87 results for Arroll, Bruce

  • New Zealand Guidelines for Rheumatic Fever. 3: Proposed Rheumatic Fever Primary Prevention Programme

    Lennon, Diana; Peat, Elizabeth; Wilson, Nigel; Atatoa-Carr, P; Kerdemelidis, Melissa; Arroll, Bruce (2009-05)

    Report
    The University of Auckland Library

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  • New Zealand Guidelines for Rheumatic Fever. 2: Group A Streptococcal Sore Throat Management

    Lennon, Diana; Peat, Elizabeth; Arroll, Bruce; Kerdemelidis, Melissa (2008-05)

    Report
    The University of Auckland Library

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  • Prescribing Information Resources: Use and preference by general practitioners An exploratory survey of general practitioners

    Arroll, Bruce; Goodyear-Smith, Felicity; Patrick, Daniel; Kerse, NM; Harrison, Jeffrey; Halliwell, J; Pearson, Janet; Lay-Yee, R; von Randow, M (2005)

    Report
    The University of Auckland Library

    The Ministry of Health funded the Centre for Health Services Research and Policy (The University of Auckland) to produce a research report on general practitioners’ (GP) preferred sources for information when making prescribing decisions, and the value that GPs place in these resources. Prescribing Information Resources: Use and preference by general practitioners: An exploratory survey of general practitioners provides information on the sources of information GPs use to inform their prescribing decisions. During June and July 2004, 116 GPs were interviewed by phone, and were asked a number of questions regarding prescribing: the sources of information GPs use the factors that impact on GPs’ prescribing decision the importance attributed by GPs to each sources the sources that GPs value the most further information that GPs might like to assist them in prescribing decisions. This report is also accompanied by an overview that presents the key findings. The views expressed in this report are the personal views of the authors and should not be taken to represent the views or policy of the Ministry of Health or the Government.

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  • The psychopathology of James Bond and its implications for the revision of the DSM-(00)7

    Alrutz, Anna Stowe; Kool, Bridget; Robinson, Thomas; Moyes, Simon; Huggard, Peter; Hoare, Karen; Arroll, Bruce (2015-12)

    Journal article
    The University of Auckland Library

    To develop a more concise, user-friendly edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM advisory board is probably already hard at work on the DSM-6, so this study is focused on the DSM-(00)7 edition.We conducted an observational study, using a mixed methods approach to analyse the 50th edition boxset of James Bond experiences. James Bond was selected as a suitably complex subject for the basis of a trial of simplifying the DSM.Researchers' televisions and computers from late January to mid-April in Auckland, New Zealand.Following a review of the 23 James Bond video observations, we identified 32 extreme behaviours exhibited by the subject; these could be aggregated into 13 key domains. A Delphi process identified a cluster of eight behaviours that comprise the Bond Adequacy Disorder (BAD). A novel screening scale was then developed, the Bond Additive Descriptors of Anti-Sociality Scale (BADASS), with a binary diagnostic outcome, BAD v Normality Disorder. We propose that these new diagnoses be adopted as the foundation of the DSM-(00)7.The proposed DSM-(00)7 has benefits for both patients and clinicians. Patients will experience reduced stigma, as most individuals will meet the criteria for Normality Disorder. This parsimonious diagnostic approach will also mean clinicians have more time to focus on patient management.

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  • A qualitative study to explore health professionals' experience of treating gout: understanding perceived barriers to effective gout management

    Humphrey, C; Hulme, R; Dalbeth, Nicola; Gow, P; Arroll, Bruce; Lindsay, K (2016-06)

    Journal article
    The University of Auckland Library

    INTRODUCTION The management of gout is challenging and mainly occurs in primary care. This study aims to explore the experience of treating gout among primary care clinicians and understand the perceived barriers to effective therapy. METHODS Fourteen health professionals from primary care practices in South Auckland were recruited. Each participated in a semi-structured interview exploring their experience of treating and managing gout patients were analysed thematically. FINDINGS Participants described the large burden of gout in their communities and the importance of the clinician-patient relationship in gout management. Four themes summarise the perceived barriers to effective urate lowering therapy (ULT); unique gout factors, eg its intermittent nature and potential for stigmatisation; systemic barriers to optimal treatment, or barriers that emerge from working within a certain organisation; uncertainty about ownership, or who should carry responsibility for overcoming barriers to optimal treatment; and cultural barriers to optimal treatment. CONCLUSION Clinicians in primary practice perceive gout management to be mainly acute rather than preventive care. Patients may be stigmatised and management difficult particularly when diet is emphasised over ULT. Practice nurses are a group potentially available and willing to assist in educating patients. These findings may be helpful in planning for and improving healthcare in gout. KEYWORDS Gout; general practice; uric acid; primary health care; allopurinol; primary prevention.

