Initial insights on the impact of COVID-19 on boat-based recreational fishing in Western Australia.

The COVID-19 global pandemic and subsequent implementation of measures to reduce contact within the community have affected fisheries worldwide, yet few studies have reported the impacts on recreational fisheries. This study investigates boat-based recreational fishing in Western Australia from March to August 2020, where COVID-19 measures relevant to recreational fishers included various travel restrictions, and social and physical distancing measures. Information from surveys of licensed recreational fishers and fisheries compliance officers, and camera footage from key boat ramps is presented. A lower proportion of Perth metropolitan fishers went fishing compared with regional fishers. Metropolitan fishers also reported fewer days fished and lower participation in demersal and shore-based line fishing than regional fishers. In contrast, compliance officers observed more fishing activity in both metropolitan and regional locations. Fishing plans were mostly affected by travel restrictions with more metropolitan fishers affected compared with regional fishers. Daily recreational vessel retrievals at key boat ramps varied between locations, with metropolitan fishers initially unable to travel to regional centres. There was no decline in vessel retrievals at metropolitan boat ramps during the most rigid restrictions and northern regional boat ramps experienced substantial increases in recreational vessel activity once travel restrictions eased. Studies of this kind highlight the value of utilising established recreational fishing monitoring programmes to provide a responsive and scientific basis for policymakers to address societal behavioural changes associated with atypical events such as COVID-19.

Emergency department crowding is not being caused by increased inappropriate presentations.

Contrary to the prevailing wisdom, there may be little or no room to move with respect to reducing emergency department (ED) utilisation, as ED utilisation in Aotearoa New Zealand is low by world standards and is not driven by patients presenting inappropriately with minor conditions. We should continue the excellent work done in the primary care sector to maintain our low ED presentation rate and support primary and urgent care providers to provide alternatives to the ED for people with minor conditions. However, to reduce the system pressure and harms caused by ED crowding due to access block for admitted patients, we also need to adequately resource our hospital-based inpatient teams and EDs so that the (appropriate) acute care workload can be managed safely.

Potential unmet need for gout diagnosis and treatment: capture-recapture analysis of a national administrative dataset.

OBJECTIVE: To estimate the degree of undercount of people diagnosed with gout in administrative datasets using capture-recapture methods. METHODS: Hospitalization and drug dispensing claims (allopurinol or colchicine) data for all Aotearoa New Zealand were used to estimate the prevalence of gout in 2009 (n = 4 295 296). As a comparison, we calculated gout prevalence using a large primary care dataset using general practitioner diagnosis and prescribing records (n = 555 313). For each of these datasets, we estimated the undercount through capture-recapture analysis using a Poisson regression model. A two-list model was used, which included covariates such as age, gender, ethnic groups and New Zealand deprivation quintiles. RESULTS: The crude prevalence of diagnosed gout in the Aotearoa New Zealand population aged ≥ 20 years was 3.75%. The covariate-adjusted capture-recapture estimate of those not recorded but likely to have gout was 0.92%, giving an overall estimated prevalence of 4.67% (95% CI 4.49, 4.90%) for the population aged ≥ 20 years. This amounts to 80% of people with gout being identified by the algorithm for the Aotearoa New Zealand data-that is being recorded in either lists of dispensing of allopurinol or colchicine or hospital discharge. After capture-recapture, gout prevalence for all males aged ≥ 20 years was 7.3% and in older (≥ 65 years) Maori and Pacific men was >30%. CONCLUSION: Capture-recapture analysis of administrative datasets provides a readily available method for estimating an aspect of unmet need in the population-in this instance potentially 20% of those with gout not being identified and treated specifically for this condition.

National prevalence of gout derived from administrative health data in Aotearoa New Zealand.

