Articles de revues : « Medical ethics – New Zealand »

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MCMILLAN, JOHN, PHILLIPA MALPAS, SIMON WALKER et MONIQUE JONAS. « Ethics Education in New Zealand Medical Schools ». Cambridge Quarterly of Healthcare Ethics 27, n^o 3 (30 mai 2018) : 470–73. http://dx.doi.org/10.1017/s096318011700086x.

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Abstract:This article describes the well-developed and long-standing medical ethics teaching programs in both of New Zealand’s medical schools at the University of Otago and the University of Auckland. The programs reflect the awareness that has been increasing as to the important role that ethics education plays in contributing to the “professionalism” and “professional development” in medical curricula.

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Trundle, C. « Medical Anthropology in Aotearoa New Zealand : A Thoughtpiece ». Health, Culture and Society 9 (8 décembre 2017) : 81–89. http://dx.doi.org/10.5195/hcs.2017.241.

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In considering what makes New Zealand unique for medical anthropological focus, this think piece sets out four themes. These reflect New Zealand’s particular historical, political, social and cultural landscape, and reveal the relevance of local scholarship for wider global debates about health. By tracing the neoliberal reform of state healthcare, indigenous approaches to wellbeing, local cultural practices of health, and the complex ethics involved in health and illness, this paper spotlights the opportunities that New Zealand medical anthropology affords us for addressing the important health and wellbeing challenges that we face today.

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Campbell, A. V. « Teaching medical ethics symposium. Reflections from New Zealand. » Journal of Medical Ethics 13, n^o 3 (1 septembre 1987) : 137–38. http://dx.doi.org/10.1136/jme.13.3.137.

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Vennell, Margaret A. Mcgregor. « Medical Research and Treatment : Ethical Standards in the International Context ». Medical Law International 2, n^o 1 (septembre 1995) : 1–21. http://dx.doi.org/10.1177/096853329500200101.

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The paper considers the development of Codes of Health Research Ethics. It also considers the need for codes of ethics governing the provision of health care, and its relationship to research ethics. Is there a need for codes to regulate both research and treatment? Should the norms of the International Ethical Guidelines for Biomedical Research Involving Human Subjects (ClaMS) be incorporated into an International Convention which is binding on signatory states. The paper considers the rights of human subjects and patients to be fully informed about the research and treatment. How can the law or ethics protect this right? It considers whether New Zealand law and ethics measures up to the ClaMS Guidelines. The ClaMS Guidelines provide that any subject who is physically injured as a result of participating in research is entitled to receive financial or other assistance so as to compensate them equitably for any temporary or permanent disability. The paper looks at the effect of New Zealand legislation particularly the Accident Rehabilitation and Compensation Insurance Act 1992, and considers whether New Zealand is providing adequate compensation in compliance with the Guidelines.

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Douglass, Alison, et Ken Daniels. « Posthumous Reproduction : A Consideration of the Medical, Ethical, Cultural, Psychosocial and Legal Perspectives in the New Zealand Context ». Medical Law International 5, n^o 4 (septembre 2002) : 259–79. http://dx.doi.org/10.1177/096853320200500402.

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This paper describes the development of New Zealand policy on posthumous reproduction in assisted human reproduction. It outlines five perspectives: medical, ethical, cultural, psychosocial and legal and shows the multidisciplinary approach taken by the National Ethics Committee. It is argued that each of these perspectives has important contributions to make to the multidisciplinary approach. The guidelines determined by the Committee are outlined, along with the processes used in arriving at these.

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Wareham, Pauline, Antoinette McCallin et Kate Diesfeld. « Advance Directives : the New Zealand context ». Nursing Ethics 12, n^o 4 (juillet 2005) : 349–59. http://dx.doi.org/10.1191/0969733005ne800oa.

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Advance directives convey consumers’ wishes about accepting or refusing future treatment if they become incompetent. They are designed to communicate a competent consumer’s perspective regarding the preferred treatment, should the consumer later become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer’s competence and the document’s validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers’ and providers’ perspectives, and the medical and nursing positions in New Zealand.

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Torda, Adrienne, et Jack George Mangos. « Medical ethics education in Australian and New Zealand (ANZ) medical schools : a mixed methods study to review how medical ethics is taught in ANZ medical programs ». International Journal of Ethics Education 5, n^o 2 (19 juin 2020) : 211–24. http://dx.doi.org/10.1007/s40889-020-00097-w.

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Shipley, Jenny. « Extracts from the New Zealand minister of health's speech to the New Zealand medical association conference. 19 April 1994 ». Health Care Analysis 3, n^o 2 (mai 1995) : 116–18. http://dx.doi.org/10.1007/bf02198215.

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Humphries, Anne, et Martin Woods. « A study of nurses’ ethical climate perceptions ». Nursing Ethics 23, n^o 3 (6 janvier 2015) : 265–76. http://dx.doi.org/10.1177/0969733014564101.

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Background: Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand. Aim/objective: The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate. Research design/participants/context: This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research. Ethical considerations: Ethics approval for this study was granted by the New Zealand Ministry of Health’s Central Regional Health and Disability Ethics Committee on 14 June 2012. Findings: The themes identified in the data centred on three dominant elements that – together – shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff. Discussion: While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses’ ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere. Conclusion: Moral distress is inevitable in an ethical climate where the organisation’s main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care.

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Pargiter, Russell, et Sidney Bloch. « The Ethics Committee of a Psychiatric College : Its Procedures and Themes ». Australian & ; New Zealand Journal of Psychiatry 31, n^o 1 (février 1997) : 76–82. http://dx.doi.org/10.3109/00048679709073802.

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Objective:Ethics committees (ECs) of medical colleges and other medical associations have become part of their professional experience only in recent years. This is probably attributable to such factors as greater professional accountability and informed consumerism. Relatively little is known about the procedures and agendas of such committees. The aim of the present study was to examine the EC of the Royal Australian and New Zealand College of Psychiatrists, with respect to its practices, in order to learn how a medical college grapples with ethical concerns. Methods:Two members of the College's EC, including its foundation chairman, assembled relevant documents, and subjected them to detailed scrutiny. Consensus was used, preceded by independent attempts at categorising these issues covering the period from the EC's inception in 1978 to June, 1995. Results:Three hundred and sixty-seven issues were dealt with by the EC over a 17 year period, covering clinical practice, financial aspects, forensic psychiatry, teaching and research, liaison with other organisations and preparation of guidelines and a code of ethics. Conclusions:An EC can play a vital role in advising its parent body and members in the ethics of day-to-day professional life as well as formulating (and revising) a code of ethics and supplementary ethical guidelines.

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McCall Smith, Alexander, et Alan Merry. « Health Care Law : Medical Accountability and the Criminal Law : New Zealand vs the World ». Health Care Analysis 4, n^o 1 (février 1996) : 45–54. http://dx.doi.org/10.1002/(sici)1099-1042(199602)4:1<45 ::aid-hca1170>3.0.co;2-j.

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Azariah, Sunita, Peter Saxton, Richard Franklin, Rose Forster, Suzanne Werder et Renee Jenkins. « NZPrEP Demonstration Project : protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) to determine feasibility, acceptability, adverse and behavioural effects of PrEP provision to gay and bisexual men in publicly funded sexual health clinics in Auckland, New Zealand ». BMJ Open 9, n^o 6 (juin 2019) : e026363. http://dx.doi.org/10.1136/bmjopen-2018-026363.

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IntroductionNew Zealand has experienced a rise in HIV diagnoses in recent years and new interventions are required to address this.Methods and analysisNZPrEP (A demonstration project of HIV preexposure prophylaxis in Aotearoa New Zealand) is an open-label, single-arm treatment evaluation study to investigate feasibility, retention, adherence, and clinical and behavioural outcomes of HIV pre-exposure prophylaxis (PrEP) provision to gay and bisexual men (GBM) in a publicly funded secondary sexual health service in Auckland, New Zealand. The sample size is 150 GBM. Inclusion criteria were specific behavioural risk factors indicating an increased risk of HIV infection. Exclusion criteria were hepatitis B infection, any medical contraindications to prescribing tenofovir/emtricitabine or factors limiting ability to adhere to the study protocol. Eligible participants will be screened for HIV and other sexually transmissible infections (STIs) and for any medical contraindications to PrEP, and enrolled for a maximum follow-up period of 96 weeks. They will be required to attend for 3-monthly testing for HIV and STIs and monitoring for renal and liver toxicity. Participants will also be required to complete an online behavioural survey after each study visit. The outcomes of interest are feasibility of PrEP provision in a sexual health clinic setting, PrEP acceptability, and adverse medical and behavioural effects of PrEP. The study sample is limited to 150 participants due to funding and service constraints. Statistical analysis of all primary and secondary outcomes will be performed using Stata V.14 at the University of Auckland. Results for primary and secondary endpoints will be reported after the conclusion of the study in March 2019.Ethics and disseminationThe study was approved by the Health and Disability Ethics Committee on 15 September 2016 (16/NTA/112). Key findings will be submitted to peer-reviewed journals. A summary report will be circulated to the study and community stakeholders, and to the Auckland District Health Board, Ministry of Health and Pharmac.Trial registration numberACTRN12616001387415; Pre-results.

