Advocating for the advocates, caring for the caregivers: physician health and wellbeing.
Authors: Muthu AH PMID: 31095539 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

How do intensivists treat their patients, their loved ones and themselves? Results of a survey of intensivists facing an evolving hypothetical clinical scenario.
CONCLUSIONS: The management that intensivists would advocate for patients differs from the management that they would advocate for their loved ones and themselves. PMID: 31095540 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Incidence of retinopathy of prematurity in Christchurch Hospital, New Zealand over a 10-year period.
CONCLUSION: The incidence of retinopathy of prematurity of any stage was 4.4% in at-risk premature neonates born in Christchurch Hospital over 10 years. 0.7% of all neonates screened required treatment. This represents an extremely low incidence of treatment requiring ROP, and of ROP in general. PMID: 31095541 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Analysis of presenting symptoms and diagnoses made at Middlemore Hospital: an audit carried out between Monday 1 August and Sunday 7 August 2016.
CONCLUSIONS: Numerous patients are diagnosed with mild conditions after work-up in the emergency department, however a broad diagnostic approach is required by junior clinicians given the possibility of more worrying diagnoses. An analysis of specific markers used by junior clinicians to aid differential diagnosis shows that not all signs and symptoms are required to make common diagnoses. For example, the absence of a documented fever, raised CRP or both, does not rule out significant infection in the case of pneumonia, urinary tract infection and cellulitis. This audit contributes to understanding the case-mix within the...
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Indoor allergen exposure in primary school classrooms in New Zealand.
CONCLUSIONS: House dust mite allergen levels were low in New Zealand classrooms while about a quarter of classrooms had cat allergen levels that may be associated with respiratory symptoms. PMID: 31095543 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Dispensing of medication for alcohol use disorder; an examination of large databases in a New Zealand context.
CONCLUSION: Overall rates of dispensing were relatively low. Antidepressants followed by quetiapine were the most common treatments. In contrast, disulfiram and naltrexone were only used for a minority of clients. This suggests inadequate and poorly targeted pharmacological treatments are used for the treatment of alcohol use disorders in New Zealand. PMID: 31095544 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Reducing days of alcohol use improves lifestyle and wellbeing: an analysis of outcomes data from New Zealand adult community alcohol and other drug services.
Authors: Lai J, Hanton P, Jury A, Tuason C Abstract AIMS: The study examined the impact of alcohol use on lifestyle and wellbeing among adults accessing New Zealand community alcohol and other drug (AOD) services, and practice implications. METHODS: Routinely collected Alcohol and Drug Outcome Measure (ADOM) data for individuals at both treatment start and treatment end was analysed. Hierarchical multiple regression analyses examined the independent impact of changes in days of alcohol use on weekly lifestyle and wellbeing issues. Analyses controlled for sociodemographic variables and other substances used. ...
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Developing New Zealand's medical workforce: realising the potential of longitudinal career tracking.
