Companion Animal Fostering as Health Promotion: A Literature Review.

There is growing interest in the health-promoting potential of human-companion animal relationships from a broad public health perspective while acknowledging barriers to ownership, particularly for older adults. Companion animal fostering is an alternative to pet ownership that aligns with the Ottawa Charter health promotion principle that caring for others in everyday settings promotes health. This narrative review of the literature on companion animal fostering draws on Te Whare Tapa Wha (the four-sided house), an indigenous model of health that is influential in Aotearoa/New Zealand, and the Ottawa Charter. We found that companion animal fostering can be considered health-promoting for human and non-human animals, using a broad and multidimensional understanding of health. As well as improving the long-term outcomes for homeless animals, companion animal fostering has the potential to promote the health of the individuals, families, and communities who provide foster homes. Our review highlights the importance of health promoters considering the reciprocal relationship between human and animal health. Future research should explore different aspects of human and non-human health, perspectives of different types of fosterers in different settings and communities, barriers to fostering, and methods that explore the role of caring for a wider range of companion animals in creating and sustaining wellbeing.

Toitu te Tiriti: A Tiriti o Waitangi-led Approach to Public Health Curriculum Development.

At Te Kunenga ki Purehuroa (Massey University), Aotearoa New Zealand, we have declared our stance as a Te Tiriti o Waitangi-led institution. This necessitates the embodiment and enactment of the principles and provisions of Te Tiriti o Waitangi and the embedding of Indigenous Maori knowledge, values and belief systems in curriculum design and implementation. This article outlines the beginning of our journey toward indigenizing our postgraduate public health curriculum at Te Kunenga ki Purehuroa. We describe the redevelopment of the Master of Public Health curriculum that embeds matauranga Maori (Maori knowledge), te reo Maori (Maori language), tikanga Maori (Maori values and belief systems), and Maori pedagogy (culturally sustaining teaching and learning practices). Here, we focus on how curriculum redevelopment and pedagogy have enabled the utility of Maori knowledge and processes to be reflected at every level of the program and give life and relevancy to Te Tiriti o Waitangi. Te Tiriti o Waitangi guides our teaching practice and ensures that students can safely develop their confidence in Maori ways of knowing, being, and doing to effectively partner with Maori as Tangata Whenua. Our program aims to produce agentic graduates who are champions and advocates for Maori aspirations in health.

Breast and Cervical Cancer Screening in Palau: Have We Improved Early Detection and Survival?

The Breast and Cervical Cancer Early Detection Program (BCCEDP) was first introduced in Palau in 1997. The program's aim is to recruit and screen women for early detection of breast and cervical cancers. An assessment of this screening program was conducted to evaluate its effectiveness, including impact on stage of diagnosis and survival time of patients diagnosed with breast and cervical cancers through both screening and clinical diagnosis. A retrospective cohort study using secondary data from 2004-2013 was conducted. There were 45 women diagnosed with breast or cervical cancer. Due to the small number of cases, a comparison of two time periods was made (2004-2008) and (2009-2013). There were more cancer cases detected through screening (26%) in the earlier time period (2004-2008), as compared to those diagnosed through screening (8%) in the later time period (2009-2013), though this difference was not statistically significant (P=.09). The proportion of breast and cervical cancers diagnosed at an earlier stage (0-3) may have decreased between the two time periods (42% to 23%, P=.3). A greater proportion of women who were diagnosed between 2004-2008 lived longer than 2 years (58%), than women who were diagnosed between 2009-2013 (39%; P=.23). The screening program has not shown improvement over the years despite the measures taken to detect the early onset of breast and cervical cancer, and survival outcomes in Palau remain poor.

Assessment of Gestational Diabetes and Associated Risk Factors and Outcomes in the Pacific Island Nation of Palau.

Objective Gestational diabetes mellitus (GDM) in Palau and across the Pacific Islands is a serious public health issue that is currently understudied. Methods This study was a retrospective cohort study that included 1730 women with a single live birth in Palau between January 2007 and December 2014. Results The overall prevalence of GDM among women in Palau was 5.5%. Women who were older (≥30 years) or obese (BMI ≥30) were more likely to have GDM than women who were younger (<30 years) or non-obese (BMI <30), respectively. When adverse birth outcomes were assessed, women with GDM were found to have significantly higher prevalence of high birth weight infants, cesarean sections, and neonatal deaths when compared to women without GDM. In fact, women with GDM were five times more likely to have a neonatal death than women without GDM (p = 0.008). Conclusion Reducing overall rates of obesity in the population could help reduce rates of diabetes and GDM in Palau. Based on this work, current practices for the identification, monitoring and treatment of women with GDM should be evaluated and strengthened in order to reduce neonatal mortality rates in Palau.

Absolute lymphocyte count is not a suitable alternative to CD4 count for determining initiation of antiretroviral therapy in fiji.

Introduction. An absolute lymphocyte count is commonly used as an alternative to a CD4 count to determine initiation of antiretroviral therapy for HIV-infected individuals in Fiji when a CD4 count is unavailable. Methods. We conducted a retrospective analysis of laboratory results of HIV-infected individuals registered at all HIV clinics in Fiji. Results. Paired absolute lymphocyte and CD4 counts were available for 101 HIV-infected individuals, and 96% had a CD4 count of ≤500 cells/mm(3). Correlation between the counts in individuals was poor (Spearman rank correlation r = 0.5). No absolute lymphocyte count could be determined in this population as a suitable surrogate for a CD4 count of either 350 cells/mm(3) or 500 cells/mm(3). The currently used absolute lymphocyte count of ≤2300 cells/µL had a positive predictive value of 87% but a negative predictive value of only 17% for a CD4 of ≤350 cells/mm(3) and if used as a surrogate for a CD4 of ≤500 cells/mm(3) it would result in all HIV-infected individuals receiving ART including those not yet eligible. Weight, CD4 count, and absolute lymphocyte count increased significantly at 3 months following ART initiation. Conclusions. Our findings do not support the use of absolute lymphocyte count to determine antiretroviral therapy initiation in Fiji.

Delivering a safe and effective strain-specific vaccine to control an epidemic of group B meningococcal disease.

In response to a devastating group B meningococcal disease epidemic in New Zealand, a case was prepared for new health funding and a new outer membrane vesicle vaccine, MeNZB, developed. Following clinical trials demonstrating satisfactory immunogenicity and safety profiles a national implementation strategy was prepared. MeNZB was introduced halfway through the 14th year of the epidemic with a campaign targeting children and young people aged under 20 years delivered over 2 years. By its completion in June 2006, the vaccine had been delivered to more than 1 million young people. All of the above steps were achieved within 5 years. This unique endeavour was possible due to a private/public partnership between the New Zealand Ministry of Health and Chiron Vaccines. This paper summarises the outcomes of this campaign including coverage levels achieved, evidence of vaccine effectiveness and safety, and the strategies used to manage key events and risks that emerged during the campaign.