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Henning, Marcus A., Sanya Ram, Phillipa Malpas, Boaz Shulruf, Fiona Kelly et Susan J. Hawken. « Academic dishonesty and ethical reasoning : Pharmacy and medical school students in New Zealand ». Medical Teacher 35, n^o 6 (12 novembre 2012) : e1211-e1217. http://dx.doi.org/10.3109/0142159x.2012.737962.

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Semprini, Alex, Joseph Singer, Nicholas Shortt, Irene Braithwaite et Richard Beasley. « Protocol for a randomised controlled trial of 90% kanuka honey versus 5% aciclovir for the treatment of herpes simplex labialis in the community setting ». BMJ Open 7, n^o 8 (août 2017) : e017766. http://dx.doi.org/10.1136/bmjopen-2017-017766.

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IntroductionWorldwide, about 90% of people are infected with the herpes simplex virus, 30% of whom will experience recurrent herpes simplex labialis, commonly referred to as ‘cold sores’, which can last up to 10 days. The most common treatment is aciclovir cream which reduces healing time by just half a day compared with no specific treatment. This is a protocol for a randomised controlled trial (RCT) to determine the efficacy of medical grade kanuka honey-based topical treatment (Honevo) in reducing the healing time and pain of cold sores, compared with topical aciclovir treatment (Viraban).Methods and analysisThis open-label, parallel-group, active comparator superiority RCT will compare the efficacy of medical grade kanuka honey with 5% aciclovir cream in the treatment of cold sores in the setting of a pharmacy research network of 60 sites throughout New Zealand. Adults presenting with a cold sore (N=950) will be randomised by pharmacy-based investigators. The pharmacy-based investigators will dispense the investigational product to randomised participants and both study groups apply the treatment five times daily until their skin returns to normal or for 14 days, whichever occurs first. In response to a daily SMS message, participants complete an assessment of their cold sore healing, with reference to a visual guide, and transmit it to the investigators by a smartphone eDiary in real time. The primary outcome variable is time (in days) from randomisation to return to normal skin. Secondary endpoints include total healing time stratified by stage of the lesion at onset of treatment, highest pain severity and time to pain resolution.Ethics and disseminationNew Zealand Ethics Registration 15/NTB/93. Results will be published in a peer-reviewed medical journal, presented at academic meetings and reported to participants.Trial registration numberAustralia New Zealand Clinical Trials Registry: ACTRN12615000648527, pre-results.SCOTT Registration: 15/SCOTT/14Protocol version4.0 (12 June 2017)

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Henning, Marcus A., Phillipa Malpas, Sanya Ram, Vijay Rajput, Vladimir Krstić, Matt Boyd et Susan J. Hawken. « Students' responses to scenarios depicting ethical dilemmas : a study of pharmacy and medical students in New Zealand ». Journal of Medical Ethics 42, n^o 7 (6 mai 2016) : 466–73. http://dx.doi.org/10.1136/medethics-2015-103253.

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O'Hagan, Edel, Adrian C. Traeger, Siobhan M. Schabrun, Sean O'Neill, Benedict Martin Wand, Aidan Cashin, Christopher Michael Williams, Ian A. Harris et James H. McAuley. « It’s safe to move ! A protocol for a randomised controlled trial investigating the effect of a video designed to increase people’s confidence becoming more active despite back pain ». BMJ Open 12, n^o 7 (juillet 2022) : e063250. http://dx.doi.org/10.1136/bmjopen-2022-063250.

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IntroductionSocial media provide promising contemporary platforms for sharing public health information with a broad audience. Before implementation, testing social media campaigns that are intended to engage audiences and initiate behaviour change is necessary. This trial aims to investigate the effectiveness of a public health campaign to increase people’s confidence in becoming more active despite low back pain in comparison with no intervention.Methods and analysisThis is an online randomised controlled trial with two intervention groups and one control group in a 1:1:1 allocation. People over 18 years of age and fluent in English will be recruited via social media advertising. We developed a social media-based public health campaign to support recommendations for managing low back pain. The interventions are two videos. Participants in the control group will be asked questions about low back pain but will not view either video intervention. The primary outcome will be item 10 of the Pain Self-Efficacy Questionnaire, which asks participants to rate how confident they would feel to gradually become more active despite pain ranging from 0 (not at all confident) to 6 (completely confident). This outcome will be measured immediately in all participant groups. We will compare group mean of the three arms of the trial using univariate analyses of variance.Ethics and disseminationThis trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry. We obtained ethical approval from our institutions Human Research Ethics Committee before data collection. We will publish the results in a peer-reviewed medical journal and on institution websites.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12622000466741).

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Farquhar, Hamish, Lutz Beckert, Adrienne Edwards, Eric L. Matteson, Rennae Thiessen, Edward Ganly et Lisa K. Stamp. « Rheumatoid interstitial lung disease in Canterbury New Zealand : prevalence, risk factors and long-term outcomes—protocol for a population-based retrospective study ». BMJ Open 12, n^o 4 (avril 2022) : e050934. http://dx.doi.org/10.1136/bmjopen-2021-050934.

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IntroductionRheumatoid arthritis (RA) affects approximately 0.5%–1% of the general population. Clinically significant interstitial lung diseases (ILD) develops in just under 10% of people with RA, and subclinical disease is more common. Little is known about RA-ILD in New Zealand (NZ), or the number of persons with RA in Canterbury, NZ. This study aims to determine: (1) incidence and prevalence of RA, (2) incidence and prevalence of RA-ILD, (3) clinical characteristics and risk factors for the development of RA-ILD, (4) long-term outcomes of RA-ILD, in the population resident within the Canterbury District Health Board (CDHB) catchment area.Methods and analysisPersons aged 18 years of age and older, and resident in the region covered by the CDHB with RA as well as RA-ILD will be identified by retrospective review of medical records. Prevalent as well as incident cases of RA between 1 January 2006 and 31 December 2008 and between 1 January 2011 and 31 December 2013 will be identified, and followed until 30 June 2019. Existing as well as incident cases of RA-ILD during this time will be identified. The association between the development of ILD and clinical characteristics and environmental exposures will be examined using Cox-proportional hazard models. Kaplan-Meier methods will be used to estimate survival rates for patients with RA-ILD. Mortality for people with RA and RA-ILD will also be compared with the general population of the CDHB.Ethics and disseminationData will be obtained by retrospective review of medical records. Deidentified patient data will be stored in a secure online database. Data on individual patients will not be released, and all results will only be published in aggregate. Ethical approval has been obtained from the University of Otago Human Research Ethics Committee (REF HD18/079). Results will be published in peer-reviewed medical journals and presented at conferences.Trial registration numberACTRN12619001310156; Pre-results.

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Henning, Marcus A., Sanya Ram, Phillipa Malpas, Richard Sisley, Andrea Thompson et Susan J. Hawken. « Reasons for academic honesty and dishonesty with solutions : a study of pharmacy and medical students in New Zealand ». Journal of Medical Ethics 40, n^o 10 (16 août 2013) : 702–9. http://dx.doi.org/10.1136/medethics-2013-101420.

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Woods, Martin. « Balancing Rights and Duties in ‘Life and Death’ Decision Making Involving Children : a role for nurses ? » Nursing Ethics 8, n^o 5 (septembre 2001) : 397–408. http://dx.doi.org/10.1177/096973300100800504.

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In recent years, increasing pressures have been brought to bear upon nurses and others more closely to inform, involve and support the rights of parents or guardians when crucial ‘life and death’ ethical decisions are made on behalf of their seriously ill child. Such decisions can be very painful for all involved, and may easily become deadlocked when there is an apparent clash of moral ideals or values between the medical team and the parents or guardians. This article examines a growing number of such cases in New Zealand and analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. The article concludes with a recommendation that nurses should be recognized as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations.

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Petousis-Harris, Helen, Yannan Jiang, Lennex Yu, Donna Watson, Tony Walls, Nikki Turner, Anna S. Howe et Jennifer B. Griffin. « A Retrospective Cohort Study of Safety Outcomes in New Zealand Infants Exposed to Tdap Vaccine in Utero ». Vaccines 7, n^o 4 (11 octobre 2019) : 147. http://dx.doi.org/10.3390/vaccines7040147.

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We aimed to evaluate the safety of maternal Tdap; thus, we assessed health events by examining the difference in birth and hospital-related outcomes of infants with and without fetal exposure to Tdap. This was a retrospective cohort study using linked administrative datasets. The study population were all live-born infants in New Zealand (NZ) weighing at least 400 g at delivery and born to women who were eligible for the government funded, national-level vaccination program in 2013. Infants were followed from birth up to one year of age. There were a total of 69,389 eligible infants in the cohort. Of these, 8299 infants were born to 8178 mothers exposed to Tdap (12%), primarily between 28 and 38 weeks gestation as per the national schedule. Among the outcomes, we found a reduced risk for moderate to late preterm birth, low birth weight, small for gestational age, large for gestational age, respiratory distress syndrome, transient tachypnea of newborn, tachycardia or bradycardia, haemolytic diseases, other neonatal jaundice, anaemia, syndrome of infant of mother with gestational diabetes, and hypoglycemia in infants born to vaccinated mothers. There was no association between maternal Tdap, infant Apgar score at 5 min after birth, asphyxia, sepsis or infection, or hypoxic ischemic encephalopathy. Infant exposure to Tdap during pregnancy was associated with a higher mean birthweight (not clinically significant) and higher odds for ankyloglossia and neonatal erythema toxicum diagnoses. There were insufficient observations to allow examination of the effect of Tdap on extreme preterm and very preterm birth, and stillbirth, infant death, or microcephaly. Overall, we found no outcomes of concern associated with the administration of Tdap during pregnancy. NZ Health and Disability Ethics Committee Approval #14/N.T.A/169/AM05.

