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Issue

Vol 123 No 1327: 17 December 2010

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Issue Summary

SUMMARY

Estimating diabetes prevalence in South Auckland: how accurate is a method that combines lists of linked health datasets?

Simon Thornley, Roger Marshall, Gary Jackson, James Smith, Wing-Cheuk Chan, Craig Wright, Dudley Gentles, Rod Jackson

Linked health information (drug use, hospital diagnoses, and laboratory testing) were anonymously linked to estimate the (adult) burden of diabetes in South Auckland. About 1 in 14 adults were estimated to have diabetes in South Auckland using this method. This figure was similar to national survey estimates and a list of people known to have longstanding diabetes. A statistical technique, known as ccapture-recapture d suggests that the actual burden of diabetes in this area is much higherabout 1 in 11 adults. Our findings suggest that about 1 in 30 adults in South Auckland has diabetes but is not yet diagnosed.

SUMMARY

Evaluation of Pacific obstetric and gynaecological ultrasound scanning capabilities, personnel, equipment and workloads

Hemal Kodikara, Jenny Mitchell, Alec Ekeroma, Peter Stone

This is the first survey of obstetric and gynaecological (O&G) ultrasound in the Pacific and identified training, quality equipment, and service needs. The survey also identified the most appropriate types of training courses for those engaged in O&G ultrasound in the Pacific. Theoretical clinical and technical training is needed but hands-on practical training is most favoured. The future of utilising ultrasound to enhance clinical outcomes needs to be part of any expansion of ultrasound in the Pacific.

SUMMARY

The prevalence of diabetes among adults aged 40 years and over in Fiji

Garry Brian, Jacqueline Ramke, Louise Maher, Andrew Page, John Szetu

This paper reports a 2009 survey that estimates how many adults aged 40 years and over living in Fiji have diabetes: 99,000 people (41% of the people in this age group). In this age group: Indian Fijians have approximately twice the risk of having diabetes compared with Melanesian Fijians; females have almost twice the risk compared with males; and, risk increased with increasing age. Management of diabetes is likely to be poor in a developing country such as Fiji because of scant resources. Unless something is done about improving diagnosis and management of diabetes in the community, with passing time there is likely to be an increasing, and perhaps eventually unmanageable, burden of diabetes-related complications (e.g. blindness, loss of lower limbs, kidney problems) that will put great strain on medical services, communities and individuals.

SUMMARY

Does health status matter for the risk of injury?

Ruth Cunningham, Kristie Carter, Jennie Connor, Jackie Fawcett

Injuries which disrupt usual activities for more than a week are common and represent a significant impact on society from injury which is not captured by health care statistics. We found a strong relationship between having poor self-rated health or a high number of chronic diseases and an increased risk of injury. The information provided by this study gives some indication of level of this aspect of injury burden, and may be useful in planning interventions targeted at those most likely to experience such injuries.

SUMMARY

Assessment of obesity in New Zealand Chinese: a comparative analysis of adults aged 30–39 years from five ethnic groups

Ji Y J Wen, Elaine C Rush, Lindsay D Plank

We know that risk for diseases such as diabetes and cardiovascular disease increases with increasing body size as measured by body mass index (BMI). The risk for Asian is higher at a lower BMI than European. The immigrant Asian population in New Zealand is diverse and not homogeneous. There are differences between Asian Indian and Chinese origin people in disease prevalence and this may be related to differences in fatness, fat distribution and body proportions. For the same height and weight, Chinese had more body fat than European and less than Asian Indian. There were also differences in relative arm and leg lengths and distribution of fat and muscle. Health policy that uses BMI cutoffs to identify risk and inform treatment needs to consider ethnic disparities in the relationships between body size, fatness and other risk factors.

