NEW ZEALAND MEDICAL JOURNAL最新文献_第5页

Use of medications for migraine in Aotearoa New Zealand. 新西兰奥特亚罗瓦偏头痛患者的用药情况。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6586

Fiona Imlach, Sue Garrett

{"title":"Use of medications for migraine in Aotearoa New Zealand.","authors":"Fiona Imlach, Sue Garrett","doi":"10.26635/6965.6586","DOIUrl":"https://doi.org/10.26635/6965.6586","url":null,"abstract":"Aim: To document and assess acute and preventive medication use in people with migraine disease in Aotearoa New Zealand.Methods: Online survey of people with migraine in Aotearoa New Zealand (n=530), run from 22 August to 7 October 2022, including questions on current and previous acute and preventive medication use, reasons for medication discontinuation and use of new migraine medications.Results: Most respondents had used simple analgesics for acute treatment; 55% were currently using a triptan; 27% were currently using an opioid. Overall, 27% of survey respondents had over-used at least one acute medication in the last month. Half of respondents were taking at least one preventive medication but only 57% of those eligible for preventive treatment were currently taking it. In those who had previously tried preventives, side effects and lack of efficacy were common reasons for stopping. Cost, lack of knowledge and awareness were the main barriers to use of new migraine medications.Conclusion: Many people with migraine in Aotearoa New Zealand are not receiving optimal treatment, which increases the burden and cost of migraine disease. More effective and tolerable acute and preventive medications are needed that are affordable and available in Aotearoa New Zealand. Greater awareness of best practice prescribing is also needed.","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":"141724790","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

Review of the Health and Disability Commissioner Act and Code-your chance to have your say. 审查《健康与残疾事务专员法》和《守则》--您有机会发表意见。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.e1599

Frank Frizelle

引用次数: 0

Regulation of physician associates in Aotearoa New Zealand mitigates a medical practitioner workforce crisis and leads to stronger, diversified healthcare teams. 对新西兰奥特亚罗瓦地区医生助理的监管缓解了执业医师队伍的危机，并带来了更强大、多样化的医疗团队。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6616

Lisa deWolfe, Shelly Collins

引用次数: 0

Characteristics of low, moderate and high severity trauma hospitalisations in a health region of Aotearoa New Zealand-10-year review. 新西兰奥特亚罗瓦健康地区低度、中度和高度严重创伤住院病人的特征--10 年回顾。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6428

Grant Christey, Ishani Soysa, Alastair Smith

{"title":"Characteristics of low, moderate and high severity trauma hospitalisations in a health region of Aotearoa New Zealand-10-year review.","authors":"Grant Christey, Ishani Soysa, Alastair Smith","doi":"10.26635/6965.6428","DOIUrl":"10.26635/6965.6428","url":null,"abstract":"Aim: To describe the incidence, characteristics, outcomes and hospital costs of patients admitted to hospital following trauma in a health region in Aotearoa New Zealand over a 10-year period.Methods: A retrospective, observational study used data from the Te Manawa Taki (TMT) regional trauma registry to identify patients of all ages and injury severities that were admitted to hospital following injuries from 2013 to 2022, inclusive. This study reports on incidence of injuries with regard to age, gender, ethnicity, injury severity score (ISS), injury characteristics and direct cost to TMT facilities.Results: Searches identified 60,753 trauma events leading to patient admission to hospitals in the TMT region. Of these, 81.9% were low-severity trauma, 10.2% were moderate-severity trauma and 7.9% were high-severity trauma. There were statistically significant relationships between gender, ethnicity and ISS category. Males were more likely to be hospitalised for any traumatic injuries. High-severity trauma is dominated by road traffic injuries and low-severity trauma is dominated by falls. Advanced age was associated with higher injury severity. The direct cost of trauma care to TMT hospitals increased by 122% during the 10-year period.Conclusions: The study has identified the incidence, demographic features, severity, costs and outcomes for trauma patients admitted to hospitals in the TMT region of Aotearoa New Zealand over a continuous 10-year period. The volumes and costs of injury represent a significant burden on the health system, individuals and communities. Detailed understanding of the causes and costs of injuries of all severities will inform prevention activities, clinical quality improvement and health service planning.","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":"141724782","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

