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Issue

Vol 130 No 1460: 11 August 2017

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Issue Summary

SUMMARY

Emm type distribution of group A streptococcus isolates from the throat swabs of children living in areas with a high (Northland and Gisborne) or low (Palmerston North) incidence of acute rheumatic fever

Noah Mhlanga, Grace Sharp, Mary Nulsen

Group A streptococci (GAS) can cause throat infections in children which can, some days later, often after the GAS have gone from the throat, trigger acute rheumatic fever. GAS can be distinguished by differences in their M proteins encoded by emm genes; there are over 200 emm types. Data from the US suggest that the emm types that cause acute rheumatic fever are distinct from other GAS. Although we did find differences in the emm types of GAS from children living in areas with a high (Northland and Gisborne) or low (Palmerston North) incidence of acute rheumatic fever, there was no obvious correlation between the distribution of GAS emm types known to be associated with acute rheumatic fever in New Zealand and actual disease incidence. We also found that most of the emm patterns circulating among the throat of all three groups of children were either skin specialists or generalists, able to colonise both skin and throat. This is somewhat anomalous since all of the GAS we typed were isolated from the throats of children.

SUMMARY

Medication-related patient harm in New Zealand hospitals

Gillian Robb, Elizabeth Loe, Ashika Maharaj, Richard Hamblin, Mary E Seddon00a0

The purpose of this study was to identify the extent of medication-related harm in New Zealand and to use this information to inform decision on where to focus medication safety efforts. The study used a trigger tool, which is a method designed to identify harm from reviewing medical records, rather than relying on voluntary reporting. The results show that medication-related harms are commonfor every 100 hospital admissions, over 30 patients suffer medication-related harm. While most were minor (61%), more than a third (35%) prompting admission to hospital or prolonging the hospital stay, and 1.6% were associated with permanent harm or death. Opioids and blood thinners were the medication classes responsible for most harm (40%) and the most severe harm. This information helps target medication safety improvement efforts to reduce harm.

SUMMARY

Is a rheumatic fever register the best surveillance tool to evaluate rheumatic fever control in the Auckland region?

Diana Lennon, Te Aro Moxon, Philippa Anderson, Alison Leversha, Timothy Jelleyman, Peter Reed, Catherine Jackson

Rheumatic fever is preventable. It causes long-term heart disease in many and can even cause premature death. It is important to count the cases carefully and accurately as there is an important campaign underway to prevent it by treating strep sore throats. We looked at the different methods for case counting. A register is the best way, well established in the Auckland region for several decades and leading to the current MOH campaign.

SUMMARY

Mortality within 30 days of systemic anticancer therapy at a tertiary cancer centre: assessing the safety and quality of clinical care

Michelle Wilson, Weng Mak, Melissa Firth, Sanjeev Deva, Michael Findlay

Thirty-day mortality has been proposed to be a useful indicator of avoidable harm to patients from systemic anticancer therapies. As a quality assurance tool, we assessed the 30-day mortality rate at Auckland City Hospital and compared this with international standards. Our local 30-day mortality data compared favourably to international benchmarks of 5% and has not increased over time. Performance of similar studies locally and nationally should be undertaken to continue to assess and improve the quality of our patient care.

SUMMARY

What is the relationship between visual impairment and cognitive function in octogenarians?

Denise S de Kok, Ruth O Teh, Avinesh Pillai, Martin J Connolly, Tim J Wilkinson, Robert Jacobs, Marama Muru-Lanning, Anna Rolleston, Simon A Moyes, Dieuwke Schiphof, Ngaire Kerse

With an ageing population, it is projected that the prevalence of dementia will increase. Various modifiable risk factors for dementia have been established and vision loss is of particular interest because it is often treatable. Utilising data from the LiLACS NZ study, this study aims to examine the direct and indirect relationship between vision loss and cognition in more than 600 older adults born between 1920 and 1930. The study found that about one in five older adults have visual impairment and it is not associated with cognition. The relationship between visual impairment and cognition was influenced by one s ability to perform normal daily activities.

SUMMARY

An in-country model of workforce support for trained mid-level eye care workers in Papua New Guinea and Pacific Islands

Julie Br\u00fbl, Benoit Tousignant, Graeme Nicholls, Matthew G Pearce

Training eye care workers to alleviate the burden of blindness and vision impairment in an under-resourced area is not enough: once trained, the workers need to be integrated and retained in their country s workforce. Their competencies must be upheld, and they need to be introduced to new skills and knowledge. A workforce support programme that addresses all those needs is a powerful tool to improve the delivery of eye care services.

ALL ARTICLES
SUMMARY

Emm type distribution of group A streptococcus isolates from the throat swabs of children living in areas with a high (Northland and Gisborne) or low (Palmerston North) incidence of acute rheumatic fever

Noah Mhlanga, Grace Sharp, Mary Nulsen

Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding

A case of regurgitant vomiting

By E.C. Barnett, M.R.C.S., Capt., N.Z.M.C.

Medication-related patient harm in New Zealand hospitals

Gillian Robb, Elizabeth Loe, Ashika Maharaj, Richard Hamblin, Mary E Seddon00a0

Is a rheumatic fever register the best surveillance tool to evaluate rheumatic fever control in the Auckland region?

Diana Lennon, Te Aro Moxon, Philippa Anderson, Alison Leversha, Timothy Jelleyman, Peter Reed, Catherine Jackson

Abstracts for the 235th Scientific Meeting of the Otago Medical School Research Society

Mortality within 30 days of systemic anticancer therapy at a tertiary cancer centre: assessing the safety and quality of clinical care

Michelle Wilson, Weng Mak, Melissa Firth, Sanjeev Deva, Michael Findlay

Are young people eating their way to bowel cancer?

