Issue

Vol 131 No 1487: 14 December 2018

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Issue Summary

SUMMARY

Utility of whole genome sequencing for multidrug resistant Mycobacterium tuberculosis isolates in a reference TB laboratory in New Zealand

Indira Basu, James E Bower, Sally A Roberts, Gillian Henderson, Htin Lin Aung, Gregory Cook, Odette Lowe, Sandie Newton

The emergence of multi-drug resistant tuberculosis (MDR-TB) has become a serious public health concern all across the globe. MDR-TB requires rapid detection to prevent further spread; often requiring alternate prolonged antibiotic treatment regimens with potent side-effects for the patient. New Zealand currently has a low burden of MDR-TB. But with increasing travel by New Zealanders overseas as well as increased immigration from high-risk countries, maintaining the status quo requires knowledge of state-of-the-art molecular technology like sequencing the whole genome of the Mycobacterium tuberculosis, the bacteria responsible for causing TB. This paper shows that in a reference TB laboratory like LabPLUS, adoption of this technology adds significant value when discrepancy arises between different testing methods employed to detect MDR-TB. This work lies at the frontier of research in this area and can make a big difference in recommending timely and appropriate antibiotic treatment and preventing the spread of this deadly disease.

SUMMARY

Reliability of venous blood gas sodium, potassium and creatinine

Pourya Pouryahya, Zhiliang Caleb Lin, Lynn Tan, Alastair Meyer

A quick bedside (iSTAT/point of care blood test) electrolytes (sodium and potassium) and creatinine (a surrogate for kidney function) is as reliable as formal laboratory tests, which sometimes takes a while to be available.

SUMMARY

Sudden death in patients with serious mental illness

Erik Monasterio, Andrew McKean, Vimu Sinhalage Christopher Frampton, Roger Mulder

People who experience serious mental illnesses (SMI) are known to have poor health status and significantly premature mortality. National and international studies have shown that patients with serious mental illness have a 15- to 20-year gap in their life expectancy when compared to the general population. Of particular concern, studies also indicate that this gap in life expectancy is increasing. Our research studied the causes of sudden death for patients with SMI who received special mental health care in Canterbury between 2005 and 2009, with the aim of determining interventions to mitigate the risk of sudden death and premature mortality. This is particularly important given New Zealand s high suicide rate.

SUMMARY

Modelling the number of quitters needed to achieve New Zealand’s Smokefree 2025 goal for Māori and non-Māori

Nick Wilson, Frederieke Sanne Petrovi\u0107-van der Deen, Richard Edwards, Andrew Waa, Tony Blakely

In this modelling study we found that to achieve the New Zealand Government s Smokefree 2025 Goal (a below 5% smoking prevalence by 2025), there would need to be additional averages of 8,400 Mori long-term quitters per year (5.2 times the business-as-usual [BAU] level on average) and 8,800 extra non-Mori quitters per year during 2018 to 2025 (1.9 times the BAU level on average). Given these findings, it suggests that to achieve the Smokefree 2025 goal, the Government will need to massively increase investment in established interventions (smoking cessation support, mass media) while continuing with substantial tobacco tax increases, or else add substantive new strategies into the intervention mix.

SUMMARY

Reducing the impact of the impending myopia epidemic in New Zealand

Alex Petty, Graham Wilson

Myopia (short-sightedness) is an eye condition affecting children that is increasing around the world and is associated with a higher risk of other ocular disease later in life. Higher levels of myopia will have a profound social, economic and health burden in New Zealand. Fortunately, proven interventions to limit the onset and degree of myopia already exist. To limit the level of myopia in New Zealand we propose the creation of a multidisciplinary myopia action group (NZMAG) to serve as the guiding body for myopia related information and intervention in New Zealand. With prompt action now, the myopia epidemic seen in other countries can be reduced in New Zealand.

SUMMARY

Cutaneous squamous cell carcinoma: predictors of positive and close margins and outcomes of re-excision in Northland, New Zealand

Brodie M Elliott, Benjamin R Douglass, Daniel McConnell, Blair Johnson, Christopher Harmston

Non-melanoma skin cancer (NMSC) is the most commonly diagnosed and costly cancer in Australasia. Cutaneous squamous cell carcinoma (cSCC) accounts for approximately 25% of this disease and can be fatal. We evaluated all of the cSCC removed in Northland, New Zealand in 2015. We found that lesions of the head and neck, those removed in primary care and those with increased tumour thickness were more likely to have positive margins following surgical excision. Of the patients with a positive margin, only 52.6% went on to have a surgical re-excision and in this group 31.7% were found to have residual cutaneous squamous cell carcinoma. This is important as patients with a positive margin after surgery should be followed up and a reoperation considered.

