Selecting New Zealand medical students for the New Zealand medical workforce.
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Career Choice↗
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Vascular trauma in New Zealand: an 11-year review of NZVASC, the New Zealand Society of Vascular Surgeons' audit database.
AIM: To describe vascular trauma in New Zealand: its management and early outcomes. METHODS: Patients suffering vascular trauma between January 1993 and December 2003 were analysed using data collected prospectively by the New Zealand Society of Vascular Surgeons' database (NZVASC). RESULTS: There were 549 cases of vascular trauma amongst 45,759 vascular admissions collected by the database in the 11-year period. This study confirmed the findings in international studies that younger adult males were more likely to suffer vascular trauma. Elderly patients, especially females, were most at risk of iatrogenic vascular injury, which accounted for 22% of cases in this study. Complication rates reported by rural vascular surgeons in New Zealand were comparable to results in the main centres and to international reports. CONCLUSION: While programmes to slow down and sober up road users help reduce injuries in the younger age groups, it lies in the hands of our own profession to reduce the iatrogenic injuries in the older patients.
Adolescent↗
New Zealand futures trust visit to New Zealand. Australasia revisited--towards the transTasman federation.
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Australia↗
Major trace elements limiting livestock performance in New Zealand.
Many New Zealand soils are naturally deficient in cobalt and/or selenium and/or copper, or are naturally high in molybdenum. Livestock grazing pasture grown on such soils may be deficient in one or more of these trace elements. In the 1940s and 1950s, New Zealand researchers were at the forefront of research to define the cause of trace-element related ill-thrift and clinical diseases like white muscle disease, peat scours and enzootic ataxia. New Zealanders have devised production-related reference ranges for blood and liver copper, vitamin B12 and selenium that are used for the diagnosis and prevention of deficiencies. A range of supplementation procedures has been devised, from topdressing or spraying pasture to direct animal supplementation, to suit the range of livestock management systems found in New Zealand. Trace-element monitoring programmes are now a routine procedure for farmers grazing cattle, sheep, and deer on trace-element deficient land. Copper deficiency is the main trace-element deficiency diagnosed in deer.
Journal Article↗
The world's first brewery exclusively designed to use continuous fermentation: biotechnology history made in New Zealand.
When New Zealand Breweries Ltd's Standard Brewery opened in Palmerston North, New Zealand on October 9, 1958 it was the first brewery in the world built exclusively to brew beer using continuous fermentation. The use of continuous fermentation in New Zealand sparked a revolution in the way beer was brewed around the world. This is the story of the people and the brewery that made continuous beer fermentation a reality.
Beverages↗
Fatty acid and sterol composition of frozen and freeze-dried New Zealand Green Lipped Mussel (Perna canaliculus) from three sites in New Zealand.
In view of previously reported anti-inflammatory bioactivity of the New Zealand Green Lipped Mussel (NZGLM), the overall lipid profile and fatty acid and sterol composition of the NZGLM from various sites in New Zealand (Hallam Cove, Port Ligar. Little Nikau) were investigated using thin layer chromatography (TLC) and gas liquid chromatography (GLC). Samples were either frozen (F) or freeze-dried (FD) soon after collection. It was also thought prior to the study, there may be differences in the dietary sources of phytoplankton between the sites, responsible for the bioactivity, however data collected in New Zealand reported no difference in the type of phytoplankton, but a difference in the quantity. There were no major significant differences in the major components of the lipid, fatty acid and sterol composition between FD or frozen samples, nor were there any significant differences in the major composition between sites. The only major difference was between total lipid composition of the freeze-dried and frozen samples due to the removal of water during freeze-drying. Total lipid content on a dry weight basis in FD samples was 8.4 g/100 g tissue and was significantly higher than frozen samples (P < 0.05) and there was no significant site variation. The lipid class content between sites was also not significantly different as judged by TLC. Triglyceride (TG) lipid fraction appeared to be the most prominent in the frozen and FD samples. The free fatty acid (FFA) band was the next most prominent band and was visually more prominent in the frozen samples. Sterol esters (SE) were detected in higher amounts in the frozen samples compared with the FD samples. Phospholipid (PL) and sterols (ST) were distributed throughout all samples. Polyunsaturated fatty acids (PUFA) were the main group of fatty acids in both FD and frozen samples (45-46%), most of which were omega-3 (n-3) fatty acids (40-41%). Saturated fatty acids (SFA) accounted for approximately one quarter of total fatty acids, with little variation between FD and frozen samples. The major fatty acids of the NZGLM were docosahexaenoic acid (DHA: 22:6 n-3) (19% in both FD and frozen samples), eicosapentaenoic acid (EPA; 20:5 n-3) and palmitic acid (16:0) (15% in both FD and frozen samples). Cholesterol was the most prominent sterol (31% of total sterols). Other major sterols included desmosterol/brassicasterol (co-eluting), 24-methylenecholesterol, trans-22-dehydrocholesterol, 24-nordehydrocholesterol and occelasterol. This study is unique as it compares the lipid composition of the NZGLM from three sites in New Zealand with the additional effect of processing. This is the second comparative study investigating the lipid, fatty acid and sterol composition of the NZGLM with added interest in the effect of freeze-drying on the lipid content of the mussel. This study showed that there were no major significant differences in lipid, sterol and fatty acid composition between the FD and frozen samples of the NZGLM for three sites in New Zealand. Food chain studies and further research is warranted to investigate the presence and role of major and minor lipid components of the NZGLM.
