The principal scientific journal for the profession in New Zealand

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.

The New Zealand Illicit Drug Harms Index: how can it inform a health-based approach to drug use? | OPEN ACCESS

Psychoactive drugs are widely available in Aotearoa New Zealand, and their use has potential to cause harm; either to the person using the drug, or to others. Drug harm is multi-factorial, and forms a complex health, equity, and public health issue.

Vaccine mandates in the time of Omicron | OPEN ACCESS

There is often confusion about the term “vaccine mandate”. In the late 19th and early 20th centuries, vaccination of children against smallpox was compulsory in New Zealand, as in many other countries, but the mandate was not rigorously enforced.

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.

The 1985 O’Regan report and a history of Otago Medical School’s admissions processes for Māori students

Policies for selection and admission to Otago Medical School have changed considerably over the past 50 years and are the subject of ongoing debate. In 2020, there was media coverage of the University’s attempts to introduce a cap to the current affirmative pathway for Māori students.

Low but increasing rates of inflammatory bowel disease in Māori: a report from Lakes District Health Board IBD

Inflammatory bowel diseases (IBD) are chronic, inflammatory diseases comprising ulcerative colitis (UC) and Crohn’s disease (CD). New Zealand has one of the highest incidence rates of IBD worldwide, with an estimated 20,792 patients with IBD (1 in 227) increasing by 5.6% per year.

Measuring drug harm in New Zealand: a stocktake of current data sources

The harm resulting from a drug is complex, can be acute or chronic, and depends upon factors including pharmacological properties, purity, the population who use it, consumption patterns, context of use and administration practices, and policy/regulatory settings. Minimising this harm forms the current overarching goal for New Zealand drug policy; to minimise alcohol and other drug (AOD)-related harm and promote and protect health and wellbeing.

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.

In defence of mātauranga Māori: a response to the ‘seven academics’

On 28 July 2021, a group of academics from the University of Auckland published a letter in the Listener, a well-known, non-academic magazine. The letter writers expressed their moral outrage that the Government’s NCEA curriculum working group proposed that science would be taught to Māori students along with its colonising history.

Comprehensive healthcare system needed

Abiding by the principles of the Treaty of Waitangi could be life-saving. Care of the community is far more important than the rights of individuals.

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.