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Issue

Vol 136 No 1577: 16 June 2023

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Issue Summary

Article
SUMMARY

Inequities in the physical activity of disabled young people in Aotearoa New Zealand: a stakeholder SWOT analysis of the physical activity sector | OPEN ACCESS

Oliver WA Wilson, Justin Richards, Melody Smith, Robert C Townsend

Inequities contribute to persistent disparities in the physical activity participation of disabled young people in Aotearoa New Zealand. The genuine investment of Sport NZ Ihi Aotearoa and the establishment of Whaikaha – Ministry for Disabled People were perceived as strengths. Awareness of physical opportunities among disabled young people was identified as a weakness. Greater cohesion/coordination among physical activity providers was viewed as an opportunity. Overlap/competition among physical activity providers could pose a threat.

Article
SUMMARY

Attitudes towards the mixing of COVID-19 vaccinated and unvaccinated patients in multi-bed hospital rooms | OPEN ACCESS

Sylvi Low, Sonya Aum, Luke Nie, Jacob Ward, Khanh Nguyen, Leilani Pereira, Jenny Mi, Jocelyn Soti, Ben Harford, Robert J Hancox, John D Dockerty

At the height of the attempts to contain the COVID-19 pandemic in 2022, most public places required people to have been vaccinated against COVID-19 before they could enter. This did not apply to hospitals where patients could spend days sharing rooms with other patients without knowing their vaccination status. We asked staff and patients in Dunedin Public Hospital about their views on this: most patients and staff would prefer to keep vaccinated and unvaccinated in separate rooms, but recognised that there are practical and ethical difficulties in doing this. There was a range of views about the actual risks involved in mixing vaccinated and unvaccinated patients and vaccine mandates have now been withdrawn, but these issues should be considered in the planning for future outbreaks and pandemics.

Article
SUMMARY

How well do we support whānau with postpartum contraception? Comparison of two Auckland maternity hospitals

Jordon Wimsett, Lynn Sadler, Charlotte Oyston, Emelia Legget, Sue Tutty, Helen Roberts

The provision of postpartum contraception is an important part of reproductive health. Best practice is to discuss contraceptive options both during and after pregnancy. We found only small numbers of people recalled these conversations and less than half left hospital with a reliable method of contraception. We found differences in the contraceptive services between two large tertiary maternity services which suggests an opportunity for quality improvement around contraception provision.

Article
SUMMARY

Investigating the distribution of primary and secondary care referrals for public-funded bariatric surgery at Counties Manukau Health (CMH)

Kate Bradley, Sarah Cowan, Richard Babor, Jon Morrow, Andrew MacCormack, Jamie-Lee Rahiri, Rinki Murphy

This paper explores the patterns in referrals for public bariatric surgery in Counties Manakau DHB. Current evidence demonstrates that Māori and Pasifika are less likely to be referred and less likely to proceed to surgery. The inequity in bariatric surgery needs to be explored further and this paper is one step in this process.

Viewpoint
SUMMARY

What is affirmative action in tertiary education? An overview of affirmative action policies in health professional programmes, drawing on experience from Aotearoa and overseas

Sophia Barham, Jo Baxter, Peter Crampton

Both the universities of Auckland and Otago have had affirmative selection policies for entry into health professional programmes for a number of decades. These policies have been created and strengthened as a result of the leadership and advocacy of Māori leaders, academics and communities. The aims of this paper are to: 1) define affirmative action and outline the rationale for affirmative policies, 2) give examples of how affirmative action policies have been implemented in Aotearoa, and 3) give examples of legal challenges to affirmative action drawing on international experience.

Clinical Correspondence
SUMMARY

End-stage hiatal hernia with cardiac complications

John Ahn, Gary Lau

Extreme herniation of the stomach into the chest cavity can have life threatening complications on rare occasions.

Research Letter
SUMMARY

Paternal depression among fathers in the Christchurch Health and Development Study

Louise Rippin, Geraldine McLeod, Jacki Henderson, Joseph Boden

Paternal depression is a growing global health concern, as the mental health of fathers impacts the developing child and their family. Data for this study were collected by the University of Otago’s Christchurch Health and Development Study. This study has tracked the health and psychosocial development of 635 boys born in Christchurch in 1977 to age 40. These cohort members were assessed on symptoms of major depression within 1 year of becoming a first-time father; finding 9/168 (5.4%) were classified as having major depression during that time-period. All major depression cases were among fathers younger than 30 years. Doctors and health professionals should consider assessing both new mothers and fathers for depressive symptomology.

Research Letter
SUMMARY

How far are we with Indigenising psychology training curriculum in Aotearoa New Zealand?

