ORCID Profile
0000-0002-7581-8275
Current Organisations
National University of Samoa
,
University of Otago Wellington
,
Capital and Coast District Health Board
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Publications
Building reproductive health research and audit capacity and activity in the pacific islands (BRRACAP) study: methods, rationale and baseline results
Publisher: Springer Science and Business Media LLC
Date: 19-06-2014
Sexual and reproductive health needs, challenges and opportunities in the Pacific
Publisher: Routledge
Date: 05-01-2023
Who are the successful reproductive health clinician-researchers?
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 30-06-2016
Abstract: Huge investments into research capacity building in low to middle-income countries sup /sup have resulted in a significant increase in the critical mass of research scientists. sup /sup However, the increase in researchers and research output has been more easily achieved in larger countries with a multitude of research institutions. Efforts have been less successful in small countries, such as those in the Pacific region, sup 4 /sup despite the many research collaborations from within and from outside the region. Pacific Island countries with small economies, especially those with populations less than 50,000, do not have the capacity to produce a critical mass of researchers. Therefore training in idual clinicians to perform clinical or health services research is a viable alternative. sup /sup sup /sup To address the lack of regional and local research evidence, the Pacific Society for Reproductive Health (PSRH) passed a resolution in 2007 to promote clinical research and audit amongst its members. Research workshops were conducted in conjunction with biennial conferences to stimulate research activity. In 2013, the BRRACAP (Building Reproductive Research and Audit Capacity and Activity in the Pacific Islands) Study was conducted to increase research activity in the 18 months after a 7-day research workshop and subsequent research mentoring. sup /sup This short report summarises one aspect of the BRRACAP Study’s findings - the characteristics of the most successful clinician-researchers. Implications of these findings are discussed.
The Pacific Journal of Reproductive Health
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 21-06-2015
Abstract: Why a new journal and why in the Pacific? Are there not already many journals concerning reproductive science and the clinical aspects of human reproduction, its outcomes and a broad women’s health context? The answer to the second question, in part answers the first. Yes there are excellent journals with very high impact factors in reproductive health and the information presented in these journals is informed by research outputs from established researchers.
Opening Editorial
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 21-06-2015
Abstract: It has been exciting journey getting the Journal thus far and I am optimistic that reproductive health researchers and clinicians in the Pacific Islands and Pacific-rim countries will share in the excitement and the journey that lies ahead as we take the Journal forward.
2015 PSRH CONFERENCE ABSTRACTS
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 21-06-2015
Wealth of Pacific research
Publisher: Pasifika Medical Association
Date: 22-06-2021
Ethnicity and birth outcome: New Zealand trends 1980-2001: Part 4. Pregnancy outcomes for European/other women
Publisher: Wiley
Date: 12-2004
Association between maternal sleep practices and risk of late stillbirth: a case-control study
Publisher: BMJ
Date: 14-06-2011
DOI: 10.1136/BMJ.D3403
Vitamin D activity of breast milk in women randomly assigned to vitamin D3 supplementation during pregnancy
Publisher: Elsevier BV
Date: 02-2016
Abstract: Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation. Breast-milk s les were obtained from women who were enrolled in a randomized, double-blinded, placebo-controlled trial of vitamin D supplementation during pregnancy. Pregnant women were enrolled at 27 wk of gestation and randomly assigned to the following 3 groups: a placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU). Serum 25-hydroxyvitamin D [25(OH)D] was measured at enrollment, at 36 wk of gestation, and in cord blood at birth. Study participants who were breastfeeding were invited to provide breast-milk s les for VDA measurement [concentration of vitamin D2, vitamin D3, 25(OH)D2, and 25(OH)D3] at 2 wk and 2 mo postpartum. A linear mixed model was used to compare breast-milk VDA between the 3 study groups. A total of 75 women provided breast-milk s les (44 women provided breast-milk s les at both 2 wk and 2 mo postpartum). The mean (95% CI) VDA at age 2 wk was 52 IU/L (12, 217 IU/L) in the placebo group, 51 IU/L (17, 151 IU/L) in the 1000-IU group, and 74 IU/L (25, 221 IU/L) in the 2000-IU group and at age 2 mo, the mean (95% CI) VDA was 45 IU/L (16, 124 IU/L), 43 IU/L (18, 103 IU/L), and 58 IU/L (15, 224 IU/L), respectively. There was no significant interaction in VDA between the s le-collection time and treatment (P = 0.61), but there was a difference between lower- and higher-dosage treatment groups (P = 0.04). Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12610000483055.