Jacqui Keenan, Alan Aitchison, Frank Frizelle

What is the relationship between visual impairment and cognitive function in octogenarians?

Denise S de Kok, Ruth O Teh, Avinesh Pillai, Martin J Connolly, Tim J Wilkinson, Robert Jacobs, Marama Muru-Lanning, Anna Rolleston, Simon A Moyes, Dieuwke Schiphof, Ngaire Kerse

Cricket, collision and coronary clot

Gary TE Lau, Ali Khan

Erratum

An in-country model of workforce support for trained mid-level eye care workers in Papua New Guinea and Pacific Islands

Julie Br\u00fbl, Benoit Tousignant, Graeme Nicholls, Matthew G Pearce

Not too much; not too little; just right: remediation during medical school

Phillippa Poole

Rheumatic fever as an indicator of child health

Diana Lennon

SUMMARY

Emm type distribution of group A streptococcus isolates from the throat swabs of children living in areas with a high (Northland and Gisborne) or low (Palmerston North) incidence of acute rheumatic fever

Noah Mhlanga, Grace Sharp, Mary Nulsen

Group A streptococci (GAS) can cause throat infections in children which can, some days later, often after the GAS have gone from the throat, trigger acute rheumatic fever. GAS can be distinguished by differences in their M proteins encoded by emm genes; there are over 200 emm types. Data from the US suggest that the emm types that cause acute rheumatic fever are distinct from other GAS. Although we did find differences in the emm types of GAS from children living in areas with a high (Northland and Gisborne) or low (Palmerston North) incidence of acute rheumatic fever, there was no obvious correlation between the distribution of GAS emm types known to be associated with acute rheumatic fever in New Zealand and actual disease incidence. We also found that most of the emm patterns circulating among the throat of all three groups of children were either skin specialists or generalists, able to colonise both skin and throat. This is somewhat anomalous since all of the GAS we typed were isolated from the throats of children.

SUMMARY

Medication-related patient harm in New Zealand hospitals

Gillian Robb, Elizabeth Loe, Ashika Maharaj, Richard Hamblin, Mary E Seddon00a0

The purpose of this study was to identify the extent of medication-related harm in New Zealand and to use this information to inform decision on where to focus medication safety efforts. The study used a trigger tool, which is a method designed to identify harm from reviewing medical records, rather than relying on voluntary reporting. The results show that medication-related harms are commonfor every 100 hospital admissions, over 30 patients suffer medication-related harm. While most were minor (61%), more than a third (35%) prompting admission to hospital or prolonging the hospital stay, and 1.6% were associated with permanent harm or death. Opioids and blood thinners were the medication classes responsible for most harm (40%) and the most severe harm. This information helps target medication safety improvement efforts to reduce harm.

SUMMARY

Is a rheumatic fever register the best surveillance tool to evaluate rheumatic fever control in the Auckland region?

Diana Lennon, Te Aro Moxon, Philippa Anderson, Alison Leversha, Timothy Jelleyman, Peter Reed, Catherine Jackson

Rheumatic fever is preventable. It causes long-term heart disease in many and can even cause premature death. It is important to count the cases carefully and accurately as there is an important campaign underway to prevent it by treating strep sore throats. We looked at the different methods for case counting. A register is the best way, well established in the Auckland region for several decades and leading to the current MOH campaign.

SUMMARY

Mortality within 30 days of systemic anticancer therapy at a tertiary cancer centre: assessing the safety and quality of clinical care

Michelle Wilson, Weng Mak, Melissa Firth, Sanjeev Deva, Michael Findlay

Thirty-day mortality has been proposed to be a useful indicator of avoidable harm to patients from systemic anticancer therapies. As a quality assurance tool, we assessed the 30-day mortality rate at Auckland City Hospital and compared this with international standards. Our local 30-day mortality data compared favourably to international benchmarks of 5% and has not increased over time. Performance of similar studies locally and nationally should be undertaken to continue to assess and improve the quality of our patient care.

SUMMARY

What is the relationship between visual impairment and cognitive function in octogenarians?

Denise S de Kok, Ruth O Teh, Avinesh Pillai, Martin J Connolly, Tim J Wilkinson, Robert Jacobs, Marama Muru-Lanning, Anna Rolleston, Simon A Moyes, Dieuwke Schiphof, Ngaire Kerse

With an ageing population, it is projected that the prevalence of dementia will increase. Various modifiable risk factors for dementia have been established and vision loss is of particular interest because it is often treatable. Utilising data from the LiLACS NZ study, this study aims to examine the direct and indirect relationship between vision loss and cognition in more than 600 older adults born between 1920 and 1930. The study found that about one in five older adults have visual impairment and it is not associated with cognition. The relationship between visual impairment and cognition was influenced by one s ability to perform normal daily activities.

SUMMARY

An in-country model of workforce support for trained mid-level eye care workers in Papua New Guinea and Pacific Islands

Julie Br\u00fbl, Benoit Tousignant, Graeme Nicholls, Matthew G Pearce

Training eye care workers to alleviate the burden of blindness and vision impairment in an under-resourced area is not enough: once trained, the workers need to be integrated and retained in their country s workforce. Their competencies must be upheld, and they need to be introduced to new skills and knowledge. A workforce support programme that addresses all those needs is a powerful tool to improve the delivery of eye care services.

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