National Study of Pain Medicine Access Among Māori and Non-Māori Patients With Lung Cancer in New Zealand.

Purpose: Pain is among the most common and consequential symptoms of cancer, particularly in the context of lung cancer. Māori have extremely high rates of lung cancer, and there is evidence that Māori patients with lung cancer are less likely to receive curative treatment and more likely to receive palliative treatment and to wait longer for their treatment than non-Māori New Zealanders. The extent to which Māori patients with lung cancer are also less likely to have access to pain medicines as part of their supportive care remains unclear.

InterRAI assessments: opportunities to recognise need for and implementation of palliative care interventions in the last year of life?

Objectives: To explore how interRAI assessments could be used to identify opportunities to integrate palliative care into a plan of care.

Methods: A population-based, cross-sectional design using unique identifiers to link deaths with a national interRAI database. Data were analysed using logistic regression models and chi-square tests.

Impact of health system protocol on patient qualification for influenza point-of-care testing.

Background: Point-of-care testing (POCT) is a service that community pharmacies are implementing to increase patient access to care. Many pharmacies develop protocols with physicians to maximize patient qualification for POCT, while maintaining patient safety.

Objective: To determine the number of patients seen for influenza in the emergency department (ED) during the 2018-2019 season who would qualify for protocol-driven influenza testing.

Alterations in heart-brain interactions under mild stress during a cognitive task are reflected in entropy of heart rate dynamics.

Many people experience mild stress in modern society which raises the need for an improved understanding of psychophysiological responses to stressors. Heart rate variability (HRV) may be associated with a flexible network of intricate neural structures which are dynamically organized to cope with diverse challenges. HRV was obtained in thirty-three healthy participants performing a cognitive task both with and without added stressors.

End of life care for long-term care residents with dementia, chronic illness and cancer: prospective staff survey.

Background: Little is known about the quality of end of life care in long-term care (LTC) for residents with different diagnostic trajectories. The aim of this study was to compare symptoms before death in LTC for those with cancer, dementia or chronic illness.

Methods: After-death prospective staff survey of resident deaths with random cluster sampling in 61 representative LTC facilities across New Zealand (3709 beds).

Anaerobic biodegradation of dissolved ethanol in a pilot-scale sand aquifer: Gas phase dynamics.

Groundwater contamination from ethanol (e.g., alternative fuels) can support vigorous biodegradation, with many possible reactions producing dissolved gases.

Anaerobic biodegradation of dissolved ethanol in a pilot-scale sand aquifer: Variability in plume (redox) biogeochemistry.

The use of ethanol in alternative fuels has led to contamination of groundwater with high concentrations of this easily biodegradable organic compound. Previous laboratory and field studies have shown vigorous biodegradation of ethanol plumes, with prevalence of reducing conditions and methanogenesis. The objective of this study was to further our understanding of the dynamic biogeochemistry processes, especially dissolved gas production, that may occur in developing and aging plume cores at sites with ethanol or other organic contamination of groundwater.

Updated New Zealand health system cost estimates from health events by sex, age and proximity to death: further improvements in the age of 'big data'.

Aims: We aimed to: (i) update previous health system cost estimates (Blakely et al NZMJ 2014;127(1393)) using updated costing data and more refined methods; and (ii) provide context around current developments in the improved networking of health information systems in New Zealand.

Methods: As per our previous work, national health event data were linked for hospitalisations, inpatient procedures, outpatient events, pharmaceuticals, laboratory tests, and primary care consultations for the whole country. For each health event a cost was assigned.

Likelihood of residential aged care use in later life: a simple approach to estimation with international comparison.

Objectives: In New Zealand (NZ), place of death among decedents aged 65+ years has been reported as residential aged care (RAC, 38%), acute hospital (34%) or elsewhere (28%). However, lifetime risk of use of RAC (or nursing homes) is unknown. A simple method of estimation is demonstrated for NZ and Australia, with comparisons to other countries.

