groups. Results: The study population was predominantly female (66%) with a mean age of 76.3 (SD 9.9) years. New systemic and ocular disease affected 18.4% and 10.3% of subjects respectively, and 10.3% required referral to either a general practitioner (2.1%) or ophthalmologist (8.2%). Mean best spectacle corrected visual acuity (BSCVA) was 0.2 (0.2) logMAR units (6/9 Snellen equivalent), with mean spherical equivalent −0.37 (1.01) dioptres (D) and astigmatism −1.07 (0.70) D 2 years postoperatively, compared to mean BSCVA 0.1 (0.2) logMAR units (6/7.5 Snellen equivalent), spherical equivalent −0.59 (1.07) D, and astigmatism −1.14 (0.77) D 4 weeks after surgery. 94.9% of subjects retained a BSCVA of 6/12 or better, irrespective of pre-existing ocular disease. The overall posterior capsule opacification (PCO) rate was 20.4% and this was visually insignificant in all but 3.1% of eyes that had already undergone Nd:YAG posterior capsulotomy. Orbscan II elevation technology demonstrated corneal stability 2 years after uncomplicated phacoemulsification. Although corneal astigmatism was eliminated in approximately half of the subjects 1 month postoperatively, astigmatism showed a tendency to regress towards the preoperative level with local corneal thickening at the site of incision 2 years after cataract surgery. Of fellow eyes, 61.2% had undergone cataract surgery. Overall, 75.3% of subjects were moderately to very satisfied with their
Background The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand. Methods The study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%), 1049 provided a matched specimen (provision rate 80.4%). Results HIV prevalence was 6.5% (95% CI: 5.1-8.1). After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9%) of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection. Conclusions This is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics, HIV prevalence was
Riley, Andrew F; Malik, Tahira Y; Grupcheva, Christina N; Fisk, Michael J; Craig, Jennifer P; McGhee, Charles N
Aim: To prospectively assess cataract surgery in a major New Zealand public hospital by defining presenting clinical parameters and surgical and clinical outcomes in a cohort of subjects just below threshold for treatment, based upon a points based prioritisation system. Methods: The prospective observational study comprised 488 eyes of 480 subjects undergoing consecutive cataract operations at Auckland Hospital. All subjects underwent extensive ophthalmic examination before and after surgery. Details of the surgical procedure, including any intraoperative difficulties or complications, were documented. Postoperative review was performed at 1 day and 4 weeks after surgery. Demographic data, clinical outcomes, and adverse events were correlated by an independent assessor. Results: The mean age at surgery was 74.9 (SD 9.6) years with a female predominance (62%). Significant systemic disease affected 80% of subjects, with 20% of the overall cohort exhibiting diabetes mellitus. 26% of eyes exhibited coexisting ocular disease and in 7.6% this affected best spectacle corrected visual acuity (BSCVA). A mean spherical equivalent of −0.49 (1.03) D and mean BSCVA of 0.9 (0.6) log MAR units (Snellen equivalent approximately 6/48) was noted preoperatively. Local anaesthesia was employed in 99.8% of subjects (94.9% sub-Tenon's). The majority of procedures (97.3%) were small incision phacoemulsification with foldable lens implant. Complications included: 4.9% posterior capsule tears, 3.8% cystoid macular oedema, and one case (0.2%) of endophthalmitis. Mean BSCVA after surgery was 0.1 (0.2) log MAR units (6/7.5 Snellen equivalent), with a mean spherical equivalent of −0.46 (0.89) D, and was 6/12 or better in 88% of all eyes. A drop in BSCVA, thought to be directly attributable to the surgical intervention, was recorded in a small percentage of eyes (1.5%) after surgery. Conclusion: This study provides a representative assessment of the management of cataract in the New
Full Text Available The aim of this review was to present ethnic differences in body size and body composition in Asian Indian migrants in New Zealand, associated with metabolic syndrome and type 2 diabetes, through the comparison with other ethnic groups in New Zealand. International databases including PubMed and Google scholar were consulted, as well as the websites of the World Health Organization and International Diabetes Federation. About 74 studies out of 128 publications were selected to ensure relevance to the topic of the review. Seven research projects were presented for the body size and body composition of Asian Indian migrants in New Zealand. The prevalence of type 2 diabetes of 8.6% in Asian Indians in New Zealand is still higher than in their homeland, owing to their ethnicity, genetic predisposition, sedentary lifestyle and altered nutrition, and other psychosocial factors related to migration and living conditions like stress at work and depression. For the same body mass index, in comparison with people of other ethnic groups in New Zealand Asian Indians had more total body fat, higher percent body fat, more central fat, less lean mass and appendicular skeletal muscle mass. Central obesity was associated with insulin resistance and low grade systemic inflammation. Considering the evidence that type 2 diabetes develops ten years earlier in Asian Indians than in other populations, further studies are warranted to shed some light on the still incompletely understood metabolic syndrome and “thin-fat” Indian phenotype.
