Mitigating imported fuel dependency in agricultural production: Case study of an island nation's vulnerability to global catastrophic risks.

A major global catastrophe would likely disrupt trade in liquid fuels. Countries dependent on imported oil products might struggle to sustain industrial agriculture. Island nations importing 100% of refined fuels are particularly vulnerable.

Food security during nuclear winter: a preliminary agricultural sector analysis for Aotearoa New Zealand.

Aim: We aimed to estimate the current dietary energy content of food exports for Aotearoa New Zealand and food security during "nuclear winter" scenarios following a nuclear war.

Methods: From published sources we estimated dietary energy available from the major domains of food exports, with adjustments for wastage. The impacts on food production in New Zealand during three nuclear winter scenarios were based on those published in Nature Food in 2022 and from an earlier New Zealand Planning Council study.

Mathematical optimization of frost resistant crop production to ensure food supply during a nuclear winter catastrophe.

This study aimed to estimate the optimal mix of frost resistant crops and land area needed to provide basic nutrition during various nuclear winter scenarios for New Zealand (NZ), a temperate island nation. It used linear programming to minimize land area required for cropping while producing enough food to achieve dietary energy and protein requirements for the whole population. The potential agricultural impacts of three nuclear winter scenarios on NZ, were sourced from the literature.

Assumptions, uncertainty, and catastrophic/existential risk: National risk assessments need improved methods and stakeholder engagement.

Two key shortcomings of national risk assessments (NRAs) are: (1) lack of justification and transparency around important foundational assumptions of the process, (2) omission of almost all the largest scale risks. Using a demonstration set of risks, we illustrate how NRA process assumptions around time horizon, discount rate, scenario choice, and decision rule impact on risk characterization and therefore any subsequent ranking. We then identify a neglected set of large-scale risks that are seldom included in NRAs, namely global catastrophic risks and existential threats to humanity.

Impact of the Tambora volcanic eruption of 1815 on islands and relevance to future sunlight-blocking catastrophes.

Island nations may have potential long-term survival value for humanity in global catastrophes such as sun-blocking catastrophes from nuclear winter and large magnitude volcanic eruptions. One way to explore this issue further is to understand the impact on islands after the largest historically observed volcanic eruption: that of Mt Tambora in 1815. For each of the 31 large, populated islands selected, we conducted literature searches for relevant historical and palaeoclimate studies.

Island refuges for surviving nuclear winter and other abrupt sunlight-reducing catastrophes.

Some island nations in the Southern Hemisphere might survive a severe sun-reducing catastrophe such as nuclear winter and be well placed to help reboot-collapsed human civilization. Such islands must be resilient to the cascading effects abrupt sunlight reduction scenarios (ASRS) would impose beyond the impacts on agricultural systems. We aimed to identify island nations whose societies are most likely to survive nuclear winter or other ASRS.

The 2021 Global Health Security (GHS) Index: Aotearoa New Zealand's improving capacity to manage biological threats must now be consolidated.

The 2021 Global Health Security (GHS) Index Report was published on 8 December 2021. With an average country score of 38.9 out of a possible 100 points, global scores are essentially unchanged from 2019.

Photorefraction Screening Plus Atropine Treatment for Myopia is Cost-Effective: A Proof-of-Concept Markov Analysis.

Purpose: The prevalence of myopia is increasing globally, putting individuals at risk of myopia-associated visual impairment. Low-dose atropine eye drops have been found to safely reduce the risk of progression from myopia to higher levels of myopia and pathological states. In New Zealand, school children have an eye check at age 11.

Chemical, Biological, Radiological, or Nuclear Response in Queensland Emergency Services: A Multisite Study.

A disaster overwhelms the normal operating capacity of a health service. Minimal research exists regarding Australian hospitals' capacity to respond to chemical, biological, radiological, or nuclear (CBRN) disasters. This article, and the research supporting it, begins to fill that research gap.

Optimizing Island Refuges against global Catastrophic and Existential Biological Threats: Priorities and Preparations.

Human civilization is vulnerable to global catastrophic biological threats and existential threats. Policy to mitigate the impact of major biological threats should consider worst-case scenarios. We aimed to strengthen existing research on island refuges as a mitigating mechanism against such threats by considering five additional factors as well as recent literature on catastrophic risks and resilience.

Proof-of-concept calculations to determine the health-adjusted life-year trade-off between intravitreal anti-VEGF injections and transmission of COVID-19.

Background: Clinical ophthalmological guidelines encourage the assessment of potential benefits and harms when deciding whether to perform elective ophthalmology procedures during the COVID-19 pandemic, in order to minimize the risk of disease transmission.

Method: We performed probability calculations to estimate COVID-19 infection status and likelihood of disease transmission among neovascular age-related macular degeneration patients and health-care workers during anti-VEGF procedures, at various community prevalence levels of COVID-19. We then applied the expected burden of COVID-19 illness and death expressed through health-adjusted life-years (HALYs) lost.

