Autumn Keeping in Touch - Asthma Foundation New Zealand

Autumn 2015
…keeping in touch
A healthy home means healthy children – is your home a healthy home?
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10 Smokefree Aotearoa – what can you do?
11 Latest research
12 Development of a National Respiratory
Strategy
13 Dance 4 Asthma - It’s time to dance
14 Epic cycle adventure begins
15 Healthy building for preschool
16 Important dates and news
NATION
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Looking outside the health sector for
solutions to our poor respiratory health
Our people
What is the connection between our homes
and our health?
COPD – Making life easier
What’s happening at Asthma Hawke’s Bay
Ask a nurse
New resources to help educate
Wha
¯nau Ora Healthy Housing and Budgeting
Cookbook
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2
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02
President’s message
Farewell to our Chief Executive
March/15
M A C O UNC
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Level 3, Greenock House
39 The Terrace
PO Box 1459
Wellington 6140
t (04) 499 4592
f (04) 499 4594
e info@asthmafoundation.org.nz
www.asthmafoundation.org.nz
John Knight
President
It is with regret and sadness that I advise that
Angela Francis our chief executive is leaving to
become Chief Executive of Nelson Bays Primary
Health Organisation. Angela has been with the
Foundation for nearly five years and in that time
she has transformed the Asthma Foundation into
a high performing organisation with an excellent
profile and reputation. This includes overseeing a
new strategy based on Sir Mason Durie’s Pou Ora
Framework; making significant gains in Ma¯ori Health
including a Ministry of Health contract to research
health literacy; commencing the Ma¯ori Engagement
Strategy and forming a national Expert Advisory Group.
Angela’s other achievements include securing
significant unbudgeted revenue, notably increased
revenue for the Sensitive Choice® Australasian business
development venture and redesigning how we procure
research resulting in a joint Health Research Council of
NZ partnership research programme.
Angela oversaw the 50th Anniversary celebration in
2014 that included a dinner hosted by the Governor
General at Government House, and the publication
of the commemorative book A Breath of Hope by
historian Lou Ormsby.
Personally I would like to thank you Angela for your
dedication, passion, hard work and loyalty to the
Asthma Foundation. You are leaving our organisation in
a stronger position than when you arrived! It has been a
pleasure working with you and we wish you all the best
in your new role.
John Knight, President
the asthma foundation…keeping
in touch is produced with the
assistance of Pub Charity
Chief Executive’s message
The Asthma Foundation greatly
appreciates their support.
Angela Francis
Chief Executive
As this will be my last contribution to ‘Keeping in
Touch’, I wanted to take the opportunity to express
my gratitude to you as a key contributor in the
Respiratory health sector. Whether it is as a client,
care giver, hauroa provider, physician or funder, you
have helped us ‘make a difference’ to those whose
lives are affected with a respiratory condition.
Philip Aldridge and Matthew Allen
With your continued support, the Asthma
Foundation will continue to advocate for respiratory
health to become a health target so that:
• Respiratory health is prioritised by government
and all health providers
• There is standardised care utilising updated
guidelines
• Respiratory health is appropriately funded
A core strand of the Asthma Foundation’s strategy
is lobbying for a reduction in social inequalities –
in particular decreasing poverty, providing better
housing, improving health literacy and providing
better access to primary health care for all New
Zealanders.
It is for this reason that I am pleased to announce
that the Foundation was the successful recipient of
a Community Programme Internship jointly funded
by the Department of Internal Affairs and the
Ministry of Health. This will allow us to progress the
development of the first ever National Respiratory
Strategy with an emphasis on health equity.
The Asthma Foundation governance structure has
undergone recent change with the addition of
two new members: Matthew Allen, director and
owner of Wellington based policy consultancy,
Allen + Clarke; and Philip Aldridge, director of
business services and operations at the Social Policy
Evaluation and Research Unit.
On a solemn note, one of our life members
Professor Tom O’Donnell passed away on Christmas
Day. I enjoyed all my meetings with Tom who was a
gentleman and a passionate advocate for those with
respiratory conditions. You can read more about
Tom in this edition.
In closing I would like to thank the Asthma
Foundation Board for their ongoing commitment
and work towards respiratory health. I would also
like to thank the team for their dedication and work,
without which the achievements over the last four
years would not have been possible.
Angela Francis, Chief Executive
03
Updates
Our people
Our Achievers
continue to not let
their condition stand
in their way
A year ago Tomairangi Pihema-Brown received
her Asthma Foundation Achievers’ Award –
just two months later she was learning to
walk again after she had a life threatening
asthma attack. The story has a happy ending
with Tomairangi fighting back and competing
at the Waka Ama Nationals in January.
Her mum Sharon says Waka Ama has given
Tomairangi a focus. “It’s been her goal to
get here to Nationals. We’ve had to take it
week by week because some days she’ll be in
hospital and miss out on training and then the
next day back out on the boat.”
Swimming legends relay
Tomairangi you are still an inspiration to us all.
Professor Tom O’Donnell CBE
Our superstar swimming legends raised $2,700 to support people with respiratory conditions
– a very big thank you once again to Steven Kent, Sam Caradus, John Gatfield and 97-year-old
Kath Johnstone.
Tom O’Donnell was well known as a courteous gentleman
who made a major contribution to medicine, science and the
community. He cared greatly for his patients and trainees as
dean of the Wellington Medical School and as a consultant
physician at the Wellington Hospital Board.
Tomairangi (second from left in white shirt)
paddling in the Intermediate Women’s W12
500m
Best of luck to Nicole
Doriguzzi who has
headed off to Chile
for two months as
a volunteer helping
abandoned dogs.
This is all the more
impressive as Nicole, an
animal lover, has cystic
fibrosis and cannot get travel insurance while
she is away. Before Nicole departs she will
get two weeks of intravenous antibiotics to
clear her lungs.
“I’m not afraid,” Nicole says, “as someone has
to help and I will be making a difference.”
You certainly will, Nicole. Well done!
