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Active+ Offers Virtual Physio For Injured Kiwis During Lockdown

Active+, a 100% Kiwi owned physiotherapy and rehabilitation network, is offering virtual physio clinics for New Zealanders suffering from aches and pains during lockdown.

ACC has predicted that homebased injuries will go up over the coming weeks as Kiwis tackle DIY and other projects. That is on top of the surge in people working from home, often using unsuitable furniture and makeshift working arrangements. This means that the need for physio is also likely to increase.

Consultations with registered Active+ physiotherapists are being carried out via video call using secure chat platforms. Telephone can be used for those that may not have the technological or IT set-up ability.

“There’s a lot we can do without being hands on. We can still assess injuries, either ACC or private. We can still lodge ACC claims. Physios can refer their patients to a specialist if further treatments or assessments, such as x-rays and ultrasounds are necessary,” explains Active+ Director and qualified physiotherapist, Andy Schmidt.

“Our physios are hard at work providing rehabilitation exercise programmes to support those injured and rehabilitating at home with video-based exercises and reporting. We have also launched a number of free to air exercise programmes via social media.”

During a consultation, Active+ physios ask a series of questions to find out where things hurt, and will get the patient to carry out movements and actions on camera, such as bends or stretches — so they can make an assessment. They can then give advice on managing the injury, prescribe exercises and arrange further appointments.

Physios can even help with work set-ups at home.

“It can be challenging to create a home office, especially if you don’t have a separate space, and you’re having to use the kitchen or living room,” says Andy. “A physio can look at how you’re working, so you don’t hurt yourself. It might be as simple as tweaking your screen height or changing your posture.”

Active+ hopes that the virtual physio clinics will take some pressure off GPs, by being a primary point of contact and referral for the kinds of problems that physiotherapists are experts in managing.

“This will be particularly important as primary care clinics are likely to get busier in the coming autumn and winter months, especially if some of the Covid-19 modelling is correct and we see a peak in mid-May,” says Andy.

Active+ was founded by Gill Webb in 1990. Since then, it is estimated that Active+ has helped more than 300,000 New Zealanders with injury prevention, rehabilitation and wellness.

There is now a growing network of over 20 clinics across the North and South Islands that deliver physiotherapy and multidisciplinary rehabilitation services. 650 clinicians deliver services to New Zealanders every day in their workplaces, in their homes and from the practices.

For more details, visit activeplus.co.nz or follow Active+ on Facebook.

Amazing Switch To NZ Virtual Healthcare During Covid-19 Work Lockdown

Into the second week of coronavirus lockdown, New Zealand’s primary care doctors, nurses and staff are putting in an amazing effort to switch to phone and online health consultations in such a very short timeframe, a leading New Zealand IT health expert says.

GP clinics across the country have moved quickly to ensure continuity of care by providing the majority of their consultations online or over the phone meaning that patients don’t have to physically go into the clinic unless they absolutely have to, NZ Health IT chief executive Scott Arrol says.

“These are extraordinary times and it requires special measures to make sure we grab this opportunity during the lockdown to help control this virus.

“The tireless work by everyone involved both at the frontline and behind the scenes to make virtual healthcare happen is incredible.

“This is clearly an absolute necessity for the Kiwi healthcare system and also means an adjustment is needed from the public, so they know what to expect when doing an online consultation with their doctor or nurse. Being prepared ahead of the consultation will help.”

Arrol says that there are a number of online resources available to the public so they can better understand what to expect and recommends NZ Telehealth and Health Navigator as excellent publicly available sites to learn more.

“Most people are already used to connecting with friends and family by phone, text, social media, email and video apps plus the GP’s patient management systems provide options for them to connect safely and securely in a virtual way with their patients.

“It doesn’t mean that patients won’t be able to be physically examined by their doctor. When doing a virtual consultation, the GP will make the call on whether the patient should come into the clinic or not.

“The clinicians involved will always put their patients’ health first and we should view this move to virtual healthcare as just another way to engage with the health system, not only during the pandemic but into the future as well,” he says.

The dedicated Healthline COVID-19 support number is 0800 358 5453.

NZHIT is the key go-to health tech organisation representing the health IT industry sector and has many members with digital solutions that enable the delivery of

Will Coronavirus (Covid-19) Weaken In Springtime In The Northern Hemisphere?

A group of consultants at Azabu Insights Inc., a strategic consulting company in Azabu Juban Tokyo, have been analyzing data to understand the correlation between air temperature and spread of the coronavirus (Covid-19). We wondered if the coronavirus was spreading more widely in colder climates and if this suggests some respite in the warmer months for the northern hemisphere.

Table 1: Beijing data as a proxy for Chinese travelers, based on available data. Source: ChinaTravelGuide
Table 2: In most cases we used country-wide data, while specifically noting the epicenter of the outbreak for temperature data. Source: Various weather sources.

Our team members came up with the hypotheses when looking at lists of countries and regions with the most affected patients. We compared this to our “expectations” of most affected areas based on our understanding of where we saw large numbers of travelers from China. This was later backed up by travel data.

Within Japan we noticed large outbreaks in Hokkaido (Japan’s most northern and very cold island) and very few outbreaks in Okinawa (Japan’s subtropical southern island). Okinawa is a place that one might have expected to see a large outbreak as we knew that the Diamond Princess cruise ship docked there and many passengers got off the ship on February 1st. However, only three cases have been found in Okinawa, where the average temperature in February is 17 degrees Celsius. On the other hand in Hokkaido, where the average temperature in the outbreak epicenter of Kitami was -7 degrees Celsius in February, there have been seventy-seven cases (as of March 3, 2020).

Hokkaido and Okinawa are comparable in other ways. Both Hokkaido and Okinawa have large numbers of Chinese travelers. Both are comparatively more reliant on car travel than much of the rest of Japan. And while Hokkaido has a larger population of 5.3m compared with Okinawa’s 1.5m, Hokkaido’s much larger area leads to Okinawa having a much higher population density at 640/km2 versus Hokkaido’s 63 persons/km2.

From a business perspective they are also similar in having multiple listed companies related to banking, power, and cellular. Hokkaido has many more listed companies, however, with broader offerings that include retail, food, service, and others. Hokkaido is also home to the Sapporo Securities Exchange (SSE) and Ambitious (AMB).

Okinawa’s listed companies include: The Bank of Okinawa Ltd. (TSE1: 8397); Bank of the Ryukyus, Limited (TSE1: 8399); Okinawa Electric Power Company (TSE1: 9511), Okinawa Cellular Telephone Company (JASDAQ: 9436), SAN-A Co., Ltd. (TSE1: 2659). Hokkaido listed companies include: Hokkaido Electric Power (TSE1: 9509), Kanamoto Co., Ltd. (TSE1: 9678), Sapporo Clinical Laboratory (JASDAQ: 9776), CE Holdings (TSE1: 4320), as well many others.

Looking at a country level we saw a similar relationship between cold weather and high infections. We first examined the three countries where Beijing travelers are said to travel most frequently: Japan, Thailand, and Korea. Although 19% of Beijing tourists travelled to Thailand (data from first quarter 2019), there were just 43 cases of Covid-19 confirmed. In contrast, Japan has 980 confirmed cases (including the Diamond Princess). Korea had more than 10 times more cases (4,812) despite having less than half the Chinese tourists that Thailand sees.

For reference refer to table 1 of Beijing tourists, and table 2 of temperatures in selected countries.

Looking at other regions where outbreaks have occurred also seemed to indicate a similar correlation of cold temperatures to high numbers of infections. The six cold regions that we analyzed had comparatively high outbreak numbers while the four warm regions had lower numbers compared to our expectations based on movement patterns of Chinese travelers.

In table 2 one can see that the cold areas of Wuhan, South Korea, Italy, Iran, France, Tokyo, Hokkaido all have fairly high numbers compared to expectations. The warm regions, including Singapore, Thailand, Malaysia and Okinawa all had fairly small numbers compared to expectations. Washington State would also be considered cold and news articles suggest that the outbreak may be growing faster than the current confirmed count would suggest.

Our researchers acknowledged that such a small sample size of regions does not provide statistical significance. Yet, we believe that starting to see patterns may be helpful in understanding the virus spread.

Are we suggesting that the virus cannot not spread in warmer clients? Certainly not. There have been at least 500 confirmed cases (as of March 3, 2020) in warm climates. However, there have been many more in colder climates with 10,178 (excluding Wuhan). This number would reach 90,329 if Wuhan cases were counted.

Data on the longevity of the virus on surfaces in different temperatures provides support to our hypotheses. A study published in the Canadian Journal of Microbiology referring to a different coronavirus (coronavirus 229) stated, “viral infectivity was completely lost after a 14-day incubation period at 22, 33, or 37 degrees C but remained relatively constant at 4 degrees C for the same length of time.” This again indicates that colder temperatures support the virus better.

Additionally, studies conducted by Ruhr University Bochum and the University of Greifswald indicated that some coronaviruses could survive on surfaces for 28 days or longer at 4 degrees Celsius; in warmer temperatures coronaviruses ceased to be persistent after only a few hours or days.

This does not indicate that infections spread more from surface contact, which we have not studied. But it does suggest that the virus has less ability to survive in warmer climates.

Does all of this suggest that the Coronavirus will absolutely go away in spring? We think not. Based on the data showing spread, albeit at a slower pace, in warm climates, we believe people will continue to be infected. However, it might suggest that if communities continue to make the right decisions about virus control, they might get a positive boost from warmer weather come spring and summer.

March Is Nutrition Month

There are so many high profile vegans these days, it seems everyone from Arnold Swarzenegger, Harrison Ford and Bill Clinton are eschewing meat and dairy in favour of plant-based alternatives. Our most high profile vegan, Dame Patsy Reddy, Governor-General, has been vegan since watching Forks Over Knives several years ago. She and her husband have both experienced the health benefits of going dairy free after losing weight and clearing up chronic laryngitis and sinusitis. They remain vegan for health and taste preferences.

Gareth Hughes, outgoing Green MP, took up our 21 day easy vegan challenge last year and has not looked back since. He enjoys the taste and variety of plant-based cooking and says “My kids love parmesan on their pasta and I love Angel Food’s dairy-free parmesan, my favourite vegan product”

The science is proven, a wholefood plant-based diet is able to provide all the nutrients that any ages of humans need. Many patients experience significant relief, even reversal from common complaints such as rheumatoid arthritis, type 2 diabetes, cardio-vascular disease, gout, Chrohn’s Disease, IBS, not to mention that many people experience excess weight loss and reduction of symptoms of anxiety. The wholefood plant-based diet has also been shown to prevent cancer, Alzheimer’s, PMT and cardio-vascular risk.

Dr Mark Craig said “from experience, many patients who remove dairy from their diet get very significant improvement and even resolution of various symptoms. Common improvements are in acne, rhinitis (blocked/ runny noses) and sinusitis, reduced migraine, heavy and painful periods, improved gut health, bloating and energy. People who remove high saturated fat foods like animal meats, frequently experience dramatic improvements in blood fat levels (cholesterol, triglycerides) and blood pressure, usually meaning they can reduce or come off their medications. We have no need for dairy ingestion in our diet and whilst some people can apparently ‘get away with’ small amounts of it and not suffer adverse consequences, many people do run into significant health problems eating dairy as a regular part of their diet.”

It’s an inconvenient truth that the animals we spend so many resources on to turn into food for us to eat, are in fact doing us no good at all. We are slowly destroying our planet to prop up our addiction to cheese, the most unhealthy of the dairy products, which is instead slowly killing us, clogging up our arteries and making us more susceptible to inflammatory illnesses. It’s time to make the switch to a wholefood plant-based diet for Nutrition Month. The Vegan Society is promoting our 21 day easy vegan challenge to help Kiwis trial a vegan diet and experience better health for themselves. They can sign up now for information, advice, shopping tips, daily evening meal recipe, breakfast and lunch ideas, meal planners – all you need to make a simple and easy transition to eating vegan. Www.tryvegan.org.nz

Demand For Plasma Increasing: Donor Numbers Need To Double By 2022

New Zealand Blood Service (NZBS) has today released new figures that reveal another 8,000 plasma donors are needed to meet New Zealand’s growing demand.

Plasma demand is increasing by more than 12 per cent year on year; the need for plasma donations increased by 45 per cent between 2015 and 2019. It is estimated that in the next two years, New Zealand will need to collect well over 100,000 plasma donations per year. New Zealand currently has approximately 10,000 plasma donors, with another 8,000 donors needed by June 2022.

Plasma – the gold-coloured liquid that makes up half our blood – is used for an ever-increasing number of conditions, including autoimmune disorders, accident and trauma patients, boosting the immune systems of people with low levels of antibodies, and providing special clotting factor concentrates for people with bleeding disorders. To meet growing demand, new plasma donors are being sought, and existing plasma donors asked to give more than six times per year.

“While we currently able to meet demand, the need for more plasma donors, and for more donations from existing plasma donors, is very real,” says Asuka Burge, NZBS National Manager, Marketing and Communications. “New Zealand will soon require more plasma donations than whole blood donations, and we currently rely on regular plasma donors to ensure we have enough; one plasma donation can give up to three times the amount of plasma as a regular whole blood donation.

“Plasma donors can also give more frequently; because red blood cells are returned to the body, people can donate up to every two weeks, as opposed to every three months. Plasma donation also takes marginally more time than whole blood donation – around 90 minutes as opposed to 60 minutes.”

NZBS is confident New Zealanders will step up to the challenge, ensuring enough plasma is donated to meet the country’s needs. “New Zealanders are incredibly generous, and we’re hoping that by educating people on why plasma is so crucial, we won’t need to face a situation where we are unable to meet demand from within our own country.”

NZBS is often asked why, in the face of a shortage, eligible New Zealanders don’t get paid for donating. “One of the pillars of our safe and secure ‘gold standard’ blood supply is that we are enshrined by a law stating all donations have to be voluntary and non-remunerated,” says Burge. “That’s why we recognise our donors in other ways, like the creation of our Gold Club. Our plasma donors belong to one of the most exclusive clubs in the world. “

One recipient of plasma donation is six-year-old Harry McPhail. Harry was born with X-linked agammaglobulinemia (XLA), a rare genetic disorder that means his body can’t produce mature B-cells, the antibodies which fight antibacterial infections. After three hospital admissions for pneumonia in his first year of life, Harry was given immunoglobulin from blood plasma which is injected into him weekly. Although Harry will need this treatment for the rest of his life, he hasn’t been readmitted to hospital since.

“Harry is now healthy and happy, and thanks to plasma donors he lives a normal life. He’s very sporty, and he loves soccer best,” says Harry’s mum Marie. “It’s amazing – every week he is given these little bottles of liquid people have donated, and now he doesn’t get sick any more. We are so thankful to the donors for giving their time and keeping Harry healthy.”

While NZBS is asking all eligible donors to come forward, some New Zealanders go above and beyond to help others. Annette Roberts gave her first blood donation when she was just 16, switching to plasma donation in 1980 on the advice of a nurse. Since then, she’s been joined in the plasma donor chairs by her husband Keith, sons Grant and Mark, and grandson Kodey. Between the three generations they have amassed a whopping 1,017 donations, earning them a special place in NZBS’ ‘Gold Club’ of plasma donors.

“Doing something for someone who can’t do it themselves is brilliant – I don’t feel any different after I’ve donated, and if it saves someone who’s sick, or a child who needs a plasma-derived treatment every week to survive, it’s worth it,” says Roberts, who gave her 415th lifetime donation in February.

FAQ

What is plasma?

Plasma is the straw-coloured ‘liquid gold’ component of blood that makes up just over half our blood. It can be used to create up to 11 blood products that help people who have lost a lot of blood through trauma, accident or surgery, those going through chemotherapy, and people with low levels of antibodies. Plasma is also instrumental in controlling autoimmune disorders, and providing special clotting factor concentrates for people with bleeding disorders.

How is plasma collected?

Plasma is obtained through apheresis – blood is temporarily taken from the vein and put through a machine which separates the plasma, before returning the red blood cells to the donor. The process takes around 90 minutes, and collects up to three times the usual volume of plasma, than can be removed in a single whole blood donation. Plasma taken in blood donation are more easily replaced by the donor than red blood cells, and larger quantities can be taken because red blood cells are returned to the donor.

Is plasma collected by blood type?

AB blood type is the universal blood type for plasma. This means AB plasma can be given to anyone. People with AB positive, AB negative, B positive and B negative make up 15 per cent of the population in New Zealand, and are encouraged to donate plasma, while O Negative blood types are asked to donate whole blood as it is the universal blood type for red blood cells.

Why do we need more plasma?

The rise in plasma demand is primarily due to the increased need for immunoglobulin products, also known as IVIg, such as Intragam P and Evogam. IVIg products are concentrated solutions of antibodies – natural proteins present in blood that are essential for stopping infection. IVIg products are used to treat people with low levels of antibodies, either hereditary or through illness such as infections, and by cancers of the white blood cells and bone marrow. It’s also used to treat some autoimmune disorders.

How can I donate plasma?

Make an appointment at any one of the NZBS donor centres to find out if you are eligible to donate. To become a plasma donor, donors must meet plasma eligibility criteria. This includes meeting height and weight criteria, and having good veins.

About NZBS:

New Zealand Blood Service (NZBS) is a not-for-profit Crown entity responsible for the collection, processing, testing and storage and distribution of all blood and blood products in New Zealand.

NZBS relies on voluntary and non-remunerated blood donations from individuals around the country in order to provide a constant supply of precious blood and blood products used by health services to save thousands of lives.

Media Update COVID-19

There continues to be no confirmed cases of COVID-19 in New Zealand.

This afternoon, the Government announced that temporary restrictions on travel from China will remain in place as a precautionary measure to protect against the spread of the COVID-19 coronavirus.

The restrictions which prevent foreign nationals travelling from, or transiting through, mainland China from entering New Zealand have been extended for a further 8 days. This position will be reviewed every 48 hours.

New Zealand citizens, permanent residents and their immediate family returning to New Zealand will continue to be able to enter, but are being told to self-isolate for 14 days upon their return.

Globally, the World Health Organization reports there are just over 49,000 confirmed cases of COVID-19, with only three of 1381 confirmed deaths occurring outside mainland China.

In New Zealand, self-isolation registrations with Healthline continue to grow. A further 341 registrations for self-isolation were made yesterday and as at midnight 14 February just under 4000 people (3998) had registered since the register went live at 5pm on Friday 7 February.

Healthline’s dedicated COVID-19 number, 0800 358 5453, is free and available 24 hours a day, 7 days a week.

The Ministry is encouraging anyone who has not yet registered as a result of their travel to China, to do so. This will help ensure we can regularly check on people’s welfare and wellbeing while they are in self-isolation, while supporting New Zealand’s overall response to novel coronavirus.

We also want to acknowledge and thank the thousands of people who have responded so positively to the self-isolation process.

Keeping individuals, families and our communities safe and healthy in the current global environment requires a team effort and that’s what we’re seeing across New Zealand.

A reminder that COVID-19 is spread by people coughing or sneezing, close personal contact and coming into contact with an object or surface with viral particles on it (then touching your mouth, nose or eyes).

So practicing good hygiene, regularly washing your hands, and practicing good cough etiquette (maintaining distance, covering coughs and sneezes with disposable tissues or clothing and washing hands) is really important in keeping yourself and the community safe.

There’s more information here:

https://www.health.govt.nz/our-work/diseases-and-conditions/novel-coronavirus-covid-19

https://www.govt.nz/coronavirus

Novel Coronavirus – Update 9 February 2020

The Ministry of Health continues to work closely with partner agencies in response to novel coronavirus.

While there continue to be no suspected or confirmed cases of novel coronavirus in New Zealand, Director-General of Health Dr Ashley Bloomfield says vigilance is vital.

“The National Health Coordination Centre (NHCC) at the Ministry continued its work over the weekend, and in the community I know Healthline is working hard with people who have questions or need support.

“For people in self-isolation who’ve not yet registered as a result of their travel to China, it’s important to remind them of the Healthline register. Registering will help those in self-isolation as much as it helps us – it will mean we can regularly check on people’s welfare and wellbeing as well as helping support New Zealand’s overall response to novel coronavirus.

“The latest figures from Healthline indicated that as of 8 February, 385 people had registered for self-isolation, 359 of whom had travelled from China in the previous 14 days.

“It’s very encouraging that so many people are committed to ensuring they look after their own health, and the health of the wider community.”

The dedicated 0800 number for health advice and information around novel coronavirus, including registering self-isolation, is 0800 358 5453 – it is free and available 24 hours a day, 7 days a week

Or for international SIMs +64 9 358 5453

People calling that line will be able to talk with a member of the National Telehealth Service, with the ability to access interpreters.

At the Whangaparāoa Reception Centre, the Ministry of Health continues as part of a team ensuring the welfare and wellbeing of 157 people who arrived on a special flight from Wuhan last week.

Dr Bloomfield says it has been important to try and continue routines for the guests, and that included marking Chinese New Year last night.

“Chinese New Year is an important cultural event and we organised this to honour that for both our guests with Chinese heritage and all others.

“Guests and staff organised the event together, showing the community spirit of those staying there.

“It was also one guest’s birthday, so it’s really nice that we were able to make it meaningful for them.”

The Ministry is regularly updating its information on the novel Coronavirus page and providing information on its Facebook page.

Breast Cancer Foundation calls for time off for mammograms

The two-hour challenge: Breast Cancer Foundation urges Kiwi bosses to give staff time off work for mammograms

On World Cancer Day (February 4), Breast Cancer Foundation NZ is calling on Kiwi employers to support female workers’ health by giving them time off for mammograms. BCFNZ chair Justine Smyth has emailed 100 notable organisations and leading employers, inviting them to get on board with the idea.

“Mammogram screening rates remain stubbornly low in some communities,” said Ms Smyth. “We have to tackle this gnarly problem in a range of ways – and that’s where employers can play their part.

“We all live such busy lives. By allowing staff time off during work hours to get their mammograms, businesses will be removing one of the barriers to breast screening: time. Just two hours should be enough – about 20 minutes for the mammogram itself and travel time either side of that.”

Breast Cancer Foundation NZ chief executive Evangelia Henderson said a relatively small gesture like this is a win-win: it not only leads to healthier staff, it also shows workers that they are valued. “What’s more, employers will be helping contribute to a reduction in deaths from breast cancer in New Zealand. The earlier breast cancer is detected, the more survivable it is, and mammograms can pick up a lump as small as 2mm – far smaller than a woman can feel it,” she said. “This is a low-cost initiative, which many businesses can easily implement, and the upside is potentially life-saving.”

Breast cancer is the most common cancer for New Zealand women – nine women a day are diagnosed, and one in nine women will be diagnosed in their lifetime. A woman has a 92% chance of surviving 10 years if her cancer is found on a mammogram. That drops to 75% if “finding a lump” is the first sign.

Deaths have dropped by more than 30% since free mammogram screening was introduced through BreastScreen Aotearoa. But 30% of eligible women are not enrolled in the free national screening programme.

The 100 organisations emailed by Ms Smyth include many of New Zealand’s largest employers, but also smaller businesses that are held in high regard by most Kiwis.

“We can’t wait to hear that they’re rising to this challenge,” Mrs Henderson said.

Breast Cancer Facts – NZ

• Early detection is your best protection against breast cancer. You have a 92% chance of surviving 10 years if your cancer was found by regular mammogram.

• That drops to 75% if a lump is the first sign.

• Deaths have dropped by around 30% since free mammogram screening was introduced.

• But 30% of eligible women are not enrolled in the free screening programme.

Who should get regular mammograms?

Because the risk of breast cancer increases with age, BCFNZ recommends women consider having regular mammograms from age 40.

Eligible women can have a free mammogram every two years from 45 to 69 years, and the Government has announced it will progressively increase the age for free breast screening to 74.

Freephone 0800 270 200 to book a mammogram.

New Zealand officials give update on deadly virus outbreak

Health officials are giving an update on New Zealand’s response to the new coronavirus.

Director-General of Health Dr Ashley Bloomfield and Director of Public Health Dr Caroline McElnay spoke to media about 2.30pm:

Director-General of Health Dr Ashley Bloomfield said there were 2014 confirmed cases with 98 percent of those in China. There were four cases Australia, but the situation in NZ remained unchanged.

While the likelihood of a case arriving in New Zealand was high, the likelihood of a sustained outbreak in New Zealand remained low, he said.

“As in Australia with their first case, the person that was subesquently diagnosed had in fact travelled and was asymptomatic when they came into the country and developed symptoms a few days later. We may well find ourselves in a similar situation.

“The likelihood of transmission – if we do get a case – to another person, is low to moderate because we are prepared and ready and at this stage. Based on current information our assessment is the likelihood of a sustained community outbreak remains low.

“By sustained community transmission we’re talking about a situation were there is a rapidly increasing number of cases … we don’t think that will be the situation in New Zealand and that’s for a number of reasons, one of them being the information we’ve got about the infectiousness of this virus but also about our ability to respond, to identify those initial cases and ensure that isolation is happening and ensure that that person is not passing it on.”

Dr Bloomfield said the public health advice remained the same – that people should have good hygiene and isolate themselves if they are unwell.

The current border measures – which involved travellers arriving from China being asked to come forward and be tested by a nurse if they felt sick – would remain.

He advised staying at home if sick, and said a cross-border response group had met on Friday.

“It has representatives from a range of government agencies. All government agencies have been updated on the situations and on the actions they can take as part of the cross-government effort,” Dr Bloomfield said.

“The border response has a particular emphasis on Auckland and Christchurch airports that have direct flights arriving from China.”

He said they did not plan to use quarantine powers, and doing so was very unusual – people would tend to isolate themselves if they became sick.

“I don’t think we’d be in a situation where people are trying to hide symptoms, there is a very high level of awareness of what people should do,” he said.

group of tourists who were assessed were clinically found to be free from the virus, and did not need to be quarantined or isolated.

“The group was assessed by St John in Rotorua yesterday, three of that 19 had further assessment at the hospital and were clinically assessed to be not displaying symptoms of a viral illness. There was no reason to isolate those people.”

He said the virus had relatively low infection rate of 2 percent to 3 percent – much lower than measles, for example.

“Just to put that in context, that’s a relatively low fatality rate, just as this virus has got relatively low infectiousness. So the current data suggests that every person who might have the illness will infect around two-to-three people, you can contrast that to measles, where every case infects about 14 other people … the risk of people dying in New Zealand would be similar to that in China.”

The World Health Organisation had effectively not changed its advice in the latest situation report, he said.

“There remains some gaps in informations that all countries are seeking to fill as quickly as possible. The WHO does not recommend any specific measures for travellers and it also advises against the application of travel or any trade restrictions on China, based on current information.”

“There are some reports out of China today that it’s possible people are infectious before they show symptoms, but it is most important at the border, that if they do become symptomatic, they know what to do.”

Director of Public Health Dr Caroline McElnay said she did not think sustained community transmission would happen and New Zealand was well prepared.

Public health protection officers and nurses were at Auckland and Christchurch airports for the first time this morning, but no-one on the first flights of the day from China into Auckland requested help or temperature checks.

Health officials were still to review news that had come in overnight that coronavirus could infect people during incubation. The only test for coronavirus – a blood test – takes a couple of days for results to be returned. New Zealand won’t have the ability to do that test until later in the week, so samples would have to be sent to Australia in the interim.

The virus, which has killed 56 people so far, is believed to have emerged late last year from illegally traded wildlife at an animal market in Wuhan, Hubei. Cases have been confirmed in Japan, Taiwan, Nepal, Thailand, Vietnam, Singapore, Australia, the US, and France.

The virus new, or “novel” coronavirus is of family that normally affects animals. One human variant causes the common cold, but another, Sars, killed hundreds in a major outbreak in 2003.

This new virus causes severe acute respiratory infection. Symptoms seem to start with a fever, followed by a dry cough and then, after a week, lead to shortness of breath and some patients needing hospital treatment. There is no specific cure or vaccine.

Smoke a timely reminder to check inhalers

Smoke from Australian bush fires could have effects on asthma, COPD, and other respiratory conditions if it reaches low air levels, says Asthma and Respiratory Foundation NZ.

This smoke has been drifting across the Tasman for several days, with noticeable effects on weather across the North Island.

ARFNZ Chief Executive Letitia Harding says that, while there haven’t yet been official reports of increased respiratory problems for New Zealanders, people with respiratory conditions should be mindful of potential risks.

“If you have a respiratory condition, you should ensure that you keep your medication with you at all times,” says Letitia. “It’s also a good time to remember that medication does expire, and so you should ensure that your inhalers are up to date in case you need them.”

Smoke can irritate the airways and trigger worsening of respiratory illnesses such as asthma, bronchitis, or COPD, with children and the elderly being among those most at risk of unexpected flare-ups. Reducing the chance of exposure or outdoor exertion can help to prevent any complications.

“The best advice we can give is to keep taking your preventer medications, and keep your reliever medication on hand,” says Letitia. “If you are experiencing worsening of your respiratory condition, or believe you may be developing symptoms, contact your GP as soon as possible to discuss your options.”

For more information on respiratory conditions and managing asthma, visit arfnz.org.nz

Dangers of dust from Australian fires for NZ Public Health

This ‘new decade of 2020 was mired by the arrival of dust particles from Australian fires that were carried by air borne deposition into our own NZ air shed, so what are the risks to NZ Public health now?.

To assume our lungs can breathe in dust and be medically o/k with the build-up and deposition of all sources of dust particulates inside our lower lung areas of our blood oxygen transfer areas, for our human health is implying very dangerous ideas that may harm the health of many here.

So we must treat further air pollution with a careful consideration here now since there is a potential increase of the dust from Australian fires to continue.

What are the reactions of the lungs to dust?

We use the literature from a senior Canadian agency overseas for this public health exercise; – “Canadian Centre for Occupational Health & Safety”

Quote; https://www.ccohs.ca/oshanswers/chemicals/lungs_dust.html

The way the respiratory system responds to inhaled particles depends, to a great extent, on where the particle settles. For example, irritant dust that settles in the nose may lead to rhinitis, an inflammation of the mucous membrane. If the particle attacks the larger air passages, inflammation of the trachea (tracheitis) or the bronchi (bronchitis) may be seen.

The most significant reactions of the lung occur in the deepest parts of this organ.

Particles that evade elimination in the nose or throat tend to settle in the sacs or close to the end of the airways. But if the amount of dust is large, the macrophage system may fail. Dust particles and dust-containing macrophages collect in the lung tissues, causing injury to the lungs.

The amount of dust and the kinds of particles involved influence how serious the lung injury will be. For example, after the macrophages swallow silica particles, they die and give off toxic substances. These substances cause fibrous or scar tissue to form. This tissue is the body’s normal way of repairing itself.”

Summary from CEAC;

We all now must avoid any localised increase of ‘traffic air pollution’ in future, as we have already heavily covered the ‘public health issues relating to truck transport air pollution increasing’ already in our urban communities around NZ.

Government must re-double their efforts to reduce use the truck transport and use rail instead to reduce the increasing air pollution from road freight transport.

Manage asthma for a better summer

Longer and warmer days are a welcome change, but with them comes a host of asthma and allergy triggers to watch out for.

Respiratory conditions are extremely common in New Zealand, affecting over 700,000 people across all demographics. Asthma affects one in eight adults, and one in three have allergies.

Asthma and Respiratory Foundation NZ’s Head of Education and Research Teresa Demetriou says that it’s important to be mindful of asthma and allergy triggers at this time of year.

“Triggers are conditions that make asthma worse, or bring on an attack”, says Teresa. “Knowing as much as you can about your triggers can help you to reduce exposure to them, and make your asthma easier to manage.

“Pollen is a common trigger for many people, and limiting your exposure can really help. Other common triggers include smoke and heat, so watch out around the summer barbeques and smokers. Even seemingly innocuous things like picnic blankets that haven’t been washed, or fly spray, can cause an attack if you’re not careful, so keep your eyes peeled for potential risks.”

If you have asthma or allergies, put together a management plan with your doctor, and talk to them about your triggers. You can also download the free ‘My Asthma’ app for easier asthma management.

Teresa also says that while Kiwis often don’t want to make a fuss, it’s important to know when to seek help.

“Asthma and allergies can be managed, so there’s no need to suffer through the symptoms. People often see them as something that just happens, but there are many ways to potentially alleviate the symptoms, and help you to enjoy the summer months to the fullest.

“So get informed, and enjoy the summer weather safely.”

Safe Sleep Day aims to reduce SUDI rates

Safe Sleep Day aims to reduce SUDI rates

Today is National Safe Sleep Day – Te Rā Mokopuna Ora, a day aimed at raising awareness about Sudden Unexpected Death in Infancy (SUDI). One key aspect of this is ensuring babies are sleeping in a safe sleep space, to avoid instances of SUDI through unintentional suffocation. Te Rā Mokopuna Ora has the vision of reducing the rates in which these deaths occur in our New Zealand families/whānau.

There are many steps that we can take to protect a baby’s life while they sleep:

• Placing baby flat and on their back, ensuring the face is clear (to ensure good oxygen flow through the airways)

• Keeping baby close to parents/carers

• Using gentle hands

• Protect baby with a smokefree environment

• Encourage and support breastfeeding

MidCentral DHB Safe Sleep Coordinator Marama McGrath-McDonald says “SUDI is preventable and the risk factors for our babies can be significantly reduced, Safe Sleep Day is an opportunity to encourage communities and organisations to promote safe sleep practice in creative and fun ways”.

To protect baby while sleeping, Pepi pods and wahakura are a good option. These give baby their own bed/sleeping space and can be used in the same room as their parent or caregiver.

One of the other factors in SUDI is parental smoking. Smoking in pregnancy reduces the amount of oxygen reaching the baby, who then develop as if low oxygen is normal. This means they are less likely to respond to any physical restriction to their breathing after they are born. This could include blankets over their face or other obstructions.

