Twenty-one years of saving lives: The New Zealand Resuscitation Council.
Authors: McKenzie L, Webber J, Aickin R, Considine J, Lawson A, Mildenhall L, Nation K, Nicholson T, Nuthall G, Scott T, Stuart M PMID: 29927910 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Organised stroke care to improve survival and independence: New Zealand perspectives.
Authors: Weatherall M PMID: 29927911 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Projected stroke volumes to provide a 10-year direction for New Zealand stroke services.
CONCLUSION: Efforts to optimise stroke service performance and, increasingly, stroke prevention are required to ensure that the New Zealand Health Service will be able to manage the increased volumes of patients. Better data is required to validate the presented figures, which are largely based on unvalidated health administrative data. PMID: 29927912 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Impact of discontinuation of telestroke: the Nelson experience.
CONCLUSION: These findings indicate that the transient implementation of telestroke was insufficient to upskill provincial hospital generalist clinicians to sustain high thrombolysis rates. PMID: 29927913 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Sexuality and gender identity teaching within preclinical medical training in New Zealand: content, attitudes and barriers.
CONCLUSIONS: Our finding of limited content is consistent with international literature. Our findings extend the literature by revealing that barriers to greater inclusion of content are not due to overt negative attitudes. Staff responsible for preclinical medical curriculum oversight have positive attitudes about content relating to sexuality and gender identity but perceive curriculum space to be a limiting barrier. This is important as it informs approaches to change. Future interventions with medical schools should focus on methods to increase diverse content as part of existing teaching, education to increase knowled...
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Faster Cancer Treatment pathway in gynaecological malignancy: a repeat clinical audit.
CONCLUSION: There has been an overall improvement in cancer care service provision for Northland patients since the previous audit, however it still falls short of the national FCT targets. PMID: 29927915 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Antimicrobial resistance among Shigella in New Zealand.
CONCLUSIONS: These results suggest there is an immediate need to revise the currently recommended first-line treatment for shigellosis, especially when treatment is given on an empirical basis. Equally concerning is the fact that resistance to the second-line antibiotic for shigellosis, azithromycin, appears to be emerging in New Zealand. As diagnostic laboratories increase their use of culture-independent testing, it is recommended that they should continue to culture specimens from all shigellosis cases so that isolates are available for susceptibility testing and epidemiological typing. PMID: 29927916 [PubMed - in p...
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The futility of fertility research? Barriers to embryo research in New Zealand.
CONCLUSIONS: The lack of current guidelines regarding the use of embryos for research is restricting improvements to established reproductive technologies, and any future research. We suggest that the Minister of Health instructs ministerial advisory and ethics committees to review the current guidelines and to define the term "use of embryos". PMID: 29927917 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Keeping track of antimicrobial resistance for Neisseria gonorrhoeae in Auckland, New Zealand: past, present and future considerations.
CONCLUSION: Ceftriaxone is still suitable as a component of gonorrhoea treatment in our region but resistance to other agents prohibits their use for empiric treatment regimens. Current methods of detecting antimicrobial resistance for NG needed to be updated so that they are fit for purpose. PMID: 29927918 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The impact of multimorbidity on people's lives: a cross-sectional survey.
CONCLUSIONS: These results emphasise the serious impact multimorbidity has on patients' health status compared to the general population. This research supports the development of holistic patient-centred care models designed to improve patient outcomes. PMID: 29927919 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Audit to investigate junior doctors' knowledge of how to administer and score the Montreal Cognitive Assessment (MoCA).
CONCLUSION: Junior doctors administer and score the MoCA but many have not received formal teaching on how to do so. A short teaching session improved their ability to conduct the MoCA and identify errors in administration and scoring. PMID: 29927920 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

New Zealand's health workforce planning should embrace complexity and uncertainty.
