NEW ZEALAND MEDICAL JOURNAL最新文献_第4页

Intentional physical self-injury in Auckland: patterns, associations and clinical implications in a single-centre cross-sectional study. 奥克兰的故意肢体自残：单中心横断面研究的模式、关联和临床影响。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6344

Divyansh Panesar, Ian Civil

{"title":"Intentional physical self-injury in Auckland: patterns, associations and clinical implications in a single-centre cross-sectional study.","authors":"Divyansh Panesar, Ian Civil","doi":"10.26635/6965.6344","DOIUrl":"https://doi.org/10.26635/6965.6344","url":null,"abstract":"Introduction: Intentional physical self-injury (IPSI) is a pressing health challenge and there is little awareness of injury patterns, management and outcomes. This study examines IPSI's epidemiological and clinical aspects in one major Auckland hospital, highlighting demography, injury patterns and implications for clinical practice and prevention.Methods: Using Auckland City Hospital Trauma Registry data, a retrospective, descriptive study was conducted covering adult patients admitted from January 2015 to December 2019. It assessed demographic characteristics, injury patterns and outcomes, using Mann-Whitney U tests, Fisher's exact tests and Chi-squared tests.Results: Among 137 IPSI admissions, 92 (67%) required surgery, and 24% experienced post-operative complications. Major trauma was identified in 39 (28.5%) admissions. Discharge destinations varied, with only 64 (47%) patients returning home unassisted. Injury severity did not significantly vary across sex, age or injury event location. Major injuries often resulted from falls (19 of 39) and minor injuries from lacerations/stabs (73 of 98).Conclusions: IPSI represents a significant challenge to Auckland health services, with a notable burden of care. The study highlights the need for targeted interventions to reduce the incidence of IPSI and improve outcomes. It underscores the importance of multidisciplinary approaches to care, integrating surgical, mental health and rehabilitative services.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876331","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

Time to start disease modifying drugs for adults with seropositive rheumatoid arthritis: results of the first year of the national New Zealand Rheumatology Association (NZRA) audit. 血清反应呈阳性的成人类风湿关节炎患者开始服用改变病情药物的时间：新西兰全国风湿病学协会（NZRA）第一年的审计结果。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6414

William J Taylor, Nicola Dalbeth, Tracey Kain, Douglas White, Rebecca Grainger, Vicky Quincey

{"title":"Time to start disease modifying drugs for adults with seropositive rheumatoid arthritis: results of the first year of the national New Zealand Rheumatology Association (NZRA) audit.","authors":"William J Taylor, Nicola Dalbeth, Tracey Kain, Douglas White, Rebecca Grainger, Vicky Quincey","doi":"10.26635/6965.6414","DOIUrl":"https://doi.org/10.26635/6965.6414","url":null,"abstract":"Aim: This audit describes variation in the time from referral to starting disease modifying drug (DMARD) for people with newly diagnosed seropositive rheumatoid arthritis (RA), how frequently this was within the recommended 6 weeks and whether regional, service-level or patient-level factors were associated with this variation.Method: Rheumatologists submitted data on new patients with a new diagnosis of rheumatoid factor and/or cyclic-citrullinated peptide antibody positive RA. The association between visit funding, ethnicity, socio-economic deprivation, rurality, local specialist staffing levels and the time to DMARD treatment was assessed using Cox proportional-hazard models.Results: Data were collected on 355 patients over 12 months. Overall, 64.8% of patients commenced DMARD treatment within 6 weeks of referral and this was associated with rheumatologist FTE per 100,000 population (adjusted HR 2.47, 95%CI 1.27-4.81; p=0.008) and the rurality (Geographic Classification of Health [GCH]) of the patient (for R2 compared to U1 adjusted HR 0.20, 95%CI 0.09-0.43; p<0.001). There was no association between time to DMARD and ethnicity or socio-economic deprivation.Conclusion: There was significant variation in time to DMARD treatment, mainly related to variation in rheumatologist staffing levels and patient rurality. Rheumatologist staffing levels of 1.0 FTE/100,000 population was associated with 80% of patients meeting the recommended 6-week time to DMARD treatment.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876335","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

Midwifery experiences in rural Southern Aotearoa New Zealand: insights into pre-eclampsia management. 新西兰奥特亚罗瓦南部农村地区的助产经验：对子痫前期管理的见解。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6458

