Variations in New Zealand and Australian guidelines for the management of neonatal hypoglycaemia: A secondary analysis from the hypoglycaemia Prevention with Oral Dextrose gel Trial ( hPOD )

2021 ◽  
Author(s):  
Aakash B Rajay ◽  
Jane E Harding ◽  
Keyword(s):  
New Zealand ◽  
Secondary Analysis ◽  
Neonatal Hypoglycaemia

scholarly journals A taboo topic? How General Practitioners talk about overweight and obesity in New Zealand

2018 ◽  
Vol 10 (2) ◽  
pp. 150 ◽  
Author(s):  
Lesley Gray ◽  
Maria Stubbe ◽  
Lindsay Macdonald ◽  
Rachel Tester ◽  
Jo Hilder ◽  
...  
Keyword(s):  
New Zealand ◽  
Weight Management ◽  
General Practitioners ◽  
Health Professionals ◽  
Secondary Analysis ◽  
Overweight And Obesity ◽  
Full Potential ◽  
Naturally Occurring ◽  
Interactional Analysis ◽  
General Practices

ABSTRACT INTRODUCTION Obesity is overtaking tobacco smoking in New Zealand as the leading potentially modifiable risk to health. International obesity guidelines recommend that health professionals opportunistically encourage weight management with their patients. However, research shows consistently low rates of weight management discussion, suggesting that health professionals may not be realising their full potential to address obesity. AIM To identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations. METHODS A secondary analysis was conducted of 36 video-recorded consultations in general practices, selected for relevance from a database of 205 consultations. Content and interactional analysis was conducted in the context of the entire consultation. RESULTS The topic of weight was initiated more often by GPs than patients and was raised mostly once or twice in a consultation and occasionally as many as six times. GPs employed opportunistic strategies twice as often as they used structured strategies. DISCUSSION This study of naturally occurring consultations confirmed GPs do engage in opportunistic discussions about weight. However, such discussions are challenging and interactionally delicate. Highlighting the clinical relevance of weight appears to be effective. The high frequency of patient contact with GPs provides opportunity to reach and work with people at risk of chronic conditions associated with excess weight. Further research is required to identify suitable training and brief intervention tools for use in routine consultations that may be beneficial for both GPs and patients.

scholarly journals Validation of the PredAHT-2 prediction tool for abusive head trauma

2020 ◽  
Vol 37 (3) ◽  
pp. 119-126 ◽  
Author(s):  
Helena Pfeiffer ◽  
Laura Elizabeth Cowley ◽  
Alison Mary Kemp ◽  
Stuart R Dalziel ◽  
Anne Smith ◽  
...  
Keyword(s):  
New Zealand ◽  
Head Trauma ◽  
Predictive Value ◽  
Head Injuries ◽  
Secondary Analysis ◽  
Area Under The Curve ◽  
Abusive Head Trauma ◽  
Long Bone ◽  
Prediction Tool ◽  
Zealand Population

ObjectiveThe validated Predicting Abusive Head Trauma (PredAHT) clinical prediction tool calculates the probability of abusive head trauma (AHT) in children <3 years of age who have sustained intracranial injuries (ICIs) identified on neuroimaging, based on combinations of six clinical features: head/neck bruising, seizures, apnoea, rib fracture, long bone fracture and retinal haemorrhages. PredAHT version 2 enables a probability calculation when information regarding any of the six features is absent. We aimed to externally validate PredAHT-2 in an Australian/New Zealand population.MethodsThis is a secondary analysis of a prospective multicentre study of paediatric head injuries conducted between April 2011 and November 2014. We extracted data on patients with possible AHT at five tertiary paediatric centres and included all children <3 years of age admitted to hospital who had sustained ICI identified on neuroimaging. We assigned cases as positive for AHT, negative for AHT or having indeterminate outcome following multidisciplinary review. The estimated probability of AHT for each case was calculated using PredAHT-2, blinded to outcome. Tool performance measures were calculated, with 95% CIs.ResultsOf 87 ICI cases, 27 (31%) were positive for AHT; 45 (52%) were negative for AHT and 15 (17%) had indeterminate outcome. Using a probability cut-off of 50%, excluding indeterminate cases, PredAHT-2 had a sensitivity of 74% (95% CI 54% t o89%) and a specificity of 87% (95% CI 73% to 95%) for AHT. Positive predictive value was 77% (95% CI 56% to 91%), negative predictive value was 85% (95% CI 71% to 94%) and the area under the curve was 0.80 (95% CI 0.68 to 0.92).ConclusionPredAHT-2 demonstrated reasonably high point sensitivity and specificity when externally validated in an Australian/New Zealand population. Performance was similar to that in the original validation study.Trial registration numberACTRN12614000463673.