Te Ohu Auahi Mutunga (TOAM) Stop Smoking Service is a free MidCentral DHB regional service offering support for people wanting to make a quit attempt. They support any person who smokes via a 4-6 week program. The service also has a dedicated Quit Smoking Coach who can work with hapu/pregnant mothers and their whānau to support them in becoming smokefree. The service provides both individual support or group sessions, and can be contacted on 0800 40 50 11 or at toam@tewakahuia.org.nz

If whānau would like to learn to weave a wahakura, contact dee.hikairo@midcentraldhb.govt.nz, Mokopuna Ora Coordinator or to access a pepi pod and further information about safe sleep contact marama.mcgrath-mcdonald@midcentraldhb.govt.nz

For information about the free online SUDI Prevention online training undertaken by Hāpai Te Hauora, please go to: http://sudinationalcoordination.co.nz/workforce-development

Sniffer Dog to be trialled in Bowel Cancer detection study

Kiwi Sniffer Dog to be trialled in Bowel Cancer detection study

Bowel Cancer Foundation Trust CEO Georgina Mason says a New Zealand cancer screening trial, using specifically trained dogs to identify bowel cancer in urine, could help to save lives through early detection.

The charities own trial is being sponsored by the Lindsay Foundation and will be undertaken by the K9 Medical Detection NZ Charitable Trust and Otago University between January 2020 and January 2022. The study will be conducted using ‘Levi’ – an adult German Shepherd who has received basic training in readiness for medical scent detection work. A second medical detection dog will also be added to the study.

Levi will take around a year to train to be able to detect various concentration levels of bowel cancer in saline samples followed by a second study in which he will be trained and tested in his ability to detect bowel cancer in urine.

Ms Mason says that a successful trial could provide a ‘significant breakthrough’ as more extensive screening is ‘badly needed’ and could pave the way to thousands more early detections.

“Overseas studies have found evidence of urinary biomarkers in bowel cancer patients which we’re expecting the dogs to be able to pick up in our early stage detection trial.”

“Bowel Cancer is currently the most commonly diagnosed cancer in New Zealand with around 3,000 people diagnosed with it, and 1,200 dying from it, every year”.

“Up to 90% of people can be saved if bowel cancer is detected early enough – but the existing National Bowel Cancer Screening Programme is currently only available for 60–74 year olds and probably won’t be available in all District Health Board areas in New Zealand until 2021”.

“Even when the screening programme is fully rolled out it is only expected to detect between 500 and 700 cases of bowel cancer a year – which only accounts for around 36% of the cases of bowel cancer which are registered annually with the Ministry of Health”.

Miss Mason says that more people could be saved if we can help prioritise those who need urgent treatment.

“A large number of people with a positive FIT (faecal immune) test don’t have cancer or high risk polyps which means that this test will enable us to make better use of resources by prioritising those patients that would more likely have bowel cancer and need urgent treatment”.

“This test could also be useful for applications outside of the screening programme to eliminate bowel cancer in patients who present with non-specific symptoms or who are under the age of screening and free up our struggling workforce”.

“We are extremely grateful to the Lindsay Foundation who have funded the first half of this trial. Their love of animals and desire to make an impact in Health has made 

Petitions Presented: A United Stand for Medicines

A UNITED STAND FOR MEDICINES

Today at Parliament at 12.30 pm, eight petitions are being presented for medicines to be funded for a number of diseases to Members of Parliament from ACT, National, Labour and NZ First. Representatives of the political parties will speak, as well as the petitioners. The petitions being presented are as follows:

1. Petition of Edward Porter on behalf of Kalydeco for Kiwis to fund Kalydeco for Cystic Fibrosis patients. 10,895 signatures.

2. Petition of Stephen Wilson on behalf of Lynch Syndrome NZ to fund Keytruda for Lynch Syndrome patients. 1820 signatures.

3. Petition of Marsha Mackie on behalf of Diabetes NZ to fund Continuous Glucose Monitors, GLP1 agonists including Bydureon, Byetta, Lyxumia, and Victoza, SGLT2 inhibitors including Forxiga and Jardiance, and DPP-4 inhibitors including Januvia, Onglyza, and Trajenta. 27, 958 signatures.

4. Petition of Malany Turner on behalf of PKU NZ to fund Kuvan and Palynziq for Phenylketonuria patients. 1896 signatures.

5. Petition of Elizabeth Hunt on behalf of Lysosomal Diseases NZ to fund Fabrazyme, Replagal, and Galafold for Fabry Disease patients. 201 signatures.

6. Petition of Diana Ayling on behalf of Head and Neck Cancer NZ to fund Keytruda for Head and Neck Cancer patients. 641 signatures.

7. Petition of Selina Leigh on behalf of Tahu Foundation and Brain Tumour Support NZ to fund Avastin for Glioma patients. 3368 signatures.

8. Petition of Kristin Dunne to fund Erbitux for Bowel Cancer patients. 1165 signatures.

Since October last year, twenty-two petitions (including the eight listed above) have been presented to Parliament for the funding of fifty-one medicines and medical devices across seventeen diseases and conditions (including nine cancers and five rare disorders). The total number of people who have signed the petitions is over 155,000.

States Chair of Patient Voice Aotearoa Malcolm Mulholland “In the space of just over one year, over 150,000 signatures have been collected for over twenty petitions that cover a range of diseases and conditions, asking that over fifty medicines or medical devices be funded. If that doesn’t indicate that New Zealand has a medicine funding crisis, then I don’t know what does. The blunt reality of this crisis is that thousands of New Zealanders are either dying unnecessarily, dying prematurely, or living with a low quality of life.”

“There is one reason why thousands of New Zealanders are going without the medicines they need and it is because Pharmac is not funded to the level it needs to be. This is why there are over one hundred medicines on the Pharmac waiting list, why Pharmac will challenge the efficacy of drugs that are funded in numerous other countries, and why it takes on average four years to fund one treatment. Pharmac is in crisis as evidenced by the record number of petitions being lodged to Parliament. The only way this can be achieved is by doubling the Pharmac budget.”

Ruby McGill has Type I Diabetes and requires Continuous Glucose Meters (GCM’s) to be funded. The Diabetes NZ petition asks that CGM’s be funded as well as nine drugs for Type II Diabetes. Comments Ruby “I’ve been fortunate to have an uncle fund a CGM for one year at a cost of $5000. It allowed me to live a full life as a mum, partner, sister, friend and business owner. In twenty years of living with the disease, I was in control of my diabetes and enjoyed better physical and mental health. By not funding CGM’s and the drugs, 260,000 New Zealand diabetic patients will continue to suffer from comas, seizures, blindness, kidney failure, amputations, heart disease and death. It is beyond belief that our Government allows so many people to suffer.”

Edward Porter’s son Otis has Cystic Fibrosis. Currently, Otis has a life expectancy of 37 years and maintaining a quality of life is a constant battle. If Otis could access the drug Kalydeco, he would live a relatively normal and lengthy life. “My heart breaks when I know that there is a drug that is funded in other countries that will give my son a normal life. If we stay in New Zealand, Otis’ condition will deteriorate to the point where he will die young. As the drug is funded in Australia, we face the very real prospect of becoming medical refugees, a decision that many New Zealanders we know have made in order to give their children the best shot at life. Why won’t our Government do something to help our son?”

Patient Voice Aotearoa continues to receive requests of support from patients and organisations wanting to lodge petitions for the funding of different medicines. Remarks Malcolm Mulholland “While we encourage patients and organisations to continue to lodge petitions with Parliament for certain drugs and medical devices to be funded, as Patient Voice Aotearoa, we have started our own petition that we believe will solve the medicine crisis that confronts New Zealand. We encourage all New Zealanders to take thirty seconds of their day and sign a petition that calls upon the Government to double the Pharmac budget immediately, with a view to triple the Pharmac budget over two years, and to conduct an external reform of the agency whereby international funding guidelines are followed, clear timeframes are set by which medicines will be deemed to be efficacious and when a drug or medical device will be funded, and for a rapid access scheme to be established.”

Mulholland’s final plea is to the Government, the Minister of Health, and the Prime Minister. “Stop muddying the waters by saying that Pharmac is independent of Government. We agree that politicians should not be second guessing clinical decisions about what drugs to fund or not but that is not what this debate is about. This is about the Minister taking responsibility of an agency that falls within his portfolio and equipping it with the resources it needs to do its job properly. If we fund Pharmac properly by aligning the level of funding of Pharmac with the OECD average, then the agency would clear the current backlog and fund the over one hundred medicines on its waiting list, it would be able to fund medicines much quicker, it would follow international guidelines and not swap psychotropic drugs that have potentially claimed the lives of four New Zealanders, it could develop an equitable process for the funding of drugs that treat rare disorders, and it could provide quick and easy access to drugs that are promising but require more clinical data.”

“Failure to act now and not addressing the medicine funding crisis will result in more unnecessary deaths, in people not living as long as they should, and in people having a poorer quality of life. This Government was elected to power on the promise of caring for the people, of prioritising wellbeing and being transformational in the lives of New Zealanders. It they do not act now and with urgency, then this Government will be remembered for not valuing life itself.”

More Work Needed to Reduce Harmful Drinking

Majority of New Zealanders Drinking Responsibly And Less, But More Work Needed to Reduce Harmful Drinking

NZ Alcohol Beverages Council (NZABC) says the majority of New Zealanders drink responsibly and generally Kiwis and young people are drinking less, but there is more work to be done to reduce harmful drinking, in response to the recent results of the National Health Survey .

“Eighty percent of New Zealanders who drink alcohol are drinking in a responsible way. Drinking behaviours are changing and we are drinking 25% less than we did in the 1970’s and 80’s . We are also seeing a significant reduction in drinking especially amongst young people,” says Bridget MacDonald, NZABC’s Executive Director.

“It’s going to take time and an all-of-society approach to make bigger shifts in New Zealand’s drinking culture, but we are seeing positive changes in attitudes, more no- and low- alcohol options, and momentum for change is gaining,” she says.

The survey shows that while 58.3% of 15- to 17-year-olds drank alcohol in the past year, we are still seeing a large decrease (-16.2%) in young people drinking, down from 74.5% in 2006/07. In the wider group of young people aged 15-24 years, drinking has declined 7% from 83.8% in 2006/7 to 76.8% in 2018/19.

NZABC says the industry has zero-tolerance for underage drinking, and acknowledges drinking too much alcohol can cause harm, and that more needs to be done to accelerate the changes and reduce harmful drinking.

The current hazardous drinking measure has only been surveyed for 4 years making any long-term trends difficult to establish. However, since collecting the data in 2015/16, there has been a reduction in hazardous drinking in the following age brackets:

15-24 years (-2.6%), 18-24 years (-1.7%), 25-34 years (-2.3%), 45-54 years (-0.8%).

Bridget MacDonald says, “We all have a part to play in reducing harmful drinking and ensuring those who choose to drink do so responsibly, moderately and safely. This needs the collective effort of parents, family, friends, schools and universities, workplaces, NGOs, local and central government, and the alcohol industry too. We need to tackle reducing harmful drinking through targeted education and support programmes, which are critical to educating young people on alcohol harm and encouraging adults to drink responsibly.”

Two youth-focused education programmes are already helping young Kiwis to make better decisions around alcohol and to delay drinking. The Smashed Project is a theatre-based education programme that equips to Year 9 students to deal with real life situations where there may be peer pressure to drink alcohol. Since launching in May, more than 20,000 students across New Zealand now have a better understanding of the negative effects of alcohol, how to make better choices for themselves, and where to find help if they need it. The partnership between Life Education Trust and The Tomorrow Project (Cheers NZ), which is funded by in part by NZABC members Spirits New Zealand and the Brewers’ Association, is aiming to roll out the programme to all 60,000 Year 9 students in 2020.

Cheers NZ (cheers.org.nz) also delivers social marketing initiatives to shift parents’ attitudes towards underage drinking and to support them in being better role models.

Pregnant Women blamed over nutrition – regardless of context

Pregnancy Malnutrition in Aotearoa continues to be treated as a Self-Responsibility Behaviour-Deficit … regardless of Context

Latest research analysis shows expectant NZ women struggling to achieve optimal nutritional intake as recommended by our MoH. Maternity health professionals are increasingly voicing frustration at being the “ambulance at the bottom of the cliff” when clearly our Education on choice-based rhetoric is proving inadequate.

Self-employed Dannevirke Midwife Briony Raven, and Doctor of Nursing from Massey University Dr Rochelle Stewart-Withers, have completed a CDA (critical discourse analysis) around the concept of food security, to understand pregnant women’s nutrition in NZ.

Their research conclusion summarizes “The most dominant discourse is one whereby malnutrition is seen as deficit behavior and thinking by women, and one of self-responsibility, regardless of [poverty] context. This is very much in keeping with the modus operandi of public health and neo-liberal discourse.”

Raven and Stewart-Withers continue “We argue, however, this renders silent the fact that malnutrition for some women results more from food insecurity and disempowerment.” They advise Midwives need to make audible other less dominant narratives, alongside avocation for woman-centred, policy-based approaches towards nutrition.

Three key messages were identified:
·        Pregnant women, when not viewed holistically/relationally, are isolated as being solely responsible for their nutrition
·        Women are viewed as naïve recipients who need to achieve a healthy pregnancy through education and compliance to adhere to complex food guidelines
·        There is an authoritarian-use of ‘fear’ and monitoring that attempts to motivate adherence to guidelines
Local Midwife Kathy Fray who has been NZ’s No.1 best-selling birth-babies-motherhood Author for the past a 1½ decades, responds “I agree with the research conclusion that pregnant kiwi Women are in general held personally accountable to attain oftentimes complex societal/MoH nutritional targets – which for many can be both unrealistic and unaffordable. A good quality Daily Prenatal multi-vitamin multi-mineral costs about $1 a day, and not every woman can afford even that.”

Fray continues “The pressure on pregnant women to confirm these days – to sooooo many things – can create undesirably-high levels of stressful anxiety. Fifty years ago, pregnant women just ‘got on with it’ but today they feel continuously interrogated with a ‘Are you doing everything correctly?’ undertone. A simple solution would be our government funding a daily Preggy Multi that includes the recommended levels of Folic Acid and Iodine, instead of the current policy that Pharmac supplies separate Folic Acid tablets, and Iodine tablets – but no other general Minerals or Vitamins for maternal-fetal wellness”.

10,000 Kiwis diagnosed with Parkinson’s must get more active

Exercise NZ says many of the 10,000 New Zealanders who are diagnosed with Parkinson’s need to get more active.

Richard Beddie, chief executive of Exercise NZ, says one in every 500 Kiwis suffers from Parkinson’s and regular activity will help them. Parkinson’s New Zealand starts its annual awareness week tomorrow.

Parkinson’s is the second most common neurological condition in New Zealand and Beddie says Exercise NZ has supported the training of exercise professionals to better understand the condition.

“Also as a partner of Exercise As Medicine NZ, we have helped train many exercise professionals to help those with chronic health conditions, including Parkinsons,” Beddie says.

“The health benefits of exercise have long been extolled. Heart disease treatment and prevention, cancer, and mental health are amongst the most commonly known areas to benefit from regular physical activity.

“Exercise can be cheap, relatively safe and free of side effects. It is increasingly being used to help manage other health conditions like Parkinson’s disease.

“Studies consistently reveal that people with Parkinson’s can improve in the following their strength, endurance, balance, mobility, walking ability and flexibility. Research has shown that people who exercise are less likely to develop Parkinson’s.

Everyone with Parkinson’s should exercise, according to the Michael J Fox Foundation. Fox, the actor, launched the foundation in 2000 after publicly disclosing his 1991 diagnosis, at aged 29, with Parkinson’s disease.

Meanwhile, scores of trainers and fitness facilities from all over New Zealand, many of whom help Kiwis with Parkinsons, are into the finals of the annual New Zealand exercise industry awards.

The winners of the ExerciseNZ event will be announced in Auckland on November 23.

The awards recognise exercise professionals and facilities for helping many of the 500,000 Kiwis stay active.

New Zealand is leading the world in stroke prevention

This year’s World Stroke Day campaign, #DontBeTheOne, encourages everyone, no matter what their age, to assess their individual risk of stroke using the free Stroke Riskometer mobile app developed by Professor Valery Feigin at Auckland University of Technology (AUT).

AUT and Stroke Central Region will co-host the official launch of the world stroke campaign in New Zealand, with a livestream from the university’s city campus today at 9.30am.

#DontBeTheOne is a key initiative of the World Stroke Organization (WSO) in its commitment to Cut Stroke in Half. It is the first world stroke campaign to focus on population-wide prevention and aligns with the United Nations’ Sustainable Development Goal #3 – ‘To ensure healthy lives and promote wellbeing for all at all ages’. One of the specific health targets is to reduce premature mortality from Noncommunicable Diseases (NCDs) by a third by 2030. However, a UN report showed that 138 governments had demonstrated very poor or no progress towards their time bound commitments.

The latest analysis from the Global Burden of Disease shows that that the lifetime risk of stroke, for those aged over-25, now stands at one-in-four. Stroke is a leading cause of disability and death worldwide, yet it is largely preventable. Almost 90 percent of strokes can be attributed to a few behavioural and lifestyle risk factors that can be easily modified, such as high blood pressure, physical inactivity and smoking.

The WSO believes that accessible smartphone technology can help tackle widespread stroke prevention, even in low-income settings. Validated technologies like the Stroke Riskometer (available for free in 14 languages on the AppStore and GooglePlay) are moving fast and show unprecedented uptake among the public and health professionals alike, with almost 200,000 downloads across 78 countries prior to the world stroke campaign.

The Stroke Riskometer is an easy-to-use tool for assessing your risk of stroke and what you can do to reduce that risk. It boasts a unique algorithm that combines age, gender, ethnicity, lifestyle and other health factors to calculate personal stroke risk. The mobile app successfully addresses a major barrier to stroke prevention – how to make medically accurate and reliable information on personal stroke risk accessible to populations worldwide.

Professor Feigin, Director of the National Institute for Stroke and Applied Neurosciences at AUT, is considered one of the world’s most influential scientific minds – ranking among the top one percent by citations for his global research on the epidemiology, management and prevention of stroke and traumatic brain injury. He says primary stroke prevention needs an overhaul.

New Zealand employs a ‘high-risk strategy’ in stroke prevention, using a Cardiovascular Disease (CVD) risk screening system. However, current CVD risk assessments do not include most of the behavioural and lifestyle risk factors that contribute to the vast majority of strokes. By definition, high-risk strategies exclude people at low to moderate CVD risk, who ultimately make up 80 percent of all strokes and heart attacks. This group receives no recognition, education or other preventative initiatives.

“Stroke prevention should be population-wide, rather than only targeting those at high risk. This would not only have an impact on stroke, but cardiovascular disease and the whole range of noncommunicable diseases. The results would be clearly evident within the first year or two,” says Professor Feigin.

“The greatest harm of high-risk strategies is that they mislead policymakers and health professionals into thinking they can tick the box and the problem of prevention is sorted.”

There is a growing body of evidence to support both the medical and cost effectiveness of population-wide strategies. However, there is still no country in the world where they have been implemented in full. OECD countries allocate less than three percent of health spending on average to public health and prevention initiatives. Almost half of this is spent on less cost-effective measures, such as high-risk screening.

“Let’s make New Zealand the first country in the world to implement a full stroke prevention strategy. A sector-wide district health board deficit of more than NZ$1billion highlights the unsustainable cost of inaction,” says Professor Feigin.

The urgent need for action at an individual and population-wide level is only matched by the potential for a huge reduction in stroke.

JOIN #DontBeTheOneNZ

Download the free Stroke Riskometer mobile app. Calculate your stroke risk percentage. Make small lifestyle changes to reduce that risk. And, share your progress on social media using #DontBeTheOneNZ – (FacebookTwitterInstagram).

Stroke Central Region is the official partner of the world stroke campaign in New Zealand. The Wellington-based non-profit organisation for stroke survivors and their whānau will host a series of events throughout the year, inspiring people to be active and improve their lifestyle.

You can contribute to population-wide change with a click.

Every Stroke Riskometer download is a vote of support for stroke prevention.

Underuse of Radiation Therapy in Cancer Treatment a Concern

Many cancer patients in Australia and New Zealand continue to miss out on radiation therapy in their treatment.

According to new data1 presented at the 70th Annual Scientific Meeting of the Royal Australian and New Zealand College of Radiologists (RANZCR) in Auckland today, only 25 per cent of cancer patients in NSW received radiation therapy compared to the optimal rate of 45 per cent.

This matches previous data for New Zealand which shows that less than a third of patients will actually receive radiation therapy2, despite half being likely to benefit from having it at some time during their cancer experience3.

Lead researcher and radiation oncologist Dr Roya Merie said: “These figures concerningly show that use of radiation therapy is well below the optimal figure in treating cancer effectively.

“This deficit has significant negative impacts on patient outcomes and it is important that strategies to overcome such shortfalls are developed to improve radiation therapy use and ensure patients receive the most appropriate treatment for them.”

For more information on the Royal Australian and New Zealand College of Radiologists’ 70th Annual Scientific Meeting or to review the program visit http://www.ranzcr2019.com

Smoking is Becoming A Dying Habit in Aotearoa

Hāpai Te Hauora is quietly celebrating the release of Census 2018 figures which shows a drop in the proportion of regular smokers aged 15 years and over decreasing to 13.2 per cent, compared to the 2013 Census figures of 15.1 per cent.

“That amounts to every one in eight adults in New Zealand who smoke, about half a million people,” said Mihi Blair, General Manager of the National Tobacco Control Advocacy Service at Hāpai.

“Even though the decrease is small, we should be celebrating,” Ms. Blair said.

“I would attribute this decrease to the rapidly rising cost of tobacco, an increase in smoking alternatives such as vaping and a lower number of young adults taking up smoking.”

“What’s more, these decreasing figures should make tobacco companies realise that they are not wanted in Aotearoa anymore, as they get rid of their addiction to tobacco.”

“When you consider that only 13.2 per cent of the New Zealand population aged over 15 now regularly smoke, and compare it with the 1976 Census figure of 35.6 per cent of people who smoke, you realise how far we come,” Ms. Blair said.

“However, we still have a long way to go if we are to attain the Smokefree 2025 goal of the population aged 15 and over who smoke being less than 5 per cent.”

“There still needs to be a real push towards more investment in the SF2025 goal, with a focus on targeted approaches to support people to quit combined with access to harm reduction products, with serious consideration to regulate tobacco supply, nicotine content and flavours of tobacco products,” Ms. Blair said.

Say what? What are children in New Zealand eating?

Just what New Zealand children are eating isn’t clear and new research aims to find out.

Dr Helen Eyles, Senior Research Fellow at The National Institute for Health Innovation, University of Auckland, has been awarded a Heart Foundation Senior Fellowship and Project Grant to come up with real-world solutions to improve the diets in our children and tamariki.

One of her key aims is to find out more about children’s dietary sodium and potassium intakes, which are linked to cardiovascular disease later in life.

The Heart Foundation announced $3.7 million of funding for heart research and specialist training for New Zealand cardiologists in 2019, bringing the total awarded by the charity since its formation in 1968, to more than $74 million dollars.

Dr Eyles’ world-first research will find out how much sodium and potassium New Zealand children are consuming, set manufacturer bench marks for how much sodium should be in fast foods, and develop a tool to help healthcare practitioners identify people with high sodium and low potassium diets.

High blood pressure leads to cardiovascular disease and the preference for salty food starts early in life. Diets high in salt (and sodium) and low in potassium in childhood can lead to high blood pressure. Although children and teens usually don’t show the symptoms of heart disease, the silent build-up of plaque can start in childhood and can have a serious impact on their adult life.

“We know that ideal sodium and potassium intake is important across the lifecycle, because changes to the vascular system start very early in life. In New Zealand one in five adults has high blood pressure, and this burden is unequal, with Māori being 30% more likely than non-Māori to have high blood pressure.”

“Very little is known about children’s diets in New Zealand, with the most recent Children’s Nutrition Survey undertaken in 2002. The survey of children’s sodium and potassium intakes will be the first of its kind in New Zealand, and provide important, gold standard data on children’s intakes of these nutrients, and will provide us with information about blood pressure in a large group of children,” says Dr Eyles.

The researchers will sample 300 children aged eight to 11 throughout Auckland primary schools to gather the data. This will cover the socioeconomic spectrum and also consider differences in gender and ethnicity.

The findings of Dr Eyles research will also contribute to New Zealand’s commitment to The World Health Organisation in 2013 to reduce population sodium intake by 30 per cent by 2025. Despite this New Zealand adults currently consume 40 per cent more sodium and 10 per cent less potassium than recommendations and Dr Eyles says there is clearly room for improvement.

The new research will also involve developing a tool to help healthcare practitioners identify individuals with high sodium and low potassium diets so they can make lifestyle changes.

“The Heart Foundation funding is extremely valuable to progress my career and achieve my research aims. Without this funding it would not be possible to complete my planned research to contribute towards reducing blood pressure through dietary means in Aotearoa. I feel both humbled and privileged to be a Heart Foundation Senior Research Fellow.” – Dr Helen Eyles

NZ’s first CAR T-cell cancer therapy clinical trial underway

New Zealand’s first clinical trial of CAR T-cell therapy, a revolutionary new approach to fighting cancer, is getting underway after receiving final regulatory approval.

The phase I safety trial, called ENABLE, is part the of the Malaghan Institute’s research and development of a new version of CAR T-cell technology, in partnership with Wellington Zhaotai Therapies Limited. The trial will involve up to 12 participants with certain types of relapsed and refractory B-cell non-Hodgkin lymphoma who have exhausted other treatment options.

Malaghan Institute Clinical Director Dr Robert Weinkove says the production of CAR T-cells is a major step in the development of the Institute’s cell therapy capabilities.

“Chimeric antigen receptor T-cell therapies are being offered to treat certain types of B-cell lymphoma (lymph node cancer) in countries such as Australia and the UK. For this early phase safety trial of a new type of CAR T-cell therapy, we’ll be manufacturing the cells in the dedicated cell therapy suite at the Malaghan Institute in Wellington.

“Because the safety and effectiveness are not yet known, this will be a small trial for a limited number of participants. Nonetheless, this is a very exciting milestone, and we hope the experience and knowledge we gain from the ENABLE trial will help more New Zealanders benefit from CAR T-cell therapies in the future.”

Dr Weinkove says the trial will not be the right option for everyone, and it is important that patients speak with their specialist about their treatment options. “Referrals for the trial can only be accepted from haematologists or oncologists, who will be advised of the criteria and how to refer.”

Dr Weinkove says the trial is taking place at a single centre, to allow close monitoring of participants, but referrals from other hospitals will be considered. “With support from Leukaemia and Blood Cancer NZ, we hope to be able to provide travel and accommodation support for participants from outside our region.”

Phase I trials assess the safety of a new treatment, and determine the optimal dose. Participants will be recruited gradually, to allow safety monitoring between each participant. Dr Weinkove says it is unclear exactly when the first participant will receive treatment, as this will depend on the results of pre-treatment tests, successful CAR T-cell manufacture and on ensuring that all necessary checks are satisfied before the cell are given.

“We anticipate that it will take 18 months to complete recruitment to this trial. While we will get preliminary response data over the course of the trial, full analysis of the primary outcome data could take up to a further year.”

CAR T-cell therapy is an emerging form of cancer treatment which has recently been licensed in Australia, the United States and Europe to treat patients with certain types of lymphoma and leukaemia. The Malaghan Institute’s CAR T-cell product is a new ‘third generation’ CAR T-cell technology, based on new and unique intellectual property.

“While we hope our CAR T-cells’ unique properties translate to clinical benefits, they may not. The differences mean we cannot rely on results of trials undertaken with other CAR T-cell products overseas, and must establish the optimal dose and safety of our cells before we can progress to larger trials to establish its effectiveness.”

Dr Weinkove says the aim of the Institute’s Freemasons CAR T-cell Research Programme and its clinical programme is to accelerate availability of the treatment locally.

“By establishing the production of CAR T-cells for research and early phase clinical trials, we hope to develop and support the regulatory and clinical environment for safe CAR T-cell delivery in New Zealand.

“We are also undertaking parallel laboratory research focusing on improving CAR T-cell therapies and potentially extending them to other cancers in future,” says Dr Weinkove.

“This is an exciting time for cancer research, only made possible thanks to the support of a whole cast of donors and funders including Freemasons New Zealand, David Downs’ Down with Cancer campaign, the Thompson Family Foundation, the Florence Petersen Leukaemia Trust, the Hugh Green Foundation, the K.I.A. Taylor Charitable Trust, the Tonks Family Foundation, the Lion Foundation, the Infinity Foundation, the Health Research Council and the Ministry for Business, Innovation and Employment.”

The Malaghan Institute is not a provider of health services and does not recruit patients to clinical trials directly. Referrals to the CAR T-cell ENABLE trial must be made by a relevant specialist (a haemotologist or oncologist) to the Clinical Trials Unit via RES-Research@ccdhb.org.nz or www.ccdhb.org.nz/working-with-us/clinical-trials-unit/

Stillbirths significantly reduced over last 10 years

The rate of stillbirths is reducing for Māori and NZ European mothers, a report by the Perinatal and Maternal Mortality Review Committee (PMMRC) has found.

The PMMRC is an independent committee that reviews deaths of mothers and babies in New Zealand, and advises the Health Quality & Safety Commission on how to reduce those deaths. It also reviews cases of neonatal encephalopathy, which can be caused by lack of oxygen in babies during pregnancy or birth.

Committee chair Mr John Tait says he would like to acknowledge the mothers and babies whose lives have been lost, and the families and whānau who bear the grief of losing their loved ones.

‘It is their stories that allow us to strive for and promote system change to reduce preventable death.’

The report shows that the rate of stillbirth has significantly reduced overall since 2007, and has reduced for babies of Māori and NZ European mothers, but not for other ethnic groups.

Mr Tait says while, overall, these figures are very pleasing, there are still areas where urgent improvement is needed.

‘The rates of stillbirth for Indian and Pacific mothers remain significantly higher than those for NZ European mothers. We need to improve our models of care to meet the needs of all our mothers, but particularly our Indian and Pacific mothers.’

The report shows that the leading cause of perinatal-related death continues to be physical abnormality present from birth.

The report has a number of recommendations for the government and health sector. These include:

– funding of specific maternal mental health services, to improve maternal mental health with the flow on benefit to family/whānau and the community

– developing a consistent recommended way to support women/families/whānau when they have had a bereavement with a national perinatal bereavement pathway

– mandatory fortification of bread with folic acid to reduce preventable death and serious illness from neural tube defects

– improving the quality of ethnicity data in the National Maternity Collection so we can more clearly understand differences in care

– monitoring data by ethnicity related to maternity (for example, registration with lead maternity carer, preterm birth and induction of labour) to identify variation between ethnicities and work to improve those areas.

The report says bereavement care for families and whānau is inconsistent across DHBs.

Lisa Paraku, a consumer advisor to the committee, says bereaved parents, families and whānau are pleading for a national bereavement pathway ‘in the hope our grief journey can be as gentle as it can be’.

Currently, information for bereaved families and whānau, counselling and follow up care can differ widely depending on locality and circumstances. She says it’s time to be brave and create a system that serves all peoples, where, when and how they need it.

Mr Tait says the report highlights a number of other areas of concern.

‘There are significant lifelong health issues and risk of death to babies from neural tube defects, however there is strong evidence that mandatory fortification of food with folic acid reduces the prevalence of neural tube defects – and this is what the report calls for.

‘Until bread and flour fortification is implemented, folic acid should be provided for free. The benefits of this outweigh any potential adverse effects,’ he says.

The report says a system change for Māori mothers, babies and their whānau is urgently needed.

‘Māori women living in the poorest communities in Aotearoa experience the greatest loss from perinatal related deaths, though these inequities burden Māori whānau irrespective of their socioeconomic status.

‘It is also unacceptable that suicide is the leading cause of maternal death, with Māori mothers more than twice as likely to die as NZ European mothers.

‘PMMRC continues to see inequities in perinatal and maternal mortality and morbidity in New Zealand. It is increasingly acknowledged that racism is a determinant of health and a key driver of health inequities that disadvantage some groups and advantage others.

‘We will continue to highlight the need to raise awareness of, and employ strategies to eliminate both conscious and unconscious bias and institutional racism throughout our system,’ he says.

Maternal Morbidity Working Group annual report

The Maternal Morbidity Working Group also released its annual report today. The working group addresses systemic factors that may contribute to illness in pregnant or recently pregnant women and identifies opportunity for improvement.

The two conditions of focus in the report are peripartum hysterectomy and hypertensive disorders in pregnancy, such as pre-eclampsia.

Arawhetu Gray, co-chair of the working group, says this report is about real lives and making a difference for mothers and their whānau.

‘Women who bravely shared their experiences of being very unwell when pregnant have helped inform the working group’s recommendations. We are immensely grateful for their gift of personal narratives.’

The report shows Māori and Pacific women were over-represented in pregnant or recently pregnant women admitted to a high dependency unit and/or intensive care unit compared with non-Māori, non-Pacific women.

The report also provides updates on the maternal morbidity review toolkit and the maternity early warning system.

Ms Gray says they are looking forward to seeing how these quality improvement initiatives will be implemented to ultimately improve outcomes for mothers, babies and their families and whānau.

Definitions

– A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy.

– A perinatal death is the death of a baby from 20 weeks’ gestation (pregnancy) up to 27 days after birth. This includes stillborn babies. A neonatal death is the death of a live born baby from 20 weeks’ gestation (pregnancy) up to 27 days after birth.

– A stillbirth is a baby who is born from 20 weeks’ gestation (pregnancy) without any signs of life.

– A peripartum hysterectomy is a major operation where a woman’s uterus is removed during or immediately after delivery.

– Hypertensive disorders in pregnancy are characterised by high blood pressure and, often proteinuria (protein in urine). Approximately 5-10 percent of pregnancies in New Zealand are affected by hypertensive disorders in pregnancy.

ENDS

Key findings, recommendations, and frequently asked questions attached.

Read the PMMRC report here: https://www.hqsc.govt.nz/our-programmes/mrc/pmmrc/publications-and-resources/publication/3823/.

Read the MMWG report here: https://www.hqsc.govt.nz/our-programmes/mrc/pmmrc/publications-and-resources/publication/3837/.

All pharmacists to be trained vaccinators in future

From 2020 all intern pharmacists will be trained as vaccinators as a regular part of their pharmacist intern training programme.

