Issue

Vol 132 No 1505: 8 November 2019

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Issue Summary

Viewpoint

SUMMARY

When every second counts: ampoule versus adrenaline auto-injector administration for life-threatening allergy

Elissa M McDonald, Emma Cooper

Worldwide there has been a marked increase in the rate of anaphylactic reactions with studies reporting increases in many countries. Management of anaphylaxis in the community needs to be appropriate and effective. In New Zealand, the only available adrenaline auto-injector (EpiPen\u00ae) delivers adrenaline deep into the muscle with the aid of the force of the spring-action needle. Alternative delivery is from an ampoule, needle and syringe that must be prepared and administered manually. There are justifiable concerns about the timely and safe intramuscular delivery of adrenaline manually by lay persons in the community. EpiPen\u00ae ensures the ability of individuals to administer the correct dose of adrenaline via the correct route in a timely and effective manner. PHARMAC is urged to fund the only available adrenaline auto-injection available in New Zealand, EpiPen\u00ae.

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SUMMARY

Untreated severe-to-profound hearing loss and the cochlear implant situation: how policy and practice are disabling New Zealand society

Lewis Williams

As a signatory to Convention on the Rights of People with Disabilities, Aotearoa New Zealand aims to be a non-disabling society a place where disabled people have an equal opportunity to achieve their goals and aspirations . Yet many adult New Zealanders with severe-to-profound hearing loss (SPHL) due to sensorineural deterioration over time are being denied timely access to publicly funded cochlear implants. This presents a serious inequity in Aotearoa New Zealand s health system and contravenes disability and human rights principles. For Mori affected by SPHL, this brings additional challenges along with broader impacts on Mori health and development.‍

Article

SUMMARY

The costs associated with ankylosing spondylitis/axial spondyloarthritis in Aotearoa/New Zealand

Douglas White, Chunhuan Lao, Megan Williams, Ross Lawrenson, Nicola Dalbeth

This study has detailed the costs of spondyloarthritis (SpA) in Aotearoa/New Zealand. We have demonstrated a meaningful reduction in quality of life and work productivity in patients with SpA. The major driver of direct costs in SpA are biologic medications.

Article

SUMMARY

IDI trends in antidepressant dispensing to New Zealand children and young people between 2007/08 and 2015/16

Nicholas Bowden, Sheree Gibb, Hiran Thabrew, Richard Audas, Justine Camp, Barry Taylor, Sarah Hetrick

The paper aims to examine trends in antidepressant dispensing to children and young people in New Zealand aged 1-24 years between 2007/08 and 2015/16 using the Integrated Data Infrastructure (IDI), and to determine whether these trends vary by age, sex, ethnicity and socioeconomic deprivation. Overall there was a trend towards an increase in the use of antidepressants across all age, sex and ethnic groups, but notable variation in dispensing between different ethnic and socioeconomic groups. Despite our inability to determine the clinical rationale for increased dispensing of antidepressants, the available data highlight some potentially significant improvements as well as disparities in healthcare.

Article

SUMMARY

Diagnostic delays and treatment challenges in children with coeliac disease: The New Zealand Coeliac Health Survey

Kirsten J Coppell, Rosemary A Stamm, Kiri PH Sharp

Coeliac disease is an increasingly common disorder for which the only current treatment is a life-long gluten free diet. Exclusion of gluten from the diet is challenging as gluten is a common component of the typical New Zealand diet. In a survey of 123 New Zealand children aged less than 16 years with doctor-diagnosed coeliac disease, many children presented with non-classical symptoms contributing to delays in diagnosis. Following a gluten free diet was not easy for many families, with one-third finding it very or moderately difficult. The biggest challenge with following a gluten free diet was eating away from home especially birthday parties and school functions with almost half avoiding restaurants and 19% avoiding travel all or most of the time.

Article

SUMMARY

What does palliative care look like in a New Zealand aged residential care facility when patients are admitted to die?

Eileen M McKinlay, Serena V Moran, Sonya J Morgan, Pakize Sari, Jill M Kerridge, Susan RH Pullon

Increasing pressure on the healthcare services in both public hospitals and hospices means there is a specific group of patients including those under 65 years who are being admitted-to-die in aged residential care (ARC) facilities from public hospitals and hospices. This case study of seven patients admitted-to-die in an ARC facility showed they have high symptom control needs and required what is akin to specialist palliative care including from ARC staff and health and social care professionals staff from DHBs, hospices and other privately contracted professionals. This is not the typical system of ARC care and ARC facilities are not currently set up or staffed to provide specialist palliative care of those admitted-to-die. A specific model of care funded appropriately by the government is required.

Article

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Electric scooter injuries at Auckland City Hospital

Anna BS Brownson, Paul VB Fagan, Samuel Dickson, Ian DS Civil

Our study has found 180 patients who required treatment at Auckland City Hospital in only 19 weeks, which highlights the significant number of electric scooter-related injuries. While the majority of injuries were minor trauma, these cases have placed additional demand on health system resources across Auckland. A significant group of patients had serious injuries including some severe brain injuries. This mode of transport would benefit from greater regulation, including a zero blood-alcohol limit, night-time curfews, reduced speed limits and consideration of mandatory helmet use.

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SUMMARY

Supporting mothers, protecting babies for long-term health: establishing a pasteurised human milk bank

Maggie Meeks, Anthea Franks, Hazel McGregor, Rachael Lamb, Graeme Webb

The importance of infant feeding practices to an adult s long-term physical health are of relevance to all health professionals, not just those involved with the care of the newborn and young child. Feeding is also an important part of establishing a supportive social environment for children, many aspects of which have long-term effects. This paper reviews some of the benefits of a mother s own milk, unpasteurised donated milk and pasteurised human milk supplied through a milk bank. The Christchurch Neonatal Unit opened their Human Milk Bank in 2014 and are now pasteurising over 500 litres per year. This milk is provided to support women as they develop their own milk supply during the first week after the birth of their preterm baby.

Editorial