The principal scientific journal for the profession in New Zealand

Vol 136 No 1568: 20 January 2023

Public health interventions:
the elephant in the room of the health system crisis

Vol 136 No 1568: 20 January 2023

An investigation into the digitalisation of New Zealand general practice services during COVID-19 | OPEN ACCESS

On Saturday 21 March 2020, in response to the COVID-19 pandemic in New Zealand and restrictions announced by the New Zealand Government, the Royal New Zealand College of General Practitioners (RNZCGP) requested all GP medical centres in the country immediately adopt virtual triage for all patient contacts and aim to provide 70% of consultations by virtual means, commencing Monday 23 March 2020.

ARTICLE

Vol 136 No 1568: 20 January 2023

HIV in women in Aotearoa New Zealand: 25 years of surveillance data

Ashleigh de Gouw, Susan McAllister, Jane Bruning, Judith Mukakayange, Jerram Bateman, Patricia Priest

Aotearoa New Zealand is a low HIV prevalence country, with the epidemic largely concentrated in GBM. Women in low-prevalence countries are often perceived as being at low risk for HIV infection by both themselves and medical professionals, which results in less testing, late diagnosis and barriers to treatment and support services.

ARTICLE

Vol 136 No 1568: 20 January 2023

A national audit of performance standards for blood cultures in Aotearoa New Zealand: opportunities for improvement

Juliet Elvy, Michael Addidle, Hanna-Sofia Andersson, Vivian Black, Dragana Drinković, Julia Howard, Michael O’Connor, Susan Taylor, Arthur J Morris

Blood cultures (BC) are among the most important samples processed in the clinical microbiology laboratory. They remain the gold standard investigation for bloodstream infections, and an essential diagnostic tool for severe infections such as infective endocarditis, bone and joint infections and meningitis.

ARTICLE

Vol 136 No 1568: 20 January 2023

Time for another review: following implementation of a new service model for Auckland Sexual Health service there has been an increase in referrals, case complexity and clinical workload but regional inequities in access remain

Sunita Azariah

The Auckland Sexual Health Service (ASHS) is New Zealand’s largest sexual health service, and prior to the establishment of Te Whatu Ora – Health New Zealand it was contracted to provide primary- and secondary-level specialist sexual health care to three regional district health boards (DHBs): Auckland, Counties Manukau and Waitematā. Auckland has a large, culturally diverse population of around 1.7 million people, which is younger on average than the rest of New Zealand.

ARTICLE

Vol 136 No 1568: 20 January 2023

The impact of pain on function after spinal cord injury

Jae Hong Ryu, Hannah Joyce, Christin Coomarasamy, Jessica Ozumba, Victoriya Semikina, Suresh Subramanian

In New Zealand, the most recent figures for the mean annual incidence of traumatic spinal cord injuries (TSCI) over a 10-year period has been found to be 22 per million people. This has decreased from the previously estimated rate of 49 per million from 1998; however, it is difficult to gauge where this new estimate lies in the global context, given the wide variability of figures.

ARTICLE

Vol 136 No 1568: 20 January 2023

The economic cost of Indigenous child health inequities in Aotearoa New Zealand—an updated analysis for 2003–2014

Sarah-Jane Paine, Chao Li, Karen Wright, Ricci Harris, Belinda Loring, Papaarangi Reid

Health inequities by ethnicity are unjust, preventable and amenable to intervention. Indigenous peoples, where measured, are often the most marginalised. In Aotearoa New Zealand, Māori have a life expectancy 7.5 years fewer than non-Māori, and experience higher rates of unmet health need and disease-specific mortality rates.

ARTICLE

Vol 136 No 1568: 20 January 2023

Use of healthcare resources and family planning methods 12 months after birth in women of South Auckland: The Healthy Mums and Babies (HUMBA) randomised trial

Rennae S Taylor, Jessica Wilson, Minglan Li, Katherine Anne Tyrrell Culliney, Megan McCowan, Christopher McKinlay, Lesley M E McCowan, Karaponi Okesene-Gafa

More than 7,000 babies are birthed in the Te Whatu Ora CM Health district each year and the perinatal mortality is higher than elsewhere in New Zealand. In this community, postnatal access to and engagement with maternal and child health services is important to ensure the ongoing health and wellbeing of mothers and babies.

ARTICLE

Vol 135 No 1567: 16 December 2022

Mental health inequities for Māori youth: a population-level study of mental health service data | OPEN ACCESS

Reremoana Theodore, Nick Bowden, Jesse Kokaua, Troy Ruhe, Matt Hobbs, Sarah Hetrick, Lukas Marek, Jesse Wiki, Barry Milne, Hiran Thabrew, Joseph Boden

Rangatahi Māori—Māori youth—experience higher rates of mental health distress and addictions compared to young Pākehā—New Zealanders of European descent. There are growing numbers of rangatahi Māori who report depressive symptoms (28% in 2019 vs 14% in 2012). Māori are more likely to be hospitalised for intentional self-harm and more likely to use substances than non-Māori.

