Treatment of breast cancer that is additional to treatment by surgery after complete clinical removal of disease (for example, use of radiotherapy). The aim of adjuvant treatment is to destroy any cancer that may have spread.
A university-trained professional who is specially qualified to measure hearing, diagnose and advise on the management of hearing disorders, and supply and fit hearing aids and other hearing devices to suit individual needs. The New Zealand Audiological Society is the professional body in New Zealand responsible for the clinical certification of audiologists.
The nerve that conveys information from the hearing organ in the inner ear to the central nervous system. It is part of the VIII cranial nerve (Vestibulocochlea nerve). The other part is in the vestibular nerve which comes from the vestibular or balance organs
The anatomical system that transfers energy from sound waves to neural activity for processing by the auditory centres in the brain. The auditory system consists of the outer ear, the middle ear, the inner ear, and the central auditory pathways
Autosomal recessive disorder
Each cell in our body carries two copies of each gene, one inherited from each parent. In all of us, there are "mutations" in a few of the genes. For a recessive gene mutation to result in a particular disorder, both copies of the gene must carry the mutation.
A tumour that is not malignant, which usually remains a uniform shape enclosed in a fibrous sac. It does not spread to other parts of the body, and usually does not recur after being removed. A benign tumour does not indicate cancer.
Biotinidase Deficiency (BIO)
Biotinidase Deficiency is an enzyme deficiency that occurs in about 1in 50,000 newborns and can result in seizures, hearing loss and death in severe cases. Treatment involves doses of biotin.
Blood spot card
When newborn babies are 48 hours old, a blood sample is taken from their heel. This is sometimes referred to as the heel prick test. Blood from the baby’s heel is dropped onto a special type of filter paper (previously called a Guthrie card) and stored as a series of blood spots. A number of screening tests are then carried out on these blood spots for the purposes of newborn screening. These tests are often called newborn metabolic screening to distinguish them from other types of newborn screening.
There are two main types of cervical cancer; squamous cell cancer and adenocarcinoma (or glandular cell cancer). Squamous cell cancer is the most common form of cervical cancer. It usually arises in the transformation zone of the cervix which is where the vagina meets the cervix. Adenocarcinoma is found in the glandular cells which line the inside of the cervix.
Cervical intraepithelial neoplasia (CIN)
Abnormal changes or growth in the skin layers of the cervix. These changes are not cancer, but could develop into cancer if not treated. CIN is graded as CIN 1, 2, or 3. CIN 3 means the most severe changes.
A high grade abnormality which has not yet become invasive. It is confined to the layer of cells (epithelium) of the cervix. It is a form of preinvasive cancer which may develop into invasive cancer if not treated. Also known as CIN-3.
Code of Health and Disability Services Consumers' Rights
The Code confers a number of rights on all consumers of health and disability services in New Zealand and places obligations on providers of those services. It covers all registered health professionals, such as doctors, nurses, dentists etc.
Colorectal or bowel cancer is a malignant (cancerous) growth that starts on the inside wall of the bowel. Colorectal cancer can develop in any part of the large bowel, including the colon and rectum.
An instrument that looks like a pair of binoculars on a stand. It has a light and magnifies the cervix so it can be examined more closely. A colposcope may have a camera attached, which allows a woman to see her cervix on a television screen.
Congenital Adrenal Hyperplasia (CAH)
CAH is caused by decreased or absent production of certain adrenal hormones. The most prevalent type is detected by newborn screening in about 1 in 20,000 newborns. Early detection can prevent death in boys and girls and sex mis-assignments in girls. Treatment involves lifelong hormone replacement therapy.
Congenital Hypothyroidism (CH)
CH is a disorder where a baby is born with a thyroid gland that does not work properly. A normal working thyroid gland is critical for normal growth and brain development. The thyroid can be completely absent or small and underdeveloped or not in the normal position in the neck. More rarely, CH is caused by the absence of an enzyme in the thyroid gland, preventing it from making thyroid hormone (thyroxine). The treatment is daily thyroxine.
Cystic Fibrosis (CF)
CF is a disorder in which the body's secretions, especially in the lungs and gut are much more sticky than usual. These thick secretions encourage infection in the lungs and abnormal secretions from the pancreas frequently make food digestion and absorption incomplete. CF is an autosomal recessive disorder.
Down syndrome is a genetic condition that causes delays in physical and intellectual development. It is relatively common, with a population incidence of about 1 in 1000 live births. Babies born with Down syndrome often have intellectual and growth impairment and a range of other possible medical complications.
For NCSP: the process of entering a woman's information and results on the NCSP Register. For BSA: When a woman gives her name or allows her name to be given to BreastScreen Aotearoa to begin the registration process. The registration process is when a woman has completed a registration form which includes informed consent for screening prior to having a mammogram.
