Vol 133 No 1510: 21 February 2020

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Issue Summary

Article

SUMMARY

Fasting prior to cardiac catheterisation: a single-centre observational study

Sheila Bacus, John Parsons, Jocelyne Benatar, Jithendra Somaratne, Mark Webster, Rachael Parke

Patients are fasting longer than recommended prior to cardiac catheterisation. The most common symptoms related to fasting was hunger and thirst. There was no episode of aspiration with contrast medium. Pre-hydration was underutilised in patients at risk of contrast induced nephropathy. Further studies are needed to evaluate the need for fasting prior to elective coronary angiogram and angioplasty.

Article

SUMMARY

Is the use of health services by older adults in New Zealand associated with their housing tenure?

Megan Pledger, Phoebe Dunn, Janet McDonald, Jacqueline Cumming, Kay Saville-Smith

This paper looked at the use of health services by public renters, private renters and owner-occupiers across three age groups—55–64, 65–74 and 75+. Older renters are more likely to live in poorer health than owner-occupiers and are more likely to use some public health services and yet they are more likely to have unmet health needs.

Article

SUMMARY

The prevalence of microvascular complications in Waikato children and youth with type 1 diabetes has reduced since 2003

Sukhbir K Sandhu, Vickie M Corbett, Lynne Chepulis, John Goldsmith, Priya Joseph, Sonya K Fraser, Joanna M McClintock, Ryan G Paul

HbA1c is a measure of how well blood sugar levels have been controlled during the last 10-12 weeks. It is an indication of how well controlled someone's diabetes is. Microvascular complications include those that relate to the small blood vessels of the body, commonly the eyes, the kidneys and nerves). Our study shows that fewer patients with type 1 diabetes are experiencing microvascular complications due to their disease than what was reported in 2003, despite the fact that there has been only minimal changes in blood glucose levels during this 14-year period.

Article

SUMMARY

Use of rehabilitation after hip and knee replacement in New Zealand: a national survey

Deborah L Snell, K Anne Sinnott Jerram, Jennifer A Dunn, C Jean Hsieh, Gerben DeJong, Gary J Hooper

In this study we surveyed New Zealanders six months after a hip or knee replacement to find out whether they used rehabilitation before and/or after their operation and if the amount of rehabilitation they used varied depending on where they lived. There were 608 people in the study sample. Most reported very good outcomes after their operations but delays starting rehabilitation post-operatively were associated with poorer pain and function outcomes. More rehabilitation was used after joint replacement compared with before, especially for people having knee replacements. Most rehabilitation was clinic-based physiotherapy and there were trends to more use of rehabilitation by people living in larger urban centres. Our findings suggested that broadening options for rehabilitation, for example home-based and telemedicine opportunities, might improve use of rehabilitation resources.

Article

SUMMARY

Intensive care unit utilisation post-oesophagectomy

Michael O’Grady, Rebecca Firth, Ross Roberts

The goal of this study was to see if patients needed to go to ICU after surgery to remove the oesophagus, a major operation usually done for cancer of the oesophagus. Often patients don’t need much ICU support and occasionally this can cause surgery to be cancelled, as capacity in ICU is limited. We found half of patients did need ICU level support. This means there is potential to avoid ICU admission in up to half of these patients; however, we currently don’t have a good way of predicting which patients these will be. This is an area for further investigation for us.

Article

SUMMARY

Population-level exposures associated with MRSA and ESBL-E. coli infection across district health boards in Aotearoa New Zealand: an ecological study

Matthew R Blakiston, Joshua T Freeman

The study’s findings provide insight into the potential contribution of population-level exposures to variation in the incidence of MRSA and ESBL-E. coli infection between populations (DHBs) within New Zealand; an MRSA/ESBL-E. coli endemic high-income country. Several MRSA and ESBL-E. coli infection-associated exposures are in principle modifiable. It may be that policy measures to reduce rates of household crowding and socioeconomic deprivation could present potentially novel approaches to reducing AMR. Similarly, reducing community antimicrobial use in the population may help reduce MRSA and ESBL-E. coli infections. As New Zealand devises and implements an AMR response plan, these findings highlight potentially novel opportunities to reduce the burden of AMR.

Article

SUMMARY

The role and functions of community health councils in New Zealand’s health system: a document analysis

Gagan Gurung, Sarah Derrett, Robin Gauld

Community/consumer health councils (CHCs) are usually established within district health boards (DHBs) to help address gaps in community engagement in the health sector. This literature review found that the main role of the CHCs appeared to be to advise and make recommendations to concerned DHBs and their governance and management structures about health services planning, delivery and policy. Although they were mainly engaged in information sharing and consultation, their influence on DHB decision-making is not known. As the concept is evolving and more CHCs are being set up in New Zealand, this information may be useful for setting up new CHCs in New Zealand and elsewhere.

Viewpoint

SUMMARY

Vaccine safety

Stewart Reid

The article covers adverse event reporting following vaccination, the difference between events which occur after vaccination and events which are caused by vaccination, the comprehensive safety monitoring required when vaccines are first introduced, international vaccine withdrawals because of safety concerns and some vaccine changes in New Zealand where safety was an important consideration. Finally, recent developments in vaccine safety monitoring are outlined.

Editorial