Journal of the New Zealand Medical Association, 10-August-2012, Vol 125 No 1359
This Issue in the Journal
National Breast Cancer Audit: overview of invasive breast cancer in New Zealand
Corinne Ooi, Ian Campbell, James Kollias, Primali de Silva
This paper provides an overview of women with breast cancer in New Zealand. It compares results of patients who presented with a breast symptom to their doctor and women who had breast cancer detected through the screening program. It shows that New Zealand women are generally treated appropriately according to accepted international guidelines.
The reasons for cancellation of urological surgery: a retrospective analysis
Robert Lopez, Sharryn Jowitt, Stephen Mark
Cancellations of elective surgery is costly and a wasted opportunity. Measurement of causes of cancellations improve efficiently reduces cancellations.
Screening for sexually transmitted infections in pregnancy at Middlemore Hospital, 2009
Alec J Ekeroma, Leena Pandit, Cecilia Bartley, John M D Thompson
Sexually transmitted infections can cause complications in pregnancy and it is a best practice recommendation to screen for this in pregnancy. Our study found that in 2009, only 64% of all 6795 women having babies in Middlemore Hospital had screening. Of the women screened, 10% had an infection and it was highest in Maori, Pacific and young women. Our study stresses the importance of improving and monitoring screening rates and practice.
Unintended pregnancy and therapeutic abortion in the postpartum period. Is an opportunity to intervene being missed?
Karen Joseph, Anna Whitehead
After giving birth a woman’s fertility can return within a few weeks even if she is breastfeeding. If she does not wish another pregnancy immediately then a range of contraceptive options can prevent this. Due to the unique way that maternity care is funded in New Zealand (the lead maternity carer or LMC system) women can, and should be, offered contraceptive advice and prescription by their LMC (usually a midwife) free of charge. Despite having this provision in the LMC contract there are a number of women who are not being provided with adequate contraception after they give birth; and subsequently conceiving an unwanted pregnancy and seeking an abortion while their previous child is still less than six months old. There are a number of reasons for this, and it is hoped that by identifying them it may be possible to reduce the rate of unintended pregnancy in this group of women.
SIDS prevention: 3000 lives saved but we can do better ((viewpoint article))
Edwin A Mitchell, Peter S Blair
Mortality from sudden infant death syndrome (SIDS) has decreased substantially from the late 1980s. This has been attributed to the change in infant sleep position initially from prone to side and then to predominantly supine. We calculate that this has saved over 3000 lives. However, we argue that we could save more infant lives, if more focus was given to the risks observed from parents sleeping in the same bed as their babies.
The effect of ethnic prioritisation on ethnic health analysis: a research note ((viewpoint article))
Robert Didham, Paul Callister
Ethnicity is an important variable in studies of health inequalities in New Zealand. Yet there are on-going concerns about the nature, quality and use of ethnic data. In 2004, Statistics New Zealand recommended that researchers and policy makers no longer use the system of ethnic prioritisation, a system originally designed to assign people with multiple ethnic responses to one ethnic category. The prioritisation system treated Maori responses as top priority, which means that information for people of both Maori and Pacific (or European) ethnicities remained correctly included in Maori data but was lost to the information on Pacific (or European) communities. While across a range of disciplines researchers have shifted to using either total ethnic counts or single and combination counts, many health researchers continue to use ethnic prioritisation. Census data show that when using prioritisation there are significant losses to Pacific, Asian and European groups, especially for young people. Losses are especially high for New Zealand born people in all age groups. Health researchers need to consider very carefully the costs and benefits of using prioritised data. Based on the census data we suggest the costs, in terms of loss of information and possible biases in findings, outweigh any benefits.
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