Health Promotion Agency

Growing concern surrounds the risk of neurodegenerative diseases in high-level collision sports, but research on Rugby Union's connection to these diseases is limited. This study sought to examine the long-term neurodegenerative disease risk associated with participation in high-level Rugby Union ('rugby'), utilising whole-population administrative records. This retrospective cohort study in New Zealand compared males born between 1920 and 1984 who were active in high-level (provincial or higher) rugby between 1950 and 2000 (n = 12,861) with males from the general population (n = 2,394,300), matched by age, ethnicity, and birthplace. We used Cox proportional hazards models to assess risks of Alzheimer's disease, Parkinson's disease, motor neuron disease, and other dementias, ascertained using mortality and hospitalisation records from January 1988 to June 2023. A higher percentage of rugby players (6.5%) than males in the general population (5.2%) developed neurodegenerative diseases, with hazard ratios indicating players showed increased risks for any neurodegenerative disease (1.22; 95% confidence interval [CI] 1.14-1.30), Alzheimer's disease (1.61; 95% CI 1.42-1.83), and other dementias (1.23; 95% CI 1.14-1.33). Significant differences were not observed for Parkinson's disease (1.05; 95% CI 0.89-1.22) and motor neuron disease (1.16; 95% CI 0.83-1.63). In general, this increased risk among players compared to the general population began around the ages of 70-79years. Compared to the general population, small to moderate increased risks of any neurodegenerative disease were observed for a backline playing position, provincial and/or amateur players, international and/or professional players, participation in ≥ 2years of play, and participation in five or more matches. High-level rugby participation amongst males in New Zealand is associated with a small to moderate increase in neurodegenerative disease rates compared to the general population.

The purpose of this study was to use highly complete data from publicly and privately funded radiation therapy centers to describe national-level receipt of radiation therapy for those diagnosed with lung cancer in Aotearoa New Zealand. We linked national health datasets to New Zealand Cancer Registry lung cancer registrations from the period 2012-2019 (n = 18,081) to describe the radiation therapy delivery overall and in terms of treatment intent patterns, for all lung cancer registrations and by tumor type. We use marginal standardization and regression modeling to describe the extent to which these treatment factors vary by patient characteristic and population sub-group, independent of other factors. Around 40% of people with lung cancer had radiation therapy, with similar proportions among those with small cell lung cancer (SCLC, 53%) and non-small cell lung cancer (NSCLC, 46%). Patterns of radiation therapy among those with SCLC were different from NSCLC and from lung cancer overall, in terms of stage, ethnicity, and deprivation. We observed lower rates of radiation therapy among those with the greatest socioeconomic deprivation among those with SCLC. Across all tumor types, and for lung cancer overall, those with higher comorbidity had lower rates of radiation therapy. We observed variation in the receipt of radiation therapy for people diagnosed with lung cancer in 2012-2019 in Aotearoa New Zealand in terms of tumor type, stage, ethnicity, deprivation, and comorbidity but not rurality. Differences for Asian and Pacific people and the lack of variation by rurality are potential topics for further research.

The Uchinami pluton, which is distributed upstream of the Uchinami-gawa River in Ono City, Fukui Prefecture, consists mainly of altered quartz diorite, granodiorite, and quartz monzodiorite. A previous study reported a Cretaceous K–Ar whole-rock date (106.5 Ma) of the pluton and interpreted it as one of the Cretaceous (post-Tetori–Pre-Nohi) plutonic rocks in the northern part of central Japan. We performed U–Pb dating of zircons from two rock samples of the Uchinami pluton and obtained weighted average 206Pb/238U dates of 189.3 ± 1.8 Ma and 189.7 ± 1.6 Ma (2σ). The difference between the U–Pb zircon dates and the K–Ar whole-rock date is ca. 80 million years, which is too long for the duration of cooling of the pluton from the crystallization of the zircons. Instead, the K–Ar whole-rock date presumably indicates the rejuvenation by the Miocene intrusive rocks (e.g. Arashimadake Cauldron). Thus, the Uchinami pluton is reasonably a member of the Jurassic Hida Younger Granite but not a Cretaceous pluton.

The concept of well-being extends beyond individual health practices to encompass a burgeoning industry focusing on healthy lifestyles and products. This trend reflects a global paradigm shift toward prioritizing the holistic well-being of individuals and the planet within socioeconomic policies. This shift underscores the integration of social, economic, and environmental considerations into policy frameworks, signaling a concerted effort toward a more sustainable and health-conscious future. The article highlights the crucial role of Indigenous Knowledges for Health (IKH) and Traditional, Complementary and Integrative Health/Medicine (TCIH) systems in contributing to the interconnectedness between human well-being and the health of our planet through innovation, health promotion, and fair, equitable and sustainable benefit sharing. Various contemporary global problems stem from ways of thinking that prioritize the short-term economic interests of individuals or specific groups over the well-being of Peoples and the planet as a whole. In contrast, IKH and TCIH systems often inherently adopt a holistic, sustainable worldview where individual, community, and Planetary Health and well-being are intertwined, providing transformative solutions and models toward integrative health. By incorporating IKH and TCIH systems into contemporary development models, health, and medicine, we can promote health equity, improve well-being, and create a sustainable future for Peoples and the planet.