Pharmaceutical Society President Ian McMichael says, “we are delighted to be working in collaboration with the Immunisation Advisory Centre (IMAC) to enable this to happen.”

The country’s immunisation rates for communicable diseases have been falling and are not necessarily at World Health Organisation recommended levels.

“Everyone knows that outbreaks of diseases increase when immunisation levels decrease. This has been demonstrated by the current measles outbreak that New Zealand is experiencing. With 1,000 accredited pharmacist vaccinators and pharmacies in all communities, pharmacists are part of the solution to increasing immunisation rates.”

“Your community pharmacy is the most convenient access point for vaccinations for many people,” says McMichael.

The Society is calling for a formal Ministry of Health led “Catch-Up Plan” to increase the populations immunisation levels.

“New Zealand needs additional supplies of vaccines to keep abreast of a growing population. This is the second time this year that the country’s supply of vaccines for a disease has fallen well short of demand,” explains McMichael.

“The system needs fixing. We are asking the government to change regulations, get the software “plug in” to enable pharmacists to be able to report in electronically to the National Immunisation Register, forecast and contract for increased stock levels,” states McMichael.

Let’s Talk Cancer Hui

Northland DHB is hosting a Hui in Rawene on Tuesday 10 September with the aim to build bridges and engage with the community around cancer care and what a patient’s journey currently looks like in Northland.

The ‘Let’s Talk Cancer Hui’ at Rawene Town Hall has been collectively put together by Northland DHB, Cancer Society Northern Region, North Haven Hospice, Leukaemia & Blood Cancer New Zealand and Hauora Hokianga. The event is open to members of the public and health professionals who will learn about what cancer is and the modern treatment options available, while addressing any misconceptions and concerns they may have.

Northland DHB clinical Nurse educator Courtney Morgan says there will be a range of knowledge brought to the Hui to inform the community about the signs of cancer and how to get diagnosed early.

“We are aiming to reduce inequity for our people in Northland. That is why we are going to the places that need us the most. There will be a big focus on how to live well with lots of brochures and people there to talk to, with different tips and advice on how to do this. We will also have different cancer and medical support groups representatives for people to talk to and ask questions and make connections in the community of the Hokianga.”

Northland DHB consultant haematologist Dr Sarah Poplar says they want to reassure people that they are here to listen to their wishes and put forward treatment options for discussion and advice so that they can make the right decision based on the latest evidence and the priorities of the individual.

“Our training and the treatments we offer are evidence-based, but we recognise patients sometimes choose alternatives, and we respect that.”

Sarah says her goal is to ensure Northlanders can access treatments locally that might be available to a New Zealander in the metro regions, where feasible and safe. “We work closely with colleagues in Auckland to deliver equitable access to treatments not available in the region and support patients through the practical difficulties of our unique geography where possible.”

Health Psychologist Bryony Parkes will be speaking about the emotional impacts of going through cancer and the signs of depression and anxiety, which she says will be helpful for patients and families to know what to look for, so they know when to ask for help.

“Receiving a cancer diagnosis is a big shock, and it is normal to go through stages of increased anxiety, stress and low mood. I hope that discussing this helps people to know their reaction is normal and that they are not alone.”

Doctor George Laking will also be speaking about his three month sabbatical on the East Cape where he looked at developing a model of cancer care that combines a Māori world view on health. Kaumātua Hone Taimona will follow with a talk about rongoā/traditional methods of healing.

Members of the Hokianga and other Far North communities are encouraged to attend. There is no need to register prior to the event, just turn up on the day. The Hui runs from 9am until 3pm.

PHARMAC says more medicines on the way

PHARMAC says more medicines on the way

PHARMAC has reached a deal with pharmaceutical companies for three new medicines to treat ovarian cancer, breast cancer and leukaemia.

“The $60 million boost means we can make real inroads into funding medicines on our priority list. This is great news for New Zealanders,” says PHARMAC Board Chair Steve Maharey.

Consultation has gone out today on proposals to fund three new cancer medicines. The new medicines are olaparib (Lynparza) for ovarian cancer, fulvestrant (Faslodex) for breast cancer and venetoclax (Venclexta) for chronic lymphocytic leukaemia.

PHARMAC is also proposing to make two long acting contraceptives (Mirena and Jaydess) available to more people. It also proposes that the meningococcal ACWY vaccine (Menactra) be free for people in close living situations such as university hostels and army barracks.

Nearly 60,000 New Zealanders could benefit from these medicines in the first year.

If the feedback from the consultation is positive, patients could be prescribed some of these medicines from November this year.

PHARMAC is also looking to get the best deal for New Zealanders for a medicine for a particular type of advanced breast cancer.

There are two registered medicines in New Zealand that clinical experts believe would be suitable. One of these is palbociclib (Ibrance) and the other is ribociclib (Kisqali). PHARMAC has issued a request for proposals and one of these medicines could be available from April next year.

“PHARMAC’s role is to make more medicines available to more New Zealanders to help them live healthy lives,” says Mr Maharey.

“This extra funding has taken the annual medicines budget to over $1 billion. We are working our way down our medicine priority list. These new medicines are just the beginning – more is on the way.”

Kiwis encouraged to explore their way to wellbeing

With one month to go and over 4,000 Kiwis signed up to participate in Mental Health Awareness Week (MHAW), the campaign is already its biggest ever in Aotearoa.

MHAW is 23-29 September and New Zealand workplaces, communities, schools and kura are asked to Explore your way to wellbeing – Whāia te ara hauora, Whitiora.

MHF chief executive Shaun Robinson says the week, which has been led by the Mental Health Foundation of New Zealand (MHF) for 26 years, provides an opportunity to take notice of what makes you feel good and do more of that.

“Mental health is a taonga. It’s something we all have and something to look after so we can lead our best and most fulfilling lives. When our personal wellbeing is strong, our whānau, communities and Aotearoa can flourish too,” Mr Robinson says.

Mr Robinson says wellbeing isn’t just for people who have not experienced mental illness – it’s for everyone.

1 in 5 Kiwis experience a mental illness each year. Almost all of these people will recover or live well with the right support.

“Mental Health Awareness Week is an important reminder that we all go through ups and downs in life, and that’s why we need to explore what can help us when we’re feeling good and when we’re not.

“There are many challenges within our mental health system right now and advocating for better for all New Zealanders is a key part of our daily mahi. We acknowledge there’s a lot to do and it is going to take time. Exploring our way to wellbeing is something we can all do right now to make a real difference.”

MHAW in underpinned by Te Whare Tapa Whā, a model that describes health and wellbeing as a wharenui/meeting house with four walls.

The walls are taha hinengaro/mental health, taha wairua/spiritual health, taha tinana/physical health, and taha whanau/family and friends. Connection with the whenua/land forms the foundation of the wharenui.

“While it’s important to have the freedom to find out what makes you feel good, Te Whare Tapa Whā is a great framework for all New Zealanders to explore different ways to wellbeing,” MHF Māori Development Manager Ellen Norman says.

“Identifying all parts of our wairua, whānau, whenua, tinana and hinengaro makes us feels good means we’re prepared to handle the tough times.”

This year’s MHAW activities include competitions and challenges, community and cultural events and activities that align with Te Whare Tapa Whā.

Northland Babies Sleep Safely Thanks to Lions Club

The Mangakahia Lions Club have kicked off their 50th anniversary celebrations by donating funds to Health Fund PLUS to purchase lifesaving equipment for the Special Care Baby Unit (SCBU) at Whangarei Hospital.

The funds were used to purchase a new sleep apnoea monitor for use on premature babies in SCBU. These monitors check the respiratory rate of infants, and if they stop breathing for more than 20 seconds, an alarm will sound.

SCBU associate clinical nurse manager Merophy Brown said having a new sleep apnoea monitor to use in the Unit means they can share other units they have with the Children’s Ward and lend them out to parents who need to monitor their babies after they leave the hospital.

Little Jay Junior (JJ) Thompson has been using the new monitor since it arrived in the Unit. JJ will be heading home today for the first time since he was born in March at just 27 weeks at Auckland Hospital.

He weighed 805 grams at birth and spent his first two months in the Newborn Intensive Care Unit in Auckland before being transferred to SCBU where he has been for the past four months. Now JJ is a healthy nine pounds, his parents John and Tania Thompson get to take him home with the aide of oxygen and a monitor.

Tania said it means a lot to have this equipment donated and she is extremely thankful to all the staff that have helped them out since he was born.

The Club raised the $1880 required for the equipment by cutting and selling over 100m3 of firewood and held several golf tournaments all with the goal of supporting children in hospital. Club president Ray Webb said because nearly all their club members have children and grandchildren, they understand how valuable equipment like this is for the community.

The anniversary isn’t until October, but Ray said they have several other projects planned to commemorate their anniversary.

The money they donated was distributed by Northland Community Foundation through Health Fund PLUS which has been set up by Northland DHB and the Foundation to provide a way for people to give to the DHB by way of donations or endowments.

Health Fund PLUS enables Northland DHB to purchase equipment and services over and above what can be purchased through Government funding, helping the organisation provide the best quality healthcare possible to the people of Northland.

Giving is easy. People can give a regular donation, a one-off gift, or there is an option to make provisions in your Will. The first thing is to contact the Northland Community Foundation to talk about your idea for a gift and discuss how you would like to contribute.

Call Northland Community Foundation on 021 558 224 at any time for all the information you need.

New Zealand Ranks Last in OECD for Medicines Access Again

“A Bitter Pill to Swallow”: New Zealand Ranks Last in OECD for Medicines Access Again

The 2019 IQVIA ‘International Comparisons of Modern Medicines’ (ICoMM) Report, which compares the public funding of modern medicines in 20 OECD countries, paints a bleak picture for New Zealanders who desperately need access to medicines. Despite its strong economic indicators New Zealand comes last, with the worst access to modern medicines and the lowest pharmaceutical investment level overall.

“It’s a bitter pill to swallow,” says Patient Voice Aotearoa (PVA) Chair Malcolm Mulholland. “Of the 304 modern medicines included, only 17 were funded by Pharmac. No modern medicines were funded for conditions including arthritis, cardiovascular disease, diabetes, rare diseases and mental health.

“For cancer, only 6 modern medicines were funded – leaving 28 cancer medicines and more than 120 medicines in total sitting on Pharmac’s waiting list. The average time taken for Pharmac to fund medicines (512 days) was also twice as slow as the OECD average (233 days).

“The report confirms what other research has been saying for some time now. That New Zealanders are being denied medicines that patients in other OECD countries take for granted, and the few modern medicines that are funded take far too long to be approved.

“We have fallen well behind the rest of the first world and it is beyond belief that treatment for conditions that affect countless New Zealanders – such as cardiovascular disease, diabetes and mental health – are not being funded” says Malcolm.

Despite Pharmac’s recent decision to fund Alectinib (Alecensa) for lung cancer patients pending a period of consultation, Lung Foundation Chief Executive and PVA Trustee Philip Hope has called for “an immediate tripling of the medicines budget.

“The gap that has been uncovered in medicines funding has been growing year on year in real terms, when taking population growth and inflation into account. All six of the lung cancer drugs (including Alectinib) sitting with Pharmac are endorsed as standard of care, and they are reimbursed right across the bulk of OECD countries, including Australia.

“The question we have to ask as advocates, and the question that patients are asking, is when will the government (and Pharmac) undertake corrective action to fill the investment gap into modern medicines?”

PVA Trustee and Spinal Muscular Atrophy (SMA) Lead Advocate Fiona Tolich said “There are 377,000 New Zealanders living with a rare disease and there is no system in New Zealand to support the funding of medicines for this community. Not a single modern medicine has been funded in this space. Pharmac is not fit for purpose for many conditions but least of all rare disorders. When you have families fleeing like refugees to save their own or their children’s lives does that not tell you that something is seriously wrong with our country?”

Patient Voice Aotearoa believes that the IQVIA Report reinforces the lived experience of New Zealand patients with a range of diseases and illnesses. Many of whom appeared before the Parliamentary Health Select Committee (HSC) last week asking the HSC to urge Pharmac to fund more modern medicines.

“Yet again the Health Select Committee heard first-hand the devastating effects Pharmac is having by delaying decisions and not funding drugs that are so badly needed to improve the quality of life, extend life, or save lives” says Malcolm. “The time for increased funding for Pharmac, and reform of the Pharmac model is well overdue. If this doesn’t happen New Zealanders will continue to needlessly suffer and die.

“Pharmac’s decision to fund Kadcyla (for breast cancer), Alectinib (for lung cancer), and Ocrelizumab (for multiple sclerosis), is a welcome decision but one that took far too long. As advocates for patients with a range of conditions we will continue fighting for access to modern medicines for the good of New Zealanders and generations to come. We will leave nobody behind.”

About Patient Voice Aotearoa: Patient Voice Aotearoa (PVA) is a newly established charitable trust, which advocates for the rights of New Zealand Patients. PVA has already amassed nearly 3,000 members and is a national collective of patients, caregivers, whānau and disease and illness advocacy organisations.

Read the ICoMM 2019 Report here: https://bit.ly/2MOb6bw

Thousands of Kiwis Living with Asthma at Risk

Thousands of Kiwis Living with Asthma at Risk During Whooping Cough Outbreak

Thousands of Kiwi adults living with common respiratory diseases such as asthma risk potentially life-threatening complications from whooping cough this winter.

The warning comes with the country experiencing a nationwide outbreak of whooping cough with over 4,690 New Zealanders contracting the disease since it began in 2017.

Whooping cough (pertussis) is a common and potentially deadly illness caused by the bacterium Bordetella pertussis, rivaling measles as one of the most contagious diseases affecting the human population.

Rates of pertussis are higher in Maori and Pasifika people aged 15+, with rates of respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) also a significant health issue in these populations.

Internationally, New Zealand has a high prevalence of asthma with one in eight (12%) adults reporting taking current asthma medication New Zealand also has one of the highest hospital admission rates for asthma of OECD countries and pre-existing asthma can increase the rate of hospitalisation from pertussis.

Similarly, COPD, which is a term covering emphysema, chronic bronchitis and chronic asthma, is the fourth leading cause of death nationwide. One in seven adults over 45 have COPD with hospitalisation rates highest for Maori. The rate of hospitalisation as a result of this respiratory disease are also five times higher in the most deprived areas than in the least deprived.

Dr Helen Petousis-Harris, Vaccinologist and Senior Lecturer, Dept General Practice and Primary Health Care of the University of Auckland says although generally not severe in otherwise healthy adults, pertussis can be associated with serious complications in patients with existing chronic conditions such as obesity, asthma or COPD, and can be readily transmitted to other vulnerable populations, including infants before they complete their first vaccination.

She says while awareness is growing for the need to get vaccinated for influenza at this time of year, the burden of whooping cough among the adult population is widely underestimated and there is a clear rationale for extending vaccination throughout life to prevent disease in this group.

“While the focus is often on ensuring the protection of infants, there are other susceptible members of the community that risk serious health complications from whooping cough.

“For someone who lives with asthma or COPD, contracting pertussis could be life-threatening as these pre-existing respiratory diseases leave them more vulnerable.

“In the same way we advise protecting infants from exposure to whooping cough, it is important for adults living with asthma or COPD, as well as their whanau to look at immunising themselves against this highly contagious disease,” she says.

Dr Petousis-Harris says whooping cough immunity from childhood vaccinations will wane over time and will need booster shots to help prevent disease later in life.

She says exposure to colds and influenza during winter may further impact on the body’s ability to protect itself.

According to latest figures from the Institute of Environmental Science and Research, more than half (51%) of the 2,110 whooping cough cases notified over the past twelve months were adults aged 20+, with this age group representing 45% of hospitalisations. Maori and Pasifika make up the bulk of adults who contract the disease.

Dr Petousis-Harris, says local research into Kiwis’ awareness of pertussis suggest they fail to understand how readily the disease can be transmitted.

The research found that almost all (96%) of respondents had heard of whooping cough however only a quarter of respondents said they were vaccinated for whooping cough and had received a booster shot.

A further 29% said they had been vaccinated but had not had a booster and almost half (46%) of NZ adults were unaware whether they were vaccinated or had received a booster against whooping cough.

Guidelines recommend whooping cough booster vaccinations for adults who are at risk of severe illness or complications from the disease, such as those with chronic respiratory conditions, every ten years.

Under a new proposal, PHARMAC is set to widen access to the whooping cough vaccination for adults aged 45 and 65, pregnant women in their second and third trimesters, as well as for parents and primary caregivers of infants admitted to a Neonatal Intensive Care Unit or Specialist Care Baby Unit for more than three days.

Dr Petousis-Harris says adults are also at risk of other complications including rib fractures, weight loss, and urinary incontinence syncope from severe coughing.

“It is possible to reduce the risk of catching and spreading this disease – if you’re pregnant, in close contact with an infant or have asthma/COPD you need to talk to your health care professional about getting a booster shot,” she says.

Celebrating 15 years of ‘Latching On’

On Friday, August 2nd and Saturday, August 3rd of 2019, somewhere near you, parents will be gathering…..

Pioneered by Women’s Health Action, the Big Latch On is an event that has been working to create a supportive breastfeeding culture in Aotearoa for fifteen years.

“We are proud of how the Big Latch On has grown over time,” says Isis McKay, Women’s Health Action’s General Manager. What started as a Guinness World Record attempt to have the largest simultaneous breastfeed in in 2005, has become an inclusive and supportive event. The event went Global in 2011, and now has 60,0000 people participating in over 28 countries. With over 80 venues already registered in New Zealand alone (even in the Chatham Islands!) it is shaping up to be a great event.

Although the event started as a part of World Breastfeeding Week celebrations, it has grown way past that. “The Big Latch On welcomes and all parents, no matter what their infant feeding journey’s look like” Say’s Isis, “This event is all about connecting parents with positive peer to peer and professional support, parenthood can be a difficult time, and it’s common to feel isolated, the Big Latch On is the ideal place to build relationships and community”

If people can’t make it to a venue, they can take part in the #BigLatchOnNZ online with the #HowWeLatch campaign “We want to flood the internet with hundreds of images showing all the beautiful way’s we nurture our babies/children” Says Isis. From Friday, August 2nd through to Sunday, August 4th hundreds of photos will be posted to Facebook @BigLatchOnNZ Instagram @Thebiglatchonnz and on Twitter @LatchOnNz

While the world record wasn’t broken that day 15 years ago, something important was born, an annual celebration of the joy and labour of nurturing our babies.

To find out more about the Big Latch On visit www.biglatchon.org.nz.

World Brain Day: NZ at leading edge of migraine research

This year’s World Brain Day today is dedicated to one of the most complex of all neurological disorders that affects millions of people worldwide: migraine.

Recent breakthroughs in treatment with a new class of drugs that, for the first time, prevent migraine rather than treat it after the fact, have been life-changing for many people but they don’t work for everyone.

Leading edge research at the University of Auckland is focused on understanding why these drugs are not always effective by investigating how they interact with a key hormone in the brain and nerves called CGRP.

The new migraine prevention drugs, released in the US last year, work to ‘mop up’ excess CGRP in the bloodstream or by blocking it completely, preventing it from acting on nerve cells. This is life-changing for some people, particularly chronic sufferers who may have more than 15 headache days per month.

CGRP is regarded as a key suspect in causing migraine because it is involved in chemical signalling between cells in the nerves and in the brain. Scientists have known for some time that people who suffer from migraine have elevated levels of, or are more sensitive to, CGRP, which acts as a spark, setting off an attack.

The Auckland team synthesised a fluorescent molecule of CGRP in the laboratory allowing the researchers to investigate in minute detail its interaction with cells in real time under a microscope.

“By successfully creating this CGRP molecule we hope to develop and refine the next wave of treatments to work even better and to understand exactly how these new drugs interact with CGRP in the body,” says PhD candidate Erica Hendrikse, a member of the research team whose mother has suffered severe migraine most of her life.

Erica remembers having to come home from school to ring an ambulance because her mother could not leave her darkened bedroom.

“Mum got them regularly but I definitely remember some being worse than others,” she says. “It feels really important for us to do this work because migraine has such a big impact on people’s lives. It also affects people so differently that even in the scientific world, the condition still has an air of mystery about it.”

The Auckland team includes Professor Debbie Hay, Dame Professor Margaret Brimble and Dr Christopher Walker at the School of Biological Sciences. The team previously discovered there are two ‘receptors’ for CGRP. This work seeks to understand whether they behave differently and if one receptor is more sensitive to CGRP that the other.

Public Safety Notice: Copycat Medical IDs pose serious risk

MedicAlert® Foundation is becoming increasingly concerned about a number of copycat unsupported medical IDs being advertised as Medical Alert Medical IDs.

Copycat medical IDs pose a serious risk to both patients and first responders in the event of a medical emergency if the correct patient information is not easily accessible.

MedicAlert® Foundation chief executive Murray Lord says, “MedicAlert is the only Medical ID service that is backed by a New Zealand based 24/7 emergency hotline to support first responders with vital information on your medical condition – no other copycat Medical ID provides this essential benefit.”

Copycat medical IDs are often advertised as a cheaper alternative to incentivise their purchase, but they are not registered or supported by the 24/7 emergency hotline enabling first responders to access accurate information about your medical status.

If you are unsure about the validity of your medical ID, the MedicAlert® Foundation is offering to help. Visit your GP and complete a MedicAlert® Enrolment form: forward this along with payment to enrol with MedicAlert® Foundation, along with the copycat ID.

The Foundation will then activate the support services you need and provide you with a new clinically validated custom engraved stainless-steel Medical ID at no additional cost.

“It is extremely important people are aware of the serious risks presented by using copycat IDs, they are not a Medic Alert® Medical ID and have none of the health, safety, privacy and identity fraud protection standards provided by a MedicAlert® Medical ID,” Murray Lord said.

Michael J Fox Foundation gives $221,000 to NZ

Michael J Fox Foundation gives $221,000 to NZ hunt for new Parkinson’s drugs
A $221,000 grant from The Michael J Fox Foundation will allow a team of researchers at the University of Auckland’s Centre for Brain Research to ramp up their hunt for new drugs that could potentially slow down Parkinson’s disease.
The Michael J Fox Foundation, founded by the Canadian actor and writer, is the world’s largest non-profit funder of Parkinson’s research, and is dedicated to accelerating a cure for Parkinson’s disease and improved therapies for those living with the condition.

Worldwide, an estimated six million people – including 10,000 in Aotearoa New Zealand – live with the condition, which has no cure. Parkinson’s disease is a neurodegenerative disorder that progressively erodes a person’s mobility and quality of life. By the time symptoms are apparent enough for diagnosis, the damage to the brain is too extensive to repair.

“Current treatments only alleviate symptoms but do not target the actual cause,” says Dr Victor Dieriks from the Centre for Brain Research, co-lead of the research team.

“What we are seeking is treatments that would delay or even prevent degeneration by targeting the earliest disease processesOne of these early processes is inflammation of brain cells, called ‘neuroinflammation’, and that’s what we are focusing on.”

Neuroinflammation is when cells that usually clean up waste and debris, or fight off infection, become activated for long periods of time, which leads to an attack on healthy brain tissue.

The new project will bring together two strands of research at the centre: one looking at neuroinflammation in brain disorders, including in Parkinson’s disease, the other investigating the actions of alpha synuclein (a-SYN), the problem protein that forms clumps in the brains of people with Parkinson’s disease.

Study co-lead Professor Mike Dragunow and his team at the centre had already discovered that inflammation occurs not only in brain immune cells called microglia – most commonly studied in Parkinson’s – but also in the cells that line the blood vessels throughout the brain, which regulate blood flow and the permeability of the blood-brain barrier.

It is these cells, called pericytes, which may hold the key to a new treatment avenue, and shed light on how a-SYN is involved in degeneration.

The researchers will first determine exactly how a-SYN acts on pericytes (sourcing a pure form of the protein from a collaborator in France). They will test this on pericyte cells isolated from donors with Parkinson’s disease and from people without brain disease, which are held in the Hugh Green Biobank at the centre; and in tissue sections from these same people held in the Neurological Foundation Human Brain Bank, also based at the centre. The team’s access to both brain cells and tissues from the same patients gives them a unique edge.

“If we find that a-SYN causes an inflammatory response in pericytes, then we will test pericyte anti-inflammatory compounds (recently discovered in Professor Dragunow’s laboratory) to see if they have protective effects on cells from people with Parkinson’s,” says Dr Dieriks.

“This could prove the first step towards a new drug therapy that could slow down the progression of the disease early on, before the more debilitating effects set in.”

Professor Dragunow says the Hugh Green Biobank is a huge asset in this project. Established in 2011 with funding from the Hugh Green Foundation, the biobank is dedicated to identifying new treatments for brain disorders by growing and studying human brain cells derived from autopsy and neurosurgical brain tissue donors, including those with Parkinson’s.

He says, “We are immensely grateful for The Michael J Fox Foundation grant, and most importantly to the generous patients and their families who donate tissue for our research. Our hope is that it will one day lead to real improvements in the lives of those affected by this disease.”

The other study investigators are Professor Maurice Curtis, Dr Helen Murray, Dr Deidre Jansson, and PhD student Taylor Stevenson, who with Dr Justin Rustenhoven (now based at the University of Virginia) made the first observations, in Professor Dragunow’s laboratory, of the actions of a-SYN on human brain pericytes. Results are expected by early 2022.

The grant was made to the University of Auckland’s For All Our Futures Campaign, which is raising funds to address major issues affecting New Zealanders. Essential funding also comes from the Hugh Green Foundation (which funds the Hugh Green Biobank), the Health Research Council of New Zealand, Neurological Foundation (which funds the Human Brain Bank), Neuro Research Charitable Trust, and Ian and Sue Parton.

Rural proofing government’s mental health boost

Rural Health Alliance Aotearoa New Zealand (RHAANZ) congratulates Government on its commitment of $1.9 billion to mental health in its recent wellbeing budget.

The wellbeing budget included over $500 million investment in new front line mental health services by 2024, and the total of $1.9 billion was the largest single item in the budget.

Professor Jane Mills, Chairperson of RHAANZ, said the increase comes at a time when concerns over rural mental health have never been greater, with elevated levels of mental stress, anxiety and suicide risk placing greater demand on already stretched services.

“We need to remember, rural New Zealand in population terms is equivalent to New Zealand’s second largest city in numbers, with all the diversity and challenges a population that size brings.

“We will be working hard to ensure that the government’s rural proofing policy that was launched by Minister for Rural Communities Damien O’Connor at last year’s Fieldays is clearly reflected in the implementation of the wellbeing budget for mental health,” she said.

As a sector responsible for almost half this country’s income earning exports, having a mentally sound, healthy population to generate that wealth is essential for the entire country’s economic and social wellbeing.

“RHAANZ has focused strongly on rural mental health in recent years, based around our Framework to Improve Mental Health and Addiction Outcomes, which we worked with our members to complete two years ago,” she said.

The framework calls for equitable access for rural people to health and social services, and ensuring rural communities receive their fair share of health expenditure.

Professor Mills said the framework endorsed many invaluable programmes developed specifically to recognise the unique needs and realities of people who are living and working in rural NZ.

“The framework is there, ready to go – it provides a ready pathway to ensure rural communities benefit quickly from the mental health allocation, and government can deliver the funds in a cost effective, efficient and effective manner.

“RHAANZ looks forward to working with Government over the next five years to ensure its rural proofing policy supports rural communities and health professionals to be around the table at every level of implementing and allocating the wellness budget mental health funding boost”.

Polio Survivors support vaccinations for children

Polio Survivors support vaccinations for children

Polio NZ urges parents to ensure their children take part in New Zealand’s vaccination programme to get vaccinated against Poliomyelitis and other devastating viruses such as Measles which is experiencing outbreaks around New Zealand and the world due to unvaccinated children.

The New Zealand vaccination programme gives children vaccines against Polio through a schedule of three vaccines between six weeks and five months of age* as part of the Ministry of Health’s National Immunisation Schedule.

The Polio virus can cause paralysis in one or more limbs with the most severe cases resulting in death or having to stay inside an ‘iron lung’ when the breathing muscles became paralysed, says Polio NZ’s President, Brian Robinson.

“Our members mainly contracted the Polio virus during the epidemics of the 1940’s and 50s,” says Mr Robinson who is a Polio survivor himself.

“The Polio epidemics had a devastating impact on New Zealand society. Children were unable to go to school, workers couldn’t go to their jobs, people couldn’t travel and children were taken away from their families. There was a huge climate of fear and it was a very traumatic period for the country.”

Until 1955, when the Salk vaccine created by American virologist Jonas Salk was introduced, Polio was considered one of the most frightening public health problems in the world. Prior to the development of Polio vaccines nearly every person became infected, with the highest disease rate being in infants and young children. The Salk vaccine arrived in New Zealand in 1957.

“Thanks to the success of New Zealand’s immunisation programme against Polio nowadays most parents have no idea what Polio is and the devastating impact it can have on families’ lives,” says Mr. Robinson.

“However, there are only a few countries where the wild virus is still active because of the inability for the vaccine to be delivered. Until Poliovirus is completely eradicated worldwide, there remains a risk of Polio returning to any Polio-free country, including New Zealand.”

Since 1962, seven cases of Polio have been reported in New Zealand, the most recent was in 1998. Humans are the only host for Polioviruses. People infected with a Poliovirus excrete the virus in their saliva and faeces, whether they have symptoms of the disease or not. Polioviruses are passed from person-to-person through the faecal-oral or oral-oral route. The viruses may be passed on through contaminated water, milk or food.

According to Polio NZ’s estimates, there are still about 9000 people currently living with the effects of Polio in New Zealand. Many of them are now experiencing the ‘Late Effects of Polio’, also known as ‘Post Polio Syndrome’ where Polio survivors experience new and different symptoms 20 to 40 years after first contracting the virus.

“Most doctors and health professionals have little understanding of the Late Effects of Polio or how to treat it,” explains Mr Robinson.

“Polio NZ is working to educate health clinicians as well as Polio survivors themselves about how to treat the effects of Post Polio Syndrome.”

Continence NZ urges Kiwis to have a ‘wee chat’

Incontinence isn’t the usual topic of conversation, but this week Continence NZ is encouraging Kiwis to get together and have a ‘wee chat’.

One in four Kiwis live with some bladder or bowel incontinence – that’s over 1.1 million New Zealanders. Urinary incontinence affects 590,000 New Zealanders. Bladder control problems are also common in mothers – one in three women have suffered urinary incontinence after having a baby.

This Continence Awareness Week, Auckland mother and grandmother, Emma Cherrington (48) is speaking out about her own incontinence journey to encourage others to overcome the taboo and have a ‘wee chat’ of their own.

Emma spent two decades living with incontinence and received several misdiagnoses before she found out the real problem. Emma first noticed she had an issue when she returned to indoor netball two months after her son was born. She recalls she came off the court just an absolute mess after wetting herself through the game. “I was really, really embarrassed. I didn’t talk to anybody about it at first, not even my mum,” says Emma.

When she eventually sought medical help, she was told it was a result of a weak core, and later, her weight. It wasn’t until recently, more than 20 years after having her son, Emma found out she has a pelvic support structure issue. The turning point for her was attending a community continence talk put on by Waitemata DHB.

“Women like to talk and have conversations with our girlfriends but sometimes personal issues like this are too hard to talk about and you can feel very isolated,” Emma explains.

“However, when you’re sitting a room full of women who have exactly the same issue that you do – and some have suffered far more than you have – it puts things into perspective.”

Emma’s among 1 million New Zealanders living with incontinence. Many are just doing their best to get on with everyday life and are too afraid or embarrassed to ask for help. Emma encourages those suffering in silence to get quality help and support.

“You deserve to live a full life. If a bladder issue is stopping you, then get it sorted. Don’t miss out on the things you enjoy because of this issue. Don’t be embarrassed and don’t let the shame of the issue get the better of you.”

This Continence Awareness Week (17-23 June), Continence NZ is encouraging New Zealanders from all walks of life to break through the taboo and ‘have a wee chat’.
“Kiwis could have a wee chat with a family member, a friend, a GP, a physio, a carer, by attending a continence talk, or they could simply start by calling our helpline on 0800 650 659 which operates from Monday to Friday,” says Continence NZ CEO, Louise Judd.

Expert continence nurse Janet Thackray is available on the helpline on Mondays and Tuesdays and has helped changed the lives of countless Kiwis living with this health problem.

“Anyone with a concern, no matter how big or small, shouldn’t hesitate to get in touch.”

The public can find out more information/advice here:

Facebook: @continenceNZ
#haveaweechat
www.continence.org.nz
Freephone helpline: 0800 650 659

Breast Cancer Foundation to fund scalp cooling for patients

Breast Cancer Foundation NZ (BCFNZ) has announced funding for up to 10 scalp cooling systems worth $500,000 in public hospitals around New Zealand.

The chief executive of BCFNZ, Evangelia Henderson, says District Health Boards across the country are invited to apply. “Scalp cooling systems minimise hair loss during chemotherapy and can make a hugely positive difference to women as they go through breast cancer treatment,” she says.

BCFNZ funded a successful pilot in Nelson Hospital last year, led by consultant medical oncologist Dr Kate Gregory. Of the patients that completed treatment, none lost more than 50% of their hair, and some had as little as 10% hair loss. None of the patients needed a wig.

Mrs Henderson says she is delighted that generous Kiwi donors have made the scalp cooling roll-out possible. “This kind of service makes an enormous difference to some patients, yet it is unlikely to ever be a priority for government spending,” she says.

“We hope as many DHBs as possible will jump at the chance to offer scalp cooling to their patients, and we look forward to receiving their applications.

“Breast cancer is a heartless disease that affects more than 3,300 Kiwis every year, and treatment can be harrowing,” she says. “These systems will reduce suffering by helping women keep most of their hair.”

Dr Gregory says hair loss is “hugely distressing for patients and many would describe it as the side effect they dread most.”

Scalp cooling is widely used throughout the United Kingdom, and more than 120 machines have been installed in Australian hospitals in the last few years.

What is scalp cooling?

Cold caps and scalp cooling systems are tightly fitting, strap-on, helmet-type hats filled with a gel coolant that’s chilled to between -15 to -40 degrees Fahrenheit. Scalp cooling works by narrowing the blood vessels beneath the skin of the scalp, reducing the amount of chemotherapy medicine that reaches the hair follicles. With less chemotherapy medicine in the follicles, the hair may be less likely to fall out. The cold also decreases the activity of the hair follicles, which slows down cell division and makes the follicles less affected by the chemotherapy medicine.

Is scalp cooling hard to tolerate?

Most people can tolerate it, although about half the patients feel chilly and experience headaches. Some people find the caps uncomfortable. A small number discontinue scalp cooling because of these effects.

Does scalp cooling take longer?

Yes. The cold cap needs to be applied before, during and after treatment so may extend the time at hospital by 1-2 hours.

Fifth case of measles in Northland

Fifth case of measles in Northland

A fifth case of measles has been confirmed in Northland, resulting in more people being placed into isolation.

“A daycare has been identified in the contact tracing for this latest case. As a result, the Centre has elected to close, and given the impact of the isolation requirements on both staff and families, this is entirely reasonable for this situation. The 14 day isolation period is up to and including Friday 7 June, for those who do not have proof of immunity to measles,” Medical Officer of Health Dr Virginia McLaughlin said.

“We understand the significant impact of isolation. However, this is the only way we can minimise the spread of this highly infectious disease.

“Immunisation is the only way to prevent measles, make no mistake measles can be a severe illness, is easily prevented by vaccination and if you are not immune you will be placed in isolation if required.”

Isolation means staying at home and not having visitors who are not immune to measles. That is, not using public transport, going to work, preschool, school, visiting neighbours, friends or family; going to church or other places of worship; social or sports activities; movie theatres, supermarkets and shops etc.

“For those people who have been contacted by our Public Health Nursing team and asked to remain in isolation, please do so, we need your full cooperation and support, to ensure the rest of the community are protected,” Dr McLaughlin said.

“We have identified over 100 contacts with the most recent case, and are currently working to find who has or has not got evidence of immunity. Please support your Northland DHB Public Health team and be vaccinated and if you are asked to stay in isolation do so, because they are working hard to keep you all safer!”

People aged 15 months to 50 years who have not previously been vaccinated against measles can be vaccinated at their general practice.

Almost everyone aged 50 or older had measles as a child and are therefore immune. Teenagers and young adults are least likely to have been immunised as young children.

“I can’t emphasise enough the importance of everyone getting their immunisations up to date given the recent cases of measles in our community – now is the time to act.”

If you’re not sure of your vaccination history, you can check you’re Well Child/Tamariki Ora (or Plunket) book, or ask your general practice.

The community need to be very aware of the symptoms of measles which start with a fever and cough and runny nose and sore red eyes, and then after three or four days a rash appears on the face and then spreads to the body.

Anyone believing they have been exposed to measles or exhibiting symptoms should not go to the ED, after hours’ clinic or general practitioner.

Instead call Healthline free on 0800 611 116 for advice and information from a trusted registered nurse, anytime, 24 hours a day, seven days a week.

Go to the DHB website www.northlanddhb.org.nz for more information about the signs and symptoms of measles and what to do if you are concerned.

New Event Aims to Add Fun into Stopping Smoking

New Event Aims to Add Fun into Stopping Smoking for Māori Women
Ready Steady Wahine launched in Auckland

Recent statistics indicate that only 62% of young Māori women are smokefree, and remain the highest smoking population group in New Zealand. Ready Steady Quit, a funded quit smoking service, this month launched Ready Steady Wahine to help build a community of wahine who can empower each other to a smokefree future.

Ready Steady Quit quit coach Arnia Appleby says “it’s so great that we’ve been able to provide a platform that brings wahine together, without shame or stigma, so they can make steps to improving their health and that of their whānau by becoming smokefree.”
Raewyn Crowe, who attended the event with her children comments “It was the best night and just what the kids and I needed. The kai was delicious and host beautiful and entertaining. I am so happy I came and grateful I could bring my children.”

The launch of Ready Steady Wahine was held in West Auckland and over 40 women, and children came along to enjoy a fun evening with entertainment from Buckwheat, kai and to hear inspiring stories from wahine who have become smokefree.
Stop Smoking Services Manager Angela Chong adds “Let’s be honest, stopping smoking can be really hard and people don’t know about the amazing supports available to help make this easier. We wanted to have a fun event to engage young Māori women so they can get to know us and how we and other support services are here for them.”

Another free event is planned for Wednesday 24 July, free registration via readysteadyquit.org.nz/events

Ready Steady Quit’s personal one-to-one quit smoking service can be accessed at any time and the programme is free for anyone who lives, works or studies in north, west or central Auckland. To find out about the service for yourself, whanau and friends visit www.readysteadyquit.org.nz.

Heart Kids applauds announcement of $12m funding boost

The money, announced by Associate Health Minister Jenny Salesa yesterday (Saturday 18th May), will go towards supporting programmes that will reduce the incidence of rheumatic fever among Maori and Pacific people and better management of the illness.

Heart Kids supports those children who contract Rheumatic Heart Disease and the 1 in 100 children born in New Zealand with a congenital heart defect.

Heart Kids CEO Kate Figgins says for years the charity has been pushing for more funding to fight the disease. “We have been the ambulance at the bottom of the rheumatic cliff. We see first hand how RHD derails entire families and we’re left to pick up the pieces. It’s heart breaking, especially when you know it could’ve been prevented. This initiative will provide a much needed boost to fighting the disease and improving health outcomes for our young and vulnerable.”

Pacific people make up 57 per cent of rheumatic fever cases and Māori make up 37 per cent. This is in stark contrast to the rest of the population which represent just five percent of cases. The latest data for the 2018 calendar year suggests the rates of rheumatic fever in Pacific people are increasing.

The health initiative is focused on the Auckland region because two-thirds of rheumatic fever cases occur there. A third of Heart Kids families dealing with the disease are from South Auckland and Heart Kids Family Support worker Montee Stehlin is at the coal face.

“Families whose children get struck down with RHD are affected in so many ways, not just physically, but emotionally and financially as well. A child goes from being fit and healthy one day, to being a permanent spectator the next, with constant trips to the hospital and possibly facing a shortened life. Then there is the emotional affect. The guilt many parents feel is huge. With RHD there are often no symptoms presenting prior to the diagnosis. The parent feels they’ve neglected their child, and as a result that child’s life will be scarred forever. And finally, there’s the financial stress. The loss of income for parents who have to reduce hours to care for their sick child. In some cases, parents have lost their jobs because of the level of care needed.”

Rheumatic Fever causes the joints, brain skin and heart to become inflamed and swollen, which can cause rheumatic heart disease, a scarring of the heart valves which can cause premature death.

“We look forward to working with local communities on this new rheumatic fever initiative and lowering the rates of this entirely preventable disease,” said Kate Figgins.

Get immunised against measles if you’re going overseas

The Ministry of Health is reminding travellers to make sure they are fully immunised against measles before they go overseas.

Measles is one of the most contagious diseases in the world and globally cases have increased by 300 percent in the first three months of 2019. Measles outbreaks are being recorded around the world including in countries with high overall vaccination rates including Australia, the United States of America, and Thailand.

There has also been an increase in measles cases reported across New Zealand since the start of this year. More than 110 confirmed cases have been recorded in Canterbury, Auckland, Waikato, Bay of Plenty, Lakes, Northland, Capital and Coast and Southern DHB areas.

“If you’re travelling overseas it’s really important to make sure you’re fully immunised against measles before you go. This will protect you from getting measles and also reduce the risk of you bringing measles back into this country when you return,” says the Ministry of Health’s Director of Public Health Dr Caroline McElnay.

“New Zealand eliminated endemic measles in 2012, meaning all cases of this highly infectious virus reported here since then have come from people bringing the disease in from overseas.”

“Local health authorities are working hard to contain the diseases spread, but we are concerned that there is a risk of measles becoming established in New Zealand again.”

“Immunisation is the best way to protect against getting measles. This spike in cases highlights why it is so important that our national immunisation schedule continues on track and children receive their free routine MMR immunisations on time at 15 months and 4 years of age.

“We are encouraging people, especially children, teenagers and young adults who have never been vaccinated to get immunised. The MMR vaccination is free for those under 50 who haven’t had two doses.”

“Children who have not yet been immunised are at greatest risk of the disease. The MMR vaccine is safe to give to children as young as 6 months. So, if you’re taking your infant to a country where there is a significant measles outbreak we recommend that they’re given a MMR vaccination before you go. Because the vaccine’s effectiveness is lower for babies under 12 months of age, if they are given the vaccine, they will still need two further doses of the vaccine at 15 months and 4 years for long term protection.”

“Measles can be deadly. If you’re feeling sick or if you or a family member aren’t fully immunised and may have been in contact with someone with measles you should stay away from work, school or public places, to help prevent putting other people at risk,” says Dr McElnay.

Those unsure of their vaccination status can check Well Child Tamariki Ora or Plunket books, or contact their General Practice. Further information is available on the Ministry of Health website or by calling Healthline (0800 611 116).

An up-to-date list of countries with a measles outbreak can be found on the Centers for Disease Control and Prevention website: Measles For Travellers

Schools get involved for World Asthma Day tomorrow

Over 130 schools throughout New Zealand have signed up to celebrate World Asthma Day tomorrow May 7, to educate children and teachers on the triggers and management of asthma.

Now into it’s second year, the fun and interactive World Asthma Day campaign provided by the Asthma and Respiratory Foundation NZ (ARFNZ) has seen almost twice as many schools sign up, with this year’s focus on how to manage an asthma emergency.

Letitia O’Dwyer, Chief Executive of Asthma and Respiratory Foundation NZ comments, “Statistics show there will be at least four children in a class of 30 students who have asthma, so we know that asthma has a large prevalence within our schools and communities. This year we have provided free activity packs for schools, educating students on how to respond to an asthma emergency should their classmate have one, and asking schools to check that their asthma emergency kit is up-to-date. The information provided within these resources is crucial, and could very well save lives” says Letitia.

Hundreds of asthma school activity packs have been sent out to schools in preparation for World Asthma Day. The activities involve fun and interactive games, arts and crafts, and suggestions for school fundraisers to aid in raising the national profile of asthma and respiratory illnesses within New Zealand. There are also prizes up for grabs – for every $25 a school raises gives them one entry into the draw to win a scooter, kindly donated by Micro Scooters NZ.

“Winning schools could potentially use the scooters as a prize for an outstanding leader or someone who demonstrates a positive attitude within their school community,” says Letitia.

ARFNZ is a charitable organisation that strives to provide resources and education across all areas of the community despite receiving no government funding. Some of the Foundation’s school-related initiatives include Sailor the Puffer Fish, a musical show educating primary school children about asthma which was recently launched in Te Reo Māori. ARFNZ also provides a‘Teachers’ Asthma Toolkit’, designed for teachers to have important information about asthma in one place – via an interactive website.

World Asthma Day is celebrated world wide and the activity pack is available for all early childhood education centres, primary schools, intermediate schools and secondary schools throughout New Zealand.

• To register your school for a World Asthma Day free electronic version of the activity pack, contact:marketing@asthmaandrespiratory.org.nz.
• Order an Asthma Emergency Kit for your schoolhere
• View the Teachers’ Asthma Toolkit

Implantable medical devices – the way of the future?

Medicine is moving away from drugs to implantable medical devices to treat chronic diseases, an international meeting of specialist pain medicine physicians has heard.

Pain specialist Dr Nick Christelis, from Victoria, Australia, has told a pain medicine conference in Kuala Lumpur that there is a shift from the biochemical era (medications) to the bioelectrical era (using implantable medical devices) to treat chronic diseases like chronic pain.

Addressing the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (ANZCA) Annual Pain Medicine Symposium, Dr Christelis says it is an immensely exciting time in medicine.

“We can now treat diseases that we’d never even dreamed of treating in the past like persistent nerve (neuropathic) pain, complex regional pain syndrome, chronic pain after spinal surgeries and other surgeries. Nerve stimulation can also now be used to treat bladder and bowel dysfunction, and even some movement disorders like Parkinson’s disease,” he explained.

But he also sounded a note of caution.

He says it is vital that these new technologies are used wisely and carefully to enable the best possible patient outcomes and results.

“They cannot be seen as the cure for all pain diseases, that is, there is no one size fits all pain treatment. They are a tool we use in the management of these disease and should always be combined with other forms of pain therapy approaches.”

The symposium follows the recent release of a Faculty commissioned report which found chronic pain costs New Zealand more than diabetes and dementia. One in five New Zealand adults suffer from chronic pain, about 770,000 people.

As secretary of the Society of Neuromodulation for Australia and New Zealand, he used his presentation to explore the “art” of neuromodulation, which he says combines clinical expertise with experience and empathy to ensure the best possible outcomes for every single patient.

“The art is making sure that the right patient gets the right form of nerve stimulation, at the right time, for the right disease process, with the smallest possible risk.”

Dr Christelis says failing to adopt new techniques is not an option.

“It would mean denying patients meaningful medical advances,” he said.

However, he says with any new technique in medicine there comes risk. He says pain medicine needs to continue to question how it provides patients with the newest medical technologies but limit the risks to the patients in a profession where medical expertise must be learned on patients.

The Pain at the Interface meeting being held at the Kuala Lumpur Convention Centre features Australian, New Zealand and international speakers presenting on a wide range of topics including opioids, chronic pain, post traumatic stress disorder and new developments in spinal cord stimulation.

About FPM

The Faculty of Pain Medicine is a world-leading professional organisation for pain specialists that sets standards in pain medicine and is responsible for education and training in the discipline in Australia and New Zealand. Pain medicine is multidisciplinary, recognising that the management of severe pain requires the skills of more than one area of medicine.

Chronic pain affects about one in five people in Australia and New Zealand. Specialists also manage acute pain (post-operative, post-trauma, acute episodes of pain in medical conditions) and cancer pain.

Growing acceptance for alternatives to cigarettes

A Majority of Healthcare Professionals in New Zealand are Supportive of Alternatives to Cigarettes if Regulated for use in Tobacco Harm Reduction
New Zealand, 23 April 2019 — A majority of healthcare professionals in New Zealand view Electronic Nicotine Delivery Systems (ENDS), such as e-cigarettes and heated tobacco products, as a viable alternative to cigarettes if they are legalised and regulated appropriately, according to new research conducted by Frost & Sullivan.

Over 500 adults in New Zealand (including current, former and non-smokers), as well as 60 healthcare professionals (including GPs, medical specialists (such as psychiatrists, surgeons and radiologists), nurses, pharmacists, and allied healthcare professionals) were interviewed as part of an opinion research study to gauge the level of understanding and attitudes towards alternatives to cigarettes.

New Zealand has moved to reduce smoking rates in recent decades, and currently boasts one of the lowest smoking rates in the developed world. However, almost 600,000 New Zealanders continue to smoke, with particularly high smoking rates among population groups such as Māori and the most economically-disadvantaged New Zealanders.

While the Government has set a target of achieving a Smokefree New Zealand by 2025, with a smoking rate of 5% or less nationwide, achieving this goal is likely to be challenging. Smoking is therefore likely to continue to be a significant health and economic challenge for New Zealanders.

Managing Director of Frost & Sullivan ANZ, Mark Dougan noted: “Smoking is still a key area of concern amongst healthcare professionals, with 90% believing that the government still needs to do more to address smoking. Our research shows that there is broad acceptance that ENDS are significantly less harmful than cigarettes, and widespread agreement amongst healthcare professionals that ENDS should be legalised as long as they are appropriately regulated.”

Healthcare professionals are largely supportive of the use of ENDS, with 65% agreeing that they would prefer smokers who are unable or unwilling to quit to switch to these instead of smoking cigarettes, with 33% unsure and only 2% opposed.

“In general, healthcare professionals believe that tobacco harm reduction products such as ENDS can aid in reducing the harm from smoking,” Mr Dougan said.

“Our survey indicates that 60% of smokers overall and 64% of Māori smokers would like to quit, but are facing challenges in doing so, with current smokers who have tried to quit reporting, on average, over six unsuccessful attempts to do so,” he added.

“However, about 40% of smokers do not wish to quit or are not sure. In this case, switching to tobacco harm reduction products is a better option in the long term than continuing to smoke cigarettes,” he said.

The survey also showed that healthcare professionals believe that greater promotion and raising awareness of the role of ENDS to both healthcare professionals and smokers and their families is necessary.

About Frost & Sullivan
For over five decades, Frost & Sullivan has become world-renowned for its role in helping investors, corporate leaders and governments navigate economic changes and identify disruptive technologies, Mega Trends, new business models and companies to action, resulting in a continuous flow of growth opportunities to drive future success.

This research was commissioned by Philip Morris International, however the analysis contained in this research reflects the views of Frost & Sullivan analysts without any bias or influence from any third party.

Two in five Auckland and Northland kids have teeth cavities

Two in five Auckland and Northland kids have teeth cavities by age five.

A new University of Auckland study shows two in five (41 percent) children living in Auckland and Northland have one or more decayed, missing or filled tooth when they start school.

The rate is higher still in Māori and Pacific children (59 percent and 65 per cent respectively), children from very deprived neighbourhoods (60 percent) and those living in Northland (54 percent).

This compares to rates of 25 percent in England, 35 percent in Wales, and 34 percent in Queensland, Australia in a similar age group.

The new study, published in the New Zealand Medical Journal, analysed records from school-entry dental exams of 27,333 children in 2014-2015. It also revealed that children who had been hospitalised for an injury at least once had a higher chance of rotten teeth at school entry.

Researchers say their findings underline the urgent need for society-wide actions to improve oral health in young children and tackle inequalities, including water fluoridation, measures such as a tax and health warnings to reduce consumption of sugary drinks, and oral health promotion that is meaningful in communities where children currently experience poorer oral health.

“Oral health is so important for the wellbeing of children. As a doctor, it is distressing to see children who have painful, eroded teeth when caries [tooth decay and cavities] are so preventable,” says researcher Dr Tim Jelleyman, an academic at the Faculty of Medical and Health Sciences and community paediatrician at Waitakere Hospital.

“It causes sleepless nights, loss of appetite, and general misery. And the bugs that set up in our mouths early in life probably impact the later health of our permanent teeth.”

Previous overseas studies linked several other childhood medical conditions and infectious diseases, such as asthma and middle ear infections, to a raised risk of tooth decay and cavities. The Auckland researchers were the first to check for these kind of associations in Aotearoa New Zealand by analysing dental records alongside hospital records.

Co-researcher Dr Sandar Tin Tin, a senior research fellow in the University’s School of Population Health, says they found no evidence that being hospitalised for avoidable medical conditions went hand in hand with a greater likelihood of tooth disease, once other known risk factors were taken into account.

“Instead, we found that children who had been hospitalised for injuries at least once had a 17 percent higher chance of caries at school entry.”

The reasons for this link are not known, but may partly reflect living conditions. There is a practical implication though, the researchers say.

Dr Jelleyman: “When we see children with injuries and other illness, probably we should be checking their mouths and discussing good care of teeth with them and their whanau/families.”

The issue calls for action on many levels, he adds, including caring for the teeth of mothers. “Good oral health in mothers during pregnancy will set their babies up for good oral health, too.”

Researchers say the higher rates in Northland could reflect in part the lack of community water fluoridation in the region. More broadly, they point to a shortage of dentists, and minimal regulation on the availability and promotion of sugary foods and drinks in this country.

“Ideally, we want to make water the first drink choice at home, early childhood centres and school, but this kind of shift takes time,” says Dr Jelleyman. “Avoiding sweet snacks between meals and providing water instead of sugary drinks in places where children play and learn would be worthwhile steps in this direction.”

The study’s other authors were former masters student Yan Myo Aung and Professor Shanthi Ameratunga.

World Allergy Week

Ahead of World Allergy Week kicking off on April 7, the Asthma and Respiratory Foundation NZ places a timely reminder on the benefits of maintaining a healthy home for those who live with asthma and allergies.

In New Zealand, approximately 70 to 80 percent of asthma is associated with allergies, with mould being one of the leading triggers.

Epidemiological studies also suggest that ongoing exposure to damp, mouldy buildings can worsen asthma symptoms in adults and children, increasing the risk of an asthma flare-up.

Asthma and Respiratory Foundation NZ, Head of Education and Research, Teresa Demetriou comments, “Many homes in New Zealand are cold and damp, which creates the perfect environment for asthma and allergy triggers such as mould. To help reduce this impact during the colder winter months, it is essential to create a warm, dry and pollution free environment.”

The World Health Organisation also recommends that room temperatures be a minimum of 18 degrees, to aid in reducing these allergy triggers.

Teresa continues, “The Foundation provides the Sensitive Choice® programme that assists people with asthma and allergies find out more information on reducing exposure to allergens within the home. The programme features hundreds of products that demonstrate a potential benefit and most importantly aren’t harmful.”

Sensitive Choice® is a well-established programme that has been running in New Zealand for over 10 years by Asthma and Respiratory Foundation NZ. All approved products have gone through an incredibly extensive approval process by a group of experts in their field

“People can easily identify that a product is asthma and allergy friendly by looking out for the Sensitive Choice butterfly on product packaging in stores.”

For further advice on minimising exposure to triggers in your home visitsensitivechoice.co.nz.

Lessons for NZ Farmers in Cancer Link to Herbicides

New Zealand farmers should end the practice of spraying crops with herbicides prior to planting and harvest after a widely used herbicide has again been linked to cancer.

Two US courts have found direct links between Bayer AG’s glyphosate-based herbicide (GBH) Roundup and non-Hodgkin’s lymphoma (NHL). Damages and costs of $81 million have been awarded to Mr. Hardeman. [1]

New Zealand NHL statistics have been rising at an alarming rate in direct relation to the increase in agricultural and council use of GBHs.

Desiccation of crops and pre-seed burn off of farmland using glyphosate-based herbicides is common. The concern is that a cavalier attitude to spraying and the overuse of these pesticides is now showing up in the cancer statistics.

For many years it has been claimed that GBHs are safe enough to drink and no more toxic than vinegar. However, mounting research has uncovered vital data. A meta analysis [2] published in the International Journal of Epidemiology (2019) found a high risk to agricultural workers, linking Diffuse large B-cell lymphoma, the most common form of NHL, to the use of glyphosate based herbicides.

The New Zealand Ministry of Health statistics show that in 1950, before the widespread use of pesticides, there were only 77 cases of NHL. When Roundup was commercialised in 1974 there were 177 cases or 5.5 per 100,000 people. In 2015 there were 845 or 12/100,000 and in 2016 there were 923, 13.3 /100,000. [3] [4]

Glyphosate has been found in cereals, beers, wine and honey. The herbicide is now found in genetically modified foods and vegetable oils such as corn, canola and cottonseed. However the regulator Food Standards Australia New Zealand (FSANZ) that approves genetically modified foods for the food chain has never accounted for the increasingly toxic levels of Roundup herbicides when approving these novel foods. The Environmental Protection Agency (EPA) has also been implicated in covering up concerns about toxicity and rewriting industry PR in their assessments.

“FSANZ, and the EPA have been negligent in not properly considering the increasing use of pesticides in the work place and in novel foods they approve,” said Claire Bleakley, president of GE-Free NZ.

“They have ignored the concerns over GM foods carrying high levels of Roundup residue although they are responsible for protecting the public health.”

Adverse Data on Monsanto’s/Bayer’s Roundup, uncovered by public interest researchers, have eluded authorities who have never dug deep enough to ask the appropriate questions on ghost written industry reports. [5]

There is an urgent need for government to look into the increasing risk from these pesticides and the wider implications. The government must act to remove toxic pesticides and start investing in regenerative agro-ecological solutions for better environmental and human health outcomes.

UNICEF NZ warns a global rise in measles cases is a threat

Following recent measles outbreak in North Canterbury, UNICEF NZ announced today that global cases of measles are surging to alarmingly high levels.

Ten countries account for more than 74 per cent of the total increase. In Brazil, Madagascar, the Philippines, Ukraine, and Yemen, there have been significant measles outbreaks.

Countries with ten highest increases in cases between 2017 & 2018
1. Ukraine: 30,338
2. Philippines: 13,192
3. Brazil: 10,262
4. Yemen: 6,641
5. Venezuela: 4,916
6. Serbia: 4,355
7. Madagascar: 4,307
8. Sudan: 3,496
9. Thailand: 2,758
10. France: 2,269

Globally, 98 countries reported more cases of measles in 2018 compared to 2017, eroding progress against this highly preventable, but potentially deadly disease.

“This is a wake up call. We have a safe, effective and inexpensive vaccine against a highly contagious disease – a vaccine that has saved almost a million lives every year over the last two decades,” says Henrietta H. Fore, UNICEF’s Executive Director. “These cases haven’t happened overnight. Just as the serious outbreaks we are seeing today took hold in 2018, lack of action today will have disastrous consequences for children tomorrow.”

Measles is highly contagious, more so than Ebola, tuberculosis or influenza. The virus can be contracted by someone up to two hours after an infected person has left a room. It spreads through air and infects the respiratory tract, potentially killing malnourished children or babies too young to be vaccinated. Once infected, there is no specific treatment for measles, so vaccination is a life-saving tool for children.

In response to these outbreaks, UNICEF and its partners are supporting governments to urgently reach millions of children in countries around the globe.

Notable reported measles cases in 2018 in countries with no reported cases in 2017
Brazil: 10,262
Moldova: 312
Montenegro: 203
Colombia: 188
Timor-Leste: 59
Peru: 38
Chile: 23
Uzbekistan: 17

Poor health infrastructure, civil strife, low community awareness, complacency and vaccine hesitancy in some cases have led to these outbreaks in both developed and developing countries. For example, in the United States, the number of measles cases increased six-fold between 2017 and 2018, reaching 791 cases. More recently, the U.S. has seen outbreaks in New York and Washington state.

“Almost all of these cases are preventable, and yet children are getting infected even in places where there is simply no excuse,” says Fore. “Measles may be the disease, but, all too often, the real infection is misinformation, mistrust and complacency. We must do more to accurately inform every parent, to help us safely vaccinate every child.”

To fight measles, UNICEF is issuing an urgent appeal to governments, health care providers, and parents to do more to contain the disease by:

• Understanding that vaccines are safe and effective and can save a child’s life 
• Vaccinating all children between the ages of six months to five years during outbreaks
• Training and equipping health workers so they can provide quality services
• Strengthening immunisation programmes to deliver all life-saving vaccines

Diseases move. People travel. New Zealand cannot afford to be complacent.

Care around the clock to continue throughout strike

To be attributed to: Michael Frampton, Chief People Officer, Canterbury DHB

With the New Zealand Resident Doctors’ Association 48-hour strike action starting tomorrow at 8am, Canterbury District Health Board is reminding people that they can help take the pressure off emergency services by always making their General Practice team the first port of call for their healthcare needs.

The 48 hour junior doctors’ strike runs from 8am tomorrow, Tuesday 26 February until 8am on Thursday 28 February.

The Emergency Department at Christchurch Hospital will continue to provide emergency care during the strike, and you shouldn’t hesitate to dial 111 in a life-threatening emergency. However, for most other healthcare you should always call your own general practice team first. Save their phone number in your mobile phone so you can easily access free health advice after hours.

When you call your general practice after hours, follow the instructions on their voicemail and a team of registered nurses will be ready to take your call – any time of day or night. They provide free health advice. If you need to be seen urgently, they can tell you what to do and where to go.

You can meet some of the #carearoundtheclock nursing team and learn more about the service they provide here.

If you need to visit a general practice after hours, you can visit one of these Urgent Care practices:

• The 24 Hour Surgery – 401 Madras Street. Phone (+64) 3 365 7777

• Moorhouse Medical – 3 Pilgrim Place, open 8am – 8pm daily. Phone (+64) 3 365 7900

• Riccarton Clinic – 6 Yaldhurst Road, open 8am – 8pm daily. Phone (+64) 3 343 3661

For trusted health advice, you can also visit our HealthInfo website or visit your community pharmacy for health advice.

HealthInfo is a health information website that has information specific to Canterbury. It is written and approved by local doctors, practice nurses, hospital clinicians, and other healthcare professionals, and features a mix of health information, fact sheets on different topics and descriptions of local health services.

People shouldn’t delay seeking medical treatment if they need urgent medical assistance at any time. Always dial 111 if it’s a life-threatening emergency.

People whose surgery or outpatient appointment has been postponed due to the strikes have been contacted directly. If you want to check if your appointment or surgery is still on, please call 0800 778 226 – after hours you can leave a message and someone will return your call the following day.

ESR calls for robust regulations over medicinal cannabis

One of the country’s main drug testing laboratories says robust regulations are needed to cover locally produced medicinal cannabis.

ESR says with Parliament having given the green light permitting a medicinal cannabis industry, it’s crucial that an evidence-based regulatory process is developed that defines strict quality standards.

ESR’s Manager of Forensic Toxicology and Pharmaceuticals, Mary Jane McCarthy, says there also needs to be robust safety data to ensure the products are safe and are shown not to cause harm to the people that use them.

She says there is a lot of confusion about medicinal cannabis.

“Our concern is that people don’t necessarily know or understand what is in the product they are taking.”

“We have had a number of the medicinal cannabis products available here in New Zealand – supplied to us by concerned patients and parents – and our tests have shown that there’s quite a lot of variability in the quality of products with some difference in the concentrations of the active ingredients,” Dr McCarthy says.

That includes tetrahydrocannabinol (THC), the psychoactive component of cannabis, and cannabidiol (CBD), which is not psychoactive. CBD has now been rescheduled so that it is no longer a controlled drug and is only a prescription medicine under the new law changes. Products containing it should become more available to patients from now on.

“We see a range of products – imported and homemade. Some of them have much higher concentrations of THC than they are stated to.

“We really do need to be testing and understanding the safety of these products and make sure they are effective for the condition which they are being used for, and won’t cause harm, she says.

She cites one instance when a worried grandfather contacted ESR about the product his grandchild was using for uncontrolled epilepsy.

“In this case, there should have been high CBD and low THC – in fact it was the opposite. I would be very worried about a child taking a product like that.”

ESR already provides testing services for pharmaceutical products for New Zealand and the Ministry of Health.

It is also part of the Medicinal Cannabis Research Working Group, a collaborative of both New Zealand and international expert specialists in medicinal cannabis research. The group has been set up in advance of upcoming clinical trials, which, once approved, will be the first time a locally grown pharmaceutical grade cannabis product will be tested on New Zealand trial participants.

ESR will carry out the chemical testing on any pharmaceutical grade cannabis being used in the trial and will also be testing patient results.

Parents Urged to Take Action with Men W Clinics

Parents Urged to Take Action with Men W Clinics in all Northland High Schools

With just three weeks left of the Northland outbreak meningococcal W campaign clinics in secondary schools are being established to ensure all eligible 13 to under 20 year olds have the chance to be vaccinated.

“The outbreak campaign was launched just three weeks before Christmas so many schools had already broken up for the holidays,” Medical Officer of Health Dr Jose Ortega Benito said.

“We really want parents and caregivers to take advantage of the free meningococcal W outbreak campaign so that our Northland children are better protected from this deadly disease.”

In the past two weeks, two new cases of invasive meningococcal disease were reported in Auckland and Canterbury and with the usual increase in cases in winter it is vital that our Northland community is better protected. As of 3 February 11,797 children had been vaccinated against meningococcal W.

“Sadly we had three deaths in Northland last year and therefore we are really focused on ensuring that every single eligible Northland child (22,707) is given the opportunity to be protected.”

Vaccinating 13 to under 20-year-olds is really important because this is the age group that generally carries the bacterium that causes the disease.

“Even if they have no symptoms, carriers can infect those around them. Vaccinating this age group will lower the number of carriers in Northland and stop the spread of meningococcal disease across the entire community.”

Phase Three of the outbreak vaccination campaign is underway with pharmacy, general practice, targeted Māori Provider outreach and secondary school-based clinics being offered until 22 February.

And, the DHB is offering the chance to win five $200 phone data vouchers as incentive for all children to return a signed consent form and receive the vaccination over the next two weeks.

“Parents and caregivers please take action now while you still can,” Dr Benito urges.

“Northland could be the safest place in New Zealand from meningococcal W if we get high enough levels of coverage from the outbreak campaign, so offering the chance to win some phone data might just encourage those undecided to go ahead.”

All clinic information is published on the Northland DHB website and Facebook page.

Meningococcal W

• Symptoms of meningococcal disease include fever, nausea, vomiting, headache, stiff neck, rash, drowsiness or irritability. 
• It is important to seek medical help immediately if you or your child has any of the symptoms of meningococcal disease.
• Contact your local hospital, GP or call Healthline 0800 611 116.

For more information go to the DHB website: www.northlanddhb.org.nz

Measles outbreak in the Waikato

Waikato DHB Medical Officer of Health, Dr Richard Hoskins is urging people to catch up on measles immunisations and to take appropriate action if they think they might have measles. The Medical Officer of Health has been notified of six cases of measles in the last week, some of them dating back to late December.

“Measles is easily passed from one person to another. The best form of protection is immunisation,” said Dr Hoskins.

“It is important to be aware of the symptoms of measles and what to do if you think you or a family member has measles. The first symptoms of measles are a fever, and a runny nose or cough or red eyes. After a few days a red blotchy rash develops and lasts up to one week. The rash usually starts on the face and spreads to the rest of the body.”

Public Health are working to inform individuals who may have been exposed to measles in various settings. Contacts who are not immune to measles are advised to stay at home and away from all public places, school or work for 14 days after their contact, or until their immunity is proven.

“Contacts” are people who shared the same indoor air as someone while they were infectious with measles (for example, by being in the same room as someone with measles). People most at risk of contracting the disease are those born after 1 January 1969 who have not had two doses of the Measles, Mumps, Rubella (MMR) vaccine.

About 2 in 10 people with measles will require hospital support. Measles can also lead to complications including ear infections, pneumonia, diarrhoea, seizures and encephalitis (swelling of the brain).

Measles can be very serious. If you or your child becomes unwell please phone your GP or call Health line on 0800 611 116 for advice or seek medical attention depending on severity of illness. It is important to call first because measles is highly infectious, and people with measles can infect others around them for example in waiting rooms of GP surgeries or ED. Measles is spread by tiny droplets in the air and is one of the few diseases that can spread so easily to those nearby.

