Issue

Vol 133 No 1514: 8 May 2020

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Issue Summary

Article
SUMMARY

Comparison of characteristics and outcomes for type A aortic dissection surgery by Māori, Pasifika or other ethnicities

Tom Kai Ming Wang, Danting Wei, Thomas Evans, Thaurmenthiran Ramanathan, David Haydock

A tear in the enlarged major artery coming out of the heart (type A aortic dissection) requires urgent surgery that is high risk, but without which almost all will die. Māori and Pasifika patients who have this condition are younger with more risk factors like high blood pressure and smoking than other ethnicities. Our study found that adjusting for age, Pasifika and Maori patients have higher risk dying in the short- and long-term respectively after surgery for this condition. It is important to educate, control risk factors and monitor closely these high-risk patients with enlarged major heart artery to prevent this condition from happening.

Article
SUMMARY

An estimate of limited duration cancer prevalence in New Zealand using ‘big’ data

Naomi Brewer, June Atkinson, Parry Guilford, Cristin Print, Tony Blakely, Andrea Teng

A larger number of people are being diagnosed with cancer in New Zealand, while cancer mortality is decreasing, meaning that there are now more people living beyond a cancer diagnosis. It is important to understand how many of these people there are since estimates of the number of people living with cancer (cancer prevalence) can indicate the demand for healthcare, psychosocial support, practical assistance and social services. We aimed to estimate cancer prevalence in the New Zealand population. We used national health, social and census datasets linked up by the Stats NZ Integrated Data Infrastructure to identify the number of New Zealand residents who had at least one cancer diagnosis in New Zealand from January 1995 to June 2013, and used the 2013 census for demographic and socioeconomic data. We estimated that on 30 June 2013, 140,600 of 4,438,900 (3.2%) New Zealand residents had a recorded diagnosis of cancer from the last 18.5 years. The prevalence was greatest in the oldest ages, European/Other, highest qualified, highest income, least deprived, ex-smokers, and Canterbury, Bay of Plenty and Nelson/Marlborough District Health Boards (age-standardised).

Article
SUMMARY

Exploring the impact of public health campaigns for glaucoma and macular degeneration utilising Google Trends data in a New Zealand setting

Adeline Kho, Rachael Niederer, Graham Wilson

This study evaluated the impact of public health campaigns for glaucoma and age-related macular degeneration compared to breast cancer and prostate cancer using Google Trends data. Glaucoma and macular degeneration search behaviour in New Zealand demonstrated a low impact following health awareness campaigns in comparison to breast and prostate cancer. This implies there is scope for improvement with these campaigns and a large increase in macular degeneration internet search activity following a public meeting, and report release suggests that increased funding may increase impact. This study also highlights the utility of internet data for monitoring of public interest in health issues. It also demonstrates the power of internet and social media in the dissemination of information amongst the public.

Article
SUMMARY

An economic evaluation of the All New Zealand Acute Coronary Syndrome Quality Improvement Registry programme—subanalyses for Māori (ANZACS-QI 42)

Peter Lee, Ella Zomer, Danny Liew

The All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) programme comprises a clinical quality registry of acute coronary syndrome patients admitted to hospitals across New Zealand. Its primary purpose is to improve quality of care by promoting evidence- and guidelines-based practice, and benchmarking against performance targets. We aimed to evaluate the clinical and cost impacts of the ANZACS-QI programme in New Zealand. Our analyses show that the ANZACS-QI programme is cost-saving, with an expected return of $1.50 New Zealand Dollars (NZD) for every $1 NZD invested.

Article
SUMMARY

Non-resident orthopaedic admissions to Dunedin Hospital 1997 to 2017 and Southland Hospital 2011 to 2017

Annabel Merrett, Jennifer Keys, Chris Crane, David Gwynne-Jones

The purpose of this paper was to audit the numbers of non-residents requiring admission to the orthopaedic departments at Dunedin and Southland Hospitals and determine the effects of increasing tourist numbers on healthcare resources. We found that with the increase in tourist numbers in New Zealand there has been a subsequent increase in the number of non-resident admissions. Non-resident orthopaedic admissions accounted for 1.6% of the total orthopaedic workload in Dunedin and 3.9% in Southland. These patients represent a cost in excess of $1,000,000 per annum to Southern DHB.

