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1.
Mar Environ Res ; 163: 105218, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33385975

RESUMEN

The distribution of benthic ecosystems, dominated by filter-feeding communities, is highly influenced by the seabed geomorphology. However, the spatial variation in settlement of these species is also affected by near-bottom currents and any changes in light, nutrient concentration and food quality often associated with increases of suspended sediment concentrations within the water column. Detailed predictions of the geographic distribution of filter-feeder species and a deeper understanding of the physical processes influencing their distribution patterns is key for effective management and conservation. To date, predictive distribution modelling has been derived essentially from geomorphological parameters, mainly using spatially limited observations. In this study, seabed mapping, oceanographic modelling, hydrographic records and biological observations are integrated to provide high-resolution prediction of filter-feeder habitat distribution within Queen Charlotte Sound/Totaranui and Tory Channel/Kura Te Au, South Island of New Zealand. The aim is to evaluate potential suitable habitat areas for filter-feeders to inform where habitat restoration management should focus efforts to recover communities such as the horse mussel (Atrina zelandica) or the green-lipped mussel (Perna canaliculus), both of which have high economic impact in New Zealand. To accomplish this, Maximum Entropy (MaxEnt) predictive modelling was used to produce Habitat Suitability (HS) maps, using geomorphological parameters and seafloor classification information. Final HS maps also incorporated oceanographic and sediment dynamic information, showing that filter-feeder habitat distribution is highly influenced by the hydrodynamics and sedimentary processes apart from the seafloor geomorphology. Filter-feeder communities inhabit quiescent areas, limited by depth, slope and sediment type; and coincide with regions presenting low near-bottom currents and low turbidity levels. Additionally, the obtained results reveal the effects of the coastal settlements and major marine traffic routes, limiting the suitable habitats to areas with less human impact. This study demonstrates that a multidisciplinary approach is crucial to better predict the spatial distribution of benthic communities, which is key to improve benthic habitat restoration and recovery assessments.


Asunto(s)
Organismos Acuáticos , Conservación de los Recursos Naturales , Ecosistema , Conducta Alimentaria , Nueva Zelanda
2.
J Environ Manage ; 279: 111715, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33387866

RESUMEN

Fishing cooperatives around the world have increasingly taken on co-management of commercial fisheries in recent decades, with generally positive results in meeting management targets and increasing economic value. To better understand which commercial fisheries or fleets are likely to form cooperative associations in the future, we utilized a database of management and fleet-level attributes for 106 fisheries-mainly industrial fisheries from the United States, New Zealand, Canada, and the United Kingdom-to develop a predictive model. We considered two alternative definitions of cooperatives: a legal, operational definition that classified 51 of the fisheries as cooperatives, and a more stringent proactive definition that classified 35 of the fisheries as cooperatives. Random forest classification analyses showed that cooperatives of both types were most likely to form in fisheries with greater boat cost, greater level of participation in industry associations, and in fisheries with bycatch limits; strong regional effects were also observed. Cross-validation prediction accuracy levels were high: using 10 predictor variables, 86% and 91% of fisheries were correctly classified under the operational and proactive cooperative definitions, respectively. These predictions suggest which fisheries may be next to create cooperative fishing associations or engage in more proactive arrangements within cooperatives. These results point to which regulatory reforms, such as flexible bycatch restrictions, could lead to more cooperative behavior in fisheries.


Asunto(s)
Conservación de los Recursos Naturales , Explotaciones Pesqueras , Canadá , Nueva Zelanda , Reino Unido
3.
Viruses ; 13(1)2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33430050

RESUMEN

Phylodynamic inference is a pivotal tool in understanding transmission dynamics of viral outbreaks. These analyses are strongly guided by the input of an epidemiological model as well as sequence data that must contain sufficient intersequence variability in order to be informative. These criteria, however, may not be met during the early stages of an outbreak. Here we investigate the impact of low diversity sequence data on phylodynamic inference using the birth-death and coalescent exponential models. Through our simulation study, estimating the molecular evolutionary rate required enough sequence diversity and is an essential first step for any phylodynamic inference. Following this, the birth-death model outperforms the coalescent exponential model in estimating epidemiological parameters, when faced with low diversity sequence data due to explicitly exploiting the sampling times. In contrast, the coalescent model requires additional samples and therefore variability in sequence data before accurate estimates can be obtained. These findings were also supported through our empirical data analyses of an Australian and a New Zealand cluster outbreaks of SARS-CoV-2. Overall, the birth-death model is more robust when applied to datasets with low sequence diversity given sampling is specified and this should be considered for future viral outbreak investigations.


