Bergersutton6106
We examined the documentation underlying the decision to permit the Southern District Health Board (SDHB) to join the National Bowel Screening Programme (NBSP) at a time when it was not providing an adequate colonoscopy service for symptomatic patients. A coordinated sequence of relevant Official Information Act 1982 (OIA) requests was lodged with the New Zealand Ministry of Health (MoH), which is responsible for determining the readiness of district health boards (DHBs) to join the NBSP. However, the MoH OIA process was obfuscating, unduly long and responded only after they anticipated imminent intervention by the Office of the Ombudsman. see more The amount of information provided was massive, partly irrelevant and presented in an inconvenient format. It revealed that the MoH readiness process was incomplete, and permission for the SDHB to join the NBSP was given prematurely without following due process and despite concerns expressed by some MoH staff. Subsequently, the MoH has failed to admit that they made errors in this case or have any weaknesses in their readiness assessment process. The MoH readiness process failed to determine that the SDHB was not ready to join the NBSP in 2018. Concerns have been expressed in the public media that such failures have occurred with the assessment of other DHBs. The process needs to be overhauled or replaced before further permissions are granted to DHBs. Requests for information under the OIA from the MoH, and similar public entities and agencies subject to the OIA, are too easily deferred, derailed or declined. The OIA is in need of revision.New Zealand achieved a major sexual reproductive health and rights milestone when abortion ceased to be a crime. Introduction of the Abortion Legislation Act 2020 has significantly changed the way abortion care can be provided in New Zealand, with the potential to improve access, reduce inequities and transform the abortion experience for those people who choose to end their pregnancy. The primary care sector stands to be a key player in the provision of first-trimester abortion care. However, with issues relating to funding, training and access to medications yet to be resolved, the health sector is not yet ready to provide best-practice abortion care within the new legislative framework.
Historically methoxyflurane was used for anaesthesia. Evidence of nephrotoxicity led to abandonment of this application. Subsequently, methoxyflurane, in lower doses, has re-emerged as an analgesic agent, typically used via the Penthrox inhaler in the ambulance setting. We review the literature to consider patient and occupational risks for methoxyflurane.
Articles were located via PubMed, ScienceDirect, Google Scholar, Anesthesiology journal and the Cochrane Library.
Early studies investigated pharmacokinetics and considered the resulting effects to pose minimal risk. Pre-clinical rodent studies utilised a species not vulnerable to the nephrotoxic fluoride metabolite of methoxyflurane, so nephrotoxicity was not identified until almost a decade after its introduction, and was initially met with scepticism. Further evidence of nephrotoxicity led to abandonment of methoxyflurane use for anaesthesia. Subsequent research suggested there are additional risks potentially relevant to recurrent patient or occupnerally appear safe for patients. However, the safety of recurrent patient or occupational healthcare-worker exposure has not been confirmed, and merits further investigation.
To investigate medicinal cannabis users' intentions to transition to the new prescription Medicinal Cannabis Scheme (MCS) in New Zealand.
An online survey of 3,634 past-year medicinal cannabis users completed prior to implementation of the MCS in New Zealand in April 2020. Logistic regression models were fitted to identify predictors of intended future engagement with the MCS.
Seventy-eight percent of respondents were aware of the new MCS and 66% intended to use it. Higher income (OR=1.57), younger age (OR=1.02) and smoking cannabis (v. vaping (OR=2.0) or oral ingestion in edible form (OR=2.22)) predicted intention to engage with the MCS. Conversely, Māori (OR=0.63) and those who grew their own cannabis (OR=0.52) were less likely to intend to engage with the new prescription MCS.
The lower intended engagement with the MCS by Māori, lower income groups and those who home-grow cannabis may reflect their perceptions of the MCS as restrictive and expensive.
The lower intended engagement with the MCS by Māori, lower income groups and those who home-grow cannabis may reflect their perceptions of the MCS as restrictive and expensive.
This study compared accelerometer-measured physical activity (PA) patterns in adolescents living in diverse urban and rural areas of Otago, New Zealand.
Participants (n=377; age 14.9±1.4 years; 66.8% female; 23 schools) completed an online school travel survey, anthropometry and seven-day PA accelerometer assessment. Participants resided in large (n=237), medium (n=45) and small (n=44) urban areas or rural settings (n=51).
Overall, participants participated in 54.4±21.0 minutes of moderate-to-vigorous physical activity (MVPA) daily and 35.0% met PA guidelines (school day vs weekend day 40.8% vs 26.0%; p<0.001) with no difference across geographical settings. A greater proportion of males (43.2% vs 31.9%; p=0.016), school sport participants (70.1% vs 54.0%; p=0.005) and active-transport-to-school users (40.2% vs 26.1%) met PA guidelines compared to their counterparts. Compared to rural adolescents, those from large urban areas accumulated more MVPA during the school commute time (before school 8.3±6.7 vs 5.3±3.8 minutes, p<0.001; after school 10.1±6.0 vs 7.7±4.3 min, p=0.003), but overall spent more time sedentary (584.9±84.7 vs 527.8±88.2 minutes/day; p<0.001).
PA in Otago adolescents is low, with significant differences by gender, sport participation, mode of travel to school and geographical setting. Increased PA should be encouraged in both urban and rural adolescents.
PA in Otago adolescents is low, with significant differences by gender, sport participation, mode of travel to school and geographical setting. Increased PA should be encouraged in both urban and rural adolescents.