Vilstruplara8072

INTRODUCTION New Zealand veterans may have complex mental and physical complaints related to multiple exposures to war environments. They are entitled to, but often do not, access a range of physical, mental health and social services funded through Veterans' Affairs New Zealand. eCHAT (electronic Case-finding and Help Assessment Tool) is a self-completed electronic holistic screen for substance misuse, problem gambling, anger control, physical inactivity, depression, anxiety, exposure to abuse; and assesses whether help is wanted for identified issues. AIM A proof-of-concept study was conducted to develop a modified version of eCHAT (VeCHAT) with remote functionality for clinical assessment of mental health and lifestyle issues of contemporary veterans, and assesses acceptability by veterans and Veterans' Affairs staff, and feasibility of implementation. METHODS We used a co-design approach to develop VeCHAT. Veterans' Affairs and service organisations invited veterans to remotely complete VeCHAT and a subsequent short online acceptability survey. Veterans' Affairs medical and case manager staff underwent semi-structured interviews on feasibility and acceptability of VeCHAT use. RESULTS Thirty-four veterans completed VeCHAT. The tool proved acceptable to veterans and Veterans' Affairs staff. Key emergent themes related to tool functionality, design, ways and barriers to use, and suggested improvements. Veterans' Affairs staff considered VeCHAT use to be feasible with much potential. DISCUSSION Capacity of Veterans' Affairs to respond if their engagement with veterans increases and employment of VeCHAT is scaled up, is unknown. Work is needed to assess how introducing VeCHAT as a standard procedure might influence Veterans' Affairs case management processes.INTRODUCTION Most cutaneous vascular lesions are benign and do not require treatment. Many are referred to specialist dermatologists from primary care. AIM This study aimed to investigate the characteristics of cutaneous vascular lesions and the reasons for their referral from primary care. METHODS Lesions diagnosed as cutaneous vascular abnormalities or dermatoses were retrospectively selected from a database of patients attending the Waikato Virtual Lesion Clinic. Demographic data, diagnosis and clinic outcome were recorded for each imaged lesion. selleck inhibitor Primary care referrals were reviewed to determine the reasons for referral. RESULTS In total, 229 referrals for vascular lesions were received between January 2010 and February 2019. Patient ages ranged from 6 to 95 years and 64.2% of patients were female. Nearly half the lesions (47.2%) were located on the head and neck; 64.1% had a dermatological diagnosis of a vascular tumour and 18.7% had a malformation. The most common reason for referral was pigmentation (45.7%) and bleeding was least common (8.2%). No diagnosis was given in 34.2% of referrals and less than one-quarter had a correct diagnosis. Malignancy was suspected in 40.2% of referrals; however, the dermatologists found that 95.2% of patients did not require further treatment. Half of excisions (n=2) were for bleeding and all were histologically benign. DISCUSSION Diagnostic uncertainty and suspected malignancy commonly result in referral of benign cutaneous vascular lesions to public dermatology services. This study highlights the usefulness of teledermatology in the timely access of specialist input, minimising the need for intervention or excision.INTRODUCTION Medication errors are one important cause of harm to patients. Information about medication errors can be obtained from diverse sources, including databases administered by poisons centres as part of their routine operation. AIM The aim of this study was to describe the data regarding therapeutic errors captured by the New Zealand National Poisons Centre (NZNPC). METHODS A retrospective study of calls made to the NZNPC between 1 September 2016 and 31 August 2018 was conducted, which involved human patients and were classified as 'therapeutic error' in the NZNPC database. Variables extracted and analysed included the demographics of the individual, the substance(s) involved, and site of exposure. RESULTS During the study period, a total of 43,578 calls were received by the NZNPC, including 5708 (13%) that were classified as 'therapeutic error'. Just over half of the exposures occurred in females, 3197 (56%) and 4826 (85%) of the calls involved a single substance. All age groups were affected and 2074 (37%) of the calls were related to children aged less then 12 years. A residential environment (n=5568, 97%) was the site of exposure for almost all reported therapeutic errors, most commonly in the patient's own home (n=5207, 91%). DISCUSSION This study provides insights into therapeutic error-related calls to the NZNPC. Almost all errors occurred in the residential setting. Over one-third of the calls involved children. Enhanced data capture and classification methods are needed to determine the types of errors and their possible causes to better inform prevention efforts.INTRODUCTION There are few studies of user perceptions of the Levonorgestrel Intrauterine System (LNG-IUS; Mirena™), which now has the potential to play an important role in the treatment of women with hyperplasia or early stage endometrial cancer. There is limited evidence on how well the Mirena™ is perceived and accepted by women in this context. AIM To gain an understanding of New Zealand women's views on the use of the Mirena™ contraceptive device to inform policies in endometrial cancer prevention. METHODS An online survey platform (Qualtrics™) was disseminated over social media sites such as Facebook once a week for 3 weeks. The survey used mixed methods (closed questions, multiple choice and open-ended questions) and covered topics relating to the knowledge and use of the Mirena™ for endometrial protection. Data were collected and explored using content and thematic analysis. RESULTS In total, 89 women responded to the survey. Half (42/89) of respondents had never used a Mirena™ in their life. Most women (79/89) did not know anyone who had had endometrial cancer. The frequency of negative comments about the Mirena™ was higher than positive comments (42 and 26 respectively), largely attributed to personal or reported poor experiences with other contraceptives (including the copper intrauterine device). DISCUSSION Although health-care providers may view the Mirena™ favourably, this view was not reciprocated in this community sample.