The principal scientific journal for the profession in New Zealand

NZMJ: under new ownership

The New Zealand Medical Journal (NZMJ) is now owned by the Pasifika Medical Association Group (PMAG).

A new opportunity for a fairer, more equitable approach to alcohol supply—minus the marketing

A key issue the review must traverse is how can we ensure safe and responsible supply of alcohol while reducing the inequities in wellbeing and health to which alcohol significantly contributes.

Time for Rangatiratanga

As July the first rolls around, in the time of renewal following Matariki, and the proposed revamp of the public health system is operationalised, Howard et al, in the current issue of the Journal, provide a timely reminder of the importance and responsibilities of clinical leadership in the health system.

All the cancer you cannot see

Lung cancer is the leading cause of cancer death in New Zealand with 1,700 deaths each year. More New Zealanders die of lung cancer than of breast cancer, prostate cancer and melanoma combined. Between 2008–2017, lung cancer was diagnosed in 43:100,000 Māori and 13:100,000 non-Māori/non-Pacific New Zealanders; a number we need to keep in mind as we look at the information on lung cancer in this edition of the journal.

From here to where: the continued metamorphosis of the NZMJ

Most of us are resistant to change as it requires some effort to adjust, and at times it feels uncomfortable. What we are familiar with is predictable and frequently reliable enough. Change challenges us and forces us to reassess what we think of as important. Change, however, is inevitable, and is the only way to see improvement.

Trauma, COVID-19 and healthcare investment

Just over two years have passed since the first cases of COVID-19 were recognised in New Zealand. In that time, there have been a range of restrictions and lockdowns during which individuals’ ability to travel and engage in a range of work-related and personal activities have been severely constrained.

Leadership and governance—what is needed to deliver Aotearoa New Zealand health reforms

Aotearoa New Zealand is implementing a significant health reform agenda heralded as a “once in a generation” opportunity, derived from the Health and Disability System Review. The reforms move us from delivering more healthcare activity and accepting unwarranted variation in care, to focusing on wellbeing and health outcomes and delivering services to meet people’s needs.

Delay in funding of tolvaptan for polycystic kidney disease in Aotearoa New Zealand

Autosomal dominant polycystic kidney disease (ADPKD) is characterised by the formation and growth of multiple cysts within the kidney that distort and destroy the kidney structure and function.

Innovation in Aotearoa New Zealand’s healthcare system—how to make it happen

There are many different definitions of innovation, although most include the elements of novelty, application and benefit.[[1,2]] In health services, innovation can simply be doing something differently, and better than how it is generally done or has previously been done—it could be a new process, device, technology, system or service. It is not just having the idea of how to do something differently (the idea or invention) but also getting it embedded into standard clinical practice (the implementation).

Did new treatments contribute to a decrease in melanoma deaths?

Given these high melanoma rates and the link to an environmental exposure, melanoma incidence and mortality are routinely monitored as part of the Environmental Health Intelligence NZ (EHINZ) surveillance programme, which provides information for action on environmental health issues in New Zealand. Decreasing the burden of melanoma in New Zealand would have a substantial impact on the health of many New Zealanders.

Consent for teaching

The issue of consent for student involvement with patient care was raised by the Cartwright Inquiry. Evidence was presented that medical students were required to perform vaginal examination on anaesthetised women without their knowledge or consent. As a result of the Inquiry, the Code of Health and Disability Consumer Rights (HDC Code) was established that includes rights on consent for teaching (Rights 5,6 and 7). There are concerns that this requirement is not being observed, and a Consensus Statement (CS) was developed by Auckland and Otago medical schools on informed consent for teaching.

Doctors as leaders and governors

The health system in Aotearoa New Zealand (Aotearoa NZ) is implementing a significant reform agenda derived from the Health and Disability System Review. Unique to the Aotearoa NZ context, a key challenge facing the system and central to the reform agenda is a drive to achieve equitable outcomes, particularly related to Māori, Pasifika, and disabled populations.

Digital solutions for providing patients access to hospital-held health information: what are the design issues that need to be addressed?

With the increased digitisation of hospital health records across Aotearoa New Zealand, providing patients with access to their hospital-held health information should become easier. It is well known that patients want access to the health information stored by health services as well as the ability to correct any inaccuracies in the information.

Doctors’ travel in the Anthropocene

Climate change is now a global emergency, a red alert for humanity. Increased global temperatures are already resulting in dangerous storms, fires, heat waves and droughts. Transformative change is needed in every sector of every country to adapt to change that is already occurring and to prevent it getting worse.

New Zealand’s first practical demonstration of the telemedicine system specific to ophthalmology: MedicMind teleophthalmology platform

A recently published review article in Clinical Ophthalmology has foresighted teleophthalmology to play a critical role in ophthalmology management.

Indoor air quality, largely neglected and in urgent need of a refresh

Despite people in high- and middle-income countries spending 85–90% of their time indoors, and adults inhaling 11,000 litres of air every day, the health impacts of indoor air quality in Aotearoa New Zealand are barely recognised by Government agencies.

Current role of sentinel lymph node biopsy in early-stage melanoma

There has been significant evolution in the management of surgically resectable melanoma the past five years with the success of adjuvant therapy for stage 3, and more recently, high-risk stage 2 melanoma. In the context of these recent changes, the role of sentinel lymph node biopsy (SLNB), which has been debated for many years, has come under the spotlight again.

The incidence of diabetic ketoacidosis associated with empagliflozin use in Aotearoa New Zealand: a preliminary review

Diabetic ketoacidosis (DKA) is a life-threatening but largely preventable complication of diabetes, resulting from excess ketone production due to relative or absolute insulin deficiency. DKA is primarily associated with type 1 diabetes mellitus (T1D), but may also occur in end-stage type 2 diabetes mellitus (T2D), and in those treated with sodium-glucose cotransporter-2 inhibitors (SGLT2).

General Practitioners in leadership and governance

Stolarek et al’s editorial on leadership and governance[[1]] applies the Cynefin framework of complex systems to health provision and governance.

Response to Letter: General Practitioners in leadership and governance

Access to acute secondary healthcare services is for all

A key measure of a society’s worth is how well it provides healthcare for its members, particularly the young and the elderly. The increasing fashion of finding reasons not to provide effective care undermines the worth of society and can ferment a loss of societal cohesion with widespread consequences.

This pākehā life: an unsettled memoir

This pākehā life: an unsettled memoir is a candid memoir by Alison Jones, who currently is a Professor in the Faculty of Education and Social Work at the University of Auckland in the school of Māori and Indigenous Education, Te Puna Wānanga.

Perfection: The life and times of Sir William Manchester

I recently spent a weekend in Martinborough and as many people do spent some time browsing the local bookshop.

From Southland to Surgery: A Journey around Values

Professor John Morton has not only written an intriguing catalogue of the Christchurch surgical scene in the latter part of the 20th century, but has also provided a well-considered philosophy for medical care.

My Life in Public Health

In the time of Covid, some of the superheroes of the health sector are the public health physicians. This book outlines the active and varied personal and professional life of one New Zealand public health physician.

Mind That Child; A Medical Memoir

This a book that recounts the experience of the Auckland Starship’s paediatrician Dr Simon Rowley over his professional lifetime.

Fat Off; the Right Way A clever and sustainable eating guide for weight loss and healthy living

Paul Anderson is a New Zealander who trained in general surgery and works part-time in Australia and part-time in New Zealand.

The Art of Recovery: six personal journeys

As an editor you receive books for review, which are sent to suitable people following an email agreement to review.