The New Zealand medical journal
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The National Primary Medical Care survey was undertaken to describe primary health care in New Zealand, including the characteristics of accident and medical (A and M) clinic providers, their practices, the patients they see, the problems presented, and the management offered. ⋯ The main impression is that the medical A and M clinics provide episodic treatment for relatively young patients mainly related to a new, short-term problem, particularly an injury or a respiratory illness. This picture is consistent with previous research and the role of similar clinics overseas. Further work is needed to compare A and M clinics with established general practice in relation to the services that are provided as well as the acceptability and quality of these services.
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Comparative Study
Unplanned overnight hospital admission after strabismus surgery.
To examine the reasons for unplanned overnight hospital admission in paediatric patients undergoing strabismus repair, to identify preventable causes (particularly postoperative nausea and vomiting), and to compare the rate of unplanned overnight stay with a group undergoing inguinal hernia repair. ⋯ The provision of suitable accommodation and careful planning of the type and timing of surgery would be expected to reduce the overnight stay rate after strabismus surgery.
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Comparative Study
Prevalence of complementary and alternative medicine use in Christchurch, New Zealand: children attending general practice versus paediatric outpatients.
There is little information about the use of complementary and alternative medicines (CAM) in New Zealand children who attend a general practitioner for intercurrent illness compared to children attending secondary care with a chronic condition where CAM use is high. This study aims to establish whether there are differences in prevalence and non-disclosure rates, information sources, and potential predictors of CAM use in these two populations of children. ⋯ CAM-use amongst New Zealand children is higher, and disclosure rates lower, when compared to overseas populations of children. This suggests that there is greater potential for New Zealand children to be at risk of adverse events directly and through interaction with prescribed medicines. Contrary to expectations, CAM-use behaviours and disclosure rates are comparable between GP and outpatient populations--suggesting that all prescribers need to explicitly ask parents about CAM-use with their children, particularly those that report CAM-use themselves.
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Penetrating thoracic trauma poses a management challenge to the on-call surgeon. A casual and unwary approach can lead to unforeseen complications in the initial height of management of such patients. We present a case of penetrating thoracic trauma where initial management with closed tube thoracostomy resulted in intubation of the stomach that had herniated into the chest through a diaphragmatic rent. Patients with penetrating injuries to the zone between the abdomen and chest should be managed with a high index of suspicion.
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Trans fats (trans fatty acids) are commonly used for deep frying in restaurants and in the fast food, snack food, fried food, and baked goods industries, often to extend the shelf life of foods. However they are widely considered to be harmful to health. ⋯ Denmark became the first country, in March 2003, to introduce laws regulating the content of trans fats in food (maximum of 2% of edible fats and oils). What are trans fats, what harm do they cause, and should New Zealand also consider imposing mandatory regulations on their use in food? This article explores the issues.