BackgroundMāori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into seven models of primary care: Traditional, Corporate, Health Care Home, Māori, Pacific, Trusts / Non-governmental organisations (Trust/NGOs) and District Health Board / Primary Care Organisations (DHB/PHO). We describe nurse work in relation to these models of care, populations with high health need and patient health outcomes.MethodsWe conducted a cross-sectional study (at 30 September 2018) of data from national datasets and practices at patient level. Six primary outcome measures were selected because they could be improved by primary care: polypharmacy (≥ 65 years), glucose control testing in adults with diabetes, immunisations (at 6 months), ambulatory sensitive hospitalisations (0–14, 45–64 years) and emergency department attendances. Analysis adjusted for patient and practice characteristics.ResultsNurse clinical time, and combined nurse, nurse practitioner and general practitioner clinical time, were substantially higher in Trust/NGO, Māori, and Pacific practices than in other models. Increased patient clinical complexity was associated with more clinical input and higher scores on all outcome measures. The highest rates of preventative care by nurses (cervical screening, cardiovascular risk assessment, depression screening, glucose control testing) were in Māori, Trust/NGO and Pacific practices. There was an eightfold difference, across models of care, in percentage of depression screening undertaken by nurses and a fivefold difference in cervical screening and glucose control testing. The highest rates of nurse consultations afterhours and with unenrolled patients, improving access, were in PHO/DHB, Pacific, Trust/NGO and Māori practices. Work not attributed to nurses in the practice records meant nurse work was underestimated to an unknown degree.ConclusionsTransferring work to nurses in Traditional, Health Care Home, and Corporate practices, would release general practitioner clinical time for other work. Worse patient health outcomes were associated with higher patient need and higher clinical input. It is plausible that there is insufficient clinical input to meet the degree of patient need. More practitioner clinical time is required, especially in practices with high volumes of complex patients.

Although self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it with annual screening with a provider. Building on our baseline article, we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling. The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and older who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, whereas clinic-based participants were asked to schedule and attend 1 of 5 participating clinics at baseline and 12 months. Using Poisson regression, we conducted an intention-to-treat analysis of 240 randomized participants who were invited to screen at both timepoints. More than half (58.8%) of participants completed annual (median = 370 days) anal screening. In the home arm, 65.0% of participants engaged in annual screening compared with 52.5% of clinic-based participants ( P = 0.049). When stratified by HIV status, persons living with HIV had a higher proportion of home (71.1%) versus clinic (22.2%) annual screening ( P < 0.001). Non-Hispanic Black participants participated more in home-based annual anal screening (73.1%) than annual clinic screening (31.6%; P = 0.01). Overall, annual screening engagement was significantly higher among participants who had heard of anal cancer from an LGBTQ organization, reported "some" prior anal cancer knowledge, preferred an insertive anal sex position, and reported any prior cancer diagnosis. Annual screening engagement among those at disproportionate anal cancer risk was higher in the home arm.

Despite the growing number of global initiatives aimed at reducing adverse maternal health outcomes, there remain critical gaps and disparities in access to maternal health services in Cameroon and across the sub-Saharan Africa. Digital health innovations represent unique opportunities for addressing maternal and newborn child health in sub-Saharan Africa. This article documents the approach to developing the BornFyne-Prenatal Management System (PNMS) as an intervention to support maternal health issues in Cameroon. The mixed-method design employed the three-delays model conducted in four health districts purposefully selected with a mix of urban and rural settings as defined in the context. The study employed focus group discussions and interviews to inform the development features. A total of 25 providers were interviewed, 12 focus group discussions and 4 workshops were held and a total of 3654 households were surveyed. Participants highlighted multifaceted advantages of using digital health platform such as BornFyne-PNMS to enhance communication and care during pregnancy such as remote consultations, emergency response, increased patient engagement and improved continuity of care and convenience. Most respondents believed that the use of a digital platform like BornFyne-PNMS would greatly facilitate access to health facilities, especially during emergencies. The BornFyne-PNMS deployment includes community engagement, training and practical skills building of health workers in the use of digital technologies, the establishment of an emergency transport mechanism for response to emergency cases, assessment and upgrading of the computer hardware of enrolled health facilities and support to health system managers to review and interpret the BornFyne data and interoperability with the national health management information system.

Currently, there are multiple breast dosimetry estimation methods for mammography and its variants in use throughout the world. This fact alone introduces uncertainty, since it is often impossible to distinguish which model is internally used by a specific imaging system. In addition, all current models are hampered by various limitations, in terms of overly simplified models of the breast and its composition, as well as simplistic models of the imaging system. Many of these simplifications were necessary, for the most part, due to the need to limit the computational cost of obtaining the required dose conversion coefficients decades ago, when these models were first implemented. With the advancements in computational power, and to address most of the known limitations of previous breast dosimetry methods, a new breast dosimetry method, based on new breast models, has been developed, implemented, and tested. This model, developed jointly by the American Association of Physicists in Medicine and the European Federation for Organizations of Medical Physics, is applicable to standard mammography, digital breast tomosynthesis, and their contrast-enhanced variants. In addition, it includes models of the breast in both the cranio-caudal and the medio-lateral oblique views. Special emphasis was placed on the breast and system models used being based on evidence, either by analysis of large sets of patient data or by performing measurements on imaging devices from a range of manufacturers. Due to the vast number of dose conversion coefficients resulting from the developed model, and the relative complexity of the calculations needed to apply it, a software program has been made available for download or online use, free of charge, to apply the developed breast dosimetry method. The program is available for download or it can be used directly online. A separate User's Guide is provided with the software.