Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific

Background:
Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children’s perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries.

Objectives:
To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region.

Design:
A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava’u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0.

Results:
HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen’s d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen’s d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen’s d 0.6).

Conclusion:
The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

Implementing an international health treaty in small Pacific Island nations

Erik Martin explored the implementation of an international tobacco control policy in the Pacific Island nations of the Cook Islands, Nauru, Palau and Vanuatu. This qualitative study explored how tobacco control policies are influenced and provided recommendations on how to advance tobacco control policy to benefit population health.

Prevalence of hyponatremia in acute medical admissions in tropical Asia Pacific Australia

To determine prevalence of hyponatremia in acute medical admissions in Northern Australasia.

The diet of Pacific gulls (Larus pacificus) breeding at Seal Island in northern Bass Strait

The endemic Pacific gull (Larus pacificus) is Australia's largest larid, and though little is currently known of its foraging ecology, its size and wide distribution suggest that it may play an important role within the marine environment. In the present study, regurgitate pellets collected from Seal Island in northern Bass Strait were used to compare intra- and interannual trends in diet composition. The main taxa identified in pellets were the common diving-petrel (Pelecanoides urinatrix), leatherjacket species (Family Monacanthidae), short-tailed shearwater (Puffinus tenuirostris) and mirror bush (Coprosma repens). Analysis of similarity (ANOSIM) identified no significant differences in numerical abundance of the dominant prey species between years, suggesting that the prey base in this region is temporally consistent or that the gulls consume low enough numbers to be unaffected by fluctuation in prey populations. Diving-petrels were consumed in consistently high numbers, suggesting the gulls may be an important predator of this species, or that the gulls are particularly skilled at foraging for them. © CSIRO 2014.

Phosphate absorption across multiple epithelia in the Pacific hagfish (Eptatretus stoutii)

Inorganic phosphate (Pi) is an essential nutrient for all organisms, but in seawater, Pi is a limiting nutrient. This study investigated the primary mechanisms of Pi uptake in Pacific hagfish (Eptatretus stoutii) using ex vivo physiological and molecular techniques. Hagfish were observed to have the capacity to absorb Pi from the environment into at least three epithelial surfaces: the intestine, skin, and gill. Pi uptake in all tissues was concentration dependent, and saturable Pi transport was observed in the skin and gill at <2.0 mmol/l Pi. Gill and intestinal Pi uptake was sodium dependent, but Pi uptake into the skin increased under low sodium conditions. Gill Pi transport exhibited an apparent affinity constant ∼0.23–0.6 mmol/l Pi. A complete sequence of a type II sodium phosphate cotransporter (Slc34a) was obtained from the hagfish gill. Phylogenetic analysis of the hagfish Slc34a transporter indicates that it is earlier diverging than, and/or ancestral to, the other identified vertebrate Slc34a transporters (Slc34a1, Slc34a2, and Slc34a3). With the use of RT-PCR, the hagfish Slc34a transcript was detected in the intestine, skin, gill, and kidney, suggesting that this may be the transporter involved in Pi uptake into multiple epithelia in the hagfish. This is the first measurement of Pi uptake across the gill or skin of any vertebrate animal and first sodium phosphate cotransporter identified in hagfish.

Predictors and risks of body fat profiles in young New Zealand European, Māori and Pacific women: study protocol for the women's EXPLORE study.

Body mass index (BMI) (kg/m(2)) is used internationally to assess body mass or adiposity. However, BMI does not discriminate body fat content or distribution and may vary among ethnicities. Many women with normal BMI are considered healthy, but may have an unidentified "hidden fat" profile associated with higher metabolic disease risk. If only BMI is used to indicate healthy body size, it may fail to predict underlying risks of diseases of lifestyle among population subgroups with normal BMI and different adiposity levels or distributions. Higher body fat levels are often attributed to excessive dietary intake and/or inadequate physical activity. These environmental influences regulate genes and proteins that alter energy expenditure/storage. Micro ribonucleic acid (miRNAs) can influence these genes and proteins, are sensitive to diet and exercise and may influence the varied metabolic responses observed between individuals. The study aims are to investigate associations between different body fat profiles and metabolic disease risk; dietary and physical activity patterns as predictors of body fat profiles; and whether these risk factors are associated with the expression of microRNAs related to energy expenditure or fat storage in young New Zealand women. Given the rising prevalence of obesity globally, this research will address a unique gap of knowledge in obesity research.

Introduction: IP and the Asia-Pacific ‘spaghetti bowl’ of free trade agreements

The contributions to this book show the strategies and policies of countries in the Asia-Pacific region that have to grapple with international standard setting in what has been called the ‘spaghetti bowl’ of criss-crossing free trade agreements. The chapters show how intellectual property is just one among many political and economic factors that are used in trade off discussions. It leads to an often considerable further raising of IP standards in those countries that agree to higher protection levels, often for reasons that have little to do with the provision of incentives for technological progress. A more nuanced picture of IP protection in Asia shows the different interests of high protection countries, ‘first’ and ‘second tier’ newly industrialized and industrializing countries and the rather peculiar position of Australia and New Zealand. The chapter introduces the contributions to this volume according to these various groups of countries and of international law and the political economy of the region.