ARTICLE

Vol 135 No 1567: 16 December 2022

We still don’t count: the under-counting and under-representation of Māori in health and disability sector data | OPEN ACCESS

Ricci B Harris, Sarah-Jane Paine, June Atkinson, Bridget Robson, Paula T King, Jennifer Randle, Anja Mizdrak, Melissa McLeod

Longstanding and significant inequities exist between Māori and non-Māori across most health indicators including life expectancy, health determinants, health outcomes and healthcare.

ARTICLE

Vol 135 No 1567: 16 December 2022

Documented incontinence after stroke: a secondary analysis of a cohort study. Reducing Ethnic and Geographic Inequities to Optimise New Zealand Stroke Care (REGIONS Care)

E Jean C Hay-Smith, Stephanie G Thompson, Mark Weatherall, Annamarei Ranta

Urinary incontinence after stroke may be caused by the direct effects of the cerebral lesion on neurological bladder control physiology, but may also be caused by motor (mobility and dexterity), cognitive (apraxia and agnosia), visual, and language effects of the stroke that adversely affect toileting.

EDITORIAL

Vol 136 No 1568: 20 January 2023

Public health interventions: the elephant in the room of the health system crisis

Caroline Shaw, Christine Cleghorn

This increased demand for healthcare is being managed by a workforce experiencing illness itself, causing high levels of shortages. Long-standing health workforce shortages have been amplified by COVID-19, and burnout, exhaustion and distress amongst clinical staff are endemic and acute.

EDITORIAL

Vol 135 No 1567: 16 December 2022

Whakairo: carving a values-led approach to understand and respond to the mental health and substance use of the New Zealand population

Helen Lockett, Cameron Lacey, Angela Jury, Talya Postelnik, Amanda Luckman, Richie Poulton

We (the authors) are proposing an innovative approach to defining what good epidemiological data is in the Aotearoa New Zealand context; how to collect it, and most importantly how it can be used to design and offer supports and services that respond to peoples’ needs.

EDITORIAL

Vol 135 No 1566: 2 December 2022

Doctor owned investigation and treatment facilities: a conflict of interest or a pragmatic way forward?

Peter Robertson

The New Zealand health system is implementing a significant reform agenda amidst continued pressure related to the COVID-19 pandemic. A feature of the response, as the system continues to work through the reform agenda, has been the use of capacity and capability across both public and private components of the sector.

EDITORIAL

Vol 135 No 1565: 11 November 2022

The long road to good care

Jason K Gurney

This travel issue impacts our Indigenous Māori population to a much greater extent than it impacts our non-Māori population. Around 25% of Māori live in rural areas, compared to 20% of NZ Europeans, 7% Pasifika and 5% Asian—and nearly a third (32%) of those who live in the most remote areas of Aotearoa are Māori.

EDITORIAL

Vol 135 No 1564: 28 October 2022

Suicide amongst doctors

Roger Mulder, Frank Frizelle

Burnout has been documented to affect 45% in a consultant survey in one New Zealand hospital prior to the COVID-19 pandemic, and this is likely to have increased with the present frustrating work environment.

EDITORIAL

Vol 135 No 1563: 7 October 2022

Early-onset colorectal cancer: Never too young

Oliver Waddell, Jacqui Keenan, Frank Frizelle

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.

EDITORIAL

Vol 135 No 1562: 23 September 2022

Regional vs Metropolitan. Bigger is not always better

Chris Wakeman, Rachael Lauchlan, Ros Pochin

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.

VIEWPOINT

Vol 136 No 1568: 20 January 2023

Sleep-in to stay well: addressing school start times for the health and wellbeing of teens in Aotearoa

Charmaine Barber, Sarah Hetrick, Liza Edmonds, Rachael W Taylor, Mohamed Alansari, Leigh Signal, Jillian Haszard, Jacinta Oldehaver, Barbara Galland and members of the School Start Time Study Advisory Group

We need to talk about sleep and adolescent health in Aotearoa (New Zealand). Sleep is essential for survival as well as being vital for children’s health, wellbeing and development. It is well known that insufficient and poor-quality sleep is endemic in adolescents, to the detriment of their health and wellbeing, yet we have failed to prioritise the issue.

VIEWPOINT

Vol 135 No 1567: 16 December 2022

The past, present and future of liver cancer control for Māori

Sydney Clough, Tara Cleverley, Clarence Kerrison, Matire Harwood, Jonathan Koea, Jason K Gurney

Liver cancer is one of the top 10 most common cancers among New Zealand’s Indigenous Māori population, and one of the top 5 most common causes of Māori cancer death.