Judith Sligo, Julia Corfe-Tan, Zoe Cotter, Jimmy Senara Eteuati, Hannah-Rose Hart, Rachael McConnell

{"title":"Midwifery experiences in rural Southern Aotearoa New Zealand: insights into pre-eclampsia management.","authors":"Judith Sligo, Julia Corfe-Tan, Zoe Cotter, Jimmy Senara Eteuati, Hannah-Rose Hart, Rachael McConnell","doi":"10.26635/6965.6458","DOIUrl":"https://doi.org/10.26635/6965.6458","url":null,"abstract":"Aim: This study investigated the experiences of rural midwives in the Southern region of Aotearoa New Zealand, focussing on practices and challenges in caring for pregnant individuals displaying signs of pre-eclampsia (PE).Method: Conducted as part of the University of Otago's Trainee Intern Healthcare Evaluation Project, investigating the efficacy of the soluble FMS-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio test, this exploratory study employed qualitative research methods. Twenty-three midwives from nine locations across the Southern region were interviewed by trainee intern doctors (TIs) using a semi-structured interview protocol. Thematic analysis was applied to the data.Results: The study highlighted the challenging context of rural midwifery, emphasising diverse working conditions, geographic complexities and the impact of the midwifery shortage. Midwives' decision making about PE depended on location, experience, scientific evidence, holistic model of care and the constant concern about PE. A model illustrating midwifery decision making in PE management was developed.Conclusion: Rural midwives in Aotearoa New Zealand's Southern region managing PE cases face complex challenges. The model derived from this study illustrates the delicate balance that rural midwives navigate, emphasising the need for strategies to support their practice and preserve Aotearoa New Zealand's distinctive maternity care model.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876332","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

Provision of care for diabetic retinopathy in New Zealand: are there ethnic disparities? 新西兰提供的糖尿病视网膜病变治疗：是否存在种族差异？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6282

Jahnvee Solanki, Tiwini Hemi, Amy Chen, Sarah Welch, Rachael Niederer

{"title":"Provision of care for diabetic retinopathy in New Zealand: are there ethnic disparities?","authors":"Jahnvee Solanki, Tiwini Hemi, Amy Chen, Sarah Welch, Rachael Niederer","doi":"10.26635/6965.6282","DOIUrl":"10.26635/6965.6282","url":null,"abstract":"Aims: Ethnic disparities have been observed in treatment at first specialist appointments across various specialties within New Zealand. This study aimed to examine documentation and treatment decisions for diabetic retinopathy by ethnicity.Methods: Retrospective audit of first specialist diabetic retinopathy clinic appointments for 388 patients at the Department of Ophthalmology, Te Whatu Ora Te Toka Tumai Auckland. Multiple domains of care were assessed, including comprehensiveness of history taking, examination, investigations and treatment decisions.Results: Europeans comprised 42%, Māori only 9.5%, Pacific peoples 13.19%, Asian 32.7% and Middle Eastern/Latin American/African in 2%. Māori patients were eligible for a significantly greater number of treatments (p=0.001). The comprehensiveness of history taking (p=0.809), examination (p=0.513), investigations (p=0.623) and proportion of eligible treatments provided (p=0.788) was similar but did not reach the gold standard of care across all ethnicities.Conclusions: The standard of care provided in first specialist appointments for diabetic retinopathy appear to be similar across all ethnic groups, although Māori were underrepresented and had a higher disease burden at presentation. Our data highlights the need to reduce barriers faced by Māori in accessing GP, optometry and retinopathy screening referrals in Auckland, and improving local consultation and treatment guidelines.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876333","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

Value for money of reusable versus disposable ophthalmic instruments for intravitreal injections. 用于玻璃体内注射的可重复使用眼科器械与一次性眼科器械的性价比。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6557

Saghir Ahmed Sadiq, Sarah Winsloe

{"title":"Value for money of reusable versus disposable ophthalmic instruments for intravitreal injections.","authors":"Saghir Ahmed Sadiq, Sarah Winsloe","doi":"10.26635/6965.6557","DOIUrl":"https://doi.org/10.26635/6965.6557","url":null,"abstract":"Aim: The aim of this study was to follow the instruments' pathways and cost each segment to calculate whether reusable or disposable ophthalmic instruments offer better value for money for intravitreal injections.Methods: The cycles and costs of reusable and single-use disposable instruments used for intravitreal injections were mapped out, including purchase costs, transport to and from the place of use, opening and disposal, sterilisation, replacement, salary costs of staff involved, etc. results: The cost of using reusable instruments for intravitreal injections (NZ$29.00) was lower than the cost of using disposable instruments ($30.51) by $1.51 per patient.Conclusions: Intravitreal injections performed with reusable instruments offer better value for money than when performed with disposable instruments. This equates to a beneficial financial saving just for this one low-complexity case. Such savings can multiply significantly when considering the instruments used in a wider variety of ophthalmic procedures. There are of course trade-offs between safety, quality, cost and sustainability.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876336","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

Speeding towards danger: the concerns and consequences of increasing speed limits on our roads. 超速驶向危险：提高道路限速的担忧和后果。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.e1600

Christopher Wakeman, Shanthi Ameratunga, Teuila Percival, Braden Te Ao, Jamie Hosking

引用次数: 0

A hard pilsner to swallow: a case series of bottle cap foreign bodies in Canterbury over a 3-month period in 2023. 难以下咽的比尔森啤酒：2023 年坎特伯雷 3 个月内瓶盖异物病例系列。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-08-02 DOI: 10.26635/6965.6450

Asim Abdulhamid, Heidi Yi-Han Su, Steven Leslie Ding

引用次数: 0

Cribriform adenocarcinoma of the minor salivary glands: case report and literature review. 小唾液腺楔形腺癌：病例报告和文献综述。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6576

Maria van Kuijk, Harsha De Silva, Ling Chan, Guangzhao Guan

引用次数: 0

ANZACS-QI Heart Failure Registry: a new approach using age-stratified sampling of hospital discharges to guide quality improvement (ANZACS-QI 79). ANZACS-QI心力衰竭登记：一种利用出院病人年龄分层抽样指导质量改进的新方法（ANZACS-QI 79）。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6572

Daniel Zl Chan, Robert N Doughty, Mayanna Lund, Aleisha Easton, Katrina K Poppe, Daman Kaur, Lia Sinclair, Julie Chirnside, Catherine Malone, Helen McGrinder, Andy McLachlan, Jo Scott, Jennifer Roberts, Cara Wasywich, Gerry Devlin, Matire Harwood, Sue Wells, Wil Harrison, Andrew J Kerr

{"title":"ANZACS-QI Heart Failure Registry: a new approach using age-stratified sampling of hospital discharges to guide quality improvement (ANZACS-QI 79).","authors":"Daniel Zl Chan, Robert N Doughty, Mayanna Lund, Aleisha Easton, Katrina K Poppe, Daman Kaur, Lia Sinclair, Julie Chirnside, Catherine Malone, Helen McGrinder, Andy McLachlan, Jo Scott, Jennifer Roberts, Cara Wasywich, Gerry Devlin, Matire Harwood, Sue Wells, Wil Harrison, Andrew J Kerr","doi":"10.26635/6965.6572","DOIUrl":"https://doi.org/10.26635/6965.6572","url":null,"abstract":"Heart failure is a major healthcare problem in New Zealand. The Acute Decompensated Heart Failure (ADHF) Registry was introduced in 2015, and has identified the need for quality improvement strategies to improve care of patients hospitalised with heart failure. In this paper, we describe the implementation of the revised ANZACS-QI Heart Failure Registry, which has a primary aim to support evidence-based management of and quality improvement measures for patients who are hospitalised with heart failure in New Zealand. Taking the learnings from the initial experience with the ADHF Registry, the revised ANZACS-QI Heart Failure Registry i) utilises age-stratified sampling of hospital discharge coding to identify a representative heart failure cohort, ii) utilises existing ANZACS-QI infrastructure for data-linkage to reduce the burden of manual data entry, iii) receives governance from the Heart Failure Working Group, and iv) focusses on established quality improvement indicators for heart failure management.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724781","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

Erratum: Prevalence of urinary incontinence in New Zealand women from the cross-sectional Sexual and Reproductive Health module of the New Zealand Health Survey 2014/2015 勘误：2014/2015 年新西兰健康调查性健康和生殖健康横断面模块中新西兰妇女的尿失禁患病率

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.er1599

引用次数: 0