The New Zealand medical journal
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Letter Case Reports
Spinal cord stimulation for intractable chronic upper abdominal pain: a case report of the first patient in New Zealand.
We present the first patient in New Zealand to undergo Spinal Cord Stimulation (SCS) for intractable upper abdominal pain. The patient was a 53-year-old man with a 20-year history of debilitating upper abdominal pain associated with chronic pancreatitis secondary to pancreatic divisum. ⋯ Despite the intense analgesia, he still suffered monthly attacks of upper abdominal pain requiring hospitalisation. Nine months after implanting a Spinal Cord Stimulator, the monthly attacks ceased, his background pain was effectively controlled and the need for opioids decreased to 510 mg of morphine sulphate equi-analgesia a day.
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To determine whether adding a low tax category for very-low nicotine content (denicotinised or Denic) cigarettes would facilitate higher excise and reduced consumption of addictive cigarettes (AddictiveCigs, defined as containing =2 mg nicotine per cigarette). ⋯ Introducing a lower excise rate for Denics would: (1) allow smokers to select their own mix of AddictiveCigs and Denics; (2) make Denics available to reduce cravings, reduce addiction, and reduce smoking costs of continuing smokers; (3) increase the political feasibility of increasing excise on AddictiveCigs sufficiently to greatly reduce addictive smoking; and (4) enable smokers to reduce their addiction before they quit, and therefore probably become more likely to succeed when they do so.
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Randomized Controlled Trial Comparative Study
An assessment of the Hua Oranga outcome instrument and comparison to other outcome measures in an intervention study with Maori and Pacific people following stroke.
Health outcomes research for Maori has been hampered by the lack of adequately validated instruments that directly address outcomes of importance to Maori, framed by a Maori perspective of health. Hua Oranga is an outcome instrument developed for Maori with mental illness that uses a holistic view of Maori health to determine improvements in physical, mental, spiritual and family domains of health. Basic psychometric work for Hua Oranga is lacking. We sought to explore the psychometric properties of the instrument and compare its responsiveness alongside other, more established tools in an intervention study involving Maori and Pacific people following acute stroke. ⋯ The Hua Oranga instrument, developed for Maori people with mental illness, showed good responsiveness and adequate psychometric properties in Maori and Pacific people after stroke. Its simplicity, relative brevity, minimal cost and adequate psychometric properties should favour its use in future studies with both Maori and Pacific people. Suggestions are made for refinements to the measure. These should be tested in a new population before Hua Oranga is recommended for general use in a clinical setting.