18,112 results match your criteria New Zealand Medical Journal [Journal]


We don't have more time to wait to measure how well our healthcare system is doing.

Authors:
Emma Hannay

N Z Med J 2019 Apr 12;132(1493):77-78. Epub 2019 Apr 12.

Head of Health, Acasus, Hong Kong.

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Acute compartment syndrome complicating deep venous thrombosis.

N Z Med J 2019 Apr 12;132(1493):73-76. Epub 2019 Apr 12.

Orthopaediac Surgeon, Department of Orthopaedics, Christchurch Hospital, Christchurch.

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April 2019
2 Reads

Unusual presentation of spinal epidural abscess and a cautionary tale of acupuncture.

N Z Med J 2019 Apr 12;132(1493):69-72. Epub 2019 Apr 12.

General Medicine Consultant, Department of General Medicine, Auckland District Health Board, Auckland.

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April 2019
8 Reads

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.

N Z Med J 2019 Apr 12;132(1493):54-59. Epub 2019 Apr 12.

Director Medical Clinical Training and Consultant Physician, Medical Education and Training Unit, Canterbury District Health Board, Christchurch.

Aim: Collating quality feedback from interns on their training and educational experiences allows training institutions to identify issues or concerns within the learning environment and provides an opportunity for continuous quality improvement. This study aimed to investigate whether feedback obtained from a modified version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was used by departments to facilitate change and enhance the education and training experiences of interns at Canterbury District Health Board (CDHB).

Method: Data from intern evaluations is collated and sent to departments at the end of each three-month period. Read More

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Dental caries and previous hospitalisations among preschool children: findings from a population-based study in New Zealand.

N Z Med J 2019 Apr 12;132(1493):44-53. Epub 2019 Apr 12.

Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland.

Background: Early childhood caries (ECC) is a significant public health problem, and may be associated with other health conditions.

Aim: To investigate whether an association exists between ECC and previous hospitalisations due to avoidable medical conditions, including injury-related admissions among preschool children.

Methods: This population-based retrospective study involves all five-year old children who resided in one of the two contiguous regions in northern New Zealand (Northland and Auckland) and received school entry dental examinations between 1 January 2014 and 31 December 2015. Read More

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April 2019
1 Read

Management of acute sigmoid volvulus in a provincial centre-a 20-year experience.

N Z Med J 2019 Apr 12;132(1493):38-43. Epub 2019 Apr 12.

Head of Department in General Surgery, Consultant General Surgeon, Department of General Surgery, Taranaki Base Hospital, New Plymouth.

Aim: At our institution there has been a long-standing early operative approach to large bowel volvulus as well as initial decompression with rigid sigmoidoscopy. The primary aim of this study was to investigate the safety and efficacy of this approach on reducing readmissions and complications. Secondary aims were to investigate the safety and efficacy of bedside rigid sigmoidoscopy in decompression of sigmoid volvulus and investigate the sensitivity of abdominal x-ray in the diagnosis of acute large bowel volvulus. Read More

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April 2019
3 Reads

Point-of-care troponin use in New Zealand rural hospitals: a national survey.

N Z Med J 2019 Apr 12;132(1493):25-37. Epub 2019 Apr 12.

Head of Rural Section and Associate Dean Rural: Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin; Rural Doctor, Dunstan, Central Otago Health Services.

Aims: Accelerated diagnostic chest pain pathways (ADP) have become standard of care in urban emergency departments. It is, however, unknown how widely they are used in New Zealand's rural hospitals because ADP require immediate access to contemporary or high-sensitivity troponin (hs-Tn). We aimed to determine for rural hospitals the troponin assay being used, if they were using an ADP and if they had access to on-site exercise tolerance testing (ETT). Read More

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April 2019
1 Read

Adverse childhood experiences and school readiness outcomes: results from the Growing Up in New Zealand study.

N Z Med J 2019 Apr 12;132(1493):15-24. Epub 2019 Apr 12.

Center for Social Data Analytics, Auckland University of Technology, Auckland.

Aim: The Center for Disease Control's (CDC) Adverse Childhood Experiences (ACEs) have been associated with adverse health consequences in adults and children, but less is known about any association between ACE and early learning skills. We investigated the relationship between ACEs and objective preschool measures of skills using the Growing up In New Zealand (GUiNZ) cohort study (n=5,562; 2009-2015).

Methods: We mapped standard ACE definitions to GUiNZ to determine the prevalence of ACEs. Read More

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Building collaborative research networks across rural and provincial Aotearoa.

N Z Med J 2019 Apr 12;132(1493):12-14. Epub 2019 Apr 12.

Rural Health Academic Centre Ashburton, Department of Surgery, University of Otago, Christchurch.

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Cancer Care at a Crossroads: time to make a choice.

N Z Med J 2019 Apr 12;132(1493):6-11. Epub 2019 Apr 12.

General Practitioner and Primary Care Lead for the Bowel Screening Programme.

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Adoption of international privacy standards in New Zealand health information research.

N Z Med J 2019 Mar 29;132(1492):70-72. Epub 2019 Mar 29.

Clinical Trials and Research Pharmacist, Pharmacy Services, Waikato District Health Board, Hamilton, Waikato.

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Bilateral clicking tinnitus due to myoclonus of middle ear muscles.

N Z Med J 2019 Mar 29;132(1492):67-69. Epub 2019 Mar 29.

Otolaryngologist Department of Otolaryngology, Head and Neck Surgery, Christchurch Hospital, Christchurch.

Isolated middle ear myoclonus can be a cause of objective tinnitus. 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. Read More

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Upholding Te Tiriti, ending institutional racism and Crown inaction on health equity.

N Z Med J 2019 Mar 29;132(1492):61-66. Epub 2019 Mar 29.

Policy Advisor Māori; Kerri Nuku, Kaiwhakahaere, Te Rūnanga o Aotearoa, New Zealand Nurses Organisation, Wellington.

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. Read More

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The contribution of avoidable mortality to the life expectancy gap in Māori and Pacific populations in New Zealand-a decomposition analysis.

N Z Med J 2019 Mar 29;132(1492):46-60. Epub 2019 Mar 29.

Public Health Physician, Planning Funding and Outcomes, Waitemata District Health Board, Auckland.

Aim: To determine the contribution of avoidable causes of death to the life expectancy differentials in both Māori and Pacific compared with non-Māori/non-Pacific ethnic groups in New Zealand.

Methods: Death registration data and population data for New Zealand between 2013-15 was used to calculate life expectancy. A recent definition of avoidable mortality was used to identify potentially avoidable deaths. Read More

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Prime Minister for a day: children's views on junk food marketing and what to do about it.

N Z Med J 2019 Mar 29;132(1492):36-45. Epub 2019 Mar 29.

National Institute for Health Innovation, University of Auckland, Auckland.

Aims: This study explored children's awareness of and engagement with food marketing, and their views on action to address it.

Methods: A purposeful sample of 33 children (11-13 years) from the Wellington region of New Zealand were interviewed.

Results: Children were knowledgeable about food marketing, although most were not aware of the extent to which they were exposed. Read More

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Pyogenic liver abscess: incidence, causality, management and clinical outcomes in a New Zealand cohort.

N Z Med J 2019 Mar 29;132(1492):30-35. Epub 2019 Mar 29.

Department of Gastroenterology, Christchurch Hospital, Canterbury District Health Board, Christchurch.

Aims: The determinants, management and outcomes of pyogenic liver abscess [PLA] are changing. We aimed to compare these in a New Zealand cohort.

Methods: We have retrospectively reviewed all PLA cases presenting to Christchurch Hospital over 12 months between 2014 and 2015. Read More

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March 2019
1 Read

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).

N Z Med J 2019 Mar 29;132(1492):19-29. Epub 2019 Mar 29.

Section of Epidemiology and Biostatistics, University of Auckland, Auckland.

Background: The All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry was designed to collect data on all coronary angiograms and percutaneous coronary interventions (PCI) in New Zealand, and all acute coronary syndromes (ACS) associated with these procedures. This study compares the completeness of capture in ANZACS-QI of coronary procedures and ACS admissions with those recorded in the National Hospitalisation Dataset and evaluates data quality by assessing agreement in ACS diagnoses and coronary procedures between datasets.

Methods: The national dataset, which included all New Zealand public hospital admissions in 2015 (n=962,700 episodes), was anonymously linked with the ANZACS-QI CathPCI (n=14,649 coronary angiogram episodes) and ACS cohorts (n=8,141 episodes) for 2015. Read More

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The perspectives of Samoan patients and health professionals about access to renal services in New Zealand.

N Z Med J 2019 Mar 29;132(1492):11-18. Epub 2019 Mar 29.

Medicine, University of Otago, Dunedin.

Aim: Information about Pacific patients' access to renal services is limited. This research aims to describe Samoan patients' access to nephrology services in New Zealand.

Methods: Interviews were conducted with six health professionals and four Samoan patients about access to renal services in 2016. Read More

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Call for action on equity from three angles.

N Z Med J 2019 Mar 29;132(1492):8-10. Epub 2019 Mar 29.

Pou Herenga, Waikato District Health Board.

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This is not us.

Authors:
Kate Baddock

N Z Med J 2019 Mar 29;132(1492):6-7. Epub 2019 Mar 29.

Chair, New Zealand Medical Association, Wellington.

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Nothing short of universal healthcare coverage, fully funded and without charge both in primary and hospital care is good enough for New Zealand.

N Z Med J 2019 Mar 8;132(1491):107-108. Epub 2019 Mar 8.

General Practitioner, Hokianga Health, Rawene Hospital, Hokianga.

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Advancing transgender healthcare teaching in Aotearoa/New Zealand.

N Z Med J 2019 Mar 8;132(1491):104-106. Epub 2019 Mar 8.

Associate Professor, Department of Psychology, University of Otago, Dunedin.

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March 2019
1 Read

Switching from gabapentin to pregabalin.

Authors:
Pauline McQuoid

N Z Med J 2019 Mar 8;132(1491):101-103. Epub 2019 Mar 8.

Clinical Pharmacist, Medwise, Tauranga.

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Comment on: "Quality of electronic records documenting adverse drug reactions…".

N Z Med J 2019 Mar 8;132(1491):99-100. Epub 2019 Mar 8.

Manager, Clinical Risk Management, Medsafe, Ministry of Health, Wellington.

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Lifespan of New Zealand Second World War veterans from one large cemetery: the case for a national-level study.

N Z Med J 2019 Mar 8;132(1491):96-98. Epub 2019 Mar 8.

Professor of War Studies, Massey University, Palmerston North.

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Successful intravascular lithotripsy for severely calcified left anterior descending coronary artery stenosis.

N Z Med J 2019 Mar 8;132(1491):93-95. Epub 2019 Mar 8.

Senior Registrar, Christchurch Hospital, Christchurch.

Percutaneous coronary intervention (PCI) of heavily calcified stenoses remains a significant challenge to interventional cardiologists. Over the last years, high-pressure balloons, cutting balloons as well as atherectomy devices have been used to tackle such lesions. Lithoplasty is a method of lesion modification using intravascular lithotripsy (IVL, shockwave) to treat particularly calcified coronary lesions. Read More

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March 2019
1 Read

Beau lines and telogen effluvium following aluminium phosphide poisoning.

N Z Med J 2019 03 8;132(1491):90-92. Epub 2019 Mar 8.

Rocky Mountain Poison and Drug Center, Denver, CO, USA

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District health board of residence, ethnicity and socioeconomic status all impact publicly funded insulin pump uptake in New Zealand patients with type 1 diabetes.

N Z Med J 2019 Mar 8;132(1491):78-89. Epub 2019 Mar 8.

Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin.

Aims: Insulin pump therapy (CSII) is becoming increasingly common for those living with type 1 diabetes (T1D), and has been publicly funded in New Zealand since 2012. The aim of the current study was to examine national uptake of publicly funded pumps from 2012 to 2016, with a focus on the proportion of patients using pumps analysed according to district health board (DHB) as well as demographic characteristics.

Methods: Data from nationally held data collections including the New Zealand Virtual Diabetes Register were used to calculate the overall and subgroup proportions using pumps. Read More

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Considering evidence for ethnicity bias using assessment case scenarios and medical student correctness and certainty.

N Z Med J 2019 Mar 8;132(1491):71-77. Epub 2019 Mar 8.

Senior Lecturer, Māori Indigenous Health Institute (MIHI), University of Otago, Christchurch.

Aims: There is inequitable distribution of health risks, exposures, resources and outcomes by ethnicity. This may be contributed to by health professional bias. The aim of this study was to investigate the relationship between ethnicity of patients, within written assessment case scenarios, and medical students' response correctness and certainty. Read More

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Vision screening in New Zealand: an audit of the B4 School Check.

N Z Med J 2019 Mar 8;132(1491):63-70. Epub 2019 Mar 8.

Ophthalmologist, Gisborne Hospital, Clinical Senior Lecturer, University of Otago, Gisborne.

Aims: To assess the accuracy of the B4 School Check (B4SC) vision screening programme in two distinct regions of New Zealand.

Methods: A retrospective audit of all children who were screened for vision in the Southern and Tairawhiti District Health Boards, between 1 April and 30 September 2016. Results from the B4SC screening programme (n=2,109) were compared to records for all children who were screened and subsequently presented to an optometrist at a DHB eye clinic (n=116). Read More

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March 2019
5 Reads

New Zealand Society of Gastroenterology Guidelines on Therapeutic Drug Monitoring in Inflammatory Bowel Disease.

N Z Med J 2019 Mar 8;132(1491):46-62. Epub 2019 Mar 8.

Associate Professor, Gastroenterology Unit, Southern District Health Board, Dunedin; Department of Medicine, University of Otago, Dunedin.

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. Read More

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Developing a regional cancer service; lessons from the Waitemata Cancer Patient Experience Survey.

N Z Med J 2019 Mar 8;132(1491):38-45. Epub 2019 Mar 8.

The Centre for Innovation and the Faster Cancer Treatment Service, Waitemata District Health Board, Takapuna, Auckland.

Aim: As part of a project developing cancer service capability, the National Health Service (NHS) Cancer patient experience survey was used to assess the currently available services at Waitemata District Health Board (WDHB).

Methods: Patients presenting with cancer to WDHB in the previous 12 months were mailed a copy of the survey, to the initial cohort in 2013 and to the second in 2015. Results were compared between survey periods and with the 2015 NHS Cancer Patient Experience Survey. Read More

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March 2019
2 Reads

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.

N Z Med J 2019 Mar 8;132(1491):27-37. Epub 2019 Mar 8.

Consultant Surgeon, Department of General Surgery, Whakatane Hospital, Whakatane.

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. Read More

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Relationship between estimated glomerular filtration rate and incident cardiovascular disease in an ethnically diverse primary care cohort.

N Z Med J 2019 Mar 8;132(1491):11-26. Epub 2019 Mar 8.

Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland.

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 datasets. Read More

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March 2019
1 Read

Where are we going with cancer treatment in New Zealand?

N Z Med J 2019 Mar 8;132(1491):7-10. Epub 2019 Mar 8.

Department of Surgery, Christchurch Hospital, Christchurch.

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Smokefree signage at railway stations: a survey of 54 stations in 11 local government areas.

N Z Med J 2019 Feb 22;132(1490):59-61. Epub 2019 Feb 22.

Department of Public Health, University of Otago, Wellington.

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February 2019

Getting surgical antibiotic prophylaxis right, lessons from the National Orthopaedic Surgical Site Infection Improvement Programme: a call for action!

N Z Med J 2019 Feb 22;132(1490):55-58. Epub 2019 Feb 22.

Infection Prevention and Control Advisor, Infection Prevention and Control Programme, Health Quality and Safety Commission, Wellington.

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February 2019

A response to: The 'elephants in the room' for New Zealand's health system in its 80th anniversary year: general practice charges and ownership model.

N Z Med J 2019 Feb 22;132(1490):52-54. Epub 2019 Feb 22.

Chief Executive, New Zealand Medical Association, Wellington.

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February 2019

Multimorbidity and multiple social disadvantage in a New Zealand high-needs free primary healthcare clinic population: a cross-sectional study.

N Z Med J 2019 Feb 22;132(1490):42-51. Epub 2019 Feb 22.

Elaine Gurr Professor of General Practice, Department of General Practice & Rural Health, Dunedin School of Medicine, University of Otago, Dunedin.

Aims: Multimorbidity is a major issue in primary healthcare. The study aim was to determine the prevalence of multimorbidity and multiple social disadvantage in relation to age, gender, deprivation and ethnicity in a New Zealand high-needs primary healthcare clinic population.

Methods: A cross-sectional study using data manually extracted from electronic medical records was conducted on all patients registered with a Dunedin free 'third sector' primary healthcare clinic. Read More

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February 2019
1 Read

The cost of teriflunomide in the treatment of relapsing-remitting multiple sclerosis.

N Z Med J 2019 Feb 22;132(1490):36-41. Epub 2019 Feb 22.

Physician and Clinical Pharmacologist, Adjunct Clinical Professor, Curtin University Medical School, Bentley, Western Australia 6102, Australia.

Aims: Teriflunomide, used globally to treat multiple sclerosis (MS) and widely subsidised for this indication including in Australia and New Zealand, is the main metabolite of leflunomide, an older immune-modulating drug. Leflunomide therefore represents a potential alternative therapy for MS. Teriflunomide is about 50-500 times more expensive than leflunomide, depending on prices in each jurisdiction. Read More

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February 2019
1 Read

Patterns of referral and uptake of BReast CAncer (BRCA) gene testing of eligible women with ovarian cancer in New Zealand.

N Z Med J 2019 Feb 22;132(1490):26-35. Epub 2019 Feb 22.

Senior Lecturer, Department of Obstetrics & Gynaecology, University of Otago, Christchurch & Gynaecological Oncologist, Christchurch Women's Hospital, Christchurch.

Aims: To determine the proportion of eligible patients with high-grade serous carcinoma of the ovary, fallopian tube or peritoneum discussed at gynaecological oncology multidisciplinary meetings (MDMs) in New Zealand and subsequently referred for genetic counselling and BRCA pathogenic variant testing.

Methods: Eligible cases were identified from Auckland, Wellington, Christchurch and Dunedin gynaecologic oncology MDM databases between 1 January 2015 to 31 December 2016. Patients who met the eligibility criteria for genetics referral were identified, and cross-referenced against genetic services databases to ascertain the rates of referrals received, the numbers attending appointments, genetic testing offered and range of results. Read More

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February 2019
2 Reads

Post-operative mortality rates for neck of femur fracture at Waitemata District Health Board.

N Z Med J 2019 Feb 22;132(1490):17-25. Epub 2019 Feb 22.

Director of the Institute of Innovation and Improvement, Waitemata District Health Board, Auckland.

Aim: Mortality rates of up to 38% at one year have been reported following surgery for neck of femur fractures. The aim of this review is to evaluate the post-operative mortality rates and trends over time for patients with fractured neck of femur at Waitemata District Health Board.

Method: A retrospective cohort study of all patients who received surgery following a neck of femur fracture at Waitemata District Health Board between 2009 and 2016. Read More

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February 2019

Electronic whiteboards improve the acute surgical patient admission process.

N Z Med J 2019 Feb 22;132(1490):10-16. Epub 2019 Feb 22.

General Surgeon (Upper GI), Department of General Surgery, Christchurch Public Hospital, Christchurch District Health Board, Christchurch.

Background: Electronic whiteboards have largely replaced the use of traditional whiteboards in many hospital departments. They are used to electronically record and display a variety of patient information to streamline the admission process and the quality of handover between relevant staff. We assessed the impact of such a system upon the patient admission process in a busy general surgery department. Read More

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February 2019

Smoke in our eyes: the Sense Partners' evaluation of the legalisation of cannabis in New Zealand.

N Z Med J 2019 Feb 22;132(1490):6-9. Epub 2019 Feb 22.

SHORE & Whariki Research Centre, College of Health, Massey University, Auckland.

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February 2019

Local experience with methamphetamine associated stroke at a small district health board.

N Z Med J 2019 Feb 1;132(1489):105-108. Epub 2019 Feb 1.

Consultant Physician, Department of Medicine, Rotorua Hospital, Bay of Plenty.

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February 2019

Minimal risk of PFOS residues in eel to Māori consumers.

N Z Med J 2019 Feb 1;132(1489):102-104. Epub 2019 Feb 1.

Student, University of Canterbury, Christchurch.

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February 2019

Examining the accuracy of the New Zealand B4 School Check universal health service anthropometric measurements of children.

N Z Med J 2019 Feb 1;132(1489):89-101. Epub 2019 Feb 1.

Dean of the Dunedin School of Medicine, Dean's Department, Dunedin School of Medicine, University of Otago, Dunedin.

Background: The aim of the current study was to determine whether anthropometric data from the New Zealand B4 School Check (B4SC) universal health service assessments are comparable to research grade anthropometric data.

Methods: B4SC anthropometric data were obtained for a subsample (n=394) of children who participated in the Prevention of Overweight in Infancy (POI) randomised control trial. B4SC anthropometric measures were compared to POI anthropometric values that had been interpolated to align with the date of the B4SC assessment. Read More

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February 2019

Addition of explicit guidance to acute pancreatitis guidelines increases compliance with amylase measurement recommendations.

N Z Med J 2019 Feb 1;132(1489):81-88. Epub 2019 Feb 1.

Clinical Editor, Hospital HealthPathways, Canterbury District Health Board, Christchurch.

Aim: Hospital HealthPathways is an online database of local clinical guidelines produced by a dedicated team for use within Canterbury District Health Board (CDHB) hospitals. A 'Practice Point'-a bullet point making explicit a recommendation within the body of a clinical guideline-was added to the guideline for acute pancreatitis, instructing users to avoid serial measurements of serum amylase levels. The aim was to explore whether the addition of this Practice Point affected compliance with the amylase measurement recommendations. Read More

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February 2019
2 Reads

SF-12 indicators of health following the 22 February 2011 Christchurch earthquake.

N Z Med J 2019 Feb 1;132(1489):69-80. Epub 2019 Feb 1.

Director and Professor, Health Services Research Centre, Victoria University of Wellington, Wellington.

Aim: To explore the health status of people who experienced the magnitude 6.3 earthquake in Christchurch on 22 February 2011, across time and in comparison with other New Zealanders.

Methods: Data from five New Zealand Health Surveys (2011/12, 2012/13, 2013/14, 2014/15 and 2015/16), which each sampled around 13,000 people, aged 15+ years, living in New Zealand. Read More

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February 2019