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Biomedical subjects

Nick Wilson

Publications and source records attributed to Nick Wilson.

At least 73 records · Page 4Linked to original sources
PubMed2004

Estimating the impact of the next influenza pandemic on population health and health sector capacity in New Zealand.

AIM: To estimate the impact of the next influenza pandemic on population health and health sector capacity in New Zealand. METHOD: Population data for New Zealand was used with the software package 'FluAid' (CDC, Atlanta). Additional data was used to provide estimates of impacts on health sector capacity. RESULTS: For incidence rates in the 15% to 35% range for the first pandemic wave, the modelling results give a range of 1600 to 3700 deaths attributable to pandemic influenza. The estimated range of hospitalisations was between 6900 and 16,200. The estimated number of cases of illness requiring medical consultation ranged from 325,000 to 759,000. For the peak week of an 8-week epidemic (35% incidence scenario), it was estimated that 42% of all public hospital beds would be required at least for some proportion of the week and that the average general practitioner would be consulted by around 80 people with influenza. CONCLUSION: This modelling work has a number of limitations and so these results could still substantially over- or under-estimate the impact of the next influenza pandemic. Nevertheless, the potentially severe impact of pandemic influenza on population health and health sector capacity provides a strong case for health authorities to intensify preparatory efforts and to strengthen health sector infrastructure.

Computer Simulation↗
PubMed2004

Print media response to SARS in New Zealand.

To examine the media response to severe acute respiratory syndrome, we reviewed New Zealand's major newspaper (261 articles for 3 months). While important accurate health messages were frequently included, some were missed (e.g., hand washing in only 2% of articles). No incorrect information was identified, and health spokespersons were accurately quoted.

Health Education↗
PubMed2003

Estimating the Haemophilus influenzae type b (Hib) disease burden and the impact of Hib vaccine in Fiji.

AIMS: To estimate Haemophilus influenzae type b (Hib) disease burden in Fiji in children under the age of 5 years (under-5s) prior to vaccine introduction. To compare estimates from WHO's Hib rapid assessment tool (RAT), with that from decline in disease after vaccine introduction. METHODS: Laboratory data (meningitis), hospitalization and mortality data (pneumonia and meningitis) before and after Hib vaccine introduction were collected. The RAT protocol provides two independent estimates of pre-vaccine disease burden (one based on meningitis incidence laboratory data and the other based on mortality statistics). A third estimate uses the decline in disease following vaccine introduction. RESULTS: The decline in meningitis hospitalizations implies a pre-vaccine Hib meningitis incidence of 66 per 100,000 in under-5s. This compares with a pre-vaccine RAT estimate of Hib meningitis incidence of 84 per 100,000 (for 1992-1993). The RAT estimated the total annual pre-vaccine Hib burden (meningitis plus pneumonia) at 476 cases and 36 deaths per year ("meningitis incidence method") and 70 cases and 5 deaths ("child mortality method"). Hib vaccine led to declines of 32% (95% confidence interval (CI)=11-48%), and 78% (95% CI=22-94%) for all under-5s meningitis hospitalizations and deaths, respectively. There was no similar consistent decline in pneumonia hospitalizations or deaths after vaccine introduction, except for a statistically significant reduction in pneumonia mortality in children aged under 1 year. CONCLUSIONS: Hib disease constitutes an important burden on the health of Pacific children that can be rapidly reduced with Hib vaccine. In this setting, routine morbidity statistics (comparing pre-and post-vaccine) provided an estimate of Hib meningitis burden which is broadly similar to that of the Hib RAT, suggesting that both might be valid ways to estimate Hib meningitis incidence. However, Hib pneumonia burden could not be estimated from routine statistics.

Animals↗
PubMed2002

Still dying from second-hand smoke at work: a brief review of the evidence for smoke-free workplaces in New Zealand.

AIM: To briefly review the evidence on the hazard from, and control of, second-hand smoke (SHS) in New Zealand workplace settings. METHODS: Medline searches and searches of New Zealand health databases for unpublished reports. RESULTS: The New Zealand evidence suggests that over 30% of workers continue to be exposed to SHS in workplace settings. The best available estimate is that SHS exposure in these settings causes around 100 avoidable deaths per year from lung cancer, coronary heart disease and stroke collectively. National survey data and studies in hospitality industry settings (measuring nicotine in hair and cotinine in saliva), strongly indicate that smoke-free workplaces result in reduced exposure to SHS. The data indicate that there is widespread concern regarding SHS and clear support for smoke-free workplaces. CONCLUSIONS: Available New Zealand data are fully consistent with the extensive international data indicating that smoke-free policies in workplaces can improve health protection for workers. New legislation is likely to enhance the control of SHS in New Zealand, but additional actions such as a mass media campaign on SHS are also desirable.

