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The article discusses the continuous observations for the atmospheric carbon dioxide (CO2) in Baring Head, New Zealand. It says that the observations use infrared analyser instruments with calibration procedures, intercomparison efforts, and data-filtering methods to determine the variability in CO2. It mentions that CO2 has been 0.3 ppm which is compatible with the Scripps Institute of Oceanography (SIO) and World Meteorological Organisation (WMO) scales.

Purpose: Trauma registries are essential tools for trauma systems and underpin any quality improvement activities. This paper describes the history, function, challenges, and future goals of the New Zealand National Trauma Registry (NZTR). Methods: Using the available publications and knowledge of the authors, the development, governance, oversight, and usage of the registry is outlined. Results: The New Zealand Trauma Network has run a national trauma registry since 2015 and this now contains over fifteen thousand major trauma patient records. Annual reports and a range of research outputs have been published. Key quality improvement initiatives have been undertaken and are described. Vulnerabilities include lack of longterm funding and a small workforce. Conclusions: The NZTR has proven to be a critical component of trauma quality improvement in New Zealand. A user-friendly portal and a simple minimum dataset have been keys to successes but maintenance of an effective structure in a constrained healthcare system is a challenge. [ABSTRACT FROM AUTHOR]

This paper draws upon a personal research journey and makes the case for recording this experience using a research journal to The context for this paper is based on a study of family life and leisure, which collected data using more traditional qualitative methods, namely focus groups and interviews with pre-birth and post birth couples and leisure managers in New Zealand. The research design for this study was based on phenomenology, where the experience of the subjects being studied was significant and involved developing an understanding of the lived experiences of pre-birth and post-birth couples, where the way they acted was dependent upon their understanding and meaning of their behavior (Waters, 1994) This paper draws on the researcher's own reflections recorded in a research journal, whilst undertaking this research study over a five year period. The paper discusses the meaning and importance of reflection as a way of evaluating the researcher's own research journey and highlights a number of issues with reference to the validity of such data. The paper concludes by revisiting the key benefits of reflection and affirms the belief that research journals are a useful tool, which enables the researcher to record personal thoughts and observations in a systematic manner. [ABSTRACT FROM AUTHOR]

A nationally significant collection of mayflies that has been amassed and curated at Canterbury Museum, Christchurch, New Zealand is described. A project to formally catalogue the backlog of this collection was completed in 2018. This collection has been primarily worked on, added to, and curated by Terry Hitchings since the early 1990s, with his son Tim Hitchings assisting this work since the late 2000s. This paper outlines this process involved in cataloguing the collection and preparing the data for publication to online biorepositories. The dataset was published to the Atlas of Living Australia (ALA) and the Global Biodiversity Information Facility (GBIF) in late 2021. This dataset contains just under 49,000 published specimen records with high quality field collection information. It represents nearly all currently described mayfly species in New Zealand. Areas of collecting focus include most of the South Island of New Zealand, with collecting gaps in South Westland and Marlborough. There are large collecting gaps throughout the North Island of New Zealand. An overview of the trends shown in the dataset is provided. Future work is identified and recommended to enhance and improve this dataset to highlight and promote freshwater ecosystems in New Zealand. [ABSTRACT FROM AUTHOR]

In late 2022, the Australia New Zealand Policing Advisory Agency National Institute of Forensic Science (ANZPAA NIFS) Document Specialist Advisory Group (DocSAG) began a capability mapping project with the broad aim to consider, in the Australian and New Zealand context, forensic document examination: where are we now, and where to from here? Our capability mapping project is based largely on the approach used for the 2022 Forensic Capability Mapping – Firearm Examination Project, led by ANZPAA NIFS. A survey was developed and disseminated to capture information addressing key topics: current and emerging risks, improvement areas, current and future capability, and business continuity. This paper outlines the project process and summarizes key findings of the first round of data collection. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic significantly impacted research regarding data collection methods during lockdowns and border closures. Consequently, online methods have become the present-day benchmark. This article shares our experiences adapting to COVID-19 while conducting focus groups and online interviews. Guided by the Samoan methodology Teu le va that recognises the special relationships between people from a Samoan context and the Talanoa method of storytelling of the Pacific people, we provide insights concerning the practical and cultural challenges of collecting data during lockdowns that strengthened the continuation and completion of the project. We demonstrate the importance of flexibility in the research design regarding apprehension, health, and research in New Zealand. We highlight the value of a multifaceted approach to recruiting participants, incorporating the services of Pacific leaders, and utilising telephone calls and letter writing for participants without digital access. Furthermore, we reveal an unexpected side-effect of COVID-19 regarding the 'Pacific digital divide.' The paper concludes with several avenues for future research on redesigning data collection methods during COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: Workplace bullying involves a power imbalance, and despite laws in New Zealand which prohibit discrimination on the grounds of gender, women remain under-represented in top-level roles. The aim of the study was to examine whether gender and role (managerial/non-managerial) were related to the bullying experienced by women and men. Design/methodology/approach: An online survey collected data from 991 (41%) men and 1,421 (59%) women. The survey provided a definition of bullying and asked participants whether they had been bullied at work. If they replied yes, then follow-up questions asked for the gender and role of the perpetrator. Findings: Women were more likely than men to self-identify as having been bullied. Male employers, senior managers, middle managers, supervisor and peers bullied men and women about equally, whereas women bullied women far more than they bullied men. The largest group of bullies of women were female peers, who rarely bullied male peers, while male peers bullied both genders about equally. Female clients bullied female staff but almost never male staff; male clients bullied both men and women but the numbers were small. Research limitations/implications: These data relied on self-report, and people may be reluctant to identify themselves as targets or may not recognize that the negative behaviours they have been facing amount to bullying. Qualitative data can help explore these issues from societal, organizational and policy perspectives. Practical implications: While men and women may differ in how often they recognize or admit to having been bullied, the gendered nature of power in the workplace is well established and reinforced in the findings here. It is clear that organizational leaders, both male and female, need to understand gender and power imbalance and act as role models. Currently, the authors' findings show that the behaviour of at least some of those at the top of New Zealand organizations needs to improve. Social implications: The problem of bullying at work will not be easy to solve. The solutions lie, not with "fixing" individuals via training, stress management and well-being programmes but with effective systems, procedures, policies and leadership that recognize the power dynamics at work. Originality/value: Little is known at present about the relationships between gender and bullying behaviour. The paper focusses on who bullies whom in the workplace and finds that men tend to bully both men and women while women tend to bully women. Importantly, the authors' works suggest that instead of structural and organizational measures to manage bullying, greater initiatives to manage bullying need to consider how gender and power dynamics interact at work. [ABSTRACT FROM AUTHOR]

