The New Zealand medical journal
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Multicenter Study
The use of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC) by caregivers in dementia care.
Pain is often under-detected and under-treated in nonverbal patients with severe dementia. PACSLAC is a behavioural assessment tool designed to improve the detection of pain in severe dementia. Previous studies on PACSLAC were primarily with qualified nurses in Canada and The Netherlands. This pilot study is aimed to evaluate the inter-rater reliability of the PACSLAC when it is administrated by caregiver staff. ⋯ This pilot study demonstrated PACSLAC has good inter-rater reliability when it is used by caregivers. We believe a baseline PACSLAC could be performed for each patient at the time of admission to a dementia care facility and re-administered on regular intervals to detect pain-related behaviour and to prompt earlier pain management. Future studies with larger samples and collaboration between different centres will be useful in providing normative PACSLAC values in New Zealand.
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Parathyroid hormone concentration (PTH) is elevated in vitamin D insufficiency and when prolonged, this condition leads to reduced bone mass and possibly osteoporosis. The threshold of 25-hydroxyvitamin D above which PTH plateaus, is a criterion often used to define vitamin D adequacy. ⋯ The higher PTH concentration in winter than summer suggests that the low 25-hydroxyvitamin D concentration in the winter months may be having an adverse effect on bone health. Many New Zealanders have 25-hydroxyvitamin D concentrations less than 62 nmol/L, especially in winter. Strategies to improve the vitamin D status of the population such as supplementation and food fortification may be needed.
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Dr Eric Anson was New Zealand's first specialist anaesthetist. Following his father's footsteps, his basic and advanced medical training were done in England. He served in the Royal Navy in World War I and in the New Zealand Army Medical Corps in World War II, both in Egypt and on the hospital ship Oranje. ⋯ Dr Anson was Director of Anaesthesia to the Auckland Hospitals from late 1945 until 1957. He played major roles in the development of anaesthesia in New Zealand, being the first President of the New Zealand Society of Anaesthetists (NZSA) and a member of the NZ Committee of the Faculty of Anaesthetists in the Royal Australasian College of Surgeons (now the Australian and New Zealand College of Anaesthetists). He is remembered by the Anson Memorial Foundation in the NZSA.
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To estimate the prevalence of vitamin D deficiency in a tertiary multidisciplinary pain clinic. ⋯ The prevalence of vitamin D deficiency in patients attending a multidisciplinary pain clinic is similar to if not less than that of the normal New Zealand population. Recent African immigrants and south Asian females are two patient groups that are frequently vitamin D deficient. The identification and treatment of vitamin D deficiency has the theoretical potential to help a number of chronic pain patients. Only a limited number of interventional clinical trials have looked at this.
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Editorial Comment Biography Historical Article
The rise and rise of anaesthesia in New Zealand.