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Macneill, P. U., A. N. May et S. B. Dowton. « An opportunity to reinforce ethical values : declarations made by graduating medical students in Australia and New Zealand ». Internal Medicine Journal 39, n^o 2 (février 2009) : 83–88. http://dx.doi.org/10.1111/j.1445-5994.2008.01695.x.

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Valiani, Arafaat Amin. « Frontiers of Bio-Decolonization : Indigenous Data Sovereignty as a Possible Model for Community-Based Participatory Genomic Health Research for Racialized Peoples in Postgenomic Canada ». Genealogy 6, n^o 3 (2 août 2022) : 68. http://dx.doi.org/10.3390/genealogy6030068.

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This paper explores the manners in which Indigenous and allied non-Indigenous researchers, medical directors, and knowledge-keepers (among others) extend the ethical precepts and social justice commitments that are inherent in community-based participatory research (CBPR) approaches to genomics. By means of a genealogical analysis of bioethical discourses, I examine the problem in which genomic science claims to offer potentially beneficial genetic screening tools to Indigenous and racialized peoples who have and continue to struggle with historical health inequity, exploitation, and exclusion by the very biomedical institutions which would be charged with the task of ethically introducing these biomedical tools. This investigation focuses on Indigenous data sovereignty (IDS) as an approach established by Indigenous communities and scientists to gain access to the benefits of genomic health which, if the field’s promises are true, aims to counter the historical neglect or exploitation by biomedical researchers and institutions. I chart the role of CBPR principals as it pertains to collective efforts by both Indigenous communities and non-Indigenous allies to create the social, biomedical, and institutional conditions to improve Indigenous health equity in the context of genomic science in two specific studies: the Silent Genome initiative (British Columbia) and the Aotearoa Variome (Aotearoa/New Zealand). This investigation contributes insights to social science literatures in health equity for racialized communities, biomedical ethics, Indigenous Science and Technology Studies, and decolonial biomedical and technoscience histories.

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Gaughwin, Peter C. « A Consideration of the Relationship between the Rules of Court and the Code of Ethics in Forensic Psychiatry ». Australian & ; New Zealand Journal of Psychiatry 38, n^o 1-2 (janvier 2004) : 20–25. http://dx.doi.org/10.1177/0004867404038001-210.

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Objective To consider the relationship between the Rules of Court for expert witnesses and the revised Ethical Guideline No. 9 and Practice Guideline No. 9 of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and how this affects the responsibilities that psychiatrists have to a court and to their profession, when they enter the legal arena. Method Literature relevant to the subject, the Federal Court rules relating to expert witnesses and the RANZCP Guidelines are discussed and compared, with examples used to illustrate particular issues that arise from time to time in the civil jurisdiction. A distinction is drawn between the functions of those psychiatrists who undertake forensic assessment and those who undertake clinical work, and some of the ethical challenges facing forensic psychiatrists are considered. Results The Rules of Court relating to expert witnesses and the RANZCP Guidelines No. 9 have a complementary relationship and are thus ethically consistent with each other and provide a basis for psychiatrists to maintain and enhance the integrity of their profession. Conclusion Forensic psychiatry is a particularly complex medical speciality and one that can create enormous personal conflict for clinicians, especially those who are not forensic consultants. It may therefore be time for the College to develop an accreditation process for those prepared to undertake further study in the nature and practice of forensic psychiatry.

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Thom, Ogilvie, Kym Roberts, Peter A. Leggat, Susan Devine, Amy E. Peden et Richard Charles Franklin. « Addressing gaps in our understanding of the drowning patient : a protocol for the retrospective development of an Utstein style database and multicentre collaboration ». BMJ Open 13, n^o 2 (février 2023) : e068380. http://dx.doi.org/10.1136/bmjopen-2022-068380.

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IntroductionThis retrospective observational study aims to create a comprehensive database of the circumstances of drowning (including care provided and outcomes of care) to report against the Utstein style for drowning (USFD) for patients presenting to the emergency department (ED). Four areas will be examined: a feasibility study of the USFD; a comparison of classification and prognostication systems; examination of indications and efficacy of different ventilation strategies; and differences in the circumstances, severity, treatment and outcomes of drowning by sex and gender.Methods and analysisThis protocol outlines retrospective data collection for all patients presenting to EDs of the Sunshine Coast Hospital and Health Service in Queensland, Australia with the presenting problem or discharge diagnosis of drowning or immersion between 2015 and 2022. Patients computerised health records (emergency medical service record, pathology, radiology results, medical and nursing notes for ED, inpatient units and intensive care units) will be used to extract data for entry into an USFD database. Descriptive (eg, median, IQR) and inferential statistical analyses (eg, analysis of variance) will be used to answer the separate research questions. Development of an International Drowning Registry using the USFD dataset and the Research Electronic Data Capture (REDCap) web application is discussed.Ethics and disseminationThis study has been approved by Metro North Human Research and Ethics Committee (Project No: 49754) and James Cook University Human Research Ethics Committee (H8014). It has been endorsed by national drowning prevention organisations Royal Life Saving Society Australia (RLSSA) and Surf Life Saving Australia (SLSA). Study findings will provide data to better inform clinical management of drowning patients and provide an evidence base on sex and gender differences in drowning. Results will be disseminated through peer review publications, conference presentations and media releases. Results will also be disseminated through RLSSA and SLSA membership of the Australian and New Zealand Resuscitation Council and the Australian Water Safety Council.

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Lack, Liza, Jill Yielder et Felicity Goodyear-Smith. « Evaluation of a compulsory reflective group for medical students ». Journal of Primary Health Care 11, n^o 3 (2019) : 227. http://dx.doi.org/10.1071/hc18030.

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ABSTRACT INTRODUCTIONThe ability to reflect – reflection – taking time to stop, think and evaluate is an important professional skill to develop. AIMTo evaluate a compulsory reflective group activity to determine whether compulsory participation enabled students to constructively share emotional clinical experiences and develop ethical and professional behaviour. METHODSThis was a case study with mixed methodology. Participants were Years 5 and 6 medical students at the University of Auckland, New Zealand. Data collection included pre- and post-reflective group questionnaires with Year 5 and 6 students, questionnaires with general practice academic facilitators, and audiotapes of the reflection group discussions. RESULTSStudents shared emotional experiences that were organised into three themes: (i) witnessing unprofessional behaviour; (ii) meeting difficult clinical scenarios for the first time; and (iii) the hierarchy of medicine. They reported positive learning experiences relevant to their future practice and valued the opportunity to share their experiences safely. Facilitators thought the groups provided unique educational opportunities that students appreciated. Eighty-two percent of participants would like to repeat the activity during their medical school training. CONCLUSIONSelf-reflection is an essential condition for professionalism. Use of reflective groups can help students become ethical and professional doctors.

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Caperchione, Cristina M., Gregory S. Kolt, Trevor N. Savage, Richard R. Rosenkranz, Anthony J. Maeder, Corneel Vandelanotte, Mitch J. Duncan, Anetta Van Itallie, Rhys Tague et W. Kerry Mummery. « WALK 2.0 : Examining the effectiveness of Web 2.0 features to increase physical activity in a ‘real world’ setting : an ecological trial protocol ». BMJ Open 4, n^o 10 (octobre 2014) : e006374. http://dx.doi.org/10.1136/bmjopen-2014-006374.

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IntroductionLow levels of health-enhancing physical activity require novel approaches that have the potential to reach broad populations. Web-based interventions are a popular approach for behaviour change given their wide reach and accessibility. However, challenges with participant engagement and retention reduce the long-term maintenance of behaviour change. Web 2.0 features present a new and innovative online environment supporting greater interactivity, with the potential to increase engagement and retention. In order to understand the applicability of these innovative interventions for the broader population, ‘real-world’ interventions implemented under ‘everyday conditions’ are required. The aim of this study is to investigate the difference in physical activity behaviour between individuals using a traditional Web 1.0 website with those using a novel Web 2.0 website.Methods and analysisIn this study we will aim to recruit 2894 participants. Participants will be recruited from individuals who register with a pre-existing health promotion website that currently provides Web 1.0 features (http://www.10000steps.org.au). Eligible participants who provide informed consent will be randomly assigned to one of the two trial conditions: the pre-existing 10 000 Steps website (with Web 1.0 features) or the newly developed WALK 2.0 website (with Web 2.0 features). Primary and secondary outcome measures will be assessed by self-report at baseline, 3 months and 12 months, and include: physical activity behaviour, height and weight, Internet self-efficacy, website usability, website usage and quality of life.Ethics and disseminationThis study has received ethics approval from the University of Western Sydney Human Research Ethics Committee (Reference Number H8767) and has been funded by the National Health and Medical Research Council (Reference Number 589903). Study findings will be disseminated widely through peer-reviewed publications, academic conferences and local community-based presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry Number: ACTRN12611000253909, WHO Universal Trial Number: U111-1119-1755

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Jackson, Melissa A., Amanda L. Brown, Amanda L. Baker, Gillian S. Gould et Adrian J. Dunlop. « The Incentives to Quit tobacco in Pregnancy (IQuiP) protocol : piloting a financial incentive-based smoking treatment for women attending substance use in pregnancy antenatal services ». BMJ Open 9, n^o 11 (novembre 2019) : e032330. http://dx.doi.org/10.1136/bmjopen-2019-032330.