Purpose - The primary purpose of this paper is to test an appropriate methodology for quantifying a return to residential property homeowners who were committed to make improvements to their homes prior to placing on the market for sale. Design/methodology/approach - This is a pilot study where empirical data were collected via two survey instruments from nine homeowners within the Horowhenua/Manawatu region of New Zealand. Market values of the properties before and after home improvement were assessed using a variety of market value measures including a valuation by a registered valuer, property owner''s assessment and sale price. Findings - The findings reveal that both the registered valuations and the property owner''s assessment of expected sale price was within the range ±8 per cent of the final sale price. Seven of the nine houses included in this pilot study showed a positive return on time and money invested in minor home improvements. Research limitations/implications - Limitations relate to the dated data, small sample size and geographical spread of the sample. The time and cost required to gather home improvement activity data is another limitation. Practical implications - Potential exists for the model developed in this paper to be replicated internationally. This paper supports the view that homeowners who are actively involved in the real estate market have an accurate assessment of the value of their own homes. Improvements increase the quality and condition of existing residential housing stocks. Minor improvements are often overlooked due to the cost of gathering data. This paper encourages further studies of minor improvement expenditure on residential property. Originality/value - This paper adds to the body of renovation literature as the data collection was conducted at the time improvements were being made, thus reducing response errors. The inclusion of comprehensive valuation reports by registered valuers increased the reliability of market value assessments. Research in this area is useful to provide greater understanding of the benefits of minor improvement expenditure. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim. The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods. A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results. Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion. E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion. This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Indigenous peoples' rights include the right to self-determine one's identity. For Māori, this includes self-assignment of ethnicity, and traditional identities such as Iwi (tribe). New Zealand's Ministry of Health requires health services to collect ethnicity data using standard protocols. Iwi data are also collected by some health services; however, with no health-specific protocols, little is known about Iwi data collection and quality. The National Hauora Coalition (NHC) Primary Healthcare Organisation (PHO) sought to understand Iwi data collection across its network of primary care providers. AIM: To understand Iwi data collection at the NHC PHO; specifically, is it being routinely collected, how is it being collected and what are the results? METHODS: In 2017, NHC's general practice clinics were invited to submit their enrolment forms, which capture ethnicity and potentially Iwi information, by e-mail to the audit team. Forms were reviewed to determine whether Iwi information was being collected and if so, what question was being used. Iwi numbers were collated from the annual data extract. RESULTS: Thirty-three of a total of 35 clinics (94%) submitted their enrolment forms to the audit team. Nine of the 33 clinics (27%) sought Iwi name/s with a specific question on their enrolment form. Six different 'Iwi' questions were used by the nine clinics. The data extract revealed that the NHC had Iwi data for 13% (2672/20,814) of its Māori enrolments. Ngāpuhi were the largest Iwi group at the NHC. DISCUSSION: This is the first study to describe the quantity and quality of Iwi data collection in NZ primary care. Standard procedures for collecting, recording and using Iwi data are being developed by the NHC PHO. These could inform national protocols to optimise the quality of Iwi data. [ABSTRACT FROM AUTHOR]

Introduction: The Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities.Methods: An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted using the Snowballing Method between September 2018 and February 2019. Participants were recruited via a non-random sampling technique to complete an online survey. Descriptive statistical and content analyses were conducted.Results: The data use priorities identified by 102 trauma professionals from a range of locations participated were clinical improvement and system/process improvement (86.3%). Participants reported that access to trauma data should primarily be for clinicians (93.1%) and researchers (87.3%). Having a standardised approach to review trauma cases across hospitals was a priority in trauma quality improvement.Conclusion: Trauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Introduction. Aotearoa New Zealand has a range of community pharmacies; independent, corporate, hybrid, and mail-order, each with differing service delivery models. Corporate and hybrid pharmacies do not charge the NZ$5.00 co-payment on standard prescriptions; however, prescription co-payments were universally removed from 1 July 2023. Aim. This research aims to describe the consumer profiles of Aotearoa New Zealand's different types of community pharmacies prior to the removal of the prescription co-payment. Methods. A nationwide retrospective observational study linked 1-year of dispensing data (1 March 2022-28 February 2023) from the Pharmaceutical Collection to patient enrolment data using a National Health Index (NHI) number to identify the demographic details of people who use the different pharmacy types. People were assigned to a particular type of pharmacy if they collected at least 70% of their prescriptions from there; if they did not meet this threshold, they were defined as mixed users. Results. Independent pharmacies had an older customer base and fewer Asian users compared to other pharmacy types. Hybrid pharmacies served a greater proportion of Pacific peoples and those from areas of high deprivation. Māori made up relatively equal proportions of users across all pharmacy types. Areas without major cities had fewer corporate pharmacies and only four hybrid pharmacies were identified outside of Auckland. Discussion. There appears to be differences in the consumer profiles of the different pharmacy types. These results will serve as a comparison to how removing prescription co-payments shifts patients' behaviour. [ABSTRACT FROM AUTHOR]

SUMMARY Background Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. Method A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. Results Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. Conclusion Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools. [ABSTRACT FROM AUTHOR]

Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

Background: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse‐led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife‐led trials will be reported elsewhere. Aim: To quantify number, type and quality of nurse‐led randomised controlled trials registered between 2000–2021. Design: A scoping review of RCTs. Data Sources: Medline, Emcare and Scopus were searched from 2000 to August 2021. ANZCTR, NHMRC, MRFF and HRC (NZ) registries were searched from inception to July 2021. Review Methods: This review was informed by the JBI scoping review framework using the PRISMA‐ScR. Results: Our search yielded 188 nurse‐led publications and 279 registered randomised controlled trials. Multiple trials had the same nurse leaders. There were more registrations than publications. Publications were predominantly of high methodological quality; however, there was a reliance on active controls and blinding was low. Trial registrations indicate that universities and hospital/healthcare organisations were the major sources of funding, while publications indicate that Governments and the National Health and Medical Research Council were the main funding bodies. Conclusion: A small number of high‐quality, large‐scale, nationally funded randomised controlled trials were identified, with a larger number of locally funded small trials. There was a disparity between the number of registered trials and those published. Additional infrastructure, funding and career frameworks are needed to enable nurses to design, conduct and publish clinical trials that inform the health system and improve health outcomes. Relevance to Clinical Practice: Research initiated and led by nurses has the potential to improve the health and well‐being of individuals and communities, and current nurse‐led research is of high methodological quality; however, there were very few nurse‐led RCTs, conducted by a small pool of nurse researchers. This gap highlights the need for support in the design, conduct and publishing of nurse‐led RCTs. Patient or Public Contribution: This is a scoping review; therefore, patient or public contribution is not applicable. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports research undertaken to investigate nurses' and parents' experiences of communication about parental emotions in a hospital setting, with a focus on the environmental and cultural context within which the communication occurs.Methods: A focused ethnography was employed as the aims were to understand the context within which nurse-parent interaction takes place, by exploring cultural factors, such as ways of living affecting nursing communication. Data collection occurred in a children's unit of a New Zealand hospital, involving 260h of participant observation field work, informal interviews with parents and nurses, followed by 20 formal interviews with nurses and parents.Results: Nurses are cultural brokers, with the potential to be a link between the insider culture, the hospital and the outside, the parents. Parents look to nurses for cultural brokerage, to help them cross the strong cultural boundaries present in a hospital unit.Conclusion: The context and culture of a hospital unit influences nurse-parent communication. There is a disconnection between parents' emotional needs in hospital and nurses' ability to meet those needs.Practice Implications: Nurses must be supported to provide effective cultural brokerage for parents. Unit managers need to acknowledge that meeting parents' diverse needs is vital. [ABSTRACT FROM AUTHOR]

Introduction. Traditionally, gender-affirming hormonal therapy (GAHT) is initiated in secondary care, but a primary care based approach has been developed to reduce access barriers. Aim. We aim to describe the demographics, hormone choices, and additional referrals made for young people initiating GAHT in a primary care setting in Aotearoa New Zealand. Methods. Clinical notes were reviewed for all patients who commenced GAHT between 1 July 2020 to the end of 2022 at a tertiary education health service. Data were collected on age, ethnicity, gender, type of hormones prescribed, and any additional referrals. Results. Eighty five patients commenced GAHT during the review period (64% assigned male at birth and starting oestrogen-based GAHT, 36% assigned female at birth and commencing testosterone-based GAHT). Fourty seven percent of patients identified as transgender female, 38% as non-binary, and 15% as transgender male. Spironolactone was the most common choice of testosterone blocker (81%). The choice of oestrogen formulation was fairly equal between patches (54%) and tablets (46%). Eighty percent of those assigned male at birth chose to preserve fertility, 54% requested voice therapy, and 87% of those assigned female at birth requested top surgery. Discussion. There is a need for improved understanding of non-binary gender affirmation needs, in particular those of Māori and Pasifika youth. An informed consent approach in primary care can reduce barriers and distress for transgender youth seeking GAHT. The high unmet need for top surgery for transgender people assigned female at birth requires attention. [ABSTRACT FROM AUTHOR]

Background: Despite a number of clinicians having been trained in Parent–Child Interaction Therapy (PCIT) in Aotearoa/New Zealand, few are regularly delivering the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, randomised, controlled pilot trial includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability and cultural responsivity of study methods and intervention components and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial. Methods: The trial will compare a novel 're-implementation' intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (audio-visual equipment, a 'pop-up' time-out space, toys), a mobile senior PCIT co-worker and an optional weekly PCIT consultation group, for a 6-month period. Outcomes will include the feasibility of recruitment and trial procedures; acceptability of the intervention package and data collection methods to clinicians; and clinician adoption of PCIT. Discussion: Relatively little research attention has been directed at interventions to resurrect stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment. Trial registration: ANZCTR, ACTRN12622001022752, registered on July 21, 2022. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Although vasectomy rates in New Zealand have been reported as among the highest worldwide, there is limited information about who is receiving these services and how they are being accessed. This information is needed to develop equitable access to vasectomy services. AIM: To describe the ethnicity and socioeconomic status of men accessing District Health Board-funded and self-funded vasectomies in Counties Manukau. METHODS: A retrospective cohort analysis of provider data linked to ethnicity and area deprivation as an indicator of socioeconomic status. RESULTS: Of 332 vasectomies, 66% were for New Zealand European men. Socioeconomic status was not associated with the number of procedures for New Zealand European men, but of the Maori and Pacific men who underwent vasectomies, most lived in the greatest areas of deprivation; 58% (18/31) and 50% (12/24), respectively. When vasectomies were funded, the number of procedures doubled for men from areas of high deprivation. The number of procedures was low for men of other ethnicities. DISCUSSION: Our findings indicate differential access to vasectomies by ethnicity and socioeconomic status. Funding vasectomies may provide community benefits in terms of improving equity in access and alleviating a financial burden for many families living in areas of high deprivation. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Outreach Immunisation Services (OIS) enable children who have not been immunised on time at general practice to be immunised in the community, thereby improving immunisation coverage and reducing equity gaps. AIM: To identify the most effective service delivery models and make recommendations for more effective and cost-efficient OIS delivery in New Zealand. METHODS: Data collection and thematic analysis through a detailed review of OIS contracts and service specifications, an online survey and in-depth interviews with stakeholders and providers, and an analysis of cost data was conducted. RESULTS: In total, 28 OIS providers completed survey questionnaires, 28 OIS staff were interviewed, and cost effectiveness data were obtained from 11 providers. The surveys and interviews identified key themes around identifying clients with the highest needs, effective engagement strategies, staffing requirements, and service challenges. On average, each OIS referral costs NZ$361 (median NZ$257), and each vaccination event costs NZ$636, ranging from NZ$145 to NZ$2403. Characteristics for two separate models of service delivery were identified based on provider size. CONCLUSION: There is considerable range in costs and style of OIS delivery, and efficiencies can be gained. Models need to fit with locality needs and include adequate resourcing, staff with good local knowledge, close relationships with other key child health services and preferably co-location, sustainable funding, and regular service reviews. OIS are part of an effective integrated service that relies on accurate data, positive relationships and a rapid response when children fail to present for vaccination in a timely fashion. [ABSTRACT FROM AUTHOR]