Article
SUMMARY

Early identification of infants at risk of cerebral palsy: developing the use of general movement assessment in routine clinical practice in a tertiary neonatal unit in New Zealand

Meghan Sandle, Alison Sheppard, Angelica Allermo Fletcher, Max Berry, Nathalie DeVries

The general movement assessment is an assessment tool which can accurately identify infants who are high risk of developing cerebral palsy. This assessment can therefore facilitate earlier diagnosis of cerebral palsy so that early intervention can be provided, which is associated with improved outcomes. In our service in Wellington we have introduced the general movement assessment as part of routine clinical practice for high-risk infants in the neonatal unit.

Viewpoint
SUMMARY

Is there systemic bias for Māori with eating disorders? A need for greater awareness in the healthcare system

Cameron Lacey, Mauterangimarie Clark, Jenni Manuel, Suzanne Pitama, Ruth Cunningham, Karen Keelan, Vivienne Rijnberg, Lana Cleland, Jennifer Jordan

Eating disorders are at least as common in Māori as non-Māori, which is consistent with other indigenous and ethnic minority groups. Factors for Māori include differential exposure to risk factors, the impact of acculturation, changing body image ideals and systemic bias reducing access to treatment and research participation. We suspect that Māori do not receive treatment in specialist eating disorders services at a level commensurate with comparable prevalence data in New Zealand and that a significant contributory factor to the apparent unmet need for Māori with eating disorders is likely to be systemic bias.

ALL ARTICLES
SUMMARY
Editorial
Vol 133 No 1514: 8 May 2020

While we have your attention… | OPEN ACCESS

Felicity Dumble, Jim Miller, Maria Poynter, Phil Shoemack

In normal times, public health professionals work in the background to ensure that the myriad health risks faced by our population do not see the light of day. Pandemics and other major outbreaks or health emergencies remind the public of the importance of public health services.

Article
Vol 133 No 1514: 8 May 2020

Comparison of characteristics and outcomes for type A aortic dissection surgery by Māori, Pasifika or other ethnicities

Tom Kai Ming Wang, Danting Wei, Thomas Evans, Thaurmenthiran Ramanathan, David Haydock

Ethnic disparities is a leading problem in healthcare, affecting many cardiovascular conditions and mortality rates in New Zealand.

Article
Vol 133 No 1514: 8 May 2020

An estimate of limited duration cancer prevalence in New Zealand using ‘big’ data

Naomi Brewer, June Atkinson, Parry Guilford, Cristin Print, Tony Blakely, Andrea Teng

A larger number of people are being diagnosed with cancer in New Zealand, while cancer mortality is decreasing, meaning more people living beyond a cancer diagnosis.

Article
Vol 133 No 1514: 8 May 2020

Exploring the impact of public health campaigns for glaucoma and macular degeneration utilising Google Trends data in a New Zealand setting

Adeline Kho, Rachael Niederer, Graham Wilson

Glaucoma and age-related macular degeneration (AMD) are the leading causes of blindness in New Zealand, as they are for the developed world.

Article
Vol 133 No 1514: 8 May 2020

An economic evaluation of the All New Zealand Acute Coronary Syndrome Quality Improvement Registry programme—subanalyses for Māori (ANZACS-QI 42)

Peter Lee, Ella Zomer, Danny Liew

Cardiovascular diseases (CVDs) represent a significant public health issue in New Zealand. In 2015, 33.0% of deaths were due to CVD, with 15.8% attributed to coronary heart disease (CHD).

Article
Vol 133 No 1514: 8 May 2020

Non-resident orthopaedic admissions to Dunedin Hospital 1997 to 2017 and Southland Hospital 2011 to 2017

Annabel Merrett, Jennifer Keys, Chris Crane, David Gwynne-Jones

Over the past several decades, New Zealand’s tourism industry has experienced exceptional growth, and forecasts for the sector indicate this expansion will continue. Statistics New Zealand has recorded that New Zealand attracted 3.5 million international visitors in the year ending December 2016.

Article
Vol 133 No 1514: 8 May 2020

Early identification of infants at risk of cerebral palsy: developing the use of general movement assessment in routine clinical practice in a tertiary neonatal unit in New Zealand

Meghan Sandle, Alison Sheppard, Angelica Allermo Fletcher, Max Berry, Nathalie DeVries

Infants born preterm (<37/40 gestation) have an increased risk of a range of neurodevelopmental disorders including learning difficulties, language and motor impairments, and social and emotional problems.

Viewpoint
Vol 133 No 1514: 8 May 2020

Is there systemic bias for Māori with eating disorders? A need for greater awareness in the healthcare system

Cameron Lacey, Mauterangimarie Clark, Jenni Manuel, Suzanne Pitama, Ruth Cunningham, Karen Keelan, Vivienne Rijnberg, Lana Cleland, Jennifer Jordan

Anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED) are serious conditions with significant adverse medical, psychological, social and economic effects on individuals, impairing quality of life.