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IntroductionWhile tobacco smoking prevalence is falling in many western societies, it remains elevated among high-priority cohorts. Rates up to 95% have been reported in women whose pregnancy is complicated by other substance use. In this group, the potential for poor pregnancy outcomes and adverse physical and neurobiological fetal development are elevated by tobacco smoking. Unfortunately, few targeted and effective tobacco dependence treatments exist to assist cessation in this population. The study will trial an evidence-based, multicomponent tobacco smoking treatment tailored to pregnant women who use other substances. The intervention comprises financial incentives for biochemically verified abstinence, psychotherapy delivered by drug and alcohol counsellors, and nicotine replacement therapy. It will be piloted at three government-based, primary healthcare facilities in New South Wales (NSW) and Victoria, Australia. The study will assess the feasibility and acceptability of the treatment when integrated into routine antenatal care offered by substance use in pregnancy antenatal services.Methods and analysisThe study will use a single-arm design with pre–post comparisons. One hundred clients will be recruited from antenatal clinics with a substance use in pregnancy service. Women must be <33 weeks’ gestation, ≥16 years old and a current tobacco smoker. The primary outcomes are feasibility, assessed by recruitment and retention and the acceptability of addressing smoking among this population. Secondary outcomes include changes in smoking behaviours, the comparison of adverse maternal outcomes and neonatal characteristics to those of a historical control group, and a cost-consequence analysis of the intervention implementation.Ethics and disseminationProtocol approval was granted by Hunter New England Human Research Ethics Committee (Reference 17/04/12/4.05), with additional ethical approval sought from the Aboriginal Health and Medical Research Council of NSW (Reference 1249/17). Findings will be disseminated via academic conferences, peer-reviewed publications and social media.Trial registration numberAustralia New Zealand Clinical Trial Registry (Ref: ACTRN12618000576224).

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Chiruta, Victor, Paulina K. Zemla, Pixie Miller, Nicola Santarossa et John A. Hannan. « Critique of the Royal Australian and New Zealand College of Psychiatrists Psychedelic Therapy Clinical Memorandum, Dated May 2020 ». Journal of Medical and Health Studies 2, n^o 2 (31 décembre 2021) : 145–60. http://dx.doi.org/10.32996/jmhs.2021.2.2.18.

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Objective: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has positioned itself against medically controlled patient access (at this current time) to 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin-assisted therapies in its Therapeutic Use of Psychedelic Substances Clinical Memorandum, May 2020. The main reason given by the RANZCP for its stance is safety concerns. Methods: Every reference in the clinical memorandum (CM) was checked against the original publications used by RANZCP to justify its position. In addition, the search engines Google Scholar, PubMed, ScienceDirect, the Multidisciplinary Association for Psychedelic Therapies (MAPS) website, the Therapeutic Goods Administration (TGA) website, relevant Australian and New Zealand legislation were searched for pertinent and up-to-date- information. Results: There is no scientific or medical evidence from the last 70 years to suggest that either psilocybin or MDMA, when administered as an adjutant to therapy in a controlled clinical setting, are linked to either mental illness or negative health outcomes. On the contrary, MDMA and psilocybin have been shown to be safe, non-toxic, non-addictive, and efficacious when administered in a medically-controlled clinical environment. All associated risks are apparent in an uncontrolled setting. Conclusion: The RANZCP’s position is based on outdated, irrelevant, misinterpreted, and misinformed evidence. With the recent positive media coverage of the efficacy of these medicines when used as an adjunct to therapy, there is an intrinsic risk of self-medication or underground therapy. This means that any medical discussion must also purvey the ethical responsibilities and social duties associated with these substances.

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Henning, Marcus A., Phillipa Malpas, Emmanuel Manalo, Sanya Ram, Vidushan Vijayakumar et Susan J. Hawken. « Ethical Learning Experiences and Engagement in Academic Dishonesty : A Study of Asian and European Pharmacy and Medical Students in New Zealand ». Asia-Pacific Education Researcher 24, n^o 1 (30 janvier 2014) : 201–9. http://dx.doi.org/10.1007/s40299-014-0172-7.

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Yusuf, Rasaq A., Phoka C. Rathebe et Wells Utembe. « Study Protocol to Determine Association between Environmental Triggers and Asthma among Children in King Williams Town ». Methods and Protocols 4, n^o 3 (10 septembre 2021) : 64. http://dx.doi.org/10.3390/mps4030064.

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Asthma affects over 330 million people worldwide, with relatively higher disease burdens in Australia, New Zealand, Africa, the Middle East, and South America. The symptoms associated with asthma were reported to be prevalent in children from the period of 1993 to 2013, in many low- and middle-income countries, due to changes in environmental conditions, such as domestic lifestyle, and urban and industrial developments. (1) Background: Several studies have also shown that children are prone to a severe type of asthma, because of their narrow respiratory airways and susceptibility to irritation from environmental agents. This study aimed to assess the association between environmental exposure and asthma among children in King Williams Town, South Africa. (2) Methodology: This study adopted a cross-sectional design method, with an estimated sample size of 262 participants. The eligible study participants were enrolled while attending Grey hospital in King Williams Town, for asthma management. Information will be collected from eligible, stable participants, on asthma treatment, through in-person interviewing in 2021. A semi-structured questionnaire will be administered to the participants. However, as a result of the prevailing COVID-19 pandemic, data may be abstracted from the asthma medical record of the eligible participants. Multivariate regression will be utilized, to describe the correlation between the variables, and the odds ratio will be calculated as well. (3) Discussion and conclusion: The study will objectively identify the local environmental agents that are associated with asthma among children in King Williams Town, in order to reprioritize treatment and preventative strategies. Ethical approval was obtained from the Research Ethics Committee, Faculty of Health Sciences at the University of Johannesburg.

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Norekvål, Tone M., Heather G. Allore, Bjørn Bendz, Cathrine Bjorvatn, Britt Borregaard, Gunhild Brørs, Christi Deaton et al. « Rethinking rehabilitation after percutaneous coronary intervention : a protocol of a multicentre cohort study on continuity of care, health literacy, adherence and costs at all care levels (the CONCARDPCI) ». BMJ Open 10, n^o 2 (février 2020) : e031995. http://dx.doi.org/10.1136/bmjopen-2019-031995.

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IntroductionPercutaneous coronary intervention (PCI) aims to provide instant relief of symptoms, and improve functional capacity and prognosis in patients with coronary artery disease. Although patients may experience a quick recovery, continuity of care from hospital to home can be challenging. Within a short time span, patients must adjust their lifestyle, incorporate medications and acquire new support. Thus, CONCARDPCIwill identify bottlenecks in the patient journey from a patient perspective to lay the groundwork for integrated, coherent pathways with innovative modes of healthcare delivery. The main objective of the CONCARDPCIis to investigate (1) continuity of care, (2) health literacy and self-management, (3) adherence to treatment, and (4) healthcare utilisation and costs, and to determine associations with future short and long-term health outcomes in patients after PCI.Methods and analysisThis prospective multicentre cohort study organised in four thematic projects plans to include 3000 patients. All patients undergoing PCI at seven large PCI centres based in two Nordic countries are prospectively screened for eligibility and included in a cohort with a 1-year follow-up period including data collection of patient-reported outcomes (PRO) and a further 10-year follow-up for adverse events. In addition to PROs, data are collected from patient medical records and national compulsory registries.Ethics and disseminationApproval has been granted by the Norwegian Regional Committee for Ethics in Medical Research in Western Norway (REK 2015/57), and the Data Protection Agency in the Zealand region (REG-145-2017). Findings will be disseminated widely through peer-reviewed publications and to patients through patient organisations.Trial registration numberNCT03810612.

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Abbot, Samuel Richard, Susanna Proudman, Kelly Hall et Nicole Williams. « Outcomes of proximal humerus fractures in children : a study protocol for a retrospective cohort study ». BMJ Open 12, n^o 9 (septembre 2022) : e062586. http://dx.doi.org/10.1136/bmjopen-2022-062586.

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IntroductionProximal humerus fractures (PHFs) comprise <3% of all fractures in children and adolescents. While it is accepted that minimally displaced PHFs can be treated conservatively, the management of severely displaced PHFs remains controversial, especially in older children. This study will aim to analyse the functional and quality-of-life outcomes of children with PHFs, in order to inform their optimal management.Methods and analysisWe will conduct a retrospective cohort study to evaluate the outcomes of patients who were diagnosed with a paediatric PHF at the Women’s and Children’s Hospital (WCH) in South Australia. The primary outcome will be each participant’s pain and quality-of-life outcome, determined by use of the Quick Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Disability Index and Paediatric Outcomes Data Collection Instrument. Secondary outcomes will include rates of non-union, persistent deformity and complications. The information for these variables will be acquired during a brief clinic appointment, and from the medical records and WCH radiology database. Multivariable logistic regression will be performed to determine the clinical variables associated with a worse clinical outcome.Ethics and disseminationThe study has been approved by the Women’s and Children’s Health Network Human Research Ethics Committee (protocol number: 2021/HRE00250). The study findings will be submitted to peer-reviewed scientific journals for publication and disseminated at conference presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12622000176763).

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Stapinski, Lexine, Kylie Routledge, Mieke Snijder, Michael Doyle, Katrina Champion, Cath Chapman, James Ward et al. « A Web-Based Alcohol and Other Drug Prevention Program (Strong & ; Deadly Futures) for Aboriginal and Torres Strait Islander School Students : Protocol for a Cluster Randomized Controlled Trial ». JMIR Research Protocols 11, n^o 1 (7 janvier 2022) : e34530. http://dx.doi.org/10.2196/34530.

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Background There are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we codeveloped the Strong & Deadly Futures well-being and alcohol and drug prevention program in partnership with an Indigenous creative design agency and 4 Australian schools. Objective This paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures in reducing alcohol and other drug use and improving well-being among Aboriginal and Torres Strait Islander youth. Methods The target sample will be 960 year 7 and 8 students from 24 secondary schools in Australia, of which approximately 40% (384/960) will identify as Aboriginal or Torres Strait Islander. The study design is a 2-group, parallel cluster randomized controlled trial with allocation concealment. Recruited schools will be block randomized (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomized to receive Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional well-being program that delivers curriculum-aligned content over 6 lessons via an illustrated story, or health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys will be administered at baseline, 6 weeks, 12 months, and 24 months (primary end point) post baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, well-being, empowerment, appreciation of cultural diversity, and truancy. Results The trial was funded by the National Health and Medical Research Council in January 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, April 2020), the Aboriginal Health and Medical Research Council of New South Wales (1620/19, February 2020), the Western Australian Aboriginal Health Ethics Committee (998, October 2021), and the ethics committees of each participating school, including the New South Wales Department of Education (2020170, June 2020), Catholic Education Western Australia (RP2020/39, November 2020), and the Queensland Department of Education (550/27/2390, August 2021). Projected dates of data collection are 2022-2024, and we expect to publish the results in 2025. A total of 24 schools have been recruited as of submission of the manuscript. Conclusions This will be the first cluster randomized controlled trial of a culturally inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth; therefore, it has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620001038987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=true International Registered Report Identifier (IRRID) PRR1-10.2196/34530

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Chakravarty, Soumitra, Mohd Khan, Shafali Singh, Bhawesh Bhushan, Geeta Jaiswal, Shweta Dwivedi et Abha Pandey. « A study of the different learning styles of the present first professional MBBS students at United Institute of Medical Sciences, United Medicity, Prayagraj, India ». National Journal of Physiology, Pharmacy and Pharmacology 12, n^o 12 (2022) : 1. http://dx.doi.org/10.5455/njppp.2022.12.09441202204112022.

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Background: The study is designed to evaluate the different learning styles of the present first professional MBBS students. Students were requested to complete the visual-aural-read/write-kinesthetic (VARK) questionnaire at VARK-LEARN.COM. Results of the questionnaire were collected by email and analyzed using Microsoft Excel. We found that 68.2% had multimodal learning preferences and 31.7% had single learning preference. Aims and Objectives: The objective of this study is to analyze the different learning styles of MBBS 1st year students of United Institute of Medical Sciences, Prayagraj, using the VARK questionnaire. Materials and Methods: This study includes the informed consent taken from each student before participating. The Institutional Ethics Committee approved the study. Copyright permission was taken from the website vark-learn.com, from VARK Learn Limited, New Zealand. One hundred and two students had consented, and out of them, 85 students participated in the study. The students were asked to complete the questionnaire on the website. The data on their learning styles were collected and analyzed using Microsoft Excel. Results: Out of 85 Students, 58 (68.2%) had multimodal learning preferences. Of these, 28.2% of students had four-part VARK or quadrimodal preferences, 28.2% of students had bimodal, and 11.7% had trimodal learning preferences. Twenty-seven (31.7%) had single learning preferences, and, out of these 27 students, 17 (20%) had kinesthetic, 6 (7.05%) had visual learning preferences, and 4 (4.7%) students had aural learning preferences. Conclusion: With the help of this study, we concluded that most of the students who participated in our study are multimodal learners, and out of the students who had a single learning preference, most had kinesthetic learning preferences.

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Tuckerman, Jane, Kelly Harper, Thomas R. Sullivan, Jennifer Fereday, Jennifer Couper, Nicholas Smith, Andrew Tai et al. « Using provider–parent strategies to improve influenza vaccination in children and adolescents with special risk medical conditions : a randomised controlled trial protocol ». BMJ Open 12, n^o 2 (février 2022) : e053838. http://dx.doi.org/10.1136/bmjopen-2021-053838.

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IntroductionInfluenza immunisation is a highly cost-effective public health intervention. Despite a comprehensive National Immunisation Program, influenza vaccination in children and adolescents with special risk medical conditions (SRMCs) is suboptimal. Flutext-4U is an innovative, multi-component strategy targeting paediatric hospitals, general practice and parents of children and adolescents with SRMC. The Flutext-4U study aims to assess the impact of Flutext-4U to increase influenza immunisation in children and adolescents with SRMC.Methods and analysisThis is a randomised controlled trial involving parents of children and adolescents (aged >6 months to <18 years) with SRMC receiving tertiary care at the Women’s and Children’s Hospital (WCH), Adelaide, South Australia, who are eligible for funded influenza immunisation with a hospital appointment between the start of the seasonal influenza vaccination season and 31 July 2021, their treating general practitioners (GPs), and WCH paediatric specialists.Parents (of children/adolescents with SRMC) are randomised (1:1 ratio) to standard care plus intervention (SMS reminder messages to parents; reminders (written correspondence) for their child’s GP from the hospital’s Paediatric Outpatients Department) or standard care (hospital vaccine availability, ease of access and reminders for WCH subspecialists) with randomisation stratified by age-group (<5, 5–14, >14 to <18 years).The primary outcome is influenza vaccination, as confirmed by the Australian Immunisation Register.The proportion vaccinated (primary outcome) will be compared between randomised groups using logistic regression, with adjustment made for age group at randomisation. The effect of treatment will be described using an OR with a 95% CI.Ethics and disseminationThe protocol and all study materials have been reviewed and approved by the Women’s and Children’s Health Network Human Research Ethics Committee (HREC/20/WCHN/5). Results will be disseminated via peer-reviewed publication and at scientific meetings, professional and public forums.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12621000463875).

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Gobarani, Rukshar Kaizerali, Michael J. Abramson, Billie Bonevski, Gregory R. Weeks, Michael J. Dooley, Brian J. Smith, Antony Veale et al. « The efficacy and safety of varenicline alone versus in combination with nicotine lozenges for smoking cessation among hospitalised smokers (VANISH) : study protocol for a randomised, placebo-controlled trial ». BMJ Open 10, n^o 10 (octobre 2020) : e038184. http://dx.doi.org/10.1136/bmjopen-2020-038184.

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IntroductionSmoking is a leading cause of premature deaths globally. The health benefits of smoking cessation are many. However, majority of quit attempts are unsuccessful. One way to potentially improve success rates is to evaluate new combinations of existing smoking cessation therapies that may work synergistically to decrease the intensity of withdrawal symptoms and cravings.AimsTo evaluate the feasibility, efficacy and safety of the combination of varenicline and nicotine replacement therapy (NRT) lozenges versus varenicline alone in assisting hospitalised smokers to quit.Methods and analysisThis is a multicentre, randomised, placebo-controlled trial. Adults with a history of smoking ≥10 cigarettes per day on average in the 4 weeks prior to their hospitalisation will be recruited. Participants will be randomly assigned to either the intervention group and will receive varenicline and NRT lozenges, or the control group and will receive varenicline and placebo lozenges. All participants will be actively referred to behavioural support from telephone Quitline. Participants are followed up at 1 and 3 weeks and 3, 6 and 12 months from the start of treatment. The primary outcome is carbon monoxide validated prolonged abstinence from 2 weeks to 6 months after treatment initiation. Secondary outcomes include self-reported and biochemically validated prolonged and point prevalence abstinence at 3, 6 and 12 months, self-reported adverse events, withdrawal symptoms and cravings, adherence to treatment, Quitline sessions attended and others. According to the Russell Standard, all randomised participants will be accounted for in the primary intention-to-treat analysis.Ethics and disseminationThe trial will be conducted in compliance with the protocol, the principles of Good Clinical Practice, the National Health and Medical Research Council National Statement on Ethical Conduct in Human Research (updated 2015) and the Australian Code for the Responsible Conduct of Research (2018). Approval will be sought from the Human Ethics Committees of all the participating hospitals and the university. Written informed consent will be obtained from each participant at the time of recruitment.Trial registration numberAustralia New Zealand Clinical Trials Registry (ACTRN12618001792213).

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Blanch, Charles, et Emma Lawrey. « Surge Capacity Planning to Inform the Need for International and Domestic Emergency Medical Team Deployments Following a Severe Wellington, New Zealand Earthquake ». Prehospital and Disaster Medicine 34, s1 (mai 2019) : s6. http://dx.doi.org/10.1017/s1049023x19000311.

