The principal scientific journal for the profession in New Zealand

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).

Katherine Bloomfield, Zhenqiang Wu, Lai Chan, Janak R de Zoysa

Frailty prevalence in Aotearoa New Zealand haemodialysis patients and its association with hospitalisations

Frailty is a syndrome of reduced physiological reserve that increases the risk of adverse health outcomes, such as hospitalisation, increasing dependency, residential care placement and death.

Erika M Stark, Spencer W Beasley, Alison Campbell

How electronically available referral guidelines for primary medical practitioners can improve the timeliness of orchidopexy

When UDT is suspected or confirmed, affected children should be referred to a paediatric surgeon for orchidopexy. Recent studies suggest that orchidopexy by one year provides the best chance of preserving fertility and reducing later development of malignancy.

Stephen Mark, Judith Clarke, Brett Shand, Jeremy Millar, Nathan Papa

Setting up the Prostate Cancer Outcomes Registry of New Zealand: reflecting and influencing clinical practice

In New Zealand, prostate cancer is the most common cancer in men, with over 3,500 registrations and more than 600 deaths each year.

Matthew McCall, Mike Peebles, N Amir Sandiford

Cancellation of elective orthopaedic procedures is not a benign practice and is often preventable

Osteoarthritis is the commonest form of arthritis. It causes debilitating pain, impairment of function, significant physical disability and consequences to mental health.

Molly Hartley, Angela Curl, Rose Crossin, Christina McKerchar

Access to primary care services using public transport in Ōtautahi Christchurch

In Aotearoa, there is long-standing evidence of enduring health inequities related to socioeconomic status and ethnicity. Access to healthcare is a social determinant of heath, and differences in the availability and attendance at healthcare appointments contribute to inequitable health outcomes.

Emma Espiner, Sarah-Jane Paine, Maree Weston, Elana Curtis

Barriers and facilitators for Māori in accessing hospital services in Aotearoa New Zealand

Māori health inequities result from systematic failures in the provision of healthcare by the public health system and historical structural failures that have led to the inequitable distribution of the social determinants of wellbeing for Māori compared to non-Māori.

Jenna Beaumont, Mirsaed Miri Nargesi, Susan Smith, David Harte, Erasmus Smit, James Ussher, Gary McAuliffe

Sensitivity and potential utility of SARS-CoV-2 rapid antigen and nucleic acid amplification tests in the context of an elimination approach | OPEN ACCESS

Typically, high-volume NAAT testing is performed in batches and results may take several hours. However, a rapid turnaround time of a test, from arrival in the laboratory to provision of results, is critical to the success of public health interventions, as well as for individual patient management.

Geraldine Wilson, Zoe Windner, Susan Bidwell, Anthony Dowell, Les Toop, Ruth Savage, Ben Hudson

Navigating the health system during COVID-19: primary care perspectives on delayed patient care | OPEN ACCESS

In response to level 4 “lockdown” from 25 March 2020, all areas of the health sector made changes to prepare for a potential influx of unwell COVID-19 patients, as had been seen overseas.

Vol 134 No 1545: 12 November 2021

Quality of life after oesophageal stenting in patients with palliative oesophageal cancer

Cameron Schauer, Anurag Sekra, Ibrahim Hassan, Yi-Ting Wu, Michael TM Wang, Henry Wei, David McGouran, Ming Han Lim, Dinesh Lal, Ravinder Ogra

Oesophageal carcinoma remains a leading cause of cancer death worldwide, with over 500,000 cases diagnosed in 2018.

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.

Lyndon Keene, Sarah Dalton

Closing the gaps: health equity by 2040

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.

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.

Vol 134 No 1542: 17 September 2021

Iti noa ana he pito mata / from the withered tree a flower blooms: healthy equitable climate policy in Aotearoa New Zealand

Caroline Shaw, Annette Bolton, Alex Macmillan, Rhys Jones

It’s hard to say anything about climate breakdown in 2021 that nature isn’t already saying through unprecedented heat waves, bush fires and flooding.

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.

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.

Sharon J Gardiner, Eamon J Duffy, Stephen T Chambers, Mark G Thomas, Michael Addidle, Brendan Arnold, Bruce Arroll, Michelle ND Balm, Carolina Batlle Perales, Sarah Berger, Emma Best, Bryan Betty, Mark Birch, Timothy K Blackmore, Max Bloomfield, Simon Briggs, Olivia Bupha-Intr, Andrew Burns, Chloë Campbell, Paul KL Chin, Simon C Dalton, Nicola Davies, Nicholas M Douglas, Tanya du Plessis, Juliet Elvy, Richard Everts, Jared Green, Kate Grimwade, Rupert Handy, Mariam G Hardie, Emma Henderson, David J Holland, Julia Howard, Ben Hudson, Paul Huggan, Heather Isenman, Mohammed Issa, Matthew J Kelly, Cat Li, Anecita G Lim, Joyce Lim, Michael Maze, Sarah CL Metcalf, Cate McCall, David Murdoch, Grant McRae, Mitzi Nisbet, Alan Pithie, Nigel Raymond, Kerry Read, Dalilah Restrepo, Stephen Ritchie, Ben Robertson, James E Ussher, Lesley Voss, Tony Walls, Haur Sen Yew

Antimicrobial stewardship in human healthcare in Aotearoa New Zealand: urgent call for national leadership and co-ordinated efforts to preserve antimicrobial effectiveness | OPEN ACCESS

Antimicrobial resistance (AMR) is an immense threat to human health. Within 30 years, the global number of deaths from AMR-associated infections is predicted to increase from ~700,000 to ~10 million people annually, if we do not act now.

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.

Prevention is better than a cure: we can do better in skin cancer control in New Zealand!

Bronwen M McNoe

Every day more than 250 New Zealanders are told that they have a skin cancer, and each week about ten die as a result. Urgent societal efforts are needed to curb this epidemic of the most prevalent cancer in Aotearoa New Zealand.

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.

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.

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.

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.”

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.

Andrea Teng, Viliami Puloka, Louise Signal, Nick Wilson

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

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.

Beth Messenger, Amy Beliveau, Mike Clark, Caroline Fyfe, Alison Green

How has long-acting reversible contraceptive provision at Family Planning clinics in Aotearoa New Zealand changed since PHARMAC funded intra-uterine systems for contraception?

Here we report de-identified administrative data about the type of long-acting reversible contraceptive (LARC) start provided to Family Planning clients for three months (November–January) across four time-periods from November 2017 to January 2021.

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

As an editor you receive books for review, which are sent to suitable people following an email agreement to review.

Vol 131 No 1477: 22 June 2018

The Older Traveller: A guide for the health professional