Existential Risks to Humanity Should Concern International Policymakers and More Could Be Done in Considering Them at the International Governance Level.

In this perspective, we consider the possible role of the United Nations (UN) with respect to existential risks to human civilization and the survival of humanity. We illustrate how existential risks have been discussed at an international governance level, specifically in documents in the UN Digital Library. In this large corpus, discussions of nuclear war account for over two-thirds (69%, 67/97) of mentions of existential risks, while mention of other existential risks, or such risks as a category, appears scant.

The 2019 Global Health Security Index (GHSI) and its implications for New Zealand and Pacific regional health security.

It is important for all countries to secure themselves against infectious disease threats, including potential global catastrophic biological risks. The Global Health Security Index (GHSI), first published in 2019, is a comprehensive, objective assessment of health security capabilities across 195 States Parties to the International Health Regulations. The GHSI is a broader assessment than the World Health Organization Joint External Evaluation and emphasises public documentation of preparedness as well as sustainable capabilities.

The Prioritization of Island Nations as Refuges from Extreme Pandemics.

In this conceptual article with illustrative data, we suggest that it is useful to rank island nations as potential refuges for ensuring long-term human survival in the face of catastrophic pandemics (or other relevant existential threats). Prioritization could identify the several island nations that are most suitable for targeting social and political preparations and further investment in resiliency. We outline a prioritization methodology and as an initial demonstration, we then provide example rankings by considering 20 sovereign island states (all with populations greater than 250,000 and no land borders).

Expediting cataract surgery in New Zealand is cost-effective for falls prevention and improving vision-so what might be the next steps?

Multifactorial individual assessment with interventions tailored to the individual's risk factors can reduce the rate of falls and risk of fractures. Assessment of vision is one key aspect of multifactorial assessment and first eye cataract surgery reduces the rate of falls. We recently modelled the impact of expediting first eye cataract surgery in New Zealand for falls prevention (Boyd et al Injury Prevention).

Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country.

Aim: To estimate the health gain, health system costs and cost-effectiveness of cataract surgery when expedited as a falls prevention strategy (reducing the waiting time for surgery by 12 months) and as a routine procedure.

Methods: An established injurious falls model designed for the New Zealand (NZ) population (aged 65+ years) was adapted. Key parameters relating to cataracts were sourced from the literature and the NZ Ministry of Health.

Economic evaluation of border closure for a generic severe pandemic threat using New Zealand Treasury methods.

Objective: To perform a comprehensive economic evaluation of border closure for an island nation in the face of severe pandemic scenarios.

Methods: The costing tool developed by the New Zealand (NZ) Treasury (CBAx) was used for the analyses. Pandemic scenarios were as per previous work; epidemiological data were from past New Zealand influenza pandemics.

Just ask Siri? A pilot study comparing smartphone digital assistants and laptop Google searches for smoking cessation advice.

Objective: To compare voice-activated internet searches by smartphone (two digital assistants) with laptop ones for information and advice related to smoking cessation.

Design: Responses to 80 questions on a range of topics related to smoking cessation (including the FAQ from a NHS website), compared for quality.

Setting: Smartphone and internet searches as performed in New Zealand.

The long history of health inequality in New Zealand: occupational class and lifespan in the late 1800s and early 1900s.

Objective: As relatively little is known about how socioeconomic position might have affected health prior to the Second World War, we aimed to study lifespan by occupational class in two cohorts in New Zealand.

Methods: The first study included men on the electoral rolls in Dunedin in the period 1893 to 1902. The second study used an established cohort of male military personnel who were recruited for the First World War.

Colorectal Cancer Screening: How Health Gains and Cost-Effectiveness Vary by Ethnic Group, the Impact on Health Inequalities, and the Optimal Age Range to Screen.

Screening programs consistently underserve indigenous populations despite a higher overall burden of cancer. In this study, we explore the likely health gains and cost-effectiveness of a national colorectal cancer screening program for the indigenous Māori population of New Zealand (NZ). A Markov model estimated: health benefits (quality-adjusted life-year; QALY), costs, and cost-effectiveness of biennial immunochemical fecal occult blood testing (FOBTi) of 50- to 74-year-olds from 2011.

Protecting an island nation from extreme pandemic threats: Proof-of-concept around border closure as an intervention.

Background: Countries are well advised to prepare for future pandemic risks (e.g., pandemic influenza, novel emerging agents or synthetic bioweapons).

Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study.

Background: Patient safety depends on effective teamwork. The similarity of team members' mental models - or their shared understanding-regarding clinical tasks is likely to influence the effectiveness of teamwork. Mental models have not been measured in the complex, high-acuity environment of the operating room (OR), where professionals of different backgrounds must work together to achieve the best surgical outcome for each patient.

Students' responses to scenarios depicting ethical dilemmas: a study of pharmacy and medical students in New Zealand.

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress.