NEW ZEALAND MEDICAL JOURNAL最新文献_第10页

Persistent left superior vena cava after insertion of central venous catheter. 插入中心静脉导管后，左上腔静脉仍然存在。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6639

Nandika Muruvan, Arthur Cavan, Marilyn Aday, Ankur Gupta

引用次数: 0

Quantifying cost-savings in the treatment of neovascular age-related macular degeneration in Aotearoa New Zealand. 量化新西兰奥特亚罗瓦地区治疗新生血管性老年黄斑变性的成本节约。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6533

James S Lewis, Matthew Roskruge, John Ah-Chan

{"title":"Quantifying cost-savings in the treatment of neovascular age-related macular degeneration in Aotearoa New Zealand.","authors":"James S Lewis, Matthew Roskruge, John Ah-Chan","doi":"10.26635/6965.6533","DOIUrl":"https://doi.org/10.26635/6965.6533","url":null,"abstract":"Aims: To estimate the cost-impact if faricimab were approved for the treatment of neovascular age-related macular degeneration (nAMD) in New Zealand.Methods: A retrospective, single-centre cost-analysis study. Data on intravitreal agent and injection intervals were obtained and statistically compared. Cost estimates were based on internal facility and publicly available data. The current costs of care were compared to two scenarios: one where all eyes receive faricimab, and another where eyes receiving aflibercept switch to faricimab.Results: A total of 352 eyes from 292 patients were analysed. Present values locally over 10 years were estimated at -$6,776,340 for the first scenario and $5,015,922 for the second, releasing 252 and 176 hours of clinical time per year, respectively. Nationally, the savings extrapolated to -$187,925,737 and $139,104,706, respectively. The analysis indicates significant direct cost savings for the health sector and potential reductions in patient harm due to fewer injections.Conclusions: The approval of faricimab for the treatment of nAMD could result in substantial direct cost savings for the health sector. Additional benefits include reducing patient harm and improving ophthalmic health inequalities for Māori and Pacific peoples. Further research in diverse patient populations across multiple centres is needed to estimate the magnitude of cost savings more accurately. This study highlights the potential of faricimab to alleviate the treatment burden and provide a more sustainable healthcare option for nAMD in New Zealand, especially in cases of recalcitrant nAMD, if used in a tailored and patient-specific manner alongside the existing armamentarium of treatments.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"35-41"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477846","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

Awareness and preparedness of healthcare workers for the initial wave of COVID-19 in Aotearoa New Zealand. 新西兰奥特亚罗瓦医护人员对 COVID-19 初潮的认识和准备情况。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6550

Thomas Pirker, Ibrahim S Al-Busaidi

{"title":"Awareness and preparedness of healthcare workers for the initial wave of COVID-19 in Aotearoa New Zealand.","authors":"Thomas Pirker, Ibrahim S Al-Busaidi","doi":"10.26635/6965.6550","DOIUrl":"10.26635/6965.6550","url":null,"abstract":"Aims: The TMGH-Global COVID-19 Collaborative was a multinational, multicentre, cross-sectional survey assessing the awareness and preparedness of healthcare workers (HCWs) during the first wave of the pandemic across 57 countries. Here, we report the results from Aotearoa New Zealand.Methods: This cross-sectional survey was conducted at Christchurch Hospital between February and May 2020. Data were collected from a convenience sample of HCWs and analysed using descriptive and multivariate regression to determine awareness (out of 40) and preparedness (out of 15) scores and influencing factors.Results: Of the 158 participants (response rate 20.8%), most were women (73%) and doctors (58%) with a median age of 38 years (interquartile range [IQR] 29-49). The median awareness and preparedness scores were 33.6 (IQR 31.1-35.1) and 8 (IQR 6-8), respectively. Mainstream media was the primary source of information on COVID-19 among HCWs. The awareness score was significantly affected by gender and profession, whereas the preparedness score was influenced by age, profession, clinical experience duration and COVID-19 training.Conclusions: Although frontline HCWs had high awareness levels, preparedness was low. Variables influenced awareness and preparedness differently. These findings identified gaps in pandemic readiness and factors that can be leveraged to enhance future pandemic preparedness and response in New Zealand.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"42-52"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477839","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

Predictors of symptom recurrence and survival in patients with malignant gastric outlet obstruction treated with self-expanding metal stents. 使用自膨胀金属支架治疗恶性胃出口梗阻患者症状复发和存活率的预测因素。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6601

