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Issue

Vol 128 No 1426: 4 December 2015

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Issue Summary

SUMMARY

A bug in the ointment: topical antimicrobial usage and resistance in New Zealand

Deborah A Williamson, Stephen R Ritchie, Emma Best, Arlo Upton, Alison Leversha, Alesha Smith, Mark G Thomas

New Zealand has extremely high rates of bacterial resistance to topical antibiotics such as Bactroban and Foban. This is because we use a lot of these antibiotics. In this article, we look at who gets prescribed topical antibiotics in NZ, and suggest some ways in wihch we might control and reduce rates of resistance.

SUMMARY

Maxillofacial fractures at Waikato Hospital, New Zealand: 2004 to 2013

Blake K Moore, Ryan B Smit, Angus N Colquhoun, W Murray Thomson

The rate of facial fractures presenting to Waikato Hospital has been increasing since 1989. In addition the rate of violence-related facial fractures is now at almost double the rate seen in 1998-2000. It continues to be the dominant cause of injury, while road traffic accident related fractures are decreasing. This continual increase in fractures presenting to Waikato Hospital places significant demands on scarce clinical resources, such as operating theatre time and staffing numbers. Violence is an escalating cause of facial fractures that requires urgent and interventional public health prevention strategies.

SUMMARY

Late-life self-harm in the Waikato Region

WA de Beer, J Murtagh, G Cheung

This paper looked at the attributes of late life suicide attempts i.e. in the group over 65 years of age, in the Waikato region. Elderly people identified that concomitant medical conditions and depressive illnesses were important stresses contributing to their self-harm attempts. The study highlighted some important strategies for identifying and better managing elderly people who may attempt suicide in the future.

SUMMARY

Thirty years of condom-based HIV prevention by gay men in New Zealand

Anthony J Hughes, Peter J Saxton

Three decades after the first government-funded HIV prevention campaign in 1985, gay and bisexual men remain the population most at risk of infection in New Zealand. We review the major reasons why this is the case and describe the approach that has been taken to HIV prevention here. We have a good international record in HIV prevention for gay men, however new HIV diagnoses rates are increasing once again around the world. Lessons from the first three decades must underpin future HIV control efforts and additional intervention strategies will also now be required.

SUMMARY

Drug misuse in sport: a New Zealand perspective

Andrew Curtis, David Gerrard, Peter Burt, Hamish Osborne

Drug misuse in sport is an international phenomenon that has not escaped the attention of health professionals in New Zealand. Young athletes are vulnerable to the use of performance-enhancing substances and the increasing use of sports supplements reflects a particularly worrying trend fostered by unscientific endorsements. Drug-Free Sport New Zealand is the national anti-doping agency responsible for the oversight and education of our athletes in an environment where sport is an integral part of our culture. Doctors responsible for the care of athletes have an obligation to respect the Code of the World Anti-Doping Agency.

SUMMARY

What makes a child a ‘competent’ child?

Amanda van Rooyen, Tineke Water, Shayne Rasmussen, Kate Diesfeld

To give informed consent to healthcare in New Zealand, competence is a requirement. A person needs to understand the nature, purpose and consequences of treatment and non-treatment in order to give a legally valid agreement to healthcare. However, New Zealand law is unclear on this matter where children are concerned. Although not overtly stated, New Zealand law infers that children under the age of 16 years may give or withhold consent to healthcare, independent of their parents, so long as they are competent to do so. This article raises the questions; what is child competence, why is it so important to acknowledge and how do healthcare professionals assess for child competence? Unfortunately, there is meagre research in this area and no clear answers. The assessment, recognition and respect for a childs level of competence not only supports ethical arguments regarding respect for their rights and personhood; it has other more tangible benefits to both the child and healthcare services. These include improved treatment adherence, clinical effectiveness, health service delivery and disease prevention. Therefore, this article addresses how these benefits can be realised through a better understanding and assessment of childrens abilities to participate in and consent to healthcare.

SUMMARY

‘Real-time’ burden of community and healthcare-related infections in medical and rehabilitation patients in a public hospital in Auckland, New Zealand

Kerry Read, Hasan Bhally, Sabrina Sapsford, Thomas Sapsford

This study, performed in a single public hospital in Auckland which does not provide acute surgical services, shows that a high proportion of patients admitted to hospital have a diagnosis of infection as the main or a secondary reason requiring admission- the common types being chest, urine and skin infections. It also confirms the previous finding that hospital acquired infections are relatively common with approximately 1 in 10 patients acquiring it during their hospital stay.

SUMMARY

Infrequent condom use with casual partners among New Zealand gay and bisexual men

Peter J Saxton, Nigel P Dickson, Anthony J Hughes, Adrian H Ludlam

In 2014, the highest number of gay men were diagnosed with HIV in New Zealand. Our study examined condom use in a large and diverse sample of this population. Of those having intercourse with casual partners, a quarter (27.2%) reported infrequent condom use. Attitudes to condoms and exposure to condom promotion predicted condom use, among other factors such as adoption of condoms early on in life. Internet dating sites are common places to meet sexual partners. The relationship these commercial sites have with HIV prevention and public health agencies is mixed. Cooperative models where dating sites are partners in prevention should be developed. HIV and many STIs are asymptomatic communicable infections. Like vaccination, high levels of condom use are needed to control transmission within communities. The increases in HIV and STI diagnoses seen in New Zealand provide early warning of riskier behaviours happening.

ALL ARTICLES
SUMMARY

Safety and efficacy of digoxin

Post mortem examinations a public service

A bug in the ointment: topical antimicrobial usage and resistance in New Zealand

Deborah A Williamson, Stephen R Ritchie, Emma Best, Arlo Upton, Alison Leversha, Alesha Smith, Mark G Thomas

Maxillofacial fractures at Waikato Hospital, New Zealand: 2004 to 2013

Blake K Moore, Ryan B Smit, Angus N Colquhoun, W Murray Thomson

Late-life self-harm in the Waikato Region

WA de Beer, J Murtagh, G Cheung

Successful conservative management of campylobacter cholecystitis occurring post chemotherapy and rituximab: a rare disease entity

Ajay Gupta, Louise Teo

Over five years on, we still don’t need a pilot bowel cancer screening programme: Please just get on with it!

Guy Hingston

Thirty years of condom-based HIV prevention by gay men in New Zealand

Anthony J Hughes, Peter J Saxton

The first 30 years of HIV in New Zealand: Review of the epidemiology

Nigel Dickson, Bible Lee, Timothy Foster, Peter Saxton

Drug misuse in sport: a New Zealand perspective

Andrew Curtis, David Gerrard, Peter Burt, Hamish Osborne

Modelling of tobacco endgame interventions: a response

Richard Edwards, Tony Blakely, Frederieke van der Deen

Drug misuse in sport: a historical perspective

David Gerrard

What makes a child a ‘competent’ child?

Amanda van Rooyen, Tineke Water, Shayne Rasmussen, Kate Diesfeld

Selected proceedings of the APAC Forum 2015

‘Real-time’ burden of community and healthcare-related infections in medical and rehabilitation patients in a public hospital in Auckland, New Zealand

Kerry Read, Hasan Bhally, Sabrina Sapsford, Thomas Sapsford

Infrequent condom use with casual partners among New Zealand gay and bisexual men

Peter J Saxton, Nigel P Dickson, Anthony J Hughes, Adrian H Ludlam

HIV prevention today: with coordinated action, we can end transmission

Peter J Saxton, Anthony J Hughes, Massimo Giola

SUMMARY

A bug in the ointment: topical antimicrobial usage and resistance in New Zealand

Deborah A Williamson, Stephen R Ritchie, Emma Best, Arlo Upton, Alison Leversha, Alesha Smith, Mark G Thomas

New Zealand has extremely high rates of bacterial resistance to topical antibiotics such as Bactroban and Foban. This is because we use a lot of these antibiotics. In this article, we look at who gets prescribed topical antibiotics in NZ, and suggest some ways in wihch we might control and reduce rates of resistance.

SUMMARY

Maxillofacial fractures at Waikato Hospital, New Zealand: 2004 to 2013

Blake K Moore, Ryan B Smit, Angus N Colquhoun, W Murray Thomson

The rate of facial fractures presenting to Waikato Hospital has been increasing since 1989. In addition the rate of violence-related facial fractures is now at almost double the rate seen in 1998-2000. It continues to be the dominant cause of injury, while road traffic accident related fractures are decreasing. This continual increase in fractures presenting to Waikato Hospital places significant demands on scarce clinical resources, such as operating theatre time and staffing numbers. Violence is an escalating cause of facial fractures that requires urgent and interventional public health prevention strategies.

SUMMARY

Late-life self-harm in the Waikato Region

WA de Beer, J Murtagh, G Cheung

This paper looked at the attributes of late life suicide attempts i.e. in the group over 65 years of age, in the Waikato region. Elderly people identified that concomitant medical conditions and depressive illnesses were important stresses contributing to their self-harm attempts. The study highlighted some important strategies for identifying and better managing elderly people who may attempt suicide in the future.

SUMMARY

Thirty years of condom-based HIV prevention by gay men in New Zealand

Anthony J Hughes, Peter J Saxton

Three decades after the first government-funded HIV prevention campaign in 1985, gay and bisexual men remain the population most at risk of infection in New Zealand. We review the major reasons why this is the case and describe the approach that has been taken to HIV prevention here. We have a good international record in HIV prevention for gay men, however new HIV diagnoses rates are increasing once again around the world. Lessons from the first three decades must underpin future HIV control efforts and additional intervention strategies will also now be required.

SUMMARY

Drug misuse in sport: a New Zealand perspective

Andrew Curtis, David Gerrard, Peter Burt, Hamish Osborne

Drug misuse in sport is an international phenomenon that has not escaped the attention of health professionals in New Zealand. Young athletes are vulnerable to the use of performance-enhancing substances and the increasing use of sports supplements reflects a particularly worrying trend fostered by unscientific endorsements. Drug-Free Sport New Zealand is the national anti-doping agency responsible for the oversight and education of our athletes in an environment where sport is an integral part of our culture. Doctors responsible for the care of athletes have an obligation to respect the Code of the World Anti-Doping Agency.

SUMMARY

What makes a child a ‘competent’ child?

Amanda van Rooyen, Tineke Water, Shayne Rasmussen, Kate Diesfeld

To give informed consent to healthcare in New Zealand, competence is a requirement. A person needs to understand the nature, purpose and consequences of treatment and non-treatment in order to give a legally valid agreement to healthcare. However, New Zealand law is unclear on this matter where children are concerned. Although not overtly stated, New Zealand law infers that children under the age of 16 years may give or withhold consent to healthcare, independent of their parents, so long as they are competent to do so. This article raises the questions; what is child competence, why is it so important to acknowledge and how do healthcare professionals assess for child competence? Unfortunately, there is meagre research in this area and no clear answers. The assessment, recognition and respect for a childs level of competence not only supports ethical arguments regarding respect for their rights and personhood; it has other more tangible benefits to both the child and healthcare services. These include improved treatment adherence, clinical effectiveness, health service delivery and disease prevention. Therefore, this article addresses how these benefits can be realised through a better understanding and assessment of childrens abilities to participate in and consent to healthcare.

SUMMARY

‘Real-time’ burden of community and healthcare-related infections in medical and rehabilitation patients in a public hospital in Auckland, New Zealand

Kerry Read, Hasan Bhally, Sabrina Sapsford, Thomas Sapsford

This study, performed in a single public hospital in Auckland which does not provide acute surgical services, shows that a high proportion of patients admitted to hospital have a diagnosis of infection as the main or a secondary reason requiring admission- the common types being chest, urine and skin infections. It also confirms the previous finding that hospital acquired infections are relatively common with approximately 1 in 10 patients acquiring it during their hospital stay.

SUMMARY

Infrequent condom use with casual partners among New Zealand gay and bisexual men

Peter J Saxton, Nigel P Dickson, Anthony J Hughes, Adrian H Ludlam

In 2014, the highest number of gay men were diagnosed with HIV in New Zealand. Our study examined condom use in a large and diverse sample of this population. Of those having intercourse with casual partners, a quarter (27.2%) reported infrequent condom use. Attitudes to condoms and exposure to condom promotion predicted condom use, among other factors such as adoption of condoms early on in life. Internet dating sites are common places to meet sexual partners. The relationship these commercial sites have with HIV prevention and public health agencies is mixed. Cooperative models where dating sites are partners in prevention should be developed. HIV and many STIs are asymptomatic communicable infections. Like vaccination, high levels of condom use are needed to control transmission within communities. The increases in HIV and STI diagnoses seen in New Zealand provide early warning of riskier behaviours happening.

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