Animals↗
Australia and New Zealand Health Policy: a new journal.
Australia and New Zealand Health Policy is a new journal which aims to promote debate and understanding about contemporary health policy developments in Australia and New Zealand. Although there are other international journals focussing on health policy, there are no Australian or New Zealand journals with this focus.One of the aims of Australia and New Zealand Health Policy is to focus on contemporary critiques and contemporary developments. Accordingly an e-journal format is particularly appropriate. Australian and New Zealand Health Policy is an open access journal which means that all articles will be freely and universally accessible online which, amongst other things, means that all articles will be freely and universally accessible online without any barriers to access, which increases their visibility.
Journal Article↗
Adolescents at risk: causes of youth suicide in New Zealand.
The New Zealand suicide rate among 15- to 19-year-olds has almost trebled over the past 20 years--from 5.8 per 100,000 in 1970 to 15.7 in 1991 (UNICEF, 1994). New Zealand has one of the highest teenage suicide rates among industrialized countries. The aim of this paper is to shed light on the causes of this phenomenon by examining environmental-social factors. Some of the problems New Zealand youth face are noted and their risk-taking behaviors explored. Findings are linked to current theory on adolescent suicide. How governmental agencies are addressing this problem is discussed.
Adolescent↗
Blood pressures in a random sample of the New Zealand population: preliminary data from the life in New Zealand survey.
Blood pressures (BPs) were measured as part of a health check in a randomly selected sample of the New Zealand population in the Life in New Zealand survey. A total of 1,410 men and 1,605 women over 15 years of age were studied. Measurements were made by trained observers using the Hawksley random zero instrument. Systolic BP (SBP) and diastolic BP (DBP) increased with age in men and women. There were 29% of men and 24% of women over the age of 45 years with BPs over 160/95 mm Hg, of whom 24% of men and 33% of women indicated they were on treatment for hypertension. No regional or urban/rural differences were seen in either SBPs or DBPs. A history of hypertension in the fathers of respondents related to BPs in the highest tertile of SBPs in males, and SBPs in females. The association was not seen between mothers of respondents, except for DBP in women respondents.
Adolescent↗
Contracting opportunities: interpreting post-asylum geographies of mental health care in Auckland, New Zealand.
In New Zealand, the process of deinstitutionalization is continuing to unfold as a specific manifestation of welfare state restructuring rather than as a discrete process within the health care sector. In this paper we consider the geography of mental health care in Auckland, New Zealand's only metropolitan city. Here, a highly fluid and competitive housing market has profoundly (re)shaped the opportunities for community care. We report on findings from a survey of representatives of the key agencies providing mental health care in central Auckland. We argue that the re-placing of mental health care into the community has often involved the separation of residential and treatment issues, to the detriment of the communities, institutions and (especially) individuals involved. We trace this fragmentation back to the primacy of the ideology of restructuring over the philosophy of deinstitutionalization. We build our argument around a discussion of the Mental Health (Compulsory Assessment and Treatment) Act 1992 and the apparent subordination of the Act to the emerging of a 'contract state' and broader legislation, such as the Resource Management Act 1991, the Privacy Act 1992 and the Commerce Act 1986, which underpins the re-regulation of New Zealand society.
Community Mental Health Services↗
Dollars and sense. Is there a better way to determine private surgical fees in New Zealand?
In New Zealand, private insurers reimburse surgeons on a fee-for-service basis. Ideally, the level of reimbursements should reflect competitive market prices. Due to concerns such a market does not exist, other countries have adopted Relative Value Scales (RVS) to estimate a fair reimbursement level for different procedures. No such scale exists in New Zealand for surgeons, but it does for anaesthetists. This study compares reimbursements to surgeons and anaesthetists from private insurers using data from 3186 procedures performed between 1996 and 2002. We calculate an implicit hourly rate of reimbursement and compare the level of reimbursement between procedures and the variance of reimbursements within procedures for surgeons and anaesthetists. The results suggest that there are significantly greater deviations in average reimbursements between procedures for surgeons than for anaesthetists. Furthermore, the variability of reimbursements is greater for reimbursements to surgeons within specific procedures. While the results do not necessarily imply that surgical reimbursements are inconsistent with underlying market rates, the results are consistent with the hypothesis that anaesthetist's fees show greater stability because of the existence of a RVS. We conclude by discussing what would be required to implement a RVS for surgical fees in New Zealand.