SUMMARY

SF-36v2 norms for New Zealanders aged 55–69 years

Christine Stephens, Fiona Alpass, Merel Baars, Andy Towers, Brendan Stevenson

A survey of the health of older New Zealanders aged 55-69 showed that there were few differences in mental and physical health between the sexes in this age group, which may indicate a closing of the gap between men and womens health status. Physical health scores generally decrease with age as expected but mental health scores increase with age. This trend toward improved mental health as people age has also been shown in international studies.

SUMMARY

Adverse reactions to food in New Zealand children aged 0–5 years

Christine Crooks, Rohan Ameratunga, Maia Brewerton, Michelle Torok, Stephen Buetow, Shannon Brothers, Clare Wall, Penny Jorgensen

This study examined food allergy symptoms in a sample of infants attending Plunket Clinics in Auckland and Wellington. Food allergy symptoms were very common and eczema was a common problem in young infants across all ethnic groups. Very few children were tested for food allergy, even though some had severe symptoms. This study shows there is an urgent need for funding further studies on food allergy in New Zealand.

SUMMARY

Can imaging determine if a rotator cuff tear is traumatic?

Khalid D Mohammed, Ben Wilkinson, Chethan Nagaraj

Traumatic rotator cuff tears are entitled to treatment through the ACC scheme in New Zealand. The imaging report is considered by the ACC in determining causation of the rotator cuff tear. This paper reviews the relevant historic and contemporary scientific literature on shoulder imaging in the context of causation of rotator cuff tears. Some imaging findings indicate a significant rotator cuff tear has been present for a long time, others findings may not have relevance. The common criteria in the literature for determining if a rotator cuff tear was traumatic was a history of a traumatic event with onset of symptoms.

SUMMARY

Inappropriate trace element testing in the Auckland region

David Song, Barry Palmer, Stephen du Toit, James S Davidson

This paper reports that the number of trace element tests done by Labplus, the Auckland City Hospital laboratory, increased markedly from 2004 to 2008. The most commonly requested tests were blood levels of zinc, copper, selenium and mercury. The majority of test requests were from a small minority of doctors, who were mostly associated with calternative d or cholistic d types of medical practice. The paper discusses the appropriate medical uses of these tests, and concludes that the majority of the tests requested have been unnecessary and of little or no benefit to patients. The paper suggests that this wastage of public health resources could be addressed by carefully defining the clinical situations in which these tests should be used.

ALL ARTICLES
SUMMARY

Estimating diabetes prevalence in South Auckland: how accurate is a method that combines lists of linked health datasets?

Simon Thornley, Roger Marshall, Gary Jackson, James Smith, Wing-Cheuk Chan, Craig Wright, Dudley Gentles, Rod Jackson

Proceedings of the 205th Scientific Meeting of the Otago Medical School Research Society, Thursday 4 November 2010

Food allergies in children: common but overlooked

Rodney P K Ford

New Zealand Injury Prevention Strategy: significant shortcomings after 5 years

John Langley

Evaluation of Pacific obstetric and gynaecological ultrasound scanning capabilities, personnel, equipment and workloads

Hemal Kodikara, Jenny Mitchell, Alec Ekeroma, Peter Stone

The prevalence of diabetes among adults aged 40 years and over in Fiji

Garry Brian, Jacqueline Ramke, Louise Maher, Andrew Page, John Szetu

On some principles of hospital management: part 1

Chalmers, Bunkle and Bryder correspondence

Ronald W Jones

Does health status matter for the risk of injury?

Ruth Cunningham, Kristie Carter, Jennie Connor, Jackie Fawcett

National Heart Foundation: 2011 Grant Applications

Assessment of obesity in New Zealand Chinese: a comparative analysis of adults aged 30–39 years from five ethnic groups

Ji Y J Wen, Elaine C Rush, Lindsay D Plank

Proceedings of the New Zealand Society of Gastroenterology Annual Scientific Meeting, 17–19 November 2010

SF-36v2 norms for New Zealanders aged 55–69 years

Christine Stephens, Fiona Alpass, Merel Baars, Andy Towers, Brendan Stevenson

Adverse reactions to food in New Zealand children aged 0–5 years

Christine Crooks, Rohan Ameratunga, Maia Brewerton, Michelle Torok, Stephen Buetow, Shannon Brothers, Clare Wall, Penny Jorgensen

Exploring the Successes of Natural Health Care (Richard Harman)

Shaun Holt

The Cartwright Legacy

Lawrence Smith

Can imaging determine if a rotator cuff tear is traumatic?