VIEWPOINT

Vol 135 No 1566: 2 December 2022

Beyond muddy waters: Three Waters reforms required to future-proof water service delivery and protect public health in Aotearoa New Zealand

Tim Chambers, Professor Nick Wilson, Professor Simon Hales, Marnie Prickett, Edward Ellison, Professor Michael G Baker

In 2016, drinking water contaminated with animal faeces made much of an entire town sick (~8,000 people), with 58 hospitalisations and four deaths, costing an estimated NZ$21million. The outbreak was an outcome of systemic flaws in Aotearoa New Zealand’s regulatory system for drinking water, which were highlighted in the ensuing Government Inquiry.

VIEWPOINT

Vol 135 No 1565: 11 November 2022

Understanding disparities in post-operative mortality for Indigenous patients

Jason K Gurney, Melissa McLeod, Courtney Thomas, Doug Campbell, Elizabeth Dennett, Sarah Jackson, Dick Ongley, Juliet Rumball-Smith, James Stanley, Diana Sarfati, Jonathan Koea

In 2014, a Lancet commission was launched to investigate the state of global surgery. Stating that “surgery is an indivisible, indispensable part of health care”, the Commission re-confirmed the importance of safe, affordable and equitable surgical care for all, and highlighted the rights of under-served populations not currently being met.

VIEWPOINT

Vol 135 No 1564: 28 October 2022

Radiology and Te Whatu Ora – Health New Zealand in 2022. Why we should all care

Anthony James Doyle

Demand for radiology in the public system continues to increase and, in recent years, has exceeded both population growth and the ability of the existing services to cope with that demand.

VIEWPOINT

Vol 135 No 1563: 7 October 2022

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

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

BOOK 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

Frank Frizelle

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

The principal scientific journal for the profession in New Zealand

Vol 136 No 1568: 20 January 2023

The economic cost of Indigenous child health inequities in Aotearoa New Zealand—an updated analysis for 2003–2014

Public health interventions: the elephant in the room of the health system crisis

An investigation into the digitalisation of New Zealand general practice services during COVID-19 | OPEN ACCESS

Sleep-in to stay well: addressing school start times for the health and wellbeing of teens in Aotearoa

An investigation into the digitalisation of New Zealand general practice services during COVID-19 | OPEN ACCESS

HIV in women in Aotearoa New Zealand: 25 years of surveillance data

A national audit of performance standards for blood cultures in Aotearoa New Zealand: opportunities for improvement

Time for another review: following implementation of a new service model for Auckland Sexual Health service there has been an increase in referrals, case complexity and clinical workload but regional inequities in access remain

The impact of pain on function after spinal cord injury

The economic cost of Indigenous child health inequities in Aotearoa New Zealand—an updated analysis for 2003–2014

Use of healthcare resources and family planning methods 12 months after birth in women of South Auckland: The Healthy Mums and Babies (HUMBA) randomised trial

Mental health inequities for Māori youth: a population-level study of mental health service data | OPEN ACCESS

We still don’t count: the under-counting and under-representation of Māori in health and disability sector data | OPEN ACCESS

Documented incontinence after stroke: a secondary analysis of a cohort study. Reducing Ethnic and Geographic Inequities to Optimise New Zealand Stroke Care (REGIONS Care)

Public health interventions: the elephant in the room of the health system crisis

Whakairo: carving a values-led approach to understand and respond to the mental health and substance use of the New Zealand population

Doctor owned investigation and treatment facilities: a conflict of interest or a pragmatic way forward?

The long road to good care

Suicide amongst doctors

Early-onset colorectal cancer: Never too young

Regional vs Metropolitan. Bigger is not always better

Sleep-in to stay well: addressing school start times for the health and wellbeing of teens in Aotearoa

The past, present and future of liver cancer control for Māori

Beyond muddy waters: Three Waters reforms required to future-proof water service delivery and protect public health in Aotearoa New Zealand

Understanding disparities in post-operative mortality for Indigenous patients

Radiology and Te Whatu Ora – Health New Zealand in 2022. Why we should all care

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

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

Reply to Iupati et al: paediatric palliative care

Iodine-only supplements for breastfeeding women: a call to action in New Zealand

Aotearoa New Zealand must learn how to vaccinate children most at risk of vaccine preventable diseases first

Medical students and informed consent—response to “Consent for Teaching”

Novel use of technology

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

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

This pākehā life: an unsettled memoir

Perfection: The life and times of Sir William Manchester

From Southland to Surgery: A Journey around Values

My Life in Public Health

Mind That Child; A Medical Memoir

The Art of Recovery: six personal journeys

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

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