The principal scientific journal for the profession in New Zealand

Tristin L Kimpton, Kim Ward

Is not fasting before cardiac catheterisation better than fasting? A systematic integrative literature review

Historically, patients undergoing coronary angiography and angioplasty have been required to fast in preparation for this procedure. However, scholars have questioned the evidence base for this practice, with some centres changing guidelines to remove fasting altogether.

Krystina V Common, H Carl Hanger

A broken neck: outcomes from conservative management of C2 fractures in older adults

Cervical fractures can occur in patients of any age. However, in older adults the force required to cause these injuries may be much less than in younger patients.

Repeated laparoscopies for pelvic pain: doing the same thing over and expecting a different outcome?

Karen Joseph

Chronic pelvic pain (CPP) afflicts around one in four New Zealand women and is commonly attributed to endometriosis, despite around half of those women affected not having demonstrable lesions.

Bridget Wilson, Nicholas Jones, Tim Wood, Anita Jagroop-Dearing, Jan Kubovy, Michael G Baker

Clinical outcomes of campylobacteriosis: a case series analysis of hospitalisations associated with the Havelock North Campylobacter outbreak

In developed countries, Campylobacter remains the leading cause of culture-confirmed bacterial gastroenteritis, and although campylobacteriosis is a self-limiting illness for most, serious complications, including haemorrhagic colitis and bacteraemia, are known to occur.

Karen Hoare, Tracy McKee, Laura Broome, Rhys Vaughan-Jones, Rawiri Jansen, Nicolette Sheridan

An audit of nurses using standing order directives to administer medications to children at risk of contracting rheumatic fever

Using standing order directives could be considered as elementary nurse prescribing. This topic has been under the spotlight in New Zealand since 2016, when the country’s nursing regulatory body announced changes that allow registered nurses (RN) to prescribe from a formulary of subsidised medications.

Rosie Dobson, Robyn Whittaker, Helen Wihongi, Penny Andrew, Delwyn Armstrong, Karen Bartholomew, Andrew Sporle, Susan Wells

Patient perspectives on the use of health information

The digitalisation of health services around the world has made patient health information more accessible for secondary uses.

Janet L Pitman, Arthur J Morris, Stephen Grice, Jay T Walsh, Leyi Wang, Martin D Burke, Amanda Dixon-McIver

Validation of a molecular assay to detect SARS-CoV-2 in saliva | OPEN ACCESS

The aim of the study was to validate the UIUC RT-qPCR protocol for detecting SARS-CoV-2 in saliva in two independent New Zealand laboratories by comparing our results to those measured at the UIUC laboratory (USA).

David Tipene-Leach, Anna Adcock, Sally Abel, Derek Sherwood

The Choosing Wisely campaign and shared decision-making with Māori

Choosing Wisely's aims are to improve clinical outcomes by reducing low-value and inappropriate clinical interventions and to promote well-informed conversations about treatment options between patients and health professionals to improve decision-making.

Fang Shawn Foo, Mildred Lee, Katrina K Poppe, Corina Grey, Geoffrey C Clare, Martin K Stiles, David Heaven, Matthew Webber, Matire Harwood, Rod Jackson, Andrew J Kerr

Ethnic variation in the trends of new implantable cardioverter defibrillator implants in New Zealand 2005–2019 (ANZACS-QI 63)

Variation in implantable cardioverter defibrillator (ICD) implant rates by ethnic groups have been identified in the United States and the United Kingdom, with African American and South Asian patients being less likely to receive an ICD compared to White patients.

Riki Anderson, Mike Stitely, Robin Willink

Rates of Māori women receiving surgical treatment for urinary incontinence and pelvic organ prolapse in Southern District Health Board

Pelvic organ prolapse (POP) and urinary incontinence (UI) are common conditions that affect women of all ages. The aim of this study was to formally document the rate of access to these surgical procedures for Māori and non-Māori women in the area served by Southern District Health Board (SDHB).