Objectives: The burden of mental illness is increasing across developed countries. EDs are often used as access points by people experiencing mental health crises, with such rising demand in Australasia. Accurate data is critical to track and address this need, but research suggests that current data collection methods undercount mental health presentations to the EDs. The present study aimed to quantify and characterise ED mental health presentations that were not identified by usual clinical coding processes. Methods: From almost 50 000 presentations to a large regional ED over 12 months, 1988 were mental health‐related as identified via discharge diagnoses and ICD‐10 codes. For a further 384 presentations, it was ambiguous whether they were mental health‐related. For these, free‐text clinical notes were reviewed to identify mental health‐related presentation missed by clinical coding practices. Demographic information, time of presentation, recent use of secondary mental health services and disposition from ED were extracted and analysed. Results: An additional 91 mental health presentations were found by review of clinical notes; 4.6% (95% confidence interval 3.7–5.6) more presentations than identified via screening of discharge codes. In these 'missed' cases, clinicians had documented clear mental health symptoms but without coding the corresponding diagnosis. Existing clinical coding practices were less accurate for patients who were not current or recent users of mental health services, and for those who were discharged directly from ED. Conclusions: The present study demonstrates that ED mental health presentations may be underestimated by nearly 5%, revealing greater mental health demand than current figures suggest. [ABSTRACT FROM AUTHOR]

Background: Māori in New Zealand (NZ) are disproportionately affected by chronic kidney disease (CKD) and experience lower life expectancy on community dialysis compared with non‐Māori. We previously identified a higher renal replacement therapy (RRT) requirement for Māori in our intensive care unit (ICU), the tertiary referral centre for NZ's Te Manawa Taki region. Aim: To describe mortality outcomes by ethnicity in the population requiring RRT in our ICU. Methods: Retrospective audit of the Australia and NZ Intensive Care Society database for adult admissions to our general ICU from Te Manawa Taki between 2014 and 2018. Patients were stratified by non‐RRT requirement (non‐RRT), RRT‐requiring acute kidney injury (AKI‐RRT) and RRT‐requiring end‐stage renal disease (ESRD). Results: Relative to the population of Te Manawa Taki, Māori were over‐represented across all strata, especially ESRD (61.8%), followed by AKI‐RRT (35.0%) and non‐RRT (32.4%) (P < 0.001). There was no excess mortality by ethnicity in any stratum. Crude in‐ICU mortality was similar by ethnicity among AKI‐RRT (30.8% among Māori, vs 31.5%; P = 1.000) and ESRD (16.4% among Māori, vs 20.6%; P = 0.826). This trend remained at 1 year. Adjusted for clinically selected variables, neither AKI‐RRT nor ESRD mortality was predicted by Māori ethnicity, both in‐ICU and at 1 year. Irrespective of ethnicity, AKI‐RRT patients had highest in‐ICU mortality (31.2%; P < 0.001), while ESRD had highest 1‐year mortality (46.1%; P < 0.001). Conclusion: Increased RRT requirement among Māori in our ICU is due to higher representation among ESRD. We did not demonstrate excess mortality by ethnicity in any stratum. AKI‐RRT had higher in‐ICU mortality than ESRD, but this reversed at 1 year. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate whether children with cochlear implants received the recommended vaccinations according to New Zealand national immunisation guidelines and to report the incidence of meningitis in this population after intervention. Method: A retrospective review of the vaccination coverage of paediatric patients receiving cochlear implants between 2005 and 2019 was performed. Results: Data were collected on 203 children. Evidence of immunisation against Haemophilus influenza B was documented in 94.1 per cent of this cohort and 21.2 per cent received the seasonal influenza vaccine. The pneumococcal conjugate vaccine was fully administered in 81.8 per cent of children; however, only 16.9 per cent of eligible children had received the pneumococcal polysaccharide vaccine. There was marked improvement in compliance to the pneumococcal conjugate vaccine once it became fully funded for cochlear implant patients. Conclusion: Despite established guidelines, the paediatric vaccination rates were less than expected. Work is in progress to address this. [ABSTRACT FROM AUTHOR]

In Australia, 2.7 million surgical procedures are performed annually. Historically, a lack of perioperative data standardisation and infrastructure has limited pooling of routinely collected data across institutions. We surveyed Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network hospitals to investigate current and potential uses of perioperative electronic medical record data for research and quality assurance.A targeted survey was sent to 131 ANZCA Clinical Trials Network-affiliated hospitals in Australia. The primary aim was to map current electronic data collection methods and data utilisation in six domains of the perioperative pathway.The survey response rate was 32%. Electronic data recording in the six domains ranged from 19% to 85%. Where electronic data exist, the ability of anaesthesiology departments to export them for analysis ranged from 27% to 100%. The proportion of departments with access to data exports that are regularly exporting the data for quality assurance or research ranged from 13% to 58%.The existence of a perioperative electronic medical record does not automatically lead to the data being used to measure and improve clinical outcomes. The first barrier is clinician access to data exports. Even when this barrier is overcome, a large gap remains between the proportion of departments able to access data exports and those using the data regularly to inform and improve clinical practice. We believe this gap can be addressed by establishing a national perioperative outcomes registry to lead high-quality multicentre registry research and quality assurance in Australia. [ABSTRACT FROM AUTHOR]

Background: Total joint arthroplasty (TJA) registries traditionally have focused on implant longevity and rates of revision surgery. Registries would benefit from the addition of standardized patient-reported outcomes (PROs) such as pain relief and improved physical function. However, PROs have not been routinely adopted, and their incorporation into TJA registries presents challenges. Questions/purposes: We review current PRO use by existing national registries, challenges to integrating PROs in national registries, lessons from national registries that have integrated PROs, and suggestions to guide future adoption of PROs. Methods: We conducted a literature search of papers addressing PRO use in national knee and hip arthroplasty registries, resulting in 15 articles. These publications were supplemented by discussions with thought leaders from international registries. Where Are We Now?: Some national TJA registries are collecting PROs and valuable research is emerging. However, challenges exist, such as selecting suitable PROs, selection bias in countries without government-mandated participation for all hospitals, and challenges with missing data. Where Do We Need to Go?: The ideal system will incorporate PROs into TJA registries. In so doing, it will be important to choose suitable PROs and develop innovative methods to collect PROs to ensure complete data and sustainability. How Do We Get There?: New methods are required to meet the challenges related to registry design, logistics of PRO collection, and registry cost and sustainability. Modifications to the traditional hospital- and implant-centric design and new procedures to collect complete data from both patients and clinicians may be necessary. For instance, England and Wales, New Zealand, and Sweden developed methods to collect PROs after TJA directly from patients and a US TJA registry collects PROs as the primary outcome. Finally, to assure long-term sustainability, PRO data must be valuable to multiple stakeholders, including patients, clinicians, researchers, and policy makers. [ABSTRACT FROM AUTHOR]

Abstract: Current approaches to second language teaching place a great emphasis on the development of learners' communicative competence. However, teachers are frequently bewildered by some learners' reluctance to communicate and wonder what impedes their oral participation. To understand this phenomenon better, I conducted a naturalistic inquiry to investigate five Chinese immigrant learners' willingness to communicate in both teacher-led and collaborative learning situations in L2 classrooms. In the study, a number of instruments (in-depth interviews, classroom observations, stimulated recall interviews, learning logs) were used to collect data about the learners' oral participation over eighteen weeks. The results revealed that the participants' WTC was context-dependent and varied in two different classroom situations. Drawing on Ajzen's theory of planned behavior, the variations were accounted for in each context. While their WTC in the collaborative context was related to different attitudes toward working collaboratively, four factors, linguistic factors, socio-cultural factors, self-efficacy, learner beliefs, had joint effects on their WTC in the teacher-led context. Based on these findings, I propose a model that aims to capture the pertinent factors mediating learners' oral communication in classrooms. The paper concludes with pedagogical implications. [Copyright &y& Elsevier]

Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the relative performance of total knee replacement constructs and discern if there is variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis.Methods: All patients who underwent a primary total knee replacement (TKR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of total knee replacement prostheses were compared with the best performing contemporary construct. Construct all-cause revision rate was estimated using the 1-Kaplan Meier survival function method to estimate net failure. The difference in all-cause revision rates between the contemporary benchmark and all other constructs was tested.Results: In total 110 183 TKR were recorded and 25 constructs (102 717 procedures) had > 500 procedures at risk at 3 years post-primary of which 5 were inferior by at least 20 % relative risk of which, one was inferior by at least 100 % relative risk. 14 constructs were identified with > 500 procedures at risk at 10 years with 5 inferior by at least 20 %, of which 2 were inferior by > 100 % relative risk.Conclusions: We discerned that there is great variability in construct performance and at all time points, greater than 25 % of constructs are inferior to the best performing construct by at least 20 %. These results can help inform patients, clinicians and health care funders when considering TKR surgery. [ABSTRACT FROM AUTHOR]

• A scale is developed measuring food involvement, food innovativeness and food responsibility. • The scale developed exhibits good cross-cultural validity. • Based on data from six countries, three cross-national segments are identified. • The segments differ in terms of life values and food-related behavioura. Segmentation is crucial for targeting product development initiatives and marketing communication nationally as well as internationally. In this paper we use the Food Related Lifestyle instrument that has been applied in the food arena for many years as a 'stepping stone' to develop a contemporary, targeted and smaller version of the Food Related Lifestyle instrument, still following the original theoretical framework. In particular we focus on three dimensions that have proven to be of core value in segmentation: food involvement; food innovativeness; and, food responsibility. Based on data collection in six countries (DK, AU, HU, UK, USA and NZ) across two rounds from 2017 to 2019 (total N = 3396), we propose a new core instrument consisting of 15 items that have been tested for cross-cultural validity. Next, we used these three dimensions for segmentation across the six countries by applying multi-level latent class analysis. A solution leading to five different segments could be identified; the foodies, the moderates, the adventurous, the uninvolved and the conservatives. The segments were profiled by means of Schwartz's ten value domains and measures of self-reported food-related behaviour to check for nomonological validity. We conclude that the 15 items were cross-culturally valid, could be used for segmentation across six countries, and that segment profiling by means of Schwartz values and behavioural items were in line with the theoretical background. [ABSTRACT FROM AUTHOR]

The evidence-based anti-bullying programme known as KiVa was introduced into New Zealand in 2015 as an attempt to address high bullying rates. A key component of this programme includes a set of 'indicated actions' that are enacted when bullying incidents are reported. This study looked at the implementation of the 'indicated actions' component in a small sample of schools in New Zealand over a specifc time period. Data collection included individual interviews with KiVa team members from each school. They were asked to provide information about the range and frequency of bullying incidents that were identifed using the 'indicated actions' procedures, a description of the KiVa procedures in place in the schools, parents and teacher involvement in the KiVa process, and their perceived effects of the programme. Results revealed large variations across schools in the frequency of bullying incidents reported and acted upon. In addition, verbal name-calling was reported by a majority of the schools as being the most prevalent form of bullying. Although all 12 schools reported (and had documentation to show) that they had followed KiVa procedures as outlined in the manual, the use of the screening form was varied and the majority of the KiVa team members perceived the effects of the programme to be positive. [ABSTRACT FROM AUTHOR]

Aim: To assess computerised tomography (CT) use and the risk of intracranial haemorrhage (ICH) in children with bleeding disorders following a head trauma. Methods: Design: Multicentre prospective observational study. Setting: 10 paediatric emergency departments (ED) in Australia and New Zealand. Patients: Children <18 years with and without bleeding disorders assessed in ED following head trauma between April 2011 and November 2014. Interventions: Data collection of patient characteristics, management and outcomes. Main outcome measures: Rate of CT use and frequency of ICH on CT. Results: Of 20 137 patients overall, 103 (0.5%) had a congenital or acquired bleeding disorder. CT use was higher in these patients compared with children without bleeding disorders (30.1 vs. 10.4%; rate ratio 2.91 95% CI 2.16–3.91). Only one of 31 (3.2%) children who underwent CT in the ED had an ICH. This patient rapidly deteriorated in the ED on arrival and required neurosurgery. None of the patients with bleeding disorders who did not have a CT obtained in the ED or had an initial negative CT had evidence of ICH on follow up. Conclusions: Although children with a bleeding disorder and a head trauma more often received a CT scan in the ED, their risk of ICH seemed low and appeared associated with post‐traumatic clinical findings. Selective CT use combined with observation may be cautiously considered in these children based on clinical presentation and severity of bleeding disorder. [ABSTRACT FROM AUTHOR]