OBJECTIVE: Previous small studies in Aotearoa New Zealand have indicated a high prevalence of gout. This study sought to determine the prevalence of gout in the entire Aotearoa New Zealand population using national-level health data sets. METHODS: We used hospitalization and drug dispensing claims for allopurinol and colchicine for the entire Aotearoa New Zealand population from the Aotearoa New Zealand Health Tracker (ANZHT) to estimate the prevalence of gout in 2009, stratified by age, gender, ethnicity and socio-economic status (n = 4 295 296). RESULTS: were compared with those obtained from an independent large primary care data set (HealthStat, n = 555 313). Results. The all-ages crude prevalence of diagnosed gout in the ANZHT population was 2.69%. A similar prevalence of 2.89% was observed in the HealthStat population standardized to the ANZHT population for age, gender, ethnicity and deprivation. Analysis of the ANZHT population showed that gout was more common in Maori and Pacific people [relative risk (RR) 3.11 and 3.59, respectively], in males (RR 3.58), in those living in the most socio-economically deprived areas (RR 1.41) and in those aged >65 years (RR >40) (P-value for all <0.0001). The prevalence of gout in elderly Maori and Pacific men was particularly high at >25%. CONCLUSION: Applying algorithms to national administrative data sets provides a readily available method for estimating the prevalence of a chronic condition such as gout, where diagnosis and drug treatment are relatively specific for this disease. We have demonstrated high gout prevalence in the entire Aotearoa New Zealand population, particularly among Maori and Pacific people.

Statin use in COPD patients is associated with a reduction in mortality: a national cohort study.

AIMS: To assess whether statin use is associated with reduced mortality in patients with chronic obstructive pulmonary disease (COPD). METHODS: Hospitalisation, drug dispensing, and mortality records were linked for New Zealanders aged 50-80 years discharged from hospital with a first admission with COPD in 2006. Patients were classified according to whether or not they were prescribed statins prior to admission. Baseline characteristics were compared and hazard ratios calculated for statin users versus statin non-users for all-cause mortality over follow-up of up to 4 years. RESULTS: A total of 1,687 patients (mean age 70.6 years) were followed, including 596 statin users and 1,091 non-users. There were more men in the statin user group (58.4% vs. 48.5%), and statin users were more likely to have a history of cardiovascular disease (58.6% vs. 25.1%), prescription for frusemide as a proxy for heart failure (47.7% vs. 24.5%) or diabetes (35.4% vs.11.6%) than statin non-users (p<0.001). A total of 671 deaths occurred during the follow-up period. After adjustment for age, sex, ethnic group, history of cardiovascular disease, diabetes, and prescription for frusemide, the hazard ratio for statin users vs. statin non-users for all-cause mortality was 0.69 (95% CI 0.58 to 0.84). CONCLUSIONS: Statin use is associated with a 30% reduction in all-cause mortality at 3-4 years after first admission for COPD, irrespective of a past history of cardiovascular disease and diabetes.

Retrospective review of abdominal aortic aneurysm deaths in New Zealand: what proportion of deaths is potentially preventable by a screening programme in the contemporary setting?

OBJECTIVES: To describe the proportions of people dying from abdominal aortic aneurysm (AAA) who might have benefited from a formal screening programme for AAA. DESIGN: Retrospective cross-sectional review of deaths. SETTING AND STUDY POPULATIONS: All AAA deaths registered in New Zealand from 2010 to 2014 in the absence of a national AAA screening programme. MAIN OUTCOME MEASURES: Known history of AAA prior to the acute event leading to AAA death, prognosis limiting comorbidities, history of prior abdominal imaging and a validated multimorbidity measure (M3-index scores). RESULTS: 1094 AAA deaths were registered in the 5 years between 2010 and 2014 in New Zealand. Prior to the acute AAA event resulting in death, 31.3% of the cohort had a known AAA diagnosis, and 10.9% had a previous AAA procedure. On average, the AAA diagnosis was known 3.7 years prior to death. At least 77% of the people dying from AAA also had one or more other prognosis limiting diagnosis. The hazard of 1-year mortality associated with the non-AAA related comorbidities for the AAA cohort aged 65 or above were 1.5-2.6 times higher than to the age matched general population based on M3-index scores. In 2014, overall AAA deaths accounted for only 0.7% of total deaths, and 1.0% of deaths among men aged 65 or above in New Zealand. At most, 20% of people dying from AAA in New Zealand between 2010 and 2014 might have had the potential to derive full benefit from a screening programme. About 51% of cases would have derived no or very limited benefit from a screening programme. CONCLUSION: Falling AAA mortality, and high prevalence of competing comorbidities and/or prior AAA diagnosis and procedure raises the question about the likely value of a national AAA screening programme in a country such as New Zealand.

