Access to emergency paediatric surgery for testicular torsion or intestinal volvulus in New Zealand: A system perspective

2021 ◽  
Author(s):  
Cameron Castle ◽  
Spencer W Beasley ◽  
Kiarash Taghavi
Keyword(s):  
New Zealand ◽  
Testicular Torsion ◽  
Paediatric Surgery ◽  
System Perspective ◽  
Intestinal Volvulus

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

scholarly journals Complexity, Evaluation and the Effectiveness of Community-based Interventions to Reduce Health Inequalities

2020 ◽  
Author(s):  
Anna Matheson ◽  
Kevin Dew ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Health Inequalities ◽  
Comparative Case Study ◽  
Successful Implementation ◽  
Intervention Effectiveness ◽  
Community Based Interventions ◽  
Community Based ◽  
Theoretical Understanding ◽  
System Perspective

Reducing health inequalities has been part of the New Zealand government's agenda since the early 1990s. As a result, interventions have been implemented nationally with the explicit goal of reducing health inequalities. This paper describes findings from a comparative case study of two community-based interventions - carried out in different New Zealand communities. Complexity theory was used as an analytic tool to examine the case data, and provided a systematic way in which to explore 'local' issues by taking a 'whole system' perspective. The findings showed that two important influences on the successful implementation of the interventions were the existence and capacity of local organisations and their relationships with government agencies. The analysis provided a dynamic picture of shared influences on the interventions in different communities and in doing so offered insight into intervention effectiveness. It is argued in this article that, for examining intervention effectiveness, it is essential to have a theoretical understanding of the behaviour of the complex system in which they are implemented. This theoretical understanding has implications for the appropriate design of interventions to reduce health inequalities, and in turn should lead to more meaningful ways to evaluate them.

Evaluation of website information provided by paediatric surgery centres in Australia and New Zealand

2019 ◽  
Vol 89 (9) ◽  
pp. 1119-1121 ◽  
Author(s):  
Vivek Meiyappan ◽  
Timothy A. Little ◽  
Paul Jackson
Keyword(s):  
New Zealand ◽  
Paediatric Surgery

Paediatric surgery

2012 ◽  
Author(s):  
Matthew D. Gardiner ◽  
Neil R. Borley
Keyword(s):  
Testicular Torsion ◽  
Hypertrophic Pyloric Stenosis ◽  
Anorectal Malformations ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Abdominal Wall Defects ◽  
Paediatric Surgery ◽  
Basic Principles ◽  
Anatomy And Physiology ◽  
Congenital Abdominal Wall Defects ◽  
Case Based

This chapter begins by discussing the basic principles of paediatric anatomy and physiology and paediatric abdominal pain before focusing on the key areas of knowledge, namely congenital abdominal wall defects, anorectal malformations, miscellaneous neonatal conditions, infantile hypertrophic pyloric stenosis, intussusception, penile conditions, testicular torsion, epididymitis and orchitis, infantile inguinal hernia and hydrocele, and testicular maldescent. The chapter concludes with relevant case-based discussions.

scholarly journals Does the source of referral affect outcomes for paediatric testicular torsion?

2019 ◽  
Vol 101 (6) ◽  
pp. 411-414 ◽  
Author(s):  
R Peeraully ◽  
M Jancauskaite ◽  
S Dawes ◽  
S Green ◽  
N Fraser
Keyword(s):  
Primary Care ◽  
Testicular Torsion ◽  
Paediatric Surgery ◽  
Single Centre ◽  
Significant Difference ◽  
Single Centre Study ◽  
The Difference ◽  
Surgery Department ◽  
Surgical Unit ◽  
Do So