Anesthesiology↗
The prevalence of abnormal cervical cytology in a group of New Zealand women using contraception: a preliminary report. The New Zealand Contraception and Health Study Group.
Between 1980 and 1986, cervical smears were obtained from 9430 women throughout New Zealand to determine their eligibility to enter the New Zealand contraception and health study. Excluded were 128 women in whom the smear was unsatisfactory or the cytological diagnosis was inconclusive. The prevalence of mild dysplasia or worse was 4.3% and of carcinoma in situ/invasive carcinoma was 0.5%. Risk factors that were identified were age at first intercourse, number of sexual partners, age and smoking. Over the age range studied (essentially 20-39), the prevalence of dysplasia decreased slightly with increasing age but the prevalence of carcinoma in situ/invasive cancer increased from 0.18% at ages 20-24 to 0.74% at ages 35-39.
Adolescent↗
'Help, educate, encourage?': Geographical variations in the provision and utilisation of diabetes education in New Zealand.
In New Zealand, as elsewhere, it is argued that a diabetes epidemic is underway. With careful management from individuals and professionals and appropriate levels of education, it is possible to prevent many complications of diabetes. The overall objective of the paper is to evaluate the role and impact of Diabetes New Zealand (DNZ), the key voluntary sector provider of diabetes education and support services, with respect to four criteria: (i) the extent to which DNZ is reaching groups most at risk of diabetes; (ii) the degree to which it has encouraged levels of member involvement; (iii) whether voluntary group provision of education is that most preferred by members; and (iv) the extent to which members see the voluntary sector model as being effective in combating the growth of diabetes. A survey of members of six of the 41 affiliated societies of DNZ suggests that such organisations, although having a high proportion of older members, have generally failed to target more deprived groups. While the societies generally score more positively in encouraging member involvement and being perceived as effective by their members, they do not always utilise the preferred form of educational provision. However, there are significant contextual variations by urban-rural location and according to the organisational structure of the societies. Rural societies and those with decentralised organisational structures generally score highest on the above criteria. The results pose a problem for DNZ which, like many other voluntary sector organisations, is facing pressures of increased corporatisation and centralisation. We see this as an important challenge that DNZ needs to address if New Zealand is going to better cope with the emerging diabetes epidemic.
Aged↗
Demography and survival of patients receiving treatment for chronic renal failure in Australia and New Zealand: report on dialysis and renal transplantation treatment from the Australia and New Zealand Dialysis and Transplant Registry.
There were 7,059 (403 per million) Australian patients and 1,341 (388 per million) New Zealand patients receiving renal replacement treatment at the end of 1992. Fifty-three percent and 50%, respectively, were dependent on a functioning transplant, 87% and 80%, respectively, from a cadaver donor. In Australia the majority of dialysis patients depended on hemodialysis (68%) and continuous ambulatory peritoneal dialysis (CAPD) (31%); 68% of patients were dialysing at home or in a satellite (free-standing) facility. The majority (62%) of home dialysis patients used CAPD treatment. In New Zealand there were 44% of patients on hemodialysis; 83% dialyzed at home and the majority (65%) used CAPD treatment. Few dialysis units (five of 71) in Australia were "for-profit" facilities; there was none in New Zealand. Universal health care has been available for renal replacement treatment for 20 years. The annual incidence of new patients increased steadily during the past 10 years, to 61 per million (Australia) and 69 per million (New Zealand) in 1992. There were disproportionate numbers of indigenous Australian Aboriginals (51%), New Zealand Maoris (30%), and Polynesian Pacific Islanders (11%) compared with their distribution in the general population. There was a considerable increase in elderly and diabetic patients during the period from 1983 to 1992: in Australia, 25% of patients were over 65 years of age and 14% of patients were diabetic, and in New Zealand, 16% of patients were over 65 years of age and 25% of patients were diabetic. The renal transplantation rate has remained unchanged since 1983 at 27 per million in Australia, but has increased markedly from 20 to 33 per million in New Zealand. The annual transplantation rate was 20% to 30% of those patients aged 15 to 64 years who were likely to be transplanted. The multifactorial analysis of risk factors for survival of dialysis patients showed age, male gender, CAPD treatment, Aboriginal race, and diabetic or analgesic nephropathy to be associated with lower rates of survival. Deaths were commonly due to a cardiac cause (43%), mostly myocardial infarction, or to infection (17%) or withdrawal from treatment (14%). The overall death rate was 12% of patients at risk in 1992. Multifactorial analysis of risk factors for graft survival in transplanted patients showed patient age, diabetic nephropathy, donor age, single-drug regimen, and low transplant activity (operations) at a center to be associated with lower rates of survival.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Ballistosporous yeasts found on the surface of plant materials collected in New Zealand. 1. Six new species in the genus Sporobolomyces.