Molecular tools for identification of shark species involved in depredation incidents in Western Australian fisheries.

Shark depredation is an issue of concern in some Western Australian recreational and commercial fisheries where it can have economic, social and ecological consequences. Knowledge of the shark species involved is fundamental to developing effective management strategies to mitigate the impacts of depredation. Identification of the species responsible is difficult as direct observation of depredation events is uncommon and evaluating bite marks on fish has a high degree of uncertainty. The use of trace DNA techniques has provided an alternative method for species identification. We demonstrate proof of concept for a targeted DNA barcoding approach to identify shark species using trace DNA found at bite marks on recovered remains of hooked fish. Following laboratory validation, forensic analysis of swabs collected from samples of bitten demersal fish, led to the definitive identification of shark species involved in 100% of the incidences of depredation (n = 16).

Family characteristics have limited ability to predict weight status of young children.

The ability of (a) family characteristics (marital status, income, race, and education), (b) parental control over child's food intake, and (c) parental belief in causes of overweight to predict weight status of children was assessed. Parents/caretakers of elementary school-aged children were surveyed to determine attitudes related to childhood nutrition and overweight. Anthropometric measurements were obtained from children to determine weight status (n=169 matched surveys and measurements). chi(2) tests and nested logistic regression models were used to determine relationships between children's weight status and family characteristics, parental control, and parental belief in the primary cause of overweight. Low household income was an important predictor of overweight; marital status and race added no further explanatory power to the model. Parental control was not a significant predictor of overweight. Parental belief in the primary cause of overweight in children (diet vs physical activity) was significantly related to children's weight; however, it was not significant after controlling for income. Low household income relates strongly to increased childhood weight status; therefore, school and government policies should promote an environment that supports affordable, safe, and feasible opportunities for healthful nutrition and physical activity, particularly for low-income audiences.

Co-occurrence and clustering of tobacco use and obesity in New Zealand: cross-sectional analysis.

OBJECTIVE: To describe the co-occurrence and clustering/aversion of tobacco use and obesity in New Zealand. METHOD: Data were sourced from the 2002/03 New Zealand Health Survey, a nationally representative household survey that included measured body mass index (BMI) and self-reported smoking status. The association of cigarette smoking, obesity, and the combination of these risk factors with socio-demographic variables was analysed by multiple logistic regression. Clustering/aversion (defined as observed prevalence of [smoking + obesity] > or < expected prevalence, where expected prevalence = prevalence of [smoking] x prevalence of [obesity]) was also estimated. RESULTS: The joint prevalence of smoking plus obesity in the adult population (15+ years) was 4.5%. However, this was 10% for Maori and 8.5% for deprivation quintile 5. Adjusting for relevant covariates, Maori were twice as likely to have both risk factors as non-Maori. A smooth deprivation gradient was found, with deprivation quintile 1 (least deprived) only one-fifth as likely to have both risk factors as quintile 5 (most deprived). There was no evidence of clustering, and aversion (negative clustering) was demonstrated only for middle-aged adults and for Maori. DISCUSSION: Since smoking cessation is associated with weight gain, substantial aversion might have been expected across all subgroups, yet this was not found. The most likely explanations are that the extent of weight gain associated with smoking cessation has been overestimated or is often not sustained. Even so, health promotion and clinical interventions need to take the dually exposed population into account, addressing not only the unhealthy behaviours themselves but also the social context in which dual exposure occurs.

Do healthy and unhealthy behaviours cluster in New Zealand?

OBJECTIVE: To describe the co-occurrence and clustering of healthy and unhealthy behaviours in New Zealand. METHOD: Data were sourced from the 2002/03 New Zealand Health Survey. Behaviours selected for analysis were tobacco use, quantity and pattern of alcohol consumption, level of physical activity, and intake of fruit and vegetables. Clustering was defined as co-prevalence of behaviours greater than that expected based on the laws of probability. Co-occurrence was examined using multiple logistic regression modelling, while clustering was examined in a stratified analysis using age and (where appropriate) ethnic standardisation for confounding control. RESULTS: Approximately 29% of adults enjoyed a healthy lifestyle characterised by non-use of tobacco, non- or safe use of alcohol, sufficient physical activity and adequate fruit and vegetable intake. This is only slightly greater than the prevalence expected if all four behaviours were independently distributed through the population i.e. little clustering of healthy behaviours was found. By contrast, 1.5% of adults exhibited all four unhealthy behaviours and 13% exhibited any combination of three of the four unhealthy behaviours. Unhealthy behaviours were more clustered than healthy behaviours, yet Maori exhibited less clustering of unhealthy behaviours than other ethnic groups and no deprivation gradient was seen in clustering. DISCUSSION: The relative lack of clustering of healthy behaviours supports single issue universal health promotion strategies at the population level. Our results also support targeted interventions at the clinical level for the 15% with 'unhealthy lifestyles'. Our finding of only limited clustering of unhealthy behaviours among Maori and no deprivation gradient suggests that clustering does not contribute to the greater burden of disease experienced by these groups.

Measures of expressions of love.

This study developed scales for Chapman's five expressions of love: quality time, receiving gifts, words of affirmation, physical touch, and acts of service (two dimensions). A total of 338 student respondents were surveyed resulting in 321 usable surveys (95%). Of this total, 177 were women and 144 men, with a median age of 24 yr.

Congenital cholesteatoma: theories, facts, and 53 patients.

Congenital cholesteatoma has a different pathophysiology than acquired cholesteatoma in that these patients rarely have eustachian tube dysfunction. This likely accounts for their reasonable preoperative hearing and their lack of complications or recurrences postoperatively. The most important factor is early detection. Treatment remains surgical removal.

Accuracy and efficiency of detection dogs: a powerful new tool for koala conservation and management.

Accurate data on presence/absence and spatial distribution for fauna species is key to their conservation. Collecting such data, however, can be time consuming, laborious and costly, in particular for fauna species characterised by low densities, large home ranges, cryptic or elusive behaviour. For such species, including koalas (Phascolarctos cinereus), indicators of species presence can be a useful shortcut: faecal pellets (scats), for instance, are widely used. Scat surveys are not without their difficulties and often contain a high false negative rate. We used experimental and field-based trials to investigate the accuracy and efficiency of the first dog specifically trained for koala scats. The detection dog consistently out-performed human-only teams. Off-leash, the dog detection rate was 100%. The dog was also 19 times more efficient than current scat survey methods and 153% more accurate (the dog found koala scats where the human-only team did not). This clearly demonstrates that the use of detection dogs decreases false negatives and survey time, thus allowing for a significant improvement in the quality and quantity of data collection. Given these unequivocal results, we argue that to improve koala conservation, detection dog surveys for koala scats could in the future replace human-only teams.

ER function in the adult male rat: short- and long-term effects of the antiestrogen ICI 182,780 on the testis and efferent ductules, without changes in testosterone.

Male rats, 30 d old, were treated with the antiestrogen ICI 182,780 (3-150 d) to determine sequences of events leading to testicular atrophy and infertility. Plasma testosterone and LH concentrations were unchanged. ICI 182,780 induced dilation of efferent ductules as early as 3 d post treatment, and the dilation increased over time, resulting in an overall increase of 200% in tubule diameter. A gradual reduction in height of the ductule epithelium was observed; however, the microvilli height increased up to d 73 but subsequently decreased. A transient increase in lysosomes in nonciliated cells was seen from d 15 to d 100. Testicular weight increased by d 45 and seminiferous tubules were dilated by d 52. These effects on testes persisted until d 100, but on d 150 the weight decreased and severe atrophy was observed. These testicular effects were probably owing to accumulation of fluid following inhibition of reabsorption in the efferent ductules, similar to the ER-alpha knockout mouse. In agreement with this conclusion, there was a decrease in Na+-H+ exchanger-3 mRNA and protein, which is consistent with previous studies showing that ER is required for expression of Na+-H+ exchanger-3 and ultimately fluid reabsorption in the efferent ductules.

