Pilot study of methods for assessing unmet secondary health care need in New Zealand.

Aims: In this pilot study, the primary aim was to compare four potential methods for undertaking a national survey of unmet secondary healthcare need in New Zealand (one collecting data from GPs, and three from community surveys). The secondary aim was to obtain an estimate of the prevalence of unmet secondary healthcare need, to inform sample size calculations for a national survey.

Methods: An electronic system was set up for GPs in Christchurch (Pegasus PHO) and Auckland (Auckland PHO) to record cases of unmet need as encountered in clinics.

Telemedicine in Cleft Care: Reliability and Predictability in Regional and International Practice Settings.

Background: Regional and international cleft care providers are challenged in their ability to deliver reliable, comprehensive care. Our institution utilizes video teleconferencing to facilitate initial evaluation and postoperative cleft care. This study describes our experience using telemedicine, generates a perioperative treatment algorithm using this technology, and compares cost-utility of telemedicine to in-person ambulatory visits when regional practices are involved.

Projected costs of colorectal cancer treatment in New Zealand in the absence of population screening.

Aim: To estimate volumes and costs of health services required for new cases of colorectal cancers in New Zealand from 2014 to 2026 in the absence of population screening.

Method: Annual incidence of colorectal cancer, by stage, location and age was estimated for 2006-2026 based on NZ cancer registry data for 2001-2005. Treatment protocols were determined based on current best practice.

Cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry meat food supply.

An analysis of the cost-effectiveness of interventions to control Campylobacter in the New Zealand poultry supply examined a series of interventions. Effectiveness was evaluated in terms of reduced health burden measured by disability-adjusted life years (DALYs). Costs of implementation were estimated from the value of cost elements, determined by discussions with industry.

Colonoscopy requirements of population screening for colorectal cancer in New Zealand.

Aim: To estimate the colonoscopy burden of introducing population screening for colorectal cancer in New Zealand.

Methods: Screening for colorectal cancer using biennial immunochemical faecal occult blood tests offered to people aged 50-74 years of age was modelled using population estimates from Statistics New Zealand for 2011-2031. Modelling to determine colonoscopy requirements was based on participation and test positivity rates from published results of screening programmes.

Bone mineral density and functional measures in patients with arthrogryposis.

Background: Patients with arthrogryposis often report decreased ambulation and physical activity. Given that skeletal mineralisation is responsive to force, we identified the need to characterize bone mineral density and functional measures in this population, and conducted a cross-sectional study to establish a reference for future investigations.

Methods: Thirty consecutive patients aged 5 to 18 years with either the diagnosis of amyoplasia or nonsyndromic arthrogryposis with predominantly lower extremity involvement underwent bone densitometry testing, and lumbar spine Z-scores were calculated against an age and sex-matched control population as is customary in children.

Corrective osteotomies and osteosynthesis for supination contracture of the forearm in children.

Purpose: The purpose of this study was to present the authors' experience with corrective osteotomies of the forearm for supination contracture in children.

Methods: Fourteen patients with supination contracture of the forearm due to brachial plexus lesion (11), poliomyelitis residuals (2), or Monteggia fracture malunion (1) underwent distal ulnar osteotomy without fixation and subsequent midradial osteotomy with plate fixation to produce a position of greater pronation. A minimum of 6 months' follow-up was required to be included in the series.

Prospects for population colorectal cancer screening in New Zealand.

Aim: In 2005 the National Screening Unit of the Ministry of Health appointed a Colorectal Screening Advisory Group to provide independent strategic advice and recommendations on population screening for colorectal cancer (CRC) in New Zealand.

Method: Evidence-based review of relevant literature and assessment of CRC screening using the New Zealand Criteria to Assess Screening Programmes.

Results: Guaiac faecal occult blood test (FOBTg), immunochemical FOBT (FOBTi), flexible sigmoidoscopy, colonoscopy, and CT colonography were considered.

Reduction in crime by drug users on a methadone maintenance therapy programme in New Zealand.

Aim: The study aimed to estimate changes in drug use, crime, imprisonment and societal costs among a sample of Maori and non-Maori injecting drug users (IDUs) on a methadone maintenance therapy (MMT) programme in Christchurch, New Zealand.

Methods: Fifty-one non-Maori and 34 Maori IDUs were interviewed to obtain a self-reported history of drug use, crime, imprisonment, and effects on personal health. Information was obtained on drug use and crime before starting MMT and also after stabilisation on MMT.

The costs of not treating hepatitis C virus infection in injecting drug users in New Zealand.

This paper estimates future health service costs of the current practice in New Zealand of not funding treatment of hepatitis C virus (HCV) infections. Costs are estimated separately for Māori and non-Māori, male and female IDUs. Markov modelling is used to track the infection and progression of HCV to severe liver disease and death, and accumulated costs are estimated for the life of the cohort.

Growth rates in skeletally immature feet after triple arthrodesis.

Many authors delay triple arthrodesis in skeletally immature patients secondary to the belief that such a surgery would cause excessive shortening in a foot that is often already short. In the current study, foot growth rates were compared between a group of skeletally immature patients (<11 years) and a group of more skeletally mature patients (>11 years) after triple arthrodesis. The average age at surgery in the skeletally immature group was 9.

Complications of tibial osteotomies in children with comorbidities.

Tibial osteotomies in children have been associated with a number of complications. A retrospective review of 116 children who had 129 tibial osteotomies was performed to assess these complications at our institution. Results showed that there were 35 cases of wound problems, 6 cases of recurrence/reoperation, 5 cases of delayed union, 2 cases with transient peroneal nerve palsy, 1 case of nonunion, and 1 case of mal-union.

Recurrence of varus deformity after proximal tibial osteotomy in Blount disease: long-term follow-up.

In a retrospective review of 74 tibial osteotomies performed for Blount disease, the patients were divided into three groups based on age and treatment. Group A (26 osteotomies), 4 years old or younger, and group B (34 osteotomies), older than 4 years, were treated the same with osteotomy and crossed pins. Group C (14 osteotomies), older than 4 years, was treated with osteotomy and external fixator.