Authors: Rees GH, Crampton P, Gauld R, MacDonell S Abstract Concerns over New Zealand's health workforce sufficiency, distribution and sustainability continue. Proposed solutions tend to focus on supplying medical professionals to meet predicted numbers or to resolve distributional problems. This is despite quantitative forecasts being known to have poor reliability. A recent study on New Zealand's health workforce planning, which focused less on medical workforce numbers and more on the system's organisation and constituent interrelations, highlights the use of complementary methods to define the problems and desi...
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Is New Zealand immigration policy a barrier to TB elimination?
Authors: Badu E, Mpofu C, Farvid P PMID: 29927922 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The Smokefree 2025 goal: an opportunity for the new government.
Authors: Witt M, Edwards R, Hoek J, Thomson G PMID: 29927923 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 22, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Lynch syndrome: much progress but many questions remain.
Authors: Keating J PMID: 29879721 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Is it time for New Zealand to adopt alcohol policy that will reduce the harm from alcohol?
Authors: Connor J PMID: 29879722 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Changes in New Zealand's alcohol environment following implementation of the Sale and Supply of Alcohol Act (2012).
CONCLUSION: Maximum trading hours were the only element of the SSAA found to create a swift change in the alcohol environment, by slightly reducing availability in main cities. LAPs and new licence criteria may gradually constrain future availability, but the strength of LAPs has been muted by alcohol industry appeals. Introducing national, evidence-based policy measures would assist the SSAA to achieve its aim of minimising harm more swiftly, as would measures to protect the LAP development process from alcohol industry influence. PMID: 29879723 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The New Zealand PIPER Project: colorectal cancer survival according to rurality, ethnicity and socioeconomic deprivation-results from a retrospective cohort study.
CONCLUSIONS: Disparity in outcome following diagnosis with CRC exists in New Zealand. Much of this disparity can be explained by stage of disease at diagnosis for Māori, but for Pacific peoples and those in deprived areas other factors may influence outcome. Further analyses of the PIPER data will explore the impact of any differences in management. PMID: 29879724 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Crisis resolution: consumer, family and referrer perspectives on care.
CONCLUSION: High levels of satisfaction and agreement were found among consumers, family and referrers with CR. Open-ended questions identified which issues matter the most to key stakeholders, which may have implications for service evaluation tools. PMID: 29879725 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Violence and aggression in the emergency department is under-reported and under-appreciated.
CONCLUSIONS: Reports of violence and aggression in the emergency department underestimate the true incidence. Failure to report has potential impacts on organisational recognition of risk and the ability to develop appropriate policy responses. PMID: 29879726 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Holding a mirror to society? Progression towards achieving better sociodemographic representation among the University of Otago's health professional students.
CONCLUSION: Between 2010 and 2016 there was an overall increase in diversity in the health professional student body, with strong growth in Māori, Pacific and rural students. The recent introduction of new affirmative categories will hopefully result in an increase in socioeconomic diversity and in the number of refugee students. PMID: 29879727 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Paediatric team handover: a time to learn?
CONCLUSIONS: Learning opportunities exist within team handovers and the associated learning frequently occurs either opportunistically or implicitly. Adoption of a reflective approach to learning opportunities is likely to result in improved educational experiences for handover participants, particularly medical students and junior doctors. Handover represents a clinical event within which valuable workplace learning occurs. PMID: 29879728 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Development of an otitis media strategy in the Pacific: key informant perspectivesThe Matthew effect in New Zealand rural hospital trauma and emergency care: why rural simulation-based education matters.
We describe a phenomenon of self-reinforcing inequality between New Zealand rural hospitals and urban trauma centres. Rural doctors work in remote geographical locations, with rare exposure to managing critical injuries, and with little direct support when they do. Paradoxically, but for the same reasons, they also have little access to the intensive training resources and specialist oversight of their university hospital colleagues. In keeping with international experience, we propose that using simulation-based education for rural hospital trauma and emergency team training will mitigate this effect. Along with several d...
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Acute appendicitis in an incarcerated femoral hernia.
Authors: Richards S, D'Souza J PMID: 29879730 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Diagnosing pre-clinical dementia: the NZ Genetic Frontotemporal Dementia Study (FTDGeNZ).
