The principal scientific journal for the profession in New Zealand

Himali Aickin, Katherine Bloomfield, Zhenqiang Wu, Martin J Connolly

Prevalence of frailty and frailty outcomes within the inpatient rehabilitation setting: use of routinely collected electronic health information

There are several approaches to measuring frailty, but most screening tools fit into one, or a combination, of two broad categories: the phenotypic frailty model and the cumulative deficit model.

Danting Wei, Jithendra B Somaratne, Mildred Lee, Andrew Kerr

Revascularisation and outcomes after acute coronary syndromes in patients with prior coronary artery bypass grafting—ANZACS-QI 67

In those with acute coronary syndromes (ACS) and previous coronary artery bypass grafts (CABG), invasive coronary angiography and percutaneous coronary intervention (PCI) are technically more challenging.

Belinda J Gabbe, Siobhan Isles, Paul McBride, Ian Civil

Disability-Adjusted Life Years and cost of health loss of hospitalised major trauma patients in New Zealand

Injury remains one of the top five contributors to disease burden, accounting for 252 million Disability-Adjusted Life Years (DALYs) and 10% of the global burden of disease in 2017.

Oriana Munevar Aquite, Michael Hayes, Kebede Beyene, Amy Hai Yan Chan, Cameron Schauer, Henry Wei, Jiayi Gong

Bleeding risk of oral anticoagulants in liver cirrhosis

Liver cirrhosis results from hepatic cell death, nodule formation and irreversible liver scarring.

Renata Bastos Gottgtroy, Patria Hume, Alice Theadom

Healthcare pathways for mild traumatic brain injury patients in New Zealand, determined from Accident Compensation Corporation data

Mild traumatic brain injuries (mTBI) affect 35,000 people every year in New Zealand.

Ruth Barratt, Grace Clendon, Barbara Gibson, Sally A Roberts

Sources of healthcare-associated Staphylococcus aureus bacteraemia in New Zealand acute hospitals

Staphylococcus aureus is a common human commensal of the skin and upper respiratory tract, and is an important opportunistic pathogen.

Andrew McLachlan, Andrew Kerr, Mildred Lee

A nurse-led and medically supported outpatient follow-up model following an acute coronary syndrome is as safe and effective as medical follow-up alone (ANZACS-QI 69)

Despite effective evidenced-based therapies, acute coronary syndrome (ACS) and its complications remains one of the leading causes of mortality, morbidity and healthcare expenditure worldwide.

Maria Nonis, Andrew McCombie, Christopher Wakeman, Dominic Fleischer, Laura Joyce

Trauma Team Activation: improved care of major trauma patients

Injury is the leading cause of death for New Zealanders under the age of 35 and is the second leading cause of hospitalisation.

Asha Shashikumar, Karaponi Okesene-Gafa, Te Hao Apaapa-Timu, Jessica Wilson, Charlotte Oyston

Teleclinics for the management of diabetes in pregnancy during COVID-19—maternal satisfaction and pregnancy outcomes | OPEN ACCESS

Diabetes in pregnancy (DiP) describes both gestational (GDM; glucose intolerance first recognised in pregnancy), or pre-existing (type I or II) diabetes.

Tess Patterson, Linda Hobbs, Gareth J Treharne, Melanie Beres

Seeking of help and support after experiencing sexual harm: considerations for cisgender women, cisgender men and gender-diverse people

There is a recognised gap, both within the research literature and clinical settings, regarding provision of specialised support and treatment for male and gender-diverse (including all gender identities outside the gender binary male/female) survivors of sexual harm (including any type of forced or coerced sexual contact, assault, harassment or behaviour that happens without consent).

Oliver Waddell, Jacqui Keenan, Frank Frizelle

Early-onset colorectal cancer: Never too young

Colorectal cancer (CRC) is the second most common cancer in Aotearoa New Zealand, second only behind prostate cancer in men and breast cancer in woman. It is the second highest cause of cancer death behind lung cancer, with approximately the same death rate as prostate and breast cancer combined.

Chris Wakeman, Rachael Lauchlan, Ros Pochin

Regional vs Metropolitan. Bigger is not always better

Trauma team activation is used throughout the world to gather the multi-disciplinary teams to meet trauma patients in emergency department (ED) trauma bays, with the aim of providing the best possible treatment for the unwell trauma patient. Trauma teams have been shown to reduce the time to resuscitation, time to computed tomography (CT), time to discharge from the ED and, most importantly, time to transfer to the operating theatre.

Vol 135 No 1561: 2 September 2022

Does the smokefree generation proposal go far enough?

Janet Hoek, Andrew Waa, Richard Edwards

The Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Bill currently progressing through Parliament will establish a smokefree generation (SFG) by ending the sale of smoked tobacco products to people born on or after 1 January 2009.

Vol 135 No 1561: 2 September 2022

The present healthcare crises and the delusion of looking for an answer to this in the restructuring of the health system

The New Zealand primary and secondary health sectors are struggling to provide an adequate service and meet demand.

Philip Bagshaw, Pauline Barnett, Susan Bagshaw

Unmet healthcare need and the significance of charity hospitals in Aotearoa New Zealand

The story of the Aotearoa New Zealand health system is one of early optimism, some success and then disappointment at the failure of the public sector to respond to the needs of the community.

Vol 135 No 1559: 5 August 2022

NZMJ: under new ownership

Frank Frizelle, Kiki Maoate

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

Vol 135 No 1558: 15 July 2022

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

Sally Casswell

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.