scholarly journals Nutrients and foods consumed by New Zealand children on schooldays and non-schooldays

2010 ◽  
Vol 14 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Jennifer E Rockell ◽  
Winsome R Parnell ◽  
Noela C Wilson ◽  
Paula ML Skidmore ◽  
Asher Regan
Keyword(s):  
New Zealand ◽  
Soft Drink ◽  
Secondary Analysis ◽  
Normal Weight ◽  
Computer Assisted ◽  
Food Groups ◽  
Nutrient Intakes ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Soft Drink Consumption

AbstractObjectiveTo describe and compare food and nutrient intakes in New Zealand (NZ) children on schooldays and non-schooldays.DesignSecondary analysis of cross-sectional data from the NZ 2002 Children’s Nutrition Survey. Dietary intake was assessed using computer-assisted multi-pass 24 h dietary recalls in the home. Data were adjusted for survey weightings to be representative of the NZ population. The effect of day category on nutrient intake, and likelihood of consumption of food categories were determined using linear and logistic regression.SettingNZ homes and schools.SubjectsA total of 2572 children (538 non-schooldays and 2034 schooldays) at the age of 5–14 years.ResultsThere were differences in the proportion consuming some food groups between schooldays and non-schooldays, although the majority of nutrient intakes including energy did not differ by day category. Mean cholesterol intake was higher on non-schooldays; dietary fibre and available carbohydrate, in particular sucrose and fructose, were higher on schooldays. Hot chips were twice as likely to be consumed on a non-schoolday. Soft drink consumption was higher on non-schooldays for Māori/New Zealand European and others and powdered drinks/cordial consumption did not vary by day category. More children consumed snack bars (normal weight, obese), fruit, sandwiches, biscuits/crackers and snack foods on schooldays. There was no difference in consumption of pies/sausage rolls by day category.ConclusionsThe proportion of consumers of a variety of foods differed significantly between non-schooldays and schooldays; few nutrient intakes differed. The present study indicates that family food, wherever it is consumed, is the mainstay of nutrition for NZ schoolchildren.

scholarly journals Intersex adolescents seeking help for their depression: the case study of SPARX in New Zealand

2021 ◽  
Author(s):  
MFG Lucassen ◽  
Y Perry ◽  
C Frampton ◽  
Theresa Fleming ◽  
SN Merry ◽  
...  
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Adolescent Depression ◽  
Behavioral Therapy ◽  
Secondary Analysis ◽  
Online Resource ◽  
Patient Health ◽  
Seeking Help ◽  
Self Harm

Objective: SPARX is a computerized cognitive behavioral therapy self-help program for adolescent depression that is freely available in New Zealand. At registration, users identify themselves as either male, female, intersex, or transgender. We aimed to describe the mental health of adolescent intersex users. Method: A secondary analysis of SPARX usage data over 5 years. Results: Of the 8922 adolescents users, 0.6% (n = 50) identified as intersex. Based on Patient Health Questionnaire 9 – modified for Adolescents (PHQ-A) results, 78.3% of intersex users had high levels of depression and/or self-harm and suicidal ideation. The mean PHQ-A scores for intersex users were significantly higher than for males and females (p <.001). As only three intersex users completed SPARX Level 4 or more (of the seven-level program), we were unable to meaningfully investigate any reductions in their depressive symptoms over time. Conclusions: There is a dearth of empirical data on the mental health of intersex adolescents. These results suggest that intersex adolescents seeking help from an online resource have high mental health needs compared with other young people, possibly because they defer seeking help.

