The principal scientific journal for the profession in New Zealand

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).

Jan Kubovy, Murray L Barclay

Helicobacter pylori in New Zealand: current diagnostic trends and related costs

Helicobacter pylori (Hp) related chronic gastritis is a common infection with varied prevalence rates throughout the world.

Rachael L Parke, Alana Cavadino, Shay P McGuinness

Transfusion practice in patients undergoing cardiac surgery in New Zealand—impact of the TRICS III study (the TRICS TRIPS study)

Cardiac surgery is the largest perioperative user of donated blood products accounting for 14–20% of total blood product consumption and consuming 50% of all red blood cell (RBC) transfusions given to surgical patients.

Nicole Cant, Mary Buchanan, Anitra C. Carr, Joseph M Boden

Cannabis use and patterns of psychotic symptomatology in a longitudinal birth cohort

Cannabis is a drug used widely for “recreational” purposes, with over 75% of New Zealanders have reported using cannabis at least once by age 25, and with 12.5% showing use consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for dependence.

Bailey Yee, Eleanor Barrett, Mona Jeffreys, Anne Haase, Caz Hales

Improving health services for patients with extreme obesity requiring bariatric level care at Wellington Regional Hospital: a clinical audit

Bariatric service delivery refers to the care received by those with additional needs due to extreme obesity; this includes appropriate spatial facility design, equipment uses, and collection of information needed to inform high quality services. It does not explicitly relate to specialist care for weight loss management (i.e., bariatric surgery).

Andreas Nicolaou, Amy Moore, Ben Wamamili, Tony Walls, Philip Pattemore

E-cigarette use patterns, brand preference and knowledge about vaping among teenagers (13–16 years) and parents of children attending Christchurch Hospital

Currently in New Zealand, patients are asked about whether they smoke on admission to hospital, but information is lacking whether vaping is also asked. Understanding the e-cigarette use habits and knowledge of patients about vaping presenting to hospital can enable clinicians to provide relevant information to help patients make informed decisions.

Sita T Clark, Hilary R Barker, Luke R Bradshaw, Jyoti Kathuria, Charlotte Oyston

Audit of cervical excision depth of large loop excision of the transformation zone procedures at Counties Manukau District Health Board

Cervical cancer is the fourth most common malignancy in females worldwide, affecting 5.7 per 100,000 women in New Zealand, with higher rates in Māori compared to non-Māori (8.1 vs 4.4, per 100,000 women, respectively). Despite Australia and New Zealand both having some of the lowest rates of cervical cancer in the world,[[4]] cervical cancer remains an important and preventable cause of morbidity and mortality.

Matthew R Blakiston, Mark B Schultz, Indira Basu, Susan A Ballard, Deborah Williamson, Sally Roberts

Epidemiology of carbapenem resistant Acinetobacter baumannii in New Zealand

Acinetobacter baumannii is a gram-negative coccobacillus that has emerged as a multi-drug resistant (MDR) cause of hospital acquired infection in many locations worldwide. Infections primarily affect vulnerable patients in the intensive care setting and are associated with high crude mortality. The emergence of MDR A. baumannii has occurred in association with regional and international spread of hospital adapted clones.

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.

Janet Hoek, Andrew Waa, Richard Edwards

Does the smokefree generation proposal go far enough?

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.

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.

Frank Frizelle, Kiki Maoate

NZMJ: under new ownership

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.

Vol 135 No 1557: 1 July 2022

Time for Rangatiratanga

Jonathan Koea

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.

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.

Andi Crawford, Fiona Langridge

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

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.

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

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.

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.

Vol 135 No 1558: 15 July 2022

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

Robyn Whittaker, Penny Andrew, Rosie Dobson, Dale Bramley

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).

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.

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

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.

Julie Bennett, Caroline Shorter, Amanda Kvalsvig, Lucy Telfar Barnard, Nick Wilson, Julian Crane, Jeroen Douwes, Chris Cunningham, Phoebe Taptiklis, Robyn Phipps, Bill Trompetter, Manfred Plagmann, Mikael Boulic, Jennifer Summers, Terri-Ann Berry, Michael G Baker, Philippa Howden-Chapman

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.

Vol 135 No 1557: 1 July 2022

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

Gareth Rivalland, Rosalie Stephens, Michael McCrystal

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.

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