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Introduction:Wellington, New Zealand has a significant earthquake risk with unique response challenges posed by its geography and limited road, rail, and sea access. In 2014, the World Health Organization (WHO) Emergency Medical Team (EMT) initiative published minimum and technical standards for EMTs in response to failures by responding teams to deliver appropriate and ethical clinical care during a number of disasters (Norton, 2014). The initiative has evolved to develop national and International EMTs in addition to a support capacity building within Ministries of Health to better coordinate clinical capacity during an emergency.Aim:Over the last two years, the WHO EMT Coordination Cell (EMTCC) course has trained over 300 health personnel globally to coordinate clinical surge capacity using a three-step Impact Assessment, Needs Assessment, and Tasking process informed by disaster epidemiology and mass casualty ratios.Methods:EMTCC planning methodology was applied to the “Wellington Earthquake National Initial Response Plan” (MCDEM, 2017) to develop a Health Action Plan for a significant Wellington earthquake. Known earthquake impact modeling for injuries was applied against predicted capacity in receiving hospitals in the affected region, and the ability to transfer patients nationally to determine unmet response needs. EMT minimum standards and operational insights from recent disasters were then used to determine the number of EMTs required for optimal tasking.Discussion:The surge planning methodology provided a theoretical framework for national and local health emergency management staff to engage with clinical colleagues. This allowed likely EMT assistance to be pre-planned, which facilitates further planning with national and local emergency management, border, and registration agencies for rapid entry into NZ, including onward transport and logistical support. While injury treatment ratios had to be refined to reflect NZ context, the methodology proved useful for Ministries of Health to pre-identify the need for international assistance in national emergencies.

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Heath, J. A., et C. J. Stern. « Fertility preservation in children newly diagnosed with cancer : Existing standards of practice in Australia and New Zealand ». Journal of Clinical Oncology 24, n^o 18_suppl (20 juin 2006) : 9047. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.9047.

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9047 Background: Over the past two decades, rapid advances have occurred in both the successful treatment of childhood cancers and reproductive medicine. We sought to establish the current level of clinical practice for sperm, oocyte and gonadal tissue collection and storage in children newly diagnosed with cancer in Australia and New Zealand (ANZ). Methods: A cross-sectional survey of all pediatric oncology services in ANZ was performed. Comparisons to recently published North American practices and to current recommendations for best practice were also made. Results: Of the 13 centers invited to participate, 12 (92%) completed the survey. All centers had offered sperm conservation, but only ten (83%) had offered oocyte/ovarian tissue conservation. Available methods of gamete collection and storage were not consistent. Two centers were using GnRH agonists as fertility protection in post-pubertal females. Forty-two per cent had offered fertility conservation to males and females prior to completion of sexual development. All centers were more likely to offer sperm conservation than oocyte conservation for any given disease. The most common diseases for which conservation was offered were lymphomas and sarcomas. The anticipated cumulative dose at which centers elected to offer fertility preservation varied widely, both for the alkylator cyclophosphamide (1g/m2 to 10g/m2) and for abdominal/pelvic irradiation (any to 12 Gy) and spinal irradiation (any to 18Gy). Fertility counseling was offered in a variety of settings by 82% of centers. Despite 92% of centers agreeing that fertility preservation guidelines would be helpful, only two (17%) had any in place. Overall, there was greater uptake and consistency of utilization of fertility services in ANZ when compared with published North American data. Conclusions: There are inconsistencies regarding the indications for and methods of gamete conservation in pediatric oncology centers throughout ANZ. Unresolved medical, legal and ethical issues suggest the development of guidelines and a voluntary code of practice would be helpful. No significant financial relationships to disclose.

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Hewitt, Lyndel, Carolyn Frohmuller, Li Ming Wen et Anthony D. Okely. « Effect of a multicomponent intervention in postnatal mothers’ groups on meeting the Australian Physical Activity Guidelines for infants : protocol for a randomised controlled trial ». BMJ Open 12, n^o 4 (avril 2022) : e054183. http://dx.doi.org/10.1136/bmjopen-2021-054183.

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IntroductionGiven the importance of tummy time and the low levels of tummy time reported globally, there is a need for high-quality intervention strategies to promote tummy time. This study describes the protocol of a randomised controlled trial that aims to determine the effectiveness of a multicomponent intervention delivered in postnatal mothers’ groups in increasing infant tummy time.Methods and analysisA randomised controlled trial will be conducted. Eligible participants will be mothers and their infants attending postnatal mothers’ groups (New South Wales, Australia). Participants will be randomised to participate in either (1) infant tummy time intervention group (practice, education, WhatsApp) plus usual care; or (2) usual care group. Randomisation process and outcome assessors will be blinded. The intervention will comprise an online education and practice session (60 min) and 4 weeks of WhatsApp messaging (standardised, three times per week). Usual care will be attendance at a mothers group once per week for 3 weeks for information and support for ad hoc mother craft activities (standard practice provided by early childhood nurses for this local health district). The primary outcome will be the amount of infant tummy time using the GENEActiv accelerometer and a questionnaire (post intervention). The accelerometer will be worn on the right hip secured by an elastic belt around the waist. Wear and non-wear time will be classified using temperature and z-axis cut points as per previous research. This protocol paper presents the scientific background and proposed methods of the randomised controlled trial. Findings will inform the design of practically based strategies to inform clinicians, educators and parents about infant physical activity.Ethics and disseminationThe University of Wollongong and Illawarra Shoalhaven Local Health District Health and Medical Human Research Ethics Committee approved the study (2020/ETH02970). Dissemination plan is publication, staff training and conference presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry ACTRN12621000575831; Pre-results.

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Nickels, Marc R., Leanne M. Aitken, James Walsham, Adrian G. Barnett et Steven M. McPhail. « Critical Care Cycling Study (CYCLIST) trial protocol : a randomised controlled trial of usual care plus additional in-bed cycling sessions versus usual care in the critically ill ». BMJ Open 7, n^o 10 (octobre 2017) : e017393. http://dx.doi.org/10.1136/bmjopen-2017-017393.

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IntroductionIn-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown.Methods and analysisA single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions. The primary outcome is change in rectus femoris cross-sectional area at day 10 in comparison to baseline measured by blinded assessors. Secondary outcome measures include muscle strength, incidence of ICU-acquired weakness, handgrip strength, time to achieve functional milestones (sitting out of bed, walking), Functional Status Score in ICU, ICU Mobility Scale, 6 min walk test 1 week post-ICU discharge, incidence of delirium and quality of life (EuroQol Five Dimensions questionnaire Five Levels scale). Quality of life assessments will be conducted post-ICU admission at day 10, 3 and 6 months after acute hospital discharge. Participants in the intervention group will complete an acceptability of intervention questionnaire.Ethics and disseminationAppropriate ethical approval from Metro South Health Human Research Ethics Committee has been attained. Results will be published in peer-reviewed publications and presented at scientific conferences to assist planning of future multicentre randomised controlled trials (if indicated) that will test in-bed cycling as an intervention to improve the physical, cognitive and health-related quality of life outcomes of patients with critical illness.Trial registration numberThis trial has been prospectively registered on the Australian and New Zealand Clinical Trial Registry (ACTRN12616000948493); Pre-results.

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Gao, Lan, Ralph Maddison, Jonathan Rawstorn, Kylie Ball, Brian Oldenburg, Clara Chow, Sarah McNaughton et al. « Economic evaluation protocol for a multicentre randomised controlled trial to compare Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) versus usual care cardiac rehabilitation among people with coronary heart disease ». BMJ Open 10, n^o 8 (août 2020) : e038178. http://dx.doi.org/10.1136/bmjopen-2020-038178.

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IntroductionIt is important to ascertain the cost-effectiveness of alternative services to traditional cardiac rehabilitation while the economic credentials of the Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) programme among people with coronary heart disease (CHD) are unknown. This economic protocol outlines the methods for undertaking a trial-based economic evaluation of SCRAM in the real-world setting in Australia.Methods and analysisThe within-trial economic evaluation will be undertaken alongside a randomised controlled trial (RCT) designed to determine the effectiveness of SCRAM in comparison with the usual care cardiac rehabilitation (UC) alone in people with CHD. Pathway analysis will be performed to identify all the costs related to the delivery of SCRAM and UC. Both a healthcare system and a limited societal perspective will be adopted to gauge all costs associated with health resource utilisation and productivity loss. Healthcare resource use over the 6-month participation period will be extracted from administrative databases (ie, Pharmaceutical Benefits Scheme and Medical Benefits Schedule). Productivity loss will be measured by absenteeism from work (valued by human capital approach). The primary outcomes for the economic evaluation are maximal oxygen uptake (VO2max, mL/kg/min, primary RCT outcome) and quality-adjusted life years estimated from health-related quality of life as assessed by the Assessment of Quality of Life-8D instrument. The incremental cost-effectiveness ratio will be calculated using the differences in costs and benefits (ie, primary and secondary outcomes) between the two randomised groups from both perspectives with no discounting. All costs will be valued in Australian dollars for year 2020.Ethics and disseminationThe study protocol has been approved under Australia’s National Mutual Acceptance agreement by the Melbourne Health Human Research Ethics Committee (HREC/18/MH/119). It is anticipated that SCRAM is a cost-effective cardiac telerehabilitation programme for people with CHD from both a healthcare and a limited societal perspective in Australia. The evaluation will provide evidence to underpin national scale-up of the programme to a wider population. The results of the economic analysis will be submitted for publication in a peer-reviewed journal.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618001458224).

