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Background The present study describes the development of evidence-based practice guidelines for the nutritional management of adult patients with head and neck cancer using a wiki platform to enable wide international stakeholder consultation and maintain currency. Methods A dietitian steering committee and a multidisciplinary steering committee were established for consultation. Traditional methods of evidence-based guideline development were utilised to perform the literature review, assess the evidence and produce a draft document. This was transferred to a wiki platform for stakeholder consultation and international endorsement processes in Australia, New Zealand and the UK. Data were collected on website traffic utilising Google Analytics. Results In addition to broad stakeholder consultation through the steering committees, an additional twenty comments were received via the wiki by twelve individuals covering six different professions from three different countries, compared to four comments by e-mail. The guidelines were subsequently endorsed by the dietetic associations of Australia, New Zealand and the UK. During a 4-month period monitoring the use of the guidelines, there were 2303 page views to the landing page from 33 countries. The average number of pages accessed per visit was five and the duration of time spent on the website was approximately 6 min. Conclusions Using a wiki platform for guideline development and dissemination is a successful method for producing high-quality resources that can undergo wide international stakeholder review and include open public consultation. This can replace conventional methods whereby guidelines can quickly become outdated. [ABSTRACT FROM AUTHOR]

The partial skeletons of two marine turtles are reported from Late Eocene strata of Northland, northern New Zealand. One, from the autochthonous Ruatangata Sandstone near Whangarei, is identified as a new species of the previously monotypic cheloniid genus Eochelone Dollo, 1903. It is larger than the European type species, E. brabantica Dollo, 1903. The new species, E. monstigris, represents a geographic range extension for Eochelone and for the group of 'Eocene stem cheloniines' to which it belongs, a long-distance interchange that the configuration of Late Eocene-Early Oligocene marine currents and land-sea distribution must have permitted. The other specimen, from the allochthonous Pahi Greensand of northeast Kaipara Harbour, was previously reported as a cheloniid but we believe it more likely to belong to the Toxochelyidae. Given previous records of two dermochelyids (Psephophorus and Maoriochelys), the Middle to Late Eocene of New Zealand hosted at least four species of marine turtle which approaches the modern diversity of five species. [ABSTRACT FROM AUTHOR]

Introduction Most New Zealanders experience low back pain (LBP) at least once throughout their lifetime and many seek help from the large range of health providers in primary care. Accident Compensation Corporation (ACC) funds a significant proportion of those claims, but which services are they funding and what are the costs? Method This was a retrospective audit and descriptive analysis of ACC-funded, non-public hospital healthcare service use by people with LBP in New Zealand (NZ). Outcome measures were the healthcare services accessed by people with ACC-funded LBP,the claims (all occurrences for a service that has generated a payment/year), single contact (with a service), and costs (NZ$) for services between 2009 and 2020. Results The number of claims for services were 129 000 for physiotherapy, 105 000 for general practitioner and 59 000 for radiology services. Per single contact, elective surgery and radiology services were the most expensive. During 2009-2020, there were 3.3 million ACC claims for LBP with a total cost of NZ$4 billion. Over this time, there was an increase in claims, costs and single contacts. Costs decreased slightly during 2010 due to changes in healthcare funding and in 2020 due to the COVID-19 pandemic. Discussion Consumers have considerable choice in where they access health care for ACC-funded LBP services. This study shows the services they use most frequently and the cost to NZ for those services. These data can inform service planning for ACC-funded LBP health care in NZ.

