Vol 135 No 1567: 16 December 2022

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Issue Summary

Article

SUMMARY

Dying in hospital—staff perceptions on providing quality care

Claire Whitehead, Kate Grundy, Rachel Wiseman, Suzanne Pitama

For patients that died in hospital, staff perceptions of the last days of life of patients they cared for were evaluated using a Likert scale and free-text options. This allowed 3 key themes to be identified; coordinated care, culture of practice and complexity of care. These 3 themes can be used to identify areas of the dying process that went well and areas that could be improved. This tool could be used to improve the dying process for patients, family/whānau and staff.

Article

SUMMARY

Endoscopic retrograde cholangiopancreatography in the comorbid elderly: a retrospective comparative study in New Zealand

Kirsty Macfarlane, Reuben Wilson, Nicholas J Fischer, Henry Wei

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to treat disorders of the liver and bile duct (drainage of the liver). It is debated whether ERCP is safe for the elderly compared to younger patients. This study found ERCP to be relatively safe, although careful consideration is required when selecting patients with comorbidities to avoid subjecting those with short life expectancy to unnecessary procedures.

Article

SUMMARY

Outcomes in mild hyperphenylalaninemia: a comparison with PKU and healthy controls across cognition, behaviour, and quality of life

Nastassia Randell, Suzanne Barker-Collo, Kathryn Murrell, Callum Wilson

This study assessed thinking, behaviour, and quality of life in children with mild, non-PKU hyperphenylalaninemia. The aim was to establish whether active management of blood phenylalanine levels was indicated, as is standard practice for children with the more severe variant, PKU. The study was affirming of current practice, but with the addition of monitoring of blood levels during high-risk periods, such as pregnancy.

Article

SUMMARY

Documented incontinence after stroke: a secondary analysis of a cohort study. Reducing Ethnic and Geographic Inequities to Optimise New Zealand Stroke Care (REGIONS Care)

E Jean C Hay-Smith, Stephanie G Thompson, Mark Weatherall, Annamarei Ranta

A previous large New Zealand study of acute stroke care had collected data about bladder and bowel leakage. We examined these data to find out how common it was to have incontinence after stroke, whether it was more common for some ethnicities, and whether people with incontinence had worse outcomes. We found 14% of people had documented incontinence, which is much less common that previous New Zealand or international studies. People living with stroke and incontinence were more likely to die or be living in a residential care up to 12 months after stroke. People living with stroke and incontinence also had less good quality of life, due to the incontinence.

Article

SUMMARY

We still don’t count: the under-counting and under-representation of Māori in health and disability sector data | OPEN ACCESS

Ricci B Harris, Sarah-Jane Paine, June Atkinson, Bridget Robson, Paula T King, Jennifer Randle, Anja Mizdrak, Melissa McLeod

This paper explores the undercounting of Māori in health data. It shows that Māori are under-represented in health care user data and in primary care data. When a Māori individual’s self-identified ethnicity on the 2018 Census was compared with their ethnicity on primary care enrolment data, 21% of people who identified

Viewpoint

SUMMARY

The past, present and future of liver cancer control for Māori

Sydney Clough, Tara Cleverley, Clarence Kerrison, Matire Harwood, Jonathan Koea, Jason K Gurney

Liver cancer is a substantial health problem for Māori. Māori are more likely to be diagnosed with liver cancer than non-Māori, and less likely to survive once diagnosed. This disparity is primarily driven by difference between Māori and non-Māori in exposure to the viruses hepatitis B and hepatitis C. In this manuscript, we call for a national primary care-based programme to detect and treat hepatitis B and C and to screen for liver cancer among high-risk patients, along with renewed effort to maximise hepatitis B vaccination rates, to reduce the burden of liver cancer for Māori in Aotearoa.

Clinical Correspondence

SUMMARY

Isolated splenic hydatid disease: a rare case in rural New Zealand

David Thomas Bardsley, Gerhardus Bonnet, Michael O'Grady

Our paper explores an uncommon presentation of a parasitic infection in the Whanganui region. This parasite, known as echinococcus granulosus, has not been observed in our region for over a decade. We discuss important key points in the medical diagnosis and management of this condition. Including some of the pitfalls that we may run into when trying to diagnose this disease. We attempt to highlight some of the complications of hydatid disease, and why it is still an important consideration for clinicians to remain cognisant of. Our papers then demonstrates the interesting and uncommon aspect of the case, and how it varies from a ‘typical’ presentation of the disease. We hope to highlight the key points as outlines above.

Article

SUMMARY

Mental health inequities for Māori youth: a population-level study of mental health service data | OPEN ACCESS

Reremoana Theodore, Nick Bowden, Jesse Kokaua, Troy Ruhe, Matt Hobbs, Sarah Hetrick, Lukas Marek, Jesse Wiki, Barry Milne, Hiran Thabrew, Joseph Boden

In this population-wide study we examined administrative mental health service data for Māori youth compared to non-Māori/non-Pasifika youth (10–24 years). Using specialist mental health service, hospital discharge and pharmaceutical dispensing data, we found that Māori were less likely to be identified for emotional conditions (anxiety and/or depression) than NMNP. They were more likely to be identified for substance problems and self-harm. Māori living in high deprivation areas compared to Māori in least deprived areas were significantly more likely to be identified for substance problems, but less likely for emotional conditions. These findings suggest that rangatahi Māori as compared to NMNP youth are less likely to be identified at earlier stages of distress until distress symptoms become more severe with explicit markers (e.g., self-harm injuries).

Research Letter

SUMMARY

Inadequate sun protection practices lead to sunburn among New Zealanders

Geraldine F H McLeod, Bhubaneswor Dhakal, Anthony I Reeder

In New Zealand, more people die from skin cancers than on our roads, even though most people understand the importance of protecting their skin from excessive sunlight and ultraviolet radiation (UVR). Since previous research suggested that using one strategy may reduce the use of additional strategies (known as compensation behaviour), a team of University of Otago researchers aimed to see if New Zealanders used compensation behaviours when choosing how to protect their skin. Analysis of data from the Te Hiringa Hauora (Health Promotion Agency) survey on the sun exposure and sunburn experience of 2,272 people (15+years) across New Zealand showed that more than one in six (14.9%) respondents were sunburned: many people relied on inadequate sun protection when they were outdoors (nearly 70% of respondents only used one or two forms of sun protection); those using only sunglasses and sunscreen reported sunburn most often, even when other sun protection, weather and demographic factors were taken into account. These findings are consistent with the conclusion that many New Zealanders use a narrow range of sun protection types to compensate for recommended comprehensive protection, thus becoming sunburned and putting themselves at increased risk of skin cancer.

Editorial

SUMMARY

Whakairo: carving a values-led approach to understand and respond to the mental health and substance use of the New Zealand population

Helen Lockett, Cameron Lacey, Angela Jury, Talya Postelnik, Amanda Luckman, Richie Poulton

Te Rau Hinengaro (the last mental health survey) is nearly 20 years old. The last 20 years has seen fundamental changes to life which are likely to have profound effects on mental health and wellbeing. These effects on population mental health and wellbeing remain unquantified. To speculate on something as important as peoples’ emotional health and wellbeing is not acceptable.

Editorial