Southern Community Laboratories (New Zealand)

To assess the hepatitis C virus (HCV) seroprevalence data for defined regions in New Zealand. Email or mobile phone text invitations were sent out to adults enrolled with three participating general practices in different parts of New Zealand. Patients who provided informed consent were instructed to self-present for HCV blood tests. Patients with positive HCV antibodies had reflex testing of HCV antigen and ribonucleic acid (RNA) viral load. In total, 26,247 invitations were issued. Of these, 1,368 (5.2%) people gave informed consent and 1,021 patients (3.9%) had HCV blood tests. Ten out of 1,021 (0.98%; 95% confidence interval [CI] 0.51-1.82%) tested positive for HCV antibodies, of whom two (0.2%; 95% CI <0.01-0.76%) had positive antigen and elevated RNA viral load. The proportion of NZ Māori and Pacific people was low, at 3.8% and 0.4%, respectively. Volunteers with a high deprivation index were under-represented (3% from New Zealand Index of Deprivation deciles 9 and 10). The HCV viraemia prevalence in this general practice-based screening programme is 0.2%, which is lower than previous estimates. This may have implications for appropriate resource allocations and the determination of the best strategies to find new HCV infections. Participation rates of people with high deprivation indexes or who were NZ Māori and Pacific people were low, suggesting that a tailored screening approach is needed.

The New Zealand Medical Journal (NZMJ) is the principal scientific journal for the medical profession in New Zealand. The Journal has become a fundamental resource for providing research and written pieces from the health and medical industry.

Abstract Many mid‐19th‐century immigrants to New Zealand are presumed to have been in pursuit of a “better life” than was achievable in their origin countries. Here, we utilize histological analyses of internal indicators of enamel growth disruption (accentuated lines [ALs]) in 19 European and Chinese immigrants and five colony‐born children from three 19th‐century Otago sites. Observations of regular enamel microstructure were used to estimate a chronology of periods of enamel growth disruption. Clear or potential ALs were present in 18/19 (95%) adults and 4/5 (80%) subadults. Mean occurrence of ALs was higher in Chinese individuals than in European individuals between birth and 1 year of age (Chinese mean = 11; European mean = 3.8) and between 3 and 5 years of age (Chinese mean = 12.7; European mean = 1.3). Potential prenatal ALs were observed in three colony‐born children. Although similar stressors such as malnutrition and infectious disease would have been present in both Europe and China, their expression in these individuals may reflect the embodiment of different push factors that stimulated emigration to New World colonies such as New Zealand. The presence of ALs in colony‐born children indicates some continuation of developmental stressors in New Zealand. The results presented here highlight the value of utilizing microscopic analyses on poorly preserved archeological samples that are frequently excluded from histological examination. This preliminary glimpse into enamel formation disruption challenges the ubiquitous 19th‐century narrative of New Zealand as free from the hardships of industrial revolution era Europe and sheds light on the stresses of childhoods spent in rural China and the potential attractions of the Pacific goldfields in comparison. Future work with larger sample sizes will contribute to a critical exploration of experiences of childhood physiological stress in those who lived and died in colonial New Zealand.

Abstract BackgroundMental health acute and crisis care consumes a large share of mental health budgets internationally but is often experienced as unsatisfactory and difficult to access. As a result, there is an increasing move towards developing innovative community crisis services, to improve patient experience and relieve pressure on inpatient and emergency services. This study aims to understand what helps and hinders the implementation of innovative mental health crisis care projects in England.MethodsUsing a qualitative approach, 18 interviews were conducted with crisis care service managers exploring their experiences and views of the development and implementation of their service developed with support from an English national capital funding programme. A framework analysis was conducted informed by implementation science.ResultsKey facilitators to implementation of innovative crisis services included bottom-up development, service user involvement, strong collaborative working, and leadership and management buy-in. Key barriers that affected the projects implementation included the complexities of crisis care, workforce challenges and resourcing issues.ConclusionThere is a recognised need to improve, update, and innovate current crisis care offers. Results from this study suggest that a range of models can help address the heterogenous needs of local populations and that such services can be successfully implemented where they utilise a whole-systems approach, involving service users and relevant professional stakeholders beyond mental health services in planning and developing the service.

Abstract New Zealand (NZ)’s elimination of community transmission of influenza and respiratory syncytial virus (RSV) infections in May 2020, due to stringent COVID-19 countermeasures, provided a rare opportunity to assess the impact of border restrictions and relaxations on common respiratory viral infections over the subsequent two-years. Using multiple surveillance systems, we observed that border closure to most non-residents, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Partial border relaxations through quarantine free travel with Australia and other countries were associated, within weeks, with importation of RSV and influenza into NZ in 2021 and 2022. Border restrictions did not have effect on community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type 1. These data can inform future pandemic influenza preparedness as well as provide insights into effective strategies to plan and model the impact of seasonal influenza, RSV, and other respiratory viral infections.

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To identify circulating proteins predictive of acute cardiovascular disease events in the general population, we performed a proteomic screen in plasma from asymptomatic individuals. A “Discovery cohort” of 25 individuals who subsequently incurred a cardiovascular event within 3 years (median age = 70 years, 80% male) was matched to 25 controls remaining event-free for > 5 years (median age = 72 years, 80% male). Plasma proteins were assessed by data independent acquisition mass spectrometry (DIA-MS). Associations with cardiovascular events were tested using Cox regression, adjusted for the New Zealand Cardiovascular Risk Score. Concentrations of leading protein candidates were subsequently measured with ELISAs in a larger (n = 151) independent subset. In the Discovery cohort, 76 plasma proteins were robustly quantified by DIA-MS, with 8 independently associated with cardiovascular events. These included (HR = hazard ratio [95% confidence interval] above vs below median): fibrinogen alpha chain (HR = 1.84 [1.19–2.84]); alpha-2-HS-glycoprotein (also called fetuin A) (HR = 1.86 [1.19–2.93]); clusterin isoform 2 (HR = 1.59 [1.06–2.38]); fibrinogen beta chain (HR = 1.55 [1.04–2.30]); hemoglobin subunit beta (HR = 1.49 [1.04–2.15]); complement component C9 (HR = 1.62 [1.01–2.59]), fibronectin isoform 3 (HR = 0.60 [0.37–0.99]); and lipopolysaccharide-binding protein (HR = 1.58 [1.00–2.49]). The proteins for which DIA-MS and ELISA data were correlated, fibrinogen and hemoglobin, were analyzed in an Extended cohort, with broader inclusion criteria and longer time to events, in which these two proteins were not associated with incident cardiovascular events. We have identified eight candidate proteins that may independently predict cardiovascular events occurring within three years in asymptomatic, low-to-moderate risk individuals, although these appear not to predict events beyond three years.