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This Issue in the Journal
Lung cancer treatment in
New Zealand: physicians’ attitudes
T Christmas, M Findlay The aim of this study was to determine treatment practices
of New Zealand physicians who manage non-small cell lung cancer (NSCLC). A
questionnaire was emailed to physicians asking them to choose what treatment
they would offer for different stages of lung cancer. This study showed that
treatment practices varied significantly between specialty groups (particularly
for more advanced disease), and highlights the need for standardisation of
treatment within New Zealand.
Application of asthma
action plans to childhood asthma: national survey repeated
A McNally, C Frampton, J Garrett, P Pattemore An increased dose of inhaled steroid medication has
previously been used for acute asthma, and incorporated into paediatric action
plans. Evidence now exists against the efficacy of an increased dose of inhaled
steroid in acute asthma. Our repeat postal survey (from 1995) of New Zealand
general practitioners, paediatricians and paediatric registrars aimed to
identify whether any changes existed in the administration of an increased dose
of inhaled steroid for acute childhood asthma, and in the way asthma action
plans are used.
Economic cost of
community-acquired pneumonia in New Zealand adults
G Scott, H Scott, M Turley, M Baker This study estimated that in 2003 there were 26,826 episodes
of community-acquired pneumonia in New Zealand adults; a rate of 859 per 100,000
people. The annual economic cost was calculated to be $63 million. The major
generators of costs were the number of hospitalisations (particularly for the
group aged 65 years and over) and loss of productivity.
End of life decision-making
by New Zealand general practitioners: a national survey
K Mitchell, G Owens A study of 1255 New Zealand general practitioners (GPs)
indicates that a medical decision at the end of life is made prior to
approximately two-thirds of deaths attended, including decisions that
may hasten death, and decisions
explicitly to hasten death. Moreover, in one year, 39 GPs indicated that they
had supplied or administered drugs specifically to end life. These actions are
reported within a context of high access to multidisciplinary palliative care.
In this paper, events surrounding decision-making are explored, and
doctors’ comments are reported.
Caring for patients and
families at the end of life: withdrawal of intensive care in the patient’s
home
S Mann, D Galler, P Williams, P Frost The Department of Intensive Care at Middlemore Hospital has
taken 17 patients home to die. These patients (in whom ongoing care was deemed
either inappropriate or futile) were transported home and extraordinary means of
care such as artificial ventilation were withdrawn. This was seen as a positive
experience by the family members concerned.
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