Immunisation is the best protection against this potentially serious disease. You need two doses of Measles, Mumps, Rubella (MMR) vaccine to be fully immune. If you were born after 1 January 1969 check your vaccination status – if you are not sure, ask your doctor. The vaccines are free for children and for adults who have not received two doses.

Further information:

What is measles?

• Measles is a highly infectious viral disease that can be serious.

• It is spread from person to person through the air by breathing, sneezing or coughing. Just being in the same room as someone with measles can lead to infection if you are not immune.

What should you do?

• Ensure you are up to date with your immunisations.

• If you are not immune it is important to be aware of the symptoms of measles. The early symptoms of measles are fever, and runny nose or sore eyes or cough.

• After 2-4 days a red, blotchy rash appears on the face and head and then spreads down the body.

If you develop symptoms of measles:

• Stay at home and away from public places (such as sports events, gatherings, parties, school, work, child care, shopping centres, public transport and so on).

• See your doctor as soon as possible so a diagnosis can be confirmed. However, phone the surgery ahead to alert them of your symptoms and to allow them to make arrangements to assess you safely and without infecting other people.

• If you are unable to visit your GP phone Healthline on 0800 611 116.

People who are regarded as not immune to measles are:

• People younger than 50 years old (born after 01 January 1969) who have not had two doses of the measles-mumps-rubella (MMR) vaccine or have not had a laboratory result showing immunity

• Children over four years old who have not received their second dose of MMR vaccine

• Infants under the age of 15 months who have not received their first routine dose of MMR vaccine. They are susceptible and rely on everyone else to be immune so that measles does not spread to them

Other sites for more information:

Ministry of Health

Health Navigator

Bite and sting searches spike

Kiwis appear to be curious about summer misfortunes, with the Ministry of Health’s website seeing a spike in the number of people searching for information on jellyfish stings, wasp and bee stings, spider and insect bites this holiday season.

Between 24 December 2018 and 6 January 2019, the number of people heading to the Ministry of Health’s website for advice on jellyfish stings more than tripled (up from 264 to 853 on the previous two weeks). Those looking for information on bee and wasp stings shot up 86 percent (1,423 to 2,640), insect bites increased 73 percent (from 645 to 1,115) and spider bites rose 39 percent (from 2,712 to 3,764 ).

The Ministry of Health’s website (www.health.govt.nz) provides information on how to avoid and treat different types of bites and stings, how to identify what caused the injury, and how to know when you need to seek professional help. It also contains information on many other common health conditions.

As you’d expect, most people appeared to manage any bites and stings themselves and didn’t need to go an additional step of ringing Healthline to speak to a health professional for advice – Healthline reported only the usual number of calls related to bites and stings over the same period.

Stings and bites can range from mild irritations to serious, even life-threatening, wounds. Some people who are especially sensitive may develop a severe allergic reaction called anaphylaxis. It is important to call 111 for an ambulance if you or someone else has been stung and has symptoms of a serious allergic reaction or anaphylaxis.

A total of 3,764 people accessed information on spider bites between 24 December 2018 and 6 January 2019. Although it’s rare for significant problems to result from a spider bite, the katipô, redback and white-tailed spiders can be harmful and should be avoided. If somebody is bitten you should try to catch the spider and take it with you when you seek medical help.

During the same period, more than 850 people accessed information on jellyfish stings, to help them identify what had stung them, and the best way to treat the wound.

Fortunately New Zealand has to date avoided the rash of bluebottles currently invading beaches in Queensland Australia, with thousands of people being stung there over the past week. It is worth noting that the treatment of a bluebottle sting is slightly different to that of other types of jellyfish.

If you need to treat a bluebottle sting, follow these steps: 
1. Splash on lots of sea water straight from the sea immediately. 
2. Pull the tentacles off with a dry towel. Wear gloves if you have some. 
3. If you can, pour over warmed up sea water. You can put hot water into the sea water to add warmth. 
4. Immerse the stung area in heated tap water for 20 minutes. Have it as hot as the person can bear. Or use a wet, hot towel. 
5. Elevate the area, apply ice packs and take pain relief.
Follow these steps to treat stings from other jellyfish: 
1. Apply sea water to the area. If you are able to warm up some sea water, pour this over the area (even urine is better than nothing!). 
2. Do not apply fresh water as this will activate the stingers. 
3. Pull the tentacles off with a dry towel. Wear gloves if you have some, but you can use your fingers – although wash them immediately afterwards. 
4. Immerse the stung area in heated tap water for 20 minutes. Have it as hot as the person can bear. Or use a wet, hot towel. 
5. Elevate the affected area for 24 hours, and apply ice to decrease the pain

It’s important to remember to stay safe in the sun and water this summer. Always supervise children near water and remember to slip on a shirt or into shade, slop on sunscreen, SLAP on a hat and wear wrap-around sunglasses, to lower your risk of getting sunburn and skin cancer.
B

BACKGROUND
The Ministry of Health website has more information on bites and stings: 
Jellyfish stings: https://www.health.govt.nz/your-health/conditions-and-treatments/accidents-and-injuries/bites-and-stings/jellyfish-stings 
Bee and wasp stings: https://www.health.govt.nz/your-health/conditions-and-treatments/accidents-and-injuries/bites-and-stings/bee-and-wasp-stings 
Spider bites: https://www.health.govt.nz/your-health/conditions-and-treatments/accidents-and-injuries/bites-and-stings/spider-bites 
Insect bites: https://www.health.govt.nz/your-health/conditions-and-treatments/accidents-and-injuries/bites-and-stings/insect-bites

Visit the Sunsmart website for information on how to stay safe in the sun. https://www.sunsmart.org.nz/ 
Visit the AdventureSmart website, for advice and resources on how to enjoy water activities safely. https://www.adventuresmart.nz/

If however you do have any concerns, Healthline is available anytime, free on 0800 611 116 for advice and information from a trusted health professional.

Junior doctors’ strike will affect some surgery and clinics

Planned junior doctors’ strike will affect some surgery and outpatient clinics planned for next Tuesday 15th and Wednesday 16th of January

Members of the New Zealand Resident Doctors’ Association [RDA] are planning to strike for 48 hours from 7am on Tuesday 15th January until 7am on Thursday 17 January 2019

Like all District Health Boards affected by this strike, Canterbury DHB is well advanced in its contingency planning to ensure it continues to provide safe care during the strike period when we expect most Resident Medical Officers/junior doctors will withdraw their services.

Canterbury DHB employs around 550 Resident Medical Officers [RMOs] and understands about 70 percent are RDA members.

A number of the others belong to a new RMO union.

Canterbury DHB employs RMOs at most of its facilities.

Michael Frampton, Canterbury DHB’s Chief People Officer, says continuing to provide safe care for patients during the strike remains the highest priority and focus for the Canterbury Health System.

“We are prioritising essential and acute services, which means that some outpatient appointments and planned surgeries are being rescheduled,” he says. “We will be re-booking those affected to the next available appointment,” Michael Frampton said.

“Patients who have appointments or surgery booked during the strike period can expect to hear from Canterbury DHB. If people don’t hear from us, they should turn up as per their appointment letter.

“I apologise in advance to those whose surgery or outpatient appointment has to be postponed.”

The Emergency Department (ED) at Christchurch Hospital will remain open during the strike as will Christchurch Women’s Hospital.

“Canterbury people can help take some of the pressure off emergency services during the strike period by phoning their General Practice team first for all non-urgent care. When you call your usual general practice number after-hours your call will be answered by a nurse who can provide free health advice. If you need to be seen, they can tell you what to do and where to go for #carearoundtheclock.”

“Staff are starting to phone those affected by this industrial action. Some complex surgery that was planned for the days leading up to the strike will also need to be postponed, as well as some surgery and outpatient clinics on the 15th and 16th of January. Our contingency plans involve reducing the numbers of people in our hospitals. Some people may be discharged with in-home care and support where it’s safe and appropriate to do so.

“We are setting up an 0800 number for people who may want to check if their surgery or outpatient clinic appointment is affected. However, our intention is to contact everyone affected by phone. Details of the 0800 number will be publicised later this week,” Michael Frampton said.

Enlafax – Monitoring to Continue

Two separate Ministerial Expert Advisory Groups have concluded that a rise in adverse reaction reporting to a commonly prescribed antidepressant is not caused by medicine safety or quality concerns.

The Medicines Adverse Reactions Committee and the Medicines Assessment Advisory Committee (MAAC) made their assessments following a brand switch for the antidepressant: venlafaxine.

Both Committees recognised the public concern about Enlafax described in the adverse reaction reports. The MARC were pleased to see that the new online reporting tool for consumers was making it easier for consumers to report their experiences. The Committee found these reports very valuable, allowing them to understand consumers experiences and concerns.

Pharmac’s change to only fund Enlafax XR in September last year triggered a significant increase in reports of suspected adverse reactions to the Centre for Adverse Reactions Monitoring.

The Medicines Adverse Reactions Committee (MARC) – reconsidered the safety of venlafaxine at their meeting earlier this month.

Committee Chair Associate Professor David Reith said it was important to investigate if there was something significantly different about the adverse reaction reports for different brands of venlafaxine which should prompt further action.

He says the large number of reports are concerning, but not unexpected given the response to previous brand switches. The number of reports alone does not mean that there is a safety problem with the medicine. The numbers of reports can be explained by publicity encouraging reporting which may also prompt some loss of confidence in the medicines.

The group’s overall assessment is that the type of events being reported fit with the known adverse reaction profile for all medicines containing venlafaxine. Associate Professor Reith says the Committee understands that many people are undergoing some very distressing experiences. ‘We are very grateful that people have taken the time to report these to CARM. These reports have been thoroughly reviewed as we did when similar reactions were reported to Efexor XR.’

Associate Professor Reith says we have good data on the adverse reactions caused by specific medicines regardless of whether they are originals or copies.

The group were reassured that Medsafe had taken seriously the increase in reports of suicidality and in an exploratory analysis had found no change in the number of people needing hospitalisation for mental health conditions while taking venlafaxine in the six months following the brand switch.

The group’s assessment was that the adverse reactions reported for Enlafax (or medicines containing the same active ingredient) were known or were related to the patient’s condition. Importantly the type of adverse reactions reported did not change with any change in brand.

As lack of choice may be an important factor behind the concerns related to Enlafax the Committee encourages Pharmac to promote its exemption option for the small number of patients unable to move on due to issues they attribute to the brand switch.

Associate Professor Richard Robson chair of the MAAC said, the Committee audited Medsafe’s evaluation of Enlafax and found it to be appropriate; no issues were identified with the evaluation of the product. We agreed that the bioequivalence studies for Enlafax show it is bioequivalent and therefore interchangeable with Efexor. In addition we considered that the manufacturing and testing of the medicine should result in a good quality medicine in line with international standards.

Professor David Reith emphasised that anyone who is experiencing adverse effects from taking their medicine should go to their doctor and seek help as soon as possible.

To contact Associate Professor David Reith, in the first instance, contact Charlotte Gendall 021 500 947

BACKGROUND

The Medicines Adverse Reactions Committee (MARC) advises the Minister of Health on the safety of medicines. The Committee terms of reference, minutes and reports are published on the Medsafe website. https://medsafe.govt.nz/committees/marc.asp

The Medicines Assessment Advisory Committee (MAAC) provides advice to the Minister of Health on the benefits and risks of new medicines. Further information on this committee is available on the Medsafe website https://medsafe.govt.nz/committees/maac.asp

Enlafax is a generic medicine containing the active ingredient venlafaxine. Generic medicines are approved by Medsafe if they can show bioequivalence with the Innovator medicine. In this case Enlafax was shown to be absorbed to the same amount over the same time as Efexor. The study has been published on the Medsafe website. Enlafax has also been approved in other countries including Australia. https://medsafe.govt.nz/publications/OIA/27SeptRequestForBioequivalenceStudyForEnlafaxXR.pdf

The Centre for Adverse Reactions Monitoring (CARM) are contracted by Medsafe to collect reports of suspected adverse reactions to Medicines. The Centre informs Medsafe and the MARC of safety signals identified from these reports. Summaries of these reports can be found on the Medsafe website https://medsafe.govt.nz/projects/B1/ADRDisclaimer.asp

CARM received four fatal reports for Efexor (the innovator) up to the end of 2010, one linked to suicide.

Adverse reaction reports for Efexor (innovator product) include, 25 cases where the patient required hospital treatment, 9 considered by CARM as life threatening – including four suicide attempts or suicidal tendency

Adverse reaction reports for Enlafax include 25 reports are considered by CARM to be life threatening; one of persisting disability and 8 which required hospital treatment (received up to end of September 2018).

The data sheets provide information to healthcare professionals on who to prescribe medicines safely and the known side effects. Data sheets are published on the Medsafe website. The Efexor data sheet link: https://medsafe.govt.nz/profs/Datasheet/e/Efexorxrcap.pdf The Enlafax data sheet link: https://medsafe.govt.nz/profs/Datasheet/e/enlafaxXRcap.pdf

Both data sheets acknowledge the risk of worsening symptoms and suicide risk for patients:

The risk of suicide attempt is inherent in depression and may persist until significant remission occurs. The risk must be considered in all depressed patients.

Patients with depression may experience worsening of their depressive symptoms and/or the emergence of suicidality (suicidal ideation and behaviours) whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, all patients treated with venlafaxine should be monitored appropriately and observed closely for clinical worsening and suicidality, especially at the beginning of a course of treatment or at the time of dose changes, either increases or decreases.

The placebo effect has been defined as a beneficial effect produced by a placebo drug or treatment, which cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient’s belief in that treatment. The magnitude of this effect in patients with persistent depressive disorder has been quantified in a meta-analysis as a therapeutic response rate in around 30%. The placebo response was greater when the patient had a reduced chance of being randomly assigned to placebo in a trial. [Meister R, Jansen A, Haerter M et al (2017) ‘Placebo and nocebo reactions in randomized trials of pharmacological treatments for persistent depressive disorder. A meta-regression analysis’ Journal of Affective Disorders 215: 288-298]

The nocebo effect is the opposite of the placebo effect. A nocebo effect describes a negative outcome based on beliefs of harm. The magnitude of this effect has been assessed in placebo controlled trials. A meta-analysis to quantify the effect in patients participating in clinical trials for depression has been published. In patients taking placebo the nocebo effect was so significant and severe that 4.5% of patients had to stop taking the placebo. [Mitsikostas D, Mantonakis L, Chalarakis N. (2014) ‘Nocebo in clinical trials for depression: A meta-analysis’ Psychiatry Research 215:82-86]

Enlafax has been approved in Australia https://www.tga.gov.au/artg/artg-id-143552

Reposts of suspected adverse reactions are published on the TGA website https://www.tga.gov.au/database-adverse-event-notifications-daen

Pacific course looks to address alarming statistics

Pacific people need to focus more on improving nutrition, if they are to reverse the alarming life expectancy statistics which is seeing them dying younger and having higher rates of chronic diseases than all other New Zealanders.

The call for greater focus in this area comes as the Associate Minister of Health Hon. Jenny Salesa officially recognised the achievements of this year’s graduates of the AUT Certificate of Proficiency in Pacific Nutrition course.

The Heart Foundation’s Pacific Health Manager Mafi Funaki-Tahifote says this year’s graduates are now ready to join the fight against heart disease.

“The course provides students with hands-on learning and practical nutrition information with a distinctive Pacific ‘flavour’. It’s aimed at supporting New Zealand’s Pacific communities to make better and life-long food choices.

“The course which has been running since 2002, is a very important step forward in terms of improving the cardiac health and life expectancy of our Pacific people.

“Students are taught to develop meals with a reduced amount of saturated fat and a controlled portion of less healthy ingredients. All this is done while still maintaining the great taste and flavours of the food.”

Mafi says cardiovascular disease is the primary cause of death for Pacific people and is significantly higher for this group than for the remainder of the general population.

“Statistics show that 1 in 3 Pacific deaths from heart disease happen between ages 35-65, compared to 1 in 12 for Europeans.”

According to the New Zealand Health Survey 2017/18, 6 out of 10 Pacific adults and 3 out of 10 Pacific children are obese, increasing their risk of developing cardiovascular disease.1

“It is a serious matter that our Pacific people are dying much younger and the great news is that we can do something about it. Our Pacific communities need to collectively focus on improving what, how much, where and whom we eat with to encourage good, healthy and yet tasty food, and with this graduation a brand-new batch of graduates are now well equipped to go out and spread the healthy lifestyle message.”

1Tier 1 statistics 2017/18: New Zealand Health Survey.

Symptoms of Heavy Digital Device Use on the Rise among Gen X

Lack of awareness and vanity are the two main reasons Kiwis don’t seek treatment for an age-related vision condition, with Generation X being the worst offenders according to experts.

Optometrists are warning that prolonged exposure to digital devices may exacerbate the symptoms of presbyopia a common vision condition, which along with affecting eyesight can leave sufferers with eyestrain and neck pain.

Presbyopia is an age related condition estimated to affect more than 2.2 million Kiwis aged over 40. The number of Kiwis in this age bracket is expected to increase to 2.6m by 2028 according to Government statistics.

The disorder results in the eye being no longer able to focus on near objects. It is often characterised by digital device users needing to hold their phone further away from their face or needing brighter lights to read by.

Optometrist Bruce Nicholls says the strain caused by trying to focus on small print for long periods can cause headaches and tired or sore eyes.

He says that constantly switching our focus between devices such as smartphones, tablets, PCs as well as hard copies of printed pages is putting our eyes under an unnatural level of stress.

“Presbyopia is a normal condition which has always been present in humans but in recent years our increasing dependence on digital devices has meant the frequency of these symptoms like headaches, eye strain and neck pain occurring seems to be on the rise.

“For many people, devices are in constant use from the time we wake up until the time we go to sleep.

“Many of us simply transition from one device to another through the day which places continuous pressure on eye muscles that become less able to handle this kind of workload as we age,” he says.

Palmerston North optometrist Brian Naylor says from the age of around 40, we lose some of our ability to focus each year and the change is often so subtle that patients are not aware of it until someone else points it out.

“We often see male patients coming to us in their late fifties who have been living with the condition for almost two decades.

“Presbyopia is characterised by difficulty in reading small print, fatigue from doing close work, squinting and needing to hold reading material at arm’s distance to focus on it properly.

“Each year after 40 we lose a small amount of vision and need to move the device about 2cm further away from our face to focus on it. At 65 this change begins to plateau.

“The loss of lifestyle in that time can be significant and many of them have simply no interest in even reading the newspaper because the toll on their eyes is too much, but it’s not until their family members point it out to them that they will come in for a check up.

“An increase in the consumption of digital media has not aided those with this condition as the default font size of some smartphone content is smaller than the equivalent hard copy newspaper.

“There are other ergonomic implications as well as extending the arm beyond a right angle to better focus on your device for any period of time is not a movement the body is accustomed to.

“There is also a vanity factor in there, the traditional progressive lens which is associated with this condition is a sign of aging many middle aged men don’t want to admit they are at that stage in their life.

“Unfortunately, left untreated the condition can potentially become a health and safety issue as these men may avoid reading key information such as instructions,” he says.

Maile Tarsau from Visique Eye Spy Optometrists says the early onset of presbyopia may be associated with other conditions such as cardiovascular disease, diabetes or autoimmune disease and so it is important to have regular screenings if you are experiencing any reduction in vision symptoms or have any of these conditions.

Tarsau advises adults over 40 to be screened every two years by an optometrist and says new technology to treat the condition is entering the market regularly.

“Every person’s vision has different ‘blind spots’ which impact on their ability to focus while reading, but new diagnostic equipment coming on to the market will now allow the creation of personalised lenses to treat presbyopia. The equipment looks at a patient’s posture and behaviour while reading text on a digital device and from that, a new type of Varilux Progressive lens can be made.

These glasses will allow users to switch between screens without having to shift their head in the same way the older style progressive lenses did,” she says.

Community Vaccination Programme Announced

Today the Prime Minister and Minister of Health announced a community meningococcal W vaccination programme to combat the community outbreak in Northland.

A community outbreak of meningococcal W is the epidemiology term for a sudden increase in occurrences of a disease in a particular time and place.

“We have been working closely with the Ministry of Health for some months and recently have been strongly advocating for them to approve this campaign as it’s the only truly effective preventative measure for our population,” noted chief executive Dr Nick Chamberlain.

Northland has been the worst affected, with seven cases this year, including three deaths. There have been four cases reported in Northland in September and October. There has been no link between cases, and they are from a range of ages, geographical areas and both Māori and NZ European.

“The Ministry of Health advised us that vaccine stock is in short supply globally, but that they have been able to purchase 20,000 doses which will be coming to Northland,” Dr Chamberlain said.

“We are hopeful that more vaccine will become available so we can vaccinate the entire population under 20 years as we did in 2011 with the meningococcal C vaccination programme.

“However, with Christmas approaching, it will be a huge logistical feat to vaccinate 20,000 children and youth before they go on holiday.”

The free three week community vaccination programme will be starting on Wednesday 5 December until Friday 21 December, 7 days a week, at selected high schools and community centres across Northland.

The location of the clinics will be confirmed as soon as possible, with the information published on our website, social media, newspaper and radio.

Northland DHB will vaccinate Northland children aged from 9 months to under 5 years and those aged 13 to under 20 years at the time of presentation. To be eligible the child will need to be a Northland resident.

“We are targeting those two population groups because research shows that vaccinating them will have the greatest impact on reducing meningococcal disease spreading in the entire community.”

To keep up to date on clinic locations go to www.northlanddhb.org.nz

14th annual Exercise NZ awards in Auckland this week

The country’s fitness experts and exercise facilities who help half a million Kiwis get physically active and healthier will be vying for the Exercise NZ annual awards in Auckland on Saturday night.

The exercise industry awards, now in their 14th year, are designed to recognise those doing amazing work to help get and keep more people active through exercise in New Zealand.

Exercise NZ chief executive Richard Beddie says it is such a it’s a privilege for his organisation to be able to recognise those that are finalists and winners.

“We also hear stories about how people in the exercise industry are improving the lives of others and inspiring Kiwis to become and stay active.

“The awards night on November 24 is a reminder that this is the best industry to work in as we all help people, through fun, innovative and creative ideas that we broadly call exercise.

Exercise is now the biggest sport in New Zealand with participation rates larger than the next three sports combined, including rugby, cricket and netball, Beddie says.

“We are seeing huge benefits from the large gym chains helping tens of thousands of members, through to the individual trainers and teachers who help people one on one,” he says.
“I’m impressed and inspired by the stories of how exercise professionals, exercise facilities and community organisations are improving the kiwis in so many different and creatives ways.”

The Exercise NZ award finalists are:

Personal Trainer of the Year 
Claire Bellingham, Auckland
Dan Hardie, Wellington
Freya Thomson, Palmerston North
Ginera Ozich-Linton, Auckland
Matt McKay, Dunedin
Naz Spencer, Auckland
Ngarama Milner-Olsen

Up and Coming Personal Trainer of the Year – For Personal Trainers in business for less than two years
Ben Marvin, Auckland
Ben Means, Wellington
Hayley Rapson, Auckland
Jane Williams, Christchurch
Kelly MacDonald, Auckland
Radley Harahap, Dunedin

Small Group Trainer of the Year – Personal trainers who lead small group training sessions
Boris Belmar, Auckland
Calvin Mitchell, Rotorua
Karen Hulston, Canterbury
Reece McCaffrey, Christchurch
Vanessa Warren, Christchurch

Chain / Group Facility of the Year – For facilities that are part of a larger chain or group
Cityfitness – 3 Kings, Auckland
Cityfitness – Willis St, Wellington
Les Mills New Lynn, Auckland
Stanmore Bay Leisure Centre, Auckland
YMCA at Lynfield Youth & Leisure, Auckland

Independent Facility of the Year
ABSolute Health and Fitness, Dunedin
Huddle Group Fitness, Christchurch
Iron Hood Fitness, Christchurch
Peak Fitness and Health, Hawkes Bay

Franchise Facility of the Year – For facilities that are part of a franchise
Anytime Fitness Cashmere, Christchurch
Anytime Fitness Shirley, Christchurch
Anytime Fitness Rangiora, Canterbury

Studio of the Year – Studios and specialist facilities
Adapted Yoga and Pilates, Christchurch
FXU VIBE, Wellington
Mind Body Movement, Whakatane
Studio Glow, Hamilton

Supreme Club of the Year – The best of the best.
Selected from the winners of the above four facility categories.

Group Exercise Instructor of the Year – Pre-choreographed – Instructors teaching pre-choreographed classes
Helen Suckling, Wellington
Julie Bish, Auckland
Kelly Hadwin, Auckland

Group Exercise Instructor of the Year – Own Choreography – Instructors teaching freestyle group exercise classes
Julia Ryder, Christchurch
Michelle Cross, Christchurch
Roxanne Flawn, Christchurch

MindBody Teacher of the Year –This category includes yoga and pilates but can be any class style that incorporates extensive principles of mind-body philosophy
Jase Te Patu, Wellington
Mans Parsotam, Auckland
Pooja Maddela, Auckland

Outstanding Support Award – Individuals working in a support role in an organisation or a facility
Charmaine Aitken, Christchurch
Kate Maxwell, Canterbury
Michelle Cross, Christchurch
Tabassum Razi, Auckland

Community Excellence Award – Individuals or organisation offering exercise to populations
that may normally find exercise difficult to access
FXU VIBE for Chronic Illness, Wellington
Instinctive Fitness Community Work, Rotorua
Seeding Yoga in Schools, Wellington
Soaringwords with Zumba at Wilson Home, Auckland
Your Way Wellbeing / Wellbeing – Your Way, Hamilton

Programme Excellence Award – Programmes involving exercise nutrition or other lifestyle interventions
Farm Boot Camp, Canterbury
Nats Levi Challenge, Auckland
Running Hot Coaching Hawkes Bay
Gold Fit at YMCA Auckland, Auckland

Innovation Award – A programme that is either a new idea or adds a unique angle onto an existing concept
Human Weapon Self Defence, Auckland
Safari Fitness (Wild New Zealand), Rotorua
Circuband- Christchurch

Educator of the Year – A person supporting or training exercise professionals in a lecturing mentoring or presenting role
Jesse Laughton, Wellington
Joe Waide, Wanaka
Mark Hurdle, Christchurch
Wendy Sweet, Hamilton

Inspiration to Live Well, Eat Well

A new recipe book with a fresh take on healthy, tasty meals will make life much easier for the quarter of a million New Zealanders living with diabetes.

Eat Well, Live Well is launching today at celebrity chef Simon Gault’s restaurant, Giraffe, as part of Diabetes Action Month.

“As a chef, and having battled with type 2 diabetes myself, I’m all too familiar with how smart and inventive you may have to be to put healthy food on the table,” says Simon. “This recipe book will be most welcome in Kiwi homes.”

Dame Valerie Adams, DMNZ, who wrote the foreword for Eat Well, Live Well, will be the special guest at the launch.

The new recipe book will help everyone to eat well, but in particular those with type 1 or gestational diabetes and the increasing number of people who develop type 2 diabetes.

“Time-poor lifestyles, take-away meals and microwave dinners all contribute to an unhealthy diet, which is a risk factor for type 2 diabetes,” says Heather Verry, CEO of Diabetes New Zealand.

“To help people enjoy more healthy home-cooked meals, we created a new recipe book with delicious, nutritionally balanced recipes. Each dish uses readily available and affordable ingredients, with easy recipes that are quick to prepare and family-friendly.”

Eat Well, Live Well is a compilation of recipes contributed by notables such as MasterChef winner Brett McGregor, Simon & Alison Holst, Robert Oliver, Jax Hamilton of MasterChef fame and Registered Nutritionist Claire Turnbull, among others.

The book launch forms part of Diabetes Action Month, which this year has the theme Act Now to Live Well. Eating well is just one part of what everyone can do to live well – both in terms of improving the health of those living with any type of diabetes and reducing the risk of others developing type 2 diabetes.

“This is just one way we can support New Zealanders living with diabetes to take action to help manage their condition,” says Heather.

Eat Well, Live Well contains more than 50 diabetes-friendly recipes every family will love, for everyday meals, snacks, desserts or for entertaining friends. It features a great variety of dishes from a range of cuisines, and many of the recipes were inspired by traditional Maori, Pacific and south Asian dishes. They include a modern version of a traditional Māori boil-up, Pacific classics such as Sapasui (Chop Suey) and a selection of Indian, Sri Lankan and Thai dishes.

Every recipe was approved by dietitian Helen Gibbs and all of the recipes have reduced levels of salt and saturated fats, using healthier alternatives to ensure that the food tastes great.

In addition to recipes, the book also contains general guidelines for healthy eating for people with diabetes, as well as tips on how to make sense of food labels. Parents of children with type 1 diabetes, in particular, will be delighted by the lunch box ideas in the book.

Eat Well, Live Well will also be on sale from booksellers at a recommended retail price of $34.99. It is also available directly from the Diabetes NZ website (www.diabetes.org.nz) and from Diabetes NZ branches around the country.

The proceeds from all sales will go towards Diabetes New Zealand’s education programmes.

NZ AI can predict retinal and eye diseases

New Zealand-designed artificial intelligence framework MedicMind which enables the development and design of AI without coding has been used to develop an advance set of algorithms to detect a range of common eye diseases. Findings are published on Clinical and Experimental Ophthalmology.

The Dunedin-based research was part of an initiative to tackle growing aging population and degenerative eye diseases, oDocs Eye Care director Dr Hong Sheng Chiong says.

A total of 4435 images were used for developing the artificial intelligence and its underlying algorithm. The average accuracy was 80 percent, with sensitivity of 75 percent and specificity of 89 percent. The AI is capable of detecting common eye diseases such as diabetic retinopathy, age-related macular degeneration, glaucoma, and retinal vessel disease.

Age-related degenerative diseases such as macular degeneration, glaucoma, and diabetic retinopathy are on the rise, causing huge delays and backlogs to clinic appointments and clinical workload, Dr Hong says.

“With an AI that is capable of triage and making initial predictive diagnosis, it would help clinicians with limited knowledge and experience in ophthalmology – eye care – to screen through retinal photographs efficiently”

“This is a pilot study and its performance can be improved with a much larger dataset. We are calling for all New Zealand clinical and artificial intelligence scientists to join the movement to explore this field.”

The research and algorithm are not designed to replace more conventional approaches such as a visit to an optometrist or ophthalmologist. It is merely a way to improve efficiency and safety of patients’ eye care. The scientific article is available here.

Dr Hong is an ophthalmologist registrar at Dunedin Hospital and is chief executive of oDocs Eye Care. He says he is on a mission to end preventable blindness globally.

Earlier this year, ODocs Eye Care signed its first overseas international partnership with Riyadh’s King Saud University, which is the biggest medical university in the Arab world.

Research For Life awards $57,500 to Medical Researchers

Ten Wellington-based medical researchers received grants in the second funding round of the year from Research For Life. Four research grant applicants received a total of $43,843 to undertake innovative medical research and six travel grants totalling $13,598 were approved to assist local researchers meet the cost of presenting their research findings at international conferences.

Research For Life funds innovative quality research undertaken by researchers in the early stages of their careers who, through their work, will advance the quality of healthcare in the Wellington region and beyond.

The successful applicants for research grants were: 
Morgane Brunton-O’Sullivan, a PhD student at the Department of Surgery and Anesthesia, University of Otago, Wellington, received a Research for Life grant of $15,040.
Working in collaboration with the Wellington Cardiovascular Research Group, her research aims to characterise a pathological fibrotic phenotype in order to identify patients at risk of adverse remodeling processes.
Acute myocardial infarction represents a significant health and economic burden worldwide. Despite advances in medical treatment and management following a heart attack, a subset of patients will undergo fibrotic remodeling which significantly contributes to the development of heart failure and poor cardiac function.

Dr Laura Ferrer Font, a Research Fellow at the Malaghan Institute of Medical Research received a Research For Life grant of $11,531 to undertake research to evaluate different immune cells in cancer. She is specifically using new techniques to establish how macrophages contribute to cancer, and whether their activity can be modified with specific drugs that alter their function.

Professor John Miller received a $10,000 Research For Life grant to undertake the screening of new compounds for bioactivity against cancer cells. New drugs, or modifications to old drugs are needed in the fight against cancer. New natural products from marine animals or algae, or from terrestrial plants, or synthesised analogues will be screened for their ability to inhibit cancer cell growth in tissue culture. Professor Miller is an Emeritus Professor in the School of Biological Sciences and the Centre for Biodiscovery at Victoria University of Wellington.

Dr Andrew Munkacsi, a Senior Lecturer in the School of Biological Sciences at Victoria University of Wellington, received a $7,272 Research For Life grant to undertake research to help children suffering with a rare disease and also provide insight into a fundamental process that is not well understood in healthy people.
Sphingolipids are critical structural and signaling molecules in all eukaryotic cells, that when defective in humans, are involved in the onset and progression of many human diseases including cardiovascular disease, diabetes, cancer and neurodegenerative diseases. However, the molecular regulation of sphingolipid metabolism is not fully understood in healthy or diseased cells.
Dr Munkacsi’s research is exploring new therapeutic options to treat Niemann-Pick type C disease, a fatal paediatric neurodegenerative disease caused by sphingolipid toxicity that typically results in loss of life before adolescence. By identifying the genes that regulate each particular form of sphingolipid, his research will identify genes that can be targeted with drugs or gene therapy to ameliorate the onset and progression of NPC disease and other diseases with defective sphingolipid metabolism, as well as further understand a process that is happening normally in healthy persons.

Travel Grants were awarded in this round to the following:
Deanna Ayupova, a PhD student from the MacDiarmid Institute for Advanced Materials and Nanotechnology at Victoria University of Wellington received a travel grant of $3,000 to present her research at the first conference on Computational Biology of Cancer in Paris, France in September 2018 and at the Applied Nanotechnology and Nanoscience International Conference which will be held in Berlin from October 22-24 October 2018.
Her research aims to develop a non-invasive device (such as a breathalyser) that can help detect lung cancer by using breath exosomes as biomarkers. Deanna is using exosomes that she isolates from a cancer cell line and serum from patients for the detection of proteins carrying tumour gene and plans to use it to capture these proteins using nanomaterials (InP/ZnS quantum dots). Exosome studies are very innovative and not many researchers take this unknown path. One of the important steps in that process is to determine the cytotoxicity of nanomaterials so they don’t result in harming patients.

