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Campylobacter – Are Antibiotics Being Excessively Used?

Due to increasing concerns about the emergence of quinolone-resistant Campylobacter strains and varying guidelines regarding antibiotic use in acute diarrhoea, this descriptive study attempts to investigate the extent of antibiotic use in patients with presumed and confirmed Campylobacter infection who have been notified to Public Health South in the Otago District over the years of 2000, 2001, 2004 and 2005. We also examined the demographic features and clinical characteristics of the patients.

Authors of Report

Amy Chen, Anthony Kueh, Tommy Lee, Mark Longman, Dennis The, Xaviour Walker, Eileen Young

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Does Waiting Make Pannus Angry?

Outpatient follow up intervals for Rheumatoid Arthritis patients and associated QoL scores.

The purpose of conducting an audit of rheumatoid arthritis patients is to investigate the adequacy of the follow up that patients in Otago are receiving. A comparison will be made between the actual follow up intervals and the follow up intervals recommended by the New Zealand Rheumatology Association in 2004[14].  The recommended follow up intervals are primarily based on patients' disease activity.  The New Zealand follow up guidelines are a consenus document developed by the New Zealand rheumatology executive. They are the first such guidelines to be developed internationally[16].  It is hoped that as a result of this audit, the information provided will assist in future directives for the optimisation of the resources and services that are provided for patients with rheumatoid arthritis in the Otago and Southland regions.

Authors of Report

Georgina Chan, Fern Goh, Timothy Hodgson, Erica Hsu, Deborah Johnstone, Jasen Ly, Timothy Platt, Edrich Rodrigues, Wendy Tsai

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Early Intervention in Psychosis Service: A Clinical Audit of Outcomes

The aim of this project is to retrospectively examine data of patients seen through the Dunedin Early Intervention in Psychosis Service from 1999-2003, in order to measure the short and long term outcomes for these patients.

Authors of Report

Kathy Burt, Matilda Hamilton, Sophie Hart, Rawiri Keenan, Kate Kerr, Peter Lee, Ray Lin, Linda Sung

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New Zealanders’ Attitudes to Resuscitation and End of Life Care

Aim

To investigate the attitudes towards resuscitation and end of life care in the over 65 age group resident in Dunedin.

Authors of Report

Abdulrahman Al-Qahtani, Mohammad Amer, Benjamin Chang, Mike Foss, Jamish Gandhi, Rasita Haji Abdul Rahman, Elham Haji Mohd Ismail, Norafizan Hazipin

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Pandemic Influenza:  Community Knowledge, Attitudes and Preparedness

Abstract

Pandemic influenza typically occurs 2-3 times each century with this in mind the next pandemic influenza is currently overdue. Recent outbreaks of the H5N1 strain of influenza virus in birds around the world has lead to a media frenzy surrounding this virus and its possible consequences.

This study was commissioned to assess the current level of community knowledge and preparedness for pandemic influenza in the Otago/Southland region. It also aimed to determine the attitudes of members of this community on ethical issues that may arise in the event of pandemic influenza.

To complete these aims 450 randomly selected participants were sampled using a questionnaire with a total response rate of 58%.

The results of the survey indicated that the community thought that a pandemic influenza would occur but they are not fully prepared, and more information is wanted and needed. The prioritization of vaccinations is generally acceptable, but people cannot rely on their neighbours to care for them during pandemic influenza.

The proposed plans by the Ministry of Health to provide further information and engage in further planning regarding pandemic influenza seems warranted.

Authors of Report

Claus Bader, Kynan Bazley, Liz Briggs, Gloria Dainty, Mel Lauti, Ross Scott-Weekly, Kati Taghavi, Rebecca Thomas, Richard Walsh

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The Changing Face of Coeliac Disease (1990-1994, 2001-2005)

Purpose and Significance of this Study

This study is intended to investigate any change in initial presentation of Otago coeliac patients which has occurred since the introduction of serological screening.  The time periods studied were chosen as the first was before use of any serology was widespread and the second was after the introduction and uptake of all three serological tests.

Authors of Report

Raymond Chan, Erin Chen, Hung-Kai Chen, Jessica Hardyment, Jennifer Hii, Alvin Tan, Aveline Teo

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What do Gastroenterologists See All Day? A Summary of Endoscopic Procedures at DPH

Aims

To retrospectively analyse endoscopies conducted over a 17 year period at Dunedin Public Hospital, Otago, New Zealand, for trends in patient demographics, indications and findings.

Methods

Gastroscopy, ERCP and Colonoscopy data from 1986, 1991, 1997 and 2003 were obtained from a database and patient paper records.  Dada obtained included demographic data, the procedure type and date, indications for the procedure, and findings.

Results

All 3 endoscopic procedures were increasing in number and rate.  An increase in cancer surveillance and detected carcinomas over the study period was found in colonoscopies.  Fewer ulcers and more hiatus herniae were found in gastroscopies.  Increased frequency of unexplained anaemia, GI bleeding and heartburn as indications for gastroscopies were noted whereas a decreased frequency for healing surveillance as indicators were noted.  More ERCPs were conducted as follow-ups and for jaundice, with an apparent increase in gallstones found and fewer normal findings.

Conclusion

As a descriptive study this contributes important data regarding workload issues for Gastroenterology services, which can assist with service planning and delivery, as well as being the basis for further research.

Authors of Report

Aaron Zhang, Aimee Rondel, Angus Turnbull, Andrew Davidson, Chris Hopkins, Marie-Michelle Ernesta, Philippa Ho, Sarah Donald

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“What’s Hurting More… Pests or Pesticides?”

Aim

To determine the perceptions and impact of Head Lice (HL) amongst parents of primary school children and the associated influence on treatment practices. To assess the sources of treatment recommendations and the current knowledge of Public Health guidelines amongst parents. To assess factors related to number of HL infestations.

Method

Surveys were sent to 542 families from 5 primary schools in Dunedin, based on interviews with school principals, Public Health nurses, and a Professor of Pharmacology. Responses were sent back within 2 weeks, after which we used SPSS to collate results.  Another survey was sent to 33 pharmacies in Dunedin, to be returned within 2 weeks.

Results & Conclusions

From a 34.1% response rate, most parents had seen official guidelines (85.3%) but this is not necessarily reflected in treatment practices. The majority of parents utilize advice either from pharmacists and their assistants (39%) or friends and relatives (34%). The physical impact of HL is a greater problem for children than the social impact, which is contrary to the experiences of the public health nurses.  Parents cited cost as the biggest impact of HL, but for the few citing embarrassment they went on to state that it was the most distressing feature. Vet products, Fly Spray, Kerosene are being used albeit rarely to treat HL in Dunedin (7, 5, and 3 parents respectively).  Most parents however are aware of the toxicities of these treatments. Chemical treatments are being used on average more times (e.g. malathion 2.52 times, 2.45 times) in a 10 day period than guidelines advise, suggesting that knowledge of potential toxicity is poor. Tea tree oil was the most common preventative (25 parents) without awareness of toxicity. There was no association between choice of treatments and corresponding perceptions of HL.

Authors of Report

Andrea McDonald, Andrew Hill, Animesh Chatterjee, Bek Wilson, Ella Calder, Jalal Alsaad, Mai Alshammari, Sung-Ya Lin

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