Khalid D Mohammed, Ben Wilkinson, Chethan Nagaraj

Necrotising pneumonia and pandemic influenza

Andrea Adjetey, Ruthraj Edwards

Medical image. Computed tomographic images of membranes in a pulmonary hydatid cyst

Prem P Gupta, Krishan B Gupta, Dipti Agarwal

Complementary Therapies for Cancer: what works, what doesn't—and how to tell the difference (Shaun Holt)

Richard Beasley

Medical Benevolent Fund

Inappropriate trace element testing in the Auckland region

David Song, Barry Palmer, Stephen du Toit, James S Davidson

Ethical Issues in Governing Biobanks: Global Perspectives (B Elger, N Biller-Andorno, A Mauron, AM Capron, eds)

Bridget Robinson

Another bitter pill: a case of toxicity from DMAA party pills

Paul Gee, Suzanne Jackson, Josie Easton

Rotator cuff imaging and the Accident Compensation Corporation (ACC)

Mike Caughey

A patient journey and the ACC

Andrew Slaven

Medical image. A thrilling mass

Rajesh B Dharmaraj, Abu H A Samah, Jon Griffin, Anantha Ramanathan

Cartwright Inquiry correspondence in the NZMJ: enough is enough

Frank A Frizelle

Malcolm Ross (Barney) Mowat

Drug use is a health issue

Simon J Adamson, Fraser C Todd

National Heart Foundation: Māori Cardiovascular Research Fellowship

SUMMARY

Estimating diabetes prevalence in South Auckland: how accurate is a method that combines lists of linked health datasets?

Simon Thornley, Roger Marshall, Gary Jackson, James Smith, Wing-Cheuk Chan, Craig Wright, Dudley Gentles, Rod Jackson

Linked health information (drug use, hospital diagnoses, and laboratory testing) were anonymously linked to estimate the (adult) burden of diabetes in South Auckland. About 1 in 14 adults were estimated to have diabetes in South Auckland using this method. This figure was similar to national survey estimates and a list of people known to have longstanding diabetes. A statistical technique, known as ccapture-recapture d suggests that the actual burden of diabetes in this area is much higherabout 1 in 11 adults. Our findings suggest that about 1 in 30 adults in South Auckland has diabetes but is not yet diagnosed.

SUMMARY

Evaluation of Pacific obstetric and gynaecological ultrasound scanning capabilities, personnel, equipment and workloads

Hemal Kodikara, Jenny Mitchell, Alec Ekeroma, Peter Stone

This is the first survey of obstetric and gynaecological (O&G) ultrasound in the Pacific and identified training, quality equipment, and service needs. The survey also identified the most appropriate types of training courses for those engaged in O&G ultrasound in the Pacific. Theoretical clinical and technical training is needed but hands-on practical training is most favoured. The future of utilising ultrasound to enhance clinical outcomes needs to be part of any expansion of ultrasound in the Pacific.

SUMMARY

The prevalence of diabetes among adults aged 40 years and over in Fiji

Garry Brian, Jacqueline Ramke, Louise Maher, Andrew Page, John Szetu

This paper reports a 2009 survey that estimates how many adults aged 40 years and over living in Fiji have diabetes: 99,000 people (41% of the people in this age group). In this age group: Indian Fijians have approximately twice the risk of having diabetes compared with Melanesian Fijians; females have almost twice the risk compared with males; and, risk increased with increasing age. Management of diabetes is likely to be poor in a developing country such as Fiji because of scant resources. Unless something is done about improving diagnosis and management of diabetes in the community, with passing time there is likely to be an increasing, and perhaps eventually unmanageable, burden of diabetes-related complications (e.g. blindness, loss of lower limbs, kidney problems) that will put great strain on medical services, communities and individuals.