Regulation of Sertoli cell number and activity by follicle-stimulating hormone and androgen during postnatal development in the mouse.

The roles of FSH and androgen in the postnatal development of Sertoli cell number and function have been investigated using mice that lack FSH (FSHbetaKO), FSH-receptors (FSHRKO), or androgen receptors (Tfm). At birth and d 5, Sertoli cell number was normal in FSHRKO and FSHbetaKO mice, but was significantly reduced on d 20 and in adulthood. In contrast, Sertoli cell number was reduced at birth in Tfm mice and remained significantly less than normal up to adulthood. Sertoli cell activity was determined through measurement of 11 different mRNA transcript levels. From birth to adulthood, the expression of most transcripts increased, with a significant rise occurring between d 5 and 10. In animals lacking FSH stimulation, mRNA expression (measured per Sertoli cell) was largely normal on d 5, but was reduced in seven transcripts on d 20 and in five transcripts at adulthood. In Tfm mice two transcripts showed reduced expression on d 5, and four were reduced on d 20, although expression in adult Tfm mice did not differ from that in normal cryptorchid controls. The results show that 1) testosterone, but not FSH, is required for Sertoli cell proliferation during fetal and early neonatal life; 2) FSH and testosterone both regulate the late stages of Sertoli cell proliferation; 3) FSH has a general trophic effect on Sertoli cell activity in the pubertal and adult mouse; and 4) androgens are required for specific transcript expression during prepubertal development. Specific effects of androgens were not seen in the adult, although these may be masked by the effects of cryptorchidism.

The GABA(B) antagonist CGP 52432 attenuates the stimulatory effect of the GABA(B) agonist SKF 97541 on luteinizing hormone secretion in the male sheep.

The objectives of this study were to determine if the gamma-aminobutyric acid (GABA)(B) agonist, 3-aminopropyl (methyl) phosphinic acid (SKF97541), would increase luteinizing hormone (LH) secretion when infused by microdialysis into the medial basal hypothalamus (MBH) of the castrated ram, and to determine if the action of SKF97541 would be attenuated by co-infusion of the GABA(B) antagonist CGP52432. Initial experiments established that infusion of SKF alone, at concentrations as low as 5 microM, increased mean LH, LH pulse amplitude, and in some cases, pulse interval. In the last experiment, animals were treated with artificial cerebrospinal fluid (CSF) alone, SKF alone (30 microM), 3-[[(3, 4-dichlorophenol) methyl] amino] propyl] diethoxymethyl) phosphinic acid (CGP) alone (500 microM), or SKF plus CGP. SKF increased both mean LH and LH pulse amplitude as compared with CSF. CGP alone had no significant effect on LH, but it attenuated the effect of SKF on mean LH. These observations indicate that the stimulatory effects of GABA(B) agonists on LH pulse patterns are mediated through GABA(B) receptors and provide further evidence that GABA(B) receptors located in the MBH can regulate pulsatile GnRH-LH release.

Customers' perceptions of salespersons' orientation and susceptibility to salespersons' influence.

This study examined correlations of scores for salespersons' and customers' orientation, as indicated by a modified Salesperson Orientation-Customer Orientation scale, with self-reported consumers' susceptibility to salespersons' information, recommendations, and relational influence. Vehicle purchasers provided 508 useable survey responses. Correlations for customers' perceptions of both salespersons' orientation (-.39 and -.21) and customers' orientation (.39 and .24) were related to self-reports of susceptibility to salespersons' information and relational influence.

Variation in benzodiazepine and antipsychotic use in people aged 65 years and over in New Zealand.