Identification of clinically relevant cohorts of people with heart failure from electronic health data in Aotearoa: potential, pitfalls and a plan | OPEN ACCESS

Heart failure (HF) is a complex clinical syndrome caused by underlying abnormalities of cardiac structure and/or function that reduces the ability of the heart to fill with blood and/or eject adequate blood volume to meet the needs of the body.

Amanda Luckman, Paul Clements, Thomas White, Angela Jury, Jennifer Lai, Mark Smith

Responding to the tāngata whai ora voice: an Aotearoa New Zealand quality improvement solution

To truly recognise and hear the voices of people who experience mental health challenges and substance use issues (tāngata whai ora – people seeking wellness) it is imperative to act on information about people’s service experiences.

Vol 135 No 1561: 2 September 2022

Pākehā/Palangi positionality: disentangling power and paralysis | OPEN ACCESS

Andi Crawford, Fiona Langridge

This paper explores our viewpoint based on experiences as Pākehā/Palangi health practitioners and researchers working in Māori and Pasifika communities. In reflecting on our practice, we noted there was limited literature that explored and critiqued Pākehā/Palangi perspectives in health and health research environments.

Matt Boyd, Michael G Baker, Cassidy Nelson, Nick Wilson

The 2021 Global Health Security (GHS) Index: Aotearoa New Zealand’s improving capacity to manage biological threats must now be consolidated

The Global Health Security (GHS) Index was first published in 2019 by the Nuclear Threat Initiative (NTI), Johns Hopkins Centre for Health Security, and the Economist Intelligence Unit. It is a comprehensive, criteria-based assessment of health security capabilities across 195 States Parties to the International Health Regulations. The metric encompasses six categories relevant to health security and biological threats: Prevent, Detect, Respond, Health, Norms, and Risk.

Chok G Chan, Ralph Stewart

The unexpected benefits of sodium glucose co-transporter 2 (SGLT2) Inhibitors

The sodium glucose co-transporter 2 (SGLT2) inhibitors were developed in the 1990s, over a century after an isolate from an apple tree bark was found to be glucosuric. The isolate, phlorizin, was found to inhibit active co-transport of sodium and glucose in the proximal kidney tubules and this was later modified to develop the first orally active SGLT2 inhibitor.

Vol 135 No 1559: 5 August 2022

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

Tracy Chan, Walter van der Merwe, Janak R de Zoysa

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.

Vol 135 No 1558: 15 July 2022

Did new treatments contribute to a decrease in melanoma deaths?

Kylie Mason, Liam Kelly, Christopher Jackson, Deborah Read, Barry Borman

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.

Elissa M McDonald, Rachel T Woodcock, Felix S F Ram

Azithromycin versus doxycycline: management of female urogenital and rectal Chlamydia trachomatis infections

Chlamydia trachomatis infection is the most common sexually transmitted infection (STI) internationally, with the greatest burden of disease in young sexually active adults, and it is associated with pelvic inflammatory disease, chronic pelvic pain, infertility and pregnancy complications.

Jeffrey Sebastian, Tina Thomas, Francis Wu, Su Yin Tang, Budresh Joshi, Niels van Pelt, Ruvin Gabriel, Tim Sutton, Mansi Turaga, Jen-Li Looi

Cardiac Computed Tomography to exclude left atrial appendage thrombus in atrial arrhythmias prior to electrical cardioversion during the COVID-19 pandemic

Our group had recently showed that an early rhythm control strategy, with either early inpatient transoesophageal echocardiogram (TOE)-guided direct current cardioversion (DCCV) or ablation in patients hospitalised with AF or AFL and decompensated heart failure with reduced ejection fraction, had a low rate of all-cause mortality and rehospitalisation for heart failure at one year.

Elaine Rush, Heather Came, Gayle Souter-Brown, Geoff Kira

Global food security, self-sufficiency and the cost of bread to Aotearoa

Agriculture is the main driver of food and nutrition security, yet few governments and trade agreements have cohesive policies that link national food guidelines based on evidence for prevention of disease and promotion of health and immunity to agricultural and economic policies.

Geraldine FH McLeod, Anna Fenton, Bryony Manning, Andrea Insch, Joseph M Boden

Just because you can…does not mean you should: an examination of efficacy and potential harms from non-prescribed supplements taken by members of the Christchurch Health and Development Study at age 40

The development and sale of non-prescribed dietary supplements is a growing industry. According to Euromonitor (2020) the value of global retail sales of non-prescribed supplements increased by 105% between 2007 and 2021. New Zealand’s market grew by 72% during the same period from NZ$194.8 million to NZ$335.5 million. Global demand for supplements such as vitamins C and D, minerals and herbal supplements increased as the COVID-19 pandemic has worsened despite, in most cases, no scientific evidence that their consumption can directly combat SARS CoV-2.

Karim M Mahawish, Muir Wallace

A quality improvement project to improve access to stroke clot retrieval from a regional stroke centre

Stroke clot retrieval (SCR) in patients with large vessel occlusion (LVO) is associated with significantly reduced disability at 90 days compared with intravenous thrombolysis alone.

Trends in the service provision and patient outcomes from 2013 to 2021 at a regional stroke centre

Karim M Mahawish

At the service level, admission to stroke units, routine assessment for dysphagia, interdisciplinary team work, higher ratios of nursing staff to patients and stroke unit accreditation are all associated with improved outcomes.

Vol 135 No 1559: 5 August 2022

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

Christopher Robert Giles Arthur, Renoh Chalakkal, Ben O’Keeffe

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

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

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.

Vol 132 No 1488: 18 January 2019

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