Tom was a specialist in respiratory medicine. He became
president of the New Zealand Asthma Society in 1973.
Tom’s immediate goals were to encourage research on the
management of asthma, and establish a strong network of
societies to apply the results through education programmes.
He remained president until 1984 and chaired the Medical
Advisory Committee from 1973 to 1987.
Tom was a member of the Asthma Task Force and edited two reports outlining current statistics and
information on asthma in 1984 and 1987. The 1987 review highlighted the economic burden to the
community of badly controlled asthma and resulted in government funding of asthma management
plans as part of the solution. In 1991 he was elected president of the Asthma Foundation, a position
he held until 1994.
On behalf of the Foundation, Tom issued the first of many forceful statements condemning tobacco
manufacturers who claimed smoking was harmless.
We were very honoured that Tom was a champion of the Asthma Foundation for so many years. He
was made a life member of the Foundation and awarded a CBE in 1989.
Prime Minister’s Science Prize winner
Our warmest congratulations to Professor Philippa Howden-Chapman from the University of Otago
who won the Prime Minister’s Science Prize for the He Kainga Oranga/Housing and Health Research
Programme. “I wanted to provide evidence to support the premise that everyone should have the
right to warm, dry, safe housing regardless of whether they own or rent,” says Professor HowdenChapman.
04
Your Health
What is the connection between
our homes and our health?
Quite a lot is the answer.
Living in a dry, warm environment is good for everyone. For people
with poor respiratory health it is especially important. Being aware and
taking a few simple steps – keeping moisture to a minimum, keeping
heat in and keeping the air clean – can help ensure your home is a
healthy place to live.
Tips for a dry, warm,
pollution-free home
Many houses in New Zealand are damp and cold, leading to more colds
and flu and aggravating respiratory health. A dry, warm and pollutionfree home can make you healthier and save you money and energy.
Have a dry home by keeping moisture to a minimum
Damp homes are more difficult to heat so it is important to try to
identify the causes of the dampness and correct them. If a home is
insulated, ventilated and adequately heated yet dampness and mould
growth continue, it is likely that moisture is coming from damp ground
beneath the floor, from rainwater leaking into the home, or from leaks
in plumbing.
The cheapest and most effective method to ventilate your home
is to have windows open a small amount for long periods of time
(security concerns can be addressed through fitting security stays or
fitting aluminium windows with passive ventilation and condensation
channels). Other actions you can take include:
Have a warm home by keeping heat in
The World Health Organization recommends a minimum internal
temperature of 18°C. Below 16°C there is an increased risk of respiratory
disease, so keeping your home warm will help keep you healthy. Tips
for keeping heat in include:
• have well-fitting curtains to reduce heat loss at night and keep in the
heat gained from the sun during the day
• use a healthy form of heating such as a flued gas heater, heat pump,
or pellet or wood burner
• insulate your ceiling and under the floor to keep heat in and heating
costs down – 40% of heat can be lost through an uninsulated ceiling
and 10% of heat lost through the floor
• install double glazing to halve the heat loss through single glazed
windows.
Have a pollution-free home by keeping the air clean
• put lids on pots when cooking
• dry your clothes outside
• vent your clothes dryer to the outside of your house
• use extractor fans or open windows in the kitchen and bathroom to
remove moisture
• remove mould using very diluted household bleach
• check for water leaks from guttering, plumbing etc, and have them
repaired if they occur
The biggest thing you can do to make your home pollution-free is to
not smoke inside, especially around children. Approximately three
quarters of people with asthma become wheezy in a smoky room.
Other actions you can take include:
• let your family and friends know that your home is smokefree
• use an electric or flued gas heater rather than an unflued gas heater
• air your house on fine days
• ensure there is adequate drainage around your house
• limit the use of strong-smelling cleaners, air fresheners and flysprays
• place black plastic on the ground under your house to keep the
moisture in the ground and your house drier and easier to heat
• keep dust to a minimum – dust with a damp cloth and vacuum
regularly (use a vacuum cleaner with a HEPA* filter) to reduce house
dust mites (a common asthma allergy trigger)
• install an in-roof ventilation system to reduce condensation
• consider installing double glazing if you are building or replacing
windows.
• consider hard floors and rugs, ideally with underfloor insulation,
instead of fitted carpets.
* HEPA = high energy particulate air
05
Your Health
COPD – Making life easier
• when you get out of the shower, put on an absorbent robe rather
than using your energy to towel-dry yourself
• try to do most of your jobs at times when your energy levels are
highest
• meals on wheels are a convenient alternative to preparing meals
• use a grocery trundler or a bag on wheels to avoid carrying heavy
items
• ask your supermarket if they provide a home delivery service.
Ask for help when you need it
Be realistic about what you can and can’t do. It’s important to have
people around to help you with tasks that become too difficult for you
to perform. Don’t be afraid to ask.
Plan your day
Spend a little time each morning organising your day so there are
periods of planned rest between activities that are more strenuous.
Make your home as efficient as possible
Chronic obstructive pulmonary disease (COPD)
affects your breathing and can make it harder to
enjoy everyday activities. Taking steps to make
your everyday life easier can help control your
shortness of breath, tiredness and other common
COPD symptoms.
Here are some ideas that may help:
Sign up to pulmonary rehabilitation
Pulmonary rehabilitation can improve your quality of life, your
breathlessness and your strength. It consists of exercise, nutritional
education and training to help you learn to live with COPD and stay
active and functional. Ask your doctor or local hospital for more
information.
Become attuned to your body and listen to
what it needs
Even though pulmonary rehabilitation is important, if your COPD
symptoms flare up, take a break and just continue with milder exercises
and your daily living activities.
Practice breathing control
Keep things you use in the area where you use them, e.g. keep
dishtowels by the sink and your shoes by the back door to save energy
by reducing the distance you walk.
Manage anxiety
Anxiety is common in people with COPD, and it can sometimes spiral
out of control. This can lead to shortness of breath, which leads to
more anxiety, which leads to more shortness of breath, and so on. Try
activities that relax you, such as listening to music, and practice your
breathing exercises when you feel anxiety creeping in.
