Vol 133 No 1509: 7 February 2020

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Issue Summary

Article

SUMMARY

Quality assessment of a large primary GP skin cancer service in Auckland, New Zealand

Daniel Wen, Katherine Gale, Richard CW Martin

A group of general practitioners were recruited in 2014 by Waitematā District Health Board to be further trained in the management of skin cancer by experts in the field. This study aimed to evaluate the performance of this group of doctors and identify the strengths and weaknesses of the programme. The results of our research showed that the upskilled general practitioners’ performance was as good as, if not better than, other skin cancer services and was acceptable under international skin cancer standards. Treatment by these general practitioners was also less expensive for the health sector when compared to in-hospital treatment and also associated with reduced wait times.

Article

SUMMARY

Does screening for myopia in New Zealand meet screening programme criteria?

Ben Wilkinson, Graham Wilson

There is a worldwide myopia (short-sighted epidemic). Our paper aimed to assess whether a myopia (short-sighted) screening programme could be useful in New Zealand to provide early diagnosis, treatment and prevention of secondary cause of blindness associated with myopia. Seven out of 10 of the criteria were met for a screening programme being worthwhile. Once robust clinical treatment guidelines are established, a pilot screening programme could be run in New Zealand to test real-world viability of a screening programme for myopia in New Zealand.

Viewpoint

SUMMARY

Healthcare-associated Staphylococcus aureus bacteraemia: time to reduce the harm caused by a largely preventable event

Sally A Roberts, Nikki Grae, Sharmini Muttaiyah, Arthur J Morris

Bacteria that live on our skin such as Staphylococcus aureus usually do not cause us any harm. However, if you are admitted to hospital and require surgery or treatment for a medical condition then the risk of infection is increased if you have a surgical wound or your skin is punctured by a needle or other medical device. Each time this happens S. aureus to is able to get beyond the barrier created by your healthy skin and cause infection. There are a number of ways that healthcare workers can reduce this from happening; cleaning your skin before breaching it, performing hand hygiene at appropriate times, removing medical devices when they are no longer needed and looking after wounds. Interventions to support adherence to these and other activities can significantly reduce the risk for acquiring infection in hospital.

Article

SUMMARY

Good care close to home: local health professional perspectives on how a rural hospital can contribute to the healthcare of its community

Katharina Blattner, Tim Stokes, Marara Rogers-Koroheke, Garry Nixon, Susan M Dovey

This study was set at Hauora Hokianga, an established rural health service with a small rural hospital serving a largely Māori community in New Zealand’s far north. The aim of the study was to understand how Hauora Hokianga’s staff (both medical and non-medical) viewed the role of the Hokianga hospital. The study provides a perspective of how a rural hospital can contribute to the healthcare of its community. Findings highlight the importance of geographically as well as culturally appropriate health services. Further research into the function of New Zealand rural hospitals and their contribution to the health system is needed.

Article

SUMMARY

Epidemiology of traumatic spinal cord injury in New Zealand (2007–2016)

John Mitchell, Joanne Nunnerley, Chris Frampton, Tracey Croot, Alpesh Patel, Rowan Schouten

The causes and population affected by traumatic spinal cord injuries (TSCI) is changing in New Zealand. Falls are now the most common cause of TSCI, which is reflected by an increased rate in elderly patients. Māori patients are 1.8 times more likely to have a TSCI compared to New Zealand Europeans, a disparity that is shown to be increasing over time. Sporting-related TSCI remains high in New Zealand compared to the rest of the world with team ball sports (eg, rugby) the biggest cause.

Article

SUMMARY

Ethnic inequities in life expectancy attributable to smoking

Michael Walsh, Karen Wright

Our study provides an updated assessment of the burden of smoking-related mortality in New Zealand for deaths registered from 2013 to 2015 and examines the contribution of these deaths to the life expectancy gap in the Māori and Pacific populations compared with the non-Māori/non-Pacific population. Over this time, 13.4% of deaths were potentially attributable to smoking. Among Māori, 22.6% of deaths were potentially attributable to smoking, compared with 13.8% of deaths among Pacific peoples and 12.3% among non-Māori/non-Pacific people. We estimate that smoking attributable deaths contributed 2.1 years to the life expectancy gap in Māori men, 2.3 years in Māori women (nearly one third), 1.4 years of Pacific men (one quarter) and 0.3 years in Pacific women. Smoking remains an important preventable risk factor contributing to ethnic inequities in life expectancy for Māori men and women, and Pacific men. Addressing this inequity needs to remain a top health priority. In order to achieve health equity and the Smokefree 2025 goal, a Tiriti o Waitangi compliant response inclusive of targeted investment and expansion of Māori and Pacific tobacco control programmes is required.

Viewpoint

SUMMARY

Nutrition guidelines for dental care vs the evidence: is there a disconnect?

Sarah Hancock, Caryn Zinn, Grant Schofield, Simon Thornley

Eating refined, high carbohydrate foods is the principal cause of tooth decay, and consumption of these foods are also implicated in the increased prevalence of both malnutrition and obesity in children and young people. Furthermore, eating full-fat dairy produce is associated with reduced risks of tooth decay and obesity in children and young people. Although government-endorsed dietary guidelines for young people correctly provide recommendations to decrease intake of high-sugar foods, recommendations are also provided to increase the amount, and frequency of consumption of high carbohydrate foods as children age, and to choose low-fat dairy produce. Given that the epidemics of dental caries and obesity are a significant and ongoing public health challenge in New Zealand, it is imperative that the guidelines for healthy eating for young New Zealanders incorporate the best dietary advice to improve their health. It is time to update the guidelines to limit the intake of ultra-processed foods and encourage intake of full-fat dairy products to prevent the dental caries and obesity, which share a common cause.

Editorial