SUMMARY

Public health and the radio frequency radiation emitted by cellphone technology, smart meters and WiFi

\"more research needed\"and in the meantime

For many years there has existed good scientific evidence that radio frequency emissions like those put out by cellphones and their base stations, electricity smart meters and WiFi cause a number of biological effects likely to result in cancer, dementia and other diseases. However, the official narrative in New Zealand remains \causation not proven\"

SUMMARY

Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa, New Zealand

Jeannie Oliphant, Jaimie Veale, Joe Macdonald, Richard Carroll, Rachel Johnson, Mo Harte, Cathy Stephenson, Jemima Bullock, David Cole, Patrick Manning

Health professionals and transgender advocates from around the country have created a new set of guidelines: Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealand. The guidelines provide an approach to healthcare delivery which is uniquely Aotearoa/New Zealand, by utilising Mori models of health that recognise the importance of holistic care, while also referencing international standards. The new guidelines promote healthcare based on informed consent. This means that healthcare providers duty of care is to make sure that people seeking gender affirming care are empowered with all the information they need to make the best decisions for themselves. The guidelines make recommendations for district health boards. There is an urgent need for each DHB to develop a clear pathway for provision of gender affirming healthcare locally.

SUMMARY

Public support and sociodemographic correlates of public breastfeeding support in New Zealand

Yanshu Huang, Danny Osborne, Chris G Sibley

In 2016/17, the New Zealand Attitudes and Values Study, a large survey of New Zealander s social attitudes, assessed public attitudes toward women breastfeeding in public. We found that three quarters (75.3%) of New Zealanders support women breastfeeding in public. Only a small minority (5.2%) were opposed to women breastfeeding in public whereas a moderate proportion (19.5%) of New Zealanders were neutral on the issue. These results highlight that most New Zealanders hold relatively positive views of women breastfeeding in public. We recommend that future public health initiatives continue to work towards fostering support for women who choose to breastfeed in public.

SUMMARY

New Zealand s experience of the 1918 19 influenza pandemic: a systematic review after 100 years

Jennifer A Summers, Michael G Baker, Nick Wilson

The 1918-1919 influenza pandemic has been New Zealand s most severe disaster event (around 9,000 deaths) and while it is a relatively well-studied disaster, there remain important research questions relating to this pandemic in New Zealand. This systematic review summarises all known published literature on the epidemiological, societal and transmission characteristics of the pandemic in New Zealand. Nevertheless, some research gaps remain, including the apparent marked reduction in birth rates in 1918-1919 and the reasons for no socioeconomic gradient despite other New Zealand evidence for occupational class variation in lifespan at this time. In the Centenary year of the 1918-19 Influenza Pandemic, now is the time for New Zealand to reflect on its impact and to ensure appropriate plans are in place to deal with future pandemics.

ALL ARTICLES
SUMMARY

Addressing the treatment gap in New Zealand with more therapists is it practical and will it work?

Julia J Rucklidge, Kathryn A Darling, Roger T Mulder

Utility of whole genome sequencing for multidrug resistant Mycobacterium tuberculosis isolates in a reference TB laboratory in New Zealand

Indira Basu, James E Bower, Sally A Roberts, Gillian Henderson, Htin Lin Aung, Gregory Cook, Odette Lowe, Sandie Newton

Trial of Ibudilast in progressive multiple sclerosis

Reliability of venous blood gas sodium, potassium and creatinine

Pourya Pouryahya, Zhiliang Caleb Lin, Lynn Tan, Alastair Meyer

Why the new ˜living Australian Stroke Guidelines matter to New Zealand

Karim Mahawish, P Alan Barber, Anna McRae, Julia Slark, Annemarei Ranta

Sudden death in patients with serious mental illness

Erik Monasterio, Andrew McKean, Vimu Sinhalage Christopher Frampton, Roger Mulder

Modelling the number of quitters needed to achieve New Zealand’s Smokefree 2025 goal for Māori and non-Māori

Nick Wilson, Frederieke Sanne Petrovi\u0107-van der Deen, Richard Edwards, Andrew Waa, Tony Blakely