Owen Sinclair (Te Rarawa), Jin Russell, Danny de Lore (Ngāti Tuwharetoa), Erik Andersen (Ngāti Raukawa), Teuila Percival, Siouxsie Wiles

The urgent need for an equitable COVID-19 paediatric vaccine roll-out to protect tamariki Māori | OPEN ACCESS

In this editorial, we argue for a vaccination programme for all New Zealand children to be rolled-out as soon as possible after regulatory approval, and that the design of the paediatric vaccine roll-out should be underpinned by equity to uphold the Crown’s obligations to Māori under Te Tiriti o Waitangi.

Michael G Baker, Amanda Kvalsvig, Sue Crengle, Matire Harwood, Collin Tukuitonga, Bryan Betty, John Bonning, Nick Wilson

The next phase in Aotearoa New Zealand’s COVID-19 response: a tight suppression strategy may be the best option | OPEN ACCESS

In this editorial, we consider the implications of the New Zealand Government’s shift away from a national COVID-19 elimination strategy. This is a critical stage in managing the pandemic.

Vol 134 No 1545: 12 November 2021

New Zealand’s staffed ICU bed capacity and COVID-19 surge capacity | OPEN ACCESS

Paul J Young, Alex Psirides, Stephen Streat

In 2020, COVID-19 case numbers in many countries required intensive care units (ICUs) to adapt to treat critically ill patients when demand for beds exceeded staffed capacity.

Jane Morgan, Teena Mathew, Sunita Azariah

Eliminating congenital syphilis from Aotearoa New Zealand

We all recognise the “aha” moment in the congenital syphilis case reported in this issue of the New Zealand Medical Journal, when “a subtle desquamating rash on the soles was noted and urgent treponemal serology requested,” which led to a successful clinical outcome for this whānau.

Vol 134 No 1543: 8 October 2021

Closing the gaps: health equity by 2040

Lyndon Keene, Sarah Dalton

Health inequities have existed in New Zealand since records began. They have been described as immoral because for many years governments have known what is needed to address them.

Vol 134 No 1543: 8 October 2021

COVID-19: what comes after elimination? | OPEN ACCESS

Des Gorman, Murray Horn

Although the delta variant of Covid emerged last year and was detected in our managed isolation and quarantine (MIQ) facilities five months ago, we were poorly prepared for and have struggled to control this current outbreak.

Vol 134 No 1542: 17 September 2021

The human and health costs of failure to implement pro-Tiriti and pro-equity health policies: let’s act as if we know this

Peter Crampton

After a twenty-year period of relative stability in the health system, we are entering a period of very considerable change. These changes are driven, in part, by a clearly stated desire on the part of government for fairer health outcomes for Māori.

Lynsey Sutton-Smith, Mark Weatherall, Elliot M Bell, Susanna Every-Palmer, Paul Skirrow

What are the long-term outcomes for New Zealand survivors of critical illness?

The COVID-19 pandemic has drawn considerable attention to the survival journey and recovery of patients post critical illness.

Jane Casey, Sandy Macleod

The assessment of competency and coercion in the End of Life Choice Act 2019

For doctors, the matter of medically assisted dying may raise many conflicts: the duty to preserve life yet the duty to relieve suffering, the duty to respect patient autonomy yet the duty to do no harm.

Sherly Parackal, Kirsten Coppell, Carlos Lam Yang, Trudy Sullivan, Rathan M Subramaniam

Hidden figures and misnomers: a case for disaggregated Asian health statistics in Aotearoa New Zealand to improve health outcomes | OPEN ACCESS

People of Asian ethnicity are the third largest ethnic group in New Zealand, and addressing their health is increasingly important.

Vol 134 No 1545: 12 November 2021

Testing for dihydropyrimidine dehydrogenase deficiency in New Zealand to improve the safe use of 5-fluorouracil and capecitabine in cancer patients

Nuala Helsby, Kathryn Burns, Michael Findlay, David Porter, Matthew Strother

Intravenous 5-fluorouracil (5-FU) and oral capecitabine (which forms 5-FU) are commonly used in New Zealand to treat a range of solid tumour types, particularly gastrointestinal and breast cancers. Routine use of these agents carries a risk of treatment-limiting toxicities, including diarrhoea, mucositis, myelosuppression, Hand-Foot syndrome and sometimes cardiotoxicity.