SUMMARY

Does health status matter for the risk of injury?

Ruth Cunningham, Kristie Carter, Jennie Connor, Jackie Fawcett

Injuries which disrupt usual activities for more than a week are common and represent a significant impact on society from injury which is not captured by health care statistics. We found a strong relationship between having poor self-rated health or a high number of chronic diseases and an increased risk of injury. The information provided by this study gives some indication of level of this aspect of injury burden, and may be useful in planning interventions targeted at those most likely to experience such injuries.

SUMMARY

Assessment of obesity in New Zealand Chinese: a comparative analysis of adults aged 30–39 years from five ethnic groups

Ji Y J Wen, Elaine C Rush, Lindsay D Plank

We know that risk for diseases such as diabetes and cardiovascular disease increases with increasing body size as measured by body mass index (BMI). The risk for Asian is higher at a lower BMI than European. The immigrant Asian population in New Zealand is diverse and not homogeneous. There are differences between Asian Indian and Chinese origin people in disease prevalence and this may be related to differences in fatness, fat distribution and body proportions. For the same height and weight, Chinese had more body fat than European and less than Asian Indian. There were also differences in relative arm and leg lengths and distribution of fat and muscle. Health policy that uses BMI cutoffs to identify risk and inform treatment needs to consider ethnic disparities in the relationships between body size, fatness and other risk factors.

SUMMARY

SF-36v2 norms for New Zealanders aged 55–69 years

Christine Stephens, Fiona Alpass, Merel Baars, Andy Towers, Brendan Stevenson

A survey of the health of older New Zealanders aged 55-69 showed that there were few differences in mental and physical health between the sexes in this age group, which may indicate a closing of the gap between men and womens health status. Physical health scores generally decrease with age as expected but mental health scores increase with age. This trend toward improved mental health as people age has also been shown in international studies.

SUMMARY

Adverse reactions to food in New Zealand children aged 0–5 years

Christine Crooks, Rohan Ameratunga, Maia Brewerton, Michelle Torok, Stephen Buetow, Shannon Brothers, Clare Wall, Penny Jorgensen

This study examined food allergy symptoms in a sample of infants attending Plunket Clinics in Auckland and Wellington. Food allergy symptoms were very common and eczema was a common problem in young infants across all ethnic groups. Very few children were tested for food allergy, even though some had severe symptoms. This study shows there is an urgent need for funding further studies on food allergy in New Zealand.

SUMMARY

Can imaging determine if a rotator cuff tear is traumatic?

Khalid D Mohammed, Ben Wilkinson, Chethan Nagaraj

Traumatic rotator cuff tears are entitled to treatment through the ACC scheme in New Zealand. The imaging report is considered by the ACC in determining causation of the rotator cuff tear. This paper reviews the relevant historic and contemporary scientific literature on shoulder imaging in the context of causation of rotator cuff tears. Some imaging findings indicate a significant rotator cuff tear has been present for a long time, others findings may not have relevance. The common criteria in the literature for determining if a rotator cuff tear was traumatic was a history of a traumatic event with onset of symptoms.

SUMMARY

Inappropriate trace element testing in the Auckland region

David Song, Barry Palmer, Stephen du Toit, James S Davidson

This paper reports that the number of trace element tests done by Labplus, the Auckland City Hospital laboratory, increased markedly from 2004 to 2008. The most commonly requested tests were blood levels of zinc, copper, selenium and mercury. The majority of test requests were from a small minority of doctors, who were mostly associated with calternative d or cholistic d types of medical practice. The paper discusses the appropriate medical uses of these tests, and concludes that the majority of the tests requested have been unnecessary and of little or no benefit to patients. The paper suggests that this wastage of public health resources could be addressed by carefully defining the clinical situations in which these tests should be used.

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