Michael Chieng, Henry Wei, Sarah Haydon, Cameron Schauer

{"title":"Predictors of symptom recurrence and survival in patients with malignant gastric outlet obstruction treated with self-expanding metal stents.","authors":"Michael Chieng, Henry Wei, Sarah Haydon, Cameron Schauer","doi":"10.26635/6965.6601","DOIUrl":"10.26635/6965.6601","url":null,"abstract":"Background: Malignant gastric outlet obstruction (GOO) poses a substantial symptomatic burden. While various therapeutic options exist, self-expanding metal stents (SEMS) are a common palliative choice for patients who are ineligible for surgery. We studied SEMS outcomes to identify factors influencing stent dysfunction and patient survival.Methods: A multi-centre, retrospective review of 190 patients with GOO undergoing SEMS at three tertiary hospitals was performed over 2016-2022. Technical success, clinical success and adverse outcomes were recorded. Predictors of stent dysfunction and survival were evaluated using multivariate regression.Results: Technical success was achieved in 186/190 (97.9%) and clinical success in 156/186 (83.9%), defined as post-procedural gastric outlet obstruction symptom score (GOOSS) ≥2. Eighty-two (44.1%) patients experienced an adverse event with stent occlusion the most common (23.1%). Approximately one-third (32.3%) underwent a repeat intervention. Mean stent patency time was 67 days (standard deviation=76), and median post-stent survival was 95 days (37-197). Covered and partially covered SEMS carried three times the risk of stent dysfunction compared to uncovered SEMS (odds ratio 3.06, p=0.008). Mortality predictors were Eastern Cooperative Oncology Group score ≥2 (p=0.03), extrinsic outlet obstruction (p=0.05) and presence of ascites (p=<0.001).Conclusion: SEMS demonstrated technical and clinical success but posed a high risk of recurrence, with stent patency time falling short of survival in our cohort. With an evolving landscape of therapeutics for GOO, appropriate patient selection is paramount. Individuals with reduced performance status, extrinsic obstruction and/or ascites may be better candidates for SEMS due to more limited life expectancy. In this setting, uncovered SEMS carry the lowest risk of reintervention.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"22-34"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477845","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

Adult decision-making capacity and health research in Aotearoa New Zealand. 新西兰奥特亚罗瓦的成人决策能力与健康研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6684

Ben Gray, Angela Ballantyne

引用次数: 0

Polokalama Fekumi ki he Kanisā 'o e Halanga-me'atokoní-Ko e vakai 'a e Tongá: Tongan New Zealanders' views on how to ensure the National Bowel Cancer Screening Programme works well for the Tongan community. Polokalama Fekumi ki he Kanisā 'o e Halanga-me'atokoní-Ko e vakai 'a e Tongá：汤加籍新西兰人对如何确保国家肠癌筛查计划在汤加社区良好运作的看法。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6489

Viliami Puloka, Aivi Puloka, Michelle Lambert, Louise Signal

{"title":"Polokalama Fekumi ki he Kanisā 'o e Halanga-me'atokoní-Ko e vakai 'a e Tongá: Tongan New Zealanders' views on how to ensure the National Bowel Cancer Screening Programme works well for the Tongan community.","authors":"Viliami Puloka, Aivi Puloka, Michelle Lambert, Louise Signal","doi":"10.26635/6965.6489","DOIUrl":"10.26635/6965.6489","url":null,"abstract":"Aim: The National Bowel Screening Programme (NBSP) fails to deliver screening equitably to Pacific New Zealanders. This research explored Tongan New Zealanders' experiences of participating in the NBSP and their views on ensuring the programme works well for the Tongan community.Method: In 2021, we conducted two talanoa focus groups with Tongan New Zealanders who had participated in the NBSP (n=26), recruited through a Pacific provider in Auckland. Participants were aged 60 or more and were Tongan born. Interviews with four Pacific experts working in the NBSP were also undertaken. Their views on the NBSP were explored and analysed using thematic analysis.Results: While the research participants valued the opportunity to participate in the NBSP, they had many valuable insights about strengthening it, as did the Pacific experts. Key was a by Tongan, for Tongan service run by Tongan providers, one based on Tongan models of health and health promotion, Tongan values and ways of working, and using the Tongan language, which empowers Tongans to take control of their health.Conclusions: This research demonstrates critical elements of an effective, culturally appropriate and empowering NBSP for Tongans led by Tongan providers. If these findings are enacted, more effective delivery of bowel screening to Tongans will likely be enabled, reducing inequity in participation between Tongans and other New Zealanders. What is required is courage and political will to shift power and resources to ensure equitable outcomes in the NBSP, not only for Tongans but for all Pacific peoples.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"53-61"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477844","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

