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Issue

Vol 127 No 1404: 17 Oct 2014

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Issue Summary

SUMMARY

Variation in gout care in Aotearoa New Zealand: a national analysis of quality markers

Gary Jackson, Nicola Dalbeth, Leanne Te Karu, Doone Winnard, Peter Gow, Catherine Gerard, Nikolai Minko

We used health data to determine that for New Zealanders aged 20-79 years with gout, 57% were dispensed allopurinol in 2010/11. Of these, 69% were receiving allopurinol regularly, and only 34% of people dispensed allopurinol had serum urate testing in a 6-month period. The annual hospitalisation rate was 1% of people with gout. Mori and Pacific people with gout were less likely to be on regular allopurinol treatment, despite having more than twice the chance of being hospitalised with acute gout. We conclude that primary care initiatives that focus on ensuring a continuous supply of urate-lowering therapy to achieve therapeutic serum urate targets are required to improve the impact of gout in Aotearoa New Zealand.

SUMMARY

Pathways to health and wellbeing for Pacific children—how are we tracking?

Faasisila Savila, Elaine Rush

The governments 5-year strategy for improving Pacific peoples health and wellbeing, Ala Moui Pathways to Pacific Health and Wellbeing 2010-2014, emphasised disease prevention and improvements in health systems as priority outcomes. Actions that would contribute to disease prevention included reducing barriers to health in structural mechanisms (such as better access to healthy housing) and improving health service systems. However, after 4 years since its release, not only have important structural barriers remained but so have the poor health outcomes of Pacific peoples in New Zealand.

SUMMARY

A descriptive study of urethral discharge among men in Fiji

Lavenia Gaunavinaka, Dashika Balak, Sumanthla Varman, Sharan Ram, Stephen M Graham

An evaluation of the medical records of men presenting to clinics in Fiji with urethral discharge over recent years found that this form of sexually transmitted infection is very common. There were also cases of repeated infection. There was also no association between risky sexual behaviours and recurrence and this may be due to the fact that the reported behaviours were totally dependent on the subjective view of the clients. We need to know more about the causes and risk behaviours for this disease in order to provide the most effective treatment, but also to educate the public in order to reduce the burden of sexually transmitted diseases in Fiji.

SUMMARY

Observational study of the visibility of branded tobacco packaging and smoking at outdoor bars/cafés in Wellington, New Zealand

Natasha Martin, Hugh McHugh, Jono Murtagh, Connor Oliver-Rose, Div Panesar, Harriet Pengelly, Scott Rieper, Henry Schofield, Vidit Singh, Amanda Speed, Rhona Strachan, Te Kahui Tapsell, Sara Trafford, Stefan van Ryn, Ethan Ward, Rosie Whiting, Merryn Wilson-van Duin, Zhou Wu, Gordon Purdie, Frederieke S van der Deen, George Thomson, Amber L Pearson, Nick Wilson

This study aimed to collect data on tobacco brand visibility on packaging on outdoor tables at bars/caf\u00e9s prior to New Zealands proposed plain packaging law. Observational data were systematically collected at 55 bars/caf\u00e9s with outdoor tables (in Central Wellington City). A total of 19,189 patrons, 1707 tobacco packs and 1357 active smokers were observed.-One tobacco pack was visible per 11.0 patrons and the active smoking prevalence was 7.1%, similar to Australian results (8.3%). Eighty percent of packs were positioned face-up (showing the brand), 8% face-down (showing the large pictorial warning), and 12% in other positions.-Pack visibility per patron was significantly greater in areas without child patrons (RR=3.1, p

SUMMARY

Intensification of blood pressure treatment in Pasifika people with type 2 diabetes and renal disease: a cohort study in primary care

Jasmine Tan, Fifita McCready, Fiona Noovao, Oketi Tepueluelu, John Collins, Tim Cundy

This paper investigated the efficacy of blood pressure lowering conducted in primary care practice in Pasifika patients with type 2 diabetes and chronic kidney disease over 2 years. The integrated model of care involving a diabetologist, primary care physicians and nurses in an ethnic-concordant primary care setting was successful in improving patients medication adherence and blood pressure. This translated to improved cardiac outcomes and slower decline in kidney function especially in those who have a reduction in the urinary protein excretion (which is a surrogate for kidney injury).

SUMMARY

The importance of measuring unmet healthcare needs

Robin Gauld, Antony Raymont, Philip F Bagshaw, M Gary Nicholls, Christopher M Frampton

Objective assessment of the outcomes of health system restructuring is rare. In the absence of comprehensive objective data, the success or otherwise of health reforms has been inferred from narrowly-focussed data or anecdotal accounts. A recent example relates to a buoyant Kings Fund report on the quest for integrated health and social care in Canterbury, New Zealand which prompted an equally supportive editorial article in the British Medical Journal (BMJ) suggesting it may contain lessons for Englands National Health Service. At the same time, a report published in the New Zealand Medical Journal expressed concerns at the level of unmet healthcare needs in Canterbury. Neither report provided objective information about changes over time in the level of unmet healthcare needs in Canterbury. -We propose that the performance of healthcare systems should be measured regularly, objectively and comprehensively through documentation of unmet healthcare needs as perceived by representative segments of the population at formal interview. Thereby the success or otherwise of organisational changes to a health system can be better documented.

SUMMARY

Barriers to early initiation of antenatal care in a multi-ethnic sample in South Auckland, New Zealand

Sarah Corbett, Carol Chelimo, Kara Okesene-Gafa

It is recommended that women commence maternity care before 10 weeks of pregnancy. This study looked into barriers to initiation of antenatal care before 19 weeks of pregnancy in over 800 women in South Auckland. Findings indicated that women were more likely to book late (after 18 weeks) for care if they had limited resources (e.g. no transport), no tertiary education, were not living with a partner, or were of Mori or Pacific ethnicity.

ALL ARTICLES
SUMMARY

Variation in gout care in Aotearoa New Zealand: a national analysis of quality markers

Gary Jackson, Nicola Dalbeth, Leanne Te Karu, Doone Winnard, Peter Gow, Catherine Gerard, Nikolai Minko

Pathways to health and wellbeing for Pacific children—how are we tracking?

Faasisila Savila, Elaine Rush

A descriptive study of urethral discharge among men in Fiji

Lavenia Gaunavinaka, Dashika Balak, Sumanthla Varman, Sharan Ram, Stephen M Graham

Ethnicity of psoriasis patients: an Auckland perspective

Martin Lee, Steven Lamb

A safe and effective drug?

Matthew P Doogue

Proceedings of the Waikato Clinical School Research Seminar, Wednesday 17 September 2014

Observational study of the visibility of branded tobacco packaging and smoking at outdoor bars/cafés in Wellington, New Zealand

Natasha Martin, Hugh McHugh, Jono Murtagh, Connor Oliver-Rose, Div Panesar, Harriet Pengelly, Scott Rieper, Henry Schofield, Vidit Singh, Amanda Speed, Rhona Strachan, Te Kahui Tapsell, Sara Trafford, Stefan van Ryn, Ethan Ward, Rosie Whiting, Merryn Wilson-van Duin, Zhou Wu, Gordon Purdie, Frederieke S van der Deen, George Thomson, Amber L Pearson, Nick Wilson

Request for tubercular pathological material from children 16 years of age and under

Intensification of blood pressure treatment in Pasifika people with type 2 diabetes and renal disease: a cohort study in primary care

Jasmine Tan, Fifita McCready, Fiona Noovao, Oketi Tepueluelu, John Collins, Tim Cundy

The importance of measuring unmet healthcare needs

Robin Gauld, Antony Raymont, Philip F Bagshaw, M Gary Nicholls, Christopher M Frampton

Barriers to early initiation of antenatal care in a multi-ethnic sample in South Auckland, New Zealand

Sarah Corbett, Carol Chelimo, Kara Okesene-Gafa

Needle-free jet injection for administration of influenza vaccine

Medical image. A rare and unexpected cause for bronchiectasis

Thomas C Reid, Vinu M Abraham

Proceedings of the 225th Scientific Meeting of the Otago Medical School Research Society, Wednesday 24 September 2014

SUMMARY

Variation in gout care in Aotearoa New Zealand: a national analysis of quality markers

Gary Jackson, Nicola Dalbeth, Leanne Te Karu, Doone Winnard, Peter Gow, Catherine Gerard, Nikolai Minko

We used health data to determine that for New Zealanders aged 20-79 years with gout, 57% were dispensed allopurinol in 2010/11. Of these, 69% were receiving allopurinol regularly, and only 34% of people dispensed allopurinol had serum urate testing in a 6-month period. The annual hospitalisation rate was 1% of people with gout. Mori and Pacific people with gout were less likely to be on regular allopurinol treatment, despite having more than twice the chance of being hospitalised with acute gout. We conclude that primary care initiatives that focus on ensuring a continuous supply of urate-lowering therapy to achieve therapeutic serum urate targets are required to improve the impact of gout in Aotearoa New Zealand.

SUMMARY

Pathways to health and wellbeing for Pacific children—how are we tracking?

Faasisila Savila, Elaine Rush

The governments 5-year strategy for improving Pacific peoples health and wellbeing, Ala Moui Pathways to Pacific Health and Wellbeing 2010-2014, emphasised disease prevention and improvements in health systems as priority outcomes. Actions that would contribute to disease prevention included reducing barriers to health in structural mechanisms (such as better access to healthy housing) and improving health service systems. However, after 4 years since its release, not only have important structural barriers remained but so have the poor health outcomes of Pacific peoples in New Zealand.

SUMMARY

A descriptive study of urethral discharge among men in Fiji

Lavenia Gaunavinaka, Dashika Balak, Sumanthla Varman, Sharan Ram, Stephen M Graham

An evaluation of the medical records of men presenting to clinics in Fiji with urethral discharge over recent years found that this form of sexually transmitted infection is very common. There were also cases of repeated infection. There was also no association between risky sexual behaviours and recurrence and this may be due to the fact that the reported behaviours were totally dependent on the subjective view of the clients. We need to know more about the causes and risk behaviours for this disease in order to provide the most effective treatment, but also to educate the public in order to reduce the burden of sexually transmitted diseases in Fiji.

SUMMARY

Observational study of the visibility of branded tobacco packaging and smoking at outdoor bars/cafés in Wellington, New Zealand

Natasha Martin, Hugh McHugh, Jono Murtagh, Connor Oliver-Rose, Div Panesar, Harriet Pengelly, Scott Rieper, Henry Schofield, Vidit Singh, Amanda Speed, Rhona Strachan, Te Kahui Tapsell, Sara Trafford, Stefan van Ryn, Ethan Ward, Rosie Whiting, Merryn Wilson-van Duin, Zhou Wu, Gordon Purdie, Frederieke S van der Deen, George Thomson, Amber L Pearson, Nick Wilson

This study aimed to collect data on tobacco brand visibility on packaging on outdoor tables at bars/caf\u00e9s prior to New Zealands proposed plain packaging law. Observational data were systematically collected at 55 bars/caf\u00e9s with outdoor tables (in Central Wellington City). A total of 19,189 patrons, 1707 tobacco packs and 1357 active smokers were observed.-One tobacco pack was visible per 11.0 patrons and the active smoking prevalence was 7.1%, similar to Australian results (8.3%). Eighty percent of packs were positioned face-up (showing the brand), 8% face-down (showing the large pictorial warning), and 12% in other positions.-Pack visibility per patron was significantly greater in areas without child patrons (RR=3.1, p

SUMMARY

Intensification of blood pressure treatment in Pasifika people with type 2 diabetes and renal disease: a cohort study in primary care

Jasmine Tan, Fifita McCready, Fiona Noovao, Oketi Tepueluelu, John Collins, Tim Cundy

This paper investigated the efficacy of blood pressure lowering conducted in primary care practice in Pasifika patients with type 2 diabetes and chronic kidney disease over 2 years. The integrated model of care involving a diabetologist, primary care physicians and nurses in an ethnic-concordant primary care setting was successful in improving patients medication adherence and blood pressure. This translated to improved cardiac outcomes and slower decline in kidney function especially in those who have a reduction in the urinary protein excretion (which is a surrogate for kidney injury).

SUMMARY

The importance of measuring unmet healthcare needs

Robin Gauld, Antony Raymont, Philip F Bagshaw, M Gary Nicholls, Christopher M Frampton

Objective assessment of the outcomes of health system restructuring is rare. In the absence of comprehensive objective data, the success or otherwise of health reforms has been inferred from narrowly-focussed data or anecdotal accounts. A recent example relates to a buoyant Kings Fund report on the quest for integrated health and social care in Canterbury, New Zealand which prompted an equally supportive editorial article in the British Medical Journal (BMJ) suggesting it may contain lessons for Englands National Health Service. At the same time, a report published in the New Zealand Medical Journal expressed concerns at the level of unmet healthcare needs in Canterbury. Neither report provided objective information about changes over time in the level of unmet healthcare needs in Canterbury. -We propose that the performance of healthcare systems should be measured regularly, objectively and comprehensively through documentation of unmet healthcare needs as perceived by representative segments of the population at formal interview. Thereby the success or otherwise of organisational changes to a health system can be better documented.

SUMMARY

Barriers to early initiation of antenatal care in a multi-ethnic sample in South Auckland, New Zealand

Sarah Corbett, Carol Chelimo, Kara Okesene-Gafa

It is recommended that women commence maternity care before 10 weeks of pregnancy. This study looked into barriers to initiation of antenatal care before 19 weeks of pregnancy in over 800 women in South Auckland. Findings indicated that women were more likely to book late (after 18 weeks) for care if they had limited resources (e.g. no transport), no tertiary education, were not living with a partner, or were of Mori or Pacific ethnicity.

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