The New Zealand medical journal
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To explore police officers' perceptions of the mentally ill and of their working relationship with mental health services. ⋯ Although the police are generally happy with the dealings they have with providers of mental health services, when police are dealing with those identified as mentally ill they are placed in the dilemma of having to liaise with other agencies and bodies about something that is not a police problem and for which they have little training. It would appear that there is some merit in identifying, or lobbying for, agencies who could provide support for those people who require help but who do not fulfil committal criteria.
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Practice Guideline Randomized Controlled Trial Clinical Trial Guideline
Recommendations on population screening for colorectal cancer in New Zealand. Members of the National Health Committee Working Party on Population Screening for Colorectal Cancer.
The National Advisory Committee on Health and Disability invited a working party to make recommendations on population screening for colorectal cancer in New Zealand. Recent results from randomised controlled trials of screening with guaiac faecal occult blood tests have provided evidence that population screening could reduce mortality from colorectal cancer. However, given the modest potential level of benefit, the considerable commitment of health sector resources, and the small but real potential for harm, the working party does not recommend population screening for colorectal cancer with faecal occult blood tests in New Zealand. ⋯ Wider consultation and further consideration should be undertaken to develop appropriate advice on surveillance recommendations for groups identified to be at increased risk of colorectal cancer. These decisions should be reviewed as evidence of benefit from new types of faecal occult blood test and other screening modalities becomes available. The working party recognises that colorectal cancer is an important cause of morbidity and mortality and recommends that New Zealand participate in international research in this area.
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Comparative Study
Chemotherapy for small cell lung carcinoma: the Greenlane Hospital experience 1993-1995.
1. To compare treatment response and survival of patients with small cell lung carcinoma managed at Greenlane Hospital with published results. 2. To compare the outcome of patients with extensive disease treated with oral etoposide with those who received combination chemotherapy. ⋯ 1. The survival in our series was comparable with published data on other treatment regimes. 2. Patients with extensive disease who received etoposide only had poorer median survival compared with those treated with more than one drug. This is likely a result of selection bias and the role of etoposide in palliation needs to be further assessed. 3. In spite of achieving good local control in patients with limited disease, late relapse with cerebral metastases was common. Prophylactic cranial irradiation, particularly in responders, needs to be considered in planning future treatment strategies. Small cell lung carcinoma (SCLC) accounts for 15-20% of all primary lung carcinomas and has an aggressive natural history because of its short tumour-doubling time and early metastatic potential. Chemotherapy has been used as the primary treatment modality for SCLC at Greenlane Hospital since 1979. Carboplatin, etoposide and vincristine (CEV) is an effective combination for patients with limited disease and has been adopted as the standard regime at Greenlane Hospital since 1993. Oral etoposide has attracted attention as a single agent for palliation in patients with advanced small cell lung carcinoma. Aggressive chemotherapy may not be appropriate in these patients whose prognosis is poor in spite of treatment. Etoposide offers the advantage of being an active oral agent and avoids the need for repeated venous access. It has been perceived as less toxic than other regimes and thus a preferred option for frail patients with extensive disease. The aims of this study were to compare treatment response and survival of patients with small cell lung carcinoma treated in our service since the introduction of the CEV regime with published data and to compare the outcome of patients with extensive disease treated with combination chemotherapy with those who receive oral etoposide only.