Be prepared for an emergency
Keep inhalers, cell phones, important phone numbers and a list of your
medications close at hand, so you can quickly call for help if needed.
Visitors
Ask friends to avoid visiting if they have a cold, the flu, or any virus or
infection that could weaken your health. If visitors want to smoke,
make sure they do it outside your home and away from areas of
ventilation.
Your physiotherapist or nurse can teach you techniques such as pursedlip breathing and diaphragmatic breathing to help reduce shortness of
breath.
Develop a bedtime routine that encourages relaxation
and restful sleep
Find ways to make your everyday
activities easier to perform
To keep warm choose a duvet or quilt rather than heavy blankets. Have
a table and lamp beside your bed, and keep your inhaler, telephone and
important numbers close at hand.
For instance:
• place chairs strategically so you can sit and conserve energy when
showering, cooking or washing dishes
• keep frequently used objects within easy reach to avoid bending,
reaching or climbing
Being diagnosed with COPD will inevitably change your life. But by
taking some steps to make your day-to-day activities a little easier, you
can avoid some of the frustration and discomfort that often comes
after a COPD diagnosis and continue to enjoy time with your family and
friends.
06
Regional News
News from Asthma Hawke’s Bay
Asthma Hawke’s Bay has
0800 dial up…
Asthma Hawke’s Bay is on a mission to improve the respiratory health
and access to services for the community. The idea of making it
easier to communicate with the team came from a discussion on how
to make it simpler for people to engage with our services. An 0800
toll free number has been introduced, which can be used to book
appointments or speak directly to a respiratory nurse. Having the 0800
number means you don’t need a landline or credit on a mobile to get
hold of the team.
Text messaging is also a popular way of staying connected. Currently
text reminders are sent out when mobile nurses visit clients. Monthly
clinics are held in Wairoa and Waipukurau, ensuring services are
reaching those who need them.
For emergencies or difficulties with breathing
please call 111 for an ambulance.
2014 Hawke’s Bay Health Awards
– Commitment to Quality Award
presented to the Respiratory Pilot
Programme
In July 2013 Health Hawke’s Bay in partnership with HBDHB and Asthma
Hawke’s Bay commenced a Respiratory Pilot Programme. The focus
on asthma and COPD aimed to improve the respiratory health and
wellbeing of our community by delivering quality respiratory services.
This involved working together across different health agencies to
improve access and provide workforce development and continued
support. Working collaboratively has strengthened relations between
services and improved service delivery, which contribute towards
achieving our goals.
Maraea, Angela and Matiaha Tuavera
Tuavera family in control of
managing their asthma
Maraea Tuavera (12) of Flaxmere, Hastings was spotted two years ago
during her swim class and invited to join the Heretaunga Sun Devils Swim
Club. The Tuavera’s lounge is now adorned with trophies and medals. But
perhaps the best reward is the fact that Maraea’s asthma is now well under
control, something her mum Angela Tuavera attributes to swimming.
One of five children in the busy Tuavera household, Maraea started
suffering from asthma when she was two years old. “Rushing into the
Emergency Department for the first time, seeing them test her oxygen
levels and being told we ‘just made it’ made me think ‘Whoa, this is
scary,’” explains Mrs Tuavera. This helped the family understand how
serious asthma is and to recognise the symptoms in others. Due to her
experience with Maraea, by the time Matiaha (3) came along, Mrs Tuavera
recognised the tell-tale signs as her baby suffered from frequent bouts
of bronchiolitis resulting in trips to the hospital and rounds of Redipred
(steroidal medication).
In the case of both Maraea and Matiaha the family have found Asthma
Hawke’s Bay’s advice invaluable; especially education about ‘what to do
and what not to do’ when it comes to asthma. “They give you reassurance
that you’re doing the right thing, which is really important for a parent,”
adds Mrs Tuavera. On their last visit, Maraea qualified for an Asthma
Hawke’s Bay swim subsidy, an incentive to help asthmatics stay active
through swimming by reducing costs to the family. Research has shown
that many asthmatics experience an improvement in asthma symptoms
from swimming or exercise.
For any family living with asthma, staying out of hospital is a priority.
“In Hawke’s Bay every year twice as many Ma¯ ori and Pacific children are
hospitalised due to asthma or wheezing, as European children,” states Dr
Russell Wills, paediatrician and children’s commissioner.
Alistair Mackie MD BAND (sponsor), Sue Ward, Trish Freer, Jo Aston,
Carole Donnelly, Chris Davidson, Julie Shaw, Chris Trow and Alinka Julian
from Asthma Hawke’s Bay
Asthma Hawke’s Bay clinical nursing manager Jo Smiley says, “If you are
in the Hawke’s Bay region we can help support you to manage and gain
better control of your asthma or any other respiratory condition. Anyone
can self-refer into the free service and we can now be contacted for free
from any landline or cell phone. You don’t have to have credit and our
nurses can come to you.”
07
Regional News
Ask a nurse – your questions answered
This month’s questions and answers are from the team at Asthma Hawke’s Bay
My son is on puffers (the blue one and
the orange one) and seems ok with using
the inhalers without the spacer. He likes
to be independent and wants to do his
inhalers on his own. He is six. Should he be using
the spacer or is he ok using the inhaler without the
spacer?
Q
Q
A
A
A spacer should be used at all times with a puffer. A
spacer is a plastic tube with a one-way valve. An inhaler
(a metered dose inhaler or ‘puffer’) is attached to one end.
The other end has a mouth-piece for the user to
breathe through. After the inhaler has been shaken, then press the
medication into the spacer and it is breathed into the lungs of the
user. Without a spacer the medication is administered directly into
the mouth and can land on the tongue, the roof of the mouth
or even out the sides of the mouth, allowing only a small
amount of medicine to enter the lungs. It has been
shown that up to 70% more medicine enters the
lungs using a spacer.