The carbon footprint of milk from year-round grazed-pasture dairy systems and its variability has had limited research. The objective of this study was to determine temporal, regional, and farm system variability in the carbon footprint of milk from New Zealand (NZ) average dairy production. Farm production and input data were collected from a national database for 2010/11 to 2017/18 across regions of NZ and weighted on relative production supplied to the major dairy cooperative Fonterra to produce an NZ-average. Total greenhouse gas emissions were calculated using a life cycle assessment methodology for the cradle-to-farm gate, covering all on- and off-farm contributing sources. The NZ-average carbon footprint of milk varied from 0.81 kg of CO 2 equivalent (CO 2 eq)/kg of fat- and protein-corrected milk (FPCM) in 2010/11 (with widespread drought) to 0.75 to 0.78 kg of CO 2 eq/kg of FPCM in 2013/14 to 2017/18, with a trend for a small decrease over time. Regional variation occurred with highest carbon footprint values for the Northland region due to greatest climatic and soil limitations on pasture production. Dairy cattle diet was approximately 85% from grazed pasture with up to 15% from brought-in feeds (mainly forages and by-products). The CO 2 emissions from direct fuel and electricity use constituted <2% of total CO 2 eq emissions, whereas enteric methane was near 70% of the total. An estimate of potential contribution from direct land use change (plantation forest to pasture) was 0.13 kg of CO 2 eq/kg of FPCM. This was not included because nationally there has been a net increase in forest land and a decrease in pasture land over the last 20 yr. Data used were highly representative, as evident by the same estimated carbon footprint from 368 farms (in 2017/18) from the national database compared with that from a direct survey of 7,146 farms. New Zealand-specific nitrous oxide emission factors were used, based on many validated field trials and as used in the NZ greenhouse gas inventory, resulting in an 18% lower carbon footprint than if default Intergovernmental Panel on Climate Change factors had been used. Evaluation of the upper and lower quartiles of farms based on per-cow milk production (6,044 vs. 3,542 kg of FPCM/cow) showed a 15% lower carbon footprint for the upper quartile of farms, illustrating the potential for further decrease in carbon footprint with improved farm management practices., (The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objective: To review current systems for recognising and responding to clinically deteriorating patients in all New Zealand public hospitals., Design: A cross-sectional study of recognition and response systems in all New Zealand public hospitals was conducted in October 2011. Copies of all current vital sign charts and/or relevant policies were requested. These were examined for vital sign based recognition and response systems. The charts or policies were also used to determine the type of system in use and the vital sign parameters and trigger thresholds that provoke a call to the rapid response team., Setting: All New Zealand District Health Boards (DHBs)., Main Outcome Measures: Physiological parameters used to trigger rapid response, the weighting of any early warning score assigned to them, type of system used, values of physiological derangement that trigger maximal system response., Results: All DHBs use aggregate scoring systems to assess deterioration and respond. A total of 9 different physiological parameters were scored with most charts (21%) scoring 6 different parameters. All scored respiratory rate, heart rate, systolic blood pressure and conscious level. 86% scored oliguria, 14% polyuria, 33% oxygen saturation and 24% oxygen administration. All systems used either aggregate scores or a single extreme parameter to elicit a maximal system response. The extremes of physiological derangement to which scores were assigned varied greatly with bradypnoea having the greatest range for what was considered grossly abnormal., Conclusion: A large variance exists in the criteria used to detect deteriorating patients within New Zealand hospitals. Standardising both the vital signs chart and escalation criteria is likely to be of significant benefit in the early detection of and response to patient deterioration., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Objective: To investigate the prevalence and clinical significance of upper gastrointestinal (UGI) findings during endoscopic placement of postpyloric feeding tubes in intensive care patients., Design and Setting: A retrospective observational case study conducted at the intensive care unit in a single tertiary teaching hospital in New Zealand., Participants: Intensive care patients who underwent postpyloric feeding tube insertion under endoscopic guidance, January 2008 - August 2011., Main Outcome Measures: Endoscopic findings at tube placement and risk factors for UGI abnormalities. UGI abnormalities were considered to be clinically significant if recommendations for patient management or follow-up endoscopy were made., Results: 19 patients underwent feeding tube placement during the study period and 17 endoscopy reports could be retrieved. UGI abnormalities were diagnosed in 16/17 patients: erosions from nasogastric tube (7), gastritis (4), oesophagitis (2), gastric ulcer (1) and duodenal ulcer (1). Seven patients had clinically significant endoscopic findings that prompted treatment recommendations. Risk factors for UGI abnormalities included previous UGI abnormalities in six patients and antiplatelet treatment in seven patients. In addition, our patient series was characterised by a high median Acute Physiology and Chronic Health Evaluation II score (24.5; interquartile range [IQR], 17.8-28.3) and Sequential Organ Failure Assessment score (9; IQR, 6-12)., Conclusion: Endoscopic placement of postpyloric feeding tubes resulted in the identification of a significant number of patients with previously undiagnosed UGI abnormalities.