Introduction This single centre study retrospectively analysed the intraoperative findings relative to source of referral for emergency scrotal explorations performed in a tertiary level paediatric surgery department. Methods All patients who underwent emergency scrotal exploration under the care of paediatric surgeons in our unit between April 2008 and April 2016 were identified. Clinical data were obtained from contemporaneous records. Results Over the 8-year study period, 662 boys underwent emergency scrotal exploration: 6 (1%) were internal referrals, 294 (44%) attended our emergency department (ED) directly, 271 (41%) were referred from primary care and 91 (14%) were transferred from other hospitals. Excluding procedures in neonates, testicular torsion was present in 100 cases (15%). Testicular detorsion with bilateral 3-point testicular fixation was performed in 66 (66%) and orchidectomy with contralateral fixation in 34 (34%) where the torted testis was non-viable intraoperatively. The orchidectomy rate in the presence of torsion was 23% in ED referrals (12/52), 43% in primary care referrals (12/28) and 50% for transfers (10/20). The difference in rates between ED referrals and patients transferred from other hospitals was significant (p=0.026). There was no significant difference in median age between any of the groups (p=0.10). Conclusions Boys undergoing emergency scrotal exploration had a higher orchidectomy rate when transferred from other hospitals to our unit. This difference was statistically significant when compared with boys presenting directly to our ED. This supports advice from The Royal College of Surgeons of England for undertaking paediatric scrotal explorations in the presenting hospital when safe to do so rather than delaying the care of these patients by transferring them to a tertiary paediatric surgical unit.

scholarly journals 116 An Assessment of Current Practice for Suspected Paediatric Testicular Torsion

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Gibb ◽  
O Babawale ◽  
D Hodgson ◽  
R Harrison
Keyword(s):  
Testicular Torsion ◽  
Current Practice ◽  
Late Presentation ◽  
Paediatric Surgery ◽  
Late Presenters ◽  
Number Of Children ◽  
Atypical Features ◽  
Senior Clinician ◽  
Atypical Presentations ◽  
Immediate Surgery

Abstract Aim British Paediatric surgery guidelines (2019) state ‘immediate surgery should be performed if testicular torsion is suspected’. However, imaging ‘may be considered for a small number of children under the guidance of a senior clinician in late presenters or in those with atypical features. This study reviewed current practice in our hospital. Method Boys aged 16 and under in 2017-2019 who underwent scrotal exploration for suspected testicular torsion were reviewed. Outcomes assessed were number having ultrasound prior to theatre, pathological findings, number who had an orchidectomy, and post-op complications. Additionally, all testicular ultrasounds in those aged under 16 were screened to establish how many were requested for possible or missed torsion. Results 46 patients underwent surgical exploration of which 18 had a confirmed torsion. Six patients had imaging prior to surgery, of which five suggested torsions and four of these were confirmed in theatre. 202 boys under 16 had a testicular ultrasound; 26 of these were for late presentation or those with atypical features of torsion. Three underwent scrotal exploration two of whom had reports suggestive of torsion which was confirmed on exploration. Conclusions Most testicular torsions occur around the age of puberty with no torsion identified in patients under 10. Ultrasound is a useful tool for identification of vascularity or alternative pathology in late or atypical presentations of torsion; but does not replace clinical judgement. Imaging may have prevented unnecessary exploration in 23 cases, although negative imaging did not always preclude exploration.

GS23P PAEDIATRIC SURGERY PERFORMED BY GENERAL SURGEONS IN A PROVINCIAL NEW ZEALAND (NZ) HOSPITAL

2007 ◽  
Vol 77 (s1) ◽  
pp. A31-A31
Author(s):  
S. L. Peng ◽  
M. Fancourt ◽  
W. Gilkison ◽  
S. Kyle ◽  
D. Mosquera
Keyword(s):  
New Zealand ◽  
Paediatric Surgery ◽  
General Surgeons

PAEDIATRIC SURGERY CARRIED OUT BY GENERAL SURGEONS: A RURAL NEW ZEALAND EXPERIENCE

2008 ◽  
Vol 78 (8) ◽  
pp. 662-664 ◽  
Author(s):  
Szelin Peng ◽  
Michael Fancourt ◽  
William Gilkison ◽  
Stephen Kyle ◽  
Damien Mosquera
Keyword(s):  
New Zealand ◽  
Paediatric Surgery ◽  
General Surgeons
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