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Issue

Vol 131 No 1485: 9 November 2018

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Issue Summary

SUMMARY

Incidence of motor neurone disease within MidCentral Region, New Zealand

Alexandra Caulfield, Pietro Cariga

Motor neuron disease is one of the most devastating pathologies and can affect people seemingly at random with severe disability, rapid unstoppable progression and short survival. Despite extensive research efforts, it remains essentially untreatable. Previous studies suggested that New Zealand has an unusually high number of subjects affected by motor neuron disease. This study, looking at all new cases of motor neuron disease in the Midcentral DHB region in the last five years, corroborates the suspicion of a high rate compared to other areas of the world, and could contribute to the understanding of potential environmental or genetic factors linked with the disease.

SUMMARY

A prospective audit of the 10-year outcomes from low dose-rate brachytherapy for early stage prostate cancer

David S Lamb, Lynne Greig, Grant Russell, John N Nacey, Kim Broome, Mohua Jain, Judith Murray, Peter J Lamb, Lisa Woods

This is one of the largest series of men with early stage prostate cancer treated with radioactive seed implantation reported anywhere in the world. The treatment has been shown to cure most men with only minor side effects, confirming its position as a front line treatment option for men with such cancers. The results also confirm that the use of complex modern technology can sometimes lead to remarkable medical outcomes.

SUMMARY

Privacy protection for health information research in New Zealand district health boards

Vithya Yogarajan, Michael Mayo, Bernhard Pfahringer

All DHBs that provided patient data for research self-reported that their practices met New Zealand standards. This was done through a combination of individual patient consent, research approval and data de-identification. However, not all the de-identified data was de-identified to the full extent considered best practice internationally. DHBs also lacked standard operating procedures specifically for de-identification of patient data.

SUMMARY

Distress in informal carers of the elderly in New Zealand

Nicola Swain

For most elderly people in New Zealand, care is provided by a family member. These carers, who are unpaid, can find the job tough. As well as economic costs they have high rates of anxiety and depression. We also found caring restricted their personal and social lives and compromised their physical and emotional health. Most people in the survey said the reason they cared for their relative was love. The health system needs to offer more support for these people to continue this extremely valuable service.

SUMMARY

Proposal for a National Interprofessional School of Rural Health

Garry H Nixon, Ngaire M Kerse, Warwick Bagg, Margot A Skinner, Peter J Larmer, Peter Crampton

Shortages of health professionals persist in much of rural New Zealand despite a range of initiatives. The proposed National Interprofessional School of Rural Health is not a separate education provider, but rather an enabling body that would lever off the expertise and resources of the existing tertiary institutions, colleges and rural communities. Sharing human, physical and other resources would permit these institutions to educate students and undertake research in rural communities in ways currently not possible. It would create a community of health professional teachers and researchers in rural areas. The NISRU would help lift the profile and status and support standards of practice for a range of rural health professional groups.

SUMMARY

Te Wero tonu—the challenge continues: Māori access to medicines 2006/07–2012/13 update

Scott Metcalfe, Kebede Beyene, Jude Urlich, Rhys Jones, Catherine Proffitt, Jeff Harrison, \u0100tene Andrews

This paper summarises a commissioned update, by the University of Auckland for 2012/13, of previous research on the shortfall in community medicines dispensed for Mori compared with non-Mori, adjusting for age, population and burden of disease and what PHARMAC and the health sector needs to do about it. Although complexities and limitations affect interpretation, substantial and unacceptable inequities in medicines access for Mori remain, and are unchanged six years on. Their causes are likely many, complex and entrenched, needing an all-of-sector approach and beyond to address. Deeper understanding of systems and barriers is required, as well as pragmatic ways to monitor outcomes. PHARMAC is committed to eliminating inequities in access to medicines as one of its key priorities; everyone in the health sector has a role.