Ethnicity and birth outcome: New Zealand trends 1980-2001: Part 2. Pregnancy outcomes for Maori women
Publisher: Wiley
Date: 12-2004
Building Capacity for Research and Audit: Outcomes of a Training Workshop for Pacific Physicians and Nurses
Publisher: Redfame Publishing
Date: 10-06-2015
The effectiveness of the levonorgestrel intrauterine system in obese women with heavy menstrual bleeding
Publisher: Wiley
Date: 03-10-2016
DOI: 10.1111/AJO.12528
Abstract: To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-IUS and had a body mass index (BMI) of >30 kg/m The median age (range) and BMI of the 20 women were 40.5 years (27-52 years) and 40.6 kg/m The LNG-IUS was an effective treatment for 67% of obese women with heavy menstrual bleeding over a 12-month period, as assessed by the reduction in menstrual bleeding and the improvement in the quality of life measures.
A systematic review of transvaginal ultrasonography, sonohysterography and hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women
Publisher: Wiley
Date: 29-05-2003
DOI: 10.1034/J.1600-0412.2003.00191.X
Abstract: To determine the accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy for the investigation of abnormal uterine bleeding in premenopausal women. Systematic review of common diagnostic imaging tests. Relevant papers were identified through electronic searching of MEDLINE (1980 to July 2001) and EMBASE (1980 to July 2001) and manual searching of a bibliography of primary and review articles. Studies were selected if accuracy of transvaginal ultrasonography, sonohysterography and diagnostic hysteroscopy was compared with a reference standard and included data that could be abstracted into a two-by-two table in order to calculate sensitivity and specificity. Quality assessment and data extraction were performed by at least two independent reviewers. Diagnostic accuracy was determined by calculating positive and negative likelihood ratios for all intrauterine pathologies, submucous fibroids and endometrial hyperplasia. Nineteen studies met the inclusion criteria. Statistically significant heterogeneity was present between the likelihood ratios for studies of transvaginal ultrasound. A positive test result with sonohysterography diagnosed submucous fibroids with a pooled likelihood ratio of 29.7 (17.8, 49.6). A positive test result with hysteroscopy diagnosed submucous fibroids with a pooled likelihood ratio of 29.4 (13.4, 65.3), and any intrauterine pathology with a pooled likelihood ratio of 7.7 (4.3, 13.7). A negative test result with hysteroscopy for diagnosing any intrauterine pathology had a pooled likelihood ratio of 0.07 (0.04, 0.15). Although there was considerable variability present between the studies, all three diagnostic tests were moderately accurate in detecting intrauterine pathology. However, sonohysterography and hysteroscopy performed better than transvaginal ultrasound in detecting submucous fibroids.
An evidence-based guideline for the management of uterine fibroids
Publisher: Wiley
Date: 05-2001
Antenatal exercise in overweight and obese women and its effects on offspring and maternal health: design and rationale of the IMPROVE (Improving Maternal and Progeny Obesity Via Exercise) randomised
Publisher: Springer Science and Business Media LLC
Date: 26-04-2014
Blood transfusion in obstetrics and gynaecology
Publisher: Wiley
Date: 03-1997
DOI: 10.1111/J.1471-0528.1997.TB11454.X
Abstract: Tenosynovial giant cell tumor (TSGCT) is a benign tumor derived from the synovium of the joints, bursa, and tendon sheaths, which is mainly located around the tendon sheath of hand and foot. Extra-articular TSGCT are relatively rare and are mainly found in the soft tissue around the large joint. They are rarer when located purely intramuscular or subcutaneous, and mostly in the lower extremities. We report two rare cases of completely extra-articular TSGCT located at the buttocks. One case was a 23-year-old young male presenting with left buttock swelling and pain for 1 year. Magnetic resonance imaging (MRI) examination revealed a dumbbell-type cystic solid mass in the left buttock, growing anteriorly from the deep surface of the gluteus muscle along the medial of the lesser trochanter. The lesion showed a heterogeneous mixed signal and was well-defined. MRI presentation needs to be differentiated with neurogenic or mesenchymal tumors, and radical resection of left gluteal tumor + neurovascular exploration surgery was performed. Another case of TSGCT we present here was diagnosed in a 55-year-old male elderly patient. Computed tomography angiography (CTA) revealed an irregular soft tissue mass in the left buttock involving the sacroiliac joint. T1-weighted imaging (T1WI) on MRI showed a mixed signal with predominantly isosignal, well-defined, and seemingly enveloped. A left buttock tumor resection with the scraping of the sacroiliac joint lesion was performed. Based on histopathological examination, the diagnosis was diffuse-type TSGCT for both cases. Both patients were periodically monitored after surgery, and one of them showed no imaging findings of recurrence or metastases seven years after surgery the other case showed recurrence one year after surgery, which was resected and treated with radiotherapy, and there has been no recurrence so far. TSGCT occurring completely intramuscular is rare, with atypical clinical symptoms and imaging presentation, requiring differentiation with mesenchymal and giant cell-rich tumors.