Olivia Burn, a PhD student in the Cancer Immunotherapy Programme at the Malaghan Institute of Medical Research, received a travel grant of $2,122 to present her research at the International Cancer Immunotherapy Conference in New York this October. Olivia’s research is focused on a new immunotherapy that acts by disrupting a key pathway in immune cells to enhance their activation against cancer-specific proteins and drive a strong anti-tumour immune response.
As this research was recently patented and therefore not previously presented, Olivia noted it was exciting to promote New Zealand-based research to an international audience and discuss her findings with experts in the field.

Dr Hayley Denison from the Centre for Public Health Research, Massey University, received a travel grant of $1,539 to present her research findings at the International Union against Sexually Transmitted Infections Asia Pacific Congress in Auckland this year. Hayley is an epidemiologist, with a particular interest in sexually transmitted infections.
The research she will be presenting examines the trends in gonorrhoea diagnoses at the Christchurch Sexual Health Centre. Hayley hopes that a better understanding of diagnosis trends will enable more targeted testing and treatment of sexually transmitted infections, and lead to a reduction in infection and subsequent ill-health.

Sonja Hummel, a Masters student at Victoria University of Wellington, received a travel grant of $1,000 to present her research findings at the AussieMit conference in Melbourne this year. Sonja’s research investigates a mechanism cancerous cells use to resist the effects of chemotherapy and radiation therapy called mitochondrial transfer. By using yeast to model the conditions that cancer cells are in, Sonja aims to identify the underlying genetical signals which could lead to the potential development of new cancer treatments in the future.

Nicholas Lowther, a PhD student at the University of Canterbury is advancing radiotherapy treatment techniques to improve outcomes for head-and-neck cancer patients. Nick is conducting research based at the Wellington Blood & Cancer Centre and was awarded a $1,457 travel grant to present his research at the Engineers & Physical Scientists in Medicine conference in Adelaide this year. His research aims to optimise current treatment approaches by reducing toxicity and unwanted side-effects, such as xerostomia – a dry mouth resulting from reduced or absent saliva flow. This research will ultimately lead to an enhanced quality of life for patients.

Dr Michelle Thunders, a Senior Lecturer at the Department of Pathology and Molecular Medicine at the University of Otago, Wellington, received a travel grant of $4,480 to present her research at the Chromatin and Epigenetics workshop held at the European Molecular Biology Laboratory Advanced Training Centre in Heidelberg Germany. Michelle’s research interests lie with the identification of epigenomic biomarkers to aid in clinical diagnosis, prognosis and treatment of Myocardial Infarction and in Renal Cancer. Her intention is to aid in understanding the molecular pathogenesis of both conditions to facilitate improving outcomes for patients.

Last year, Research For Life approved 11 research grants and 10 travel grants constituting a total of $203,698 available to researchers.

Dr Rebecca Grainger, Chair of RFL’s Research Advisory Committee, said: “Research For Life congratulates the successful applicants of this round of funding. The research they are undertaking is innovative, well-conceived and vital to achieving continuing improvements in health outcomes in the community.”

The closing date for the next round of Research For Life grant applications – including travel grant applications – is Friday, 29 March 2019.

Tragic suspected meningococcal disease death

The 16-year-old male from Kerikeri, who had been among 190 people attending the St John youth camp on Motutapu Island this weekend, died in Auckland City Hospital on Saturday of suspected meningococcal disease.

“This is very tragic for the family of the young man who died, and for everyone at the camp,” offered Medical Officer of Health, Dr Simon Baker.

“We acknowledge the young people, their families and the staff at the camp will also be feeling very upset and anxious.”

Auckland Regional Public Health Service went to Motutapu to provide protective antibiotics and assess the risk to others, however only a few people were considered to be “close contacts” and at risk of infection.

Northland’s Public Health Nurses have been talking to the family about who else might have been at risk in the previous seven days in which the young man was infectious. Those who were in close contact with the young man have been provided with antibiotics.

“Meningococcal disease is a serious and sometimes fatal disease, and can be difficult to diagnose, so we are providing information to the young people and parents so they can be alert for symptoms,” Baker said.

“It can look like the flu early on but quickly gets much worse. It is important to get early treatment.”

Symptoms included some or all of the following: fever; headache; vomiting; feeling sleepy, confused and delirious; loss of consciousness; joint pains; aching muscles; stiff neck; dislike of bright lights; or rashes, purple or red spots, or bruises.

Other symptoms in babies and infants include being unsettled, floppy or irritable, refusing drinks and feeds, and becoming harder to wake.

Children who have previously received meningococcal vaccination can still get meningococcal disease because the vaccine does not protect against all types of meningococcal bacteria. Therefore, be on the lookout for signs or symptoms of meningococcal illness even if your child has previously been vaccinated.

“If you or anyone you know has these symptoms, don’t wait.”

People should phone Healthline on 0800 611 116 or visit a doctor. If they are concerned

The following website also has useful information.

Ministry of Health http://www.health.govt.nz/our-work/diseases-and-conditions/meningococcal

Northland scholarships announced

Four Northland DHB staff will benefit from a scholarship that encourages staff to further their education. The scholarship was made possible by an anonymous $50,000 donation.

Workforce and Wellbeing Manager, Catherine Parker said they received 40 scholarship applications. The selection panel narrowed these down to 16 before the final four were chosen. A portion of the original grant will be distributed to the successful applicants for the 2018/19 academic year and the balance of the monies will be invested for future distribution through Health Fund PLUS. .

The four successful applicants are:

Auriole Cook 
Auriole works as an auxiliary worker in the Mental Health and Addictions Department. She applied to the fund to help with her Applied Diploma of Mental Health & Addictions Level 6 through the Open Polytechnic, which she is studying part-time. When she completes an assignment she is more conscious of what she has learnt and is able to apply it to her daily schedule at work. After having applied for several scholarships, Auriole said it now feels like someone has finally given her a break.

Her Team Leader Daniel Manihera says what makes Auriole stand out is that she is always positive, striving to implement new strategies or ideas that will benefit our whai ora and our service while keeping everyone safe. Sally Hapi who works alongside Auriole as a Registered Nurse said she is a real benefit to the service because she is honest, reliable, efficient and highly respected by both staff and IPU clients. “Auriole is absolutely deserving of this scholarship as she is self-driven and passionate, which signifies her dedication and ability to complete what she sets out to start. Auriole is passionate about her role and this is evident in her ability to apply what she has learnt on the ward, which has been beneficial and had positive outcomes for our In Patient Unit clients.”

Amanda House 
Amanda works as Administration Support for Medicine, Health of Older People and Clinical Support and is studying towards a Diploma in Business Studies, with a focus on Human Resources from Massey University. Amanda has always been interested in Human Resources and feels that working towards this Diploma would be an achievable challenge for her. She said she is incredibly fortunate to have been awarded the scholarship, and would like to be able to thank the donor personally.

Business and Project Analyst Amanda Gentil recommended her for this scholarship because of her dedication to their team, and her willingness to help others and learn new skills. “She is an organised and driven person and I have no doubt she would put her all into any study she was to enrol in. I believe Amanda would benefit greatly from this scholarship as it would extend her knowledge and skill base, which Northland DHB would, in turn, benefit from.” Fellow team member Jennifer Fielden also commended Amanda’s organisational skills and said that this makes her stand out, combined with being structured and determined, “she will reach any goal or outcome she sets herself”.



Glenys Epiha 
Glenys is a Health Care Assistant in the Jim Carney Cancer Treatment Centre. She is studying through the Southern Institute of Technology for a NZ Certificate in Study and Career Preparation Level 4 so that she can go on to be a registered nurse, then eventually complete her Masters. Glenys said her passion is to stay in New Zealand working in health and she encourages others working in the industry to remain working here as well.

Clinical Nurse Manager at the Centre, Dee Telfer, supported her application saying that she is one of those people who have exceptional skills and life experiences that she can put to use in positions that will benefit not only her but the people/patients she will care for. “This will make the transition seamless for her. Glenys will make a fantastic nurse and I will continue to support her in this journey to ensure we have another exceptional nurse (in the making) added to our profession.” Christina Edmonds who works as a Clinical Nurse Specialist in Oncology said to know Glenys Epiha is to know that she is a ray of sunlight, always smiling, always helpful. “She has empathy for patients and the challenges they are experiencing. Softly spoken, patients feel supported and are gently guided. She works hard. Her productivity is spot on. She is well regarded by us all and a joy to work alongside.”

Daryn Thompson 
Daryn is a Community Support Worker who is taking the next step toward his Bachelor of Nursing at Northtec. Darren was honoured to have made it through to the final four after hearing how many people applied for the scholarship.

Service Manager Adrian Hatton said that Daryn is a highly regarded Mental Health worker who has shown remarkable loyalty to the service. “He has all the qualities we look for when appointing registered nurses – humanity, honesty, advanced communication skills, intellect, calmness, motivation, engagement and problem-solving skills. Daryn has approached his studies in a serious manner and has excelled.”

Samantha Parata also said that Daryn has proven himself to be a leader within the organisation. “He has impeccable work ethics and always upholds the values of the DHB. It was on my recommendation that Daryn start undergraduate BHsc Nursing study. Early on in his employment I identified his potential and have delegated higher level duties that he has accomplished with ease. He is open to learning and is an exceptional educator. Daryn is committed to his professional development and his grades are in the higher range. He takes any opportunity to enhance his skill base and share his knowledge with others.”

Health Fund PLUS
Health Fund PLUS was set up by Northland District Health Board and Northland Foundation. Health Fund PLUS allows people to make donations to our Northland hospitals or services for the ‘optional extras’ that are so important to patients and their whānau.
For more information on Health Fund PLUS go to this link.

Time to reflect on 1918 influenza pandemic

One hundred years ago the influenza pandemic killed an estimated 9000 New Zealanders during this country’s largest public health crisis, says Manatū Taonga Ministry for Culture and Heritage chief historian Neill Atkinson.
“The majority of deaths occurred between October and December 1918, so as we come into this period a century later it’s important to reflect on and commemorate this major event in our history,” Neill Atkinson says.

“No other event has claimed so many New Zealand lives in such a short time. More than half as many New Zealanders died from influenza in three months as died while serving during the four years of the First World War.”

The commemoration has links to the First World War. It acknowledges the impact the flu pandemic had on Western Samoa, which resulted in the death of a quarter of Western Samoa’s population. A dance piece called ‘1918’ by Pacific performing arts group Le Moana will be showcased at Pukeahu National War Memorial Park in early November to mark this tragic event.

“A number of events will be happening throughout the country to remember the pandemic and inform the public. These include performances, public talks, digital storybooks and guided walks to remember the lives of those lost.

“We are planning to have a plaque to commemorate the influenza pandemic installed at Pukeahu early next year.

“The commemoration is also a reminder that we remain at risk from influenza viruses, and need to be aware of the ways that risk can be minimised by seasonal flu vaccines, good hygiene practices like cough and sneeze etiquette, and being prepared to look after yourself and family,” Neill Atkinson says.

More information is available on the Ministry for Culture and Heritage websiteregarding the commemoration and Ministry of Health website for health resources.

Dyslexia Awareness Week 1-7 October 2018

A LONG WAY TO GO

Aidan Milner is one of the lucky ones. He has severe dyslexia and dyscalculia – massive struggles with reading, writing and maths. Yet he has managed to graduate with a Masters Degree in Geology and now works as an engineering geologist – a feat he never dreamed possible as a kid.

Labelled lazy, Aidan’s primary school teachers told him he simply needed to try harder and stop misbehaving. Understandably, Aidan suffered severe anxiety. Fortunately he had proactive parents who could afford a diagnostic assessment to figure out what was going on, and then specialised one-on-one tuition to arm Aidan with the strategies he needed to learn successfully.

Many thousands of others with dyslexia do not have that privilege and fall through the cracks, never learning to read or write properly. As a result, they may have difficulty holding down jobs and can be immensely frustrated, suffering from very low self-esteem or even depression. It is estimated dyslexia affects one in ten people and studies show at least 50 per cent of prison inmates have dyslexia.

Giving all children a level playing field with access to support is critical. Last week the government announced a Disability and Learning Support Action Plan to better support struggling students like Aidan. The fine details have yet to be determined but after years of clamour for change, families with dyslexic children are hopeful this is finally a move in the right direction.

There is also a growing awareness that dyslexia can have a flip side – some even call it a gift. Progressive schools such as Kapiti College now run what they call ‘neuro-diversity’ classes where students are encouraged to own and embrace their dyslexia. Given the right support, people with dyslexia often flourish as adults in their chosen careers. The arts, design, IT and business worlds are packed with super smart, creative, dyslexic minds that can see things in the ‘big picture’ and ‘outside the box’.

Dyslexia Awareness Week is a reminder that we need to celebrate and support these diverse learners. We have certainly come a long way since the existence of dyslexia was formally recognised by the Ministry of Education in 2007. However, we still have a long way to go.

By SPELD NZ Executive Officer Jeremy Drummond

SPELD NZ is a not-for-profit provider of support for people with dyslexia and other specific learning disabilities. For nearly 50 years, it has offered diagnostic assessment, specialised one-on-one tuition, training, advice and advocacy throughout New Zealand.

MORE ON AIDAN’S JOURNEY

Aidan’s academic success has also taken a lot of grit, access to special accommodations and some clever strategies to enable him to thrive in spite of his severe learning disabilities. In his own words, here is more on his amazing journey.

It was extremely humbling graduating and reflecting on how most of my teachers viewed dyslexia and how wrong they were. It just goes to show you can’t judge a book by its cover. It also goes to show that one-on-one specialist teaching works very well for people like me.

I was formally diagnosed with severe dyslexia and dyscalculia when I was 10 years old. Despite my diagnosis, my primary school teachers still thought they knew best and refused to believe that I was dyslexic. They said I was in fact just a lazy kid who needed to try harder and to stop misbehaving in class. I was given numerous detentions for not completing work. It was clear that the school system on its own wouldn’t be of any help. So we turned to SPELD. I don’t think I would have made it through without the help of my tutors.

At school I also had trouble with anything and everything to do with maths. This included things as basic as recalling my home phone number. As a kid I was terrified of getting lost and not being able to call home. Maths was put on the back burner as my spelling and reading alone were enough to make anyone tear their hair out. But eventually I began working one-on-one with a maths tutor and had much better results.

Most people would think that transitioning from high school to university would be a big challenge. However it was manageable thanks to the fantastic support of the disability services team at Victoria University. Unlike school, university also felt like a safe place to say that you have dyslexia. Most of my lecturers had some kind of dyslexia and those that didn’t, fully understood how it worked.

Dealing with dyslexia in the workplace means using the same skills I learned while I was studying. I have assistive text-to -speech software to help me read documents on the computer. In the field, I’m up front with people on site about my dyslexia and dyscalculia. I explain that recording numbers is not my strong point and let them know how I work around this issue and how they could help. Everyone has responded well. They respect someone who’s up front and offers a solution.

Link between time spent in nature and positive mental health

Survey findings* released by the Mental Health Foundation of New Zealand (MHF) today reveal the positive impact spending time in nature has on the mental health of New Zealanders. Of those Kiwis surveyed following last year’s Mental Health Awareness Week, 95% said that spending time in nature during the week made them feel good and 75% said they intended to spend more regular time in nature.

These new findings have been released ahead of this year’s Mental Health Awareness Week (MHAW) from 8–14 October, which encourages people to Let nature in, strengthen your wellbeing – Mā te taiao, kia whakapakari tōu oranga!

The week will involve a number of events, challenges, resources and educational activities to help New Zealanders place their wellbeing front and centre.

“We all have mental health,” MHF chief executive Shaun Robinson says. “It’s something we all need to take good care of, every day.”

“We know connecting with nature makes us feel good, and every little bit helps us find balance, build resilience and boost mental wellbeing.”

Research has shown that spending time in nature lifts people’s moods, decreases feelings of depression and anxiety, improves concentration, buffers against stress, makes lives meaningful, speeds recovery from tough times and reduces health inequalities related to poverty.

“We are lucky to live in a country surrounded by natural beauty. Every day we have opportunities to stop, take it in and appreciate the goodness that already surrounds us,” Mr Robinson says.

“Mental Health Awareness Week is about encouraging people check-in with their mental health. We want you to think about what makes you feel good and do more of that.

“We never know what life challenges lie around the corner, but if we invest in our mental health we are much better equipped to handle tough times and can prevent mental health issues.”

Nearly 50% of New Zealanders will experience a mental health problem in their lifetime, and depression is set to overcome heart diseases as the biggest global health burden by 2020.

The emphasis on this year’s Mental Health Awareness Week is helping workplaces, schools and communities to let nature in and strengthen their wellbeing. The MHF has woven together the Five Ways to Wellbeing with the nights of the Maramataka/Māori lunar calendar to maximise energy with the natural world and boost wellbeing.

“We want people to experience the benefits of being in nature, notice the good feelings and want to repeat these good things as part of their daily lives,” Mr Robinson says.

This year’s activities include a wellbeing photo challenge, community and cultural events, a fancy dress ball, and a workplace challenge for the first time in 2018.

To learn more about Mental Health Awareness Week, visit www.mhaw.nz.

Meat Free Week – Little changes can make a big difference

Bowel Cancer New Zealand invites you to take part in the seven-day meat free challenge from Monday 24 September and discover how easy it is to make little changes that can create a big difference.

Going meat free for one week is a great opportunity to start thinking about how much meat you eat and the impact eating too much meat can have on your bowel health. We are challenging all New Zealanders to a week without meat to help reduce their risk of bowel cancer and raise funds for a worthwhile cause.

Meat Free Week is now a global initiative and through this collaboration, you’ll get access to a dedicated website, with mouth watering recipes for you to try and resources to use.

Paul, Mary, and Stella McCartney (Founders of Meat Free Monday) say, “Taking part in Meat Free Week is a fun and easy way to have a positive impact on the planet and on our health. It’s also a way to become familiar with a whole variety of meat free foods and extend our range of imaginative menus. Enjoy!”

Studies show bowel cancer risk increases by 12% per 100g of red meat consumed per day and by 16% per 50g of processed meat consumed per day.

Bowel Cancer New Zealand (BCNZ) general manager Rebekah Heal says, “Meat Free Week gives people the perfect opportunity to include more plant-based foods in their meals, such as fruits, veggies and grains, and to see if a meat-reduced diet is for them – whether it’s just for one week a year or they get inspired and carry it on for one day a week.”

All funds raised will aid the work of BCNZ in supporting approximately 3,000 New Zealanders diagnosed with bowel cancer each year through vital prevention programmes.

To take up the challenge of Meat Free Week visit our website and sign up today!

BCNZ encourages open discussion about bowel cancer with medical professionals and avoiding ‘sitting on your symptoms’. Symptoms include:

Bleeding from the bottom or seeing blood in the toilet after a bowel motion;
Change of bowel motions over several weeks that can come and go;
Persistent or periodic severe pain the abdomen;
A lump or mass in the abdomen;
Tiredness and loss of weight for no particular reason;
Anaemia.
About Bowel Cancer New Zealand

Bowel Cancer New Zealand (BCNZ) is a patient and family-led charity organisation.
The registered charity was founded in 2010 by a group of people affected by bowel cancer, committed to improving bowel cancer awareness and outcomes for people with the disease.
BCNZ aims to provide clear and up-to-date information about the disease, symptoms, what to do if diagnosed and to support patients and families affected by bowel cancer.
The ultimate aim of BCNZ is to prevent lives being lost to this disease and to promote the national screening program rollout in New Zealand.

Working together to prevent suicide

Southern DHB and WellSouth mark World Suicide Prevention Day 2018 encouraging connection and conversation to support vulnerable people in our communities

Southern DHB and WellSouth, primary health network, are supporting the message of hope that marks World Suicide Prevention Day 2018, this Monday 10 September.

‘Working together to prevent suicide’ is the theme this year and everyone is being encouraged to take a minute to reach out to others in the community – a family member, friend, colleague or even a stranger – to help keep them safe. Equally, people feeling vulnerable, should know they can reach out to those they can trust to help keep themselves safe.

It’s an important message of empathy and action and optimism, says Paul Martin, suicide prevention coordinator for the Southern district, even in light of recent Coroner’s Office data indicating there were 668 suspected suicides in New Zealand last year, the highest number to date since 2010.

“There are improvements to be made, but good work is being done by dedicated health professionals, support workers, counsellors and others – and people’s lives are being saved because they have sought and received help, ” he says. “It is important to remember that we all can reach out. And doing so could change someone’s life.”

Dr Evan Mason, Southern DHB’s Acting Medical Director, Mental Health, Addictions and Intellectual Disability Directorate, says: “Throughout our community, the DHB, other government organisations and the many agencies in Otago and Southland, mental health is a priority for us all. Preventing suicide is complex and we all have an important part to play in preventing suicide. We encourage people to speak with someone and seek help if they are feeling at risk.”

While there are no simple solutions to suicide prevention, there are simple steps we all can take, starting with talking and listening:

Practical Ways to take a minute and help friends, family and even strangers:

Talk:

• People who have lived through a suicide attempt often say they desperately wanted someone to ask if they were okay.

• Connection and conversation are the keys to helping those who are vulnerable to suicide. We know that sharing, bringing hope, caring and compassion help us all feel good about our world.

• It is okay to ask someone if they are suicidal. If you suspect that they are, if your gut feeling tells you ‘something does not feel right’, or you know that they are suicidal, asking them something like “what you have just talked about sounds pretty hard to cope with right now; sometimes people in those kind of situations start thinking about suicide – are you thinking about killing yourself?’ This will not trigger something. If they say ‘yes’, you can guide them to people who can support them and keep them safe.
Listen:

• Suicidal people are often looking for someone to ask them how they are, and they do really want to talk to someone about what they are feeling. Once you have asked them the question, it is important to listen to them, to hear them out in a caring and comforting environment and help them to access the support they need.

• Stigma around suicide plays a large role in why people do not reach out for help. If you are talking to someone about suicide, it is vital that you listen without judgment.

• People having thoughts of suicide cannot see another way out of their current situation, but there is always another, better option than suicide. Let them talk about how they are feeling in a way that they feel understood and not judged. Understand that it is their life’s journey to date that has made them conclude suicide is an option. They simply need more options, skills and people they can trust to get them through this bad patch.

• Know where to go for help in your local community: emergency services, counselling services, your GP. Who else in the whānau or local community can be a trusted contact for this person?
• As a family member or friend, you can use a Safety Plan working in trust alongside a vulnerable person to help guide them to a safer place and give them the tools to get there, along with their access to professional support.

Where to get help:

• 1737 free text/phone number service (www.1737.org.nz) will connect you to a trained counsellor who can help if you have feelings of anxiety, helplessness or just need to talk to someone.
• Emergency Psychiatric Services (EPS) 0800 443 366 (1 for Southland and 2 for Otago). It may be useful to have a support person or advocate available to assist.
• Suicide Crisis Help Line – 0508 TAUTOKO (0508 828 865) is a free, nationwide service available 24 hours a day, 7 days a week and is operated by trained and experienced telephone counsellors who have undergone advanced suicide prevention training.
• Talk with your GP or a trusted health professional and work on improving coping strategies and keeping yourself well. They can then assess or prescribe as necessary and/or make a referral to:
• In an emergency, dial 111.

New Study Looks Set to Reduce Harm for Older Patients

A surprising finding from a major international study involving hundreds of New Zealanders, looks set to reduce major side effects including death among older patients facing cardiac surgery, as well as conserve the use of a precious and expensive resource … donated blood.

Published in the prestigious New England Journal of Medicine, the study has shown that using lesser amounts of transfused blood in older patients undergoing cardiac surgery is not only just as safe, but actually safer than using more liberal amounts.

One of the study’s lead investigators, Auckland Hospital Intensive Care Specialist Dr Shay McGuinness, says the new findings go against what, until now, has been international accepted best practice for surgical teams operating on older patients having open heart surgery.

“Prior to this study it was accepted wisdom that older patients need to be transfused to a higher haemoglobin level because it was thought their body’s physiology and ability to cope with the stresses of surgery made them less able to tolerate lower levels than younger patients” says Dr McGuinness.

“The results from this new study, which follows patients six months after their surgery, clearly show that using less transfused blood during and after heart surgery actually lowers the patient’s subsequent risk of heart attack, stroke, kidney failure and death” he says.

The randomised study, the world’s largest ever transfusion trial in cardiac surgery, was carried out on over 5200 patients at 74 hospitals in 19 counties. It included more than 560 patients from Auckland City, Waikato, Wellington, Christchurch and Dunedin hospitals. New Zealand supplied the second highest number of patients for the trial.

Some moderate-to-high risk heart surgery patients were given a liberal blood transfusion strategy while others were given a lesser, more restrictive strategy. For every 28 patients aged 75 years or older treated with a restricted blood transfusion strategy, one patient was prevented from experiencing a major complication up to six months post-surgery.

Study co-author Dr Paul Young, from Wellington’s Medical Research Institute of New Zealand (MRINZ) says these findings will change clinical practice around the world in terms of when and how much blood needs to be given during and after cardiac surgery.

“Not giving a blood transfusion until an older patient’s haemoglobin measurement is as low as 65% of normal, while once considered risky, now appears to be just as safe if not safer than giving blood more liberally” says Dr Young. “This means many who would have been transfused in the past will no longer require it at all, and patients who previously required several units of blood may now only require one”.

Researchers say these results have one other significant implication for the health system….one with the potential to conserve a precious and expensive resource.

“If these research findings are adopted into every day practice then not only will they result in better health outcomes for older patients but also major savings for health systems in the use of less donated blood for transfusion” says Dr McGuinness. “This is important as cardiac surgery uses significant amounts of donated blood in theatre”.

NZ Blood Service spokesperson and Transfusion Medicine Specialist Dr Richard Charlewood agrees.

“As our population ages and we do more and more cardiac surgery on a growing number of older patients, a reduction in the use of blood may help to ease the pressure on both donors and the blood service, where donors are finding it difficult to make time to donate” says Dr Charlewood.

The Health Research Council-backed study is the very first completed by the New Zealand Improving Outcomes After Cardiac Surgery Network – a new programme within the Medical Research Institute of New Zealand (MRINZ) which brings together cardiac surgeons, anaesthetists, Intensive Care Specialists, nursing and support staff.

“The next step now is to develop robust guidelines to determine exactly when we should use transfusions for older people having cardiac surgery” says Dr McGuinness.

NZDA President calls out school dental service

The New Zealand Dental Association (NZDA) President used his opening address at the annual conference to call on the government to improve the school dental service.

NZDA President, Dr Bill O’Connor, said the Community Oral Health Service is failing New Zealand kids, highlighting figures showing 96000 children are overdue their recalls with the dental therapist, 29000 young NZ children had teeth extracted last year, and 7000 kids required hospital dental treatment under general anaesthetic.

“I believe the Community Oral Health Service – is failing our kids – failing the children of New Zealand,” said Dr O’Connor.

Dr O’Connor said the issue was concerning for him, and he was using his platform to speak out on behalf of kids. “Today 120 young Kiwi kids will have teeth extracted. Why have they not been treated before they got to this point?”

Dr O’Connor stressed that he was not pointing the finger at dental therapists.

“None of what I have outlined is a negative comment regarding the dental therapists – they have a hard job, they are our colleagues. We all know how hard their job is.

“The system has failed these children and their parents. The system has failed those who work in it, trying to deliver the best outcomes for their patients,” said Dr O’Connor.

The large number of children being enrolled with the service is at odds with the large numbers of school-aged children that have untreated tooth decay.

He had a message for the government, that it was now time to act.

“I call on the Minister of Health to make this a priority of this government and to act now to address this appalling situation. It’s time to look after our kids!”

Kiwis share their dementia experience in documentary

Kiwis share their dementia experience in an international documentary
Every three seconds someone in the world develops dementia.

Before Helen Doyle’s diagnosis of Alzheimer’s disease, she knew something was wrong. She just didn’t know what.

Helen, who lives in Whanganui, was relieved when she finally got a diagnosis, so she could “keep on keeping on”.

Her experience, and many like hers, has been given new precedence in a documentary produced by Alzheimer’s Disease International and ITN Productions.

The nearly five-minute short film shows how Alzheimers New Zealand is working to support New Zealanders living with dementia to live well with dementia.

It is being launched ahead of the start of the World Alzheimers Month campaign, which will begin in September.

Ms Doyle’s friend, and carer, Maxine Pringle, hopes people will one day see Helen and others for who they are, and not just the condition they’ve been diagnosed with.

Ms Doyle is one of a growing number of New Zealanders living with dementia, currently totalling nearly 70,000. That number is expected to almost triple to 170,000 people by 2050.

Mike Bailey and his wife Lesley also share their personal experience of living with dementia, and how best they can be supported to maintain independent, fulfilling lives.

The four bring a personal touch to the full-length film ‘Every 3 Seconds’ that discusses the risks, growth and future response to dementia here in New Zealand.

Alzheimers New Zealand chief executive Catherine Hall praises the courage of Ms Doyle and Mr Bailey who shared their stories in the video.

“This video draws people’s attention to the fact that New Zealand simply cannot afford to do nothing about dementia.

“As a society, we must do more to support people living with dementia to live well and play meaningful roles in their communities.

“The sooner we fully implement the New Zealand Framework for Dementia Care, the better it will be for the many, many thousands of Kiwis affected by dementia.”

Life-skills programme for kids dubbed “Huge Success”

A two-year pilot programme teaching kids key life skills has been deemed a “huge success”, capturing 85% of Gisborne’s primary school population.

According to a recent report by Sport Gisborne Tairāwhiti, all schools that participated in the newly developed Crackerjack Kids educational programme will continue their involvement beyond the pilot after seeing the positive impact on their students.

“The two-year Crackerjack Kids pilot across 14 schools in Tairāwhiti (involving over 3,500 students from years 1 to 6) can be deemed a success,” says the report. “This is evidenced by the desire of all the pilot schools to continue with the initiative in 2018, the favourable responses from principals and teachers, observations of positive changes in the behaviour and attitudes of children and, most importantly, the enjoyment of the participating children.”

Crackerjack Kids, developed by InnerFit NZ, is a sports-based programme linked to the Health and Physical Education curriculum for primary schools. The material gives teachers an easy way to empower Kiwi kids to become leaders, positive role models and well-rounded, stable individuals who are well equipped to achieve on and off the field.

With seven more schools signing up to use the Crackerjack Kids resource, the programme is gaining momentum across the wider Tairāwhiti community.

Labour List MP Kiri Allan recently visited Te Hapara School, one of the pilot schools in her electorate, to see the programme in action, and says she is impressed by the impact that Crackerjack Kids has had on the children.
“It was fantastic to witness Crackerjack kids being taught in the class and see a programme that incorporates health and fitness, alongside teaching kids decision-making skills that can be carried into a broad range of areas in their lives.”
InnerFit NZ founder Ken Youngson, whose mission is to help individuals achieve their full potential in life, believes that schools have a critical role to play in ensuring that children get a good start in life to set them up for future success.

“We know that the life course is set at an early age,” says Youngson. “By partnering with schools, the one institution that every single New Zealander has an experience of, we can reach every child to teach them how to make healthy life choices.

“The Gisborne primary education network is showing real national leadership in instituting the Crackerjack Kids programme so broadly in schools,” says Youngson. “After the proven success of the pilot, we are committed to supporting teachers to empower Kiwi kids throughout New Zealand.”

InnerFit NZ partnered with Sport Gisborne Tairāwhiti to run the pilot. The organisations worked together to provide comprehensive training and professional development for the participating teachers, ensuring they had hands-on support to effectively implement the resource in their schools.

For more information, visit http://www.crackerjackkids.org.nz/
See the full Sport Gisborne Tairāwhiti report here: Gisborne CJK Report

Research aims to find ‘sweet spot’ for pertussis vaccination

Research aims to find ‘sweet spot’ for pertussis vaccination in babies

The pertussis (whooping cough) vaccine given to infants at six weeks of age will be tested for its effectiveness in babies whose mums were vaccinated during pregnancy.

A University of Auckland researcher suspects that antibodies passed on from mother to baby might interfere with an infant’s primary immune response when receiving their first pertussis vaccine, which in New Zealand happens at six weeks old.

Dr Helen Petousis-Harris has just been awarded a $210,000 grant from PHARMAC and the Health Research Council of New Zealand (HRC) to test the protective effect that maternal vaccination offers against whooping cough, taking into account the additive overall effect of baby’s own first vaccine.

In most other high-income countries, the vaccine is given at eight weeks of age and there is evidence to show that at that age, combined with maternal vaccination, it offers additional protection in infants. But a major question remains around the additive benefit or risk posed by immunisation at an earlier age, says Dr Petousis-Harris.

“Giving vaccines to pregnant women is a very effective way to protect babies in their first weeks of life and many countries have adopted this strategy. But we might be able to improve the effectiveness even more by looking at how we time things,” she says.

“Somewhere there is a sweet spot where the benefits of both maternal and infant immunisation can be maximised.”

Her findings will inform the National Immunisation Schedule and could affect when infants are first given their pertussis vaccine.

PHARMAC medical director, Dr John Wyeth says that PHARMAC is pleased to support this research.

“The aim of our partnership with the Health Research Council is to support research that helps people get the best out of medicines that are funded. There are significant benefits to New Zealand from making the best use of pertussis vaccine, and understanding the optimal timing of vaccination. This research could ultimately inform how this vaccine is funded for babies in future, and help healthcare professionals and patients make well-informed decisions,” says Dr Wyeth.

Another newly-funded study under the PHARMAC-HRC partnership involves the development of a decision aid to help rheumatoid arthritis patients make choices about treatment.

