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Issue

Vol 129 No 1440: 19 August 2016

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Issue Summary

SUMMARY

Why are those most in need of Sudden Unexplained Infant Death (SUDI) Prevention information the least likely to receive it? A comment on unconscious bias and Māori health

Carla A Houkamau, Kathrine Clarke

This paper expands discussions of unconscious bias into the New Zealand health care arena. We review international research which links health provider bias to inequitable health outcomes for ethnic minorities as well as local data which indicates Mori may be vulnerable to bias. Our focus is on outcomes from the 2014 Well Child/Tamariki Ora (WCTO) Programme Delivery Report which shows Mori are less likely to receive SUDI prevention information from their Well-child health provider than other ethnic groups in New Zealand.

SUMMARY

In-hospital morbidity and brain metrics of preterm neonates born 1998 2009

Sarah L Harris, Nicola C Austin, Malcolm Battin, Roland Broadbent, John Horwood, Ross Keenan, Scott Wells, Carole Spencer, Patricia Graham, Lianne J Woodward, Brian A Darlow

Mortality and morbidity of infants born extremely premature in the antenatal steroid and early surfactant era have fallen. Morbidity following extremely preterm birth impacts on future health. Brain metrics is a novel simple, reproducible means of assessing brain growth in neonates born preterm. This study describes the survival, in-hospital morbidity, brain metrics and two-year neurodevelopmental outcomes of two extremely preterm cohorts and discusses the contribution of changes in clinical practice to these outcomes. The outcomes at hospital discharge of extremely preterm infants have improved since 1998 with better initial physiological stability, improved nutrition, decreased rates of chronic lung disease and improved brain metrics and neurodevelopment. This study adds to the accumulating data regarding the utility of brain metrics as a means of assessing brain growth in the preterm population and identifies multiple quality improvements in clinical care.

SUMMARY

Productivity losses associated with Fetal Alcohol Spectrum Disorder in New Zealand

Brian Easton, Larry Burd, J\u00fcrgen Rehm, Svetlana Popova

FASD, Foetal Alcohol Spectrum Disorders, arise from the drinking of alcohol by pregnant mothers damaging the brain development of the unborn child causing permanent cognitive damage which limit the child and impact on the child s family and society as a whole by greater demand for health services, poorer educational performance, lower labour productivity and, in some cases, greater pressure on the justice system; it is thought that about one percent of the population suffer from FASD. The research estimates that the labour force productivity loss due to FASD-attributable morbidity and premature mortality translated to an aggregate loss in 2013 in the range from $49 million to $NZ200 million between 0.03% and 0.09% of the annual gross domestic product. An effective preventive program, which made the public aware of drinking alcohol during pregnancy and discouraged pregnant women from drinking, would more than pay for itself in terms of productivity gains in the labour force; there would be additional public gains from reductions in demands on health services, more effective educational services and lower use of justice services, while family stress would be reduced.

SUMMARY

Methods of a national colorectal cancer cohort study: the PIPER Project

Melissa J Firth, Katrina J Sharples, Victoria A Hinder, Jerome Macapagal, Diana Sarfati, Sarah L Derrett, Andrew G Hill, Charis Brown, Papaarangi MJ Reid, Ross A Lawrenson, Carol Atmore, John P Keating, Mark Jeffery, Adrian H Secker, Charles De Groot, Christopher GCA Jackson, Michael PN Findlay

A national study looking at bowel cancer in New Zealand has previously been completed (the PIPER Project). The study included 5,610 patients and collected medical information about how each person was found to have bowel cancer and the treatment they received. This paper reports how the study was carried out. The information collected in the study will be used to look at the quality of care being provided to New Zealand patients with bowel cancer, and to find out if differences in care occur based on where people live, their ethnicity and their socioeconomic status.

SUMMARY

The incidence of Orofacial Cleft in live births in New Zealand

John MD Thompson, Peter R Stone, Megan Sanders, Harriette van der Zee, Barry Borman, Peter V Fowler

The overall incidence of oro-facial cleft in New Zealand over a ten year period was found to be 1.79 per 1,000 live births, higher than the norm for Western society. Mori rates are higher mainly due to a high rate of cleft palate alone (the highest known reported rate in the world). Different sex ratios were also seen in relation to Cleft Lip and Cleft Lip and Palate for Mori and Pacific compared to those normally reported. This data provides the basis for ongoing research in relation to outcomes of children born with oro-facial cleft. It also provides the impetus for further work understanding the environmental and genetic risk factors associated with oro-facial cleft.

SUMMARY

Little risk of severe complications associated with Zika infection in New Zealand

Gareth J Parry, Matthew Peacey, Eric J Buenz

Zika virus has established endemicity in the Pacific basin and has engendered considerable anxiety about its possible entry into New Zealand. Person-to-person infection through the mosquito vector is not possible in New Zealand but the country does not harbour the specific mosquito species. There is a low risk of sexual transmission or transmission through other body fluids. Serious complications associated with Zika infection include microcephaly and Guillain-Barre syndrome and individuals returning from an endemic area with a febrile illness should be checked for Zika infection and counselled regarding risk to the foetus and monitored closely if neurological symptoms occur.

SUMMARY

Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district

Simon Thornley, Roger Marshall

People who are treated in hospital and identified with a lack of housing are at high risk of death, with a life-expectancy about 20 years lower than the general population. Mori and Pacific people are over-represented in this population. Substance use and complications of use is common in this population. While cigarette smoking is likely to be responsible for the greatest burden of early death in this population, cannabis use in this group is also strongly associated with premature death.

SUMMARY

Continuity of cancer patient care in New Zealand: the general practitioner perspective

Paul Kane, Marieke Jasperse, Richard Egan, Lynn McBain, E McKinlay, Susan Pullon, Patries Herst

As cancer therapies become increasingly effective, the number of cancer patients seeking long-term support from GPs is going up. This study investigated the perspective of GPs on issues around continuity of care for these patients. GPs who contributed noted they wanted more involvement with cancer patients but were not always clear as to their role. Poor communication with other facets of the healthcare system and barriers for patients in accessing GP care, are areas for improvement. Addressing these issues will improve the lot of cancer patients.

ALL ARTICLES
SUMMARY

Is New Zealand s visual acuity screening programme in school-age children justified?

Nishanthan Ramachandran, Nick Wilson, Graham A Wilson

Why are those most in need of Sudden Unexplained Infant Death (SUDI) Prevention information the least likely to receive it? A comment on unconscious bias and Māori health

Carla A Houkamau, Kathrine Clarke

Better health or better business: a critique of the childhood obesity plan

Gerhard Sundborn, Simon Thornley, Bodo Lang, Rob Beaglehole

In-hospital morbidity and brain metrics of preterm neonates born 1998 2009

Sarah L Harris, Nicola C Austin, Malcolm Battin, Roland Broadbent, John Horwood, Ross Keenan, Scott Wells, Carole Spencer, Patricia Graham, Lianne J Woodward, Brian A Darlow

Productivity losses associated with Fetal Alcohol Spectrum Disorder in New Zealand

Brian Easton, Larry Burd, J\u00fcrgen Rehm, Svetlana Popova

A rare case of bacterial conjunctivitis: the importance of pre-antibiotic swabs for microbiology

Peter Murray, Annette Nesdale, Michelle Balm

Follow-up of cancer in New Zealand: time to review the model of care

Christopher Jackson

Untreated poultry litter as a source of antibiotic resistance

Lance Gravatt

Methods of a national colorectal cancer cohort study: the PIPER Project

Melissa J Firth, Katrina J Sharples, Victoria A Hinder, Jerome Macapagal, Diana Sarfati, Sarah L Derrett, Andrew G Hill, Charis Brown, Papaarangi MJ Reid, Ross A Lawrenson, Carol Atmore, John P Keating, Mark Jeffery, Adrian H Secker, Charles De Groot, Christopher GCA Jackson, Michael PN Findlay

The incidence of Orofacial Cleft in live births in New Zealand

John MD Thompson, Peter R Stone, Megan Sanders, Harriette van der Zee, Barry Borman, Peter V Fowler

Little risk of severe complications associated with Zika infection in New Zealand

Gareth J Parry, Matthew Peacey, Eric J Buenz

Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district

Simon Thornley, Roger Marshall

Continuity of cancer patient care in New Zealand: the general practitioner perspective

Paul Kane, Marieke Jasperse, Richard Egan, Lynn McBain, E McKinlay, Susan Pullon, Patries Herst

A short voyage on a hospital ship

Ghosts in the machine: just how accurate is PubMed?

Frank Houghton

SUMMARY

Why are those most in need of Sudden Unexplained Infant Death (SUDI) Prevention information the least likely to receive it? A comment on unconscious bias and Māori health

Carla A Houkamau, Kathrine Clarke

This paper expands discussions of unconscious bias into the New Zealand health care arena. We review international research which links health provider bias to inequitable health outcomes for ethnic minorities as well as local data which indicates Mori may be vulnerable to bias. Our focus is on outcomes from the 2014 Well Child/Tamariki Ora (WCTO) Programme Delivery Report which shows Mori are less likely to receive SUDI prevention information from their Well-child health provider than other ethnic groups in New Zealand.

