The principal scientific journal for the profession in New Zealand

Julie Bennett, Anneka Anderson, June Atkinson, Emma Best, John Malcolm, Gary McAuliffe, Rachel Webb, Jeffrey Cannon

Trends in penicillin dispensing during an acute rheumatic fever prevention programme

Acute rheumatic fever (ARF) is an inflammatory disease that can develop 2–4 weeks after group A streptococcal (GAS) infection and often progresses to permanent cardiac valve damage or rheumatic heart disease (RHD).

Makarena Dudley, Sharon Olsen, Cherry Reihana, Marcus King, Hohepa Spooner, Sarah Cullum, Alexander Merkin, Edgar Ramirez-Rodriguez, Bobby Nepia, Adrian Martinez Ruiz, Kahu Pou, Susan Yates

Te Ōranga Ō Te Roro: kaumātua perspectives on the development of a mobile app for mate wareware (dementia) awareness

Mate wareware, or dementia, is typically defined by cognitive decline that interferes with social or occupational functioning. In Aotearoa New Zealand, there are an estimated 70,000 people living with mate wareware, and this is predicted to increase to 170,000 by 2050.

Jennifer CH Cook, Abdullah AO Alhaidari, Blake W Jackson, Matthew P Ordish

Laxative-prescribing habits: a summative impact evaluation of a constipation programme implemented in two hospitals in New Zealand

Constipation among hospitalised adults is a common, burdensome and costly condition that is poorly studied. A universally accepted definition for constipation does not exist.

Katherine A Donovan, Ben Beaglehole, Christopher MA Frampton, Margaret Currie, Joseph M Boden, Jennifer Jordan

Tōku Oranga: the subjective wellbeing and psychological functioning of postgraduate and medical students in Ōtautahi Christchurch

University students have a higher prevalence of mental disorders than the general population. Within this population, postgraduate and medical students have a high prevalence of mental disorders and psychological distress with widespread personal, academic and professional repercussions.

Miriama K Wilson, Fiona Pienaar, Ruth Large, Matt Wright, Graham Howie, Siale Foliaki, Martin Mikaere, Rebecca Davis, Verity Todd

Analysis of skin condition emergency department outcomes via the free Healthline service from Whakarongorau Aotearoa

The aim of this research was to understand the utilisation of the Whakarongorau Aotearoa | New Zealand Telehealth Services’ free 24/7 Healthline service for skin conditions, with a specific interest in whether Māori and Pasifika were utilising the service and their subsequent call outcomes.

Tara Cleverley, Ineke Meredith, Dianne Sika-Paotonu, Jason Gurney

Cancer incidence, mortality and survival for Pacific Peoples in Aotearoa New Zealand

Pacific Peoples in Aotearoa New Zealand encompass over 16 culturally diverse and linguistically distinct ethnic groups,[[1]] and comprise 8% of the population in Aotearoa New Zealand. There is some evidence that Pacific Peoples experience excess cancer incidence and mortality, as well as poorer survival for several cancers, when compared to other ethnic groups in Aotearoa New Zealand.

Rory Miller, Garry Nixon, Robin M Turner, Tim Stokes, Rawiri Keenan, Corina Grey, Yannan Jiang, Sue Wells, Wil Harrison, Andrew Kerr

Investigation and treatment after non-ST segment elevation acute coronary syndrome for patients presenting to rural or urban hospitals in Aotearoa New Zealand: ANZACS-QI 75

In Aotearoa New Zealand, patients with non ST-segment elevation acute coronary syndrome (NSTEACS) may present to one of three main groups of hospitals: urban hospitals i) with (interventional) or ii) without (non-interventional) routine access to percutaneous intervention (PCI), or iii) rural hospitals.

William Park, Patricia Whitfield, Brian Corley, Simon Harper, Joe Feltham, Richard Carroll

Increasing rates of referrals for investigation of primary aldosteronism at a tertiary centre

Primary aldosteronism (PA) is a pathology of autonomous secretion of aldosterone from one or both adrenal glands, classically associated with hypertension and hypokalemia. PA appears to carry a greater burden of cardiovascular disease than essential hypertension and is independently associated with end organ damage, including cardiovascular disease, stroke, left ventricular hypertrophy, microalbuminuria and atrial fibrillation.

Lucy Wong, Agnes Wong, Lynne Maher, Bridget Farrant, Kate Palmer-Neels, Fofoa Pio, Philippa Anderson, Belinda Paku

Co-design of youth appropriate services for young people with rheumatic fever/rheumatic heart disease in Counties Manukau District

The incidence of rheumatic fever in Aotearoa New Zealand is much higher than in comparable countries and regions such as North America and the United Kingdom. Within Aotearoa New Zealand, the incidence varies greatly by geographic region and ethnicity.