Biologics are drugs that specifically target the inflammatory pathways that cause joint inflammation, the critical clinical factor in rheumatoid arthritis. They have revolutionised management of the condition, but they do come with adverse effects and a hefty price tag, says grant recipient, Professor Carlo Marra from the University of Otago.

Recent data suggests that some people who have a good response to these agents can actually stop using them and still keep their rheumatoid arthritis in check. However, some will relapse and have their arthritis symptoms return when stopping the treatment.

Helping patients choose whether to taper off their treatment (or continue with it) once remission has been achieved, is the point of the decision tool, says Professor Marra.

“Patients have to decide whether they want to risk having an arthritis flare against the prospect of being free of potentially toxic medications,” he says. “This tool helps them understand the options available, including their harms and benefits, and individually weigh each according to their values.”

HRC chief executive Professor Kath McPherson says innovations like an effective decision aid not only help people take more control over their health and wellbeing decisions, but should help ensure medicines are used as and when they’re needed.

“Both of these projects offer a fresh look into how people can most effectively use the treatments available to them, to optimise the potential benefit.”

A New Era in New Zealand’s Mental Health Treatment

Press Release: Kyle Macdonald

Today details of the Green Parties free youth counselling policy, for those aged 18 – 25, was announced. The pilot funding has been outlined and requests for tender are now invited.

The pilot looks to draw on overseas examples, most notably the “Improved Access to Psychological Therapies” or “IAPT” programme in the UK, which has seen therapy and counselling made available nationwide for mild to moderate mental health problems.

The provision of free counselling for youth was an election policy of the Green Party, and it was part of their confidence and supply agreement with the Government.

“It’s great to see this pilot get underway” says Kyle MacDonald, psychotherapist and campaigner behind the Free Counselling Open Submission to the Government Inquiry into Mental Health and Addiction. “Nationwide we continue to hear horror stories of long wait lists, and of people being unable to afford private therapy, meaning many with mild to moderate depression and anxiety are simply going untreated. This is a lifesaving service, and it can’t come to soon.”

The three year pilot looks to explore how the IAPT approach can be modified to best suit New Zealander’s, and as well as funding for treatment it also recognises the need to develop the workforce to provide the service nationwide.

“We know that counselling and talk therapy is the most effective treatment option for mild to moderate mental health needs. This represents a real commitment by the Green Party to ensure access for all young people. My only criticism of this programme is it doesn’t go far enough. Nationwide free counselling for all Kiwi’s of all ages – which I’ve dubbed ‘KiwiTalk’ – must be the next step, and without doubt such a service would be revolutionary and lifesaving.” Says MacDonald

The procurement process is now open, with the Government looking for a provider who can provide the psychological therapies, as well as determining the geographical location the pilot will run.

Background: Kyle MacDonald was one of the initiators of the People’s Mental Health Review, along with Mike King and Action Station. He started an Open Submission to the Government Inquiry into Mental Health and Addiction calling for Free Counselling for all Kiwi’s. It has just under 5000 signatures and will be submitted to the Inquiry early August.

For more see: www.freecounselling.nz

Work in funding medicines for rare disorders progressing

PHARMAC is progressing work aimed at improving funded access to medicines for rare disorders.

Chief Executive Sarah Fitt says the latest step is the appointment of a clinical subcommittee with expertise in evaluating medicines for rare disorders. The subcommittee, which includes leading New Zealand and Australian experts in managing patients with rare disorders, will provide advice to PHARMAC’s main clinical committee, PTAC.

Earlier in the month, PHARMAC published updated policy settings for assessing medicines for rare disorders, and opened a commercial process seeking funding applications from pharmaceutical suppliers, specifically for medicines for rare disorders.

“We’re pleased to have made this progress following on from the commitments we made at the end of last year,” says Sarah Fitt. “The subcommittee will provide expert clinical advice on applications we receive from the commercial process we are currently running. This involves actively seeking funding proposals for medicines for rare disorders.”

“The updated policy settings help define which medicines we will consider in this process, and provide certainty to stakeholders of the sort of medicines we are looking for.

“Ultimately, we hope this work will improve access to funded medicines for people with rare disorders.”

PHARMAC has also made a decision to change, and widen access to, the funded enzyme replacement therapy for the rare disorder Gaucher disease. Taliglucerase will be phased in from 1 August 2018 to replace the currently funded treatment, imiglucerase.

PHARMAC had earlier run a dedicated contestable process specifically for medicines for rare disorders, which resulted in decisions to list 10 medicines on the Pharmaceutical Schedule.

Young people most aware of drinking during pregnancy

Young people in New Zealand are leading the way where it comes to attitudes and awareness around the risks of drinking during pregnancy.

A Health Promotion Agency survey shows that 84% of Kiwis disagreed with the statement that drinking small amounts of alcohol is okay during pregnancy, with 15-24-year-olds showing the greatest level of disagreement of any group.

The figures show that 96% of women of childbearing age (18-44) agree with the statement, ‘I would stop drinking completely if I knew I was pregnant’, and 94% agreed with the statement that they would stop drinking completely if there was a chance they could be pregnant. However, 100% of younger women, aged 18-24, indicated a higher level of agreement with both statements than those in all other groups.

New Zealand Alcohol Beverages Council Executive Director Nick Leggett says significant trending-down of hazardous drinking among young people was also reflected in their attitudes.

He says that rather than constantly calling “crisis” on youth drinking, we should be handing out bouquets.

Overall, 88% of Kiwis agreed with the statement, ‘I would encourage a friend or family member to stop drinking completely if she was pregnant’. Once again, a higher number (92%) of 15-24-year-olds agreed. There were also no significant differences in agreement by ethnicity or household income, which is positive, he says.

“The consistently greater opposition to drinking in pregnancy and the peer pressure in younger age groups is good news because it indicates the message is getting through, and drinking while pregnant is a naturally declining problem in our society.

“We shouldn’t rest on our laurels, but we should note with some satisfaction that those coming into key childbearing ages are the most aware and least likely to take risks while drinking in pregnancy.”

Mr Leggett says the alcohol industry continues to increase its investment in awareness and education concerning the risks of consuming alcohol during pregnancy.

• See the HPA survey ‘Attitudes to drinking in pregnancy’ here

NZNO Strike Notice Withdrawn

New Zealand Nurses Organisation (NZNO) has withdrawn strike notice for Thursday 5 July. NZNO and representatives for the country’s 20 DHBs reached an agreement this afternoon on a revised offer, which the nurses’ union is expected to take to its members on Monday.

Southern DHB will begin immediately to reschedule outpatients appointments and elective surgeries – but patients will not have their original appointments reinstated.

Southern DHB had this week begun contacting patients with letters and by phone postponing outpatient appointments and elective surgeries scheduled on and, in some cases prior to, 5 July. Patients who receive letters today or in the coming days informing them their appointment is being postponed due to the nurses strike will be contacted to reschedule a new date and time. Some patients have already been rescheduled with a new date and time.

“It is unfortunate that the appointments can not necessarily proceed as originally scheduled, but rather our staff will have to reschedule all appointments that have been postponed,” says Chris Fleming, Chief Executive, Southern DHB. “We regret this is the case and apologise for the inconvenience but we will do all we can to make contact with patients and reschedule all appointments, treatments and surgeries as quickly and conveniently as possible.”

The terms of the agreement between the two sides, which will not be released until next week, will be finalised over the weekend. In the meantime, life preserving service and contingency planning continue in preparation for the strike action on Thursday 12 July, for which the strike notice remains in force.

Mr Fleming thanked staff for their work preparing for the proposed strike: “Our contingency planning team as well as other staff members were committed to continuing to provide the best healthcare possible and we are grateful to all staff for their extra efforts in advance of the proposed strike.”

Setting NZ’s health research priorities

Great minds come together to help set New Zealand’s health research priorities

Some of New Zealand’s leading health researchers, innovators, advisors and health delivery experts have been brought together to help establish New Zealand’s first set of national health research priorities.

This independent ‘Development Group’ will assess the input from stakeholders across the health, science and innovation sectors, to help ensure the process of setting priorities is inclusive and serves the needs of New Zealand’s diverse population and communities.

Until now, New Zealand has never had a unified set of health research priorities at a national level, and therefore not seen the full potential of coordinating its research efforts across the sector.

But since the introduction of the New Zealand Health Research Strategy (2017–2027), the Health Research Council of New Zealand (HRC) has been working with the Ministry of Business, Innovation and Employment and the Ministry of Health to ensure health research addresses the needs of all New Zealanders. Key to that success is identifying priorities for government investment to target.

The Steering Group for the Strategy, made up of the three forementioned government organisations and representatives from Callaghan Innovation, Universities NZ and District Health Boards, says the purpose of setting priorities is to gain a shared understanding of where to focus effort and resources, in order to get the greatest benefit and value from New Zealand’s investment in health research.

Over the course of 2018 and 2019, the Development Group will consult widely and develop a broad set of Strategic Investment Areas, which will be announced in early 2019 and are expected to guide investment activity through to 2027. The Group will continue to refine the priorities, working closely with experts to agree shorter-term research objectives, which will be announced by the Minister of Research, Science and Innovation and the Minister of Health at the end of 2019.

The Group’s members have been selected for their mana, knowledge, expertise in health services or research and different world views and experience, as well as their ability to think strategically for the benefit of all New Zealanders.

The group comprises 13 people, representing a wide range of experience:

Fepulea’i Margie Apa
Professor Michael Baker
Emeritus Professor Richard Bedford
Dr Dale Bramley
Professor Vicky Cameron
Dr Kyle Eggleton
Dr James Hutchinson
Professor Margaret Hyland
Ms Rose Kahaki
Mr Philip Patston
Professor John Potter
Professor Stephen Robertson
Professor Linda Tuhiwai Smith

The Group will have two Co-Chairs, at least one of whom is Māori.

“This is not just about how the Health Research Council allocates its funding, but how the HRC, Ministry of Health, MBIE and other government agencies will work together to form a better and more integrated health research system” says the HRC’s chief executive, Professor Kath McPherson.

“There is no end of things to do, but the reality is there are limited resources and a need to make some choices,” she says.

“What are the biggest issues that face New Zealanders where research could make a difference? Do we have areas where, in fact, New Zealand could and should lead the world? What sort of skills do we need our researchers and health professionals to have, and to develop, so they can address the problems that are just around the corner?”

Dr Andy Simpson, chief medical officer at the Ministry of Health and member of the Steering Group for the Strategy, says all New Zealanders will be able to contribute to identifying the most important issues for health research to tackle.

“This group will help guide that process and so it is great to have such a range of expertise and experience,” he says.

Funding boost helps NZ researchers

Keeping our brains sharp and memories alive is the focus of at least two research projects that have just received a significant funding boost from the Health Research Council of New Zealand (HRC).

As part of its annual funding round, the government body has just awarded $55.56 million to 49 projects with the potential to vastly improve the health of New Zealanders.

Among the projects is a one-of-a-kind study to identify the earliest signs of dementia, long before clinical diagnosis.

“Imagine you have been diagnosed with dementia. You’re told that it will progressively and irreversibly deprive you of your ability to think, your personality, and your independence,” says lead investigator Associate Professor Maurice Curtis from the University of Auckland.

“Now imagine your doctor tells you that you could have been treated if you were diagnosed 10 years earlier, but the damage to your brain now is too extensive. This is the problem we are trying to solve.”

Remarkably, the driving force behind this study is a large New Zealand family whose members carry a genetic mutation that is known to cause frontotemporal dementia. With 25 members of the family recruited into the study, it’s the world’s largest multi-generational study into this type of dementia.

By assessing blood tests taken annually and measuring ongoing changes in thinking and sense of smell, this longitudinal study aims to compare changes that occur between members of the family who carry the gene and those who don’t.

“This will allow us to measure potential markers of dementia up to 30 years before expected clinical onset, which could then make early intervention possible,” says Professor Curtis.

“We are focusing on non-invasive, cost-effective diagnostic markers, in the hope that they could one day be used widely as a screening tool for pre-clinical dementia.”

In another project aimed at preserving our memories, Professor Wickliffe Abraham from the University of Otago aims to reveal the fundamental mechanisms that disrupt brain ‘plasticity’ and affect our ability to learn and remember things.

“The ability to form memories is fundamental to all mental abilities, and there are profound consequences when memory function is impaired, including Alzheimer’s Disease, stroke and traumatic brain injury,” he says.

His team will be looking into the role of ‘astrocytes’ – cells that support and help the function of nerve cells in the brain.

“In the past 10 to 15 years, astrocytes and how they work together with the nerve cells has become a real hot topic,” says Professor Abraham. “Under normal conditions, they may be involved in protecting memories from interference, but in the presence of disease they may actually generate memory deficits.”

His study is poised to make a significant contribution to the growing international field of astrocyte biology and our understanding of how memory mechanisms are regulated.

“Understanding these processes may help identify new targets for therapeutic interventions to rescue diseased memory and cognition,” he says.

The HRC’s director of Research Investments and Contracts, Dr Vernon Choy, says this year’s project proposals once again prove that New Zealand researchers are leading the way in identifying novel solutions to difficult problems.

“The projects we’ve funded this year span across public health, biomedical research, Māori and Pacific health. All of them delve into important health issues, and many pose questions that affect us all in some way – they really do have the potential to improve the lives of all New Zealanders.”

See below for the full list of Project grant recipients, and to read lay summaries of the research projects (from Monday 18 June) visit www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Researcher Initiated Proposals’, ‘Projects’ and ‘2018’.

2018 Project grants – full list

Professor Haxby Abbott, University of Otago, Dunedin
The primary care management and impact of osteoarthritis: learning from big data
36 months, $1,199,993

Professor Wickliffe Abraham, University of Otago, Dunedin
Mechanisms of neural network metaplasticity via astrocytes
36 months, $1,175,591

Professor David Ackerley, Victoria University of Wellington
Repurposing the anthelmentic niclosamide to combat Gram negative superbugs
36 months, $1,189,475

Professor Michael Baker, University of Otago, Wellington
Developing an optimal strategy for the rheumatic fever endgame
36 months, $1,196,974

Dr Jackie Benschop, Massey University, Palmerston North
Emerging sources and pathways for Leptospirosis – a paradigm shift
36 months, $1,199,841

Professor Margaret Brimble, The University of Auckland
Naturally occurring peptaibols: “Magic bullets” for targeting breast cancer
36 months, $1,195,373

Dr Rebecca Brookland, University of Otago, Dunedin
Predictors and impact of driving cessation on older adults and whanau/families
48 months, $1,199,989

Professor Larry Chamley, The University of Auckland
Placental extracellular vesicles, controllers of the maternal vasculature
36 months, $1,187,064

Dr Linda Cobiac, University of Otago, Wellington
Choosing interventions to reduce alcohol-related harm
36 months, $1,037,229

Professor Julian Crane, University of Otago, Wellington
Are toxic moulds a real health hazard in New Zealand?
36 months, $1,193,603

Dr David Crossman, The University of Auckland
Nanoscale fibrosis and loss of contractility in the failing human heart
36 months, $1,182,220

Associate Professor Maurice Curtis, The University of Auckland
Identifying the first signs of dementia in humans
36 months, $891,792

Professor Stuart Dalziel, Auckland DHB
How safe are our emergency departments? A national prospective cohort study
36 months, $1,197,164

Dr Joanne Davidson, The University of Auckland
Look before we leap: strategies for treating mild neonatal encephalopathy
36 months, $1,185,478

Professor Michael Eccles, University of Otago, Dunedin
Epigenomic profiling to predict patient response to melanoma immunotherapy
36 months, $1,198,714

Dr Theresa Fleming, Victoria University of Wellington
Integrating survey and intervention research for youth health gains
36 months, $1,189,388

Associate Professor Mhoyra Fraser, The University of Auckland
New horizons for preterm brain protection: exploiting endogenous neuroprotection
36 months, $1,187,296

Professor Leigh Hale, University of Otago, Dunedin
Co-creating a digital self-help intervention for people with persistent pain
36 months, $1,198,177

Professor Jane Harding, The University of Auckland
Nutrition and brain development in moderate and late preterm babies
36 months, $1,187,239

Ms Gayl Humphrey, The University of Auckland
Smart phone delivered CBT for gambling related harm: An RCT
36 months, $1,190,695

Associate Professor Michael Jameson, The University of Auckland
More gain, less pain from chemoradiation for rectal cancer by adding simvastatin
60 months, $1,399,054

Dr Kelly Jones, AUT University
Reducing fatigue after stroke: A randomised controlled trial
36 months, $1,188,578

Dr Peter Jones, University of Otago, Dunedin
A novel target for the control of arrhythmias
36 months, $1,133,212

Associate Professor Nicola Kayes, AUT University
Evaluating a sustainable model of peer mentoring in traumatic brain injury
36 months, $1,192,532

Professor Ngaire Kerse, The University of Auckland
Staying UpRight in residential care
36 months, $1,443,303

Dr Bronwyn Kivell, Victoria University of Wellington
Development of novel remyelination treatments for multiple sclerosis
36 months, $1,167,846

Associate Professor Bridget Kool, The University of Auckland
Evaluating the impact of prehospital care on mortality following major trauma
30 months, $1,096,497

Dr Peter Mace, University of Otago, Dunedin
Understanding regulation of the polycomb-repressive deubiquitinase in malignancy
36 months, $1,193,468

Professor Ralph Maddison, The University of Auckland
Rugby fans in training: A randomised controlled trial
36 months, $1,199,266

Professor Sally McCormick, University of Otago, Dunedin
Targeting new receptors for lipoprotein(a)
48 months, $1,185,496

Professor Mark McKeage, The University of Auckland
Reducing oxaliplatin toxicity: A randomised dose-finding proof-of-concept trial
36 months, $1,195,454

Dr Suresh Muthukumaraswamy, The University of Auckland
Pharmacological brain-imaging of novel rapid antidepressant medicines
36 months, $1,187,508

Professor Pauline Norris, University of Otago, Dunedin
Randomised controlled trial of prescription charges
36 months, $1,035,525

Associate Professor Adam Patterson, The University of Auckland
Banishing tumour hypoxia to render cancer immunotherapy curative
36 months, $1,197,122

Dr Rohit Ramchandra, The University of Auckland
Targeting chemoreceptors in hypertension: a large animal pre-clinical trial
36 months, $1,187,099

Professor Franca Ronchese, Malaghan Institute of Medical Research
Molecular characterisation of dendritic cells during immune responses
36 months, $1,199,996

Professor Robert Scragg, The University of Auckland
Improving CVD risk prediction in primary care: novel arterial waveform method
48 months, $1,199,504

Professor Peter Shepherd, The University of Auckland
A new combination therapy for cancer
36 months, $1,166,624

Professor Lisa Stamp, University of Otago, Christchurch
Is prophylaxis required with start-low go slow dosing of allopurinol in gout?
48 months, $1,432,108

Professor Timothy Stokes, University of Otago, Dunedin
Do regional DHB groupings improve service integration and health outcomes?
24 months, $799,562

Professor Richard Troughton, University of Otago, Christchurch
Dietary sodium reduction to improve heart failure outcomes: The SODIUM-HF study
36 months, $1,412,362

Rangahau Hauora Māori Projects

Dr Donna Cormack, The University of Auckland
Te whakahaumaru taiao: safe environments for Māori medical practitioners
36 months, $994,669

Dr Cameron Lacey, University of Otago, Christchurch
Pathways to first episode psychosis and outcomes In Māori
24 months, $618,336

Dr Sarah-Jane Paine, The University of Auckland
Revealing the Realities of Racism for Rangatahi in Aotearoa – R4Aotearoa
36 months, $1,197,117

Mr Andrew Sporle, Independent Researcher, Auckland
Te Hao Nui
36 months, $1,198,494

Pacific Projects

Dr Siautu Alefaio-Tugia, Massey University, Auckland
Caring for our wisdom bearers: Pacific Matua (Elder) care
36 months, $599,713

Associate Professor Faafetai Sopoaga, University of Otago, Dunedin
Mental health and well-being of Pacific youth in higher education
36 months, $599,336

Dr Gerhard Sundborn, The University of Auckland
How has a ‘water only’ and ‘healthy kai’ school policy impacted on child obesity
36 months, $553,966

NZBS Announces Updates to Popular Donor App

New Zealand Blood Service (NZBS) announces major updates to its already successful and user-friendly Donor App.

First launched in 2016, the NZ Blood Service Donor App was created to enhance the donor experience by placing the power to save lives directly in the palm of the donor’s hand. The app has been downloaded over 66,000 times since it was launched, and currently places 6th as New Zealand’s most popular free medical app.

The app currently allows donors to book appointments, access maps of all the blood drives across the country and share via personal social media platforms, and as one of the coolest features yet, it sends a special notification to Whole Blood donors when their blood has been used to help save a life – in real time.

In addition to this already thriving donor platform, the NZ Blood Service Donor App is undergoing some exciting changes that will become available on 14th June 2018. The updates include:
• Options to associate individual donations to a Team Red group (NZBS’s group blood donation programme)
• A personal notes section where donors can record their own notes
• Notifications for up to five of your favourite donation locations
• Notifications that you’re eligible to give blood again with a link to the next available appointment in your default location
• And a wide and fun range of NZBS-themed selfie frames that you can share on social media.

“We can’t emphasise enough how important our donors are to us”, says Asuka Burge, National Manager Marketing and Communications for NZBS.

“Across New Zealand, there are 110,000 active donors, all of whom save the lives of nearly 29,000 people around the country every year. It’s great that so many donors already use the app and we hope that these new features will not only help enhance their experience but also help encourage more people out there to donate as well.”

The NZ Blood Service Donor App is free, available for download now and already includes the below features:

Scheduling appointments:
Donors are currently able to view all donor centres and mobile blood drives in the country, plotted on a map. Once a location is selected, the donor is able to choose their preferred date and time before confirming the appointment. The app also allows donors to book multiple future appointments and receive reminders for upcoming appointments. Donors also receive helpful notifications to let them know when their local mobile blood drive has been confirmed in their area.

Digital Donor ID Card:
Instead of carrying a physical Donor ID Card, donors arriving at an appointment can simply present their Donor ID in the app.

Donor Information:
Donors are able to see their blood type, access their donation history and view their upcoming appointments via the app. The number of days until they are eligible to donate again is visible to provide a handy reminder when a donor can donate again.

Blood use notification:
Once a donation has been made, Whole Blood donors receive a notification when their blood has been used. This is only available for Whole Blood donors and additional information about this notification can be found in the app’s Terms of Use.

Free app for download:
The NZ Blood Service Donor App is available for free to download for iPhone on the App Store, and for Android devices on the Google Play store. The app is available for new and current Whole Blood donors, and current Plasma donors. Platelet donors still need to contact the donor centres to book their appointments.

Download the NZ Blood Service Donor App here:
Apple:
https://itunes.apple.com/nz/app/nz-blood/id1117204900?mt=8
Android:
https://play.google.com/store/apps/details?id=nz.co.nzblood.app

Have a heart – give generously to Heart Kids

HEART KIDS APPEAL WEEK JUNE 4TH- JUNE 10TH

Aged just two years old, little Luna Clark has spent more time in a hospital bed than many adults. The granddaughter of Kiwi cycling great Stephen Swart, Luna was born with a major heart defect. At 36 weeks pregnant her parents, Olivia and Donovan were given three options: to terminate, palliative care, or if she was a candidate after birth, a series of surgeries.

For Olivia, the decision was simple. They had to give their little girl a fighting chance. Now aged two, Luna Clark has undergone three open heart surgeries, with a fourth coming up, and she could ultimately face a heart transplant in the future. 

Luna is one of the 12 babies born every week in New Zealand with a heart defect. A CHD (congenital heart defect) is the #1 cause of death in babies and infants and affects more than 600 new families a year.

Thankfully, standing by their side, through every traumatic diagnosis and surgical procedure, is Heart Kids – the only not-for-profit organisation in New Zealand dedicated to supporting heart children, otherwise known as ‘born fighters’, throughout their lives.

This week, (June 4th – 10th) Heart Kids is appealing to the New Zealand public for donations to help them continue their dedicated and much needed support for Kiwi kids like Luna.

Rob Lutter, CEO of Heart Kids New Zealand, says: “Every year, more than 600 major heart surgeries are performed on children or babies, sometimes in their first few hours of life.

For many, this won’t be their last operation and they will continue to face the day-to-day challenges associated with their heart condition – and that’s what we are here for. While there are surgical procedures that can improve the heart’s function, there is neither a prevention nor cure for a CHD.”

Heart Kids has over 8000 members and is growing by 15 per cent each year. They provide heart children and their families with practical, emotional and psycho-social services – be it an information brochure, specialist equipment, leadership development for heart youth and adults, specialised camps for heart kids, an opportunity to connect with other families or a hot meal for hospital-bound families.

For little Luna’s parents. Heart Kids has been invaluable. “They’ve made us feel like we’re not alone. And the events they put on have allowed us to meet so many other families, which is the best part. To meet families who “get it” and who can actually relate to what you’re saying and going through is huge.”

This week, Heart Kids is appealing to Kiwis to donate generously to help them provide much-needed support to New Zealand children born fighting CHD.
Heart Kids receives no funding from the government and needs your help. You can donate to Heart Kids on the website, www.heartkids.org.nz
Alternatively, a $3 donation can be made by texting HEART to 2427.

Seasonal Produce Provides Affordable Winter Wellness

Winter feels like it is well and truly here, and seasonal fruit and vegetables play a vital role in boosting immunity and fighting off unwanted ills and chills.

Niki Bezzant, food and nutrition writer and editor-at-large for Healthy Food Guide, says eating seasonally is not only economical, but ensures we are getting the right vitamins and minerals in our diet.

“Getting lots of fruit and vegetables in winter is especially important to keep up our intake of vitamins and minerals to boost immunity. Fruit and vegetables also contain fibre which is beneficial for gut health, a very important part of our immune system,” she says.

With soup season in full swing, winter produce such as kūmara, carrots, parsnips, broccoli and cauliflower lend themselves perfectly to creating hot, creamy and nutritious soups and are packed with dietary fibre and vitamins. Kūmara and broccoli in particular are bursting with Vitamin C, both containing more than the recommended daily dose, as well as Vitamins A and B6.

5+ A Day Charitable Trust General Manager Paula Dudley says familiarising yourself with what’s in season is a great way to save money. In-season produce is fresher, better value and more sustainable because it’s locally grown and minimally transported.

“Eating at least five servings a day of fruit and vegetables is great, but eating more and a good variety, is even better,” says Dudley.

Bezzant says another cost-effective idea is batch cooking winter vegetables, it is a simple way to plan meals and a great time saver for our busy lives.

“Roast up a big dish of kūmara, pumpkin, parsnip, potato and carrots at the start of the week and use them in salads for lunches, frittatas for breakfast or casseroles for dinner.

“I also love dark leafy greens like silverbeet, spinach and kale in winter, they add goodness to almost anything, particularly soups and casseroles. Citrus fruit is abundant now and perfect as a snack or dessert,” says Bezzant.

Dudley says increasing your intake of fruit and vegetables can make a big difference to the way you feel in just a couple of weeks, helping to lift your psychological wellbeing, lowering stress levels, and boosting vitality and motivation – all of which become even more important during the cold winter months.

“Consuming fruit and vegetables reduces the risk of disease, with recent studies suggesting eating plenty of fresh produce may lead to longer lives.
“Fruit and vegetables contain lots of nutrients and antioxidants, and have been shown to reduce bad cholesterol levels, lower blood pressure, and boost the health of blood vessels and the immune system,” says Dudley.

In season fruit and vegetables are also healthy for the bank balance. Currently, a family of four can buy at least two days’ worth of their five plus servings of fruit and vegetables for under $20.

For example, that could include produce such as carrots at $2.49/kg, which is approximately eight carrots; two kilograms of potatoes for $5.58 ($2.79/kg), between 10-12 medium-sized potatoes; one large broccoli head at $1.79; one kilogram of mandarins at $3.99/kg, equating to around 10 pieces of fruit; a big bag of fresh spinach at $3.29; and eight kiwifruit, equivalent to one kilogram, for $2.29/kg.

That’s a total of $19.43 to feed four people their five plus servings for at least two days, or $2.43 per person a day.

“Variety is the spice of life, so be sure to mix up different varieties of the same fresh item, like kiwifruit or kūmara. You might just discover a new family favourite,” says Dudley.

For more information on what’s currently in season, as well as handy storage and handling tips, nutritional information and recipes, visit www.5aday.co.nz.

Study: waiting a minute can save premature babies’ lives

A major international study that involved 312 babies from Aotearoa New Zealand has led to life-saving changes in the care of premature babies around the world.

Findings from the Australian Placental Transfusion Study (APTS), taken together with data from similar trials, showed that simply waiting 60 seconds after birth to clamp a premature baby’s umbilical cord dramatically improves its chances of survival.

This week, the University of Sydney-led study – which involved New Zealand researchers – won the prestigious Australian Clinical Trials Alliance Clinical Trial of the Year award presented by the Australian Minister of Health.

Associate Professor Katie Groom, the Hugo Charitable Trust clinical research fellow at the Liggins Institute, was involved in the study at National Women’s Health, Auckland City Hospital. “Before this research, we were unsure how best to care for these very small and vulnerable babies at the time of birth,” she says.

Dr Groom is also an obstetrician and maternal fetal medicine subspecialist at Auckland City Hospital. A few years ago, she explains, it was standard practice to clamp the cord immediately after preterm birth and hand the baby to a paediatrician, in case the baby needed urgent help with breathing (by inflating the lungs with oxygen via a tube passed into the windpipe, or via a facemask).

“But doctors now know that almost all preterm babies will start breathing by themselves in the first minute after birth, which meant it was safe to look into the effects of delaying clamping.”

The research team behind the award-winning study, published last October, examined its results alongside 17 other randomised trials involving about 2800 babies born before 37 weeks’ gestation, and found that delayed clamping cuts the relative risk of death in hospital by a third. Babies were also less likely to need blood transfusions, and there was no apparent increase in complications for mother or baby.

Dr Groom: “We are so pleased that New Zealand women and their babies had the opportunity to be involved in APTS. It’s such a great example of an international, high quality trial designed to answer a specific question. And because it was designed to allow researchers to combine results from similar trials, it generated even more powerful evidence, which is already changing practice and saving lives.”

Every year, around 5000 babies are born prematurely in New Zealand. The researchers estimate that worldwide, delayed clamping could save between 11,000 and 100,000 extra lives per year – and it costs nothing.

It is thought that those extra, crucial seconds may allow premature babies to receive extra red and white blood and stem cells from the placenta, which may help them maintain healthy levels of oxygen, control infection better and repair injured tissue. It also gives them more time to start breathing by themselves, avoiding invasive procedures.

“A perfect result for the research team – and for thousands of families around the world,” says Dr Groom.

Daisy’s story: “The longest 60 seconds of our lives”

Waiting a minute before doctors clamped the umbilical cord connecting tiny Daisy Salter to her placenta was “the longest 60 seconds of our lives”, remembers Auckland mum Katie Salter.

Daisy was one of more than 1600 babies from 25 hospitals in seven countries who were in the Australian Placental Transfusion Study (APTS).

The participating New Zealand hospitals were Auckland City HospitalWellington Hospital, Christchurch Hospital, Waikato Hospital and Dunedin Hospital, with University of Auckland and University of Otago researchers in the international collaboration.

The study contributed to new, powerful evidence that delaying clamping by a minute after birth for babies born before 37 weeks’ gestation lowers the relative risk of death in hospital by a third, and is safe for mothers and premature babies.

When Katie went into labour at just over 23 weeks, Katie’s obstetrician, Dr Katie Groom, asked Katie and husband Neil in the delivery suite if they would like to join the study.

Recalls Katie Salter: “Katie explained it very clearly, very concisely, and with no pressure whatsoever, and it felt very safe for us being part of the study because there was no risk to my baby or me, and potentially it could be really helpful to her. She said if there was any trouble with Daisy struggling to breathe they’d clamp her immediately, which was reassuring.”

Daisy arrived via an emergency c-section. “After she was taken out that was when the delayed cord clamping happened, and that was probably the longest 60 seconds of our lives,” says Katie.

“I couldn’t see her because I was lying on the operating table and my husband was, I think, too scared to watch, so we just had to put our complete trust in the professionals, and we waited. In retrospect, I think it was a very, very big part in how well Daisy did.

At 545g, Daisy weighed scarcely more than a pack of butter; small enough for Neil’s wedding band to fit around her arm. By the time Katie was stitched up and Daisy ventilated and stabilised, it was a couple of hours before mother and baby could touch, via a hole in the incubator.

“As I was wheeled out, I saw her little fist go up. She was born on the same day that Mohammed Ali died, and we thought it was fantastic we had a little fighter – it was a very good omen!”

Daisy spent 102 days in the neonatal intensive care unit (NICU). Katie and Neil had to juggle time at the hospital with time at home with their other, preschool daughter, Ila, who could not enter NICU because under-fives are not allowed in during winter due to infection risk. At first, survival was touch and go, and as a very premature baby, Daisy faced high risks of serious ongoing health issues. “It was probably the toughest thing we’ve ever been through,” says Katie.

But against the odds, Daisy survived and thrived. “Now she is an incredible, happy, relaxed, delightful almost-two year old,” says Katie. “She’s full of beans, full of smiles, running around. She has completed our family and we can’t be grateful enough to the team at Auckland Hospital and everyone involved in her care. And we feel so proud and privileged that we were part of this study that is saving lives by providing such high quality evidence.”

Watch Katie Salter talking about Daisy’s birth and being in the Australian Placental Transfusion Study.

Associated articles:
American Journal of Obstetrics and Gynecology: Delayed versus immediate umbilical cord clamping: a systematic review and meta-analysis

The New England Journal of Medicine: Delayed versus immediate cord clamping in preterm infants.

‘Take Life Back’: new call to action

Southern Cross Health Society this week launched a fresh new brand platform ‘Take Life Back’, urging Kiwis to reclaim the things that are important to their health and wellbeing.

‘Take Life Back’ is based on the proposition that the biggest threat to our health and wellbeing is in fact modern life. As human beings we are busier, more conflicted, more distracted and more compromised than ever before. Digital devices, social media, the proliferation of information and the massive escalation of choice have created a new set of unhealthy habits. Mental health issues and ‘lifestyle’ diseases are on the rise.

