Dispensing patterns for antidiabetic agents in New Zealand: are the guidelines being followed?
Diabetes is a major health issue in New Zealand. In New Zealand, we have clear guidelines on how to treat diabetes. These guidelines state that if medication is to be started, metformin should be started first, followed by sulfonylureas. This research shows that these guidelines are being well followed in New Zealand, particularly when compared with other countries.
Whānau perceptions and experiences of acute rheumatic fever diagnosis for Māori in Northland, New Zealand
This study explored Māori whānau experiences of ARF, including their pathways to primary health care and barriers and facilitators for the diagnosis of ARF. This was achieved by interviewing patients with ARF/RHD and their whānau. The study found that barriers to diagnosis were lack of throat swabbing and inappropriate prescription of antibiotics. Access to primary care, having health professionals follow sore throat guidelines, and trust in health professionals facilitated diagnosis. The authors recommend the development of an effective quality improvement strategy for sore throat management, promoting free rapid-response throat swabbing for high-risk populations, and exploring options of self-swabbing to improve ARF services.
Audit on first seizure presentation to Taranaki Base Hospital: a secondary centre experience
Seizures are a common symptom that can be caused by a variety of other medical problems. Management of a person after their first seizure should be dictated by their risk to develop further seizures. Adequate investigation and access to care for these patients is essential to help determine this risk and treat them appropriately. Although Taranaki does a fair job, a number of issues could be improved on.
Face-to-face versus telephone delivery of the Green Prescription for Māori and New Zealand Europeans with type-2 diabetes mellitus: influence on participation and health outcomes
In Aotearoa/New Zealand, the participation of Māori in the national Green Prescription lifestyle programme is lower than for New Zealand Europeans (Pakeha). A kaupapa Māori informed trial examined, for Māori and Pakeha people newly diagnosed with type 2 diabetes, if face-to-face or telephone delivery of the Green Prescription resulted in better engagement. Near equal participation of both Māori and Pakeha in the trial was achieved with improved health regardless of the mode of delivery, face-to-face or telephone.
Child morbidity as described by hospital admissions for primary school aged children in Tonga 2009–2013
New Zealand is situated close to the Pacific Islands geographically and has a high Pacific population. Unfortunately, children living in these small but important Pacific nations have not received much attention in regards to their health status. In this paper, 85% of admissions to hospital in Tonga for primary school children were for injury and poisoning, non-respiratory infectious disease, respiratory conditions, abdominal/surgical conditions and dental disease. This information is helpful to inform healthcare priorities for Tonga and other similar countries.
Remembering the 1918 influenza pandemic: national survey of memorials and scope for enhancing educational value around pandemic preparedness
This study aimed to systematically identify physical memorials to the 1918 influenza pandemic in New Zealand. Despite the high impact of the 1918 influenza pandemic in this country (~8,600 deaths), only seven publicly accessible local memorials which referred this pandemic were identified. Another 11 memorials were identified, but these were in private settings or did not refer to the pandemic. There is no national memorial and a marked contrast exists with the number of war memorials (260 times more per 1,000 deaths for one war). There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.
A review of squamous cell vulvar cancers in Waikato region, New Zealand
We report one of the largest retrospective single-centre review of vulvar cancers in Australasia. Multiple factors including patient choice, tumour location, advanced age, patients’ comorbidities and treatment complications have influenced and individualised treatment. Variation in treatment over the course of time, especially in the latter years were observed. Independent of Stage of vulvar cancer, patients with less comorbidities had a better overall survival. Although, treatment was associated with high morbidity, cisplatin chemo-radiotherapy was better tolerated, however this requires validation in larger prospective studies.
Metabolic monitoring in New Zealand district health board mental health services
People with mental illness have a 20-year reduction in life expectancy compared to people in the general population. One of the factors contributing to this difference is antipsychotic medication, commonly prescribed for people with severe mental illness. We surveyed the district health boards’ mental health services to investigate their policies for monitoring the physical health of people with severe mental illness. We found that most DHBs had policies for monitoring physical health, but also that there was scope for improvement in those policies. Our recommendation is that the Ministry of Health adopt a best practice standard in this area, and require DHBs to report against this standard.
Achieving health equity in Aotearoa: strengthening responsiveness to Māori in health research
Responsiveness to Māori reflects the Government’s view that health research in New Zealand will contribute to improving Māori health and eliminating health inequities. As recipients of government funding, health researchers have obligations to meet these expectations. In this paper, we consider how an equity approach to responsiveness to Māori can be used by researchers to consider Māori health priorities, develop appropriate relationships with Māori and commit to undertaking research that mitigates rather than extends health inequities.