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  • Antibiotic use for common cold

    Kenealy, Timothy; Arroll, Bruce (2009)

    Book item
    The University of Auckland Library

    Antibiotics do not help patients with an uncomplicated common cold. Antibiotics can have side effects for the individual taking them that range from unpleasant to serious, even lethal. Antibiotic use also contributes to communal harm by encouraging antibiotic resistance. If there can be no benefit, but there can be harm, why is the common cold the commonest reason for doctors to prescribe antibiotics? We note that antibiotics are also overused in other conditions and other medical disciplines, as well as in agriculture and the food industry. The harm caused by antibiotics ranges from mild gastrointestinal disturbance to death. Reasons for overuse of antibiotics to treat the common cold include patient expectations, patient and doctor uncertainty around diagnosing complications of the common cold, and the pressure on the doctor to ‘do something doctor — anything’. Strategies to limit inappropriate antibiotic use are explored, particularly the use of ‘delayed prescriptions’, and evidence is presented that with education of doctors and patients the overuse can be reduced.

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  • Prescribing Information Resources: Use and preference by general practitioners: An exploratory survey of general practitioners: The overview.

    Arroll, Bruce; Goodyear-Smith, Felicity; Patrick, Daniel; Kerse, NM; Harrison, Jeffrey; Halliwell, Joan; Pearson, Janet; Lay Yee, Roy; Von Randow, M (2005)

    Report
    The University of Auckland Library

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  • Incidence of Transient Ischemic Attack in Auckland, New Zealand, in 2011-2012

    Barber, Peter; Krishnamurthi, R; Parag, V; Anderson, NE; Ranta, A; Kilfoyle, D; Wong, E; Green, G; Arroll, Bruce; Bennett, DA; Witt, E; Rush, E; Suh, FM; Theadom, A; Rathnasabapathy, Y; Te Ao, B; Parmar, P; Feigin, VL (2016-09)

    Journal article
    The University of Auckland Library

    Background and Purpose—There have been few recent population-based studies reporting the incidence (first ever) and attack rates (incident and recurrent) of transient ischemic attack (TIA). Methods—The fourth Auckland Regional Community Stroke study (ARCOS IV) used multiple overlapping case ascertainment methods to identify all hospitalized and nonhospitalized cases of TIA that occurred in people ≥16 years of age usually resident in Auckland (population ≥16 years of age is 1.12 million), during the 12 months from March 1, 2011. All first-ever and recurrent new TIAs (any new TIA 28 days after the index event) during the study period were recorded. Results—There were 785 people with TIA (402 [51.2%] women, mean [SD] age 71.5 [13.8] years); 614 (78%) of European origin, 84 (11%) Māori/Pacific, and 75 (10%) Asian/Other. The annual incidence of TIA was 40 (95% confidence interval, 36–43), and attack rate was 63 (95% confidence interval, 59–68), per 100 000 people, age standardized to the World Health Organization world population. Approximately two thirds of people were known to be hypertensive or were being treated with blood pressure–lowering agents, half were taking antiplatelet agents and just under half were taking lipid-lowering therapy before the index TIA. Two hundred ten (27%) people were known to have atrial fibrillation at the time of the TIA, of whom only 61 (29%) were taking anticoagulant therapy, suggesting a failure to identify or treat atrial fibrillation. Conclusions—This study describes the burden of TIA in an era of aggressive primary and secondary vascular risk factor management. Education programs for medical practitioners and patients around the identification and management of atrial fibrillation are required.

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  • Do primary health care nurses address cardiovascular risk in diabetes patients?

    Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert (2014-11)

    Journal article
    The University of Auckland Library

    AIMS: To identify factors associated with assessment and nursing management of blood pressure, smoking and other major cardiovascular risk factors by primary health care nurses in Auckland, New Zealand. METHODS: Primary health care nurses (n = 287) were randomly sampled from the total (n=1091) identified throughout the Auckland region and completed a self-administered questionnaire (n = 284) and telephone interview. Nurses provided details for 86% (n =265) of all diabetes patients they consulted on a randomly selected day. RESULTS: The response rate for nurses was 86%. Of the patients sampled, 183 (69%) patients had their blood pressure measured, particularly if consulted by specialist (83%) and practice (77%) nurses compared with district (23%, p = 0.0003). After controlling for demographic variables, multivariate analyses showed patients consulted by nurses who had identified stroke as a major diabetes-related complication were more likely to have their blood pressure measured, and those consulted by district nurses less likely. Sixteen percent of patients were current smokers. Patients consulted by district nurses were more likely to smoke while, those >66 years less likely. Of those who wished to stop, only 50% were offered nicotine replacement therapy. Patients were significantly more likely to be advised on diet and physical activity if they had their blood pressure measured (p < 0.0001). CONCLUSIONS: Measurement of blood pressure and advice on diet or physical activity were not related to patient's cardiovascular risk profile and management of smoking cessation was far from ideal. Education of the community-based nursing workforce is essential to ensure cardiovascular risk management becomes integrated into diabetes management.

