Associations between body morphology and microalbuminuria in healthy middle-aged European, Maori and Pacific Island New Zealanders

The authors report their experience with 31 hypoglosso-facial anastomoses mainly carried out after removal of tumours of the cerebello-pontine angle, 26 were available for evaluation: at 18 months there were 5 of grade II, 19 of grade IV and 2 of grade V. Only one patient was dissatisfied with the result. 24 of the patients had received their hypoglosso-facial anastomosis using the clinical technique of Korte. In 3 cases the operation was by the technique of May. The authors suggest a variation of May's technique: it was carried out on the last 4 patients. It consists of a hemi-hypoglosso-facial anastomosis with rerouting of the mastoid portion of the facial nerve, without using a nerve graft. The aim of this technique is to reduce the sequelae of hemi-lingual atrophy and paralysis (which gives trouble with articulation, mastication and deglutition). The authors' experience confirms that these sequelae are greatly reduced, if not abolished. The functional results in terms of facial movements were satisfactory and consistant: 43.7% were quantified--with 3 of grade II and one of grade IV on the House Brackmann scale.     

Maori cultural identity and the New Zealand search for nationhood

The imaging techniques used to follow-up patients submitted to surgery for colorectal cancers are presented as are their advantages and disadvantages. The sensitivity of ultrasonography (US) for postoperative surveillance of the liver varies considerably according to whether the absence or presence of metastases is sought (83%) or their exact number (53-82%). US is recommended by French clinicians as the standard follow-up examination whereas, American clinicians tend to discuss CT-Scan or MRI for the same purpose. Some authors advocate Doppler ultrasonography for the detection of liver metastases. Spiral CT-Scan offers better results than conventional CT and is now considered second in rank to US for follow-up studies. Its sensitivity exceeds 90% for metastases greater than 1 cm. IRM and arterial CT-scan are not applicable for follow-up but are sometimes indicated for difficult cases before hepatectomy. US is also an appropriate technique for postoperative exploration of the abdominal cavity. When the CEA level and the US examination are normal, this technique is sufficient. However, in dubious clinical or biological cases, US should be associated with a spiral CT-Scan. Most clinicians recommend a reference CT-Scan, two to four months after the resection and every 6 months for 2 years and then annually. The same follow-up strategy is advocated after abdominoperineal resection and for surveillance of the pelvis. The sensitivity of CT-Scan is between 69 and 88% but it is unable to differentiate recurrence from fibrosis. IRM, with a sensitivity of 90%, is the best method for overcoming with problems related to the differential diagnosis and particularly novel fast acquisition imaging and contrast agents. Ultrasonoendoscopy, repeated every 4 to 6 months after anterior resection, is also a useful examination for surveillance of the pelvis. PET-Scan has produced encouraging results for the detection of metastases and for the differential diagnosis between local recurrence and fibrosis. When available, this technique could become the "gold standard" for the surveillance of patients following surgery for colorectal cancers.     

Trends in colorectal cancer incidence and histologic findings in Maori and Polynesian residents of New Zealand

BACKGROUND: The aim of this study was to combine an epidemiologic survey of colorectal cancer among Maori, Polynesian, and white inhabitants of New Zealand with a detailed analysis of tumor subsite and histopathology. METHODS: Data were obtained from the New Zealand National Cancer Registry and included all registrants from 1970 to 1984. Sections of histologic specimens of colorectal cancer of Maori and non-Maori were retrieved from three Auckland hospitals. RESULTS: The annual age-adjusted incidence rates of large intestinal cancer among male and female Maoris and male and female Polynesians were 40%, 40%, 39%, and 29%, respectively, of the total population incidence. Time-trend analysis showed the incidence of large intestinal cancer to be increasing among all racial groups. The relative proportion of rectal cancers was higher in male and female Maoris and female Polynesians than in the general population, whereas male Polynesians had a relatively high proportion of right colonic cancers. High-grade carcinoma and mucinous carcinoma occurred more frequently in young individuals regardless of race. Carcinomas were diagnosed at a more advanced stage in Maoris. CONCLUSION: Given the similar environmental characteristics of the three racial groups, the findings indicate the presence of powerful protective factors in Maoris and Polynesians. These could be constitutional or mediated by unrecognized dietary constituents.     