Pandemic prevention, preparedness and response: are we better off now than pre-COVID? 大流行病的预防、准备和应对：我们现在的情况是否好于 COVID 之前？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.e1604

David R Murdoch, Ashley R Bloomfield

引用次数: 0

Ethnicity is an evidence-based marker of need (and targeting services is good medical practice). 种族是衡量需求的循证标志（有针对性的服务是良好的医疗实践）。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-27 DOI: 10.26635/6965.e1603

Belinda Loring, Papaarangi Reid, Elana Curtis, Melissa McLeod, Ricci Harris, Rhys Jones

引用次数: 0

Adherence to New Zealand's Major Trauma Destination Policy: an audit of current practice. 新西兰重大创伤目的地政策的遵守情况：对当前做法的审计。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-27 DOI: 10.26635/6965.6594

Georgia Gibson, Bridget Dicker, Ian Civil, Bridget Kool

{"title":"Adherence to New Zealand's Major Trauma Destination Policy: an audit of current practice.","authors":"Georgia Gibson, Bridget Dicker, Ian Civil, Bridget Kool","doi":"10.26635/6965.6594","DOIUrl":"10.26635/6965.6594","url":null,"abstract":"Aim: To evaluate adherence to the New Zealand Major Trauma Destination Policy (MTDP). This audit assessed if, based on their injuries, Emergency Medical Services (EMS) attended major trauma cases were taken to the MTDP determined appropriate hospital. Findings will guide and further improve pre-hospital trauma care and associated patient outcomes.Methods: A retrospective evaluation of adherence to the New Zealand MTDP for a random sample of 100 cases (ISS >12) injured between 31 November 2017-30 November 2018 who survived to hospital. The EMS electronic patient record (ePRF) was reviewed for each case. Adherence was indicated by the transport of injured patients from the scene to the appropriate initial destination based on meeting the respective regional MTDPs.Results: Overall, there was a 94% adherence rate to the MTDP. For patients that were not classified as requiring transport to an advanced-level trauma centre, there was a 98.9% (n=86/87) adherence compared to 61.5% (n=8/13) adherence in those that did require transport to an advanced-level trauma centre.Conclusion: There was high adherence to the MTDP, with 94% of cases being taken to the appropriate destination directly from the incident scene. There is scope for improvement in cases whereby the nearest hospital should be bypassed in favour of a more distant advanced-level trauma centre.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1603","pages":"89-128"},"PeriodicalIF":1.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337032","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

Navigating the long journey of heart failure-experiences of Māori and Pacific peoples. 驾驭心力衰竭的漫长旅程--毛利人和太平洋岛屿族裔的经历。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-09-27 DOI: 10.26635/6965.6535

Sandra Hanchard, Karen M Brewer, Tua Taueetia-Su'a, Sione Vaka, Shanthi Ameratunga, Taria Tane, Rochelle Newport, Vanessa Selak, Matire Harwood, Corina Grey

{"title":"Navigating the long journey of heart failure-experiences of Māori and Pacific peoples.","authors":"Sandra Hanchard, Karen M Brewer, Tua Taueetia-Su'a, Sione Vaka, Shanthi Ameratunga, Taria Tane, Rochelle Newport, Vanessa Selak, Matire Harwood, Corina Grey","doi":"10.26635/6965.6535","DOIUrl":"10.26635/6965.6535","url":null,"abstract":"Aims: Māori and Pacific peoples in Aotearoa New Zealand experience significant inequities in heart failure rates, treatment and outcomes compared to NZ Europeans. We aimed to understand the experiences of Māori and Pacific people living with heart failure as they navigated care across primary and secondary settings.Methods: This research involved a secondary analysis of data collected in a wider qualitative study investigating evidence-practice gaps of cardiovascular care experienced by Māori and Pacific people. From the wider pool of semi-structured interviews, we identified 24 people (seven Māori and 17 Pacific peoples, 23 from the North Island) living with heart failure, and applied template and framework analysis to explore their distinct experiences.Results: Two major themes identified related to participants: 1) Condition-need for more support to understand and self-manage their heart failure condition, and 2) Journey-desire to feel well-connected to the health system in their heart failure journey.Conclusions: Addressing heart failure inequities for Māori and Pacific peoples requires that providers engage in clear and meaningful communication to support patient self-management. Strengthening pathways for Māori and Pacific patients and whānau (families) between primary and secondary services is required to reduce their likelihood of becoming disconnected from care.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1603","pages":"25-32"},"PeriodicalIF":1.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337078","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