Stories about community work in New Zealand and Scotland are presented to describe and reflect on issues central to feminist community psychology. Organizing a lesbian festival, Ingrid Huygens describes feminist processes used to equalize resources across Maori (indigenous) and Pakeha (white) groups. Heather Hamerton presents her experiences as a researcher using collective memory work to reflect on adolescent experiences related to gender, ethnicity, and class. Sharon Cahill chronicles dilemmas and insights from focus groups about anger with women living in public housing in Scotland. Each story chronicles experiences related to oppression and privilege, and describes the author's emotions and reflections. Individually and collectively, the stories illustrate the potential offered by narrative methods and participatory processes for challenging inequalities and encouraging social justice.

Antarctic fish have a high polyunsaturated lipid content and their muscle cells have a high mitochondria density suggesting that Antarctic fish are under greater oxidative stress than temperate water fish. To test this hypothesis, the plasma concentrations of the antioxidant vitamins E and C were measured in two Antarctic fish species, Pagothenia borchgrevinki and Trematomus bernacchii, and compared with the plasma concentrations of these vitamins in two New Zealand temperate water fish species, blue cod (Parapercis colias) and banded wrasse (Notolabrus fucicola). Neither vitamin is known to be synthesised in fish and so must be obtained from the diet. The plasma from both Antarctic fish species had vitamin E concentrations five to six times higher than those found in the two temperate water fish species. However, significantly higher levels of vitamin C were only found in the plasma of T. bernacchii, a benthic Antarctic fish. The average level of vitamin C in the plasma of the cryopelagic P. borchgrevinki was approximately one-third that of T. bernacchii. The T. bernacchii plasma yielded a high range of vitamin C values, possibly reflecting differences in nutritional status among the animals captured. No beta-carotene was found in any of the fish plasma samples studied. The data suggest that even though Antarctic fish live at -1.5 degrees C they may be exposed to greater metabolic stress from free radical mediated oxidation than temperate water species.

Previously published Type I (insulin-dependent) diabetes mellitus incidence in 0 to 14-year-old children from 10 countries or areas was compared with the national annual cow milk protein consumption. Countries which were selected for study had appropriate milk protein polymorphism studies, herd breed composition information and low dairy imports from other countries. Total protein consumption did not correlate with diabetes incidence (r = +0.402), but consumption of the beta-casein A1 variant did (r = +0.726). Even more pronounced was the relation between beta-casein (A1+B) consumption and diabetes (r = +0.982). These latter two cow caseins yield a bioactive peptide beta-casomorphin-7 after in vitro digestion with intestinal enzymes whereas the common A2 variant or the corresponding human or goat caseins do not. beta-casomorphin-7 has opioid properties including immunosuppression, which could account for the specificity of the relation between the consumption of some but not all beta-casein variants and diabetes incidence.

The objective of this study was to investigate the effects of contrasting nutritional regimens on milk composition from cows of different protein phenotypes. Twenty sets of seasonally calving identical twin cows that constituted five different protein phenotypes (four sets of twins per phenotype) were subjected to two nutritional treatments in crossover experiments during spring (early lactation) and summer (mid to late lactation). The phenotypes studied allowed a comparison of the AA, AB, and BB variants of both beta-lactoglobulin (beta-LG) and kappa-casein. Nutritional treatments were 1) ad libitum grazing (i.e., cows were allocated a pasture allowance of approximately 40 kg of dry matter/d per cow) plus 5 kg of a concentrate based on barley and 2) restricted grazing (pasture allowance of 20 kg of dry matter/d per cow). Milk samples were collected from each cow near the end of each 14-d treatment period and were analyzed for a detailed range of individual protein and fat constituents. Diet had significant effects on the concentrations of all milk components measured. Protein phenotype affected some protein components but not fat components. Interactions between the effects of beta-LG phenotype and diet were noted for the concentrations of some milk components. Diet and protein phenotype have important effects on the manufacturing potential of milk produced under the dairying systems of New Zealand, which rely heavily on grazing. The effects of nutrition on milk composition may depend on the beta-LG phenotype.