NEW ZEALAND MEDICAL JOURNAL最新文献

Dreaming of a Māori hospital: Mehemea, ka moemoea ahau, ko ahau anake. Mehemea, ka moemoea tātou, ka taea e tātou. 梦见毛利医院：mehemea, ka moemoea ahau, ko ahau anake。Mehemea, ka moemoea tātou, ka taea e tātou.

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6636

Marama Muru-Lanning, Hilary Lapsley

{"title":"Dreaming of a Māori hospital: Mehemea, ka moemoea ahau, ko ahau anake. Mehemea, ka moemoea tātou, ka taea e tātou.","authors":"Marama Muru-Lanning, Hilary Lapsley","doi":"10.26635/6965.6636","DOIUrl":"10.26635/6965.6636","url":null,"abstract":"This article makes a case for Māori organisations to investigate developing hospitals in addition to hauora primary care services. Our programme of research on kaumātua hauora has involved ten noho wānanga in Te Tai Tokerau, Waikato and Tauranga Moana. During our wānanga and associated kānohi-ki-kānohi interviews, we heard from older Māori who experienced hospital stays as detrimental to their wellbeing. At a whakahoki kōrero with Waikato kaumātua, we were requested to investigate the rationale for a Māori hospital, a wish that has historical roots in Princess Te Puea Herangi's efforts to create a small hospital at Tūrangawaewae Marae. Her project was stymied by the health authorities of the time. Our observations are backed up by other research demonstrating adverse outcomes for Māori at New Zealand's public hospitals. A small international literature offers some pointers for success in developing hospitals for Indigenous populations. While there are many aspects that would need thorough investigation in a development process (e.g., tikanga, scope, sites, architecture, development finance, cost structures, staffing, clientele and accessibility), we argue that hospitals developed by and for Māori are a long-held dream that could well be enacted in today's health service environment.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When do you need to get ethical approval for your research? 您的研究何时需要获得伦理批准？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.e21602

Frank Frizelle

引用次数: 0

Progesterone treatment for women who have changed their minds after taking mifepristone. 为服用米非司酮后改变主意的妇女提供黄体酮治疗。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6674

Joseph Hassan, Martin Ng

引用次数: 0

Pacific people living in New Zealand are most commonly referred with eczema to dermatologists. 居住在新西兰的太平洋岛屿居民最常因湿疹而被转诊到皮肤科。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6643

Miriam Karalus, Amanda Oakley

引用次数: 0

Faecal immunochemical test (FIT) based prioritisation of new patient symptomatic cases referred for colorectal investigation. 根据粪便免疫化学检验 (FIT) 确定转诊接受结直肠检查的无症状新病例的优先次序。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6582

James Falvey, Catherine M Stedman, Joel Dunn, Chris Sies, Susan Levin

{"title":"Faecal immunochemical test (FIT) based prioritisation of new patient symptomatic cases referred for colorectal investigation.","authors":"James Falvey, Catherine M Stedman, Joel Dunn, Chris Sies, Susan Levin","doi":"10.26635/6965.6582","DOIUrl":"https://doi.org/10.26635/6965.6582","url":null,"abstract":"Aim: Quantitative faecal haemoglobin (fHb) measurement by faecal immunochemical test (FIT) is a powerful biomarker for colorectal cancer (CRC) and is incorporated in referral, prioritisation and triage protocols for symptomatic cases in other countries. We report our use of FIT to prioritise new patient symptomatic cases referred for colorectal investigation.Method: Cases referred for investigation of new colorectal symptoms who were aged ≥50 years (≥40 years Māori/Pacific peoples), who would otherwise be triaged to non-urgent colonoscopy, were asked to provide a stool sample for FIT. Following FIT testing, cases were re-triaged to either urgent colonoscopy, non-urgent colonoscopy or computed tomography colonography (CTC) depending on fHb concentration (measured in micrograms haemoglobin per gram of stool [mcg/g]) and incorporating clinical judgement. At pathway initiation, cases already waiting for colonoscopy on the non-urgent new patient waiting list were approached first, and then new patient (NP) referrals for colonoscopy could be triaged to the pathway at the discretion of the triaging consultant.Results: Out of 739 cases, 715 (97%) returned FIT samples, and 691 cases completed colorectal investigations. Overall FIT positivity ≥10mcg/g was 17.1%. Fifteen colorectal cancers (CRC) were detected (2.2%). The sensitivity and specificity of FIT ≥10mcg/g for CRC were 80.0% (54.0-93.7%) and 84.3 (81.4-86.9%) respectively. A total of 432 cases (62.5%) completed the pathway without recourse to colonoscopy, and the median time to CRC diagnosis for NP from referral was 25 days.Conclusion: FIT based prioritisation of cases referred with symptoms concerning for CRC is feasible and reduces time to CRC diagnosis.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of ethnicity records at primary and secondary healthcare services in Waikato region, Aotearoa New Zealand. 新西兰奥特亚罗瓦地区怀卡托地区初级和二级医疗保健服务机构中种族记录的准确性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6445