The TVCs feature Kiwis living their busy, stressful lives before taking life back by rediscovering the pleasures of connection, family time and the great NZ outdoors.

The business will also be seeding digital content and a social media ‘life hacks’ campaign that will invite Kiwis to share how they are ‘taking life back’.

Chief Marketing Officer Chris Watney explains the campaign is part of Southern Cross Health Society’s vision to empower Kiwis to live their healthiest lives.

“We have a long history of being New Zealand’s favourite health insurer,” he says.

“More than 860,000 Kiwis trust us to help them get the treatment they need to get well when they are ill.

“But our vision is much broader than that. We have always been about creating a healthier New Zealand society,” Watney continues. “Now we are also focusing on the everyday health and wellbeing decisions that we all make, empowering Kiwis to be well and stay well, as well as being there for them when they’re ill.”

Earlier this year, the Health Society launched its first product in this space: BeingWell, an holistic workplace wellbeing programme for businesses.

The Health Society worked with Auckland-based creative agency True and media agency MBM to conceive and develop the campaign, which launched this week. “Right from the start we knew we were working with agency partners who believe in what we want to achieve. They have come on board to help us tell a powerful new story about a household name.” says Watney.

“The Southern Cross Health Society brand is a Kiwi icon and the team behind it is leading a transformation of the industry that will ultimately see a democratisation of health and wellbeing provision,” Says True Managing Director, Steve Kane.

“When developing the brand platform that would underpin this transformation we tapped into the cultural truth that the modern condition is putting our health and wellbeing at risk. The campaign is designed to empower more New Zealanders to take their life back, and Southern Cross Health Society can show them how.”

“We are very privileged to be working with a great values-based organisation like Southern Cross, that plays a unique and important role in the New Zealand health sector,” adds Sean McCready, MBM Managing Partner. “As New Zealand’s leading independent media agency we love working with excellent Kiwi organisations and Southern Cross is definitely one of these”.

Fight Cervical Cancer

Smear Your Mea‘ is a community funded and wahine (female) driven New Zealand Health campaign to encourage women to get their smear test and prevent the on-set of cervical cancer. ‘Smear Your Mea‘ was launched by Talei Morrison (currently battling cancer) in 2017.

Smear Your Mea website
Smear Your Mea on Facebook

Ground-Breaking Innovation for Starship

Every year 34,000 children come to the Starship children’s emergency department. The assessment area and waiting room is where the patient journey starts for many of these children.

Starship & ASB engaged RUSH to help create new ways to enhance the experience for both children, parents and the staff of the emergency department, helping calm children and prepare them for treatment, as well as create a more accommodating space for patient comfort and flow.

RUSH designed and developed two different experiences with help from their friends Watermark creative and Bootleg Design…

‘The Starship Animal Check-ups’ space is a wall of frames featuring different characters to take children through check-up experiences familiarising them with the processes they will soon undertake with the clinical team. The interactive Animal characters such as lions teach children to open their mouths wide, meerkats demonstrate different heart rates and blowfish help to coach different breathing rhythms. All experiences are controlled by RUSH proprietary sensors and interactive computer vision-based tracking system.

‘The Magic Forest’ is an avatar scene experience creating a calming space to relax and enjoy quiet time. In this space, virtual birds and flowers react to the child’s movements; move slowly and the flowers and birds will come towards visitors, move too quickly and they will be scared off.

The creative process involved behaviour observation, talking to play specialist and nurses, and understanding the different behavioral strategies to reduce anxiety in order to create a calm, fun environment. A human-centered design approach was used to empathise, ideate and prototype the experiences to ensure they had a biggest impact on our different audiences.

The space introduces a New Zealand hospital-first with world class interactive technology, created in consultation with hospital staff and young patients, to calm nervous patients and their whānau at what is often a difficult time. This includes two unique interactive areas: ‘The Starship Animal Check-ups’ and ‘The Magic Forest’.

RUSH creative director Terry Williams-Willcock said “the project combined a range of technologies and sensors to create gamified fun to help, in what was often a stressful time for families.”

“It was magical seeing the difference the experiences made. When children and parents walked into the Magic Forest they would immediately start playing together and calming down.”
“Our project KPI was to create smiles, in, what is a distressing situation, our Computer Vision technology is continuously tracking the amount of smiles and the duration so we know if we are having the impact we designed for.”

Speaking to the technology CTO and Founder at RUSH, Danu Abeysuriya highlights the use of a mix of sensors in the experiences such as custom temperature and heart-rate sensors. He also reiterated the heavy reliance on computer vision and machine learning, namely custom facial landmark detection and tracking, combined with the Microsoft Kinect for depth sensing and full body skeletal tracking.

“All the animations are rendered in beautiful real-time 3D using a mix of custom graphics shaders for the Magic Forest and fluid 2D spline animation for the Animal Check-up wall.”

Dr Mike Shepherd, Director – Starship Medical and Community, says: “The refurbishment means a better experience for our patients and their families and a more effective work space for our staff.”

Starship’s new children’s emergency department assessment and waiting area was officially revealed at an event at Starship Thursday morning.

Deaths preventable if reach of asthma medicines increased

Around the world an estimated 1,000 people a day die of asthma related conditions, with some 340 million affected by this common chronic disease.

In New Zealand more than 521,000 people are taking medicines for asthma one in nine adults and one in seven children. It causes a death here every week.

World Asthma Day is marked on 1 May, and internationally, medical professionals and researchers are taking the opportunity to draw attention to this too common chronic disease. It can be found in every country but has particularly harsh consequences in places where people have limited access to medicines because they cost too much are not prescribed, or are not available in pharmacies.

Professor Innes Asher of the University of Auckland is the Chair of the Global Asthma Network and received an ONZM in 2012 for her work in paediatrics. In 2017 she was appointed by the World Health Organisation (WHO) as an Expert on Chronic Respiratory Diseases.

She heads the international work of the Global Asthma Network that is aiming to better understand the impact of asthma around the world, involving 353 centres in 135 countries.

Phase I of the Global Asthma Network is underway, involving children in primary and secondary schools and their parents. Its aim is to better understand how common and severe asthma is, how it is being managed, and what the risk factors are. The results of this study will become available in 2019.

“Asthma affects people of all ages in all parts of the world. Symptoms can include significant difficulty in breathing, which makes ordinary activities extraordinarily hard. It affects daily like going to school, working at a job, looking after children or aging parents, exercising, or even just walking,” Professor Innes says.

“There are high costs of poorly controlled asthma, including for acute treatment at the doctor, health centre or hospital, lost productivity of people with asthma or parents of children with asthma, and lost education of children who are too unwell to attend school. This amounts to billions of dollars lost to society.”

In New Zealand, more than 3,000 children each year are being admitted to hospital with asthma, and some of these will have had a potentially life-threatening attack. Across all age groups, hospitalisation rates are much higher for Pacific peoples (3.1 times higher) and Maori (2.4 times higher) than for other ethnic groups. Asthma costs New Zealand around $800 million each year.

Professor Asher says the good news is that asthma can be treated, as there are essential asthma medicines of proven benefit, but without medicines, people are more likely to be disabled or die from it.

“It is vital that governments continue to develop coherent policies to enhance access to effective asthma medicines. Health leaders must aim to get essential asthma medicines included on the World Health Organization’s List of Prequalified Medicinal Products have them on all national essential medicines lists, and have these medicines quality-assured, available and affordable in all countries.”

“The Global Asthma Network, established in 2012, is working worldwide to reduce the burden of asthma through improving management, research, surveillance and capacity building and strives to achieve global access to quality-assured essential medicines.”

Protect yourself from influenza this winter

MidCentral District Health Board encourages everyone to take action and get their influenza immunisation to protect themselves, their families and friends, before flu season strikes in winter.

Vaccinations are now available at General Practice clinics and many pharmacies. Following vaccination it takes about two weeks for antibodies to build-up and offer protection.

The vaccines contain four inactivated influenza strains, especially formulated for the New Zealand 2018 season and to match circulating viruses, including the ‘Aussie flu’ strain in the Northern Hemisphere winter recently.

MidCentral DHB’s Chief Executive Officer Kathryn Cook says because there are no live viruses in the vaccine, you cannot get the flu from being vaccinated.

“But, the virus can be anywhere else and it is easy to catch. Also, being fit and healthy won’t protect you from the flu.”

Ms Cook had her flu vaccination this week; one compelling reason being that 80 percent of people infected with the flu virus do not have any signs or symptoms, but can still pass the virus onto other people who can become very sick.

“I didn’t want to be one of the four out of five people infected with the flu who didn’t even realise, and therefore be able to unknowingly pass it on to my loved ones, friends and colleagues,” she said.

“So the best thing to protect your health, and that of those around you, is to have a flu vaccination. The vaccine is available to some people free of charge, so remember to ask your GP or nurse or local pharmacy if you qualify.”

People who qualify for free immunisation include:

• anyone aged 65 years or over.

• pregnant women, at any stage of pregnancy.

• people under 65 years of age, including children, with long-term health conditions such as heart disease, stroke, diabetes, respiratory disease (including asthma that requires regular preventive therapy), kidney disease and most cancers.

• children aged four and under who have been hospitalised for respiratory illness or have a history of significant respiratory illness.

People who do not qualify for free immunisation may still be able to get one free or subsidised from their employer.

How easy is it to catch influenza?

The influenza (flu) virus can be anywhere. It is easy to catch through coughs and sneezes and by touching some surfaces.

Infected people coughing, sneezing or talking creates droplets that can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. When you are unwell it is important to try and keep several metres from others to reduce the spread of the virus.

Is influenza a serious illness?

Influenza (flu) is not the same as a cold. It is a serious disease that can also make other existing conditions, such as breathing or heart problems, even worse. Influenza usually has symptoms such as a sudden onset of illness, high fever, headache, a dry cough and illness usually lasts seven to 10 days. Even a mild case of influenza can disrupt your everyday activities.

Older people, young children and pregnant women can become very ill with flu. Influenza infection during pregnancy can have catastrophic consequences for both mother and baby including premature birth, stillbirth, small for gestational age and perinatal death.

Other advice:

In addition to getting an influenza vaccination, people can protect themselves, their family, friends and colleagues by following these tips:

• wash and dry your hands often

• stay away from people who are sick

• stay away from work, school or visiting people in hospital if you are unwell

• cover your coughs and sneezes; doing so into your sleeve, instead of your hands

For more info and to find out whether you qualify for free immunisation, visit www.fightflu.co.nz or call 0800 IMMUNE (0800 466 863).

Raw fruit and vegetables have better mental health outcomes

Seeking the feel good factor? Go natural.

That is the simple message from University of Otago researchers who have discovered raw fruit and vegetables may be better for your mental health than cooked, canned and processed fruit and vegetables.

Dr Tamlin Conner, Psychology Senior Lecturer and lead author, says public health campaigns have historically focused on aspects of quantity for the consumption of fruit and vegetables (such as 5+ a day).

However, the study, just published in Frontiers in Psychology, found that for mental health in particular, it may also be important to consider the way in which produce was prepared and consumed.

“Our research has highlighted that the consumption of fruit and vegetables in their ‘unmodified’ state is more strongly associated with better mental health compared to cooked/canned/processed fruit and vegetables,” she says.

Dr Conner believes this could be because the cooking and processing of fruit and vegetables has the potential to diminish nutrient levels.

“This likely limits the delivery of nutrients that are essential for optimal emotional functioning.”

For the study, more than 400 young adults from New Zealand and the United States aged 18 to 25 were surveyed. This age group was chosen as young adults typically have the lowest fruit and vegetable consumption of all age groups and are at high risk for mental health disorders.

The group’s typical consumption of raw versus cooked and processed fruits and vegetables were assessed, alongside their negative and positive mental health, and lifestyle and demographic variables that could affect the association between fruit and vegetable intake and mental health (such as exercise, sleep, unhealthy diet, chronic health conditions, socioeconomic status, ethnicity, and gender).

“Controlling for the covariates, raw fruit and vegetable consumption predicted lower levels of mental illness symptomology, such as depression, and improved levels of psychological wellbeing including positive mood, life satisfaction and flourishing. These mental health benefits were significantly reduced for cooked, canned, and processed fruits and vegetables.

“This research is increasingly vital as lifestyle approaches such as dietary change may provide an accessible, safe, and adjuvant approach to improving mental health,” Dr Conner says.

* The top 10 raw foods related to better mental health were: carrots, bananas, apples, dark leafy greens such as spinach, grapefruit, lettuce, citrus fruits, fresh berries, cucumber, and kiwifruit.

Publication details:

Intake of raw fruits and vegetables is associated with better mental health than intake of processed fruits and vegetables

Kate L. Brookie, Georgia I. Best, and Tamlin S. Conner

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00487/full

Stop smoking services called upon to support vaping

Government funded stop smoking services will keep losing customers if they refuse to help people who want to try vaping, new research has found. The services are in a bind however because the legality of selling nicotine vaping products in New Zealand remains in doubt.

The previous National-led Government claimed nicotine vaping products could not be legally imported and sold in New Zealand, but late last year they promised new regulations to allow the sale of nicotine e-cigarettes and e-liquids. Last week National MP Nicky Wagner, who championed the promised law change, introduced a private member’s bill to get vaping back on the Government’s agenda.

Vaping researcher Professor Marewa Glover, from Massey University’s School of Health Sciences says, six months in to the new Labour Government’s term, “all Associate Minister of Health Jenny Salesa has said on the matter is that she didn’t know what their position on e-cigarettes was going to be.”

She adds: “Two weeks ago Judge Patrick Butler dismissed a Ministry of Health case against tobacco giant Philip Morris on the grounds that the iQos Heets product could not be considered a ‘chewing’ tobacco product, which would be banned under the Smoke-Free Environments Act [SFEA]. His ruling could equally apply to nicotine vaping products, meaning they can be legally imported and sold in New Zealand. Of greater significance, he concluded that the Ministry of Health’s prosecution, which sought to restrict smokers’ access to an alternative less harmful product was the ‘opposite of what Parliament sought to achieve when passing the SFEA’.”

Judge Butler’s questioning of the health authority’s attempt to undermine people’s chance to stop smoking by switching to use of a harm reduced product mirrors the perceptions of vapers reported in a new research paper by Trish Fraser of Global Public Health and Professor Glover and Dr Penelope Truman from Massey University’s College of Health.

Professor Glover says the study found the ban on nicotine for vaping and calls by some public health academics to further restrict access to vaping products and where people could vape compelled vapers to form self-help groups. “Vapers set up online forums where they could support people wanting to switch from smoking to vaping. Individuals and the newly formed groups organised vape-meets to provide a supportive place where smokers could learn about vaping.

“When they heard that peoples’ GPs and the government-funded stop smoking services were refusing to support people in their choice to vape, the vaping community stepped in to fill the gap. They began providing a kind of alternative cessation support to smokers. One on one they were helping family, friends, work mates and even strangers on the street, with advice on how to switch to vaping and where to buy a device and nicotine e-liquid. One group even set up mentors throughout the country to provide support to new vapers in their area,” Professor Glover says.

“There was quite a bit of anger about the way vapers had been treated and that inaccurate claims that vaping was dangerous was leading to bans on vaping. The vapers said they had to quickly learn how to lobby local Councils and MPs. When Nicky Wagner’s Smoke-free Environments [Regulation of Electronic Cigarettes] Amendment Bill is considered, it will be important that the proposed restrictions that the bill will introduce do not, as Judge Butler warned, go against the intent of the Act – that is, to reduce the harm of tobacco smoking,” Professor Glover says.

The researchers add that if the health sector does not change to supporting smokers to vape instead of smoking, then the government should switch to funding vaper-to-smoker peer-led interactions in community contexts where these interactions are naturally occurring.

In the study, 29 vapers were interviewed to learn about the barriers preventing people who smoked from switching to less harmful electronic cigarettes. The study, published in Harm Reduction Journal last week, was conducted in 2016 before the National-led Government announced their intention to introduce regulations to control local sales of nicotine e-liquids.

Government and public health responses to e-cigarettes in New Zealand: Vapers’ perspectives was published in the Harm Reduction Journal on April 5 2018.

Live Stronger for Longer theme of April Falls campaign

Live Stronger for Longer is the theme of this year’s ‘April Falls’ campaign. The annual campaign raises awareness of the harm caused by falls, and what can be done to prevent them.

April Falls month is promoted each year by a growing number of health care providers around the country, including district health boards, aged residential care providers, and community care providers.

Clinical lead for the Commission’s reducing harm from falls programme, Sandy Blake[1], says falls can have a major impact on your life, whether they happen at home, in the community or in hospital.

‘Not every fall results in an injury, but those that do can cause broken bones, which can be painful and take a long time to heal.

‘In 2016, 216,000 people over 50 made a claim to ACC for an injury related to a fall, and nearly 27,000 attended hospital because of a fall – these are big numbers, and represent pain, immobility and inconvenience for a large number of people.

Data is from the Commission’s falls-related Atlas of Healthcare Variation – a website that uses maps, graphs, tables and words to show differences in health care in New Zealand by district health board. The updated falls Atlas domain was released today.

Live Stronger for Longer

The Live Stronger for Longer movement is gaining strength in communities throughout New Zealand. Developed by government agencies and health providers for people over 65, it aims to prevent falls and fractures, enabling people to stay well and independent in their own home.

‘A fall can be devastating for older people,’ says Sandy Blake. ‘It can make them fearful of falling again, which stops them doing the things they used to do. This can lead to social isolation and even depression.’

She says every year, one-in-three people over 65 will fall. For people aged 80 and over, the risk increases to one in two.

‘Only half of those over 80 who survive a hip fracture will walk unaided again, many will not regain their former degree of mobility, and this can result in admission to aged residential care earlier than would otherwise be expected.

‘People are often unaware of the link between a broken bone and osteoporosis. Osteoporosis is the gradual loss of bone strength and density. Over time bones become fragile and will break more easily.’

She says the good news is it’s never too late to build up bones and keep them strong and healthy.

‘The Live Stronger for Longer website offers practical information and advice on how to live an active, independent life and encourages people over 65 to join community group strength and balance classes.

‘Exercise classes can help prevent falls and give older people the chance to have some fun and meet new people, or see if in-home support is appropriate.

‘If you know of anyone who has had a fall, or has limited their activities because of a fall, encourage them to join a class in their community!’

Falls prevention in hospital shows benefits as broken hips reduced

Between September 2014 and the end of September 2017, there have been 107 fewer in-hospital falls resulting in fractured hips compared to historic trends.

Sandy Blake says these results are important and should be celebrated because hip fracture is the most common serious fall-related injury in those over 80 years old.

[1] Sandy Blake is also director of nursing patient safety and quality at Whanganui DHB.

For further information

To help reduce falls, ACC and the Commission have simple resources aimed at understanding a person’s risk of falling (Ask assess act) and identifying and removing falls hazards in the home (home safety checklist). Other resources are available on the Commission’s website and ACC’s website.

April Falls key messages

Live Stronger for Longer website

Health Quality & Safety Commission’s reducing harm from falls programme

Health Quality & Safety Commission’s falls-related Atlas of Healthcare Variation

Osteoporosis New Zealand

How committed are food companies to health?

A new study ranking the nutrition commitments of 25 of New Zealand’s largest food companies has found large variations with some companies leading the way, but many are not doing nearly enough to reduce the biggest cause of ill health in New Zealand, unhealthy diets.

The study, launched today by researchers at the University of Auckland, assessed the obesity prevention and nutrition related policies and commitments of 15 packaged food manufacturers, two beverage manufacturers, two supermarkets, and six quick-service restaurants.

It assessed company policies and commitments across six key domains related to obesity prevention and nutrition: corporate nutrition strategy, product formulation, product labelling, product and brand promotion, product accessibility, and relationships with other organisations.

The research project was conducted by 5th year medical student Apurva Kasture, as part of her medical studies.

She was encouraged by the engagement of many companies in the research and that some companies are making positive steps, but the results show that much more needs to be done.

“Some companies have taken positive steps in response to pressure from society to improve their products with Nestlé, Fonterra, Coca-Cola, Mars and Unilever the top performers, but companies could play a much greater role. There was a large variation in the scores from 0 to 75 out of 100 with eight companies scoring less than 20.”

Professor Boyd Swinburn, who supervised the study, said that many companies had committed to comply with the Advertising Standards Authority’s Children and Young People’s Advertising Code but stronger action is needed to protect children from marketing of unhealthy food.

“Companies really could go beyond the existing weak Code and include children up to the age of 18 years in marketing policies and stop using promotions like cartoon characters and interactive games for marketing unhealthy food products to children.”

Companies performed relatively well on product labelling with many committing to implement the Health Star Ratings and providing nutrition information on their foods and meals online. Countdown and FoodStuffs have committed to implement the Health Star Ratings across all their own-brand products. Unilever use a publically available nutrient-profiling system to determine the type of nutrition or health claims that are acceptable for products to carry. Although quick service restaurants provided nutrition information online, few provided calorie labelling on meals on-site.

Many food and beverage manufacturers and supermarkets are reformulating products to reduce levels of sodium and have targets to reduce sugar but this is highly variable and rarely measureable. Nestlé has a target for lowering sodium, sugar and saturated content. Frucor Suntory commits to have one in three products sold to be low or no sugar by 2030. More companies could develop targets to reduce sodium, sugar, saturated fat, trans fat and portion sizes.

Companies had few commitments to restrict accessibility of less healthy foods and improve accessibility of healthy foods. Recommended actions are to limit price promotions on less healthy products, make all checkouts free of junk food and for quick-service restaurants to not provide free refills for soft drinks.

A positive step would be to see population nutrition become a priority focus within the corporate strategy and to have specific nutrition targets and objectives as key performance indicators for senior managers. Nestlé and Fonterra are leading the way by recognising national and international nutrition priorities. Some companies were transparent about relationships with other organisations by publishing funding for external research and publically committing to not make political donations, with Coca-Cola, Arnott’s and Restaurant Brands the top performers.

The report was funded by the Health Research Council and was based on publically available information (up to the end of 2017) with half the companies providing additional information. It was assessed using the BIA-Obesity tool (Business Impact Assessment – Obesity and population nutrition) developed by INFORMAS, a global network of public health researchers that monitors food environments worldwide, co-ordinated by the University of Auckland. The study measured commitments and transparency but did not assess the actual performance of companies in meeting those commitments or the overall healthiness of their product profiles. These will be the focus of future research. Tackling the unhealthy food environment requires a comprehensive response from government, the food industry, the health sector, and the community.

Report: Committing to Health: Food company policies for healthier food environments. Company assessments and recommendations using the Business Impact Assessment tool for obesity and nutrition (BIA-Obesity). New Zealand 2018. The University of Auckland, Auckland 2018

Full report is available at: www.informas.org/bia-obesity/

Vitamin D could provide psoriasis relief

Psoriasis is a relatively common condition, affecting an estimated two to four per cent of the population. It is characterised by reddened, raised, scaly patches of skin, which commonly occur on the elbows, knees and scalp but can affect any part of the body. Psoriasis can develop at any age and tends to be a lifelong condition. For many people, it fluctuates in extent and severity, and can be challenging to manage despite the array of treatments on offer.

The Massey University study aimed to determine whether vitamin D supplementation improves psoriasis when compared with those taking placebo capsules. Dr Michelle Ingram, who conducted the research as part of her PhD in Nutritional Science says, “This study was partly motivated by observations that some people with psoriasis report a reduction in symptoms during the summer months, when vitamin D production in the skin is usually at its highest. Vitamin D incorporated into a cream or ointment is also a relatively effective treatment for psoriasis, yet no one had looked into whether vitamin D supplementation might be of similar benefit.”

The main findings of the study were inconclusive due to an unexpected increase in vitamin D levels in the placebo group, probably from sunlight. However, Dr Ingram says further analysis across data from the 101 participants in the study showed strong evidence of a link between higher levels of vitamin D and less severe psoriasis.

“Interestingly, this relationship was only found in about two-thirds of our participants, suggesting that vitamin D may be beneficial for some people with psoriasis, yet make no difference for others. It was not clear from our data why there might have been a difference in response – understanding the variability of response to psoriasis treatments in general is a long-term challenge and one that future research will hopefully be able to address,” she says.

Associate Professor Pamela von Hurst, who supervised the research, says the cause of psoriasis remains relatively mysterious, and treating this disease has long been a source of great frustration for patients and the medical profession.

“The range of treatment options are varied, impact different people in various ways and many of the complexities of the disease are yet to be uncovered,” she says. “Research involving vitamin D supplementation also poses some challenges, as vitamin D levels are primarily influenced by sun exposure. However, the collective impact of psoriasis, which is undoubtedly significant, meant it was important to go ahead with this research. While we could not confirm whether vitamin D supplementation is beneficial for psoriasis per se, we have shown that increased vitamin D levels, which can be achieved through supplementation or sun exposure, are related to less severe psoriasis. This indicates that some people with psoriasis might see an improvement in their symptoms from taking a vitamin D supplement, particularly in the colder months,” Dr von Hurst says.

The study, funded by a Lottery Health Research grant, involved participants with varying degrees of psoriasis, (mild, moderate or severe) and showed statistically significant improvements in the group taking vitamin D supplements, as well as in the group taking placebos, over a one year period. There was also a statistically significant relationship between higher vitamin D levels and PASI (Psoriasis Area and Severity Index) score across the whole group of participants.

Oral vitamin D3 supplementation for chronic plaque psoriasis: A randomized, double-blind, placebo-controlled trial was published in the Journal of Dermatological Treatment last month. It was co-authored by Dr Michelle Ingram, School of Sport, Exercise and Nutrition, Massey University, Dr Beatrix Jones, Institute of Natural and Mathematical Sciences, Massey University, Dr Welma Stonehouse, Food and Nutrition Flagship, Commonwealth Scientific Industrial Research Organisation, Dr Paul Jarrett, , Professor Robert Scragg, University of Auckland, Owen Mugridge, School of Sport, Exercise and Nutrition, Massey University and Associate Professor Pamela von Hurst, School of Sport, Exercise and Nutrition, Massey University.

Traumatic brain injury an increasingly “hidden” threat

The Laura Ferguson Trust is urging New Zealanders, particularly children and adolescents, who have experienced any head trauma to immediately seek advice from their GP to assess if they have suffered a traumatic brain injury (TBI).

“Thirteen per cent of New Zealanders will sustain a brain injury at least once in their lifetime, and it often goes undiagnosed and untreated,” said Kathryn Jones, Chief Executive Officer of Laura Ferguson Trust.

“It’s time we shine a light on this hidden disability and the effects it can have on society. Early intervention is critical.”

With few “visible” signs to indicate mild trauma, many cases remain undiagnosed. Mild traumatic brain injury or concussion, which is often caused by whiplash or a direct a knock to the head, can limit a person’s ability to function normally and symptoms are often invisible to others.

Common symptoms include feeling tired, moodiness, short temper, difficulty concentrating, intolerance of noise and difficulty with memory.

“The high correlation between violent behaviour and traumatic brain injury that may have occurred years ago is alarming,” said Jones.

“Newly released research* shows that Kiwi male prisoners have a four times higher rate of traumatic brain injury than the average New Zealand population.”

As a firm advocate of TBI rehabilitation and research, Jones says “society is paying a high price” for the growing number of undiagnosed cases.

“Appropriate screening and treatment for traumatic brain injuries in children and adolescents could help prevent at-risk youth from engaging in criminal behaviour, and potentially change the course of their lives,” said Jones.

“We have created a system of assessment, rehabilitation and support at Laura Fergusson Trust Canterbury. Together with the public, we need to make traumatic brain injury a mainstream focus and remove the stigma associated with the symptoms and behaviours TBI can cause.”

The Laura Fergusson Trust Canterbury plays a leading role in providing traumatic brain injury rehabilitation in the South Island, and aims to provide patients with the skills they need to return to their lives as soon as possible.

The Trust’s interdisciplinary team of on-site specialists include speech and language therapists, physiotherapists, occupational therapists, clinical psychologists, neuro psychologists, dieticians and social workers who work together to provide an integrated approach to rehabilitation and recovery.

If you feel you may have suffered from a traumatic brain injury, please speak to you GP first.

For more information, go to: www.lftcant.co.nz

About Laura Fergusson Trust Canterbury

• The Laura Fergusson Trust Canterbury is only one of two dedicated organisations designated to receive and treat clients with traumatic brain injuries in the South Island.

• The Trust is also the only organisation in Canterbury to offer the full spectrum of services, providing everything from post-acute traumatic brain injury inpatient rehabilitation, short-term care, on-going 24-hour rehabilitation and care, and home-based TBI-related services and assessments.

• It has a total of five beds available for specialist brain injury rehabilitation and 45 beds within its range of accommodation options for longer term care.

• Patients (referred to as clients by Laura Ferguson Trust staff) range from 16 to 65-years-old.

*Mitchell T., Theadom A, Du Preez E. 2017. ‘Prevalence of traumatic brain injury in a male adult population and links with offence type’, Neuroepidemiology 2017;48:164-170.

Toolkit to help parents with mental health issues

A New Zealand first-of-its-kind resource toolkit for community-based services to help parents struggling with mental health problems or addictions was launched in Palmerston North yesterday.

The Supporting Parents – Healthy Children Toolkit is an initiative of MidCentral District Health Board and the Manawatu Supporting Families in Mental Illness organisation, both part of the Clinical Network Mental Health and Addictions project group including community organisations, secondary and primary care health professionals.

The free toolkit is an A4 folder containing:

• a directory of community-based services

• tips and information for families/whānau where a parent is affected by mental health and/or addiction

• a template of a plan of action for children living in the presence of mental health and/or addiction issues

• a template of a family/whānau plan for the care of children should their parent be temporarily unable to do so

• a Parenting Through Challenging Times information booklet

• a Tips for Parents and Carers information story book

• life strategies for family/whānau and friends of people using alcohol and other drugs

MidCentral DHB Mental Health and Addictions Portfolio Manager Claudine Nepia-Tule says the Supporting Parents – Healthy Children context works best where the needs of the children are not seen as separate to the needs of their parents.

“Parents want the best for their children and the toolkit provides community-based services with a family-focussed way to support people in their role as parents and caregivers,” she said.

“Also, while children and young people who have a parent with mental illness or addictions are vulnerable in a variety of ways, including having a substantially greater risk of developing mental health problems later in life, there is clear evidence that most grow up well-adjusted.”

Ms Nepia-Tule said the needs of families/whānau in the community were reviewed as part of the project to develop the toolkit, which also helps implement the Ministry of Health’s Supporting Parents – Healthy Children guidelines.

“We’ve responded to the feedback from parents and caregivers who requested more information be provided to services to encourage conversations regarding their children. This can be as simple as setting a plan for their children, if that parent or caregiver became unwell or was admitted to an inpatient service or residential care.”

The tool-kit has been described as an excellent initiative which has both district-wide and national importance by Bronwyn Dunnachie, representing the National Project Team. The team comprises a collective from all of the national workforce programmes for the Ministry of Health; charged with providing support to all services implementing the Supporting Parents – Healthy Children guidelines.

The Supporting Parents – Healthy Children Toolkit will be distributed to primary care services throughout the MidCentral DHB area, and will be available online on the National Workforce Centre for Children and Adolescent Mental Health website www.werryworkforce.org and atwww.supportingparentsnz.org

Supporting foot health with new roles in podiatry

Waitemata and Auckland DHBs are investing in podiatry by creating new positions to work with primary care to ensure earlier interventions and better outcomes for patients with foot issues and diabetes-related foot disease.

The new senior role, Professional Lead of Podiatry, will support patients to get better at home, undertake workforce development, clinical leadership, and oversight for community Podiatrists and primary care professionals.

To aid the Professional lead, an Interim Podiatrist will also be introduced to monitor patients with a high risk of diabetes-related foot disease.

Diabetes-related foot disease significantly affects a person’s physical, emotional, and social wellbeing. Currently people with diabetes have a 25% life-time risk of developing a foot ulcer, with ulceration a frequent precursor to amputation being present in an estimated 80% of cases.

Waitemata and Auckland DHBs are investing in podiatry by creating new positions aimed to reduce the risk and rates of foot ulcers and lower limb amputations related to people with diabetes Professional Lead Podiatry will help building capability of primary care to undertake foot screening and risk assessment for all people with diabetes. The role will also assist community podiatry services to provide appropriate care to people with moderate to high risk of diabetes related foot disease. The professional Lead will also develop quality standards, credentialing framework and provide clinical oversight and support for primary care and community podiatrists.

The new Senior Podiatrist roles will meet the needs of people with healed ulcers who need to be monitored and managed appropriately in the community setting.

These new roles are part of a greater work programme by the joint-Waitemata and Auckland DHB Diabetes Service Level Alliance (DSLA) to develop a single system of diabetes care that aims to improve the health outcomes for people with diabetes across the Auckland and Waitemata regions.

Christchurch researcher easing the pain of gout

A Christchurch rheumatologist has won New Zealand’s top prize for research into how increasing dosages of gout medicines can dramatically improve patients’ lives.

Professor Lisa Stamp’s study showed it was safe and effective to increase doses of a crucial drug for managing gout. It provided clear evidence in an area where there was much confusion worldwide.

Gout is the most common form of inflammatory arthritis, affecting tens of millions worldwide.

Stamp, from the University of Otago, Christchurch, was this month awarded the Medicines New Zealand’s Value of Medicines Award. The award came with $20,000 to further her research.

The judges said Stamp’s study would have “a high impact on patient care, especially benefitting Māori, Pacific and renal patients.” The research would also have a big impact internationally, the judges said.

In 2016, a group of international gout experts advised doctors not to use higher doses of the drug. Stamp’s robust clinical study found using higher doses of allopurinol was safe and could prevent ongoing attacks of the painful disease. It could also help stop the disease from progressing to a chronic state in many patients.

In the study, published in the prestigious journal Annals of the Rheumatic Diseases, one group of patients had increased doses, while another group did not. Stamp found the two groups experienced similar rates of side-effects. Those on higher doses of allopurinol had better blood results for a crucial measure of the disease.

Stamp says she will use the prize money for further research on predicting patient responses to allopurinol.