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Silvers, A., A. Licina et L. Jolevska. « A Clinical Audit of An Office-Based Anaesthesia Service for Dental Procedures in Victoria ». Anaesthesia and Intensive Care 46, n^o 4 (juillet 2018) : 404–13. http://dx.doi.org/10.1177/0310057x1804600410.

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There is an increasing number of specialties performing office-based procedures, with many different providers practising in this field. Office Based Anaesthesia Solutions is a private enterprise designed to be a high-quality general anaesthesia and sedation service delivering care across 18 dental practices in Victoria. We undertook a criterion-based audit of our practice standards and outcomes. Following ethics approval, we retrospectively reviewed consecutive patients managed by our service between March 2014 and July 2017. We collected demographic data, information about anaesthesia technique, and surgical features. We assessed our findings against the Australian and New Zealand College of Anaesthetists (ANZCA) day surgery policy documents. During the specified period, we provided anaesthesia or sedation for 1,323 patients. Their ages ranged from two to 93 years (mean [standard deviation] 33.3 [18.6] years). Ninety-three percent of patients were American Society of Anesthesiologists (ASA) physical status classification 1 or 2. Patient demographics were in line with ANZCA day surgical policy documents. Total intravenous anaesthesia was used in 1,054 of the 1,096 documented general anaesthesia cases. There were three unplanned hospital transfers (annual incidence 0.07%). As this was the first Australian criteria-based audit of office-based anaesthesia (OBA) for dental procedures, we cannot compare our findings directly to previous studies. However, we feel that our patient demographics fell within acceptable ANZCA day procedure standards and our adverse event rate was both very low and similar to other published international adverse event rates. Our audit indicates that with careful screening processes, patient selection and medical governance, OBA is a viable model of care for patients undergoing dental procedures.

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GOEDEKE, S., I. RODINO et D. SHEPHERD. « Donors : To Pay, or Not to Pay ». Fertility & ; Reproduction 04, n^o 03n04 (septembre 2022) : 98. http://dx.doi.org/10.1142/s2661318222740103.

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Attitudes towards and concerns about recognition and payment options for donation in New Zealand and Australia Commercial inducement for the provision of gametes is prohibited in New Zealand and Australia. This has been argued to limit access to donor gametes and contribute to the pursuit of potentially unregulated cross-border reproductive care by domestic patients. 434 participants, including those with infertility and treatment experience, donors, recipients and clinic professionals, completed an online questionnaire assessing their support for a range of recognition and payment options, and their concerns about payment constituting financial reward. Overall, participants supported the reimbursement of direct costs associated with donation, including medical expenses, travel time, and unpaid time away from work relating to treatment. Nonmaterial forms of recognition or tokens of thanks received less support. Lowest ratings of support were noted for the outright payment of donors for the supply of their gametes. Concerns about payment related to assumptions about the type of donor motivated by financial reward, and the possibility that if paid donors might be more likely to conceal relevant treatment information. Further concerns included the increased financial burden for recipients and concern for donor-offspring wellbeing. Support for payment over and above reimbursement of costs was related to a belief that payment was necessary to ensure gamete supply. Sonja Goedeke: Sonja’s research focuses on the psychosocial and ethical implications of assisted reproductive technologies. She has published, presented and supervised projects related to egg and embryo donation, the concept of gifting in donation, counselling, cross border reproductive care, mild stimulation protocols, social egg freezing, policy/legislation, parenting/remaining child ‘free’ after IVF, embryo disposal decisions and the recognition/compensation of donors.

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Goedeke, Sonja, Daniel Shepherd et Iolanda S. Rodino. « Support for recognition and payment options for egg and sperm donation in New Zealand and Australia ». Human Reproduction 35, n^o 1 (1 janvier 2020) : 117–29. http://dx.doi.org/10.1093/humrep/dez257.

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Abstract STUDY QUESTION To what extent do infertility clinic patients, fertility industry professionals and members of the public support different forms of payment and recognition for egg and sperm donation? SUMMARY ANSWER While participants expressed support for reimbursement of expenses for both egg and sperm donation, payment constituting explicit financial advantage was regarded less favourably although potentially necessary to address donor gamete shortages. WHAT IS KNOWN ALREADY In both New Zealand and Australia, commercial inducement for the supply of gametes is prohibited. This prohibition has been argued to contribute to limited availability of donor gametes with the effect of increasing waiting lists and/or the pursuit of potentially unregulated cross-border reproductive care by domestic patients requiring donor gametes. STUDY DESIGN, SIZE, DURATION The study was a mixed methods study drawing on data from a questionnaire completed by 434 participants from across New Zealand and Australia between November 2018 and March 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Stakeholders involved in donor-assisted conception (past and present infertility patients, gamete recipients and donors), fertility industry professionals and members of the public were recruited following online advertisement of the study. All participants spoke English and primarily identified as Caucasian. Participants anonymously completed an online questionnaire gauging their support for a range of recognition and payment options. Dependent samples t-tests were used to probe for differences in support of recognition and payment options in relation to egg and sperm donation. Linear regression models were used to determine factors predicting support for the different options for both egg and sperm donation. Thematic analysis was used to identify main themes in free text question responses. MAIN RESULTS AND THE ROLE OF CHANCE Broadly, there was agreement that donors be reimbursed for medical expenses, travel time, unpaid time away from work relating to treatments and out-of-pocket expenses directly related to the gamete donation process, with greater support suggested for egg versus sperm donors. Items gauging support for non-material recognition and tokens of thanks for donations were not significantly different between egg and sperm donation programmes (P > 0.05) nor rated as highly as reimbursement alternatives. Lowest ratings of support were indicated for the outright payment or reward of donors for the supply of their gametes, options that would leave donors in better financial positions. Qualitatively, themes valuing gamete donation as ideally relating to gifting were identified, although counterbalanced in opinion by concepts of fairness in reimbursing gamete donors for their costs. Where payment over and above the reimbursement of costs was supported, this was related to pragmatic considerations of limited supply of donor gametes. LIMITATIONS, REASONS FOR CAUTION This study used a cross-sectional design and consequently causal inferences cannot be made. Additionally, participants particularly professional fertility staff, were required to self-report on politically sensitive and legal issues with the potential for social desirability response bias. Snowball sampling may have led to participation of like-minded individuals, thus limiting generalizations of findings. WIDER IMPLICATIONS OF THE FINDINGS In a climate of global commercialization of reproductive medicine, limited donor gamete availability and rising incidences of cross-border reproductive care, the findings of this study can be used as a basis for further discussion between regulators and professional industry stakeholders with respect to shaping ethical policy and practice relating to donor conception. STUDY FUNDING/COMPETING INTEREST(S) No external funds were sought for this work. None of the authors have any competing interests to declare. TRIAL REGISTRATION NUMBER N/A.

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Wall, C., T. Glyn, D. Rowbotham, M. Haines, I. Bissett, T. Eglinton et R. Gearry. « P769 Randomised feasibility study of preoperative medical nutrition therapy in adults undergoing surgery for Crohn’s disease ». Journal of Crohn's and Colitis 17, Supplement_1 (30 janvier 2023) : i899. http://dx.doi.org/10.1093/ecco-jcc/jjac190.0899.

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Abstract Background Preoperatively patients with Crohn’s disease are at high risk of malnutrition. Patients requiring surgery to manage stricturing disease are often advised to follow a low residue/low fibre diet to reduce risk of bowel obstruction. This diet is usually nutritionally inadequate and may negatively affect nutritional status. Research suggests that preoperative exclusive enteral nutrition (EEN) improves nutritional status, reduces intestinal inflammation and consequently improves surgical outcomes. Recently the Crohn’s disease exclusion diet has been shown to reduce intestinal inflammation in adults but its use preoperatively has not been reported. This research aimed to determine whether it is feasible to recruit and retain patients with Crohn’s disease in a single-blinded, multicentre, randomised controlled trial of three preoperative nutritional therapies. Methods Patients undergoing elective surgery to manage Crohn’s disease at three New Zealand tertiary care hospitals (Christchurch, Auckland and Waikato hospitals), aged >18 years old, with body mass index (BMI) > 18.5 kg/m2 and without recent significant weight loss were eligible to participate. Patients were randomised to six weeks of preoperative EEN, partial enteral nutrition with Phase-1 Crohn’s Disease Exclusion Diet (CDED) or standard care. Nutritional and radiological assessment at baseline and preoperatively was completed and surgical outcomes recorded. Descriptive statistical analysis was undertaken. Health and Disability Ethics Committee approval was given (20/NTB/134). Results Over 18 months (September 2020 to March 2022), 48 patients were screened and 17 were randomised. Patient characteristics were: median age 37.9 (range, 28-68) years, 9 (53%) female, 10 (59%) on biologic medication, median BMI 25.7 (range, 19.7-38.6) kg/m2 and 2 (12%) had low fat-free mass index. Medical nutrition therapy was completed by 13/17 (76%) patients (EEN n=4, CDED n=4 and standard care n=5) and four withdrew. BMI and simplified magnetic resonance index of activity (MaRIA) score changed by a median of -0.3 (range, -1.8 to 2.1) kg/m2 and 0.5 (range, -3 to 2) points respectively. At day 30, 10 patients had no surgical complications. Three patients had Clavien Dindo Grade 2 complications; one (standard care group) experienced fever treated with antibiotics, one (standard care group) had postoperative ileus requiring total parenteral nutrition and one (CDED group) required a blood transfusion postoperatively and antibiotics for a wound infection. Conclusion Patients who need elective Crohn’s disease surgery tolerate preoperative EEN or CDED. Use of preoperative nutrition therapies are feasible and the impact on surgical outcomes should be assessed in a larger study.

