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Issue

Vol 132 No 1495: 17 May 2019

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Issue Summary

SUMMARY

How do intensivists treat their patients, their loved ones and themselves? Results of a survey of intensivists facing an evolving hypothetical clinical scenario

Sachin Gupta, Ravindranath Tiruvoipati, Wei Chun Wang, Cameron Green, John Botha

Intensive care specialists are often required to prognosticate critically ill patients. However, this pro-cess remains challenging and subjective. This hypothetical survey implies that there are a group of ICU patients that would be offered ongoing aggressive management despite intensivists advocating for withdrawal of life-sustaining therapy for themselves or their loved ones under similar circumstances.

SUMMARY

Indoor allergen exposure in primary school classrooms in New Zealand

Rob Siebers, Bernadette Jones, Lauren Bailey, Daniel Aldridge, Jessica Draper, Tristram Ingham

Exposure to allergens is a risk factor for respiratory symptoms in sensitised asthmatic children. There is limited data on childrens exposure to allergens in schools in New Zealand. We determined exposure to a number of allergens in classrooms of 12 primary schools. We found that exposure to house dust mite allergen there was low and unlikely to be problematic. However, nearly a quarter of school classrooms had cat allergen levels that are associated with respiratory symptoms in cat sensitised individuals. As all school classrooms were carpeted, which acts as a sink for allergens, we suggest that schools should consider smooth flooring instead of carpets.

SUMMARY

Incidence of retinopathy of prematurity in Christchurch Hospital, New Zealand over a 10-year period

Louis S Han, Antony Bedggood

The retinopathy of prematurity (ROP) is a leading cause of childhood blindness in New Zealand and developed nations. We have found low rate of ROP at Christchurch hospital over 2007-2016, compared to data from the world. At this stage we do not know the cause of the findings.

SUMMARY

Reducing days of alcohol use improves lifestyle and wellbeing: an analysis of outcomes data from New Zealand adult community alcohol and other drug services

Jennifer Lai, Paul Hanton, Angela Jury, Charito Tuason

Using established research methods, it has been possible to analyse data collected from people accessing services at the start and end of treatment for their alcohol-related issues. This analysis has shown that reducing alcohol days of use has a positive impact on lifestyle and wellbeing. The sector often discusses reducing harm, this paper shows increased benefits, a paradigm shift in thinking from reduction of a negative to increased positive.

SUMMARY

Developing New Zealand s medical workforce: realising the potential of longitudinal career tracking

Phillippa Poole, Tim J Wilkinson, Warwick Bagg, Janis Freegard, Fiona Hyland, Emmanuel Jo, Bridget Kool, Eva Roberts, Joy Rudland, Bruce Smith, Antonia Verstappen, for the NZ MSOD Steering Group

For over a decade, the Medical Schools Outcomes Database and Longitudinal Tracking Project (MSOD) has collected survey information from medical students and junior doctors in Australia and New Zealand to look at social, demographic and training effects on career intentions. In New Zealand, over 4,000 students have voluntarily provided information at various time points, and the project is at a stage where some firm conclusions are starting to be drawn. This paper presents the background to the project along with some early results, and future directions.

SUMMARY

Dispensing of medication for alcohol use disorder; an examination of large databases in a New Zealand context

Ben Beaglehole, James Foulds, Roger T Mulder, Joseph M Boden

In New Zealand, patients diagnosed with alcohol use disorder by specialist mental health services are unlikely to receive pharmacological treatments targeting their addiction such as disulfiram and naltrexone. By contrast, treatment with antidepressants and quetiapine is far more common. This suggests inadequate and poorly targeting treatments for alcohol use disorder in New Zealand.

SUMMARY

Analysis of presenting symptoms and diagnoses made at Middlemore Hospital: an audit carried out between Monday 1 August and Sunday 7 August 2016

Alistair Lock, Matt Wright

Middlemore Hospital currently has the highest volumes of patients attending across Australasia with over 400 patients presenting daily. We audited all patients presenting to the hospital over one winter week in 2016, showing the most common presenting complaints and breadth of final diagnosis made by doctors. Interestingly, analysis showed that only two of the top 25 diagnoses could be classified as life-threatening. Specific analysis of common diagnoses show that not all signs and symptoms are required for diagnosis. This information can be used to educate medical students and resident medical officers, prepare them for placements and remind them of the importance of a broad diagnostic approach when seeing a patient in the emergency department.

ALL ARTICLES
SUMMARY

Repair of Old-Standing Vesicovaginal Fistula (Mayo Method)

By G. N. MACDIARMID, M.B.

How do intensivists treat their patients, their loved ones and themselves? Results of a survey of intensivists facing an evolving hypothetical clinical scenario

Sachin Gupta, Ravindranath Tiruvoipati, Wei Chun Wang, Cameron Green, John Botha

Surgical burnout: moving from the academic to the personal?