Authors: Poole P, Wilkinson TJ, Bagg W, Freegard J, Hyland F, Jo CE, Kool B, Roberts E, Rudland J, Smith B, Verstappen A Abstract For over a decade, the Medical Schools Outcomes Database and Longitudinal Tracking Project (MSOD) has collected data from medical students in Australia and New Zealand. This project aims to explore how individual student background or attributes might interact with curriculum or early postgraduate training to affect eventual career choice and location. In New Zealand, over 4,000 students have voluntarily provided information at various time points, and the project is at a stage where som...
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Ethylene glycol poisoning: mind the gap.
Authors: Lim J, Mearns A, Gresham C PMID: 31095547 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Holding a mirror to society? Sociodemographic diversity within clinical psychology training programmes across Aotearoa.
Authors: Scarf D, Waitoki W, Chan J, Britt E, Nikora LW, Neha T, Schimanski I, Macfarlane AH, Macfarlane S, Bennett ST, Hunter JA, Arahanga-Doyle HG, Abbott M PMID: 31095548 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Surgical burnout: moving from the academic to the personal?
Authors: Anderson P PMID: 31095549 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Personal experience and opinion of junior doctor burnout.
Authors: Watkins S PMID: 31095550 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Response to "Elephants in the room" editorial, 1 February 2019.
Response to "Elephants in the room" editorial, 1 February 2019. N Z Med J. 2019 May 17;132(1495):86-87 Authors: Townsend P, Toop L, Aish H, Jordan L, Cullen F PMID: 31095551 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 17, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The benefit of robust research.
Authors: Wakeman C, McKay J PMID: 31048819 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The incidence and risk factors of dog bite injuries requiring hospitalisation in New Zealand.
CONCLUSIONS: The incidence of dog bite injuries requiring hospitalisation has continued to rise in comparison with previously published rates in New Zealand. Additionally, more vulnerable population subgroups have been identified who are most likely to require hospitalisation. PMID: 31048820 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Improving patient experience and outcomes following serious injury.
CONCLUSION: This study highlights perceived issues in the patient care pathway in the transition from inpatient to community-based care, especially communication and discharge information provided by surgical clinical teams and Accident Compensation Corporation (ACC). Comprehensive inpatient care and clinical handover to primary care (rather than discharge planning processes) by dedicated clinical trauma services may provide more holistic models for surgical services to improve their influence on the transition of trauma patients into the community, assisted by organisation changes and support to enable effective service d...
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Incidence and outcomes of major trauma in New Zealand: findings from a feasibility study of New Zealand's first national trauma registry.
CONCLUSIONS: Most study participants made a good recovery, but there was still a large group of people experiencing disability, pain and not in paid employment at 12 months post-injury. PMID: 31048822 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Cycling-related injuries and cycling promotion: a trauma service perspective.
CONCLUSION: Hospital admission volumes and rates are rising with underlying variation in patient demography, place and severity of injury. Current policy direction to grow cycling participation based on the health, environmental and economic benefits is ahead of the implementation of safer cycling infrastructure, creating a timing lag. From a regional hospital-based trauma service perspective, this timing lag needs due consideration if the full benefits of increasing participation are to be realised. PMID: 31048823 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