Pregnancy outcomes in women with heart disease at the Colonial War Memorial Hospital, Suva, Fiji.
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 31-12-2016
Abstract: strong Background: /strong Cardiac disease in pregnancy is the third most common cause of maternal mortality in Fiji. The aim of this study was to determine the characteristics of pregnant women with heart disease presenting to the Colonial War Memorial Hospital (CWMH). strong Method: /strong A retrospective review of case notes of all pregnant women identified with heart disease who birthed in the hospital between January 2011 and December 2013 (36 months). strong Findings: /strong Of the 24,844 livebirths in CWMH during the study period, 153 women, aged 15 to 43 years of age, were confirmed with a cardiac lesion, which gives a prevalence rate of 6.2 per 1,000 livebirths. Rheumatic heart disease was the commonest cardiac lesion (112, 90%) followed by congenital heart disease (6, 5%) and hypertensive cardiomyopathy (3, 2%). Most of the cardiac lesions (120, 73%) were detected during pregnancy. There was a higher rate of intervention, morbidity and mortality associated with a cardiac lesion. The rate of instrumental deliveries, caesarean sections and admissions to intensive care were 3.5, 1.5 and 44 times higher compared to pregnant women without a heart lesion. The case-fatality rate was 2.0%. strong Conclusion: /strong Women with a cardiac lesion in pregnancy had more interventions, higher morbidity and mortality compared to women without a cardiac lesion. Early diagnosis and evaluation of cardiac function were essential for better maternal outcomes. All pregnant women should be screened with an echocardiogram to improve early detection of cardiac lesions. /
Dermatological conditions encountered in The Independent State of Samoa and an exploration of possible strategies to manage dermatological health‐care needs in this resource‐poor setting
Publisher: Wiley
Date: 18-07-2019
DOI: 10.1111/AJD.13118
Abstract: This report adds to the limited existing literature concerning dermatoses in Samoa. Conditions encountered during a 4-day private clinic are reported. Amongst the 75 patients reviewed, eczema was the most frequent condition diagnosed. This was followed by infective dermatoses particularly pityriasis versicolor and tinea infections. Reassuringly, in 97% of cases, suitable medications were available locally.
Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study
Publisher: Public Library of Science (PLoS)
Date: 13-06-2017
Maternal Perception of Fetal Activity and Late Stillbirth Risk: Findings from the Auckland Stillbirth Study
Publisher: Wiley
Date: 06-09-2011
Ethnicity and birth outcome: New Zealand trends 1980-2001. Part 1. Introduction, Methods, Results and Overview
Publisher: Wiley
Date: 12-2004
Our Islands health systems and the impact of COVID-19
Publisher: Pasifika Medical Association
Date: 15-07-2022
Association Between Maternal Sleep Practices and Risk of Late Stillbirth: A Case-Control Study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2011
Collaboration as a tool for building research capacity in the Pacific Islands
Publisher: Informa UK Limited
Date: 03-04-2018
Pacific Island publications in the reproductive health literature 2000-2011: With New Zealand as a reference
Publisher: Wiley
Date: 02-2013
DOI: 10.1111/AJO.12039
Abstract: There is a keen interest to develop research systems and increase research output in the 14 Pacific Island Forum Countries (PIFC) to support development of policies and practice based on locally relevant research evidence. To assess the quantity and characteristics of reproductive health research output by each country (14 PIFC) from 2000 to 2011 using New Zealand's reproductive research outputs as the reference. A systematic search of the literature using a broad definition of reproductive health. There were 174 papers published in the PIFC from 2000 to 2011 compared with 628 papers published in New Zealand (NZ). Most (57%) of the PIFC papers were from Papua New Guinea (PNG), although Samoa had the most papers by population (10/100,000). Five of the countries did not have a single publication. The majority of papers from both the PIFC and NZ were observational studies (72 vs 36%). Authors from Australia were responsible for 34% of PIFC publications followed by 25% from PNG. Sixty-three per cent of papers by PIFC sole and first authors were published in local journals, whereas 86% of non-PIFC authors published in international journals. There is a need for reproductive research in PIFC. PNG had the most publications on the back of a well-funded dedicated research institute and a significant collaboration with Australian researchers. The large number of papers in PIFC countries without PIFC authors raises the question about the need to require non-PIFC researchers to enter into genuine research partnerships in order to build research capacity in the PIFC.