Barbara M Daly, Bruce Arroll, Robert K Scragg

Trends in the primary healthcare nursing workforce in managing diabetes from two sample surveys in 2006–2008 and 2016 in Auckland, New Zealand

The changing role of the primary care nurse has been largely driven by increasing numbers of people with chronic care conditions and escalating costs of secondary healthcare.

Rachel Webb, Miriam Wheeler, Briar Peat, Mayanna Lund, Christopher Luey, Simon Briggs, Mary-Anne Ross, Belinda Paku, Philippa Anderson, Nevin Zhong, Danny de Lore, Joshua Agnew, Teuila Percival, Nigel Wilson

Aotearoa New Zealand clinicians respond to the 2022 American Heart Association Presidential Advisory Statement regarding penicillin reactions in people with severe rheumatic heart disease

In 2022, the American Heart Association (AHA) published a Presidential Advisory Statement highlighting sudden cardiac deaths in 10 individuals with severe symptomatic rheumatic heart disease (RHD), shortly after they received intramuscular benzathine penicillin G (BPG).

What might we expect as health policy with the new government?

This editorial outlines what I think is likely to be the health policy of the incoming government. This opinion is based on the pre-election policy statements of the parties that are likely to make up the new government under our mixed-member proportional representation (MMP) system.

Vol 136 No 1584: 20 October

Mental health and paid parental leave—what does the evidence say?

Kate Eggleston, Katie Douglas, Katherine Donovan, Matthew Tennant, Roger Mulder

Becoming a parent is a major life event and, while the birth of a baby is exciting, the postpartum period can be an intensely stressful time for parents.

Julia J Rucklidge, Roger T Mulder

The imperative to tax ultra-processed food if political parties are serious about improving mental health in future generations

There are good health reasons for making fruits and vegetables more affordable through removing GST. Fruit and vegetables are central to diets identified as being essential for optimising brain health, including protection from developing depression and anxiety as well as reducing the incidence of behavioural problems in children.

Vol 136 No 1582: 15 September 2023

State of general practice in New Zealand

Bryan Betty, Les Toop, Jo Scott-Jones

If general practice fails then the health system fails.

Vol 136 No 1582: 15 September 2023

Artificial intelligence in medicine: Promethean moment or Pandora’s box?

Tim Eglinton, Isaac Tranter-Entwistle, Saxon Connor

Does the transformative power of AI hold out hope for the future of healthcare, or have we opened a Pandora’s box that will create more problems for the system than it solves?

Vol 136 No 1581: 25 August 2023

The rise (and possible fall) of ketamine treatment in New Zealand

Ben Beaglehole, James Foulds, Roger Mulder

In this editorial we outline the current status of ketamine in the treatment of mental illness in New Zealand and how we see it is evolving.

Emergency department crowding is not being caused by increased inappropriate presentations

The pervasive narrative about health system pressures in Aotearoa New Zealand has been that acute demand for hospital services is too high and increasing—especially for minor conditions—driven by lack of knowledge or access to alternative care in the community, and by costs of care, reflected in presentations to the emergency department (ED).

Gerry Devlin, Collin Tukuitonga, Corina Grey, Mark Richards, Anna Rolleston, Rob Doughty, Malcolm Legget, Jim Mann

Call to action—the urgent need for a heart health plan in New Zealand

Cardiovascular disease is responsible for a third of all deaths and is the leading cause of health loss in Aotearoa New Zealand. The current health system reform presents a once in a generation opportunity to address how our health system works for all.

Vol 136 No 1584: 20 October

Planning and executing a national point prevalence study: a blueprint for the future

Sally A Roberts, Ruth Barratt, Arthur J Morris, Nikki Grae

At any one time in New Zealand district hospitals, 6.6% of adult patients, or one in every 15 patients, has a healthcare-associated infection (HAI).

Samarina MA Musaad, Vanessa Buchan, Geoff Herd, on behalf of the NZ POCT AG

Connectivity for point-of-care testing results: a call for change

Connectivity for point-of-care testing (POCT) results helps ensure that clinicians have access to complete and accurate diagnostic information for decision making. It is the capability of a POCT device to link electronically with the laboratory, hospital information systems and patients’ permanent electronic medical record or general practice patient management systems.