scholarly journals A descriptive study of New Zealand midwives' primary care management of iron status in pregnancy and the postpartum period

2021 ◽  
Author(s):  
◽  
Esther Calje
Keyword(s):  
New Zealand ◽  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Clinical Guideline ◽  
Iron Status ◽  
Secondary Analysis ◽  
Descriptive Study ◽  
Deficiency Anaemia ◽  
End Stage ◽  
Maternal Iron

<p>Background: Globally there is no consensus on haemoglobin (Hb) parameters that define maternal anaemia. Therefore it is difficult to distinguish physiological anaemia of pregnancy from anaemia associated with pathology. Low maternal iron status is associated with adverse outcomes, although the evidence is difficult to interpret. Non-anaemic iron deficiency requires prevention and treatment, before end stage iron deficiency anaemia. Increases in serum ferritin (SF) secondary to inflammation, gives misleading results of iron stores if not tested with C-reactive protein (CRP). Given the complexities, how do Lead Maternity Carer (LMC) midwives in New Zealand manage anaemia and iron deficiency, without a clinical guideline?  Methods: In this descriptive study, quantitative data was retrospectively collected from September-December 2013, from LMC midwives (n=21) and women (n=189), in one New Zealand area. Main outcomes assessed were women’s iron status. Anaemia was defined as Hb <110g/L in the first trimester, <105g/L in subsequent trimesters, and <100g/L postnatally. Iron deficiency was defined as SF <20 μg/L, if CRP<5mg/L. A secondary analysis of iron status and body mass index (BMI) was undertaken.  Results: Of the 186 women who had Hb testing at booking, 46% did not have ferritin tested concurrently. Of the 385 ferritin tests undertaken, 86% were not tested with CRP. Despite midwives prescribing iron for 48.7%, and recommending iron for 16.9% of second trimester women, 47.1% had low iron status before birth. Only 22.8% had Hb testing postpartum, including 65.1% (of 38) with blood loss >500mls. Results of a secondary analysis showed a significant difference (p=.05) between third trimester ferritin levels in women with BMI ≥ 25 (Md SF 14 μg/L) and BMI < 25 (Md SF 18 μg/L).  Conclusions: Inconsistent testing of ferritin made it difficult to assess maternal iron status, especially without concurrent testing of CRP. Midwives may not understand and recognise the progression from iron sufficiency to end-stage iron deficiency anaemia. Even without further research this small study may indicate the need for improved education for midwives, and a clinical guideline. More complex studies on the prevalence in New Zealand, BMI and iron status, and maternal outcomes especially in the postpartum period, are warranted.</p>

Do neonatal hypoglycaemia guidelines in Australia and New Zealand facilitate breast feeding?

Midwifery ◽  
2014 ◽  
Vol 30 (12) ◽  
pp. 1179-1186 ◽  
Author(s):  
Samantha L. Sundercombe ◽  
Camille H. Raynes-Greenow ◽  
Robin M. Turner ◽  
Heather E. Jeffery
Keyword(s):  
New Zealand ◽  
Breast Feeding ◽  
Neonatal Hypoglycaemia

scholarly journals Intersex adolescents seeking help for their depression: the case study of SPARX in New Zealand

2021 ◽  
Author(s):  
MFG Lucassen ◽  
Y Perry ◽  
C Frampton ◽  
Theresa Fleming ◽  
SN Merry ◽  
...  
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Adolescent Depression ◽  
Behavioral Therapy ◽  
Secondary Analysis ◽  
Online Resource ◽  
Patient Health ◽  
Seeking Help ◽  
Self Harm

