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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 18-June-2004, Vol 117 No 1196

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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