Maze, M J; Paynter, J; Chiu, W; Hu, R; Nisbet, M; Lewis, C
There is uncertainty as to the optimal therapeutic concentrations of anti-tuberculosis drugs to achieve cure. To characterise the use of therapeutic drug monitoring (TDM), and identify risk factors and outcomes for those with concentrations below the drug interval. Patients treated for tuberculosis (TB) who had rifampicin (RMP) or isoniazid (INH) concentrations measured between 1 January 2005 and 31 December 2012 were studied retrospectively. Matched concentrations and drug dosing time were assessed according to contemporary regional drug intervals (RMP > 6 μmol/l, INH > 7.5 μmol/l) and current international recommendations (RMP > 10 μmol/l, INH > 22 μmol/l). Outcomes were assessed using World Health Organization criteria. Of 865 patients, 121 had concentrations of either or both medications. RMP concentrations were within the regional drug intervals in 106/114 (93%) and INH in 91/100 (91%). Concentrations were within international drug intervals for RMP in 76/114 (67%) and INH in 53/100 (53%). Low weight-based dose was the only statistically significant risk factor for concentrations below the drug interval. Of the 35 patients with low concentrations, 21 were cured, 9 completed treatment and 5 transferred out. There were no relapses during follow-up (mean 66.5 months). There were no clinically useful characteristics to guide use of TDM. Many patients had concentrations below international therapeutic intervals, but were successfully treated.
Background New Zealand has a higher incidence of Staphylococcus aureus disease than other developed countries, with significant sociodemographic variation in incidence rates. In contrast to North America, the majority of disease is due to methicillin-susceptible S. aureus (MSSA), although relatively little is known about the comparative demographics of MSSA and methicillin-resistant S. aureus (MRSA) infections in New Zealand. Methods Our objectives were to describe the trends, incidence and patient demographics of all S. aureus infections in patients presenting to our institution between 2001 and 2011, and compare the epidemiology of MSSA and MRSA infections. We identified all patients with S. aureus infections over the study period. A unique S. aureus infection was defined as the first positive S. aureus culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated S. aureus infection. Results There were 16,249 S. aureus infections over the study period. The incidence increased significantly over the study period from 360 to 412 per 100,000 population (P New Zealand. The significant increase in community-associated S. aureus infections is of public health importance. Future studies should investigate the reasons underlying this concerning trend. PMID:24299298
Williamson, Deborah A; Lim, Alwin; Thomas, Mark G; Baker, Michael G; Roberts, Sally A; Fraser, John D; Ritchie, Stephen R
New Zealand has a higher incidence of Staphylococcus aureus disease than other developed countries, with significant sociodemographic variation in incidence rates. In contrast to North America, the majority of disease is due to methicillin-susceptible S. aureus (MSSA), although relatively little is known about the comparative demographics of MSSA and methicillin-resistant S. aureus (MRSA) infections in New Zealand. Our objectives were to describe the trends, incidence and patient demographics of all S. aureus infections in patients presenting to our institution between 2001 and 2011, and compare the epidemiology of MSSA and MRSA infections. We identified all patients with S. aureus infections over the study period. A unique S. aureus infection was defined as the first positive S. aureus culture taken from the same patient within a thirty-day period. Standard definitions were used to classify episodes into community- or healthcare-associated S. aureus infection. There were 16,249 S. aureus infections over the study period. The incidence increased significantly over the study period from 360 to 412 per 100,000 population (P New Zealand. The significant increase in community-associated S. aureus infections is of public health importance. Future studies should investigate the reasons underlying this concerning trend.