A global view of hypertensive disorders and diabetes mellitus during pregnancy
Publisher: Springer Science and Business Media LLC
Date: 15-09-2022
Our collective response to racism and intolerance
Publisher: Pasifika Medical Association
Date: 28-03-2019
Abstract: Within the context of our Pacific communities in New Zealand, this heart-wrenching atrocity has caused serious soul-searching and reflection. There are a few themes that come to mind. Of immediate concern are issues with institutional racism and cultural competence in health care and the impact on our Pacific communities, and what leaders and all those who work in health, can and should do to help address these matters.
Review: transvaginal ultrasonography, sonohysterography, and hysteroscopy have moderate accuracy in abnormal uterine bleeding
Publisher: BMJ
Date: 2004
DOI: 10.1136/EBM.9.1.26
Association Between Maternal Sleep Practices and Risk of Late Stillbirth
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
Ethnic differences in disease presentation of uterine cancer in New Zealand women
Publisher: BMJ
Date: 12-01-2012
DOI: 10.1136/JFPRHC-2011-100113
Abstract: Little is known about the ethnic differences in disease presentation of uterine cancer in New Zealand women. The objectives of this study were two-fold: (1) to estimate the incidence and mortality of uterine cancer among women in New Zealand and (2) to examine the association of ethnicity and socioeconomic status with tumour stage and grade, at presentation of uterine cancer. Retrospective survey of cancer cases identified from the New Zealand Cancer Registry. The authors analysed all 3203 uterine cancer cases registered with the New Zealand Cancer Registry during the period 1 January 1997 to 31 December 2006. Ethnic groups were defined based on the self-identified ethnicity recorded on the cancer registry: Ma-ori, Pacific and non-Māori non-Pacific women. Socioeconomic status was categorised as quintiles of the New Zealand Deprivation Index 2006. The mortality to incidence ratio was used as a measure of prognosis. Logistic regression was used to estimate age, ethnic and deprivation adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Pacific and Māori women have higher incidence (32.4 and 17.7 per 100 000 women, respectively) and mortality rates of uterine cancer (12.1 and 7.4 per 100 000 women, respectively). Women in the most deprived areas are more likely to present with an advanced stage of uterine cancer (OR 1.64, 95% CI 1.09-2.48). Māori and Pacific women are less likely to present with well-differentiated tumours (OR 0.69, 95% CI 0.52-0.92 and OR 0.72, 95% CI 0.52-0.99, respectively). Māori and Pacific women, and those from lower socioeconomic areas, are more likely to present with advanced uterine cancer.
A randomized controlled trial on the effects of antenatal exercise on birth weight and neonatal body composition
Publisher: Springer Science and Business Media LLC
Date: 28-04-2015
Abstracts of Pasifika Medical Association Conference 2022
Publisher: Pasifika Medical Association
Date: 20-12-2022
DOI: 10.26635/PHD2022.153
Abstract: The annual Pasifika Medical Association (PMA) Conference was held at the Te Papa Museum, Wellington from the 4th to the 6th of September 2022. The Pasifika Medical Association celebrated 26 years of successful navigation and the conference with a theme of ‘Reconnect, Reflect, Reframe and Reenergise’ was attended by about 500 participants. Most were Pacific health workers from across the Pacific Islands, New Zealand and Australia. Abstracts from the Conference are published here.