A clinical sample of Maori being treated for alcohol and drug problems in New Zealand

AIMS: To document key clinical characteristics of a group of Maori being treated for alcohol and drug problems; compare the characteristics of Maori accessing dedicated Maori alcohol and drug treatment services with Maori accessing non-dedicated services; and investigate these clinical characteristics in relation to patient satisfaction. METHODS: A sample of 105 Maori with alcohol and drug problems, accessing the range of treatment services in the Canterbury area, undertook a semi-structured interview. RESULTS: Overall this sample of Maori were socially disadvantaged. Their main drug of use was alcohol, followed by cannabis, opioids and sedatives/hypnotics. There were no significant differences between the subjects who attended Maori dedicated services and those who attended non-dedicated Maori services in terms of demographic variables, alcohol and drug use history, current level of dependence, or anxiety/depression state. Subjects in dedicated Maori services were more likely to have had greater than 21 days of treatment compared to those in non-dedicated Maori services and were more likely to have been to their home marae than those in non-dedicated services. In multivariate analysis, Maori in dedicated Maori services were significantly more likely to be satisfied with treatment than those in non-dedicated services (odds ratio = 5.5, 95% confidence interval = 1.81-16.78). CONCLUSION: Further research is required to investigate the relationship between high patient satisfaction by Maori with alcohol and drug problems attending dedicated Maori treatment services, treatment effectiveness and the components of dedicated Maori services that may contribute to higher retention rates, greater patient satisfaction and increased positive treatment outcome.     

The needs of Asians and Pacific Islanders living with HIV in New York City

We established reference ranges for factor VII clotting activity (FVII:C), factor VII amidolytic activity (FVII:AM), and activated factor VII (FVIIa) in 102 healthy individuals. The reference ranges were 65-160 U/100 ml, 70-165 U/100 ml, and 30-170 mU/ml, respectively (2.5 and 97.5 percentiles). Freezing and thawing of the plasma samples had no influence on the assay results. Due to the small sample size, the results were not influenced by gender, age, smoking habits, and oral contraceptive use. The plasma levels of FVII:C, FVII:AM, and FVIIa were significantly correlated with each other. The significant correlation between FVIIa and FVII:AM indicates that FVIIa is not completely independent of circulating FVII mass. There was also a significant, though weak, correlation between FVIIa and FVII:C/FVII:AM ratios. Sixteen batches of prothrombin complex concentrates (PCC) from 3 manufacturers were also analysed. FVIIa could be detected in all preparations, with considerable variations from batch to batch. In contrast to the results obtained in plasma from normal individuals, there was a close correlation between FVIIa and FVII:C/FVII:AM ratios. The preparations could be characterized by their FVII and FVIIa potencies and by their FVII:C/FVII:AM ratios. In PCC, FVII:C was very strongly correlated with FVIIa, whereas no significant correlation was observed between FVII:AM and FVII:C and between FVII:AM and FVIIa, respectively. These results demonstrate that the FVII:C assay used is sensitive for detecting FVIIa. Thus, we cannot confirm that FVIIa sensitivity of one-stage clotting assays for FVII:C is low when a rabbit thromboplastin and a non-adsorbed FVII-deficient plasma is used.     

Non-insulin-dependent diabetes mellitus in New Zealand Maori: a relationship with Class I but not Class II histocompatibility locus antigens

AIMS: To investigate the possibility of a relationship between the major histocompatibility complex (MHC) and non-insulin-dependent diabetes mellitus (NIDDM) in Maori. Such relationships have previously been shown in non-European races with a high incidence of NIDDM. METHODS: We performed serological Class I and PCR-SSP Class II HLA typing on 44 Maori with NIDDM and renal failure and compared the results with normal Maori. RESULTS: A strong relationship with the HLA-B40 groups of antigens (relative risk 5.1 chi 2 = 16.8, p < 0.001) was found; this was mainly attributable to HLA-B48 and HLA-B60. There was no HLA Class II relationship. CONCLUSION: The relationship with HLA-B40 antigens suggests that the MHC or other genes on chromosome 6 play a role in NIDDM in Maori.     

Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people

Serotonin (5-HT) is one of the major transmitters involved in supraspinal control of somatic sensation and nociception. The aim of the present study was to investigate if the 5-HT-induced modulation of sensory transmission in the dorsal horn could be due to regulation of neuronal responses to excitatory amino acids. Experiments were performed in an in vitro preparation of the young rat spinal cord. Responses to dorsal root stimulation (DR-EPSP) and to droplet application of N-methyl-D-aspartic acid (NMDA) and alpha-amino-2,3-dihydro-5-methyl-3-oxo-4-isoxazolepropanoic acid (AMPA) were obtained by means of intracellular recordings of dorsal horn neurons. Bath applications of 5-HT (50 microM) generally caused reductions in amplitude and integrated area of DR-EPSPs and of responses to NMDA but the responses to AMPA were unaltered. A linear correlation was found between the effects of 5-HT on the DR-EPSP and on the NMDA response measured as percentage change in amplitude (r2 = 0.45; P < or = 0.01) and integrated area (r2 = 0.77; P < or = 0.001). The NMDA receptor antagonist d-AP5 (50 microM) completely abolished NMDA responses and caused a depression of the DR-EPSP similar to that of 5-HT. The 5-HT1 receptor agonist 5-carboxamidotryptamine (5-CT; 1 microM) mimicked the depressant effects of 5-HT but had a stronger depressant action on the DR-EPSP than 5-HT. The depression of NMDA responses induced by 5-HT and 5-CT was tetrodotoxin (1 microM) resistant. It is concluded that 5-HT-induced depression of NMDA responses explains partially the depressant action of 5-HT on dorsal horn synaptic transmission activating a postsynaptic site sensitive to 5-CT. The possible activation of coadjuvant mechanisms is discussed.     

Paediatric nephrotic syndrome in Auckland, New Zealand

Forearm rotation affects grip strength. In a study with 40 volunteers, an overall decrease in grip strength was observed when the forearm rotated from pronation to supination. In males grip strength in pronation was significantly lower compared to the neutral and supinated position, with the wrist free as well as in an immobilized wrist position. In females this was only observed with a free wrist position, but with the wrist immobilized, the grip strength was higher in supination compared to neutral and pronation.     

Achievement motivation, occupations, and labor turnover in New Zealand.

Used a nonprojective measure of achievement motivation to investigate the relationship among need for achievement (nAch), labor turnover, and occupations in New Zealand. Questionnaire results from 315 entrepreneurs, engineers, accountants, and middle managers revealed low turnover among high nAch self-employed Ss. High-turnover Ss displayed significantly higher achievement motivation levels than low-turnover Ss. Among engineers, accountants, and middle managers, those with high nAch had high labor mobility rates. Results are supportive of D. C. McClelland's theory and demonstrate the feasibility of extension of the model through use of nonprojective research methods. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dietary intake and cognitive function in a group of elderly people

Alloparental care was investigated in the biparental West African cichlid, Pelvicachromis pulcherNon-breeding adults typically consumed young conspecifics but this trait was inhibited in both sexes during reproductive attempts. Alien conspecific young were accepted into the brood if they were of a similar age/developmental stage to the parents' own young but not if they were much older or much younger. If not accepted they were consumed by whichever adult located them. Parents separated from their brood for up to 4 days accepted their young on reunion but separation for more than 4 days resulted in the young being consumed. This latter response occurred if chemical stimuli from the young were available during the separation but not if visual stimuli were available. In this latter case parental responsiveness was maintained. Both sexes of this externally fertilizing species appeared to have the same information about their young and showed the same changes in responsiveness and the same discriminatory abilities.Copyright 1997 The Association for the Study of Animal Behaviour1997The Association for the Study of Animal Behaviour     