Clinical Correspondence
Vol 133 No 1514: 8 May 2020

Parvovirus-related anaemia and thrombotic microangiopathy in a renal transplant recipient

Prabhu Kanchi, Ankur Gupta, SE Dhanasegaran, Kaniyappan Nambiyar, Ashwani Kumar

A 35-year-old female renal allograft recipient presented with sudden onset of anaemia six months post-transplant.

Letter
Vol 133 No 1514: 8 May 2020

Takotsubo syndrome co-exıstıng with acute myocardial infarctıon: an overlooked phenomenon in clinical practice

Kenan Yalta, Tulin Yalta, Muhammet Gurdogan

Over the past years, takotsubo syndrome (TS) has drawn a particular attention as a transient form of acute cardiomyopathy that usually mimicks acute myocardial infarction (AMI) in clinical practice.

Letter
Vol 133 No 1514: 8 May 2020

Pulmonary embolism following total hip and knee arthroplasty

Richard Seigne

I found the paper by Millar et al of great interest as I have access to similar data from Burwood Hospital, Christchurch.

Letter
Vol 133 No 1514: 8 May 2020

Diabetes and COVID-19—the meeting of two pandemics: what are the concerns? | OPEN ACCESS

Kirsten J Coppell, Rosemary M Hall, Michelle Downie, Sonya K Fraser, Michele Garrett, Craig A Jefferies, Timothy W Kenealy, Roberta EH Milne, Brandon J Orr-Walker, Ryan G Paul, Kate Smallman, Helen J Snell

The coronavirus disease 2019 (COVID-19) pandemic has occurred on a background of the diabetes pandemic.

Letter
Vol 133 No 1514: 8 May 2020

Methemoglobinemia: a challenge while managing pneumocystis jirovecii pneumonia

Kamal Kant Sahu, Ajay Kumar Mishra, Amos Lal, Ahmad Daniyal Siddiqui, Susan V George

We read with great interest the recent article by Saxena et al on methemoglobinemia. We appreciate the diligent workup by Saxena et al that led to the timely diagnosis of the methemoglobinemia.

Letter
Vol 133 No 1514: 8 May 2020

COVID-19 pandemic and rural generalism: the West Coast’s rural workforce solution | OPEN ACCESS

Brendan Marshall, Laura Aileone

COVID-19 is the type of disruptive event we don’t often see in health. New Zealanders recently learnt that the first COVID-19 patient death occurred in Greymouth Hospital. What has been most revealing for local clinicians is the effect on our workforce.

Obituary
Vol 133 No 1514: 8 May 2020

Charles McKinnon (Mack) Holmes

Jim Clayton, David Jones, Barry Baker

Mack Holmes was born in Dunedin 11 June 1935 and educated in part at Harrow in England when his father was an agricultural advisor for the British government.

Obituary
Vol 133 No 1514: 8 May 2020

Dr Judith Treadwell

Mark Davis, members of the Treadwell family

Dr Judith Treadwell, a well-known Wellington psychiatrist, sadly passed away in Wanaka on 18 January 2020, in the company of her family.

100 Years Ago in the NZMJ
Vol 133 No 1514: 8 May 2020

Notes on a Case of Lethargic Encephalitis

By JAMES WHITTON, M.D., F.R.C.S.E.

On 14th July I saw a pupil of Waitaki High School. He was in bed. He lay with his eyes closed, and was apparently asleep.

Article
SUMMARY

Comparison of characteristics and outcomes for type A aortic dissection surgery by Māori, Pasifika or other ethnicities

Tom Kai Ming Wang, Danting Wei, Thomas Evans, Thaurmenthiran Ramanathan, David Haydock

A tear in the enlarged major artery coming out of the heart (type A aortic dissection) requires urgent surgery that is high risk, but without which almost all will die. Māori and Pasifika patients who have this condition are younger with more risk factors like high blood pressure and smoking than other ethnicities. Our study found that adjusting for age, Pasifika and Maori patients have higher risk dying in the short- and long-term respectively after surgery for this condition. It is important to educate, control risk factors and monitor closely these high-risk patients with enlarged major heart artery to prevent this condition from happening.