Some other advantages of using a
spacer include:
• it’s easier to co-ordinate with the hands and
breathing
• if the user is particularly breathless, using a
spacer means the breath does not need to be
deep in order to get the benefit of the medicine
• the residue of some inhalers can cause thrush on
the tongue, a sore throat and/or a husky voice. Using
a spacer means there is less residue from the medicine in the
mouth thereby reducing these side effects.
When your son uses the orange inhaler he should brush his teeth or
rinse his mouth afterwards to help get rid of any residue, even when
using the spacer, to make doubly sure he does not develop any of the
side effects noted above.
It’s great that your child wants to take his inhalers, but he will still need
some supervision to ensure that his technique and the number of puffs
is correct. Always remember to use the inhalers as prescribed and to
follow his asthma management plan.
My children are always sick with colds
and runny noses and it makes their
asthma worse. Our house is really cold
in the winter and we are all sleeping
in the lounge to keep warm. There’s mould in the
children’s bedroom and the windows are always wet.
Is there anything I can do to help my kids?
When asthma symptoms occur ensure you follow your
asthma management plan to avoid deterioration, and
always seek medical help if you become concerned.
Some houses in New Zealand are now considered unhealthy – they are
cold with inside temperatures of less than 18°C. Because of the cool,
humid conditions often found in our houses, the cold and damp can
lead to respiratory problems – particularly in young and old people
and those with severe health conditions. The main reasons
for unhealthy homes are a low inside temperature,
dampness including condensation, mould and
mildew, the use of unflued gas heaters, no curtains
and overcrowding.
Mould and mildew are directly related to the
moisture in the house and can have an effect
on eyes, nose, throat and lungs. These side
effects may appear as hayfever with sneezing,
runny nose, red/itchy eyes and skin rashes.
You can read more about how to make your
home warm and dry on page 4.
Having a warm, dry, smokefree home will mean that
your children have less respiratory infections and will
be healthier overall.
08
For Health Professionals
New resources to help educate
the Wairarapa and on Petone Beach, Wellington. It is aimed at children
aged 4–6 years and will be available for order online. It will also be
distributed to all schools and libraries.
The Asthma Foundation would like to thank Carolyn for her hard work
and commitment to raising the awareness of asthma.
Your lungs
YOUR
BREATHING
SYSTEM
Right lung
Left lung
YOUR LUNGS
ARE HERE
Diaphragm
My brother has
asthma
Oscar is a bear who
has asthma. His sister
would like him to play
but his asthma won’t let
him. After a visit to the
doctor Oscar is given an
inhaler and shown how to
use it. This makes him feel
much better and allows him to
run and play just like his sister.
Children can find it hard to understand what asthma is, why
they may have to take medicine and why they are different to
other children. Siblings also cannot understand why a brother or
sister with asthma is treated differently. Adults can often find it
challenging to give an explanation.
Oscar is a lovable character who clearly explains many of the issues
around asthma, such as triggers, visits to the doctor and inhalers, and
encourages discussion about asthma between children and grownups.
Carolyn Collis is a well-known children’s author who produces books
for her Summer Rose Books series and has produced this book for
free for the Asthma Foundation. The book is illustrated beautifully
with bright colourful photographs of Oscar and his family taken in
Breathing tube
breathing tubes
end with tiny air sacs
called alveoli
1mm in
diameter
This is a question our respiratory nurses often get asked as many of
us are unsure exactly where our lungs are. The newly designed poster
helps to visualise where the lungs are and what
they look like in the body. Understanding how the
lungs work and what is happening to the breathing
tubes when they get asthma or COPD helps
patients understand and recognise how their
different inhalers work and reinforces why they
ASTHMA
should be taken as prescribed.
AND KING
SMO
The poster comes in two sizes, A3 for hanging on
the wall and A4 for education purposes.
ciety
d
mix!
asthma don’t
Smoking and
by many things
be triggered
Asthma can
its 4000
smoke, with
and cigarette
trigger.
cals, is a major
harmful chemi
e an
profit
nesses.
The posters and a new smoking brochure are
available for ordering online from the Asthma
Foundation website. Partners of the Asthma Foundation receive a 20%
discount on resource prices.
etter
015 - ASTH24
09
Ma¯ori
Wha¯nau Ora Healthy Housing and
Budgeting Cookbook
The Tu Kotahi Ma¯ori
Asthma Trust in Lower Hutt
provides innovative services
and develops resources
for wha¯nau with COPD,
asthma, bronchiectasis and
bronchiolitis. Their focus is on
reducing inequalities for Ma¯ori
and improving their health to
where it needs to be.
In response to a request
by the Hutt Valley District
Health Board’s Ma¯ori Health
Service Development Group,
the team at Tu Kotahi
developed a resource
targeting respiratory health
for tamariki and kaumatua
using the wha¯nau ora model. The resource has been distributed via
community health workers, parenting programmes, tamariki ora and
kaumatua programmes in the Hutt Valley.
Hauora – Wha¯nau ora, asthma and respiratory
information for wha¯nau
Hauora covers very basic information on asthma, bronchiolitis, COPD
and much more. It came about after focus groups with tamariki, their
parents and kaumatua highlighted the need for a resource they could
keep referring to, something they could value and store safely rather
than a pamphlet that could easily get lost. They also came up with ideas
of what they wanted to include in the resource. Hauora covers a variety
of topics: flu injections, kutu, healthy skin, being sunsmart, eczema and
scabies as well as being smokefree, the financial and health benefits of
quitting, and second-hand smoke.
Please contact Cheryl Davies for more information cheryl.tukotahi@
kokiri-hauora.org.nz.
The resource is packaged as three books:
Kai Reka – A budget friendly cookbook for the
Koro Tom’s Re¯wena Bug Recipe
whole wha¯nau
Ingredients
Kai Reka was developed in response to Tu Kotahi seeing wha¯nau who
didn’t have the luxury of lots of food in the cupboard, hadn’t learnt the
skill of making something from the food that is available, nor learnt how
to budget to buy enough kai for meals through the week.
Eating well is part of the Wha¯nau Ora model of care. Many older
wha¯nau have co-morbidities, such as diabetes, so it is important they
are supported with healthy eating options and encouraged not to buy
takeaways.
Lynda Ryan, Tu Kotahi training coordinator says, “Wha¯nau love the
recipes, and tamariki are picking them up because there are foods they
like that they can cook for Mum and Dad.”
Wa¯ Ka¯inga – A healthy housing book for the
whole wha¯nau
Tu Kotahi have been heavily involved in housing projects with wha¯nau
in the Hutt Valley for many years. Education is a big component of
healthy housing as a lot of the skill of keeping your home warm and dry,
such as airing out your home, has been lost. Many wha¯nau also face
issues around budgeting while living in social housing or private rentals.
Wa¯ Ka¯inga educates wha¯nau on the benefits of a warm dry home and
includes information on such topics as dampness, insulation and energy
efficiency as well as heating, lighting and dustmites. It also covers home
safety such as first aid, fire safety, disaster evacuation plans and storing
water.
2 cups para¯oa/flour
2 tsp huka/sugar
1 cooked rìwai/potato (mash in cooled cooking water)
Method – Step 1: Peel and cut the potato into small pieces. Place in a
pot with 1 cup of water and the lid on. Simmer to a mashing consistency.
Mash the potato, cool and when luke warm add the sugar and flour. Mix
to a firm texture. Cover and place in a warm place for 24–48 hours to
ferment. The mixture should smell yeasty and sweet.
Step 2: After 24–48 hours, set aside 1 tablespoon of the dough and put
into a large jar. Cover and keep in a warm place. Feed one day with ½
cup of warm potato water and the next day with 1 teaspoon of sugar.
This is your ‘bug’ or the base for making future loaves of re¯wena. Skip
this step if you only want to make one loaf.
Koro Tom’s Para¯oa Re¯wena
This mixture is enough for a large loaf tin or a very small umu.
Ingredients
5 cups of high grade para¯oa/flour
¼ tsp tote/salt
2 tbsp huka/sugar
hua re¯wana/re¯wena bug
tepid wai/water
Method – Mix flour, salt and sugar. Pour in re¯wena from step 1 and mix.
Add more water if necessary. Knead for 10 minutes and put in a greased
dish and set in a warm place to rise. Place in a cold oven and bake at
150-180°C for 1 hour. This allows the bread to rise a bit more as the oven
temperature rises.
Medical Director’s Message
10
Smokefree Aotearoa - what can you do?
Dr Kyle Perrin
Medical Director
In March 2011 the New Zealand Government
committed to a goal of New Zealand becoming
smokefree by 2025. This news was welcomed by
the tobacco control sector as a real step forward in
the fight to rid our communities of the harms of
smoking. A smokefree Aotearoa does not mean a
ban on smoking, but it does mean that our children
and grandchildren will be free from exposure
to tobacco, the smoking prevalence across all
populations will be less than 5%, and that tobacco
will be much more difficult to sell and supply.
However, 2025 is fast approaching. Some in the tobacco control
sector are concerned that the drive and impetus to achieve the 2025
target has started to wane, in particular following the departure
of Dame Tariana Turia from Parliament. While there are many hard
working advocates in the community and grassroots efforts going on
in the smoking cessation area, it is generally agreed that more needs
to be done. Bold policy steps are necessary, and this will require
government to pass important legislation in the face of the wealthy
and aggressive tobacco industry with well-funded lobby groups.
5. Registration and monitoring of all tobacco retailers. It seems crazy
that you need a licence to sell alcohol in New Zealand but anyone can
sell tobacco wherever and whenever they like. A retail registry would
allow the ministry to revoke a licence if a retailer breaches the terms
of sale such as selling tobacco to minors.
It is up to all of us who are passionate about asthma and respiratory disease
to advocate and lobby for these changes. Write to the Minister of Health
and to your local MP. As a respiratory physician I am looking forward to the
day when COPD and lung cancer are considered rare diseases.
Examples of important legislative changes include:
1. Plain packaging for cigarettes. Cigarette packets are the last
remaining place that tobacco companies can advertise their brand,
and this is the reason they are fighting so hard against this proposal.
They spend large amounts of money making their branding as
attractive as possible. They are well aware they need to appeal
to children and young adults to increase the rate of new smokers
becoming addicted.
2. Significant year-on-year increases in tobacco tax. Increasing the
cost of smoking is by far the most effective way of reducing
overall consumption. It is well known that many smokers are price
sensitive, and many will cut down or quit as the costs go up.
3. Increasing the funding for, and access to, smoking cessation services.
In New Zealand, Quitline is one of the most successful smoking
cessation services in the world. But more people need to be able to
access it. We cannot make tobacco more expensive and harder to
obtain without helping those who are addicted to it.
4. Extending smokefree areas. Many ex-smokers say that a significant
factor in their decision to quit was how inconvenient it now is to
find a place to smoke. We need more smokefree spaces, including
a ban on smoking in cars carrying children, and more smokefree
outdoor public areas.
The Asthma Foundation is partnering with Asthma
Australia for their biennial conference. Partners of the
Foundation will receive a reduced rate. Please contact
Teresa Demetriou for further information Teresa@
asthmafoundation.org.nz or visit their website.
11
Research
Latest research
Asthma rife among elite athletes
In fact, the figures can seem astonishing. John Dickinson from Kent
University, a world expert on asthma in sport, who has tested all 33
UK-based swimmers from the British Swimming squad, found 70% have
some form of asthma. The result of athletes getting to grips with asthma
is that asthmatic children are increasingly being encouraged to exercise.
“We know that children with asthma are often excluded from sport, not
by the school but by their parents,” said Deborah Waddell, lead clinical
adviser for Asthma UK. “We advise people to take the right type of
exercise for them.”
http://www.theguardian.com/society/2014/dec/28/asthma-eliteathletes-study-swimmers-cyclist-eid
New inhaler makes major improvements in asthma management
The theme song to The Simpsons has helped dramatically improve the
lives of asthmatic children, a ground-breaking New Zealand study shows.