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  • Cardiovascular risk management of different ethnic groups with type 2 diabetes in primary care in New Zealand

    Elley, Carolyn; Kenealy, Timothy; Robinson, Elizabeth; Bramley, Dale; Selak, Vanessa; Drury, PP; Kerse, Ngaire; Pearson, Janet; Lay Yee, Roy; Arroll, Bruce (2008)

    Journal article
    The University of Auckland Library

    Aims: To examine cardiovascular preventive and renal protective treatment for different ethnic groups with diabetes in primary care. Methods: The study population included patients with type 2 diabetes attending an annual review in New Zealand primary care during 2004. Primary care data were linked to hospital admission data to identify previous cardiovascular disease (CVD). For those without previous CVD, 5-year cardiovascular risk was calculated. Proportions on, and predictors of appropriate treatment according to guidelines were investigated. Results: Data were available on 29,179 patients. Maori and Pacific participants had high rates of obesity, poor glycaemic control and albuminuria. Two thirds of all participants with previous CVD (68% of Maori and 70% of Pacific) and 44% with high CVD risk received appropriate CVD treatment; 73% of Maori, 62% of Pacific and 65% of European patients with albuminuria received ACE-inhibitors. Those with high CVD risk were more likely, and those that were young were less likely, to receive anti-hypertensive and lipid-lowering treatment after controlling for other factors. Conclusion: Maori and Pacific people were receiving similar high rates of appropriate CVD and renal preventive drug therapy to Europeans, but their prevalence of smoking, obesity, raised HbA1c and albuminuria were substantially higher. Non-drug components of preventive care also need to be addressed to reduce major ethnic disparities in diabetes-related morbidity and mortality in New Zealand.

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  • Assessment and management of medically unexplained symptoms

    Hatcher, Simon; Arroll, Bruce (2008)

    Journal article
    The University of Auckland Library

    Many people present with medically unexplained symptoms. For example, more than a quarter of primary care patients in England have unexplained chronic pain, irritable bowel syndrome, or chronic fatigue, 1 and in secondary and tertiary care, around a third of new neurological outpatients have symptoms thought by neurologists to be “not at all” or only “somewhat” explained by disease. ...

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  • Population Health: Meaning in Aotearoa New Zealand? A discussion paper to support implementation of the Primary Health Care Strategy

    Winnard, D; Crampton, P; Cumming, J; Sheridan, Nicolette; Neuwelt, Patricia; Arroll, Bruce; Dowell, A; Matheson, D; Head, V (2008)

    Report
    The University of Auckland Library

    There is a need for shared understanding of the terms ‘population health’ and a ‘population health approach’ to support ongoing implementation of the New Zealand Primary Health Care Strategy. This paper outlines why such definitions are needed, and the rationale for the proposed definitions, in the hope of generating robust discussion to improve the collective understanding and commitment to population health gain through the implementation of the Strategy.

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  • Should we prescribe diuretics for patients with prediabetes and hypertension

    Arroll, Bruce; Kenealy, Timothy; Elley, Carolyn (2008-12-13)

    Journal article
    The University of Auckland Library

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  • Contribution by primary health nurses and general practitioners to the Diabetes Annual Review (Get Checked) programme in Auckland, New Zealand

    Daly, B; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert (2013-08-16)

    Journal article
    The University of Auckland Library

    The 'Get Checked' annual diabetes review programme was successful in engaging practice and community-based specialist nurses in the community management of diabetes and has revealed positive relationships between nurses and doctors, extended roles for nurses and the importance of engaging nurses in the design of health care programmes. Nurses involved in the programme undertake a large proportion of all patient annual reviews at their practice and major nursing roles include measuring blood pressure, weighing patients, undertaking foot examinations and giving health promotional advice. DHBs need to continue to acknowledge the valuable contribution made by the largest health professional workforce and ensure primary health care nurses are involved in developing an effective replacement ‘Get Checked’ programme.

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  • Thiazide diuretics 'justifiable' for hypertension in patients with pre-diabetes

    Arroll, Bruce; Kenealy, Timothy; Elley, CR (2009)

    Journal article
    The University of Auckland Library

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  • Quantification of diabetes consultations by the main primary health care nurse groups in Auckland, New Zealand

    Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert (2016-09)

    Journal article
    The University of Auckland Library

    Diabetes prevalence continues to increase, with most diabetes patients managed in primary care.This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand.Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006-2008.On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.

