Vol 132 No 1500: 16 August 2019

PDF

Issue Summary

Article

SUMMARY

Optimising in-patient stays for surgical patients—an analysis utilising the Red and Green Bed Days management system

Odette Hart, Christopher Holdaway

There are significant delays during the admissions of hospital patients. These can lead to poorer patient health, impacts on family support networks and inefficient spending for hospitals. The vascular surgery department at Waikato Hospital New Zealand has delays due to wound dressing requirements, access to surgical theatre and ultrasound imaging. Improving hospital system to reduce these delays may lead to better care of patients and earlier discharge.

Viewpoint

SUMMARY

A unified national cardiovascular disease (CVD) risk generator is required to address equity in the management of CVD risk in clinical practice in New Zealand

Andrew J Kerr, Sue Wells, Allan Moffitt, Mayanna Lund, Jim Kriechbaum, Matire Harwood, Rod Jackson

New New Zealand equations to predict risk of future heart attacks and strokes are an important tool for GPs to use to help address the major inequities in heart attack and strokes in Aotearoa, New Zealand. However, while the new equations provide more accurate assessment of risk, they are more complicated and therefore more prone to error if not systematically implemented in GP electronic systems. To take advantage of this important opportunity to address equity in heart health we need strategic vision and national leadership. In this paper we make the case that to most safely and cost-effectively implement the new equations, the Ministry of Health (MOH) should support a unified national CVD risk generator.

Article

SUMMARY

Completeness of ANZACS-QI Cardiac Implanted DEVICE Registry and agreement with national datasets: ANZACS-QI 30

Fang Shawn Foo, Mildred Lee, Peter Larsen, David Heaven, Nigel Lever, Susan Sinclair, Martin K Stiles, Scott Harding, Dean Boddington, Rod Jackson, Andrew J Kerr, on behalf of the ANZACS-QI investigators

The ANZACS-QI DEVICE is a national registry for cardiac implantable electronic devices, including permanent pacemakers and implantable cardioverter defibrillators. This study compared the registry to the National Hospitalisation Datasets, which collects data on all New Zealand public hospital admissions. The ANZACS-QI DEVICE registry was found to capture a high proportion of procedures. There was excellent agreement of common data items in both datasets, which supports the use of either datasets for future research.

Article

SUMMARY

Mitral valve surgery with or without coronary bypass grafting: eight-year cohort study

Tom Kai Ming Wang, Yi-Wen (Becky) Liao, David Choi, Sophie Harmos, David Haydock, Ivor Gerber

This study reported the characteristics and outcomes of patients undergoing mitral valve with or without coronary bypass grafting at Auckland City Hospital during 2005-2012. Although patients undergoing the combined operation had more serious health conditions and greater risk for surgery than those only having mitral valve surgery, they still had worse outcomes for death and other complications compared to those having mitral valve surgery alone. Existing surgical risk models performed well for mitral valve surgery alone but only moderately accurate for the combined surgery.

Viewpoint

SUMMARY

Cannabis-based medicinal products and the role of the doctor: should we be cautious or cautiously optimistic?

Irene Braithwaite, Giles Newton-Howes, Karen Oldfield, Alex Semprini

Most cannabis-based products do not have enough information about how they are made or how safe and effective they are to be licensed as a medicine here in New Zealand. When the medicinal cannabis scheme comes into effect, these products can become available to patients provided they are prescribed. The current medical system in which doctors operate does not support the prescription of products that do not have data relating to quality, safety and effectiveness. Doctors will find themselves caught in a conflict between patient demand and professional obligations.

Article

SUMMARY

Car seat survey at a children's hospital: need a booster?

Navneet Singh, Julie Chambers, James K Hamill

Child car seats and booster seats save lives. Many children >5 years of age are not appropriately restrained. In 2013, the New Zealand Government amended child restraint legislation. We have shown that this has improved child restraint use in children aged 5-7 years. Since the law does not mandate booster seats for children >7 years of age, most of these children are still suboptimally restrained.

Article

SUMMARY

Anticoagulation and cataract surgery

Yu-Chieh Hung, Ainsley Morris, Mark Elder

This study retrospectively assessed the impact of the anticoagulants warfarin and dabigatran on patients who underwent cataract surgery at Christchurch Hospital in 2015. The results showed that compared to those who were not anticoagulated, there was no significant increase in the rates of bleeding during and after surgery in anticoagulated patients. Therefore, continuing the anticoagulation in this setting may be appropriate.

Article

SUMMARY

Declining adolescent cannabis use occurred across all demographic groups and was accompanied by declining use of other psychoactive drugs, New Zealand, 2001 2012

Jude Ball, Dalice Sim, Richard Edwards, Theresa Fleming, Simon Denny, Hera Cook, Terryann Clark

The Youth 2000 surveys (conducted in 2001, 2007 and 2012) showed that cannabis use declined in New Zealand secondary students between 2001 and 2012. This study, which is part of a doctoral project in-vestigating the decline in adolescent risk behaviours, investigated i) whether changes in adolescent cannabis use occurred across all demographic groups, and ii) whether declining cannabis use was ac-companied by increasing use of other psychoactive drugs. These questions were investigated via sec-ondary analysis of the Youth 2000 data (2001, 2007 and 2012), which is nationally representative. We found that the decline in adolescent cannabis use between 2001 and 2012 occurred across all main demographic groups and was not accompanied by a rise in the use of other psychoactive drugs. Ethnic and socioeconomic difference in adolescent cannabis use decreased over the study period. Note that (as far as we are aware) the data from the Youth 12 survey is the most recent published data on ado-lescent cannabis use in New Zealand.

Article

SUMMARY

The value of frenotomy for ankyloglossia from a parental perspective

Sam Illing, Martin Minnee, Jackie Wheeler, Lydia Illing

We conducted a large study of babies who had a tongue-tie affecting their ability to feed (a tongue tie is where there is a tether of skin holding the tongue down so it can t move normally). A simple procedure was done to cut this skin tether, which resulted in most of the babies able to feed much better. A third of babies who previously had been unable to breast feed despite their mothers best efforts, were then able to start breastfeeding normally after the treatment. Parents confirmed they found it to be worthwhile procedure, with 97% saying that if they were ever in the same circumstances, they would do it again.

Editorial