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Issue 42 - 5 December 2014

Stay safe at the beach this summer

The beach is New Zealand's favourite playground, but it can also be a dangerous place.
The Water Safety Code is a handy way to remember what to do to stay safe in and around the water.
Read more:


Articles – Phobias

1. Differentiating High-Functioning Autism and Social Phobia.
By Tyson, Katherine & Cruess, Dean
Journal of Autism & Developmental Disorders, 2012 Jul; 42 (7): 1477-90.
: Both high-functioning autism (HFA) and social phobia (SP) involve profound social interaction deficits. Although these disorders share some similar symptoms, they are conceptualized as distinct. Because both HFA and SP are defined behaviorally, the degree of overlap between the two disorders may result in misinterpretation of symptoms. However, the deficits in each disorder differ, particularly in areas of social interaction, emotion recognition and expression, and communication. This paper reviews the literature that informs our current understanding of the behavioral overlaps and differences in HFA and SP.

2. Efficacy of the trial-based thought record, a new cognitive therapy strategy designed to change core beliefs, in social phobia.
By de Oliveira, I. R.; Powell, V. B.; Wenzel, A.; Caldas, M.; Seixas, C.; Almeida, C.; Bonfim, T.; Grangeon, M. C.; Castro, M.; Galvão, A.; et al.;
Journal of Clinical Pharmacy & Therapeutics, 2012 Jun; 37 (3): 328-34
: What is known and Background: Social anxiety disorder (SAD) often follows a chronic course and is associated with substantial impairment in functioning. Although results from clinical trials clearly establish evidence for efficacy of cognitive behavioural therapy in treating this disorder, up to 50% of patients with SAD show little or no improvement. Thus, new approaches that have promised in improving the efficacy of treatment for SAD are needed.

3.  Helping a person with autism to overcome her fear of needles.
By Edwards, Joanne & Northway, Ruth
Primary Health Care, 2011 Dec; 21 (10): 26-9.
:  Health care may need to be delivered differently to people with learning disabilities to ensure equitable access (Northway 2011). 'Sara' had a phobia of needles and had not attended a GP surgery for some time. A desensitisation programme was developed and this article explores how collaborative working between community learning disability teams and primary health care resulted in Sara having her bloods taken successfully.

4.  Incentives and disincentives for the treatment of depression and anxiety: a scoping review.
By Ashcroft, Rachelle; Silveira, Jose; Rush, Brian; Mckenzie, Kwame;
Canadian Journal of Psychiatry, 2014 Jul; 59 (7): 385-92
: There is widespread support for primary care to help address growing mental health care demands. Incentives and disincentives are widely used in the design of health care systems to help steer toward desired goals. The absence of a conceptual model to help understand the range of factors that influence the provision of primary mental health care inspired a scoping review of the literature.

Articles – Communication

5. Validation: A Family-Centered Communication Skill.
By  Harvey, Pat; Ahmann, Elizabeth
Pediatric Nursing. May/Jun 2014, Vol. 40 Issue 3, p143-147. 5p
: Family-centered care can seem challenging when family member behavior, choices, attitudes, or emotions are "difficult" or "challenging"" to deal with. Yet nurses can develop skills to effectively interact with families in a wide variety of circumstances and then become able to practice family-centered care in any situation that might arise. One particularly useful skill is "validation,"" which means accepting what the family member says or does as a valid expression of thoughts and feelings in that particular circumstance at that particular time

6. Core Communication Competencies in Patient-Centered Care.
By Boykins, Davis
ABNF Journal, 2014 Spring; 25 (2): 40-5
: Effective communication between the patient and nurse is an essential requirement for nursing practice and for patient-centered care. Nursing faculty that teach in undergraduate and graduate nursing programs play a significant role in preparing the nursing workforce to communicate effectively and provide patient-centered care. Patient-centered care, interprofessional collaboration, and informatics are necessary knowledge, skills, and attitudes for nurses across educational levels in order to meet the needs of patients, and improve the quality and safety of the health care system environment.

7. Health literacy and its importance for effective communication. Part 1.
By Lambert, Veronica & Keogh, Deborah. 
Nursing Children & Young People, 2014 Apr; 26 (3): 31-7
: This is the first of two articles exploring the concept of health literacy, an often hidden barrier to effective healthcare communication. The authors define the components of health literacy, as well as describing the extent and implications of limited health literacy for parents/caregivers and their children. The article also identifies the link between poor health literacy and health outcomes and outlines a framework for adolescent health literacy

8. Health literacy and its importance for effective communication. Part 2.
By Lambert, Veronica &  Keogh, Deborah;
Nursing Children & Young People, 2014 May; 26 (4): 32-6
: This is the second of two articles exploring the concept of health literacy, an often hidden barrier to effective healthcare communication.  This article explains how to detect low levels of health literacy among parents and children, and outlines the challenges to assessing health literacy levels, including the stigma and discrimination some people experience. Some basic healthcare communication strategies for supporting health literacy in practice are suggested.


Selected articles – New Zealand Doctor

9.  Telemedicine: A difficult proposal for primary care to implement
By Reynald Castaneda. NZ Doctor, 3 December 2014
Telemedicine is gaining momentum in DHBs, but primary care is lagging behind as it has a lot of barriers to overcome, Telehealth Forum chair John Garrett says. “There are pockets of excellence but there could be a whole lot more…[telemedicine] has been a difficult proposition because of how primary care works,” Dr Garrett told New Zealand  Doctor

10.  Dramatic shortcomings in planning for future need in diabetes care
By Cliff Taylor. NZ Doctor, 3 December 2014
  A diabetes treatment advocate says the healthcare workforce is unprepared to deal with the “ballooning” diabetes epidemic. “There is a woeful lack of knowledge and expertise in the management of diabetes across the healthcare sector, especially in primary care,” Diabetes New Zealand president Chris Baty says.