Michael G Baker, Amanda Kvalsvig, Michael J Plank, Jemma L Geoghegan, Teresa Wall, Collin Tukuitonga, Jennifer Summers, Julie Bennett, John Kerr, Nikki Turner, Sally Roberts, Kelvin Ward, Bryan Betty, Q Sue Huang, Nigel French, Nick Wilson

Continued mitigation needed to minimise the high health burden from COVID-19 in Aotearoa New Zealand

This viewpoint article reviews the past, current and potential continuing health impact of COVID-19 in Aotearoa New Zealand.

Vol 136 No 1582: 15 September 2023

Low and intermediate risk aortic dissection detection risk score and negative D-dimer: a word of caution

Steve Waqanivavalagi

Acute aortic syndrome (AAS) comprises acute aortic dissection, intramural haematoma and penetrating aortic ulcer. Together with aortic rupture and aortic embolus, AAS remains a life-threatening vascular emergency for emergency department (ED) patients presenting with chest, back, or abdominal pain.

Vol 136 No 1581: 25 August 2023

Low risk of variant Creutzfeldt-Jakob disease transmission from blood transfusions in Aotearoa New Zealand suggests donor exclusion policies can be relaxed

David T S Hayman, Michael G Baker

On 23 February 2023, the Aotearoa New Zealand blood service urgently needed blood. This shortage came after the service estimated in 2022 that it required 40,000 more donors in 2023 to meet demand; yet, currently, New Zealand excludes potential donors who lived in the United Kingdom (UK) for 6 months or more (cumulative time) between 1980 and 1996 due to the potential for these people to be infected with variant Creutzfeldt-Jakob disease (vCJD).

Two approaches to enhancing patient care and job satisfaction in primary care

Marcus Hawkins

For too many years, perimenopausal women have suffered in the absence of treatment, most likely due to embarrassment or fear of discredited treatments. In addition, medicine is seeing increasing numbers of patients with co-morbidities related to insulin resistance (IR), which incidentally also includes perimenopause.

Shivani Fox-Lewis, Sharmini Muttaiyah, Sally Roberts

Increasing isolation of non-toxigenic Corynebacterium diphtheriae in Aotearoa New Zealand

Diphtheria is rare in Aotearoa New Zealand, largely due to successful vaccination (three primary series doses and two booster doses in the childhood immunisation schedule, and two adult booster doses).

Vol 136 No 1584: 20 October

Hapū with Omicron—the Wellington experience. Maternal and neonatal outcomes of pregnant people diagnosed with COVID-19

Judy Ormandy, Noor Al-Shamma, Sara K Filoche

International research demonstrated that pregnant people had more severe illness and pregnancy outcomes when infected with COVID-19. However, much of these data were obtained prior to the availability of vaccinations.

Physician associates as a potential win for the Aotearoa New Zealand healthcare workforce

Victoria Oberzil

As of July 2023, a proposal to regulate the physician associate (PA) profession under the Health Practitioners Competence Assurance Act (HPCAA) has been put forth by Manatū Hauora – Ministry of Health.

Vol 136 No 1576: 26 May 2023

An initial exploration into the benefits of a proactive post-COVID-19 health check | OPEN ACCESS

Fiona Pienaar, Ruth Large

While the sequelae of COVID infection has been given various names, in December 2022 the World Health Organization (WHO) defined the post-COVID-19 condition (commonly known as long COVID) as “the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation.”

Vol 136 No 1576: 26 May 2023

Emergency department point-of-care ultrasound in forearm fracture management

Andrew Russell Munro

Shaye Seefried et al., in their paper Paediatric forearm fractures manipulated in the emergency department: incidence and risk factors for re-manipulation under general anaesthesia, show a high rate of reduction failure in forearm fractures in children in the Starship Hospital Emergency Department (ED).

Vol 136 No 1574: 28 April 2023

Vaping in Aotearoa New Zealand teens remains problematic: stronger regulations and education warranted

Jonathan Cox, Ben Wamamili, Philip Pattemore

E-cigarette use (vaping) by Aotearoa New Zealand youth continues to trend upwards. Vapes are promoted in Aotearoa New Zealand as a less harmful source of nicotine for current smokers who have unsuccessfully attempted to quit. However, non-smokers face increased risks if they begin to vape.

Vol 135 No 1550: 25 February 2022

This pākehā life: an unsettled memoir

Kaaren Mathias

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.

Vol 134 No 1532: 26 March 2021

Perfection: The life and times of Sir William Manchester

Saxon Connor

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

Vol 133 No 1527: 18 December 2020

From Southland to Surgery: A Journey around Values

Richard Acland

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.

Vol 133 No 1521: 4 September 2020

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.

Vol 132 No 1489: 1 February 2019

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.

Vol 132 No 1488: 18 January 2019

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.

Vol 132 No 1488: 18 January 2019

The Art of Recovery: six personal journeys