Adult decision-making capacity and health research in Aotearoa New Zealand.

The Code of Health and Disability Services Consumers' Rights (the Code)1 and the Health and Disability Commissioner Act (the Act)2 are up for review. The Code currently applies to clinical care, teaching and research. When it was introduced, there were no national mechanisms to govern research, but since then the National Ethics Advisory Committee (NEAC) has developed detailed guidelines and established a network of ethics committees at various institutional levels.

How Should We Respond to Non-Dominant Healing Practices, the Example of Homeopathy.

The debate around the ethics of homeopathy in recent issues of the journal has been approached as a binary question; is homeopathy ethical or not? This paper suggests that this is an unhelpful question and instead discusses a framework to establish the extent to which the dominant (medical) culture should tolerate non-dominant health practices such as homeopathy. This requires a sophisticated understanding of the placebo effect, a critical evaluation of what evidence is available, a consideration of the harm that the non-dominant practice might cause, and a consideration of how this might be affected by the culture of the patient. This is presented as a matter of cultural competence.

Effect of oxygen versus adaptive pressure support servo-ventilation in patients with central sleep apnoea-Cheyne Stokes respiration and congestive heart failure.

Background And Aims: Central sleep apnoea with Cheyne-Stokes respiration (CSA-CSR) is a common, serious consequence of congestive heart failure. Optimal treatment is yet to be established. We compared two common treatments for CSA-CSR.

Communication difficulties with limited English proficiency patients: clinician perceptions of clinical risk and patterns of use of interpreters.

Aims: To explore clinicians' perceptions of the communication difficulties experienced with Limited English Proficiency (LEP) patients and the clinical risks these difficulties pose in hospitals, as well as patterns of interpreter use among these clinicians.

Methods: Senior health professionals in the two District Health Boards (DHBs) in the Wellington Area (about 900) of New Zealand were sent an electronic survey. Twenty clinicians were interviewed about their experience in 22 consultations with LEP patients, and an equal number with English proficient patients.

Sex bias in studies selected for clinical guidelines.

Objective: To determine the proportions of female participants in research studies selected to inform the development of national clinical guidelines and to assess these against the proportions of women affected by the conditions.

Methods: We assessed 392 published articles, involving a total of 5.2 million participants, cited as references in five influential clinical guidelines addressing the use of antiarrhythmics, chronic fatigue, depression, diabetes, and colorectal cancer.

Home set-up polysomnography in the assessment of suspected obstructive sleep apnea.

Home set-up polysomnography (PSG) has advantages over other portable monitoring devices, but remains unendorsed by professional bodies despite excellent utility in the Sleep Heart Health Study (SHHS). The study aims to determine technical reliability and diagnostic accuracy of unattended, home set-up versus attended laboratory-based PSG in patients with suspected obstructive sleep apnea (OSA). Thirty patients with suspected OSA without significant co-morbidity were recruited.

A new national smokefree law increased calls to a national quitline.

Background: A law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns.