The New Zealand medical journal
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Pressure to fund Herceptin (trastuzumab) for use in early-stage breast cancer is a welcome development for those patients who may benefit. However such a decision would have major implications since the health gains made by trastuzumab come at a very high cost (when compared to health gains achieved by other drugs currently funded on PHARMAC's schedule). The budget for trastuzumab (estimated to be NZ30m dollars/annum but this is currently being negotiated) will be funded from district health board (DHB) budgets, which will impact other patients unless DHB budgets are appropriately increased. In comparative terms, this proposed expenditure is almost the same as what is currently being spent on all other oncology agents together, and is similar to the total cost of hospital services in New Zealand regions such as Wairarapa and Marlborough.
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To identify the appropriateness of calls to on-call house officers in a major tertiary teaching hospital. ⋯ The most important function an on-call house officer performs is responding to urgent medical situations. Frequent interruptions mean that house officers may become less efficient and more prone to making mistakes. The majority of calls received by on-call house officers did not need immediate responses and would have been better communicated via a less intrusive system such as text-messaging or the keeping of a non-urgent jobs list. If house officers were paged more appropriately then they would be interrupted less frequently and would be able to provide safer, more efficient, and timelier patient care.
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Comparative Study
New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department.
Emergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. ⋯ While there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.
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There are no indigenous caterpillars known to be associated with erucism, but the recently established gum leaf skeletoniser (Uraba lugens) has venom-containing spines that cause adverse reactions in humans. Symptoms are usually characterised by a stinging sensation, followed by itching and the formation of wheals. Exposure to U. lugens should be considered by medical practitioners in the differential diagnosis of contact dermatitis in the Auckland region.