Paul Anderson

Indoor allergen exposure in primary school classrooms in New Zealand

Rob Siebers, Bernadette Jones, Lauren Bailey, Daniel Aldridge, Jessica Draper, Tristram Ingham

Advocating for the advocates, caring for the caregivers: physician health and wellbeing

Alexandra HR Muthu

Holding a mirror to society? Sociodemographic diversity within clinical psychology training programmes across Aotearoa

Damian Scarf, Waikaremoana Waitoki, Joanna Chan, Eileen Britt, Linda Waimarie Nikora, Tia Neha, Irie Schimanski, Angus Hikairo Macfarlane, Sonja Macfarlane, Simon T Bennett, John A Hunter, Hitaua G Arahanga-Doyle, Max Abbott

Incidence of retinopathy of prematurity in Christchurch Hospital, New Zealand over a 10-year period

Louis S Han, Antony Bedggood

Reducing days of alcohol use improves lifestyle and wellbeing: an analysis of outcomes data from New Zealand adult community alcohol and other drug services

Jennifer Lai, Paul Hanton, Angela Jury, Charito Tuason

Developing New Zealand s medical workforce: realising the potential of longitudinal career tracking

Phillippa Poole, Tim J Wilkinson, Warwick Bagg, Janis Freegard, Fiona Hyland, Emmanuel Jo, Bridget Kool, Eva Roberts, Joy Rudland, Bruce Smith, Antonia Verstappen, for the NZ MSOD Steering Group

Response to œElephants in the room  editorial, 1 February 2019

Peter Townsend, Les Toop, Harley Aish, Larry Jordan, Frank Cullen

Personal experience and opinion of junior doctor burnout

Simone Watkins

Ethylene glycol poisoning: mind the gap

Joevy Lim, Anna Mearns, Chip Gresham

Dispensing of medication for alcohol use disorder; an examination of large databases in a New Zealand context

Ben Beaglehole, James Foulds, Roger T Mulder, Joseph M Boden

Randomised trial of platelet-transfusion thresholds in neonates

Analysis of presenting symptoms and diagnoses made at Middlemore Hospital: an audit carried out between Monday 1 August and Sunday 7 August 2016

Alistair Lock, Matt Wright

SUMMARY

How do intensivists treat their patients, their loved ones and themselves? Results of a survey of intensivists facing an evolving hypothetical clinical scenario

Sachin Gupta, Ravindranath Tiruvoipati, Wei Chun Wang, Cameron Green, John Botha

Intensive care specialists are often required to prognosticate critically ill patients. However, this pro-cess remains challenging and subjective. This hypothetical survey implies that there are a group of ICU patients that would be offered ongoing aggressive management despite intensivists advocating for withdrawal of life-sustaining therapy for themselves or their loved ones under similar circumstances.

SUMMARY

Indoor allergen exposure in primary school classrooms in New Zealand

Rob Siebers, Bernadette Jones, Lauren Bailey, Daniel Aldridge, Jessica Draper, Tristram Ingham

Exposure to allergens is a risk factor for respiratory symptoms in sensitised asthmatic children. There is limited data on childrens exposure to allergens in schools in New Zealand. We determined exposure to a number of allergens in classrooms of 12 primary schools. We found that exposure to house dust mite allergen there was low and unlikely to be problematic. However, nearly a quarter of school classrooms had cat allergen levels that are associated with respiratory symptoms in cat sensitised individuals. As all school classrooms were carpeted, which acts as a sink for allergens, we suggest that schools should consider smooth flooring instead of carpets.

SUMMARY

Incidence of retinopathy of prematurity in Christchurch Hospital, New Zealand over a 10-year period

Louis S Han, Antony Bedggood

The retinopathy of prematurity (ROP) is a leading cause of childhood blindness in New Zealand and developed nations. We have found low rate of ROP at Christchurch hospital over 2007-2016, compared to data from the world. At this stage we do not know the cause of the findings.

SUMMARY

Reducing days of alcohol use improves lifestyle and wellbeing: an analysis of outcomes data from New Zealand adult community alcohol and other drug services

Jennifer Lai, Paul Hanton, Angela Jury, Charito Tuason

Using established research methods, it has been possible to analyse data collected from people accessing services at the start and end of treatment for their alcohol-related issues. This analysis has shown that reducing alcohol days of use has a positive impact on lifestyle and wellbeing. The sector often discusses reducing harm, this paper shows increased benefits, a paradigm shift in thinking from reduction of a negative to increased positive.

SUMMARY

Developing New Zealand s medical workforce: realising the potential of longitudinal career tracking

Phillippa Poole, Tim J Wilkinson, Warwick Bagg, Janis Freegard, Fiona Hyland, Emmanuel Jo, Bridget Kool, Eva Roberts, Joy Rudland, Bruce Smith, Antonia Verstappen, for the NZ MSOD Steering Group

For over a decade, the Medical Schools Outcomes Database and Longitudinal Tracking Project (MSOD) has collected survey information from medical students and junior doctors in Australia and New Zealand to look at social, demographic and training effects on career intentions. In New Zealand, over 4,000 students have voluntarily provided information at various time points, and the project is at a stage where some firm conclusions are starting to be drawn. This paper presents the background to the project along with some early results, and future directions.

SUMMARY

Dispensing of medication for alcohol use disorder; an examination of large databases in a New Zealand context

Ben Beaglehole, James Foulds, Roger T Mulder, Joseph M Boden

In New Zealand, patients diagnosed with alcohol use disorder by specialist mental health services are unlikely to receive pharmacological treatments targeting their addiction such as disulfiram and naltrexone. By contrast, treatment with antidepressants and quetiapine is far more common. This suggests inadequate and poorly targeting treatments for alcohol use disorder in New Zealand.

SUMMARY

Analysis of presenting symptoms and diagnoses made at Middlemore Hospital: an audit carried out between Monday 1 August and Sunday 7 August 2016

Alistair Lock, Matt Wright

Middlemore Hospital currently has the highest volumes of patients attending across Australasia with over 400 patients presenting daily. We audited all patients presenting to the hospital over one winter week in 2016, showing the most common presenting complaints and breadth of final diagnosis made by doctors. Interestingly, analysis showed that only two of the top 25 diagnoses could be classified as life-threatening. Specific analysis of common diagnoses show that not all signs and symptoms are required for diagnosis. This information can be used to educate medical students and resident medical officers, prepare them for placements and remind them of the importance of a broad diagnostic approach when seeing a patient in the emergency department.

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