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  • Antibiotics for acute bronchitis - Four reviews and still no answers: our clinical definitions are at fault

    Arroll, Bruce; Kenealy, Timothy (2001)

    Journal article
    The University of Auckland Library

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  • Milk allergy and bottles over the back fence: two single patient trials

    Arroll, Bruce; Pert, Harry; Guyatt, Gordon (2008)

    Journal article
    The University of Auckland Library

    An open access copy of this article is available and complies with the copyright holder/publisher conditions. OBJECTIVE:To determine if allergy to cows milk was responsible for symptoms in two children.DESIGN:Single patient trial.SETTING:General Practice in New Zealand.PARTICIPANTS:Two children aged about 6 monthsINTERVENTION:Alternating bottles of soya-based milk and cow's milk provided by neighbours over their back fence.MAIN OUTCOME MEASURES:Presence of diarrhea, irritability, rash and wheeze.RESULTS:After 4 cycles of soya-based milk and cows milk one child proved to have a milk allergy and one did not.CONCLUSION:A systematic approach enabled conclusive diagnoses in both children.

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  • Does a functional activity programme improve function, quality of life and falls for residents in long term care? A cluster randomised controlled trial

    Kerse, Ngaire; Peri, Kathryn; Robinson, Elizabeth; Wilkinson, Timothy; Von Randow, M; Kiata, L; Parsons, John; Latham, N; Parsons, Matthew; Willingale, Jane; Brown, Paul; Arroll, Bruce (2008)

    Journal article
    The University of Auckland Library

    Objective To assess the effectiveness of an activity programme in improving function, quality of life, and falls in older people in residential care.Design Cluster randomised controlled trial with one year follow-up.Setting 41 low level dependency residential care homes in New Zealand.Participants 682 people aged 65 years or over.Interventions 330 residents were offered a goal setting and individualised activities of daily living activity programme by a gerontology nurse, reinforced by usual healthcare assistants; 352 residents received social visits.Main outcome measures Function (late life function and disability instruments, elderly mobility scale, FICSIT-4 balance test, timed up and go test), quality of life (life satisfaction index, EuroQol), and falls (time to fall over 12 months). Secondary outcomes were depressive symptoms and hospital admissions.Results 473 (70%) participants completed the trial. The programme had no impact overall. However, in contrast to residents with impaired cognition (no differences between intervention and control group), those with normal cognition in the intervention group may have maintained overall function (late life function and disability instrument total function, P=0.024) and lower limb function (late life function and disability instrument basic lower extremity, P=0.015). In residents with cognitive impairment, the likelihood of depression increased in the intervention group. No other outcomes differed between groups.Conclusion A programme of functional rehabilitation had minimal impact for elderly people in residential care with normal cognition but was not beneficial for those with poor cognition.Trial registration Australian Clinical Trials Register ACTRN12605000667617.

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  • DeLLITE Depression in late life: an intervention trial of exercise. Design and recruitment of a randomised controlled trial

    Kerse, Ngaire; Falloon, Karen; Moyes, Simon; Hayman, Karen; Dowell, Tony; Kolt, Gregory; Elley, C. Raina; Hatcher, Simon; Peri, Kathy; Keeling, Sally; Robinson, Elizabeth; Parsons, John; Wiles, Janine; Arroll, Bruce (2008)

    Journal article
    The University of Auckland Library

    An open access copy of this article is available and complies with the copyright holder/publisher conditions. BACKGROUND:Physical activity shows potential in combating the poor outcomes associated with depression in older people. Meta-analyses show gaps in the research with poor trial design compromising certainty in conclusions and few programmes showing sustained effects.METHODS/DESIGN:The Depression in Late Life: an Intervention Trial of Exercise (DeLLITE) is a 12 month randomised controlled trial of a physical activity intervention to increase functional status in people aged 75 years and older with depressive symptoms. The intervention involves an individualised activity programme based on goal setting and progression of difficulty of activities delivered by a trained nurse during 8 home visits over 6 months. The control group received time matched home visits to discuss social contacts and networks. Baseline, 6 and 12 months measures were assessed in face to face visits with the primary outcome being functional status (SPPB, NEADL). Secondary outcomes include depressive symptoms (Geriatric Depression Scale), quality of life (SF-36), physical activity (AHS Physical Activity Questionnaire) and falls (self report).DISCUSSION:Due to report in 2008 the DeLLITE study has recruited 70% of those eligible and tests the efficacy of a home based, goal setting physical activity programme in improving function, mood and quality of life in older people with depressive symptomatology. If successful in improving function and mood this trial could prove for the first time that there are long term health benefit of physical activity, independent of social activity, in this high risk group who consume excess health related costs.TRIAL REGISTRATION:Australian and New Zealand Clinical Trials Register ACTRN12605000475640

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