Paul McBride, Thoa Hoang, Richard Hamblin, Ying Li, Carl Shuker, Janice Wilson, Dale Bramley

Using REACH, a new modelling and forecasting tool, to understand the delay and backlog effects of COVID-19 on New Zealand’s health system | OPEN ACCESS

New Zealand’s 2020 response to the rise and spread of COVID-19 has rightly been widely praised. However, as in all countries, the unintended effects of measures to control the pandemic on the operation of our health system are potentially dramatic.

Jessica E Young, Janine Winters, Jeanne Snelling, Ben P White, Colin Gavaghan, Andrew Geddis, Richard Egan

The End of Life Choice Act: a proposed implementation and research agenda

The purpose of this article is to examine the critical challenges for implementing the End of Life Choice Act 2019 (henceforth the EoLC Act or the Act) in New Zealand and to identify key future research needs.

Fiona Pienaar, Matt Wright, Robin Cooper, Kristin Good, Andrew Slater

Whakarongorau Aotearoa: insight into the delivery of New Zealand’s national telehealth services

Whakarongorau Aotearoa/New Zealand Telehealth Services (Whakarongorau Aotearoa) responded to more than 1.2 million contacts during the 2020 calendar year (an increase of 41% on the previous year) and connected with more than 790,000 individual people across Aotearoa, approximately 1 in 6.5 New Zealanders.

Psychedelic and related medicines at the end of life

David B Menkes

The Assisted Dying Service reflects the implementation last month of the End of Life Choice Act (EoLCA) 2019 and marks a turning point for medical practice in New Zealand.

St John Ambulance has and will continue to treat and transport all patients throughout the COVID-19 outbreaks in New Zealand | OPEN ACCESS

Kris Gagliardi

In a recent article in the New Zealand Medical Journal by authors Nixon et al about rural doctors and COVID-19, there is an incorrect statement about St John Ambulance policy which, having now been reported elsewhere, has propagated confusion and misinformation.

Louise Reiche, Adrian Macquet, Anna Skinner, Sarah Fursdon

Reduced excision of benign skin lesions through tiered practitioner, general practitioner with a special interest in skin cancer and dermatologist clinical review within New Zealand integrated family healthcare

eiche, Adrian Macquet, Anna Skinner, Sarah Fursdon International best evidence study data state that accuracy in diagnosing skin cancers, invasive melanoma and atypical intra-epidermal melanocytic variants is higher for in-person dermatologist diagnosis compared to image-based evaluations and compared to other trained professionals.

Response to: COVID-19: what comes after elimination?

Arindam Basu

The authors of the editorial COVID-19: what comes after elimination? deserve congratulations for writing a well-articulated, thoughtful and perhaps one of best “think pieces” from a multi-disciplinary perspective on what may happen as the country moves away from a strict COVID-19 elimination strategy to a strategy reliant on “zero tolerance for COVID-19 deaths.”

Thomas Hills, Stephen Ritchie, Mark Thomas, Eamon Duffy

Non-pharmaceutical interventions targeting COVID-19 were associated with large reductions in community antibiotic dispensing but no increase in severe morbidity from severe common bacterial infections

New Zealand’s public health response to the pandemic resulted in the elimination of COVID-19 and large reductions in the circulation of many common respiratory viruses and some bacterial pathogens, such as S. pneumoniae. We recently reported a large reduction in community antibiotic dispensing in New Zealand.

Anti-vax inactivity

Tony Devenish

As a retired GP, I am sad to realise that I am embarrassed by the apparent inability of our professional bodies to respond to the anti-vax doctors in our midst.

Vol 134 No 1543: 8 October 2021

Pacific countries lead the way on sugary drinks taxes: lessons for New Zealand | OPEN ACCESS

Andrea Teng, Viliami Puloka, Louise Signal, Nick Wilson

New Zealand has one of the highest rates of obesity in the OECD, and the health burden of death and disability from obesity and being overweight has increased by 26% in a decade to become the second largest single cause of health loss after tobacco.

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

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

Vol 131 No 1477: 22 June 2018

The Older Traveller: A guide for the health professional