Six new species of ballistosporous yeast, the genus Sporobolomyces, were isolated from dead leaves and fruit of plants collected in New Zealand; Sp. novazealandicus, Sp. dimmenae, Sp. coprosmicola, Sp. coprosmae, Sp. dracophyllus, and Sp. taupoensis. These species differ from any hitherto known species of Sporobolomyces based on chemotaxonomic characteristics.
Base Composition↗
Acute myeloid leukaemia: results of the New Zealand AML-1 study. The Leukaemia Study Group of the New Zealand Society for Haematology.
The New Zealand Acute Myeloid Leukaemia (AML-1) study ran from 1985 to 1988. Ninety-two patients with acute myeloid leukaemia between the ages of 13-65 were entered. Remission induction treatment consisted of cytosine arabinoside (Ara-C) 100 mg/m2 12 hourly for seven days and daunorubicin (DNR) 45 mg/m2 daily for three days. Fifty-six patients entered remission (61%). The patients were randomised at diagnosis to receive either three further courses of Ara-C (five days) and DNR (two days) in the same dosage or three courses of VP16 100 mg/m2 daily for five days and one dose of mAMSA of 200 mg/m2 as postremission consolidation. No difference in survival between these two consolidation treatments was seen (p = 0.96). The overall survival of the original 92 patients is 13% with a minimum follow up of two and a half years. However, for those patients solely treated with the trial protocol, disease free survival at 2% is poor. The poor long term results could reflect the relatively low intensity consolidation treatment used in this study. However, since a majority of patients presenting in New Zealand with acute myeloid leukaemia between these ages were entered into the trial, the results could also reflect the relative lack of selection bias which affects many published studies of acute leukaemia treatment.
Acute Disease↗
The use of antimicrobials in ten Australian and New Zealand intensive care units. The Australian and New Zealand Intensive Care Multicentre Studies Group Investigators.
A prospective standardized collection of clinical, microbiological and pharmaceutical information on antibiotic use was conducted in Australia and New Zealand intensive care units (ICUs) involving 481 consecutive critically ill patients who were receiving antibiotics for any reason while in ICU. Patients had a mean SAPS II score of 34.1 +/- 17.8 with an expected mortality of 15.6% (actual mortality 12%). Of these, 292 (60.8%) were admitted to the ICU within 72 hours of surgery. Among such surgical patients, 233 (79.9%) received antibiotics for "surgical prophylaxis" while in ICU (48% of sample population). The second largest group of patients treated with antibiotics in ICU included those with systemic inflammatory response syndrome and clinical suspicion of infection (38%). Antibiotics were prescribed for the treatment of clinically diagnosed infection in 268 patients. Clinical response was apparent in 62.6% and in most (71%) was achieved in the first 72 hours of treatment. The incidence of antimicrobial-related side-effects was 4%, mostly in the form of diarrhoea or rash (75% of all side-effects). The most commonly prescribed antimicrobials were gentamicin (n = 146), ceftriaxone (n = 98), vancomycin (n = 94) and metronidazole (n = 111). Three times daily prescription of aminoglycosides was uncommon (< 1%). Forty-one patients had a documented infection (positive culture) with a gram-negative organism. Of these, 17 received therapy with a single antibiotic and 24 received therapy with two antibiotics. Despite similar illness severity, there were six deaths in the former group and only two in the latter.
Anti-Bacterial Agents↗
The accuracy and completeness of childhood cancer registration in New Zealand.
The New Zealand Cancer Registry (NZCR) is the main source of data on cancer incidence in New Zealand. The accuracy and completeness of registration of childhood cancers (ages zero to 14 years) were assessed during the conduct of a case-control study. Newly diagnosed children (1990-93) were ascertained from three sources: the NZCR; the Patient Management System (hospital admissions and discharges); and the separate Children's Cancer Registry. Pathology reviews were conducted to verify the diagnoses. Capture-recapture methods were used to assess the completeness of ascertainment. During the four-year period, 409 incident cases of childhood cancer were confirmed, giving an age-standardized incidence rate of 131 per million person-years (95 percent confidence interval = 119-144). The NZCR ascertained 395 (97 percent) of these children. In addition, the NZCR notified us of 43 other 'childhood cancer' registrations which were not confirmed as new cases of childhood cancer according to our eligibility criteria. The main reasons for these were coding errors (20 registrations), duplicates (seven), and a change in the pathological diagnosis as a result of the pathology review (seven). The capture-recapture estimate of the total number of incident cases was 410. Overall, the NZCR had good completeness for childhood cancers, but the number of unconfirmed registrations was larger than expected.
Adolescent↗