Objective: SPARX is a computerized cognitive behavioral therapy self-help program for adolescent depression that is freely available in New Zealand. At registration, users identify themselves as either male, female, intersex, or transgender. We aimed to describe the mental health of adolescent intersex users. Method: A secondary analysis of SPARX usage data over 5 years. Results: Of the 8922 adolescents users, 0.6% (n = 50) identified as intersex. Based on Patient Health Questionnaire 9 – modified for Adolescents (PHQ-A) results, 78.3% of intersex users had high levels of depression and/or self-harm and suicidal ideation. The mean PHQ-A scores for intersex users were significantly higher than for males and females (p <.001). As only three intersex users completed SPARX Level 4 or more (of the seven-level program), we were unable to meaningfully investigate any reductions in their depressive symptoms over time. Conclusions: There is a dearth of empirical data on the mental health of intersex adolescents. These results suggest that intersex adolescents seeking help from an online resource have high mental health needs compared with other young people, possibly because they defer seeking help.

scholarly journals How did the Key Competencies of the New Zealand Curriculum Feature in Student Music Therapy Practice for Children with Autism Spectrum Disorder?

2021 ◽  
Author(s):  
◽  
Emmett Sutherland
Keyword(s):  
Autism Spectrum Disorder ◽  
New Zealand ◽  
Music Therapy ◽  
Secondary Analysis ◽  
Children With Autism ◽  
Well Being ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Clinical Notes ◽  
Key Competencies

<p>This study aimed to discover how the key competencies featured in student music therapy with three children who have autism spectrum disorder. Individual music therapy was carried out in the natural environment of a primary school and clinical notes were developed to record events and reflections on the sessions. This data was then retrospectively analysed in a process known as secondary analysis which used inductive and deductive techniques. A process of thematically analysing data revealed that the three children with autism spectrum disorder demonstrated the key competencies in diverse ways in music therapy, such as through letting their personalities shine (managing self) and relating from shared histories and relationships (relating to others), and that I assisted the development of the key competencies for children in equally diverse ways, such as, by being well-being focused, giving openly and making music therapy child-led. A clinical vignette is used to illustrate the findings. Additionally, it is suggested that the unique ways in which the key competencies are used in arts education and music therapy could be considered to a greater extent in the New Zealand Curriculum definitions of the competencies.</p>

scholarly journals Maternal glycaemic control and risk of neonatal hypoglycaemia in Type 1 diabetes pregnancy: a secondary analysis of the CONCEPTT trial

2019 ◽  
Vol 36 (8) ◽  
pp. 1046-1053 ◽  
Author(s):  
J. M. Yamamoto ◽  
R. Corcoy ◽  
L. E. Donovan ◽  
Z. A. Stewart ◽  
G. Tomlinson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Secondary Analysis ◽  
Neonatal Hypoglycaemia

scholarly journals Physical Activity Profiles and Perceived Environmental Determinants in New Zealand: A National Cross-Sectional Study

2012 ◽  
Vol 9 (3) ◽  
pp. 367-377 ◽  
Author(s):  
Nick Garrett ◽  
Philip J. Schluter ◽  
Grant Schofield
Keyword(s):  
Physical Activity ◽  
New Zealand ◽  
Activity Patterns ◽  
Secondary Analysis ◽  
Mail Survey ◽  
Critical Factor ◽  
Developed Countries ◽  
Environmental Barriers ◽  
Cross Sectional ◽  
Local Resources

Background:A minority of adults in developed countries engage in sufficient physical activity (PA) to achieve health benefits. This study aims to identify modifiable perceived resources and barriers to PA among New Zealand adults.Methods:Secondary analysis of a 2003 nationally representative cross-sectional mail survey, stratified by region, age, and ethnicity, and analyzed utilizing ordinal logistic regression.Results:Overall, n = 8038 adults responded to the survey, of whom 49% met updated guidelines for sufficient PA. Perceived accessibility of local resources was associated with PA; however, for some resources there was more awareness among individuals whose predominant activity was not commonly associated with that resource (eg, health clubs and walkers). Perceived local environmental barriers demonstrated negative (steep hills, crime, dogs) and positive (unmaintained footpaths) associations. The absence of perceived environmental barriers was strongly associated with increased activity, suggesting the number of barriers may be a critical factor.Conclusion:Complex relationships between perceptions of local environments and activity patterns among adults were found. Although complex, these results demonstrate positive associations between awareness of resources and perceived lack of barriers with being sufficiently physically active for health. Therefore, investments in provision and/or promotion of local resources have the potential to enable active healthy communities.

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