Patterns of entrapped air dissolution in a two-dimensional pilot-scale synthetic aquifer.

Past studies of entrapped air dissolution have focused on one-dimensional laboratory columns. Here the multidimensional nature of entrapped air dissolution was investigated using an indoor tank (180 × 240 × 600 cm(3) ) simulating an unconfined sand aquifer with horizontal flow. Time domain reflectometry (TDR) probes directly measured entrapped air contents, while dissolved gas conditions were monitored with total dissolved gas pressure (PTDG ) probes.

Health system costs by sex, age and proximity to death, and implications for estimation of future expenditure.

Aims: Health expenditure increases with age, but some of this increase is due to costs proximal to death. We used linked health datasets (HealthTracker) to determine health expenditure by proximity to death. We then determined the impact on future health expenditure projections of accounting for proximity to death in costs.

Impact of a mandatory geriatric medicine clerkship on the care of older acute medical patients: a retrospective cohort study.

Background: The impact of geriatric medicine educational programs on patient level outcomes, as opposed to educational measures, is not well studied. We aimed to determine whether completion of a mandatory geriatrics rotation changed the clinical behaviors of clerks caring for older patients admitted to a medical clinical teaching unit.

Methods: We reviewed the charts of 132 older (>70y) patients, admitted to one medical clinical teaching unit (CTU) during 2005, and cared for by a clinical clerk, for documented functional assessment, cognitive assessment, recognition of medications that cause confusion, and early removal of indwelling urinary catheters.

Large cell lymphoma: correlation of HIV status and prognosis with differentiation profiles assessed by immunophenotyping.

Diffuse large B cell lymphoma (DLBCL) and plasmablastic lymphoma (PBL) represent aggressive non-Hodgkin lymphomas, particularly in the setting of HIV infection. Since the introduction of highly active antiretroviral therapy (HAART), recent studies have documented improved survival outcome in patients with AIDS-related lymphomas. This study contributes a South African perspective by correlating the HIV status and prognosis of DLBCL and PBL with differentiation profiles assessed by immunophenotyping.

Risk equalisation in voluntary health insurance markets: A three country comparison.

The paper summarises the conclusions for health policy from the experience of three countries who have introduced risk equalisation subsidies, in their voluntary health insurance (VHI) markets. The countries chosen are Australia, Ireland and South Africa. All of these countries have developed VHI markets and have progressed towards introducing risk equalisation.

Risk equalisation and voluntary health insurance: The South Africa experience.

South Africa intends implementing major reforms in the financing of healthcare. Free market reforms in private health insurance in the late 1980s have been reversed by the new democratic government since 1994 with the re-introduction of open enrolment, community rating and minimum benefits. A system of national health insurance with income cross-subsidies, risk-adjusted payments and mandatory membership has been envisaged in policy papers since 1994.

The role of risk equalization in moving from voluntary private health insurance to mandatory coverage: the experience in South Africa.

Objective: The South African health system has long been characterised by extreme inequalities in the allocation of financial and human resources. Voluntary private health insurance, delivered through medical schemes, accounts for some 60% of total expenditure but serves only the 14.8% of the population with higher incomes.

Screening for abdominal aortic aneurysm--a pilot study in six medical schemes.

Objective: A pilot study to assess the feasibility and affordability of a targeted screening programme for abdominal aortic aneurysms in a group of employer-based medical schemes.

Design: Administrative database review and data extraction. Member enrolment by mail.

Extraction, isolation, and SDS-PAGE analysis of purified gastric mucin in a patient with Menetrier's disease.

Menetrier's disease is a rare condition characterized by marked proliferation of gastric mucosa with variable mucus secretion and achlorhydria. Although crude mucus secretion and gastric aspirates have been evaluated in this disease for output of dry matter, hexosamine, fucose, protein content, and transforming growth factor alpha activity, we report for the first time the isolation, purification, and gel electrophoresis of mucin from crude mucus scrapings. The fragmentation pattern of mucin in Menetrier's disease demonstrated less large polymeric mucin than the control.