Reducing the impact of the impending myopia epidemic in New Zealand

Alex Petty, Graham Wilson

David Murray Fergusson

Joseph M Boden

Cutaneous squamous cell carcinoma: predictors of positive and close margins and outcomes of re-excision in Northland, New Zealand

Brodie M Elliott, Benjamin R Douglass, Daniel McConnell, Blair Johnson, Christopher Harmston

Public health and the radio frequency radiation emitted by cellphone technology, smart meters and WiFi

\"more research needed\"and in the meantime

Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa, New Zealand

Jeannie Oliphant, Jaimie Veale, Joe Macdonald, Richard Carroll, Rachel Johnson, Mo Harte, Cathy Stephenson, Jemima Bullock, David Cole, Patrick Manning

There s more to this than meets the eye

Tom Kai Ming Wang, Mansi Turaga, Jen-Li Looi

Public support and sociodemographic correlates of public breastfeeding support in New Zealand

Yanshu Huang, Danny Osborne, Chris G Sibley

New Zealand s experience of the 1918 19 influenza pandemic: a systematic review after 100 years

Jennifer A Summers, Michael G Baker, Nick Wilson

The Influenza Epidemic

Acquired haemophilia A: a rare cause of postpartum haemorrhage

Philippa Davey, Helen Allen

SUMMARY

Utility of whole genome sequencing for multidrug resistant Mycobacterium tuberculosis isolates in a reference TB laboratory in New Zealand

Indira Basu, James E Bower, Sally A Roberts, Gillian Henderson, Htin Lin Aung, Gregory Cook, Odette Lowe, Sandie Newton

The emergence of multi-drug resistant tuberculosis (MDR-TB) has become a serious public health concern all across the globe. MDR-TB requires rapid detection to prevent further spread; often requiring alternate prolonged antibiotic treatment regimens with potent side-effects for the patient. New Zealand currently has a low burden of MDR-TB. But with increasing travel by New Zealanders overseas as well as increased immigration from high-risk countries, maintaining the status quo requires knowledge of state-of-the-art molecular technology like sequencing the whole genome of the Mycobacterium tuberculosis, the bacteria responsible for causing TB. This paper shows that in a reference TB laboratory like LabPLUS, adoption of this technology adds significant value when discrepancy arises between different testing methods employed to detect MDR-TB. This work lies at the frontier of research in this area and can make a big difference in recommending timely and appropriate antibiotic treatment and preventing the spread of this deadly disease.

SUMMARY

Reliability of venous blood gas sodium, potassium and creatinine

Pourya Pouryahya, Zhiliang Caleb Lin, Lynn Tan, Alastair Meyer

A quick bedside (iSTAT/point of care blood test) electrolytes (sodium and potassium) and creatinine (a surrogate for kidney function) is as reliable as formal laboratory tests, which sometimes takes a while to be available.

SUMMARY

Sudden death in patients with serious mental illness

Erik Monasterio, Andrew McKean, Vimu Sinhalage Christopher Frampton, Roger Mulder

People who experience serious mental illnesses (SMI) are known to have poor health status and significantly premature mortality. National and international studies have shown that patients with serious mental illness have a 15- to 20-year gap in their life expectancy when compared to the general population. Of particular concern, studies also indicate that this gap in life expectancy is increasing. Our research studied the causes of sudden death for patients with SMI who received special mental health care in Canterbury between 2005 and 2009, with the aim of determining interventions to mitigate the risk of sudden death and premature mortality. This is particularly important given New Zealand s high suicide rate.

SUMMARY

Modelling the number of quitters needed to achieve New Zealand’s Smokefree 2025 goal for Māori and non-Māori

Nick Wilson, Frederieke Sanne Petrovi\u0107-van der Deen, Richard Edwards, Andrew Waa, Tony Blakely

In this modelling study we found that to achieve the New Zealand Government s Smokefree 2025 Goal (a below 5% smoking prevalence by 2025), there would need to be additional averages of 8,400 Mori long-term quitters per year (5.2 times the business-as-usual [BAU] level on average) and 8,800 extra non-Mori quitters per year during 2018 to 2025 (1.9 times the BAU level on average). Given these findings, it suggests that to achieve the Smokefree 2025 goal, the Government will need to massively increase investment in established interventions (smoking cessation support, mass media) while continuing with substantial tobacco tax increases, or else add substantive new strategies into the intervention mix.