SUMMARY

Mana Tū: a whānau ora approach to type 2 diabetes

Matire Harwood, Taria Tane, Laura Broome, Peter Carswell, Vanessa Selak, Jennifer Reid, Phil Light, Tereki Stewart

This paper describes the rationale behind the development of the Mana T\u016b programme. Mana T\u016b is a unique Mori-lead programme developed and led by the National Hauora Coalition that supports people with poorly controlled type 2 diabetes to successfully self-manage with their condition. The programme was developed alongside patients with type 2 diabetes, as well as doctors, and aims to address both health barriers (things like lack of knowledge around healthy eating, what medications do and physical activity) and social barriers (things like financial, housing and transport issues) that can stop people from living well with their condition.

SUMMARY

Antidepressant prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

New Zealand has accurate data on prescriptions. In 2018, 12.6% of all New Zealanders were prescribed an antidepressant, an increase of 21% from 2008. Women are more likely to receive antidepressants than men, especially European women. The majority of antidepressants prescribed are SSRIs.

ALL ARTICLES
SUMMARY

Incidence of motor neurone disease within MidCentral Region, New Zealand

Alexandra Caulfield, Pietro Cariga

Rural matters

Peter Crampton, Jo Baxter

A prospective audit of the 10-year outcomes from low dose-rate brachytherapy for early stage prostate cancer

David S Lamb, Lynne Greig, Grant Russell, John N Nacey, Kim Broome, Mohua Jain, Judith Murray, Peter J Lamb, Lisa Woods

Privacy protection for health information research in New Zealand district health boards

Vithya Yogarajan, Michael Mayo, Bernhard Pfahringer

Do interns publish findings of their scholarly research projects?

Yassar Alamri

Nervous Debility

Surgical management of self-inflicted facial gunshot wounds

Katie Goad, Thasvir Singh

Gout in Aotearoa New Zealand: the equity crisis continues in plain sight

Nicola Dalbeth, Tony Dowell, Catherine Gerard, Peter Gow, Gary Jackson, Carl Shuker, Leanne Te Karu

Distress in informal carers of the elderly in New Zealand

Nicola Swain

Proposal for a National Interprofessional School of Rural Health

Garry H Nixon, Ngaire M Kerse, Warwick Bagg, Margot A Skinner, Peter J Larmer, Peter Crampton

Antidepressant prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

Failure to refer

A population-based study of the diabetes paradox in stress cardiomyopathy

George M Watson, Christina W Chan, Kit Doudney, Paul G Bridgman

Te Wero tonu—the challenge continues: Māori access to medicines 2006/07–2012/13 update

Scott Metcalfe, Kebede Beyene, Jude Urlich, Rhys Jones, Catherine Proffitt, Jeff Harrison, \u0100tene Andrews

Mana Tū: a whānau ora approach to type 2 diabetes

Matire Harwood, Taria Tane, Laura Broome, Peter Carswell, Vanessa Selak, Jennifer Reid, Phil Light, Tereki Stewart

Risks and benefits of direct oral anticoagulants versus warfarin

SUMMARY

Incidence of motor neurone disease within MidCentral Region, New Zealand

Alexandra Caulfield, Pietro Cariga

Motor neuron disease is one of the most devastating pathologies and can affect people seemingly at random with severe disability, rapid unstoppable progression and short survival. Despite extensive research efforts, it remains essentially untreatable. Previous studies suggested that New Zealand has an unusually high number of subjects affected by motor neuron disease. This study, looking at all new cases of motor neuron disease in the Midcentral DHB region in the last five years, corroborates the suspicion of a high rate compared to other areas of the world, and could contribute to the understanding of potential environmental or genetic factors linked with the disease.

SUMMARY

A prospective audit of the 10-year outcomes from low dose-rate brachytherapy for early stage prostate cancer

David S Lamb, Lynne Greig, Grant Russell, John N Nacey, Kim Broome, Mohua Jain, Judith Murray, Peter J Lamb, Lisa Woods

This is one of the largest series of men with early stage prostate cancer treated with radioactive seed implantation reported anywhere in the world. The treatment has been shown to cure most men with only minor side effects, confirming its position as a front line treatment option for men with such cancers. The results also confirm that the use of complex modern technology can sometimes lead to remarkable medical outcomes.

