The New Zealand medical journal
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To define ethnic origin and verify the diagnosis of sudden infant deaths among Pacific peoples in Auckland 1988-1996, and to elicit soci-econonic and demographic characteristics. ⋯ There were 52 cases of SIDS and the ethnic origins were: thirteen Samoans, nine Cook Islanders, seven Togans fifteen multiple ethnicity, and eight could not be verified. The annual rates of Pacific SIDS varied from less than one (in 1989) to 4.5 (in 1995) per 1000 Pacific live births. 34 cases (65%) couldd not be contacted and eighteen were traced. Nine in-epth interviews were conducted with caregivers of these cases. All babies had slept in the supine position, seven were breasted, and five of the mothers were non-smokers. Eight babies sept in the same room with their primary caregiver, with seven sleeping in their own bed. All of the mothers had had continuous access to childcare and support from their families, and seven had had previous children. Grief counselling for partners and children was identified as necessary by almost all the mothers. CNCLUSIONS: This preliminary study concludes that the rate of Pacific SIDS increased in 1995 and remains a serious problem. Ethnic misclassification and under reporting of SIDS cases is apparent among Pacific infants. There is a need to establish a national infant mortality database that collects accurate data incorporating standardised ethnic specific categories. Official routine and data sources also need to incorporate standardised ethnic specific categories. A national prospective study is required to study SIDS in Pacific communities as a basis for effective prevention strategies.
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To describe the demographics, nature and severity of injury of trauma admissions to a New Zealand urban Intensive Care Unit (ICU) over a ten year period; to determine differences in injury characteristics between patients received from inside and outside the local trauma catchment area; and to calculate incidence rates in the local population served, to identify high risk groups of patients. ⋯ This study identified trauma as a major component of the ICU population. ICU trauma admissions were characterised by young males with head injuries resulting from motor vehicle crashes. Referred admissions were more severely injured than local admissions and would thus distort the estimated incidence of trauma in the local geographic region served. Calculation of incidence rates highlighted a significantly higher risk of ICU trauma admission amongst Maori and Pacific Islands people than New Zealand Europeans.
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Acute upper gastrointestinal (GI) bleeding is a common and serious problem with an associated mortality of some 10%. It is desirable, both for optimising outcomes and for the efficient use of resources, that some form of risk assessment be made early and management be stratified accordingly. A risk scoring system was recently proposed and validated by Rockall and colleagues from the UK. We wished to assess its validity in a New Zealand setting. ⋯ The scoring system appears as valid in a New Zealand patient population as in the UK. We suggest that this scoring system be adopted in hospitals for patients with acute upper GI bleeding to efficiently direct the use of 'intensive care' type facilities to those most at risk, and thereby optimise management.