Asunto(s)
/epidemiología , /genética , Australia/epidemiología , Teorema de Bayes , Simulación por Computador , Evolución Molecular , Humanos , Modelos Estadísticos , Nueva Zelanda/epidemiología , Pandemias , Filogenia , /aislamiento & purificación
4.
Food Chem ; 340: 127906, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-32890857

RESUMEN

Wine quality and character are defined in part by the terroir in which the grapes are grown. Metabolomic techniques, such as nuclear magnetic resonance (NMR) spectroscopy and inductively coupled plasma mass spectrometry (ICP-MS), are used to characterise wines and to detect wine fraud in other countries but have not been extensively trialled in Australia. This paper describes the use of ICP-MS and NMR to characterise a selection of Pinot noir wines. Wines from varying terroirs could be somewhat distinguished by their mineral content using principal component analysis (PCA). PCA was able to separate wines by their Australian states more clearly than by region. Metabolomic analysis of the wines using NMR did not find any correlations with climate/daytime temperatures, or region. An analysis of coinertia suggested that the two datasets were not redundant, and it is proposed that ICP-MS data is the most useful for determining regionality.


Asunto(s)
Análisis de los Alimentos/métodos , Espectroscopía de Resonancia Magnética/métodos , Espectrometría de Masas/métodos , Vino/análisis , Australia , Clima , Análisis de los Alimentos/estadística & datos numéricos , Metabolómica , Nueva Zelanda , Análisis de Componente Principal , Temperatura , Vitis/química , Vitis/metabolismo
5.
Health Commun ; 36(1): 109-115, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33222539

RESUMEN

Aotearoa New Zealand's public health crisis communication approach amidst the COVID-19 pandemic effectively mobilized the nation into swift lockdown, significantly reducing community transmission. This communication approach has been applauded around the world. How did communities situated amongst the "margins of the margins" in Aotearoa New Zealand navigate through the existing structural barriers to health during the pandemic? In this study, we use a culture-centered analysis to foreground the structural context of disenfranchisement amidst the COVID-19 lockdown. Drawing on in-depth interviews with participants in a larger ethnographic project on poverty and health across three communities in Aotearoa New Zealand, we attend to the ways in which health is negotiated amidst the COVID-19 outbreak and lockdown response at the "margins of the margins." The narratives point out that health communication interventions to prevent COVID-19 in the context of Aotearoa New Zealand furthered the marginalization of communities at the margins, and community voices were largely erased from the enactment of interventions. With the extant structures failing to recognize these aspects of everyday struggles of health at the margins, the health and access challenges were further magnified during COVID-19. Our attention to communication situated in relationship to structures builds a register for health communication scholarship in the context of COVID-19 that is committed to disrupting the behaviorally based hegemonic health communication literature and transforming the unequal terrains of health experiences.


Asunto(s)
/etnología , Control de Enfermedades Transmisibles/métodos , Pobreza/psicología , Pobreza/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antropología Cultural , Comunicación , Competencia Cultural , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Negociación , Nueva Zelanda/epidemiología , Grupo de Ascendencia Oceánica , Pandemias , Factores Socioeconómicos , Poblaciones Vulnerables , Adulto Joven
6.
Sci Total Environ ; 754: 142005, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33254893

RESUMEN

The first national survey of Emerging Organic Contaminants (EOCs) involved sampling 121 wells located throughout New Zealand and analysis for a suite of 29 EOCs. This survey was carried out in conjunction with the 2018 national survey of pesticides in groundwater, a survey that is conducted on a four-yearly basis which included the analysis of glyphosate for first time. A total of 227 EOCs were detected in the 85 wells (70%). There were 29 different EOCs in the analytical suite and 25 different EOCs were detected in at least one well. The highest concentration measured was 655 ng/L for sucralose, an artificial sweetener. These results indicate that EOCs, sourced from either animal or human effluents/activities, are making their way into shallow groundwater systems and can be detected at low concentrations. A total of 135 wells were analysed for glyphosate, glufosinate and their principal metabolites. There was only one detection of glyphosate at a concentration of 2.1 µg/L. This well showed evidence of poor wellhead protection and the contamination likely came from containers that were stored near the well. A total of 279 wells were sampled and analysed for pesticides and 68 wells (24.4%) contained detectable residues of pesticides, with 28 of these wells having two or more pesticides detected. The maximum number of pesticides detected in one well was six. None of the sampled wells exceeded the Maximum Acceptable Value (MAV) for drinking water in New Zealand and the concentrations of most of the detected pesticides were equivalent to less than 0.5% of the MAV. Comparisons with earlier National Surveys of pesticides in groundwater in New Zealand indicate the frequencies of pesticide detections have remained similar over the last 16 years, with higher detection frequencies occurring before that time.


Asunto(s)
Agua Subterránea , Plaguicidas , Contaminantes Químicos del Agua , Animales , Contaminación de Medicamentos , Monitoreo del Ambiente , Humanos , Nueva Zelanda , Pozos de Agua
9.
BMJ Open ; 10(12): e044726, 2020 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-33361171

RESUMEN

OBJECTIVE: To examine the impact of a 5-week national lockdown on ambulance service demand during the COVID-19 pandemic in New Zealand. DESIGN: A descriptive cross-sectional, observational study. SETTING: High-quality data from ambulance electronic clinical records, New Zealand. PARTICIPANTS: Ambulance records were obtained from 588 690 attendances during pre-lockdown (prior to 17 February 2020) and from 36 238 records during the lockdown period (23 March to 26 April 2020). MAIN OUTCOME MEASURES: Ambulance service utilisation during lockdown was compared with pre-lockdown: (a) descriptive analyses of ambulance events and proportions of event types for each period, (b) absolute rates of ambulance attendance (event types/week) for each period. RESULTS: During lockdown, ambulance patients were more likely to be attended at home and less likely to be aged between 16 and 25 years. There was a significant increase in the proportion of lower acuity patients (Status 3 and Status 4) attended (p<0.001) and a corresponding increase in patients not transported from scene (p<0.001). Road traffic crashes (p<0.001) and alcohol-related incidents (p<0.001) significantly decreased. There was a decrease in the absolute number of weekly ambulance attendances (ratio (95% CI), 0.89 (0.87 to 0.91), p<0.001), attendances to respiratory conditions (0.74 (0.61 to 0.86), p=0.01), and trauma (0.81 (0.77 to 0.85), p<0.001). However, there was a significant increase in ambulance attendances for mental health conditions (1.37 (1.22 to 1.51), p=0.005). CONCLUSIONS: Despite the relative absence of COVID-19 in the community during the 5-week nationwide lockdown, there were significant differences in ambulance utilisation during this period. The lockdown was associated with an increase in ambulance attendances for mental health conditions and is of concern. In considering future lockdowns, the potential implications on a population's mental well-being will need to be seriously considered against the benefits of elimination of virus transmission.


Asunto(s)
Ambulancias/normas , Control de Enfermedades Transmisibles/métodos , Servicio de Urgencia en Hospital , Pandemias/prevención & control , Cuarentena , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Gravedad del Paciente , Estudios Retrospectivos , Adulto Joven
10.
Biomed Res Int ; 2020: 8850199, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33344650

RESUMEN

COVID-19 is a pandemic which has spread to more than 200 countries. Its high transmission rate makes it difficult to control. To date, no specific treatment has been found as a cure for the disease. Therefore, prediction of COVID-19 cases provides a useful insight to mitigate the disease. This study aims to model and predict COVID-19 cases. Eight countries: Italy, New Zealand, the USA, Brazil, India, Pakistan, Spain, and South Africa which are in different phases of COVID-19 distribution as well as in different socioeconomic and geographical characteristics were selected as test cases. The Alpha-Sutte Indicator approach was utilized as the modelling strategy. The capability of the approach in modelling COVID-19 cases over the ARIMA method was tested in the study. Data consist of accumulated COVID-19 cases present in the selected countries from the first day of the presence of cases to September 26, 2020. Ten percent of the data were used to validate the modelling approach. The analysis disclosed that the Alpha-Sutte modelling approach is appropriate in modelling cumulative COVID-19 cases over ARIMA by reporting 0.11%, 0.33%, 0.08%, 0.72%, 0.12%, 0.03%, 1.28%, and 0.08% of the mean absolute percentage error (MAPE) for the USA, Brazil, Italy, India, New Zealand, Pakistan, Spain, and South Africa, respectively. Differences between forecasted and real cases of COVID-19 in the validation set were tested using the paired t-test. The differences were not statistically significant, revealing the effectiveness of the modelling approach. Thus, predictions were generated using the Alpha-Sutte approach for each country. Therefore, the Alpha-Sutte method can be recommended for short-term forecasting of cumulative COVID-19 incidences. The authorities in the health care sector and other administrators may use the predictions to control and manage the COVID-19 cases.