Outcome measures for Māori with non-traumatic dental presentations: a retrospective observational study and Kaupapa Māori approach examining emergency department inequities. 毛利人非创伤性牙科疾病的治疗效果：一项回顾性观察研究和毛利人Kaupapa方法对急诊科不平等现象的研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6233

Sam Cameron-Dunn, Calum Fisher, Tania Huria, Andrew McCombie, Angela Forbes, Laura R Joyce

{"title":"Outcome measures for Māori with non-traumatic dental presentations: a retrospective observational study and Kaupapa Māori approach examining emergency department inequities.","authors":"Sam Cameron-Dunn, Calum Fisher, Tania Huria, Andrew McCombie, Angela Forbes, Laura R Joyce","doi":"10.26635/6965.6233","DOIUrl":"10.26635/6965.6233","url":null,"abstract":"Aim: To assess the equity of care of patients with non-traumatic dental presentations (NTDP) to Christchurch Emergency Department (ED) in Aotearoa New Zealand.Methods: This retrospective observational study reviews NTDP to Christchurch ED over a 2-year period (2018-2020). ED and hospital outcomes were compared for Māori, Pacific peoples and NZ Europeans. Results are interpreted utilising Te Ao Māori principles and discussed referencing a Kaupapa Māori framework.Results: There were a total of 2,034 NTDPs, with Māori (27.0%) and Pacific peoples (6.9%) being over-represented compared to local population estimates (9.4% and 3.2% respectively). Māori experienced shorter wait times (45 minutes, 95% CI 22-86) compared to NZ Europeans (56 minutes, 95% CI 24-97) and Pacific peoples (54 minutes, 95% CI 23-97). Māori had the highest age-standardised incidence of admission, but shorter hospital length of stay (0.9 days, IQR 0.4-2.3) compared to Pacific peoples (3.8 days, IQR 1.8-3.9) and NZ Europeans (2.0 days, IQR 1.0-3.7).Conclusion: This is the first paper to employ a Kaupapa Māori approach examining NTDP patients presenting to the ED. While outcome measures were largely positive, differences in demographic variables indicate upstream failures, specifically barriers to accessing primary oral healthcare and a paucity of Kaupapa Māori initiatives. Further action and accountability are required to provide high-quality, equitable care for Māori.","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":"141724786","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

Addressing closed and limited enrolments in general practices in Aotearoa New Zealand: a mixed-methods study. 解决新西兰奥特亚罗瓦全科诊所的封闭和有限注册问题：一项混合方法研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6517

Nisa Mohan, Maite Irurzun-Lopez, Megan Pledger, Mona Jeffreys, Jacqueline Cumming

{"title":"Addressing closed and limited enrolments in general practices in Aotearoa New Zealand: a mixed-methods study.","authors":"Nisa Mohan, Maite Irurzun-Lopez, Megan Pledger, Mona Jeffreys, Jacqueline Cumming","doi":"10.26635/6965.6517","DOIUrl":"https://doi.org/10.26635/6965.6517","url":null,"abstract":"Aim: To ascertain the reasons for and impacts of closed books in general practices in Aotearoa New Zealand and report recommendations for mitigation.Method: A mixed-methods approach was used. A first round of interviews with experts in the primary care sector was conducted, followed by a survey across general practices and, finally, a second round of interviews. Data reported here are qualitative data from the interviews and open-ended questions in the survey. Qualitative data were analysed using a general inductive approach.Results: The key reasons for not enrolling new patients included workforce shortages, high workloads and staff burnout, funding issues, concerns about quality of care and insufficient physical space. These were exacerbated during the COVID-19 pandemic. The impacts included no access or delayed access to primary care, worsening health conditions, undiagnosed or untreated diseases and less or no access to preventive care. Recommendations included recruiting more staff including administrative staff, resolving the pay disparity between general practice and hospital staff, having a longer placement period for students in general practice, utilising a multidisciplinary workforce and revising the funding formula.Conclusion: There is an urgent need to resolve key issues so that general practices can accept all who wish to enrol.","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":"141724780","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