As a field, school leadership has maintained a colorblind stance, marginalizing practitioners' awareness of culturally sustaining practice, and erasing the experiences of Indigenous and other minoritized groups of students, teachers, and families. Looking to research and practice that attempts to embrace racial and cultural difference in order to make schools more culturally sustaining places to be is imperative in order for the field to respond to the growing diversity in schools. This article specifically explores culturally sustaining and Indigenous school leadership practices. Using data collected from interviews with ten school leaders in Aotearoa (New Zealand) as well as school documents, this article presents new insights into the implementation of culturally sustaining school leadership, which has implications for theory and practice in the field of educational leadership, which has been too long dominated by white ways of knowing. [ABSTRACT FROM AUTHOR]

New Zealand has few estimates of the prevalence of autism spectrum disorder and no national registry. The use of administrative data sources is expanding and could be useful in autism spectrum disorder research. However, the extent to which autism spectrum disorder can be captured in these data sources is unknown. In this study, we utilised three linked administrative health data sources from the Integrated Data Infrastructure to identify cases of autism spectrum disorder among New Zealand children and young people. We then investigated the extent to which a range of mental health, neurodevelopmental and related problems co-occur with autism spectrum disorder. In total, 9555 unique individuals aged 0–24 with autism spectrum disorder were identified. The identification rate for 8-year-olds was 1 in 102. Co-occurring mental health or related problems were noted in 68% of the autism spectrum disorder group. The most common co-occurring conditions were intellectual disability, disruptive behaviours and emotional problems. Although data from the Integrated Data Infrastructure may currently undercount cases of autism spectrum disorder, they could be useful for monitoring service and treatment-related trends, types of co-occurring conditions and for examining social outcomes. With further refinement, the Integrated Data Infrastructure could prove valuable for informing the national incidence and prevalence of autism spectrum disorder and the long-term effectiveness of clinical guidelines and interventions for this group. New Zealand has few estimates of the prevalence autism spectrum disorder and no national registry or data set to identify and track cases. This hinders the ability to make informed, evidence-based decisions relating to autism spectrum disorder. In this study, we utilised linked health and non-health data to develop a method for identifying cases of autism spectrum disorder among children and young people in New Zealand. In addition, we examined rates of co-occurring mental health, neurodevelopmental and related conditions among this cohort and compared these to the general population. The method identified almost 10,000 children and young people with autism spectrum disorder in New Zealand. Co-occurring mental health or related problems were found in over 68% of this group (nearly seven times higher than the general population), and around half were identified with multiple co-occurring conditions. The most frequently identified conditions were intellectual disability, disruptive behaviours and emotional problems. We have developed a useful method for monitoring service and treatment-related trends, number and types of co-occurring conditions and examining social outcomes among individuals with autism spectrum disorder. While the method may underestimate the prevalence of autism spectrum disorder in New Zealand, it provides a significant step towards establishing a more comprehensive evidence base to inform autism spectrum disorder–related policy. [ABSTRACT FROM AUTHOR]

Existing infrared photoluminescence (IRPL) systems have used pulsed infrared stimulation (~830 nm) and measured IRPL emission (at 880 or 955 nm) using time resolved data collection with photomultipliers. Breakthrough of the infrared stimulation light overwhelms the IRPL, but the delayed emission during the laser-off period has been used instead. This paper describes a system for measurement of the IRPL signal from single sand-sized grains of feldspar. The attachment uses an electron-multiplying charge-coupled device (EMCCD) imaging system, and has two innovations that make it possible to use such a detector to obtain IRPL data. First, the optical detection system has been designed to minimise stray light and maximise the efficiency with which filters reject the stimulation light. This acts to reduce, but not eliminate, the breakthrough. Second, by placing the sample to be measured in a clearly defined sample grid, the spatial resolution provided by the EMCCD has been used to differentiate between regions of the image where IRPL is emitted and adjacent regions where only breakthrough is expected. This allows quantification of the breakthrough and effective subtraction to isolate the IRPL signal from the grains of interest. The attachment has been used to measure IRPL from single sand-sized grains of feldspar from an aeolian dune from New Zealand. A 1W UV LED (365 nm) is also added to the system and this is effective at resetting the IRPL signal, permitting a single aliquot regenerative dose (SAR) protocol to be used to measure equivalent dose (D e). Measurement of a known laboratory dose (104 Gy) demonstrates the reproducibility of the attachment, with no overdispersion observed in the resulting single grain D e values. The recovered dose is within 10% of the given dose. The natural IRPL signal yields D e values from single grains with low overdispersion (22%) and giving a weighted mean value (103 ± 5.8 Gy) that is consistent with that obtained using post-IR IRSL measurements (105 ± 3.8 Gy). The attachment described here provides IRPL measurements on single grains suitable for exploring the potential of this novel and exciting signal for dating geological sediments. • Attachment for measuring IRPL from single grains built using EMCCD detector. • Thermal quenching of IRPL from feldspars observed above room temperature. • 365 nm LED used to remove IRPL signal. • Equivalent dose determination using IRPL achieved for single grains. [ABSTRACT FROM AUTHOR]

Background: Interstitial Lung Disease (ILD) is a group of respiratory conditions affecting the lung interstitium often associated with progressive respiratory failure. There is increasing recognition of the need for improved epidemiological data to help determine best practice and improve standardisation of care. The Australasian ILD Registry (AILDR) is a bi-national registry of patients with all ILD subtypes designed to establish a clinically meaningful database reflecting real world practice in Australasia with an objective to improve diagnostic and treatment pathways through research and collaboration.Methods: AILDR is a prospective observational registry recruiting patients attending ILD clinics at centres around Australia and New Zealand. Core and non-core data are stored on a secure server. The pilot phase was launched in 2016 consisting of four sites in Australia. Currently in its second phase a further 16 sites have been recruited, including three in New Zealand.Results: A total of 1061 participants were consented during the pilot phase. Baseline data demonstrated a mean age 68.3 ± 12.5 (SD) years, mean FVC (%predicted) 79.1 ± 20.4 (SD), mean DLCO (%predicted) 58.5 ± 17.9 (SD) and nadir exertional SpO2 (%) 91 ± 6.9 (SD). Idiopathic pulmonary fibrosis (31%) and connective-tissue disease related ILD (21.7%) were the two most common subtypes. Baseline demographics and physiology were not significantly different across the four centres.Conclusion: AILDR is an important clinical and research tool providing a platform for epidemiological data that will prove essential in promoting understanding of a rare cohort of lung disease and provide foundations for our aspiration to standardise investigation and treatment pathways of ILD across Australasia. [ABSTRACT FROM AUTHOR]