A product of a gene that converts one chemical into another chemical. If an enzyme is defective, because of an inherited genetic anomaly, then there can be a build up to toxic levels or insufficient production in the chain of events.
Galactosaemia is an enzyme deficiency. It causes an accumulation in the blood of galactose, a sugar which is in milk. The enzyme deficiency prevents the galactose from being changed to another sugar, glucose. Galactose and other compounds accumulate and cause lethargy, vomiting, jaundice and sepsis. The treatment is a diet which completely excludes galactose.
A gene is the amount of hereditary material (sometimes called DNA) that is required to produce one protein. Some proteins control the metabolic processes in the cell, others control the function of other genes or form part of the cell structure. There are 30,000-50,000 genes in humans.
The term genetic testing is used to describe tests that reveal information about a person's genetic makeup. Sometimes the genes themselves are tested to determine the presence or absence of a change in gene structure. Newborn metabolic screening tests for the enzymes that result from a gene mutation. About 1% of samples have a test for a change in DNA (mutation) associated with cystic fibrosis, as part of routine screening. Absolutely no other DNA testing is done on samples unless authorised by the parents/guardians/individual or through legal avenues eg court order.
Health Information Privacy Code 1994
This code of practice applies specific rules to agencies in the health sector to better ensure the protection of individual privacy. The rules in the code are enforceable by complaining to the Privacy Commissioner and, if necessary, later to the Complaints Review Tribunal. The Code is available at the Privacy Commission's website.
Applies to those whose hearing is not within the normal range. It may be used to refer to those for whom the primary receptive channel of communication is, even with deficits, hearing.
- Mild: 26-40dB
- Moderate: 41-65dB
- Severe: 66-95dB
- Profound: greater than 95dB
High-grade abnormality (HSIL or high-grade squamous intraepithelial lesion)
The more serious cell changes in the cervix that may lead to cancer if not treated. The term 'high-grade abnormality' covers CIN 2 and CIN 3.
Independent monitoring group
(For NSCP) The role of the independent monitoring group is to collate, analyse, evaluate and prepare reports and provide recommendations concerning the performance of NCSP providers against National Indicators and associated targets.
Invasive cancer of the cervix
Condition where cancerous cells spread beyond the surface epithelium into the underlying tissues. It may be diagnosed by clinical examination with biopsy. Classified in four stages, from Stage I where the cance has not spread beyond the cervix, to Stage IV where it has extended beyond the pelvis.
A Maori term for protector, caretaker or trustee. Tha National Kaitiaki Group refers to the group set up under the Health (Cervical Screening (Kaitiaki)) Regulations 1995. The group's job is to oversee the disclosure, use and publication of Maori women's summary data held on the NCSP-Register.
Lead Maternity Carer
Person responsible for providing and co-ordinating a woman's maternity care, developing her care plan and attending labour and birth. A Lead Maternity Carer can be a midwife (independent or hospital based), a general practitioner, an obstetrician or a hospital team.
Low-grade abnormality (LSIL or low-grade squamous intraepithelial lesion)
Mild changes to the cells in the cervix. The term 'low-grade' abnormality includes abnormalities due to HPV changes and CIN 1. These changes need careful follow-up but may not need treatment.
A small collection of tissue along the lymphatic system which acts as a filter. Lymph nodes are found in the neck, the armpits, the groin and many other places. Lymph nodes are also know as glands.
A network of ducts throughout the body circulating fluid (lymph) that removes poisonous substances and resists disease. Some cancers can travel to other parts of the body along this system.
A cancer. A tumour that grows, invades surrounding tissue and infiltrates the blood and lymphatic vessels. It eventually destroys the surrounding tissue and may spread to other part of the body (metastasise).
Under local anaesthetic, a large needle is inserted in the area of abnormal-looking tissue. Some tissue is then gently vacuumed from the area for testing. This biopsy if often performed with the woman lying on her stomach on a table.
Maple Syrup Urine Disease (MSUD)
MSUD is a defect in the way that the body metabolizes certain amino acids and is present in about 1 in 250,000 newborns. Early detection and treatment with dietary restrictions can prevent death and severe mental retardation.
Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD)
Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD) is a rare hereditary disease that results from the lack of an enzyme required to convert fat to energy. Complications typically arise when the affected child has long periods between meals, requiring the body to use its own fat reserves to produce energy. When this action is blocked by the lack of the necessary enzyme, serious life threatening symptoms and even death can occur. MCADD causes no apparent symptoms at birth, but low blood sugar, seizures, brain damage, heart failure and serious illness can occur very quickly in infants who are not feeding well. Treatment for the disorder requires close monitoring of the child to determine "safe" time periods between meals and following a strict feeding schedule. With early detection and monitoring, and avoidance of fasts, children diagnosed with MCADD can lead normal lives particularly as "safe" time between meals expand as they grow older.