Asunto(s)
/epidemiología , Pandemias , Anciano , Brasil/epidemiología , Femenino , Predicción , Servicios de Salud , Humanos , Incidencia , India/epidemiología , Italia/epidemiología , Masculino , Modelos Estadísticos , Nueva Zelanda/epidemiología , Pakistán/epidemiología , Sudáfrica/epidemiología , España/epidemiología
11.
N Z Med J ; 133(1527): 15-25, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332325

RESUMEN

AIM: This paper outlines the results of the Royal Australian and New Zealand College of Radiologists (RANZCR) Faculty of Radiation Oncology (FRO) 2018 workforce census. Here we report the responses of New Zealand radiation oncologists and trainees in order to understand characteristics of the New Zealand radiation oncology workforce. METHOD: The workforce census was conducted online during July-September 2018. Distribution was by Survey Monkey to all radiation oncologists (fellows, life members, educational affiliates, retired) and trainees on the RANZCR membership database, including members from Australia, New Zealand and Singapore. All responses were aggregated for analysis. This paper addresses only responses from New Zealand members. The census was designed to explore issues relevant to the New Zealand workforce, and questions from previous workforce censuses were repeated in order to monitor trends. RESULTS: The response rate for New Zealand radiation oncologists was 73.3% (44/60). The majority (67%) were male. The average age was 50.8 years. Three-fifths (59.5%) reported New Zealand ethnicity. One-third obtained their specialist qualifications outside of Australia and New Zealand. Most worked in the public sector only (63.4%), with only two in exclusive private practice. Most radiation oncologists attained a consultant post immediately on completion of training, but there were 26 who pursued an overseas fellowship. Most worked one full-time equivalent or greater (FTE), with 17.5% working less than 1.0 FTE. Radiation oncologists reported working a median of 50.0 hours per week, with half working over 10 hours above their contracted hours. Most time was spent on clinical duties with minimal time spent on research. Radiation oncologists reported seeing an average of 235 new patients per year (median: 230). Leadership positions were held by 21/43 respondents. Within 15 years, 55% of the current workforce reported an intention to retire, including 30% of those currently practising highly specialised brachytherapy. Females in the workforce were less likely to work fulltime and spent less time in research and management activities. All trainees reported full-time work, although 50% expressed a desire for part-time training. Half of the trainees reported working 6-10 hours on call, and 60% reported two or less hours of protected teaching per week. Despite this, 90% of trainees were satisfied with their career choice. CONCLUSIONS: Radiation oncology is a small specialty in New Zealand, with a significant reliance on overseas-trained specialists. The specialty continues to work significant overtime hours while time spent on research and non-clinical duties remains low. The growth in staffing between the 2014 and 2018 census has been low. Trainee numbers do not appear sufficient to meet the demand for replacing staff, due to retirements and the reduction of hours. Radiation intervention rates are low in New Zealand, but growth would be reliant on an expansion of the workforce beyond simply replacing staff losses. The radiation oncology workforce in New Zealand remains vulnerable, and careful consideration must be given to expansion and retention to ensure a viable workforce for the future.


Asunto(s)
Fuerza Laboral en Salud/estadística & datos numéricos , Oncólogos de Radiación/estadística & datos numéricos , Oncología por Radiación/educación , Oncología por Radiación/estadística & datos numéricos , Adulto , Braquiterapia/estadística & datos numéricos , Censos , Empleo/estadística & datos numéricos , Becas/estadística & datos numéricos , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Práctica Privada/estadística & datos numéricos , Sector Público/estadística & datos numéricos , Oncólogos de Radiación/provisión & distribución , Jubilación/estadística & datos numéricos , Factores Sexuales , Encuestas y Cuestionarios , Adulto Joven
12.
N Z Med J ; 133(1527): 26-38, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332326