Authors: Ryan B, Baker A, Ilse C, Brickell KL, Kersten HM, Danesh-Meyer HV, Williams JM, Addis DR, Tippett L, Curtis MA PMID: 29879731 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Rarely a triple whammy in general medicine.
Authors: Okamura-Kho A, Chuah Q, Chin P, Doogue M PMID: 29879732 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Acupuncture and ACC: therapeutic regulation and funding in New Zealand.
Authors: Mordaunt DA PMID: 29879733 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Acupuncture and the Medicines Act: a reply.
Authors: Gray B PMID: 29879734 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The importance of medical assessment prior to high-intensity interval training.
Authors: Roy MC, Meredith-Jones KA, Osborne HR, Williams SM, Brown RC, Jospe MR, Taylor RW PMID: 29879735 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - June 9, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

How simple mistakes and short-term bias elevate cardiovascular risk.
Authors: Stewart RA PMID: 29771896 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Is general practice identification of prior cardiovascular disease at the time of CVD risk assessment accurate and does it matter?
Authors: Wells S, Poppe K, Selak V, Kerr A, Pylypchuk R, Wu B, Chan WC, Grey C, Mehta S, Gentles DG, Jackson R Abstract AIMS: To determine the accuracy of general practice recording of prior cardiovascular disease (CVD) at the time of CVD risk assessment and whether recording impacts on CVD management. METHODS: Prior CVD status entered at the time of a first CVD risk assessment from 2002-2015 was compared to prior ischaemic CVD hospitalisations from national datasets using anonymous linkage with an encrypted National Health Index identifier. Clinical factors associated with inaccurate recording of prior events ...
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Symptoms of bowel dysfunction and their management after spinal cord injury in a New Zealand centre.
CONCLUSION: Lack of correlation of patterns of bowel function with the level and severity of the cord lesion indicates the need to continue to individualise advice on bowel care according to symptoms. PMID: 29771898 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Excess cost and inpatient stay of treating deep spinal surgical site infections.
CONCLUSION: The costs associated with spinal SSI are significant and comparable to a previous New Zealand study of hip and knee prosthesis SSI. More awareness of the high costs involved should encourage research and implementation of infection prevention strategies. PMID: 29771899 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Inappropriate prescribing of antibiotics following discharge after major surgery: an area for improvement.
CONCLUSIONS: This study demonstrates that a significant proportion of antibiotics prescribed in patients discharged following surgery are inappropriate and there is need for enhanced antimicrobial stewardship in this area. PMID: 29771900 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Achilles tenotomy as an office procedure and current practising trends among New Zealand orthopaedic surgeons.
CONCLUSION: PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post-operative complications or recurrence. Parental satisfaction to this procedure is excellent. There are significant financial advantages. Based on this data, our institution now performs all releases in an outpatient setting. PMID: 29771901 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The impact of different tumour subtypes on management and survival of New Zealand women with Stage I-III breast cancer.
CONCLUSIONS: The pattern of phenotype in women with Stage I-III breast cancer is similar to the overseas cohorts. Most New Zealand women with Luminal A breast cancer have a very good prognosis, but the less common subtypes have relatively poor outcomes. PMID: 29771902 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Incidence, demographics and surgical outcomes of cutaneous squamous cell carcinoma diagnosed in Northland, New Zealand.
CONCLUSION: This study has defined the rate of cSCC in a large, well defined New Zealand population, and estimated age and ethnicity adjusted incidence in New Zealand. It has demonstrated the highest incidence of cSCC in the world outside Australia. Overall positive margin rate of excised lesions was acceptable. PMID: 29771903 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Development of an otitis media strategy in the Pacific: key informant perspectives.
CONCLUSION: Despite significant challenges, there is potential to develop sustainable otitis media identification, treatment and prevention strategies in Fiji. The sustainability of such a strategy is contingent on a number of key factors, which includes a long-term commitment by stakeholders, be culturally appropriate and responsive to local need, develop close linkages across health, social and educational sectors, and ensure it is embedded within a broader public health framework. PMID: 29771904 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Pharyngoconjunctival fever.
Authors: Alfeld KE, Dalton SC PMID: 29771905 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Primum non nocere: first do no harm.
Authors: Bryder L PMID: 29771906 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 19, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Live kidney donation: managing the "tyranny of the gift".
Live kidney donation: managing the "tyranny of the gift". N Z Med J. 2018 May 04;131(1474):7-9 Authors: Roake JA, Morton JB PMID: 29723173 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

"It's hard to ask": examining the factors influencing decision-making among end-stage renal disease patients considering approaching family and friends for a kidney.
CONCLUSION: Recipients desired more support to facilitate approaching donors, with cultural differences observed between Māori and non-Māori in recruitment expectations. Tailored support could be enabled with development of a screening tool to assess willingness and motivation to accept donation, cultural needs, self-efficacy, communication skills and health literacy. Psychosocial support could help address barriers such as reciprocity concerns. PMID: 29723174 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Early onset dementia in New Zealand Pacific boxers: a case series.
CONCLUSION: Historical, cultural and socio-economic factors underpin the attraction of some Pacific men to boxing as a sport. Given that New Zealand Pacific peoples may have an earlier onset of dementia than their European counterparts, further research is required to establish whether boxing is a contributory factor. Sports physicians should advise young New Zealand Pacific boxers about the long-term risks associated with their sport. PMID: 29723175 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

The Dunedin Dementia Risk Awareness Project: a convenience sample of general practitioners.
CONCLUSIONS: GPs are knowledgeable about dementia risk and protective factors. They reported optimism in their ability to modify their own risk factors through lifestyle interventions. This places GPs in a unique position to help disseminate this knowledge to their clients. PMID: 29723176 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Co-prescribing of contraindicated and use-with-caution drugs in a national cohort of new users of simvastatin: how well are prescribing guidelines followed?
CONCLUSIONS: The prescription of contraindicated and use-with-caution drugs to patients taking simvastatin is not uncommon in New Zealand. PMID: 29723177 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Off label or on trend: a review of the use of quetiapine in New Zealand.
Authors: Huthwaite M, Tucker M, McBain L, Romans S PMID: 29723178 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Outcomes following therapeutic lymphadenectomy for Stage III malignant melanoma in a single unit.
CONCLUSION: Lymphadenectomy has a high risk of post-operative complications, especially for groin dissections. Quality of lymphadenectomy can be assessed by monitoring nodal harvest numbers, and achieving nodal harvest targets provides significant prognostic information. We support the development of national tumour standards, including key performance indicators, for management of Stage III melanoma. PMID: 29723179 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Confidence in the safety of standard childhood vaccinations among New Zealand health professionals.
CONCLUSION: As health professionals are a highly trusted source of vaccine information, communicating the consensus of belief among GPs/doctors that vaccines are safe may help provide reassurance for parents who ask about vaccine safety. However, the lower level of vaccine confidence among midwives is a matter of concern that may have negative influence on parental perceptions of vaccinations. PMID: 29723180 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Eikenella corrodens retroperitoneal necrotising fasciitis post-endoscopic retrograde cholangio-pancreatography.
Authors: Lin YS, Juhasz ES PMID: 29723181 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research

Enteric duplication cyst as a cause for small bowel obstruction in adulthood.
We report a case of a patient presenting with small bowel obstruction secondary to an enteric ileal duplication cyst. Although common in infancy, they are rarely seen in adults. Radiologically they may be difficult to distinguish from a Meckel diverticulum and often the diagnosis is made retrospectively. Optimal management of the asymptomatic adult is unclear. PMID: 29723182 [PubMed - in process] (Source: New Zealand Medical Journal)
Source: New Zealand Medical Journal - May 5, 2018 Category: General Medicine Tags: N Z Med J Source Type: research