What is medicinal cannabis?
Authors: Glass M, Ashton JC Abstract As New Zealand considers cannabis legal reform, we ask: what exactly is medicinal cannabis, and why does this matter? Cannabis is not a single entity but comes in diverse forms with various active ingredients. This contrasts with the legal and pharmaceutical definitions of medicines, with wide-ranging implications for quality control, prescriber practice and the assessment of clinical evidence. We argue that what is considered a medicine in the legal and pharmaceutical sense should not be changed in an ad hoc way to accommodate cannabis, but that cannabis products should be held...
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

An updated critique of the use of the Twin Spine Study (2009) to determine causation of low back disorder.
Authors: Walls CB, Snell A, McLean DJ, Pearce N PMID: 31048825 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The importance of rurality data in understanding access to healthcare services for childhood obesity.
Authors: Wild CE, Grant CC, Cave TL, Wynter LE, Derraik JG, Willing EJ, Hofman PL, Anderson YC PMID: 31048826 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Health information research privacy standards should include M āori perspectives on privacy.
Health information research privacy standards should include Māori perspectives on privacy. N Z Med J. 2019 May 03;132(1494):64-67 Authors: Ragupathy R, Yogarajan V, Luoni C PMID: 31048827 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Mass shooting in Christchurch and the epidemiology of sudden mass fatality events in New Zealand.
Authors: Wilson N, Thomson G PMID: 31048828 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 4, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Cancer Care at a Crossroads: time to make a choice.
Authors: Sarfati D, Macfarlane S, Bissett I, Robson B, Gurney J, Kemp R, James N, Adler J, Scott N, McMenamin J PMID: 30973854 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Building collaborative research networks across rural and provincial Aotearoa.
Authors: Gutenstein M, Kiuru S PMID: 30973855 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Adverse childhood experiences and school readiness outcomes: results from the Growing Up in New Zealand study.
CONCLUSIONS: Awareness of the negative impact of ACEs on school readiness should aid in the development and prioritisation of prevention strategies to reduce the occurrence and impact of ACEs in children. PMID: 30973856 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Point-of-care troponin use in New Zealand rural  hospitals: a national survey.
CONCLUSIONS: Most New Zealand rural hospitals rely on POC-cTn to assess chest pain and are not using an ADP. There are limited data available to support this approach in rural settings especially with patients who are not low-risk. PMID: 30973857 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Management of acute sigmoid volvulus in a provincial centre-a 20-year experience.
CONCLUSION: Early sigmoid colectomy was associated with low morbidity and found to be safe in the elderly, and the results suggest that early surgery is associated with reduced readmissions and a low complication rate, with index surgery preferable to urgent elective surgery. Rigid sigmoidoscopy is a safe method of decompression as a bridge to index surgery and was not associated with any complications in this series. PMID: 30973858 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Dental caries and previous hospitalisations among preschool children: findings from a population-based study in New Zealand.
CONCLUSION: ECC was highly prevalent in New Zealand children, and associated with injury-related hospital admissions. The findings underscore more efforts to tackle ECC and associated health conditions. PMID: 30973859 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Providing departments with regular reports on intern experiences using an adapted version of the PHEEM: completing the feedback loop to enable change in the education and training environment.
CONCLUSION: Evaluations of clinical attachments by interns positively influences change in clinical departments if the information is presented to departments in an accessible and meaningful format. PMID: 30973860 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The  use of 'tie down' in New Zealand prisons​-what is the role of the health sector?
This article is timely in the context of current Government Inquiries into the criminal justice system and mental health and addictions, the review of the health and disability system, the Correction's Amendment Bill before parliament, and Government plans to expand Waikeria prison to include a 100-bed mental health facility. We call for the use of 'tie down' to be abolished in New Zealand prisons, and for all health professionals to refuse to participate in this practice. Government must make provision for sufficient forensic mental health capacity and capability in the health sector, and ensure timely, equitable access t...
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Unusual presentation of spinal epidural abscess and a cautionary tale of acupuncture.
Authors: Shew W, Bell S PMID: 30973862 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Acute compartment syndrome complicating deep venous thrombosis.
Authors: Dhayalan S, Jardine D, Goh T, Lash N PMID: 30973863 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

We don't have more time to wait to measure how well our healthcare system is doing.
Authors: Hannay E PMID: 30973864 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - April 13, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

This is not us.
Authors: Baddock K PMID: 30921305 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Call for action on equity from three angles.
Authors: Tamatea JA, Scott N, Curtis H PMID: 30921306 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The perspectives of Samoan patients and health professionals about access to renal services in New Zealand.
CONCLUSION: This study identified factors that affected Samoan patients' access to renal services in New Zealand. Raising awareness of chronic kidney diseases and addressing barriers to accessing services is likely to enable timely interventions and improved outcomes. PMID: 30921307 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