Nitrous oxide myelopathy: a case series. 一氧化二氮脊髓病：一个病例系列。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6477

Shilpan G Patel, Tony Zhang, Bernard Liem, Frederick Sundram, Richard H Roxburgh, P Alan Barber

{"title":"Nitrous oxide myelopathy: a case series.","authors":"Shilpan G Patel, Tony Zhang, Bernard Liem, Frederick Sundram, Richard H Roxburgh, P Alan Barber","doi":"10.26635/6965.6477","DOIUrl":"https://doi.org/10.26635/6965.6477","url":null,"abstract":"Aims: To describe the clinical features and outcomes of patients with myelopathy and neuropathy due to recreationally inhaled nitrous oxide.Methods: We identified patients presenting with nitrous oxide-associated myelopathy from an electronic database of all discharges in a large tertiary hospital between 2016 and 2023. Demographics, clinical features and the results of investigations were recorded. The primary outcome was modified Rankin Scale score (mRS) at least 3 months after hospital discharge where available.Results: There were 12 patients identified, six women, mean (SD) age 27.5 (5.1) years, range 19-47 years. The most common symptoms were numbness, weakness and mental state changes. Four patients used large amounts of inhaled nitrous oxide and also took over-the-counter vitamin B12 supplements. The median (range) hospital length of stay was 8.5 (2-56) days. Functional independence at last assessment (median [range] of 3 [1-34] months after discharge) was achieved in nine of the patients, with three requiring ongoing support for activities of daily living (mRS ≥3).Conclusion: Nitrous oxide abuse and its neurological complications are an important public health issue. Clinicians should be aware that some patients who use large amounts of nitrous oxide may self-supplement vitamin B12.","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":"141724785","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

Update and projections for New Zealand's ophthalmology workforce. 新西兰眼科医生队伍的更新和预测。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-19 DOI: 10.26635/6965.6361

Chuen Yen Hong, Michael Merriman, Graham Wilson, Sheng Chiong Hong

{"title":"Update and projections for New Zealand's ophthalmology workforce.","authors":"Chuen Yen Hong, Michael Merriman, Graham Wilson, Sheng Chiong Hong","doi":"10.26635/6965.6361","DOIUrl":"https://doi.org/10.26635/6965.6361","url":null,"abstract":"Aim: The aim of this study was to update and project the growth of ophthalmologists in New Zealand. This will help decision makers better understand the current ophthalmologist workforce and make appropriate resource allocations.Method: Supply and demographics of ophthalmologists in New Zealand were obtained from the Medical Council of New Zealand, Health Workforce New Zealand and Health New Zealand - Te Whatu Ora. Ophthalmology trainee numbers were extracted from the annual reports of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). New Zealand population statistics were extracted from the Stats NZ database. A simulation model was developed to project the growth of ophthalmologists from 2024 to 2050.Results: In March 2023, there were 175 practising ophthalmologists in New Zealand. Overall, there were 34.0 ophthalmologists per million population, with 201.4 ophthalmologists per million for those aged ≥65 years. To maintain the current ratio, an additional 20 practising ophthalmologists are needed by 2050.Conclusion: The ratio of ophthalmologists per million population aged ≥65 years is projected to drop by 1.5% annually. To meet the demand of an increasing and ageing population, and RANZCO's goal of 40 ophthalmologists per million population, there needs to be an increase in ophthalmologist training positions from the current 5-year average of 6.6 to 11 new trainees annually, and a more effective distribution of the ophthalmologist workforce.","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":"141724789","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