SUMMARY

Privacy protection for health information research in New Zealand district health boards

Vithya Yogarajan, Michael Mayo, Bernhard Pfahringer

All DHBs that provided patient data for research self-reported that their practices met New Zealand standards. This was done through a combination of individual patient consent, research approval and data de-identification. However, not all the de-identified data was de-identified to the full extent considered best practice internationally. DHBs also lacked standard operating procedures specifically for de-identification of patient data.

SUMMARY

Distress in informal carers of the elderly in New Zealand

Nicola Swain

For most elderly people in New Zealand, care is provided by a family member. These carers, who are unpaid, can find the job tough. As well as economic costs they have high rates of anxiety and depression. We also found caring restricted their personal and social lives and compromised their physical and emotional health. Most people in the survey said the reason they cared for their relative was love. The health system needs to offer more support for these people to continue this extremely valuable service.

SUMMARY

Proposal for a National Interprofessional School of Rural Health

Garry H Nixon, Ngaire M Kerse, Warwick Bagg, Margot A Skinner, Peter J Larmer, Peter Crampton

Shortages of health professionals persist in much of rural New Zealand despite a range of initiatives. The proposed National Interprofessional School of Rural Health is not a separate education provider, but rather an enabling body that would lever off the expertise and resources of the existing tertiary institutions, colleges and rural communities. Sharing human, physical and other resources would permit these institutions to educate students and undertake research in rural communities in ways currently not possible. It would create a community of health professional teachers and researchers in rural areas. The NISRU would help lift the profile and status and support standards of practice for a range of rural health professional groups.

SUMMARY

Antidepressant prescribing in New Zealand between 2008 and 2015

Sam Wilkinson, Roger T Mulder

New Zealand has accurate data on prescriptions. In 2018, 12.6% of all New Zealanders were prescribed an antidepressant, an increase of 21% from 2008. Women are more likely to receive antidepressants than men, especially European women. The majority of antidepressants prescribed are SSRIs.

SUMMARY

Te Wero tonu—the challenge continues: Māori access to medicines 2006/07–2012/13 update

Scott Metcalfe, Kebede Beyene, Jude Urlich, Rhys Jones, Catherine Proffitt, Jeff Harrison, \u0100tene Andrews

This paper summarises a commissioned update, by the University of Auckland for 2012/13, of previous research on the shortfall in community medicines dispensed for Mori compared with non-Mori, adjusting for age, population and burden of disease and what PHARMAC and the health sector needs to do about it. Although complexities and limitations affect interpretation, substantial and unacceptable inequities in medicines access for Mori remain, and are unchanged six years on. Their causes are likely many, complex and entrenched, needing an all-of-sector approach and beyond to address. Deeper understanding of systems and barriers is required, as well as pragmatic ways to monitor outcomes. PHARMAC is committed to eliminating inequities in access to medicines as one of its key priorities; everyone in the health sector has a role.

SUMMARY

Mana Tū: a whānau ora approach to type 2 diabetes

Matire Harwood, Taria Tane, Laura Broome, Peter Carswell, Vanessa Selak, Jennifer Reid, Phil Light, Tereki Stewart

This paper describes the rationale behind the development of the Mana T\u016b programme. Mana T\u016b is a unique Mori-lead programme developed and led by the National Hauora Coalition that supports people with poorly controlled type 2 diabetes to successfully self-manage with their condition. The programme was developed alongside patients with type 2 diabetes, as well as doctors, and aims to address both health barriers (things like lack of knowledge around healthy eating, what medications do and physical activity) and social barriers (things like financial, housing and transport issues) that can stop people from living well with their condition.

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