High level of capture of coronary intervention and associated acute coronary syndromes in the all New Zealand acute coronary syndrome quality improvement cardiac registry and excellent agreement with national administrative datasets (ANZACS-QI 25).
CONCLUSIONS: Consistent with its aim, the ANZACS-QI registry captured almost all New Zealand public hospital coronary angiography and PCI procedures including those associated with an ACS diagnosis. The high level of agreement between the registry and national dataset supports the use of both datasets for ongoing quality improvement reporting and research. PMID: 30921308 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Pyogenic liver abscess: incidence, causality, management and clinical outcomes in a New Zealand cohort.
CONCLUSION: PLA continues to carry significant morbidity. Demographics, including ethnicity, play an important role. Our tertiary centre cohort may account for higher incidence and better clinical outcomes. PMID: 30921309 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Prime Minister for a day: children's views on junk food marketing and what to do about it.
CONCLUSIONS: These findings suggest children's exposure to junk food marketing may cause them physical, mental and moral harm, in direct contradiction of the New Zealand self-regulatory code for marketing. The children's views align with the World Health Assembly's recent decision to endorse initiatives to end childhood obesity, including restricting marketing of unhealthy foods. PMID: 30921310 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The contribution of avoidable mortality to the life expectancy gap in M āori and Pacific populations in New Zealand-a decomposition analysis.
CONCLUSION: Avoidable causes of death are large contributors to the life expectancy differentials in Māori and Pacific populations. The findings provide further evidence of the need to address the determinants of health and ensure equitable access to health services to reduce the impact of avoidable mortality on inequalities in life expectancy. It also highlights the importance of looking beyond individual factors and recognising the role of healthcare services and the social determinants in improving health equity. PMID: 30921311 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Upholding Te Tiriti, ending institutional racism and Crown inaction on health equity.
Authors: Came H, McCreanor T, Manson L Abstract Upholding te Tiriti o Waitangi should eliminate institutional racism against Māori and contribute to the achievement of health equity. Given the Waitangi Tribunal is investigating health-related breaches of te Tiriti o Waitangi, we argue institutional racism, a key determinant of health inequalities, needs to be acknowledged and addressed within the health sector. Historically the Crown response can be characterised by denial and inaction. The Crown has the power and resources to take action through mechanisms such as those they are currently applying to child povert...
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Bilateral clicking tinnitus due to myoclonus of middle ear muscles.
We present an acoustically documented case of irregular bilateral middle ear myoclonus with loud clicking, and roaring tinnitus associated with essential palatal tremor. A palatal botulinum toxin injection did not eliminate the tinnitus. Division of both middle ear tendons in both ears abolished the clicking tinnitus with no effect on hearing. PMID: 30921313 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Adoption of international privacy standards in New Zealand health information research.
Authors: Yogarajan V, Ragupathy R PMID: 30921314 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 30, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Where are we going with cancer treatment in New Zealand?
Authors: Mullaney T, Frizelle F Abstract PMID: 30845124 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Relationship between estimated glomerular filtration rate and incident cardiovascular disease in an ethnically diverse primary care cohort.
Authors: Church E, Poppe K, Harwood M, Mehta S, Grey C, Selak V, Marshall MR, Wells S Abstract AIM: To investigate eGFR as an independent risk factor for CVD in a New Zealand primary care cohort, stratified by disease status (prior CVD, diabetes or no CVD or diabetes). METHOD: The PREDICT-CVD open cohort study is a large, ethnically diverse, New Zealand primary care cohort, generated by using a web-based CVD risk assessment tool. Using encrypted identifiers, participant profiles were linked anonymously to a regional laboratory database (to determine renal function) and to national hospitalisation and mortality ...
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

The factors that lead to a delay between general practitioner referral of symptomatic patients and specialist diagnosis of colorectal cancer: an audit in the Bay of Plenty District Health Board.
Authors: Yee A, Linton T, Lee MS, Raimes S Abstract AIM: To determine factors leading to delay between referral by the GP of symptomatic patients and subsequent specialist diagnosis of colon or rectum cancer (CRC). METHOD: A retrospective audit of patients with new CRC referred by their GP over a 30-month period to the specialist services. Analysis of referral letters, specialist grading and subsequent results of investigations. We focused on the High Index of Suspicion (HIS) criteria for suspected CRC. RESULTS: Only 65 out of 181 patients fulfilled the HIS criteria and of these only half were correctly ide...
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Developing a regional cancer service; lessons from the Waitemata Cancer Patient Experience Survey.
CONCLUSION: The results of these confirm that the NHS Cancer Patient Experience Survey provides meaningful data within New Zealand and that WDHB cancer patient experience has improved over the survey period. This data has assisted WDHB in prioritising patient information resources and treatment planning in developing services. PMID: 30845127 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

New Zealand Society of Gastroenterology Guidelines on Therapeutic Drug Monitoring in Inflammatory Bowel Disease.
Authors: Khan A, Berahmana AB, Day AS, Barclay ML, Schultz M Abstract The incidence of inflammatory bowel disease (IBD) in New Zealand has increased over the last several decades. The management of IBD has been transformed since the introduction of monoclonal antibody drugs. Other medications used in the treatment of IBD include amino-salicylates, steroids, thiopurines and methotrexate. Therapeutic drug monitoring (TDM) involves the measurement of serum drug levels or active metabolites and anti-drug antibodies. TDM is essential for a personalised approach to the management of patients with IBD and is used to optim...
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research

Vision screening in New Zealand: an audit of the B4 School Check.
CONCLUSIONS: The high NPV is reassuring that very few children with visual impairment are missed by screening. The low PPV was consistent with the international literature and is related to a tendency for over-referral from the B4CS programme. Further work could evaluate increasing the threshold for referral to reduce the number of false positive cases. PMID: 30845129 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - March 8, 2019 Category: General Medicine Tags: N Z Med J Source Type: research