Recognition of physical and psychological symptoms: no influence of GP demographic factors

AIM: To describe the relationship between general practitioner demographic factors and the recognition of psychological and physical symptoms in consultation. METHODS: A survey of a random sample of 70 GPs and their patients (n=3414) from the lower North Island of New Zealand. RESULTS: No relationship was found between GP personal and practice demographic characteristics and GP identification of psychological and physical symptoms. Patients were more likely not to present psychological symptoms (62%) than not present physical symptoms (5%) in consultation. Thirteen percent of GPs wanted more formal psychiatric training, 45% wanted more contact time in consultation, and 72% thought that cost was a barrier to patients attending. No significant relationship was found between these factors and GP detection of significant psychological symptoms in consultation. DISCUSSION: Personal and practice demographics of GPs may not predict their ability to detect physical and psychological symptoms. More research is needed to explore these findings which contradict previous work

Health and climate related ecosystem services provided by street trees in the urban environment

Published onlineJournal ArticleUrban tree planting initiatives are being actively promoted as a planning tool to enable urban areas to adapt to and mitigate against climate change, enhance urban sustainability and improve human health and well-being. However, opportunities for creating new areas of green space within cities are often limited and tree planting initiatives may be constrained to kerbside locations. At this scale, the net impact of trees on human health and the local environment is less clear, and generalised approaches for evaluating their impact are not well developed.In this review, we use an urban ecosystems services framework to evaluate the direct, and locally-generated, ecosystems services and disservices provided by street trees. We focus our review on the services of major importance to human health and well-being which include 'climate regulation', 'air quality regulation' and 'aesthetics and cultural services'. These are themes that are commonly used to justify new street tree or street tree retention initiatives. We argue that current scientific understanding of the impact of street trees on human health and the urban environment has been limited by predominantly regional-scale reductionist approaches which consider vegetation generally and/or single out individual services or impacts without considering the wider synergistic impacts of street trees on urban ecosystems. This can lead planners and policymakers towards decision making based on single parameter optimisation strategies which may be problematic when a single intervention offers different outcomes and has multiple effects and potential trade-offs in different places.We suggest that a holistic approach is required to evaluate the services and disservices provided by street trees at different scales. We provide information to guide decision makers and planners in their attempts to evaluate the value of vegetation in their local setting. We show that by ensuring that the specific aim of the intervention, the scale of the desired biophysical effect and an awareness of a range of impacts guide the choice of i) tree species, ii) location and iii) density of tree placement, street trees can be an important tool for urban planners and designers in developing resilient and resourceful cities in an era of climatic change

Citrobacter rodentium is an unstable pathogen showing evidence of significant genomic flux.

Citrobacter rodentium is a natural mouse pathogen that causes attaching and effacing (A/E) lesions. It shares a common virulence strategy with the clinically significant human A/E pathogens enteropathogenic E. coli (EPEC) and enterohaemorrhagic E. coli (EHEC) and is widely used to model this route of pathogenesis. We previously reported the complete genome sequence of C. rodentium ICC168, where we found that the genome displayed many characteristics of a newly evolved pathogen. In this study, through PFGE, sequencing of isolates showing variation, whole genome transcriptome analysis and examination of the mobile genetic elements, we found that, consistent with our previous hypothesis, the genome of C. rodentium is unstable as a result of repeat-mediated, large-scale genome recombination and because of active transposition of mobile genetic elements such as the prophages. We sequenced an additional C. rodentium strain, EX-33, to reveal that the reference strain ICC168 is representative of the species and that most of the inactivating mutations were common to both isolates and likely to have occurred early on in the evolution of this pathogen. We draw parallels with the evolution of other bacterial pathogens and conclude that C. rodentium is a recently evolved pathogen that may have emerged alongside the development of inbred mice as a model for human disease

Genomics of the Argentinian cholera epidemic elucidate the contrasting dynamics of epidemic and endemic Vibrio cholerae

Funder: U.S. Department of Health & Human Services | National Institutes of Health (NIH)Abstract: In order to control and eradicate epidemic cholera, we need to understand how epidemics begin, how they spread, and how they decline and eventually end. This requires extensive sampling of epidemic disease over time, alongside the background of endemic disease that may exist concurrently with the epidemic. The unique circumstances surrounding the Argentinian cholera epidemic of 1992–1998 presented an opportunity to do this. Here, we use 490 Argentinian V. cholerae genome sequences to characterise the variation within, and between, epidemic and endemic V. cholerae. We show that, during the 1992–1998 cholera epidemic, the invariant epidemic clone co-existed alongside highly diverse members of the Vibrio cholerae species in Argentina, and we contrast the clonality of epidemic V. cholerae with the background diversity of local endemic bacteria. Our findings refine and add nuance to our genomic definitions of epidemic and endemic cholera, and are of direct relevance to controlling current and future cholera epidemics

New Zealand Deprivation Index 2018 - TA68: Waitaki District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - TA021: Taupo District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - TA026: Kawerau District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - TA037: Whanganui District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/