Vol 135 No 1562: 23 September 2022

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Issue Summary

Article

SUMMARY

Improving health services for patients with extreme obesity requiring bariatric level care at Wellington Regional Hospital: a clinical audit

Bailey Yee, Eleanor Barrett, Mona Jeffreys, Anne Haase, Caz Hales

Hospitalised patients with extreme obesity frequently require additional care support to accommodate their larger physical size (also known as bariatric care). The aim of this clinical audit was to benchmark the quality of bariatric service delivery against moving and handling and patient care best practice standards and determine the prevalence of hospitalised patients admitted to Wellington Regional Hospital requiring bariatric level care. The prevalence of hospitalised patients requiring bariatric services was 6.4%; one-third of these patients did not have their bariatric care needs identified which contributes to missed care opportunities and adverse effects for patients and clinical teams. Whilst the majority of patient focused moving and handling hazards were well documented, environmental hazards or equipment limitations were poorly reported. Developing and improving policy adherence will assist in addressing shortcomings in the standard of providing a safe environment for patients with bariatric care needs to support high-quality care.

SUMMARY

Cannabis use and patterns of psychotic symptomatology in a longitudinal birth cohort

Nicole Cant, Mary Buchanan, Anitra C. Carr, Joseph M Boden

Regular cannabis use by young people (under 25 years old) seems to increase the risk that they will experience symptoms of psychotic illness when not intoxicated with cannabis. We examined whether the pattern of psychotic experiences reported by these individuals, but found no difference in the kind of symptoms reported as compared with people who had not used cannabis at all. The symptoms commonly reported were less serious in nature, and do not appear to be related to an underlying psychotic illness.

Article

SUMMARY

Transfusion practice in patients undergoing cardiac surgery in New Zealand—impact of the TRICS III study (the TRICS TRIPS study)

Rachael L Parke, Alana Cavadino, Shay P McGuinness

Cardiac surgery is the largest surgical user of donated blood products, however there has been little known around the best threshold for transfusion in patients undergoing cardiac surgery until recently. We wanted to know if the findings of a large international study (the TRICS III study) had changed real-world clinical practice. We asked clinicians what factors influenced their prescription of red blood cell transfusions and also recorded how red blood cells were transfused in all five public hospitals in New Zealand. We found that clinicians caring for patients undergoing cardiac surgery were more restrictive in administering red blood cell transfusions after the results of the TRICS III study were published.

Article

SUMMARY

Helicobacter pylori in New Zealand: current diagnostic trends and related costs

Jan Kubovy, Murray L Barclay

We provided a snapshot of real trends in diagnosis of H.pylori (a chronic bacterial infection strongly linked with several conditions including stomach cancer). We also provide real cost analysis of the diagnostic tests which is unique. We point out weaknesses in the current diagnostic trend of H.pylori and suggest simple actions to remedy this.

Article

SUMMARY

Seeking of help and support after experiencing sexual harm: considerations for cisgender women, cisgender men and gender-diverse people

Tess Patterson, Linda Hobbs, Gareth J Treharne, Melanie Beres

Sexual harm affects students of all genders on campus but there may be differential help-seeking behaviours depending on gender. Cisgender men and gender-diverse persons may be less likely to reach out to formal service providers. Support services need to consider how to accommodate the support needs of all survivors, including cisgender men and gender-diverse persons.

Article

SUMMARY

Teleclinics for the management of diabetes in pregnancy during COVID-19—maternal satisfaction and pregnancy outcomes | OPEN ACCESS

Asha Shashikumar, Karaponi Okesene-Gafa, Te Hao Apaapa-Timu, Jessica Wilson, Charlotte Oyston

Rates of diabetes in pregnancy are increasing, and new ways of providing healthcare that are efficient and accessible are needed. During COVID-19 we carried out most clinic appointments for diabetes in pregnancy over the phone. A survey of patients who used telephone clinics found that patients found the clinics useful and convenient. However phone appointments were not ideal for every situation, and optimising the clinic design and maintaining flexibility in scheduling is important if ongoing use is planned.

SUMMARY

Trauma Team Activation: improved care of major trauma patients

Maria Nonis, Andrew McCombie, Christopher Wakeman, Dominic Fleischer, Laura Joyce

Trauma team activation status at Christchurch Hospital was associated with decreased time to diagnostic imaging. Trauma team activation was also associated with a shorter ED length of stay, however these patients had increased rates of surgery and admission to ICU.

Viewpoint

SUMMARY

Responding to the tāngata whai ora voice: an Aotearoa New Zealand quality improvement solution

Amanda Luckman, Paul Clements, Thomas White, Angela Jury, Jennifer Lai, Mark Smith

This viewpoint paper advocates that when tāngata whai ora (people seeking wellness) feedback is an integral part of quality improvement activities in mental health and addiction services, there is potential for powerful change that leads to improved support and outcomes for people. Mārama Real-Time Feedback is a feedback collection tool designed for Aotearoa New Zealand’s mental health and addiction services. The paper describes the development, implementation, and use of this tool.

Clinical Correspondence

SUMMARY

Palatal keratosis associated with reverse (or “backwards”) smoking (PKARS)

John Won, Hadleigh Clark

This paper describes a rare case of reverse smoking and oral changes arising secondary to the habit (termed palatal keratosis associated with reverse smoking, or PKARS) in New Zealand. As the name suggests, reverse smoking involves smoking the lit end of the cigarettes inside one’s mouth, and is associated with a high risk of developing oral cancer (in particular of the palate). This habit is not commonly reported in Western countries and this is the first case reported in New Zealand to the authors’ knowledge.

Editorial