134 results for Kenealy, Timothy, Journal article

  • 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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  • Characteristics of nurses providing diabetes community and outpatient care in Auckland

    Daly, B; Arroll, B; Sheridan, N; Kenealy, Timothy; Scragg, R (2013-03)

    Journal article
    The University of Auckland Library

    INTRODUCTION: There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. AIM: To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. METHOD: Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006-2008. RESULTS: Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. DISCUSSION: These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access.

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  • Characteristics of nurses providing diabetes community and outpatient care in Auckland

    Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert (2013)

    Journal article
    The University of Auckland Library

    INTRODUCTION: There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. AIM: To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. METHOD: Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006-2008. RESULTS: Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. DISCUSSION: These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access.

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  • General practice changes in South Auckland from 1990 to 1999: a threat to continuity of care?

    Kenealy, Timothy; Arroll, Bruce; Kenealy, H; Scott, DJ; Scragg, Robert; Simmons, David (2002)

    Journal article
    The University of Auckland Library

    Aims To compare composition and organisation of general practices in South Auckland between 1990 and 1999 and consider implications for continuity of care. Methods Mail questionnaires were sent to all general practitioners in South Auckland in 1990 and in 1999. Results The response rates were 88% in 1990 and 76% in 1999 (p 0.3). The mean practice size increased from 2.8 to 3.7 doctors (p 0.003), the number of GPs in solo practice halved from 31.9% to 16.7% (p 0.009), and the mean number of part-time GPs per practice doubled from 0.7 to 1.3 (p 0.0004). There was no statistically significant difference in the country of origin of the doctors between 1990 and 1999. Women in 1999, compared with the men practitioners, were more likely to work fewer than eight ???tenths??? (53.3% vs 8.1%, p 0.001), were fewer years since graduation (16.1 vs 20.4, p 0.004), had worked fewer years in South Auckland (7.9 vs 12.7, p<0.0001). Conclusion Through the 1990s there have been changes in the organisation of general practice, some of which may help and others hinder provision of continuity of care. Given that patients, practitioners and politicians value continuity of care, it is an important topic that warrants New Zealand research.

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  • Sore Throat

    Kenealy, Timothy (2007)

    Journal article
    The University of Auckland Library

    Introduction About 10-30% of people present to primary healthcare services with sore throat each year. The causative organisms of sore throat may be bacteria (most commonly Streptococcus) or viruses (typically rhinovirus), although it is difficult to distinguish bacterial from viral infections clinically. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to reduce symptoms of acute infective sore throat? What are the effects of interventions to prevent complications of acute infective sore throat? We searched: Medline, Embase, The Cochrane Library and other important databases up to May 2006 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found eight systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, corticosteroids, non-steroidal anti-inflammatory drugs, paracetamol, and probiotics.

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  • Intensive primary care treatment reduced cardiovascular risk factors at 1 year in screen-detected type 2 diabetes

    Elley, CR; Kenealy, Timothy (2009)

    Journal article
    The University of Auckland Library

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  • Gems of New Zealand Primary Health Care Research: Including type 2 diabetes in cardiovascular risk equations

    Elley, C; Robinson, E; Kenealy, Timothy; Bramley, D; Drury, L (2010-06)

    Journal article
    The University of Auckland Library

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  • Review: Mixed signals from trials concerning pharmacologic prevention of type 2 diabetes mellitus

    Kenealy, Timothy; Arroll, Bruce (2005-09)

    Journal article
    The University of Auckland Library

    The article focuses on a study by researcher R. Padwal and colleagues, which reports on the pharmacologic prevention of type 2 diabetes mellitus. The study found that in patients with type 2 diabetes mellitus, some oral hypoglycemic agents and antiobesity drugs reduce the incidence of diabetes, but the findings are inconsistent and many studies have low patient follow-up or show high drug-related gastrointestinal adverse effects. It is concluded that no single agent is a clear choice for preventing diabetes in patients with impaired glucose tolerance..

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  • Management of type 2 diabetes

    Tracey, Jocelyn; Kenealy, Timothy; Sinclair, G (2002)

    Journal article
    The University of Auckland Library

    Presents a systematic approach to the monitoring of patients with diabetes. Outlines management guidelines for glycaemic control, retinal screening, diabetic nephropathy, diabetic foot care, hypertension, smoking and cholesterol. Offers a step-by-step guide to starting patients on insulin.

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  • Developing a Quality Audit Report for General Practice Prescribing for Hypertension: Methodology

    Warren, James; Gaikwad, Rekha; Mabotuwana, Thusitha; Kennelly, John; Kenealy, Timothy (2007)

    Journal article
    The University of Auckland Library

    This research aims to design and validate a Quality Audit Report (QAR) for clinical audit in general practice chronic disease management. We focus on the suitability of routinely collected Patient Management System (PMS) data as the basis for quality audit statistics. We are working with an expert panel representing the clinicians of a general practice to identify appropriate PMS-derived statistics to provide descriptive, supportive and cautionary characterisations of their chronic disease management. The report development is centring on their management of hypertension and relevant co-morbidities. After several iterations of report development a sample of patients will be reviewed by the expert panel, blind to the patients??? reporting classifications, to assess the sensitivity and specificity of the QAR. Lessons from initial iterations of the QAR development process indicate that the temporal subtlety and explosion of possible reporting statistics are major issues in defining useful quality improvement statistics where contraindications and combination therapies are involved.

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  • Higher risk of a first CVD event in Maori with diabetes quantified

    Kenealy, Timothy; Elley, C; Robinson, E; Bramley, D; Drury, P; Kerse, Ngaire (2009)

    Journal article
    The University of Auckland Library

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  • Antibiotics not first-line treatment for acute purulent rhinitis

    Arroll, Bruce; Kenealy, Timothy (2009)

    Journal article
    The University of Auckland Library

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

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

    Journal article
    The University of Auckland Library

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  • Book Review : How Universities Can Help Create a Wiser World: The Urgent Need for an Academic Revolution by N. Maxwell. Imprint Academic, Exeter, UK, 2014, $18, 156 pp. ISBN 978 1 845 40573 1.

    Kenealy, Timothy (2015-06)

    Journal article
    The University of Auckland Library

    Book Review : How Universities Can Help Create a Wiser World: The Urgent Need for an Academic Revolution by N. Maxwell. Imprint Academic, Exeter, UK, 2014, $18, 156 pp. ISBN 978 1 845 40573 1.

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  • Antibiotics for the common cold and acute purulent rhinitis

    Arroll, Bruce; Kenealy, Timothy (2002)

    Journal article
    The University of Auckland Library

    Synopsis: Antibiotics are not effective against the common cold, but cause adverse effects The common cold is an infection of the upper respiratory tract (breathing system). It can cause a sore throat, blocked and/or runny nose, and sometimes a cough or fever. Colds are usually caused by viruses, which do not respond to antibiotics. However, antibiotics cause adverse effects, especially diarrhoea, and overuse can increase levels of antibiotic resistance in the community. The review found that trials do not show any benefit from taking antibiotics for the common cold, and adverse gastrointestinal effects are common.

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  • Cardiac risk assessment--10 year or lifelong?

    Kenealy, Timothy (1995)

    Journal article
    The University of Auckland Library

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  • Learning to see in the clinician-patient relationship

    Buetow, Stephen; Kenealy, Timothy (2009-06)

    Journal article
    The University of Auckland Library

    Medical education tends to praise or pay lip-service to the art of observation, while systematically teaching the science of technology. To the extent you were taught observation skills as clinicians, you may have learned how to listen and touch but not usually how to ???see??? your patients and yourself. This paper considers how to see in the clinician???patient relationship, not merely in an optical sense but also to increase your perceptiveness. We suggest 10 strategies to enhance your ability to see.

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  • Intensive primary care treatment reduced cardiovascular risk factors at 1 year in screen-detected type 2 diabetes.

    Elley, Carolyn; Kenealy, Timothy (2009-05)

    Journal article
    The University of Auckland Library

    The article presents a study which found that an intensive, multifactorial primary care treatment strategy reduces cardiovascular (CV) risk factors more than routine care in patients with screen-detected type 2 diabetes. The study included 498 patients of 50-70 years of age who were newly diagnosed with type 2 diabetes by a 2-stage screening process. The study concluded that in patients with type 2 diabetes, intensive, multifactorial, primary care treatment strategy reduced CV risk factors..

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  • Removal of a foreign body

    Kenealy, Timothy; Murtagh, J (1996-03-01)

    Journal article
    The University of Auckland Library

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  • Analysis of Medication Possession Ratio for Improved Blood Pressure Control - Towards a Semantic Web Technology Enabled Workbench

    Mabotuwana, Thusitha; Warren, James; Gaikwad, RK; Kennelly, John; Kenealy, Timothy (2008)

    Journal article
    The University of Auckland Library

    Using a patient management ontology developed on Semantic Web technologies, we have provided a framework and workbench to identify hypertensive patients with inadequate systolic blood pressure (SBP) control. We have populated our ontology with production electronic medical record data from a general medical practice in New Zealand. Medication Possession Ratio (MPR) is used as a key concept in grouping patients whose SBP control can be improved. We also provide a prescription timeline visualisation scheme to aid a clinician in understanding a patient???s antihypertensive prescribing patterns. Both to validate our workbench and to enable immediate care improvement and research, we have utilised our framework to model the association of prescribing-based MPR to SBP. While the aggregate observed improvement in SBP is 18.55 mmHg from full as compared to nil MPR, there are poorly controlled patients among both high and low MPR groups, indicating distinct cohorts for quality improvement follow-up.

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