Dying well in Aotearoa New Zealand for ethnic minority communities: a time for reclamation? 新西兰奥特亚罗瓦少数民族社区的 "安享晚年"：开垦的时机？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-05 DOI: 10.26635/6965.6534

Shamsul Shah, Shanthi Ameratunga, Roshini Peiris-John, Rodrigo Ramalho, Tess Moeke-Maxwell, Paul Wolffram

{"title":"Dying well in Aotearoa New Zealand for ethnic minority communities: a time for reclamation?","authors":"Shamsul Shah, Shanthi Ameratunga, Roshini Peiris-John, Rodrigo Ramalho, Tess Moeke-Maxwell, Paul Wolffram","doi":"10.26635/6965.6534","DOIUrl":"https://doi.org/10.26635/6965.6534","url":null,"abstract":"Despite technological advances and a disproportionate increase in health expenditure at the end-of-life, most New Zealanders die in hospital or in aged residential care. This counters the aspirations espoused by Te Whatu Ora (Health New Zealand) for all New Zealanders \"to live well, age well and die well in their homes and communities.\" Furthermore, despite reported inequities in end-of-life care experienced by ethnic minority communities (EMCs) overseas, and increasing proportions of people identifying with Asian, Middle Eastern, Latin American and African ethnicities in Aotearoa New Zealand, local data, research and policies addressing healthcare needs of EMCs at end-of-life are scant. Acknowledging this invisibility, we reflect on and discuss the current discourses on death and dying, the complex experiences at end-of-life for EMCs, including concepts of a \"good death\", the impact of recent existential crises (e.g., COVID-19 pandemic, climate change) on death awareness, and the global rise to reclaim dying as an important part of living. We argue for the need: a) to partner with ethnic communities to co-design culturally safe end-of-life health services, and b) to adopt a \"compassionate communities\" public health approach that can support people of EMCs at the end-of-life to die well.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535630","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

Written information about retinopathy of prematurity in Aotearoa New Zealand: identification, review and opportunities for improvement. 新西兰奥特亚罗瓦地区有关早产儿视网膜病变的书面信息：识别、审查和改进机会。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-07-05 DOI: 10.26635/6965.6486

Holly White, Lisa Kremer, Liza Edmonds, Amber Young

{"title":"Written information about retinopathy of prematurity in Aotearoa New Zealand: identification, review and opportunities for improvement.","authors":"Holly White, Lisa Kremer, Liza Edmonds, Amber Young","doi":"10.26635/6965.6486","DOIUrl":"10.26635/6965.6486","url":null,"abstract":"Aims: The aims of this research include adapting a patient information tool for whānau (extended family) Māori needs, identifying and reviewing written information provided for the retinopathy of prematurity eye examination (ROPEE) and identifying improvements to ROPEE written information.Methods: ROPEE patient information (printed leaflets, website, app) was obtained from all tertiary neonatal intensive care units in Aotearoa New Zealand (Aotearoa). Information was reviewed using an adapted \"20 good-design principles\" guide and given a star rating and Flesch-Kincaid readability score to identify acceptability and usability for patients.Results: Seven ROPEE information materials were reviewed and varied in alignment with the adapted good-design principles tool. Based on the adapted good-design principles, opportunities were identified in many aspects of the written information for improvement, including words and language, tone and meaning, content and design. The Flesch-Kincaid grade level reading scores ranged from 12-22 years reading age. Written information also did not use te reo Māori (Aotearoa Indigenous language) or extensively use Māori imagery.Conclusion: Opportunities exist to improve ROPEE whānau information, including making content more readable, understandable and visually appealing. Optimising the clinical information on ROPEE nationally for Aotearoa will support whānau decision making, and aligning written information with Māori (Indigenous peoples of Aotearoa) is a priority.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535676","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