We explore how New Zealand's Chinese migrant community engaged with the Rugby World Cup. Engagement includes event awareness, participation and the event's impact on identity and pride. We also explore business engagement on the part of Chinese migrants. Quantitative and qualitative data were collected via a 6-month Web audit and analyzed using a temporal, macro-analytic, content analysis approach. A stakeholder relationship map identifies the evolving modes of participation in the event. To optimize the positive social impact, it is recommended that event planners use a stimulation strategy that factors in the temporal dimension of event participation. [ABSTRACT FROM AUTHOR]

It is one thing to read about the methodology and methods of Heideggerian hermeneutic phenomenological research, the ontic description. It is quite another thing to be faced with an interview transcript. This article draws on a study that asked doctoral students about their experience of doing such research. How did they become "phenomenological/hermeneutic" in their thinking and writing? What helped them to find their way? We offer this article as a means of letting others learn from our own experiences. We support our insights with the writings of Heidegger and Gadamer to show the methodological congruence that is essential to Heideggerian phenomenological hermeneutic research. [ABSTRACT FROM AUTHOR]

The Selwyn Waihora Project was a research project supporting a collaborative policy-making process to set environmental limits in the Selwyn Waihora catchment in New Zealand's South Island. In this Design Report we reflect on this project based on data collected from a range of project participants approximately two years after project completion. The data collection was guided by the Integration and Implementation Sciences framework (i2S). On the basis of participant responses, and the authors' first-hand experiences working on the project, we present insights for transdisciplinary research. Through the questions asked by the i2S framework insights emerged on: what it means to honour community values; the importance of context but that projects can pay too much attention to it; boundary objects to foster integration across multiple knowledge systems; the value of intra-team narratives for translation; the importance of considering the losers of the research; and sharing the burden of uncertainty. [ABSTRACT FROM AUTHOR]

Beaches around the world continuously adjust to daily and seasonal changes in wave and tide conditions, which are themselves changing over longer time-scales. Different approaches to predict multi-year shoreline evolution have been implemented; however, robust and reliable predictions of shoreline evolution are still problematic even in short-term scenarios (shorter than decadal). Here we show results of a modelling competition, where 19 numerical models (a mix of established shoreline models and machine learning techniques) were tested using data collected for Tairua beach, New Zealand with 18 years of daily averaged alongshore shoreline position and beach rotation (orientation) data obtained from a camera system. In general, traditional shoreline models and machine learning techniques were able to reproduce shoreline changes during the calibration period (1999–2014) for normal conditions but some of the model struggled to predict extreme and fast oscillations. During the forecast period (unseen data, 2014–2017), both approaches showed a decrease in models' capability to predict the shoreline position. This was more evident for some of the machine learning algorithms. A model ensemble performed better than individual models and enables assessment of uncertainties in model architecture. Research-coordinated approaches (e.g., modelling competitions) can fuel advances in predictive capabilities and provide a forum for the discussion about the advantages/disadvantages of available models. [ABSTRACT FROM AUTHOR]

High-resolution microscale modelling of the response of the Waiho River to width reduction by stopbanks reveals that, unless the river is already aggrading in its prior state, width reduction does not on its own cause bed aggradation. This finding conflicts with and corrects findings of earlier work, due to improvements in data acquisition technology, and has prompted a review of the prehistoric and historical behaviour of the Waiho River. The river has aggraded by about 10 m at the State Highway 6 bridge cross-section since records began in 1907, and since 1980 it has aggraded by about 6 m (an average rate of about 0.17 m/year). The reason for this multi-decade aggradation is presently not well understood; other major rivers in the region are not behaving in this way. At the start of the 20th century the Waiho River was incised by about 8 m into its fanhead, but by about 1970-80 aggradation was causing overbank flows during floods, affecting infrastructure, and stopbanks were constructed to confine the river to its previous bed area. The confinement caused aggradation to continue at the previous rate, whereas without stopbanks the river would have aggraded across its entire fanhead (about three times the current bed area) at about one-third the rate, i.e. at about 0.06 m/year. If stopbanks are maintained in their present positions, about 17 m of further aggradation can be anticipated over the next century; if, by contrast, the river is allowed free access to the whole of its natural bed the short-term response would be about 2 m of degradation, followed by 6 m of aggradation after 100 years - that is, a bed-level rise of about 4 m over the next century. During this time, however, a severe aggradation episode, probably due to an earthquake, is likely to alter the river behaviour drastically. The response of the river to climate change over the next century is unclear at present. [ABSTRACT FROM AUTHOR]

Future research on cannabis and methamphetamine use in New Zealand must make an explicit commitment to be of benefit to Māori, and implement Kaupapa Māori-consistent research approaches. This was the finding of a Kaupapa Māori review which analysed 30 literature sources, the majority of which were journal articles. Research mainly utilised quantitative survey data collection methods, focused on large population groups and investigated individual characteristics of cannabis and/or methamphetamine users. A general population approach was taken in most articles, with Māori only briefly mentioned, or differences in drug use assessed between Māori and others. The value of focusing on drug use, rather than drug users, was highlighted in more recent research either led by Māori or undertaken with a critical lens. [ABSTRACT FROM AUTHOR]