Article
SUMMARY

An estimate of limited duration cancer prevalence in New Zealand using ‘big’ data

Naomi Brewer, June Atkinson, Parry Guilford, Cristin Print, Tony Blakely, Andrea Teng

A larger number of people are being diagnosed with cancer in New Zealand, while cancer mortality is decreasing, meaning that there are now more people living beyond a cancer diagnosis. It is important to understand how many of these people there are since estimates of the number of people living with cancer (cancer prevalence) can indicate the demand for healthcare, psychosocial support, practical assistance and social services. We aimed to estimate cancer prevalence in the New Zealand population. We used national health, social and census datasets linked up by the Stats NZ Integrated Data Infrastructure to identify the number of New Zealand residents who had at least one cancer diagnosis in New Zealand from January 1995 to June 2013, and used the 2013 census for demographic and socioeconomic data. We estimated that on 30 June 2013, 140,600 of 4,438,900 (3.2%) New Zealand residents had a recorded diagnosis of cancer from the last 18.5 years. The prevalence was greatest in the oldest ages, European/Other, highest qualified, highest income, least deprived, ex-smokers, and Canterbury, Bay of Plenty and Nelson/Marlborough District Health Boards (age-standardised).

Article
SUMMARY

Exploring the impact of public health campaigns for glaucoma and macular degeneration utilising Google Trends data in a New Zealand setting

Adeline Kho, Rachael Niederer, Graham Wilson

This study evaluated the impact of public health campaigns for glaucoma and age-related macular degeneration compared to breast cancer and prostate cancer using Google Trends data. Glaucoma and macular degeneration search behaviour in New Zealand demonstrated a low impact following health awareness campaigns in comparison to breast and prostate cancer. This implies there is scope for improvement with these campaigns and a large increase in macular degeneration internet search activity following a public meeting, and report release suggests that increased funding may increase impact. This study also highlights the utility of internet data for monitoring of public interest in health issues. It also demonstrates the power of internet and social media in the dissemination of information amongst the public.

Article
SUMMARY

An economic evaluation of the All New Zealand Acute Coronary Syndrome Quality Improvement Registry programme—subanalyses for Māori (ANZACS-QI 42)

Peter Lee, Ella Zomer, Danny Liew

The All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) programme comprises a clinical quality registry of acute coronary syndrome patients admitted to hospitals across New Zealand. Its primary purpose is to improve quality of care by promoting evidence- and guidelines-based practice, and benchmarking against performance targets. We aimed to evaluate the clinical and cost impacts of the ANZACS-QI programme in New Zealand. Our analyses show that the ANZACS-QI programme is cost-saving, with an expected return of $1.50 New Zealand Dollars (NZD) for every $1 NZD invested.

Article
SUMMARY

Non-resident orthopaedic admissions to Dunedin Hospital 1997 to 2017 and Southland Hospital 2011 to 2017

Annabel Merrett, Jennifer Keys, Chris Crane, David Gwynne-Jones

The purpose of this paper was to audit the numbers of non-residents requiring admission to the orthopaedic departments at Dunedin and Southland Hospitals and determine the effects of increasing tourist numbers on healthcare resources. We found that with the increase in tourist numbers in New Zealand there has been a subsequent increase in the number of non-resident admissions. Non-resident orthopaedic admissions accounted for 1.6% of the total orthopaedic workload in Dunedin and 3.9% in Southland. These patients represent a cost in excess of $1,000,000 per annum to Southern DHB.

Article
SUMMARY

Early identification of infants at risk of cerebral palsy: developing the use of general movement assessment in routine clinical practice in a tertiary neonatal unit in New Zealand

Meghan Sandle, Alison Sheppard, Angelica Allermo Fletcher, Max Berry, Nathalie DeVries

The general movement assessment is an assessment tool which can accurately identify infants who are high risk of developing cerebral palsy. This assessment can therefore facilitate earlier diagnosis of cerebral palsy so that early intervention can be provided, which is associated with improved outcomes. In our service in Wellington we have introduced the general movement assessment as part of routine clinical practice for high-risk infants in the neonatal unit.

Viewpoint
SUMMARY

Is there systemic bias for Māori with eating disorders? A need for greater awareness in the healthcare system

Cameron Lacey, Mauterangimarie Clark, Jenni Manuel, Suzanne Pitama, Ruth Cunningham, Karen Keelan, Vivienne Rijnberg, Lana Cleland, Jennifer Jordan

Eating disorders are at least as common in Māori as non-Māori, which is consistent with other indigenous and ethnic minority groups. Factors for Māori include differential exposure to risk factors, the impact of acculturation, changing body image ideals and systemic bias reducing access to treatment and research participation. We suspect that Māori do not receive treatment in specialist eating disorders services at a level commensurate with comparable prevalence data in New Zealand and that a significant contributory factor to the apparent unmet need for Māori with eating disorders is likely to be systemic bias.

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