SUMMARY

Reducing the impact of the impending myopia epidemic in New Zealand

Alex Petty, Graham Wilson

Myopia (short-sightedness) is an eye condition affecting children that is increasing around the world and is associated with a higher risk of other ocular disease later in life. Higher levels of myopia will have a profound social, economic and health burden in New Zealand. Fortunately, proven interventions to limit the onset and degree of myopia already exist. To limit the level of myopia in New Zealand we propose the creation of a multidisciplinary myopia action group (NZMAG) to serve as the guiding body for myopia related information and intervention in New Zealand. With prompt action now, the myopia epidemic seen in other countries can be reduced in New Zealand.

SUMMARY

Cutaneous squamous cell carcinoma: predictors of positive and close margins and outcomes of re-excision in Northland, New Zealand

Brodie M Elliott, Benjamin R Douglass, Daniel McConnell, Blair Johnson, Christopher Harmston

Non-melanoma skin cancer (NMSC) is the most commonly diagnosed and costly cancer in Australasia. Cutaneous squamous cell carcinoma (cSCC) accounts for approximately 25% of this disease and can be fatal. We evaluated all of the cSCC removed in Northland, New Zealand in 2015. We found that lesions of the head and neck, those removed in primary care and those with increased tumour thickness were more likely to have positive margins following surgical excision. Of the patients with a positive margin, only 52.6% went on to have a surgical re-excision and in this group 31.7% were found to have residual cutaneous squamous cell carcinoma. This is important as patients with a positive margin after surgery should be followed up and a reoperation considered.

SUMMARY

Public health and the radio frequency radiation emitted by cellphone technology, smart meters and WiFi

\"more research needed\"and in the meantime

For many years there has existed good scientific evidence that radio frequency emissions like those put out by cellphones and their base stations, electricity smart meters and WiFi cause a number of biological effects likely to result in cancer, dementia and other diseases. However, the official narrative in New Zealand remains \causation not proven\"

SUMMARY

Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa, New Zealand

Jeannie Oliphant, Jaimie Veale, Joe Macdonald, Richard Carroll, Rachel Johnson, Mo Harte, Cathy Stephenson, Jemima Bullock, David Cole, Patrick Manning

Health professionals and transgender advocates from around the country have created a new set of guidelines: Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealand. The guidelines provide an approach to healthcare delivery which is uniquely Aotearoa/New Zealand, by utilising Mori models of health that recognise the importance of holistic care, while also referencing international standards. The new guidelines promote healthcare based on informed consent. This means that healthcare providers duty of care is to make sure that people seeking gender affirming care are empowered with all the information they need to make the best decisions for themselves. The guidelines make recommendations for district health boards. There is an urgent need for each DHB to develop a clear pathway for provision of gender affirming healthcare locally.

SUMMARY

Public support and sociodemographic correlates of public breastfeeding support in New Zealand

Yanshu Huang, Danny Osborne, Chris G Sibley

In 2016/17, the New Zealand Attitudes and Values Study, a large survey of New Zealander s social attitudes, assessed public attitudes toward women breastfeeding in public. We found that three quarters (75.3%) of New Zealanders support women breastfeeding in public. Only a small minority (5.2%) were opposed to women breastfeeding in public whereas a moderate proportion (19.5%) of New Zealanders were neutral on the issue. These results highlight that most New Zealanders hold relatively positive views of women breastfeeding in public. We recommend that future public health initiatives continue to work towards fostering support for women who choose to breastfeed in public.

SUMMARY

New Zealand s experience of the 1918 19 influenza pandemic: a systematic review after 100 years

Jennifer A Summers, Michael G Baker, Nick Wilson

The 1918-1919 influenza pandemic has been New Zealand s most severe disaster event (around 9,000 deaths) and while it is a relatively well-studied disaster, there remain important research questions relating to this pandemic in New Zealand. This systematic review summarises all known published literature on the epidemiological, societal and transmission characteristics of the pandemic in New Zealand. Nevertheless, some research gaps remain, including the apparent marked reduction in birth rates in 1918-1919 and the reasons for no socioeconomic gradient despite other New Zealand evidence for occupational class variation in lifespan at this time. In the Centenary year of the 1918-19 Influenza Pandemic, now is the time for New Zealand to reflect on its impact and to ensure appropriate plans are in place to deal with future pandemics.

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