Objective: The medium-term outcome and cause of death in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) is not well characterised. The aim of this study was to compare mortality and rates of recurrent events in post myocardial infarction (MI) patients with obstructive coronary artery disease (CAD) and in patients with MINOCA compared with an age and sex-matched cohort without cardiovascular disease (CVD).Methods: We performed a national cohort study of consecutive patients undergoing coronary angiography for MI during 2 years between 2013 and 2015 from the All New Zealand Acute Coronary Syndrome-Quality Improvement (ANZACS QI) registry. MI patient registry data were linked anonymously to national hospitalisation and mortality records. Age and sex matched patients without known CVD formed the comparison group.Results: Of the 8305 patients with MI, 897 (10.8%) were classified as MINOCA. Compared with those without known CVD, the adjusted HRs for the primary outcome (all-cause death or recurrent non-fatal MI) were 7.81 (95% CI 6.64 to 9.19, p<0.0001) in those with obstructive CAD and 4.64 (95% CI 3.54 to 6.10, p<0.0001) in those with MINOCA. Kaplan-Meier all-cause mortality at 2 years was 7.9% for those with obstructive CAD, with nearly half being CVD deaths (3.6% CVD deaths and 4.5% non-CVD deaths, respectively). In contrast, MINOCA all-cause mortality was 4.9% with non-CVD death (4.5%) predominating.Conclusions: MINOCA is common and has an adverse outcome rate approximately half than that of those with obstructive CAD. The predominant contributor to mortality is non-CVD death. The rate of events in MINOCA is significantly greater than the population without CVD. [ABSTRACT FROM AUTHOR]

Objectives: To examine recent trends in first and recurrent ischaemic heart disease (IHD) deaths and hospitalisations.Methods: Using anonymous patient-linkage of routinely collected data, all New Zealanders aged 35-84 years who experienced an International Statistical Classification of Diseases and Related Health Problems I(CD)-coded IHD hospitalisation and/or IHD death between 1 January 2005 and 31 December 2015 were identified. A 10-year look-back period was used to differentiate those experiencing first from recurrent events. Age-standardised hospitalisation and mortality rates were calculated for each calendar year and trends compared by sex and age.Results: 160 109 people experienced at least one IHD event (259 678 hospitalisations and 35 548 deaths) over the 11-year study period, and there was a steady decline in numbers (from almost 24 000 in 2005 to just over 16 000 in 2015) and in age-standardised rates each year. With the exception of deaths in younger (35-64 years) women with prior IHD, there was a significant decline in IHD events in men and women of all ages, with and without a history of IHD. The decline in IHD mortality was greater for those experiencing a first rather than recurrent IHD event (3.8%-5.2% vs 0%-3.7% annually on average). In contrast, the decline in IHD hospitalisations was greater for those experiencing a recurrent compared with a first IHD event (5.6%-7.3% vs 3.2%-5.7% annually on average).Conclusions: The substantial decline in IHD hospitalisations and mortality observed in New Zealanders with and without prior IHD between 2005 and 2015 suggests that primary and secondary prevention efforts have been effective in reducing the occurrence of IHD events. [ABSTRACT FROM AUTHOR]

Background: New Zealand is an example of a country with a well-established cytology-based screening program. New Zealand's National Cervical Screening Programme (NCSP) commenced in 1990, and recommends three-yearly cytology-based screening for women aged 20-69 years. In 2018, the NCSP will transition to five-yearly HPV-based screening for women aged 25-69 years. The aim of this study was to assess the impact of the program to date in different groups, to provide a benchmark for the new program.Methods: Analysis of cervical cancer trends in New Zealand by age and ethnicity over the period 1985-2013, and by morphology over the period 1997-2013, using data from the New Zealand Cancer Registry was conducted.Results: The overall incidence of cervical cancer was 56% (95% CI 51-60%) lower in 2009-2013 than in 1985-1989, and significant reductions were observed in women aged 25-49, 50-69, and 70 + years. Relative reductions in cervical cancer were very similar for Māori and non-Māori women aged 25-49 (50% in Māori; 52% in non-Māori) and 50-69 years (65% in Māori; 69% in non-Māori). In contrast, incidence appeared to increase after around 1996 in women aged 20-24. The increasing trend was significant for women aged 20-24 overall and for non-Māori women (p < 0.01 in both cases).Conclusion: There have been substantial reductions in cervical cancer among women aged 25 + years in New Zealand since the inception of the NCSP, and these reductions are similar in Māori and non-Māori women. Cervical cancer incidence among women 20-24 years has not declined since the NCSP began, and appears to be increasing. [ABSTRACT FROM AUTHOR]

We study aftershock sequences of six major earthquakes in New Zealand, including the 2016 M7.8 Kaikaoura and 2016 M7.1 North Island earthquakes. For Kaikaoura earthquake, we assess the expected number of long-delayed large aftershocks of M5+ and M5.5+ in two periods, 0.5 and 3 years after the main shocks, using 75 days of available data. We compare results with obtained for other sequences using same 75-days period. We estimate the errors by considering a set of magnitude thresholds and corresponding periods of data completeness and consistency. To avoid overestimation of the expected rates of large aftershocks, we presume a break of slope of the magnitude-frequency relation in the aftershock sequences, and compare two models, with and without the break of slope. Comparing estimations to the actual number of long-delayed large aftershocks, we observe, in general, a significant underestimation of their expected number. We can suppose that the long-delayed aftershocks may reflect larger-scale processes, including interaction of faults, that complement an isolated relaxation process. In the spirit of this hypothesis, we search for symptoms of the capacity of the aftershock zone to generate large events months after the major earthquake. We adapt an algorithm EAST, studying statistics of early aftershocks, to the case of secondary aftershocks within aftershock sequences of major earthquakes. In retrospective application to the considered cases, the algorithm demonstrates an ability to detect in advance long-delayed aftershocks both in time and space domains. Application of the EAST algorithm to the 2016 M7.8 Kaikoura earthquake zone indicates that the most likely area for a delayed aftershock of M5.5+ or M6+ is at the northern end of the zone in Cook Strait. [ABSTRACT FROM AUTHOR]

Objective Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration ( IVH) was more cost-effective than nasogastric hydration ( NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2-12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis. Methods Cost data collections included hospital and intervention-specific costs. The economic analysis was reduced to a cost-minimisation study, focusing on intervention-specific costs of IVH versus NGH, as length of stay was equal between groups. All analyses are reported as intention to treat. Results Intervention costs were greater for IVH than NGH ($113 vs $74; cost difference of $39 per child). The intervention-specific cost advantage to NGH was robust to inter-site variation in unit prices and treatment activity. Conclusion Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites. [ABSTRACT FROM AUTHOR]