Celebration of a Samoan Odyssey - Papali'i Dr Semisi Maiai
Publisher: Pasifika Medical Association
Date: 06-02-2020
Impact of using the international association of diabetes and pregnancy study groups criteria in South Auckland: prevalence, interventions and outcomes
Publisher: Wiley
Date: 11-10-2014
DOI: 10.1111/AJO.12267
Abstract: Adopting the modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosing gestational diabetes mellitus (GDM) will increase the prevalence of GDM resulting in increased resource utilisation and an unknown effect on clinical outcomes. To determine the prevalence of GDM by the modified IADPSG criteria and compare characteristics and pregnancy outcomes between women with GDM by IADPSG-additional, those with GDM by the New Zealand Society for the Study of Diabetes (NZSSD) criteria and those with a normal oral glucose tolerance test (OGTT). All women who delivered at Counties Manukau District Health Board (CMDHB) for a 12-month period from July 2012 to June 2013 had demographic, pregnancy and laboratory data obtained from hospital databases and clinical records. Of the 6376 (85%) of eligible women screened for GDM, 381 (6%) had GDM by NZSSD criteria and an additional 238 (4%) by the modified IADPSG-additional criteria, a relative increase of 62%. Women with GDM by NZSSD criteria had similar characteristics compared to women with GDM by IADPSG-additional. The outcomes between the two groups were also similar with the exception of a higher induction of labour (IOL) rate in women with GDM by NZSSD and a higher mean birthweight in the GDM by IADPSG-additional. Adopting the modified IADPSG criteria will result in a 62% increase in the number of GDM cases with a significant impact on workload and resources. Currently, there is insufficient evidence to support the introduction of the IADPSG criteria for our service.
Ethnicity and birth outcome: New Zealand trends 1980-2001: Part 3. Pregnancy outcomes for Pacific women
Publisher: Wiley
Date: 12-2004
Reduced primary care respiratory infection visits following pregnancy and infancy vitamin D supplementation: a randomised controlled trial
Publisher: Wiley
Date: 21-10-2014
DOI: 10.1111/APA.12819
Abstract: To determine whether vitamin D supplementation reduces primary care visits for acute respiratory infection (ARI). A randomised, double-blind, placebo-controlled trial was conducted in New Zealand and powered to determine the vitamin D dose needed to achieve normal vitamin D status during infancy. Healthy pregnant women, from 27 weeks' gestation to birth, and their infants, from birth to age 6 months, were assigned to placebo or one of the two dosages of daily oral vitamin D3 . Woman/infant pairs were randomised to placebo lacebo, 1000 IU/400 IU or 2000 IU/800 IU. For this ad hoc analysis, the primary care records of enrolled children were audited to age 18 months. Two hundred and sixty pregnant women were randomised to placebo (n = 87), lower-dose (n = 87) or higher-dose (n = 86) vitamin D3 . In comparison with the placebo group (99%), the proportion of children making any ARI visits was smaller in the higher-dose (87%, p = 0.004), but not the lower-dose vitamin D3 group (95%, p = 0.17). The median number of ARI visits/child was less in the higher-dose vitamin D3 group from age 6-18 months (placebo 4, lower dose 3, higher dose 2.5 p = 0.048 for higher-dose vitamin D3 vs. placebo). Vitamin D3 supplementation during pregnancy and infancy reduces primary care visits for ARI during early childhood.
Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial
Publisher: Wiley
Date: 06-11-2015
Abstract: To assess whether antenatal exercise in overweight/obese women would improve maternal and perinatal outcomes. Two-arm parallel randomised controlled trial. Home-based intervention in Auckland, New Zealand. Pregnant women with body mass index ≥25 kg/m(2) . Participants were randomised to a 16-week moderate-intensity stationary cycling programme from 20 weeks of gestation, or to a control group with no exercise intervention. Primary outcome was offspring birthweight. Perinatal and maternal outcomes were assessed, with the latter including weight gain, aerobic fitness, quality of life, pregnancy outcomes, and postnatal body composition. Exercise compliance was recorded with heart rate monitors. Seventy-five participants were randomised in the study (intervention 38, control 37). Offspring birthweight (adjusted mean difference 104 g P = 0.35) and perinatal outcomes were similar between groups. Aerobic fitness improved in the intervention group compared with controls (48.0-second improvement in test time to target heart rate P = 0.019). There was no difference in weight gain, quality of life, pregnancy outcomes or postnatal maternal body composition between groups. However, compliance with exercise protocol was poor, with an average of 33% of exercise sessions completed. Sensitivity analyses showed that greater compliance was associated with improved fitness (increased test time (P = 0.002), greater VO2 peak (P = 0.015), and lower resting heart rate (P = 0.014)), reduced postnatal adiposity (reduced fat mass (P = 0.007) and body mass index (P = 0.035)) and better physical quality of life (P = 0.034). Maternal non-weight-bearing moderate-intensity exercise in pregnancy improved fitness but did not affect birthweight or clinical outcomes. Moderate-intensity exercise in overweight/obese pregnant women improved fitness but had no clinical effects.