Hearing impairment, disability and handicap in elderly people living in residential care and in the community

The TFI-musculofasciocutaneous flap has become a standard procedure in recent years. Donor-site problems of this method, especially the biomechanical changes of the hip, the proximal femur and the knee joint are evaluated, employing biomechanical techniques. Harvesting of a TFL-flap leads to functional loss of the M. tensor fasciae latae and the iliotibial tract and band. This might lead to a weakening of active and passive stabilising structures of the hip and the knee joint. Loss of the iliotibial tract causes a loss of the lateral tension-band of the proximal femur and leads to a significant increase of shear forces on the proximal femoral shaft. The functionally important structures of the iliotibial tract for knee biomechanics are not influenced by harvesting of the TFL flap. Loss of the M. tensor fasciae latae leads to a mild reduction of hip flexion and internal rotation. The indication for a TFL-flap should consider the patient's activity to prevent overload damage of the proximal femoral shaft. In childhood, harvesting of the TFL flap is likely to influence the growing axial skeleton due to the loss of the iliotibial tract.     

Characteristics of bedridden elderly people living at home and in a hospital

We compared bedridden elderly people living at home to others who were hospital inpatients. Questionnaires regarding medical status and care were returned by 85 of 116 people caring for a bedridden elderly person at home in Obu city, Aichi prefecture and by 62 of 64 nurses and family members caring for bedridden inpatients at Chubu National hospital. All subjects were at least 65 years old. The median age in both groups was 81 years, neither age distribution nor female sex predominance differed between both groups. The percentage of subjects with only one underlying disease was 62.5% among those living at home and 64.4% among inpatients. In both groups the most common disease was cerebrovascular disease (42.5% among those at home and 39.0% among inpatients), followed by dementia (31.3%), infirmity of old age (17.5%) and bone fracture (13.8%) among those at home, and by bone fracture (27.1%), dementia (20.3%) and infirmity of old age (16.9%) among inpatients. The median durations of bedridden status were 2 years and 3 months among those at home and 3 months among inpatients. The proportion of subjects bedridden for less than 6 months was greater among inpatients (p < 0.0001). The percentage who needed medical treatment was 60.0% among those at home and 67.7% among inpatients. The most common conditions for which drugs were taken were hypertension, dementia, chronic cerebrovascular dysfunction, and osteoporosis. Among inpatients, 54.8% were ambulatory before admission, 24.2% were almost completely bedridden, and 17.7% were completely bedridden. The most common cause rending the patients bedridden was infection (usually pneumonia). The degree of disability did not differ between groups. Decubitus ulcers were present in 25.9% of those at home and 17.7% of inpatients.     

Food habits of young and middle-aged women living outside the capital cities of Australia

Young (18-22 years) and middle-aged (45-49 years) women living in urban and rural areas of New South Wales completed a brief food frequency questionnaire as part of a wider health survey. Urban women in both age groups consumed meat less frequently than women in rural areas, and women in the less populated rural areas were more likely to eat green and yellow vegetables and least likely to eat dried beans. There were few other geographic differences in food habits. Middle-aged women consumed reduced-fat milk, fruit, vegetables, fish, biscuits and cakes significantly more frequently, and rice, pasta, full-cream milk, fried food and take-away food less frequently than younger women. Smokers in both age groups consumed fresh fruit, vegetables and breakfast cereals significantly less frequently than non-smokers, and women with low levels of habitual physical activity consumed fresh fruit and cereals less frequently than more active women. The findings suggest that strategies aimed at changing eating behaviours should be age-group-specific and targeted specifically to smokers and less active women.     

Meningococcal disease epidemiology and control in New Zealand

Epidemiology, surveillance and research New Zealand has a high quality surveillance system for meningococcal disease that successfully integrates notification and laboratory data. Since 1991, New Zealand has had elevated incidence rates of meningococcal disease rising to 6.2 per 100,000 population in 1994. This represents a rate that is four times that recorded in 1989/90. Serogroup B infection predominates and international experience suggests that these elevated rates may continue for 5 to 15 years. Rates of meningococcal disease in Maori and Pacific Islands populations were three times higher than in Europeans at 10.0 and 12.3 per 100,000 respectively in 1994. The rates were particularly high for infants with the rate in Maori infants under 1 year reaching 120 per 100,000. The case fatality rate at 5.3% for 1994 would appear to be relatively low by international standards. Case control studies could be used to investigate potentially modifiable primary risk factors for disease. Intensive case review studies to investigate the role of such factors as preadmission antibiotics in reducing severe outcomes may be of benefit. The Ministry of Health or research funding organisations should consider the potential value of such studies in more detail.     

Cervical cancer and cytology screening in New Zealand

Cytology screening, used in New Zealand since 1955 at an intensity comparable to that in Canada generally, has not favourably affected incidence and mortality rates for cervical cancer; these have actually risen significantly in 20 to 34-year-old New Zealand women. Canadian claims that mortality falls are related to intensity of cytological screening are not justifiable, so that the significance of the 'pre-cancers' revealed by cytology and the value of population screening would seem to be doubtful.     

Leg extension power and walking speed in very old people living independently

BACKGROUND: Leg extension power can be determined as the product of the force and velocity of movement. Its association with maximal walking speed was studied in 131 80- and 85-year-old men and women. METHODS: Leg extension power was measured with the help of a sledge ergometer in a sitting position using a facilitated "jump test." The participant was attached by belts to a sliding chair on rails inclined at 12.6 degrees to the floor. The feet were placed on the force plate attached perpendicularly to the rails, and the knee angle was 90 degrees at the starting position. The participant was advised to extend his or her legs powerfully. The highest value of five to eight attempts was accepted as the result. The results were adjusted for body mass and expressed as watts.kilogram-1. Maximal walking speed was measured in the laboratory corridor over a distance of 10 m. RESULTS: Men and 80-year-old subjects exhibited greater leg extension power and were faster walkers than women and 85-year-old persons. Leg extension power correlated positively with maximal walking speed in all groups: the correlation coefficients were .412 in the 80-year-old men (n = 41, p = .007), .619 in the 80-year-old women (n = 56, p < .001), .939 in the 85-year-old men (n = 8, p = .001), and.685 in the 85-year-old women (n = 23, p < .001). The regression lines for leg extension power and walking speed were coincident, indicating that the power requirements to attain a given walking speed were similar for both sexes. The minimum power threshold for those with a maximal walking speed of 1.30-1.49 m.s-1 was on the order of 4 W.kg-1; a maximal walking speed of 1.50-1.99 m.s-1 required 7 W.kg-1; and for a speed over 2.00 m.s-1 the power threshold was 9.5 W.kg-1. CONCLUSIONS: Their lower average leg extension power may be one of the factors explaining the greater prevalence of mobility problems among women than men.     

Social class and male cancer mortality in New Zealand, 1984-7

Social class differences in cancer mortality among New Zealand men aged 15-64 years are examined for the period 1984-7. Age-standardised rates are presented for all cancer deaths, and for 23 specific cancer sites. The strongest social class mortality gradients were found for cancers of the larynx, liver, buccal cavity/pharynx, oesophagus, lung and for soft tissue sarcoma. On the other hand, rectal cancer, malignant melanoma, colon cancer, brain/nervous system cancers, and multiple myeloma showed higher death rates for the more advantaged socioeconomic groups. Lung cancer accounted for 54.1% of the overall social class gradient, and the major smoking related cancers (these include buccal/pharynx, oesophagus, larynx, lung and bladder, although it should be stressed that not all cases of these cancers are caused by smoking) accounted for 77.6% of the overall gradient.