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BPJ 37 August 2011

Best Practice Journal

Whānau Ora: the theory and the practice

The Honourable Tariana Turia, Minister Responsible for Whānau Ora, introduces the concept of Whānau Ora and what this means for Māori, primary care and all New Zealanders. Twenty-five collectives, bringing together 158 providers across the country, have been selected to deliver Whānau Ora services. The ultimate concept of Whānau Ora is people and agencies working collaboratively to meet the health, social and educational needs of whānau. Profiles of providers help to explain how Whānau Ora works. View Article

Rheumatic fever in Māori: what can we do better?

In New Zealand, acute rheumatic fever is now almost exclusively a disease affecting Māori and Pacific peoples. The majority of cases are occurring in low socioeconomic communities in the northern and central North Island and in pockets around the Wellington region. Primary care clinicians need to know the risk of rheumatic fever in their community and to encourage at-risk people to seek a consultation when they have a sore throat. In high-risk areas, all Māori and Pacific children who present with a sore throat should have a throat swab taken and antibiotics prescribed empirically if any red flags are present. View Article

The medical management of gout revisited

Gout has a significant impact on Māori in New Zealand. Management can be classified into three areas – treatment of an acute attack, treatment to prevent recurrent attacks and lifestyle advice for people with gout. NSAIDs are first-line treatment for an acute attack of gout. Allopurinol to lower urate levels is required for long-term treatment to prevent recurrent attacks. Aim for a target serum urate level of less than 0.36 mmol/L. Lifestyle modifications to prevent gout include; maintaining a healthy weight, moderate exercise and avoiding high purine foods such as shellfish and offal. View Article

Cardiovascular disease risk assessment: what are the PHO Performance Programme indicators and how are they best achieved?

The PHO Performance Programme is a quality improvement initiative which aims to improve health and reduce disparities among people using primary healthcare services in New Zealand. Practices can make simple changes in order to contribute towards their PHO meeting indicator targets, in turn improving health outcomes for their patients. The PHO performance indicator and target for cardiovascular disease risk assessment is for 80% of enrolled eligible patients to have their CVD risk assessed and recorded in their patient notes within the last five years. Risk assessment tools for calculating CVD risk can be integrated into the practice management system or used online. View Article

Building cultural competence: the Medical Council's direction

The New Zealand Medical Council's approach to cultural competence. View Article

Gout: an alarm bell for diabetes and cardiovascular disease

Counties Manukau DHB Māori Gout Action Group have identified five publicly held myths about gout and presented a plan with five interweaving strands aimed towards "outing gout" and moving towards 21st century management of gout. View Article

Raynaud's phenomenon: a whiter shade to winter's pale

Raynaud's phenomenon is a circulatory disorder, characterised by episodic attacks where arteries in the fingers and toes spasm, restricting blood flow and causing pain and marked colour changes of the skin. View Article

Upfront: Meeting the needs of children and young people in New Zealand who have been abused and neglected

Nearly one quarter of New Zealand children and young people come to the attention of Child, Youth and Family before they reach age 16 years. View Article

News in brief: Varenicline: amendments to Special Authority funding

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Correspondence: Oxycodone: is the problem in secondary care?

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