The Auckland Stillbirth study, a case-control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale
Publisher: Wiley
Date: 06-12-2010
Women's choice in the gender and ethnicity of her obstetrician and gynaecologist
Publisher: Wiley
Date: 10-2003
DOI: 10.1046/J.0004-8666.2003.00098.X
Abstract: Objective: To ascertain women's preferences in the gender and ethnicity of her obstetrician or gynaecologist and to determine whether there were differences in preferences among different ethnic and age groups. Study design: A simple 11‐item questionnaire was placed at the antenatal and gynaecological clinics provided by South Auckland Health. The questionnaire was voluntary and 848 women completed the questionnaire over a 4‐month period. Results: Half of the women preferred a woman doctor and the other half had no preference. There was a 6% increase in preference for a woman doctor where an examination was required. Of the women who preferred a female doctor, 45% would change their preference if a chaperone were present. There was no disproportionate increase in preference for a woman doctor by the patient's ethnicity or age group. Most of the women did not think the ethnicity of her doctor mattered however, 18% preferred the ethnicity of her doctor be similar to hers. There were more European women who preferred a European doctor and fewer Maori women would prefer a Maori doctor. Of the 9% of women who did not prefer a doctor of the same ethnicity to hers, Pacific Island women were over‐represented. Conclusion: This is the first study of this nature in New Zealand and the findings on preference for a female doctor are similar to those from other countries. The results of the present study did not show any difference in preference by women from the ethnicities studied and by age group. The use of a chaperone where a male doctor suggests an examination will reassure nearly half of those women who preferred a female doctor. Although most women did not think the ethnicity of her doctor mattered, there were distinct differences by ethnicity with more European women preferring a European doctor and fewer Maori women preferring a Maori doctor. A qualitative study is needed to ascertain reasons for these differences in preference.
Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 29-04-2015
DOI: 10.7314/APJCP.2015.16.8.3435
Abstract: To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs (ii) Lack of visible government endorsement (iii) Critical public perception of the value and safety of the HPV vaccine and (iv) Lack of clear guidelines and policies for HPV vaccination. Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.
Applicants for senior medical positions in New Zealand
Publisher: BMJ
Date: 07-1995
Abstract: Collection of spectroradiometric measurements with associated biophysical variables is an essential part of the development and validation of optical remote sensing vegetation products. However, their quality can only be assessed in the subsequent analysis, and often there is a need for collecting extra data, e.g., to fill in gaps. To generate empirical-like surface reflectance data of vegetated surfaces, we propose to exploit emulation, i.e., reconstruction of spectral measurements through statistical learning. We evaluated emulation against classical interpolation methods using an empirical field dataset with associated hyperspectral spaceborne CHRIS and airborne HyMap reflectance spectra, to produce synthetic CHRIS and HyMap reflectance spectra for any combination of input biophysical variables. Results indicate that: (1) emulation produces surface reflectance data more accurately than interpolation when validating against a separate part of the field dataset and (2) emulation produces the spectra multiple times (tens to hundreds) faster than interpolation. This technique opens various data processing opportunities, e.g., emulators not only allow rapidly producing large synthetic spectral datasets, but they can also speed up computationally intensive processing routines such as synthetic scene generation. To demonstrate this, emulators were run to simulate hyperspectral imagery based on input maps of a few biophysical variables coming from CHRIS, HyMap and Sentinel-2 (S2). The emulators produced spaceborne CHRIS-like and airborne HyMap-like surface reflectance imagery in the order of seconds, thereby approximating the spectra of vegetated surfaces sufficiently similar to the reference images. Similarly, it took a few minutes to produce a hyperspectral data cube with a spatial texture of S2 and a spectral resolution of HyMap.
The Pacific Society for Reproductive Health (PSRH) – twenty-years on.