A collection of disorders caused by enzyme deficiencies. Metabolic disorders are often referred to as inborn errors of metabolism. These are permanent and inherited biochemical disorders. An inborn error of metabolism is caused by a lack of a functional enzyme, transmembrane transporter, or similar protein, which then results in a blockage of the corresponding metabolic pathway. Approximately half of all inborn errors of metabolism can be treated through diet or addition of supplements.
National Health Committee
Advises the Minister of Health on the kinds and relative priorities of public health services, personal health services and disability services that it believes should be publicly funded.
The National Indicators are measures used to provide comparative assessments of the performance of different components of the National Cervical Screening Programme in relation to targets.
Newborn hearing screening
Audiometric testing of the ability to hear in order to identify individuals who may benefit from intervention with the aim of minimising morbidity associated with hearing impairment.
Opportunistic screening programmes
Opportunistic screening happens when someone asks their doctor or health professional for a check or test, or a check or test is offered by a doctor or health professional. Unlike an organised screening programme, opportunistic screening may not be checked or monitored.
Organised screening programmes
Organised screening programmes have to be of a high standard, and the screening services are checked and monitored by people from outside the programme. With organised screening programmes, everyone who takes part is offered the same services, information and support. Often, large numbers of people are invited to take part in organised screening programmes. The National Screening Unit oversees national organised screening programmes.
Acute or chronic inflammation of the tissues lining the middle ear cavity. Fluid (effusion) is present with or without infection in the middle ear and may cause temporary hearing impairment, which can evolve into permenant impairment if there is erosion of the middle ear structures. Children with recurring episodes of otitis media may experience fluctuating hearing impairment and may be at risk for speech and language delays
Otoacoustic emissions (OAE)
Sounds that are produced by the healthy inner ear spontaneously or after sound stimulation. Various types of OAE are referred to as TEOAE, DPOAE and EOAE. The measurement of these sounds cab be used as an objective, passive audiological test that verifies cochlear activity. This test is often used in testing infants suspected of hearing impairment. A probe is placed in the ear canal for this measurement.
PKU is a condition in which the body is unable to break down one of the protein building blocks from food. These building blocks are called amino acids and one of them is phenylalanine. In PKU, the phenylalanine cannot be processed (metabolised) normally and builds up in the blood and tissues. The high phenylalanine level can prevent the brain from developing as it should. Progressive mental retardation results if the condition is not treated in early infancy. Treatment is a special low phenylalanine diet.
Population-based Screening Programmes
A population-based screening programme is one in which screening is systematically offered by invitation to a defined, identifiable population: this requries a means of identifying and offering the target population, for example through a population register
The registration process for BreastScreen Aotearoa is when a woman has completed a registration form which includes informed consent for screening prior to having a mammogram. This is different from enrolment which is when a woman gives her name or allows her name to be given to BreastScreen Aotearoa to begin the registration process.
A test which is carried out on people who do not have any symptoms but are at risk of a particular disease. It predicts the likelihood of someone having or developing a particular disease.
Sensitivity is a way of measuring how sensitive a test is to the condition being tested for and how good it is at finding the condition. When a test is very sensitive, it will pick up all cases of the disease. When a test is not very sensitive it will miss some of the cases. This means that a screening test which is not very sensitive will show that some people do not have the condition, when actually they do, but the test wasn't sensitive enough to pick them up. When people are told that they do not have a condition, when they in fact do, this is call a false-negative result. Tests that are not very sensitive produce more false-negative results.
A person who takes cervical smear tests for women. Nurses have to complete a recognised training course on cervical screening before they are able to take smears as part of the National Cervical Screening Programme.
Specificity is a way of measuring how good a test is at picking up only the people who have the condition. A test with poor specificity is one that isn't very specific and identifies people with the disease, but also some other people who don't have the disease. A screening test that is not very specific will have some results that show a person has an illness, when actually they don't. This kind of result is called a false-positive result. Tests which are not very specific produce more false positive results.
The area of the cervix where the squamous cells covering the outside of the cervix meet the glandular (columnar) cells which line the cervical canal. Most cervical abnormalities in the cells start at this junction.
A minimum requirement to measure a service against. Services that are funded by the National Cervical Screening Programme are monitored in accordance with standards set by the National Cervical Screening Programme.
Tandem Mass Spectrometer
A device that separates and quantifies chemicals based on their mass/charge ratio. A tandem mass spectrometer consists of two mass spectrometers separated by a reaction chamber or collision cell. It is capable of analysing any body fluid including extracts of blood spotted onto filter paper (blood spot card). The process of separation takes seconds. A computer then analyses these data. The newborn metabolic screening programme has been gifted a tandem mass spectrometer which will allow for improvements in the quality of the current disorders screened for.
The region of the cervix where the glandular (columnar) cells have changed or are changing to squamous cells. The process of changing from one cell type to another may become abnormal.
Vulval intraepithelial neoplasia (see intraepithelial neoplasia).