An Auckland University study, published in The Lancet Respiratory
Medical Journal, shows that by adding a jingle and visual reminder,
researchers were able to make asthmatic children nearly three times
more likely to remember to use their inhalers.
The study followed 220 Kiwi children aged between 6 and 15 who had all
turned up in hospital emergency departments after an asthmatic episode.
The children were all given a preventative asthma inhaler, designed by
Kiwi health firm Nexus6, which plays one of 14 different ringtones to
remind them to take their dose. They could also check a display on the
side, showing when they had taken their last dose.
Using the inhaler with the ringtone led to less use of emergency medical
help, less coughing and wheezing, and overall improved quality of life,
the study found.
Professor Innes Asher, paediatric asthma specialist and member of the
Asthma Foundation’s Expert Advisory Group, said while the results are
impressive, it must be made readily available. If we’re going to use this
tool to increase reliability we’ve got to make it affordable for families,
and that’s an issue for Pharmac.
http://www.thelancet.com/journals/lanres/article/PIIS22132600%2815%2900008-9/abstract
If you don’t want your child to
smoke then stop smoking yourself
The more a parent smokes in front of their children, the more likely those
children are to become heavy smokers themselves, a new study finds. Dr
Darren Mays and his colleagues from Georgetown University interviewed
more than 400 children aged 12 to 17 several times over a five-year
period.
It’s clear that smoking addiction can be inherited, but the new study
shows there’s more than just a genetic effect. The more time children
spend seeing their parents smoke, the more they’ll smoke themselves.
http://www.georgetown.edu/research/news/parents-smokingbehavior-study.html
Work-related asthma undiagnosed
Only 15% of working adults with asthma discuss with their doctor how
their jobs might affect their breathing, even though nearly half have
asthma that is possibly work-related, according to a study published in
the February issue of the Annals of Allergy, Asthma & Immunology.
The researchers also found that doctors often don’t bring up the topic
with patients.
“Work-related asthma is under-diagnosed and under-recognised,” said
lead author Jacek Mazurek. “A thorough occupational history is critical
to first establishing a diagnosis of work-related asthma, and then
putting measures in place to prevent further exposure, or to treat it.
Unfortunately, many people may believe that nothing can be done, or
may worry about losing their jobs, so are reluctant to address the topic
with their doctor.”
Early testing is recommended. Once workplace-related asthma develops,
continued exposure to workplace-related asthma triggers can lead
to permanent lung problems, and the risk can increase the longer the
exposure continues.
http://www.doctorslounge.com/index.php/news/pb/52800
Positive link between a healthy diet
and a reduced risk of developing
COPD
Smoking is the primary cause of COPD accounting for 80–90% of all
cases. For the remaining 10–20%, it is believed exposure to air pollution,
second-hand smoke and genetic factors are involved. But in a new study
published in The British Medical Journal, researchers suggest an unhealthy
diet could be a contributing factor.
The researchers used the Alternate Healthy Eating Index 2010 (AHEI2010) to measure the participants’ diet quality. A higher AHEI-2010 score
represents a healthy diet with a high intake of vegetables, whole grains,
polyunsaturated fats, nuts and omega-3 fatty acids, a low intake of red
and processed meats, refined grains and sugary drinks, and moderate
alcohol consumption.
The team assessed the effects of diet on the risk of COPD among 73,228
women who took part in the Nurses’ Health Study from 1984 to 2000,
and 47,026 men who took part in the Health Professionals Follow-Up
Study from 1986 to 1998. During the follow-up of both studies, there
were 167 new cases of COPD diagnosed in men and 723 new cases
diagnosed in women.
The researchers found that participants with the highest AHEI-2010
scores were a third less likely to develop COPD, compared with
participants with the lowest scores, suggesting a healthy diet may reduce
the risk of developing COPD.
http://press.psprings.co.uk/bmj/february/COPD.pdf
12
Advocacy
Development of a National
Respiratory Strategy
Teresa Chalecki, Dr Api Talemaitoga, Dr Kyle Perrin, Angela Francis, Teresa Demetriou, Associate Professor Jim Reid, Betty Poot, Professor Richard
Beasley, seated Kathy Lys, Dr Tristram Ingham, Professor Innes Asher
The Asthma Foundation’s Expert Advisory Group members are all
international and national experts in their fields giving their time freely
to progress the development of a National Respiratory Strategy. The
Asthma Foundation was the successful recipient of a grant through the
Community Internship Programme jointly funded by the Department of
Internal Affairs and the Ministry of Health. Kathy Lys has been seconded
from the Ministry of Health to lead the project over the next ten
months.
The purpose of the National Respiratory Strategy is to:
• drive and inform best practice to improve respiratory health
• secure respiratory health as a national health priority
• provide support and information to health providers, families, carers,
and people living with respiratory conditions
• raise visibility of the need for effective prevention strategies
• present a set of recommendations over a defined timeframe for action
by policy makers, planners, funders, and service providers.
A 10-year celebration of clean air
Who can remember when going out to a bar meant walking into a cloud
of smoke and having to put your clothes outside when you arrived
home because the smell of smoke was so overpowering? It was 10 years
ago that the smokefree bars legislation came into effect, and going out
didn’t mean that our clothes, our hair and our lungs returned home
worse for wear.
In association with the Cancer Society and the Smokefree Coalition we
were proud to celebrate the bravery of many in pushing this unpopular
legislation, the Smoke-free Environments Amendment Act 2003,
through 10 years ago. Minister Sam Lotu-Iiga said, “This anniversary
is a good time to reflect on how far we have come. Research shows
support for the legislation increased from 38% in 2001 to 95% in 2006.”
Introduction of the legislation was associated with reductions
in: second-hand smoke exposure, smoking prevalence, tobacco
consumption and youth smoking rates; and an increase in the number
of smokefree homes in New Zealand. Ultimately, the Smokefree
Environments Amendment Act 2003 saw New Zealand become a
world leader in tobacco control, provided a plan for further policy
development in this area, and, above all improved the health and
wellbeing of New Zealanders.