Publisher: Pacific Society for Reproductive Health Charitable Trust
Date: 31-12-2016
Abstract: Benjamin Franklin has been quoted as saying that there are only two things certain in life – death and taxes. sup /sup But there is a third certainty - change. Much has changed over 20 years. For organisations to survive, they have to be relevant, sustainable and flexible. Inflexible organisations do not last long.
Development and use of a research productivity assessment tool for clinicians in low-resource settings in the Pacific Islands: a Delphi study
Publisher: Springer Science and Business Media LLC
Date: 29-01-2016
Ovarian Response to Purified FSH in Infertile Women with Long-standing Hypogonadotrophic Hypogonadism
Publisher: Wiley
Date: 02-1997
DOI: 10.1111/J.1479-828X.1997.TB02226.X
Abstract: It has previously been proposed that all anovulatory women requiring exogenous gonadotrophin therapy could be treated by purified FSH alone in the follicular phase. We have studied the ovarian response to purified FSH in 5 amenorrhoeic women with low endogenous LH production as a result of long-standing hypothalamic amenorrhoea. Follicles developed in all of the women but the rise in oestradiol was very slow. As a consequence of the HCG injection being delayed to allow the follicles to become functionally mature, too many follicles attained a preovulatory size. After the treatment was changed to more conventional preparations containing both FSH and LH, the women had improved ovarian responses and 3 of them conceived. It is clear that FSH alone will promote follicular growth but that LH is needed to stimulate follicular function. We conclude that LH does play an important role in follicular maturation and that it is a critical component of exogenous gonadotrophin therapy for women with prolonged hypogonadotrophic hypogonadism.
Antenatal care, identification of suboptimal fetal growth and risk of late stillbirth: Findings from the Auckland Stillbirth Study
Publisher: Wiley
Date: 25-01-2012
Relationship between obesity, ethnicity and risk of late stillbirth: a case control study
Publisher: Springer Science and Business Media LLC
Date: 12-01-2011
Abnormal fetal behavior and cardiotocography associated with a congenital meningo-encephalitis
Publisher: Wiley
Date: 08-1996
Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration
Publisher: American Academy of Pediatrics (AAP)
Date: 2014
Abstract: To determine the vitamin D dose necessary to achieve serum 25-hydroxyvitamin D (25(OH)D) concentration ≥20 ng/mL during infancy. A randomized, double-blind, placebo-controlled trial in New Zealand. Pregnant mothers, from 27 weeks’ gestation to birth, and then their infants, from birth to age 6 months, were randomly assigned to 1 of 3 mother/infant groups: placebo lacebo, vitamin D3 1000/400 IU, or vitamin D3 2000/800 IU. Serum 25(OH)D and calcium concentrations were measured at enrollment, 36 weeks’ gestation, in cord blood, and in infants at 2, 4, and 6 months of age. Two-hundred-and-sixty pregnant women were randomized. At enrollment, the proportions with serum 25(OH)D ≥20 ng/mL for placebo, lower-dose, and higher-dose groups were 54%, 64%, and 55%, respectively. The proportion with 25(OH)D ≥20 ng/mL was larger in both intervention groups at 36 weeks’ gestation (50%, 91%, 89%, P & .001). In comparison with placebo, the proportion of infants with 25(OH)D ≥20 ng/mL was larger in both intervention groups to age 4 months: cord blood (22%, 72%, 71%, P & .001), 2 months (50%, 82%, 92%, P & .001), and 4 months (66%, 87%, 87%, P = .004), but only in the higher-dose group at age 6 months (74%, 82%, 89%, P = .07 higher dose versus placebo P = .03, lower dose versus placebo P = .21). Daily vitamin D supplementation during pregnancy and then infancy with 1000/400 IU or 2000/800 IU increases the proportion of infants with 25(OH)D ≥20 ng/mL, with the higher dose sustaining this increase for longer.
Related Organisations
Royal College Of Obstetricians And Gynaecologists
Location: United Kingdom of Great Britain and Northern Ireland
University Of Papua New Guinea, School Of Medicine And Health Sciences
Location: Papua New Guinea
Royal Australian And New Zealand College Of Obstetricians And Gynaecologists
Location: Australia
University Of Bristol
Location: United Kingdom of Great Britain and Northern Ireland
Keele University Faculty Of Health
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Alec Ekeroma.