11.  Tea-break law a ‘cop-out that puts some workers at risk’ says GP
By Virginia McMillan. NZ Doctor, 3 December 2014
: Occupational health doctors are disappointed a “backwards step” will see mandated paid 10-minute tea breaks and unpaid half-hour lunch breaks fall by the wayside.
Just five years after these requirements came in, the law will change early next year

12.  Primary care assessment of chest pain in children: Is it cardiac?
NZ Doctor – 5 November 2014
: While many of these patients present to emergency departments, many arrive at general practice and require investigation. Health problems that seem to frighten parents disproportionally include severe headaches, afebrile seizures, odd lumps and masses, bruising and bleeding with no apparent reason and chest pain.

13.  An eczema ‘set piece’ lets your practice speak with one voice
By Jo Scott-Jones, NZ Doctor, 3 December 2014
: One thing sure to put patients off treatment is conflicting advice from different members of your team at each visit. Eczema is estimated to affect 15 to 20 per cent of New Zealand children, and it is a significant cause of discomfort, family frustration, expense and hospital admissions around the country.

Journal  –  The Tube (NZNO Gastroenterology Nurses Section)
Vol 39, Issue 3, August 2014

14A. Chair report – Cathy Whiteside
14B. Editor’s report – Lorna Scoon
14C. NZNO Gastroenterology nurses section – 30th anniversary celebration
14D. Editorial from The Tube 1995
14E. 7th Annual Sydney International Endoscopy Symposium report March 2014 – Sharon Delahunt (Pages 10 & 12)
14F. Report from Australasian Hepatology Association Summit June 2014 – Adelaide - Rosemary Tonkin – North Shore Hospital (Pages 14 & 16)
14G. Withdrawal of consent – National Endoscopy Quality Improvement Program (NEQIP) at Hawke’s Bay DHB – Sherry Sharp
14H. Developing the role of nurse endoscopist in New Zealand – Tania Waylen RN – BOPDHB
14I. Trap that polyp – Carmen Chunn RN Gastroenterology Unit
14J. Audit proves effectiveness of new split prep regime for colonoscopies – Tania Waylen RN BOPDHB
14K. Management of feeding tubes in adult patients –Report by Sherry Sharp – RN PEG Nurse
14L. Writing guidelines for The Tube
14M. Gastroenterology units in New Zealand – Contact details



15. Global action for public health
A practical one-day workshop about how global health impacts public health practice and how we can make a difference internationally
Date:  17 February 2015
Venue: University of Otago, Wellington
23a Mein Street, Newtown, Wellington
More info:

16. Close to Home - Conference 2015
New Zealand Rural General Practice Network (NZRGPN); Rural Health Alliance Aotearoa New Zealand (RHAANZ) in association with the New Zealand Rural Hospital Network (NZRHN) will host the country's premier rural primary health care conference.
Date:  12-15 March 2015
Venue:  Rotorua Energy Events Centre
More info:


News – National

17. Declaration a commitment to population health in NZ and the Pacific
Delegates at the NZ Population Health Congress jointly signed a Declaration; committing to collective action on population health in three key areas for Aotearoa New Zealand and the Pacific Region:

  • Giving all children of Aoteaora New Zealand and the Pacific nations, with which we are closely linked, the best start in life.
  • Improving health and reducing health inequities.
  • Urgently addressing climate change and planetary health

Read more:

18. Influenza estimated to kill about 400 New Zealanders each year
University of Otago - Monday, 24 November 2014
New Zealand has an average of 401 influenza-associated deaths each year according to estimates published for the first time. This is an average annual mortality rate of 10.6 per 100,000 population

19. Thousands could fall foul of new drink-driving limit
From today, police in South Canterbury will be enforcing the lower alcohol limit for drivers aged 20 and over.  It means the legal alcohol limit for drivers aged 20 years and over is 250 micrograms (mcg) of alcohol per litre of breath, or 50 milligrams (mg) of alcohol per 100 millilitres (ml) of blood. For drivers under 20, the limit remains zero

20. Butter's healthy comeback?
Otago Daily Times - Mon, 1 Dec 2014
Kiwi tastebuds are turning back to our old love of butter, prompting new warnings about heart attacks and fuelling an academic row said to have "nearly come to blows". Since the 1970s, we have been told to cut down on butter, full-cream milk, red-meat fat and other rich sources of saturated fats, for the sake of the arteries in our heart.

21. Sperm quality reduces with age
Stuff - December 1 2014
Men waiting longer to have children could have a significant impact on the health of their offspring, a new study shows. A study from the University of Otago has found sperm deteriorates as a man ages, which can lead to a range of health problems for his child.

News – international

22. World Dementia envoy Dennis Gillings warns dementia could wipe out 20th century health gains
The Age - December 3, 2014
The "ravages of dementia" could wipe out much of the hard-won health gains of the 20th century, World Dementia Envoy Dennis Gillings has warned. Dr Gillings, who was appointed to his position by UK British Prime Minister David Cameron on behalf of the Group of Seven major advanced economies in February, is visiting Australia to meet ministers, officials, researchers and patient advocates

23. GPs and patients under threat when health care is driven by cost
The Age - December 3, 2014
As a general practitioner, my first concern is the health of my patients. It's pretty depressing to see health care reduced to talk of "price signals" or "co-payments" or "barnacles". This is not what health care is about.



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