A retrospective audit of the characteristics and treatment outcomes in patients with diabetes-related charcot neuropathic osteoarthropathy
Charcot neuropathic osteoarthropathy occurs in people with diabetes and diabetes-related nerve damage of the feet. It presents as a red, hot and swollen foot and requires immediate medical attention and treatment. It can often take several weeks before the right diagnosis is made, leading to delays in treatment and long-term damage to the foot. People with longstanding diabetes and nerve damage in the feet should be aware of this condition and seek medical attention quickly if they notice these symptoms.
Paediatric testicular tumours in a New Zealand centre
Testicular tumours in children are rare. Our experience in managing such tumours is similar to that published by other major centres for paediatric surgery across the world. There may be scope to develop the practice of testicle-sparing surgery (ie, not removing the whole testicle when there is a tumour), but this has not been our practice thus far. Overall, survival rates are excellent.
Characteristics of and differences between Pasifika women and New Zealand European women diagnosed with breast cancer in New Zealand
Pasifika women were diagnosed with more advanced breast cancer and with a poorer prognosis. The presence of advanced cancer is associated with less breast screening, higher deprivation, age and some biological factors. For those of screening age, adherence to the screening programme and improvements in access to earlier diagnosis for Pasifika women under the current screening age have the potential to make a substantial difference in the number of Pasifika women presenting with late-stage disease.
Morbidity from intentional self-harm among Pacific peoples in New Zealand 1996–2015
There has been no investigation of the statistical trend for Pacific intentional self-harm and outcomes over time. The aim of this study was to describe trends in intentional self-harm for Pacific peoples in New Zealand by reviewing official data over the period 1996–2015. This information highlights specific areas for prevention, training, campaigning and further Pacific-centred research.
Office design and health: a systematic review
We undertook a review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. Our review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees’ health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. The findings of our review are consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.
Management of coronary artery disease in patients on dialysis
Coronary artery disease is common in patients with end-stage renal failure (ESRF). We assessed survival and cardiovascular outcomes in patients with ESRF undergoing coronary angiography and then having coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI) or medical management. Two hundred and eighty-eight patients had a total of 382 diagnostic coronary angiograms. There was no significant difference in survival between treatment modalities in the entire cohort, nor in the 108 patients with severe coronary artery disease. Similarly, there was no difference in the incidence of major adverse cardiac events, comparing medical management with revascularisation.
Outcome of acute hospital admission for non-specific low back pain: what is the role of MRI?
Low back pain is a common condition affecting people worldwide. Most cases are being managed non-operatively. We deduced that the use of MRI could possibly aid in the early diagnosis and possibly result in significant reduction in healthcare costs, including hospital admission. Current guidelines in managing low back pain can be adapted to be used in the hospital setting to ensure timely and appropriate treatment for patients.
An osteoarthritis model of care should be a national priority for New Zealand
Osteoarthritis affects one in ten New Zealand adults, however at present drugs and surgery are the focus of treatment rather than conservative options such as weight loss and exercise. Developing an osteoarthritis model of care for New Zealand would lead to better delivery of conservative treatments, as has occurred in Australia, the UK and Europe. Currently the Ministry of Health’s Mobility Action Programme (MAP) is supporting community-based teams of health professionals to improve early, conservative treatment for osteoarthritis. The MAP could provide a basis for developing an osteoarthritis model of care, however policy support is needed to put this into action.
Potential for public health success in tackling the hepatitis C virus epidemic
There is potential to control and possibly eliminate the hepatitis C virus epidemic in New Zealand and in Australia. It can cause more advanced liver disease, liver cirrhosis and liver cancer but it is potentially preventable and curable. There is inadequate public health policy attention to preventing new infections and reducing barriers. There is a need for increased investment to reduce barriers, improve coordination and community awareness and to collaborate to engage with the affected population who can be stigmatised and marginalised.