SUMMARY

In-hospital morbidity and brain metrics of preterm neonates born 1998 2009

Sarah L Harris, Nicola C Austin, Malcolm Battin, Roland Broadbent, John Horwood, Ross Keenan, Scott Wells, Carole Spencer, Patricia Graham, Lianne J Woodward, Brian A Darlow

Mortality and morbidity of infants born extremely premature in the antenatal steroid and early surfactant era have fallen. Morbidity following extremely preterm birth impacts on future health. Brain metrics is a novel simple, reproducible means of assessing brain growth in neonates born preterm. This study describes the survival, in-hospital morbidity, brain metrics and two-year neurodevelopmental outcomes of two extremely preterm cohorts and discusses the contribution of changes in clinical practice to these outcomes. The outcomes at hospital discharge of extremely preterm infants have improved since 1998 with better initial physiological stability, improved nutrition, decreased rates of chronic lung disease and improved brain metrics and neurodevelopment. This study adds to the accumulating data regarding the utility of brain metrics as a means of assessing brain growth in the preterm population and identifies multiple quality improvements in clinical care.

SUMMARY

Productivity losses associated with Fetal Alcohol Spectrum Disorder in New Zealand

Brian Easton, Larry Burd, J\u00fcrgen Rehm, Svetlana Popova

FASD, Foetal Alcohol Spectrum Disorders, arise from the drinking of alcohol by pregnant mothers damaging the brain development of the unborn child causing permanent cognitive damage which limit the child and impact on the child s family and society as a whole by greater demand for health services, poorer educational performance, lower labour productivity and, in some cases, greater pressure on the justice system; it is thought that about one percent of the population suffer from FASD. The research estimates that the labour force productivity loss due to FASD-attributable morbidity and premature mortality translated to an aggregate loss in 2013 in the range from $49 million to $NZ200 million between 0.03% and 0.09% of the annual gross domestic product. An effective preventive program, which made the public aware of drinking alcohol during pregnancy and discouraged pregnant women from drinking, would more than pay for itself in terms of productivity gains in the labour force; there would be additional public gains from reductions in demands on health services, more effective educational services and lower use of justice services, while family stress would be reduced.

SUMMARY

Methods of a national colorectal cancer cohort study: the PIPER Project

Melissa J Firth, Katrina J Sharples, Victoria A Hinder, Jerome Macapagal, Diana Sarfati, Sarah L Derrett, Andrew G Hill, Charis Brown, Papaarangi MJ Reid, Ross A Lawrenson, Carol Atmore, John P Keating, Mark Jeffery, Adrian H Secker, Charles De Groot, Christopher GCA Jackson, Michael PN Findlay

A national study looking at bowel cancer in New Zealand has previously been completed (the PIPER Project). The study included 5,610 patients and collected medical information about how each person was found to have bowel cancer and the treatment they received. This paper reports how the study was carried out. The information collected in the study will be used to look at the quality of care being provided to New Zealand patients with bowel cancer, and to find out if differences in care occur based on where people live, their ethnicity and their socioeconomic status.

SUMMARY

The incidence of Orofacial Cleft in live births in New Zealand

John MD Thompson, Peter R Stone, Megan Sanders, Harriette van der Zee, Barry Borman, Peter V Fowler

The overall incidence of oro-facial cleft in New Zealand over a ten year period was found to be 1.79 per 1,000 live births, higher than the norm for Western society. Mori rates are higher mainly due to a high rate of cleft palate alone (the highest known reported rate in the world). Different sex ratios were also seen in relation to Cleft Lip and Cleft Lip and Palate for Mori and Pacific compared to those normally reported. This data provides the basis for ongoing research in relation to outcomes of children born with oro-facial cleft. It also provides the impetus for further work understanding the environmental and genetic risk factors associated with oro-facial cleft.

SUMMARY

Little risk of severe complications associated with Zika infection in New Zealand

Gareth J Parry, Matthew Peacey, Eric J Buenz

Zika virus has established endemicity in the Pacific basin and has engendered considerable anxiety about its possible entry into New Zealand. Person-to-person infection through the mosquito vector is not possible in New Zealand but the country does not harbour the specific mosquito species. There is a low risk of sexual transmission or transmission through other body fluids. Serious complications associated with Zika infection include microcephaly and Guillain-Barre syndrome and individuals returning from an endemic area with a febrile illness should be checked for Zika infection and counselled regarding risk to the foetus and monitored closely if neurological symptoms occur.

SUMMARY

Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district

Simon Thornley, Roger Marshall

People who are treated in hospital and identified with a lack of housing are at high risk of death, with a life-expectancy about 20 years lower than the general population. Mori and Pacific people are over-represented in this population. Substance use and complications of use is common in this population. While cigarette smoking is likely to be responsible for the greatest burden of early death in this population, cannabis use in this group is also strongly associated with premature death.

SUMMARY

Continuity of cancer patient care in New Zealand: the general practitioner perspective

Paul Kane, Marieke Jasperse, Richard Egan, Lynn McBain, E McKinlay, Susan Pullon, Patries Herst

As cancer therapies become increasingly effective, the number of cancer patients seeking long-term support from GPs is going up. This study investigated the perspective of GPs on issues around continuity of care for these patients. GPs who contributed noted they wanted more involvement with cancer patients but were not always clear as to their role. Poor communication with other facets of the healthcare system and barriers for patients in accessing GP care, are areas for improvement. Addressing these issues will improve the lot of cancer patients.

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