AIMS: To examine the variation in the dispensing of antipsychotic and benzodiazepine medicines in the elderly (aged 65+) across New Zealand. METHODS: Data drawn from the New Zealand Pharmaceutical Collection for the New Zealand Atlas of Healthcare Variation was used to establish a regression model to examine dispensing rates by age, gender, district health board (DHB) of domicile and aged residential care usage rates over a 4 year period 2008/09 to 2011/12. RESULTS: On average 24 per 1000 people aged 65+ in New Zealand were dispensed an antipsychotic in any given quarter. Benzodiazepine dispensing rates were even higher, at 109 per 1000 aged 65+. Both rates climbed steeply with age, were higher in females, and had a 1.6 to 1.8 fold variation across DHBs. Rates did not vary significantly with rest home and private hospital residential care usage, but antipsychotic rates appeared related to the use of psychogeriatric and dementia beds. CONCLUSION: Given the evident harms associated with the use of antipsychotic and benzodiazepine medicines in the elderly, and the relatively poor efficacy of antipsychotics in dementia care, prescribing of these medicines should be reassessed. DHBs should examine the causes of the high rates in their area and design interventions to reduce the rates.

Variation in gout care in Aotearoa New Zealand: a national analysis of quality markers.

AIM: To examine whether there was variation in markers for the quality of gout care using national linked data for the entire Aotearoa New Zealand population. METHOD: Data drawn for the New Zealand Atlas of Healthcare Variation was used to examine regularity of allopurinol dispensing, laboratory testing for serum urate, and acute hospitalisation for gout. Standardised rates by age, gender, ethnicity and District Health Board (DHB) of domicile were calculated. RESULTS: For New Zealanders aged 20-79 years with gout, 57% were dispensed allopurinol in 2010/11. Of these, 69% were receiving allopurinol regularly, and only 34% of people dispensed allopurinol had serum urate testing in a 6-month period. The annual hospitalisation rate was 1% of people with gout. Maori and Pacific people with gout were less likely to be on regular allopurinol treatment, despite having more than twice the chance of being hospitalised with acute gout. CONCLUSION: We have demonstrated that routinely collected health data can be used to monitor the quality of care for people with gout at a high level. Primary care initiatives that focus on ensuring a continuous supply of urate-lowering therapy to achieve therapeutic serum urate targets are required to improve the impact of gout in Aotearoa New Zealand.

The future of population registers: linking routine health datasets to assess a population's current glycaemic status for quality improvement.

OBJECTIVES: To determine the diabetes screening levels and known glycaemic status of all individuals by age, gender and ethnicity within a defined geographic location in a timely and consistent way to potentially facilitate systematic disease prevention and management. DESIGN: Retrospective observational study. SETTING: Auckland region of New Zealand. PARTICIPANTS: 1 475 347 people who had utilised publicly funded health service in New Zealand and domicile in the Auckland region of New Zealand in 2010. The health service utilisation population was individually linked to a comprehensive regional laboratory repository dating back to 2004. OUTCOME MEASURES: The two outcomes measures were glycaemia-related blood testing coverage (glycated haemoglobin (HbA1c), fasting and random glucose and glucose tolerance tests), and the proportions and number of people with known dysglycaemia in 2010 using modified American Diabetes Association (ADA) and WHO criteria. RESULTS: Within the health service utilisation population, 792 560 people had had at least one glucose or HbA1c blood test in the previous 5.5 years. Overall, 81% of males (n=198 086) and 87% of females (n=128 982) in the recommended age groups for diabetes screening had a blood test to assess their glycaemic status. The estimated age-standardised prevalence of dysglycaemia was highest in people of Pacific Island ethnicity at 11.4% (95% CI 11.2% to 11.5%) for males and 11.6% (11.4% to 11.8%) for females, followed closely by people of Indian ethnicity at 10.8% (10.6% to 11.1%) and 9.3% (9.1% to 9.6%), respectively. Among the indigenous Maori population, the prevalence was 8.2% (7.9% to 8.4%) and 7% (6.8% to 7.2%), while for 'Others' (mainly Europeans) it was 3% (3% to 3.1%) and 2.2% (2.1% to 2.2%), respectively. CONCLUSIONS: We have demonstrated that the data linkage between a laboratory repository and national administrative datasets has the potential to provide a systematic and consistent individual level clinical information that is relevant to medical auditing for a large geographically defined population.