RESUMEN

AIM: To describe the context surrounding the deaths of homeless people in New Zealand and to determine the proportion of deaths that could be considered amenable to healthcare. METHOD: We used coroners' findings related to 171 deaths of persons with "no fixed abode" at the time of death, from 2008 to 2019. Recent lists of amenable mortality from the New Zealand Ministry of Health and the Office of National Statistics in the UK were combined to determine the rate of amenable mortality. RESULTS: The life expectancy of homeless persons identified in this sample was 30 years shorter than in the housed population, with a mean age of death of 45.7 years. Deaths occurred mainly alone, in public spaces (56.1%) or in private vehicles (14%). Three-quarters (75.8%) of homeless persons died from conditions amenable to timely and effective healthcare interventions, mostly from natural causes (45.7%) and suicide (41.5%). CONCLUSION: Homeless people experience considerable challenges when accessing the healthcare system, as uncovered by the dramatic rate of amenable mortality. Our findings highlight the urgent need to implement specific models of care that are designed to meet the social and healthcare needs of homeless persons and address the significant health inequalities they experience.


Asunto(s)
Causas de Muerte , Certificado de Defunción , Personas sin Hogar/estadística & datos numéricos , Esperanza de Vida , Accidentes/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Trastornos Relacionados con Alcohol/mortalidad , Trastornos Relacionados con Alcohol/prevención & control , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Niño , Etanol/envenenamiento , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Nueva Zelanda/epidemiología , Neumonía/mortalidad , Neumonía/prevención & control , Suicidio/prevención & control , Suicidio/estadística & datos numéricos , Adulto Joven
13.
N Z Med J ; 133(1527): 39-50, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332327

RESUMEN

AIMS: Evaluate trends in foot examinations for people with diabetes by primary healthcare nurses between 2006-2008 and 2016 in Auckland, New Zealand. METHODS: All primary care nurses in 2006-2008 and 2016 were identified and 26% and 24% were randomly sampled and surveyed, respectively. Nurse participants completed a self-administered questionnaire and telephone interview about the care provided for people with diabetes. RESULTS: Significantly more patients consulted by practice nurses received foot examinations in 2016 (58%) compared with 2006-2008 (36%), and foot-care education (66% versus 26%). Of the 43% of patients who had no foot examination in 2016, 23% had no previous examination documented. Significantly more nurses in 2016 than in 2006-2008 self-reported routinely examining patients' feet (45% versus 31%) and giving foot-care education (28% versus 13%). These practices were associated with nurses undertaking >5 hours of diabetes education within the past five years. CONCLUSIONS: Practice nurses have significantly expanded their role in managing people with diabetes over the last decade by increasing the number of foot examinations and providing recommended foot-care education. Improved management was associated with nurses attending diabetes education in the past five years. Gaps were identified in conducting the recommended number of foot examinations, categorising patients' risk of foot disease and recording previous examinations.


Asunto(s)
Pie Diabético/prevención & control , Rol de la Enfermera , Enfermeras y Enfermeros/tendencias , Examen Físico/tendencias , Atención Primaria de Salud/tendencias , Estudios Transversales , Diabetes Mellitus/enfermería , Pie Diabético/diagnóstico , Educación en Enfermería , Femenino , Pie , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Enfermeras y Enfermeros/estadística & datos numéricos , Educación del Paciente como Asunto/estadística & datos numéricos , Educación del Paciente como Asunto/tendencias , Examen Físico/estadística & datos numéricos , Atención Primaria de Salud/métodos , Autoinforme
14.
N Z Med J ; 133(1527): 51-70, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332328

RESUMEN

AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.


Asunto(s)
Estado de Salud , Estilo de Vida/etnología , Atención Primaria de Salud/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Adolescente , Adulto , África del Sur del Sahara/etnología , Anciano , Anciano de 80 o más Años , Asia Sudoriental/etnología , Bután/etnología , Índice de Masa Corporal , Niño , Preescolar , Colombia/etnología , Conducta Anticonceptiva/etnología , Conducta Anticonceptiva/tendencias , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/etnología , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Infecciones por VIH/etnología , Infecciones por Helicobacter/etnología , Helicobacter pylori , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/etnología , Lactante , Recién Nacido , Parasitosis Intestinales/etnología , Irak/etnología , Masculino , Salud Mental/etnología , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Prevalencia , Enfermedades de Transmisión Sexual/etnología , Uso de Tabaco/etnología , Tuberculosis Pulmonar/etnología , Deficiencia de Vitamina D/etnología , Adulto Joven
15.
N Z Med J ; 133(1527): 104-110, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332332

