Preventing upper respiratory tract infections with prophylactic nasal carrageenan: a feasibility study.

Aim: To observe upper respiratory tract infection (URTI) symptoms, rhinovirus levels and compliance with daily carrageenan nasal spray. Methods: 102 adults were randomized to carrageenan or saline placebo three times daily for 8 weeks and URTI symptoms were recorded. A control group (n = 42) only recorded URTI symptoms. Participants collected nasal swabs when symptomatic. Results: Regular daily carrageenan prophylaxis resulted in consistent but nonsignificant reductions in URTI symptoms versus the placebo group. Saline placebo decreased and increased some cold symptoms compared with no treatment. Conclusion: Daily prophylactic administration of antiviral carrageenan may not significantly reduce URTI symptoms. Due to low compliance, use in a population with specific reasons to avoid URTIs may be more appropriate. Disease-specific outcomes may be more useful than symptom reporting.

Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children.

BACKGROUND: Residential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children. METHODS: Using a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data. RESULTS: Half of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12). CONCLUSION: This study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.

Stocktake of Australasian Psychiatry's training resources.

OBJECTIVE: To identify all past publications from Australasian Psychiatry with subject matter particularly relevant for trainees. The results of such a search could then be collated into an easily accessible resource available to trainees and their supervisors. METHOD: An electronic search of the journal's back catalogue was conducted. RESULTS: Eighty-seven articles published on subjects particularly relevant for trainees were discovered from within Australasian Psychiatry. In particular, multiple useful resources were identified on the topics of the scholarly project and formulation skills. CONCLUSIONS: Australasian Psychiatry has published a wealth of literature that is likely to be of significant benefit for trainees as they work their way through the Royal Australian and New Zealand College of Psychiatrists training programme.

Ethnically Disparate Disease Progression and Outcomes among Acute Rheumatic Fever Patients in New Zealand, 1989-2015.

We investigated outcomes for patients born after 1983 and hospitalized with initial acute rheumatic fever (ARF) in New Zealand during 1989-2012. We linked ARF progression outcome data (recurrent hospitalization for ARF, hospitalization for rheumatic heart disease [RHD], and death from circulatory causes) for 1989-2015. Retrospective analysis identified initial RHD patients <40 years of age who were hospitalized during 2010-2015 and previously hospitalized for ARF. Most (86.4%) of the 2,182 initial ARF patients did not experience disease progression by the end of 2015. Progression probability after 26.8 years of theoretical follow-up was 24.0%; probability of death, 1.0%. Progression was more rapid and ≈2 times more likely for indigenous Maori or Pacific Islander patients. Of 435 initial RHD patients, 82.2% had not been previously hospitalized for ARF. This young cohort demonstrated low mortality rates but considerable illness, especially among underserved populations. A national patient register could help monitor, prevent, and reduce ARF progression.

Residential mobility for a national cohort of New Zealand-born children by area socioeconomic deprivation level and ethnic group.

OBJECTIVES: The aims of this study are to describe area deprivation levels and changes that occur during residential moves involving New Zealand children from birth to their fourth birthday, and to assess whether these changes vary by ethnicity. DESIGN: Longitudinal administrative data. SETTING: Children born in New Zealand from 2004 to 2018. PARTICIPANTS: All (565 689) children born in New Zealand with at least one recorded residential move. OUTCOME MEASURES: A longitudinal data set was created containing lifetime address histories for our cohort. This was linked to the New Zealand Deprivation Index, a measure of small area deprivation. Counts of moves from each deprivation level to each other deprivation level were used to construct transition matrices. RESULTS: Children most commonly moved to an area with the same level of deprivation. This was especially pronounced in the most and least deprived areas. The number of moves observed also increased with deprivation. Maori and Pasifika children were less likely to move to, or remain in low-deprivation areas, and more likely to move to high-deprivation areas. They also had disproportionately high numbers of moves. CONCLUSION: While there was evidence of mobility between deprivation levels, the most common outcome of a move was no change in area deprivation. The most deprived areas had the highest number of moves. Maori and Pasifika children were over-represented in high-deprivation areas and under-represented in low-deprivation areas. They also moved more frequently than the overall population of 0 to 3 year olds.

Neurobiology and Therapeutic Potential of Cyclooxygenase-2 (COX-2) Inhibitors for Inflammation in Neuropsychiatric Disorders.

Neuropsychiatric disorders, such as depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and neurodevelopmental disorders such as autism spectrum disorder, are associated with significant illness burden. Accumulating evidence supports an association between these disorders and inflammation. Consequently, anti-inflammatory agents, such as the cyclooxygenase-2 inhibitors, represent a novel avenue to prevent and treat neuropsychiatric illness. In this paper, we first review the role of inflammation in psychiatric pathophysiology including inflammatory cytokines' influence on neurotransmitters, the hypothalamic-pituitary-adrenal axis, and microglial mechanisms. We then discuss how cyclooxygenase-2-inhibitors influence these pathways with potential therapeutic benefit, with a focus on celecoxib, due to its superior safety profile. A search was conducted in PubMed, Embase, and PsychINFO databases, in addition to Clinicaltrials.gov and the Stanley Medical Research Institute trial registries. The results were presented as a narrative review. Currently available outcomes for randomized controlled trials up to November 2017 are also discussed. The evidence reviewed here suggests cyclooxygenase-2 inhibitors, and in particular celecoxib, may indeed assist in treating the symptoms of neuropsychiatric disorders; however, further studies are required to assess appropriate illness stage-related indication.

Residential mobility and socioemotional and behavioural difficulties in a preschool population cohort of New Zealand children.

BACKGROUND: Findings regarding early residential mobility and increased risk for socioemotional and behavioural (SEB) difficulties in preschool children are mixed, with some studies finding no evidence of an association once known covariates are controlled for. Our aim was to investigate residential mobility and SEB difficulties in a population cohort of New Zealand (NZ) children. METHODS: Data from the Integrated Data Infrastructure were examined for 313 164 children born in NZ since 2004 who had completed the Before School Check at 4 years of age. Residential mobility was determined from address data. SEB difficulty scores were obtained from the Strengths and Difficulties Questionnaire administered as part of the Before School Check. RESULTS: The prevalence of residential mobility was 69%; 12% of children had moved ≥4 times. A linear association between residential mobility and increased SEB difficulties was found (B=0.58), which remained robust when controlling for several known covariates. Moves >10 km and moving to areas of higher socioeconomic deprivation were associated with increased SEB difficulties (B=0.08 and B=0.09, respectively), while residential mobility before 2 years of age was not. Children exposed to greater residential mobility were 8% more likely to obtain SEB difficulties scores of clinical concern than children exposed to fewer moves (adjusted OR 1.08). CONCLUSION: This study found a linear association between residential mobility and increased SEB difficulties in young children. This result highlights the need to consider residential mobility as a risk factor for SEB difficulties in the preschool years.