The Minister said, “Our goal now is to achieve a Smokefree New Zealand
by 2025. This goal is a challenge, but one that can be realistically
achieved with continued and additional efforts on a range of tobacco
control fronts.”
Angela Francis with Associate Health Minister Peseta Sam Lotu-Iiga
13
Events
Dance 4 Asthma – It’s time to dance
Our free dance video competition for schools –
primary, intermediate and secondary – is back.
Video entries are due on 18 June and results will
be announced one week later.
What is Dance 4 Asthma?
It is an awareness raising competition – there is no money involved
– it is all about the kids having fun and moving around. Check out
the entries from 2014 on our website under News and Events/
Dance 4 Asthma 2014.
We all want
our kids to be
confident, healthy
and participating
fully at school.
Dance 4 Asthma
raises the profile
of asthma to all
children in a fun
and positive way
– because we all
know that talking
about it can make
it OK.
The feedback from 2014 says it all
World Asthma Day
Tuesday 5 May 2015
Jane Bassett from Havelock North Intermediate said, “It was a fun
opportunity for students to create, dance, film and edit a dance
video as a team.”
Keep an eye out World Asthma Day activities - especially those with our
friend Sailor the Puffer Fish.
Tash Osborne from Hamilton East School said, “I wanted the kids in
my class to be aware of how it feels to have asthma, especially since
we have a few kids with asthma in the class.”
What’s new this year?
New Song
Choreograph your dance video to New Zealand’s own Cameron
Rota singing ‘One of a Kind’.
New Judges
We’ve recruited some professional choreographers and dancers
– including Kyra Aoake from world hip-hop champions the Royal
Family – to join our judging panel.
New Criteria
We’ll provide criteria to help you work out how much effort to put
into the various parts of your video.
We’ll be posting videos from all registered schools on our dedicated
Dance 4 Asthma Facebook page! Let us know that you want to take
part.
Send an email to cindy@asthmafoundation.org.nz and put 18 June in
your diary.
You can control your asthma
World Asthma Day, on Tuesday 5 May, is an annual event organised by
the Global Initiative for Asthma (GINA) to improve asthma awareness
and treatment around the world. Asthma affects approximately 235
million people and causes an estimated 250,000 deaths annually
worldwide.
Dr Kyle Perrin, medical director for the Asthma Foundation says, “In
New Zealand one in nine adults and one in seven children aged under
16 years takes asthma medication (over 460,000 Kiwis in 2006). For
good asthma control it is important to keep using your medication as
prescribed, to visit your health professional regularly, and to get an
asthma management plan.” Asthma management plans should be filled
out with your health professional. They are designed to help manage
your asthma and recognise when it is deteriorating before it gets to an
emergency situation.
14
Fundraising and other events
Epic cycle adventure begins
Two years ago Adam Glover completed a 32,000 km
journey cycling from London to New Zealand. Even
before he finished that adventure, he knew what his
next challenge was going to be – cycling 40,000 km
from Alaska to Argentina over two years to raise
money for the Asthma Foundation.
He will leave from Alaska and cycle through Canada, America, Mexico,
Guatemala, Honduras, Nicaragua, Costa Rica, Panama, Colombia,
Ecuador, Bolivia, Peru, Chile and finally Argentina.
Adam started his epic fundraising journey on 14 March this year sailing
on a container ship from Auckland to Philadelphia. He will then cycle
across the USA and Canada to Alaska.
Adam says, “Asthma is not a high profile charity – a charity that not too
many people think twice about. But it is a charity that is important to
me because I have had to live with asthma all my life.”
You can follow Adam’s adventure on his Facebook page www.facebook.
com/pages/Adam-Glover-Cycling-2015-Alaska-to-Argentina-2011London-to-New-Zealand. You can support Adam online at www.
fundraiseonline.co.nz/AdamGloverCycling/
Teresa Demetriou and Phil Burt at Government House
Waitangi Day Bledisloe
Reception at Government House,
Wellington
On a beautiful hot summer’s day, in a beautiful garden setting,
Phil Burt (national fundraising manager) and Teresa Demetriou
(national education services manager) represented the Asthma
Foundation at the Waitangi Day Bledisloe Reception in the grounds
of Government House, Wellington. The event was hosted by the
Asthma Foundation’s Patron, the Governor-General, Lt Gen The Rt
Hon Sir Jerry Mateparae.
Over 3,000 guests enjoyed oysters, strawberries, gelato, nibbles
and wine. Sol3 Mio sang the national anthem and the New Zealand
Army Band provided background music. What a wonderful way to
observe this truly important day in New Zealand’s history.
Sir Jerry Mateparae’s speech reflected on the progress in Treaty
settlements and the gains that have been made, and our positive
future.
Adam Glover with bike all packed ready to commence his epic ride
from his Wellington home
Te Matatini –National Kapa Haka
Festival 2015
The Asthma Foundation and
Canbreathe shared a stand at
Te Matatini in Christchurch to raise
awareness of respiratory health.
Henare Te Karu, who took part in the Wairarapa Ma¯ori Asthma project
in 1991, conducted the draw for the Earthwise prize pack. Here he is
with Jocelyn Smith, event coordinator for the Asthma Foundation and
Rosemary Thompson, Canbreathe respiratory nurse educator. And the
winner is...Evelyn Dickson from Tauranga - Congratulations.
Sir Jerry Mateparae said, “By the time of the bicentenary in 2040,
I like to think that my mokopuna will live in a New Zealand where
we can see the success of post-settlement enterprises reflected in
equally impressive social and economic indicators.”
TH
MA COUNC
IL
•
T
H
M
(N
Z)
•
AS
Healthy building for pre-school
15
RAL I A
NATION
®
ST
AL
AS
AU
Sensitive Choice®
A F
ON
O U N D AT I
SENSITIVE
CHOICE
New partner –
Beam New Zealand Ltd
Sensitive Choice is proud to
announce that the Beam Alliance
Central Vacuum system is now
Sensitive Choice approved.
Bishopdale Community Preschool in Christchurch is a not-for-profit
preschool run by volunteers and governed by parents. The preschool
existed in a council-owned building for 40 years. After the February
2011 earthquakes the building was shut down and for the last two and
a half years the preschool has been run out of a building at a local
intermediate school. The community have been working hard to
raise funds for a new building.
Sarah Straver, manager at the preschool says, “We have a high number
of children using preventers and emergency inhaler medication – in
winter it is around 30% of the children and in summer about 25%.
Because of this it is really important for us to consider the wellness
of children within the context of our build.”
In New Zealand generally one in seven children (about 14%) take
asthma medication.
During the course of getting quotes for the build the team at
Bishopdale Community Preschool met with a number of builders,
including Fusion Homes. The Fusion Homes buildings are Sensitive
Choice approved. “When Fusion Homes started to talk about healthy
buildings it became a natural partnership for us,” said Sarah.
“We’re excited to be building a preschool as we believe all children
deserve to have a warm, healthy environment with reduced asthma
triggers in which to learn and grow,” said Chris Haughey, director from
Fusion Homes Ltd. “Health, wellbeing and sustainability should be
the minimum standard for all buildings in New Zealand.”
Taniya Scott, the Sensitive Choice programme coordinator, says, “It
is so exciting to see this preschool build becoming a reality for these
children. It is heartening to see other Sensitive Choice® partners such
as Valspar New Zealand getting involved in this initiative.”
Beam Industries was the pioneer of domestic central vacuum systems
commencing in 1957 in the USA and are now being sold in over 52
countries around the world. The Beam Airflow™ ducting carries dirt, dust
and allergens away from living areas while the Gore-Tex™ HEPA standard
filtration removes 98.3% of contaminates at 0.3 microns creating a
cleaner, quieter, healthier home environment. What a great addition to
the approved product list.
www.beam.co.nz
Current partner –
Warm Up Radiant Floor Heating
From full design through to
installation, or working as part
of the electrical services team,
Warmup has the technical
expertise, installation manpower
and experience to deliver
practical heating solutions on
time and within budget. Warm Up Radiant Floor Heating is Sensitive
Choice approved and a great way to minimise draught, dampness and
condensation in your home.
www.warmup.co.nz
Have a product or service that is
asthma and allergy friendly?
Apply for Sensitive Choice approval. Contact Taniya Scott, business
development coordinator on 04-495 0099 or taniya@asthmafoundation.
org.nz and get involved.
Have you seen the blue butterfly?
Sensitive Choice is a community service focused programme for all of us who want to breathe purer,
cleaner, fresher air and reduce allergic reactions.
You’ll find the reassuring blue butterfly on hundreds of products – from bedding to building products, from
cleaning agents to carpets, from air purifiers and vacuum cleaners to the very paint you put on your walls.
Check out www.sensitivechoice.com or www.asthmafoundation.org.nz/sensitive-choice/ for more
information and approved products and services.
16
News
Important dates for 2015
Event
Date
Dance 4 Asthma
April – Videos in by Thursday 18
June
Tuesday 5 May
Sunday 31 May
Thursday 25 June
Monday–Sunday, 31 Aug–6 Sep
Friday 4 September
Thursday and Friday,
5–6 November
Wednesday 18 November
Entries in by Friday 18 December
World Asthma Day
World Smokefree Day
Key Partners’ Forum
Asthma Awareness Week
Balloon Day
NZ Respiratory Conference /
AGM
World COPD Day
Respiratory Health Media Awards
successful treatment and management. Such stories play a key role in
increasing awareness and support of respiratory management, treatment
and education.
There will be a $1,000 prize for each of the winners in five categories:
health sector media, print and online media, radio, television and social
media (all formats e.g. blogging).
Winners will be announced and presented with the prestigious awards at
a gala dinner in Wellington in February 2016.
Journalists, videographers, bloggers and health professionals are invited
to submit respiratory-related stories published or broadcast during 2015.
Entries close on Friday 18 December, 2015 at 5:00pm.
Criteria, a list of events and further information about the awards can be
found on our website www.asthmafoundation.org.nz/ or contact Cindy
Borrie, communications consultant on 0274 433 905.
World Smokefree Day – May 31
The theme for 2015 is It’s about wha¯nau
Wha¯nau is a driving force for many people wishing to protect others
from the harms of second-hand smoke. This is a common cause for all
people, cultures, communities and wha¯nau. The call to action is for
smokers and non-smokers to take control and stop exposing others to
second-hand smoke, especially children. Smoke is a major trigger for
many people with asthma and poor respiratory health.
Wainuiomata CORD Group celebrate
It has been 21 years since the Wainuiomata CORD group first started
providing support for those in the area. Congratulations on this fantastic
milestone.
World Smokefree Day also provides an opportunity to encourage and
help those who want to quit smoking and support friends and wha¯nau
on their journey to quit.
Respiratory Health Media Awards
The Respiratory Health Media Awards recognise the important role the
media play in respiratory education. Quality reporting helps to keep
respiratory issues top of mind in the community and reinforces the
fact that we need to continue to take respiratory health seriously.
Judges will be looking for winning stories that provide a balanced
and accurate report of respiratory issues, portray a realistic account
of what it is like to live with a respiratory condition and highlight
Ken Blay, Jennifer Roulston, Genevieve Young and Bede Mexted with the cake
Yes, I want to support better respiratory health for New Zealanders.
Please accept my donation of:
$40
$55
$75
$100
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$
Surprise us!
(Donations of $5.00 and
over are tax deductible.)
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EXP
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DINERS
SIGNATURE
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a bequest in my Will for the Asthma Foundation
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to the Asthma Foundation
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(details above)
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a monthly contribution through my bank
Phone 0900 4 ASTHMA (0900 4 278462) to make an automatic $20 donation
(Please return this slip with your
donation to: Freepost 140226,
The Asthma Foundation, PO Box 1459,
Wellington 6140.)