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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 21-January-2011, Vol 124 No 1328

This Issue of the Journal
Mortality rates according to occupation in New Zealand males: 2001–2005
Erin Holmes, Anna Davies, Craig Wright, Neil Pearce, Barry Borman
The paper uses records of New Zealand males that died between 2001 and 2005 to investigate variations in overall and disease-specific mortality for different occupation groups. The occupation categories are based on the New Zealand Standard Classification of Occupation 1999 (NZSCO 1999), while the disease categories follow the International Classification of Disease (ICD10-AM). The paper shows that there continues to be marked differences in mortality between occupations in New Zealand and that many of these differences remain once the effect of socioeconomic deprivation has been taken into account.
Understanding the role of culture in pain: Māori practitioner perspectives of pain descriptors
Jane E Magnusson, Joyce A Fennell
There is growing interest in the role of cultural diversity within healthcare settings yet minority ethnic groups are underrepresented in the healthcare literature, including the literature on pain. To better assess and treat pain in different cultures the perspectives of that culture must be taken into consideration and therefore the study described in this paper was undertaken to better understand Māori perspectives of pain. In the study, Kaumātua and Māori health providers completed questionnaires pertaining to the experience of pain in order to determine their appropriateness for use with Māori pain patients. We found that commonly used and widely accepted descriptors and phrases relating to pain were appropriate to use when assessing Māori pain patients. Additionally, we found that it would be of considerable benefit to include the additional words and phrases provided by participants this study when developing a questionnaire to be given to Māori pain patients as they capture aspects of the pain experience that may be specific to that culture thereby enhancing the appropriateness and usefulness of the questionnaire.
Understanding the role of culture in pain: Māori practitioner perspectives relating to the experience of pain
Jane E Magnusson, Joyce A Fennell
There is growing interest in the role of cultural factors within healthcare settings yet minority ethnic groups are underrepresented in the healthcare literature, including the literature on pain. To better assess and treat pain within different cultures, the perspectives of that culture must be taken into consideration and therefore the study described in this paper was undertaken to better understand Māori perspectives of pain. In this study, Kaumātua and Māori healthcare providers were interviewed to better understand how pain was perceived and expressed by Māori with whom they had health-related interactions. We found that, as in many cultures, Māori perceive pain as a multidimensional experience impacting them physically, psychologically, socially and spiritually. In addition to finding that there is a commonality between cultures with regard to the experience of pain, our results showed the importance of taking into account factors related to Māori culture (e.g. the role of the whānau/family and the development of relationships with healthcare providers) when assessing and/or treating Māori patients with pain.
Changing response rates from Māori and non-Māori in national sleep health surveys
Jo W Fink, Sarah-Jane Paine, Philippa H Gander, Ricci B Harris, Gordon Purdie
National sleep health surveys in Aotearoa/New Zealand have been designed to achieve equal responses from Maori and non-Maori adults. Four postal surveys were undertaken between 1999-2008 to investigate the prevalence of and risk factors for common sleeping problems and the electoral rolls were used a sampling frame in each study. Response rates to these surveys have declined over time. The reasons for this are likely to be due to a number of factors, including changes to the research design but also factors such as inaccuracies on the electoral rolls, and an increase in mobile phone use compared with landline telephones making it harder to track non-responders. Achieving adequate response rates from Maori and non-Maori is important for sleep health surveys to ensure that the research findings are relevant for Maori and non-Maori.
The utility of routine conjunctival swabs in management of conjunctivitis
Richard J Everts, Tony Barnett, Ben R Lahood
Our results show that General Practitioners and Specialists who care for patients with conjunctivitis (‘sticky eye infections’) can choose to take swabs from patients’ eyes and use the results in an algorithm that accurately guides the use of the right treatment for the right patients.
Can general practitioners provide effective cardiovascular disease (CVD) prevention? Dreams and realities of CVD prevention
Emily Gill, Dee Mangin
Cardiovascular disease is one of the main causes of death in NZ so preventing this before people become unwell (primary prevention) is a health target for the government. NZ’s population experiences these efforts mainly through two funded approaches. Unfortunately, this study found that both approaches have significant limitations. With scarce health resources, the challenge is to advocate for a new approach that is more effective.
Transfers from rural hospitals in New Zealand
Trevor Lloyd, Katharina Blattner, Garry Nixon
Ten rural hospital doctors were required to write an assignment on patient transfer as part of their assessment for a postgraduate diploma. The experience of this group of doctors is consistent with the available published information. Transfer of patients is an inevitable part of rural hospital practice. The outcome for patients could be improved through better resourcing of rural hospitals and education for staff, improved communication with transport services and with base hospital specialists, and involvement in the development of regionalised transport protocols.
Serious ski and snowboard injuries in southern New Zealand requiring acute orthopaedic admission and treatment during winter 2009
A Gordon Burgess, Ridzwan Namazie
This is the first published article in New Zealand to look at all ski and snowboard injuries across one season that were severe enough to require acute in-patient orthopaedic treatment. It summarises the patterns of injuries between skiing and snowboarding, transfer to hospital, investigation and the treatment required, whether an operation or not. The article touches on the demographics of the injuries covered and an estimate of the costs involved in treating them. Important points are that both skiing and snowboarding carry a risk of severe injury. Secondly, there is a broad demographic of patients. Thirdly, the author proposes that the costs based on generic ACC codes for given injuries may underestimate the actual cost of treating these injuries in certain patients due to high costs of surgical equipment and resources, but this has not been adequately assessed in this article and may be a good area for further research and cost analyses.
Patterns of trust in sources of health information
Rob Lawson, Sarah Forbes, John Williams
Most studies of trust in health information have looked at either doctor/patient relationships or more recently the internet. In this study data is analysed on a wide range of official and non-official sources. Based on a nationwide survey of New Zealanders we identify that systematic variations exist in the trust that people report with respect to different sources of health information. Six major groupings of source types were identified and the levels of trust assigned to some of these groupings varied according to sex, age, income and ethnicity. Understanding these variations may assist policymakers and other agencies which are responsible for planning the dissemination of health information.
     
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