RESUMEN

Multiple myeloma is the second most common blood cancer in New Zealand with higher incidence in Maori and Pacific Island populations. It remains an incurable disease but the rapidly changing treatment landscape has led to improved outcome. In response to recent changes in funding of anti-myeloma therapy in New Zealand, the New Zealand Myeloma Interest Group has reviewed the latest literature and updated the treatment pathway of transplant-eligible patients with newly diagnosed multiple myeloma.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Trasplante de Médula Ósea , Quimioterapia de Consolidación , Quimioterapia de Inducción , Quimioterapia de Mantención , Mieloma Múltiple/terapia , Trasplante de Médula Ósea/métodos , Bortezomib/administración & dosificación , Consenso , Quimioterapia de Consolidación/métodos , Ciclofosfamida/administración & dosificación , Dexametasona/administración & dosificación , Quimioterapia de Inducción/métodos , Lenalidomida , Nueva Zelanda , Guías de Práctica Clínica como Asunto , Talidomida/administración & dosificación
17.
N Z Med J ; 133(1527): 116-122, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332334

RESUMEN

Across New Zealand, a huge programme of work is being initiated to improve the health information systems of our sector. The goals of this plan are to address major risks and issues such as cybersecurity and our inability to securely share health data across organisations for clinical care. To fulfil the promise of planned health IT initiatives, we must involve clinicians of all disciplines to help lead, design and implement projects. However, there is currently little pragmatic training available for clinicians to learn how to do so. In 2019, Waitemata District Health Board and the National Institute for Health Innovation developed and delivered a 'hands-on' Clinical Digital Academy training programme for multidisciplinary clinicians. This paper describes the programme, the initial cohort's evaluation feedback and recommendations for the future.


Asunto(s)
Sistemas de Información en Salud , Personal de Salud/educación , Liderazgo , Informática Médica/educación , Técnicos Medios en Salud/educación , Humanos , Nueva Zelanda , Enfermeras y Enfermeros , Médicos , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Autoeficacia
18.
BMC Fam Pract ; 21(1): 269, 2020 12 13.
Artículo en Inglés | MEDLINE | ID: mdl-33308161

RESUMEN

BACKGROUND: During the first COVID-19 pandemic 'lockdown' in Aotearoa/New Zealand (March-May 2020, in which strict 'stay at home' measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. METHODS: Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient's perspective. RESULTS: In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. CONCLUSIONS: Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.


Asunto(s)
Medicina General , Prioridad del Paciente , Satisfacción del Paciente , Telemedicina , Adolescente , Adulto , Anciano , Grupo de Ascendencia Continental Asiática , Control de Enfermedades Transmisibles , Prestación de Atención de Salud , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Zelanda , Grupo de Ascendencia Oceánica , Investigación Cualitativa , Encuestas y Cuestionarios , Adulto Joven
19.
Zootaxa ; 4890(4): zootaxa.4890.4.9, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33311111

RESUMEN

The New Zealand diplodactylid gecko genus Toropuku is currently monotypic, but the sole member of the genus, T. stephensi, is distributed in two disjunct, geographically distant regions of New Zealand - the islands of Cook Strait (which includes the type locality, Stephens Island), between New Zealand's North and South Islands, and the Coromandel Peninsula, in the northeastern North Island. Previously published phylogenetic results, based on three total individuals, recognized substantial-possibly species-level-diversity between these disparate localities, although no taxonomic decisions were made at that time. More recently, additional animals have been found on the Coromandel Peninsula. We here present phylogenetic and morphological evidence based on this expanded dataset to formally describe the populations on the Coromandel Peninsula as a new species, Toropuku inexpectatus sp. nov. The specific epithet refers to the species' surprise discovery in a herpetologically well-surveyed area. The recognition of T. inexpectatus sp. nov. as a distinct species has implications for the conservation status of T. stephensi, which is now considered restricted to three islands in Cook Strait.


Asunto(s)
Lagartos , Animales , Nueva Zelanda , Filogenia
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