Vol 133 No 1508: 17 January 2020

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Issue Summary

Viewpoint

SUMMARY

Teeth or no teeth: exploring punitive measures for adults smoking in cars containing children in Aotearoa/New Zealand

Frank Houghton, Diane O’Doherty, Ben Houghton

The recent announcement by the Government of New Zealand to ban smoking in cars with children is welcome. However, the thorny issue of enforcement and punishment remains. Internationally there is a deficit on research on this issue. The experiences of the UK and Ireland show little or no enforcement of such laws, unlike the State of Victoria in Australia, where the law was more robustly enforced. This viewpoint argues that enforcement is an important element in safeguarding the health and wellbeing of children.

Article

SUMMARY

Impact of human papillomavirus vaccination on rates of abnormal cervical cytology and histology in young New Zealand women

Carrie RH Innes, Jonathan A Williman, Bryony J Simcock, Phil Hider, Margaret Sage, Kieran Dempster-Rivett, Beverley A Lawton, Peter H Sykes

Cervical cell abnormalities are caused by persistent human papillomavirus (HPV) infection. Our study investigated the rate of cervical cell abnormalities in young New Zealand women. We found that women who had had the human papillomavirus (HPV) vaccination prior to 18 years were nearly a third less likely to be diagnosed with cervical cell abnormalities when aged 20–24 years. In this study, Māori women were less likely to be vaccinated but, if they were, vaccination offered similar protection for both Māori and non-Māori. This study confirms that HPV vaccination will offer protection against cervical cancer and also provide opportunities to reduce inequities. However, the study also demonstrates that both HPV vaccinated and unvaccinated women can develop high-grade cervical disease and this underlines the ongoing need for cervical screening in both vaccinated and unvaccinated women.

Article

SUMMARY

Media representation of chronic pain in Aotearoa New Zealand—a content analysis of news media

Hemakumar Devan, Jessica Young, Ceonne Avery, Liv Elder, Yulia Khasyanova, Dominic Manning, Morghan Scrimgeour, Rebecca Grainger

Media reporting of health conditions can change people’s beliefs and deliver key health messages. We evaluated how chronic pain was reported in the New Zealand news media since 2015. Chronic pain was reported to cause suffering and distress with no hope for the person living with pain. There was more focus on drug-based treatments using opioids and medicinal cannabis. There were few reports on non drug-based strategies like exercise and positive thinking, which were proven to be effective with minimal side-effects. The health system challenges of accessing pain services, inequities with access for Māori and Pasifika, and lack of trained clinicians were accurately represented. There is a need for developing media guidelines for chronic pain reporting and clinicians and researchers could work with media to provide evidence-based health information.

Article

SUMMARY

New Zealand should introduce nationwide pulse oximetry screening for the detection of critical congenital heart disease and other hypoxaemic conditions in the newborn

Elza Cloete, Thomas L Gentles, Frank H Bloomfield, for the Pulse Oximetry Screening Steering Committee

The early detection of congenital heart defects can improve outcomes for those affected. A pulse oximeter is a device that detects oxygen levels in the blood and can be utilised to screen for heart defects in newborns. The test has been adopted widely around the world as a screening tool. The feasibility of introducing the test in New Zealand’s midwifery-led maternity setting has been demonstrated. Sector-led initiatives are, however, unlikely to result in equitable outcomes. New Zealand should therefore introduce a nationwide screening programme with adequate human and material resources that is governed by the National Screening Unit.

Article

SUMMARY

Career outcomes of students of an intercalated MBChB/PhD: experience from New Zealand

Yassar Alamri, Tim J Wilkinson

We reported the career choices and academic accomplishments of MBChB/PhD students at Otago University 17 years after the programme’s introduction. A total of 25 students (of whom eight were current students) had enrolled in the combined programme between 2001 and 2018. Ten students (40%) were women. The rate of enrolment remained relatively steady through the years at 1.4±1.0 students/year. The rate of completion was high at 88.2% (15/17). The programme is considered worthwhile by our students most of whom continue (at various capacities) in academic work and produce a significant research output, although potentially in a field that is different to their PhD research.

Article

SUMMARY

Sudden unexpected death in epilepsy (SUDEP) in New Zealand; a retrospective review

Mary Brennan, Shona Scott, Peter Bergin

Sudden unexpected death in epilepsy (SUDEP) has come to prominence in New Zealand over recent months because patients on lamotrigine have been required to change to the Logem brand, and several patients have apparently died shortly after changing brands. We have conducted a retrospective study of coroners’ reports of SUDEP, which occurred prior to this enforced brand change. We identified 166 cases over a 10-year period (2007–2016), with a maximum of 26 cases occurring in 2013. Two-thirds of patients who died were aged between 15 and 45. We suspect that not all cases have been identified, and we are now undertaking a prospective study to learn more about risk factors for SUDEP.

Article

SUMMARY

Medical cannabis: knowledge and expectations in a cohort of North Island New Zealand general practitioners

Karen Oldfield, Irene Braithwaite, Richard Beasley, Allie Eathorne, Giles Newton-Howes, Alex Semprini

GPs are reporting that patients are asking them about medical cannabis prescriptions, mainly for symptoms relating to pain, cancer and palliative care, as well as reporting that patients are using illicit cannabis to self-manage conditions such as pain and anxiety/depression. Small numbers of GPs report that they have attempted to prescribe medical cannabis products, however the majority have concerns about the general use of cannabis as a medicine based on the lack of good evidence for use in the scientific literature and the confusing regulatory process currently in place for prescribing in New Zealand. GPs in the survey reported they would be likely to prescribe a cannabis product that is both regulated and has gone through clinical trials in specific medical conditions. With the upcoming implementation of the Medical Cannabis Scheme it is important that educational programmes emphasising evidence (both for and against use), medico-legal and practical elements of prescribing are in place to support the GPs to have informed discussions with their patients.

Article

SUMMARY

Stage at diagnosis for Māori cancer patients: disparities, similarities and data limitations

Jason Gurney, James Stanley, Chris Jackson, Diana Sarfati

In this study, we combined the best available data on stage of cancer at diagnosis for Māori and European/Other New Zealanders. We compared the two ethnic groups and found that while Māori are less likely to be diagnosed with early stage at diagnosis for several commonly-diagnosed cancers, this is not the case for all cancers. In our paper we talk about the weaknesses of our national cancer registry in terms of allowing us to monitor stage at diagnosis for Māori (and non-Māori) patients.

Article

SUMMARY

Trends in length of stay following acute coronary syndrome hospitalisation in New Zealand 2006–2016: ANZACS-QI 32 study

Tom Kai Ming Wang, Corina Grey, Yannan Jiang, Rod Jackson, Andrew Kerr

This study reports on trend in the length of 185,962 hospitals stay for heart attacks in New Zealand from 2006–2016. The length of hospital stay has fallen gradually over time for all age-groups, gender, ethnic group and types of heart attack. The factors that are associated with longer hospital stay include older age, female sex, Māori or Pacific ethnicities, going to a rural hospital initially, not having heart procedures or having heart surgery.

Editorial