Adult↗
PubMed2002

The beneficial impact of Hib vaccine on disease rates in New Zealand children.

AIM: To examine the impact of Haemophilus influenzae type b (Hib) vaccine on the burden of Haemophilus influenzae (Hi) disease in New Zealand children aged under five years (under-5s). METHODS: Analysis of national mortality, hospitalisation, laboratory, and notification data. RESULTS: The introduction of Hib vaccine in 1994 led to a 92% decline (95%CI = 89 94%) in the hospitalisation rate of Hi meningitis for under-5s (1995 2000 compared to 1988 1993). Pre-vaccine, the Hi meningitis hospitalisation rate was 27 per 100 000 in the under-5s and this declined to 2 per 100 000. Even though Hi meningitis declined in all ethnic groups (eg down to 3 per 100 000 among Maori), there was a worsening of equity with the proportion of children hospitalised with Hi meningitis who were Maori increasing from 23% to 40% of all cases. The rate of epiglottitis hospitalisations also declined substantially (by 94%, 95%CI = 89 - 96%). CONCLUSIONS: Hib vaccination appears to be preventing at least 80 cases of meningitis and 30 cases of epiglottitis every year in under-5s in New Zealand. But the beneficial impact of Hib vaccination has been less for Maori and so there is a need for further improvements in immunisation coverage in those populations with the highest disease burdens.

Child, Preschool↗
PubMed2002

Bioterrorism in the Northern Hemisphere and potential impact on New Zealand.

Given the historical evidence, and the characteristics of biological weapons, it appears unlikely that terrorists will use these weapons to produce mass casualties. Yet this terrorist threat will continue to be a concern while many countries still have bioweapon programmes, with advances in genetic engineering, and while determinants of terrorism persist around the world (eg, unresolved conflicts, poverty, inequality and environmental degradation). Terrorist use of smallpox, pneumonic plague and genetically engineered pathogens in the Northern Hemisphere could lead to imported cases reaching New Zealand and some risk of ongoing disease outbreaks. However, a range of disease control measures are available that could substantially limit the size of any resulting outbreaks. The risk of terrorist use of bioweapons needs to be considered in the context of the more important risk of pandemic influenza on New Zealand, the many thousands of preventable deaths in each year in this country (eg, from smoking and physical inactivity), and the current epidemic of meningococcal disease. Nevertheless, attention needs to be given to the primary prevention of terrorism and to preparatory measures that improve the country's public health infrastructure.

Bioterrorism↗
PubMedDate not supplied

Communication and health protection issues arising from a flooding emergency.

OBJECTIVE: To identify and describe the key communication and health protection issues surrounding a flooding emergency. METHODS: A telephone questionnaire was used to assess health and safety information sources, information recalled, and behavioral responses among residents of the town of Feilding, New Zealand following a major flood in February 2004. This was supplemented by key informant interviews and a newspaper content analysis. RESULTS: A total of 154 adult residents were surveyed (76% of those successfully contacted and eligible). Of the respondents, 79% recalled being provided with health and safety information from authorities. The major sources were: radio (41%), pamphlets (23%), and newspapers (20%). The regional newspaper had extensive coverage of this flooding emergency but "health" only was mentioned in 46 (7%) of the 664 flood-related articles. Of those who recalled receiving information from authorities, most (89%) perceived that it was adequate. Nevertheless, 18% actively sought out information (mainly about water safety and availability). In the post-flood period, 73% of all respondents boiled water; however, only 4% maintained boiling water or bottled water use for the necessary nine-week period. Some forms of emergency preparations did not change substantially from before the flood, compared to four months afterwards (e.g., having a radio with batteries increased from 62% to 68%). Perceived health concerns around the flooding were low, though 59% were concerned about the risk of water contamination. Actual self-reported, health consequences from the flood were rare, as only two (1%) people out of 154 reported flood-related health problems. CONCLUSIONS: Health and safety information generally was communicated successfully and was regarded as appropriate by the population of this flood-affected town. Nevertheless, there are further improvements needed in the emergency response by both residents and authorities.

Adult↗
PubMedDate not supplied

Lessons from the unsuccessful 2005 Nuclear Non-Proliferation Treaty Review Conference.

The Nuclear Non-Proliferation Treaty is probably the most important treaty for the control of nuclear weapons. A Review Conference was held in May 2005 but the member states failed to agree on any decisions or recommendations. Possible causes for this failure reside in the unsupportive geopolitical climate surrounding the conference, design limitations of the Treaty, and the obstructionist actions of particular states. However, valuable contributions were made at the conference by some states and by civil society representatives. Fortunately there are still many ways for states and civil society to make future conferences more successful in eliminating the threat to human security from nuclear weapons.

Consensus Statements as Topic↗