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Doherty, Emma, John Wiggers, Nicole Nathan, Alix Hall, Luke Wolfenden, Belinda Tully, Elizabeth J. Elliott et al. « Iterative delivery of an implementation support package to increase and sustain the routine provision of antenatal care addressing alcohol consumption during pregnancy : study protocol for a stepped-wedge cluster trial ». BMJ Open 12, n^o 7 (juillet 2022) : e063486. http://dx.doi.org/10.1136/bmjopen-2022-063486.

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IntroductionAntenatal care addressing alcohol consumption during pregnancy is not routinely delivered in maternity services. Although a number of implementation trials have reported significant increases in such care, the majority of women still did not receive all recommended care elements, and improvements dissipated over time. This study aims to assess the effectiveness of an iteratively developed and delivered implementation support package in: (1) increasing the proportion of pregnant women who receive antenatal care addressing alcohol consumption and (2) sustaining the rate of care over time.Methods and analysisA stepped-wedge cluster trial will be conducted as a second phase of a previous trial. All public maternity services within three sectors of a local health district in Australia will receive an implementation support package that was developed based on an assessment of outcomes and learnings following the initial trial. The package will consist of evidence-based strategies to support increases in care provision (remind clinicians; facilitation; conduct educational meetings) and sustainment (develop a formal implementation blueprint; purposely re-examine the implementation; conduct ongoing training). Measurement of outcomes will occur via surveys with women who attend antenatal appointments each week. Primary outcomes will be the proportion of women who report being asked about alcohol consumption at subsequent antenatal appointments; and receiving complete care (advice and referral) relative to alcohol risk at initial and subsequent antenatal appointments. Economic and process evaluation measures will also be reported.Ethics and disseminationEthical approval was obtained through the Hunter New England (16/11/16/4.07, 16/10/19/5.15) and University of Newcastle Human Research Ethics Committees (H-2017-0032, H-2016-0422) and the Aboriginal Health and Medical Research Council (1236/16). Trial findings will be disseminated to health service decision makers to inform the feasibility of conducting additional cycles to further improve antenatal care addressing alcohol consumption as well as at scientific conferences and in peer-reviewed journals.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12622000295741).

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Alam, Kazi Firoz. « Ethics in New Zealand organisations ». Journal of Business Ethics 12, n^o 6 (juin 1993) : 433–40. http://dx.doi.org/10.1007/bf01666557.

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Lake, Susanna J., Sophie L. Phelan, Daniel Engelman, Oliver Sokana, Titus Nasi, Dickson Boara, Christina Gorae et al. « Protocol for a cluster-randomised non-inferiority trial of one versus two doses of ivermectin for the control of scabies using a mass drug administration strategy (the RISE study) ». BMJ Open 10, n^o 8 (août 2020) : e037305. http://dx.doi.org/10.1136/bmjopen-2020-037305.

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IntroductionScabies is a significant contributor to global morbidity, affecting approximately 200 million people at any time. Scabies is endemic in many resource-limited tropical settings. Bacterial skin infection (impetigo) frequently complicates scabies infestation in these settings. Community-wide ivermectin-based mass drug administration (MDA) is an effective control strategy for scabies in island settings, with a single round of MDA reducing population prevalence by around 90%. However, current two-dose regimens present a number of barriers to programmatic MDA implementation. We designed the Regimens of Ivermectin for Scabies Elimination (RISE) trial to investigate whether one-dose MDA may be as effective as two-dose MDA in controlling scabies in high-prevalence settings.Methods and analysisRISE is a cluster-randomised non-inferiority trial. The study will be conducted in 20 isolated villages in Western Province of Solomon Islands where population prevalence of scabies is approximately 20%. Villages will be randomly allocated to receive either one dose or two doses of ivermectin-based MDA in a 1:1 ratio. The primary objective of the study is to determine if ivermectin-based MDA with one dose is as effective as MDA with two doses in reducing the prevalence of scabies after 12 months. Secondary objectives include the effect of ivermectin-based MDA on impetigo prevalence after 12 and 24 months, the prevalence of scabies at 24 months after the intervention, the impact on presentation to health facilities with scabies and impetigo, and the safety of one-dose and two-dose MDA.Ethics and disseminationThis trial has been approved by the ethics review committees of the Solomon Islands and the Royal Children's Hospital, Australia. Results will be disseminated in peer-reviewed publications and in meetings with the Solomon Islands Ministry of Health and Medical Services and participating communities.Trial registration detailsAustralian New Zealand Clinical Trials Registry: ACTRN12618001086257. Date registered: 28 June 2018.

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Parker, Elizabeth, Victoria Flood, Mark Halaki, Christine Wearne, Gail Anderson, Linette Gomes, Simon Clarke et al. « Study protocol for a randomised controlled trial investigating two different refeeding formulations to improve safety and efficacy of hospital management of adolescent and young adults admitted with anorexia nervosa ». BMJ Open 10, n^o 10 (octobre 2020) : e038242. http://dx.doi.org/10.1136/bmjopen-2020-038242.

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IntroductionProviding effective nutritional rehabilitation to patients hospitalised with anorexia nervosa (AN) is challenging, partly due to conservative recommendations that advocate feeding patients at low energy intakes. An ‘underfeeding syndrome’ can develop when patients are not provided with adequate nutrition during treatment, whereby malnourished patients fail to restore weight in a timely matter, and even lose weight. Of particular concern, the reintroduction of carbohydrate in a starved patient can increase the risk of developing electrolyte, metabolic and organ dysfunction. The proposed trial assesses the efficacy and safety of a lower carbohydrate enteral formula (28% carbohydrate) against a standard enteral formula (54% carbohydrate), in adolescent and young adult patients (aged 15–25 years), hospitalised with AN.Methods and analysisThe study employs a double-blind randomised controlled trial design. At admission to hospital, malnourished adolescent and young adults with AN will be randomly allocated to commence feeding on a standard enteral feeding formula (1.5 kcal/mL, 54% carbohydrate) or a lower carbohydrate isocaloric enteral feeding formula (1.5 kcal/mL, 28% carbohydrate). Assessments of nutritional intake, weight and biochemistry (phosphate, magnesium, potassium) will be conducted at baseline and during the first 3 weeks of hospital admission. The primary outcome measure will be incidence of hypophosphatemia. Secondary outcomes include weight gain, oedema, other electrolyte distortion, length of hospital admission, admission to the Intensive Care Unit (ICU) and number of days to reach medical stability, using defined parameters.Ethics and disseminationThe protocol was approved by the Western Sydney Local Health District Human Research Ethics Committee and institutional research governance approvals were granted. Written informed consent will be sought prior to study enrolment. Study findings will be widely disseminated through peer-reviewed publications and conference presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617000342314); Pre-results.

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Al-Imam, Ahmed, Farah Al-Mukhtar, Aisha Shafiq, Manolia Irfan et Mustafa M. Saleh. « Knowledge and (Ab)Use in Connection with Novel Psychoactive Substances : A Cross-Sectional Analysis of Iraqi Medical Students ». Global Journal of Health Science 9, n^o 11 (18 septembre 2017) : 61. http://dx.doi.org/10.5539/gjhs.v9n11p61.

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BACKGROUND: The extent of (ab)use of the Novel Psychoactive substances has been thoroughly mapped in the developed world, particularly in the US, Canada, UK, Western Europe, Australia, and New Zealand. However, there are still untapped geographic locations particularly in the developing world including the Middle East.MATERIALS AND METHODS: This study is observational in nature and cross-sectional in design; it is based on a survey that will aim is to estimate the level of knowledge and the extent of (ab)use of psychoactive substances, traditional and novel, in a population of undergraduate medical students from Iraq. There will be an implementation of inferential statistical analyses for the purpose of hypothesis testing. Ethical approvals were granted from the College of Medicine at the University of Baghdad and the University of Hertfordshire.RESULTS: There was some degree of knowledge in connection with psychoactive substances among a population of medical students. However, the extent of (ab)use is still minimal when compared to that of the developed countries. In general, the knowledge and the extent of NPS (ab)use did not vary substantially as the students progressed through the medical college.CONCLUSION: The use of observational analytic tools for assessing the diffusion of the phenomenon of psychoactive and novel psychoactive substances is indispensable. The extent of knowledge and (ab)use of NPS in the Middle East may still be considered minute or insignificant. Further analyses are required in the Middle East; different populations are to be targeted including; students, academics, researchers, medical and paramedical staff, psychiatric patients, prisoners, military and para-military organisations, and even terrorists.

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