Brooke Blackmore, Marianne Elston, Belinda Loring, Papaarangi Reid, Jade Tamatea

{"title":"Accuracy of ethnicity records at primary and secondary healthcare services in Waikato region, Aotearoa New Zealand.","authors":"Brooke Blackmore, Marianne Elston, Belinda Loring, Papaarangi Reid, Jade Tamatea","doi":"10.26635/6965.6445","DOIUrl":"10.26635/6965.6445","url":null,"abstract":"Aims: Ethnicity is an important variable, and in Aotearoa New Zealand it is used to monitor population health needs, health services outcomes and to allocate resources. However, there is a history of undercounting Māori. The aim of this study was to compare national and primary care ethnicity data to self-reported ethnicity from a Kaupapa Māori research cohort in the Waikato region.Methods: Through individual record linkage, prospective self-reported ethnicity, collected using New Zealand Census and Ministry of Health - Manatū Hauora ethnicity protocol as a \"gold standard\", was compared to ethnicity in secondary and primary healthcare datasets. Logistic regression analyses were used to determine if demographic variables such as age, ethnicity and deprivation are associated with inaccuracies in ethnicity recording.Results: Māori were undercounted in secondary NHI (32.5%) and primary care (31.3%) datasets compared to self-reported (34.6%). Between 9.5-11% of individuals had a different ethnicity recorded in health datasets than self-reported. Multiple ethnicities were less often recorded (secondary NHI [5.3%] and primary care [5.8%]) compared to self-reported (8.7%). Māori ethnicity (p=0.039) and multiple ethnicity (p<0.001) were associated with lower ethnicity data accuracy.Conclusion: Routine health datasets fail to adequately collect ethnicity, particularly for those with multiple ethnicities. Inaccuracies disproportionately affect Māori and urgent efforts are needed to improve compliance with ethnicity data standards at all levels of the health system.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commissioners or board-which is best for the role of Health New Zealand - Te Whatu Ora? 委员还是董事会--哪一个最适合新西兰卫生部的角色--Te Whatu Ora？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.e11602

Frank Frizelle

引用次数: 0

A quality improvement project: Rapid Access Hysteroscopy Clinics with nurse pre-procedural telephone support in the outpatient setting. 质量改进项目：在门诊环境中通过护士提供术前电话支持的快速宫腔镜检查诊所。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6423

Lucy Wong, Catherine Askew, Katherine Sowden, Kieran Dempster-Rivett, Valerio Malez

{"title":"A quality improvement project: Rapid Access Hysteroscopy Clinics with nurse pre-procedural telephone support in the outpatient setting.","authors":"Lucy Wong, Catherine Askew, Katherine Sowden, Kieran Dempster-Rivett, Valerio Malez","doi":"10.26635/6965.6423","DOIUrl":"https://doi.org/10.26635/6965.6423","url":null,"abstract":"Aim: Endometrial cancer (EC) is increasing in incidence in women across Aotearoa New Zealand as risk factors such as obesity and diabetes become more prevalent. In 2022, a Rapid Access Clinic (RAC) for hysteroscopy was implemented at Te Whatu Ora Counties Manukau District to increase early detection of EC.Method: Plan-Do-Study-Act (PDSA) cycles were used to test and implement RAC supported by a nurse pre-procedural phone consultation. Quantitative data was collected alongside patient experiences of the pre-procedural telephone call.Results: A total of 207 women successfully completed RAC, which enabled one less visit to clinic per patient, subsequent travel cost savings (NZ$35,959) and a decrease in CO2 emissions (1,782kg). Lead time from first specialist appointment (FSA) to outpatient (OP) hysteroscopy, previously 25 days (SD: 21 days), was eliminated. Wait time from referral to provisional diagnosis increased from 26 days to 31 days; however, standard variation reduced from 30 days to 15 days. Clinician productivity increased by 25% per hysteroscopy session. Twenty-six out of 30 patients reported positive experiences of their pre-procedural RAC phone consultation. Twenty-seven out of 207 women were diagnosed with endometrial cancer from RAC.Conclusion: RAC are patient-centric and have demonstrated valuable benefits for both clinicians and women with a high suspicion of EC.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to: Letter to the editor commenting on the editorial: "The cost of everything and the value of nothing: New Zealand's under-investment in health". 回应致编辑的信，评论社论："一切皆有代价，一切皆无价值：新西兰对健康的投资不足"。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6725

Virginia Mills, Lyndon Keene

引用次数: 0

The cost of everything and the value of nothing: the first corrective steps are to stop ignoring and start measuring the unmet secondary elective healthcare need. 一切皆有成本，一切皆无价值：第一个纠正步骤是停止忽视并开始衡量未得到满足的二次选择性医疗保健需求。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-06 DOI: 10.26635/6965.6727

Phil Bagshaw, Sue Bagshaw, John D Potter, Andrew Hornblow, M Gary Nicholls, Carl Shaw

引用次数: 0