Waikaremoana Waitoki, Kyle Tan, Logan Hamley, Damian Scarf, Ottilie Stolte, Joanna Chan

Our study assessed the professional programme psychology courses that are required to be completed at a satisfactory level prior to registration as a psychologist with the New Zealand Psychologists Board. The descriptors and learning outcomes of each course were carefully analysed to identify whether they adequately covered Māori content. Only four (2.9%) courses were specifically Māori-focussed and one-third (36.0%) included Māori-focussed content. Our findings raise questions regarding the existence of genuine institutional will to decolonise psychology and bolster the responsiveness of psychology for Māori. There is little evidence of meaningful integration of Māori psychology. Our research team, Working to End Racial Oppression (WERO), is conducting further research to identify barriers to Māori participation in psychology.

Article
SUMMARY

Pacific patients’ reasons for attending the emergency department of Counties Manukau for non-urgent conditions

Catherine J Yang, Vanessa Selak, David Schaaf, Vili Nosa

A lot of money and time is being spent on educating people to stay out of Emergency Department unless it is a life threatening emergency. This is especially true for Pacific people, who appear to use Emergency Departments more than other ethnicities. In 2019, a survey was done of people who came to the Emergency Department at Counties Manukau Health with a medical condition that was considered by the Emergency Department nurse to be non-urgent, on why they had come to the Emergency Department. The most common reason for coming to the Emergency Department for Pacific people (as well as for other ethnicities) were that they were told to do so by a health professional, including their GPs. This is contrary to the belief that people are using Emergency Departments because they don’t know that they should see their GPs, and further studies should be done to make sure that programmes to discourage people from using Emergency Departments do not have unintended consequences.

Editorial
SUMMARY

Medical privilege in the law of evidence in Aotearoa New Zealand

Ruth Campbell

Te Aka Matua o te Ture | Law Commission is carrying out its third, and final, review of the Evidence Act 2006, which governs the admission and use of evidence in legal proceedings. One of the issues being explored in the review is the circumstances in which information obtained by a medical practitioner or clinical psychologist can be admitted and heard in court, and the Law Commission wants to hear from interested parties on whether the law should be change. The Issues Paper for the project sets out a more detailed analysis of the issues and options for reform, and is open for consultation until 30 June.

ALL ARTICLES
SUMMARY
Editorial
Vol 136 No 1577: 16 June 2023

Medical privilege in the law of evidence in Aotearoa New Zealand

Ruth Campbell

When can information obtained in the course of medical examination or treatment be admitted and used in criminal proceedings? How is the law working in practice? Is reform necessary or desirable?

Article
Vol 136 No 1577: 16 June 2023

Inequities in the physical activity of disabled young people in Aotearoa New Zealand: a stakeholder SWOT analysis of the physical activity sector | OPEN ACCESS

Oliver WA Wilson, Justin Richards, Melody Smith, Robert C Townsend

The 2022 Aotearoa New Zealand physical activity (PA) report card for children and youth (i.e., young people [YP]) highlights a range of disparities in PA participation between disabled and non-disabled YP aligning with global evidence.

Article
Vol 136 No 1577: 16 June 2023

Attitudes towards the mixing of COVID-19 vaccinated and unvaccinated patients in multi-bed hospital rooms | OPEN ACCESS

Sylvi Low, Sonya Aum, Luke Nie, Jacob Ward, Khanh Nguyen, Leilani Pereira, Jenny Mi, Jocelyn Soti, Ben Harford, Robert J Hancox, John D Dockerty

Most New Zealand hospitals, including Dunedin Public Hospital, have multi-bed rooms, which are likely to be shared by both vaccinated and unvaccinated patients. Inpatients do not have the right to know other patients’ vaccination status or whether they have a transmissible disease, and they are not usually given a choice over who they share a room with.

Article
Vol 136 No 1577: 16 June 2023

How well do we support whānau with postpartum contraception? Comparison of two Auckland maternity hospitals

Jordon Wimsett, Lynn Sadler, Charlotte Oyston, Emelia Legget, Sue Tutty, Helen Roberts

This study aimed to compare recall of contraceptive discussion during the antenatal or postpartum period and provision of chosen contraceptive methods before discharge among patients who recently birthed in two maternity hospitals in Auckland, New Zealand (Te Toka Tumai, Auckland and Te Whatu Ora Counties Manukau).

Article
Vol 136 No 1577: 16 June 2023

Investigating the distribution of primary and secondary care referrals for public-funded bariatric surgery at Counties Manukau Health (CMH)

Kate Bradley, Sarah Cowan, Richard Babor, Jon Morrow, Andrew MacCormack, Jamie-Lee Rahiri, Rinki Murphy

Obesity is a significant health issue, with nearly a third of the Aotearoa New Zealand adult population classified as obese. In adults, Māori are almost twice as likely to be obese as non-Māori, and Pasifika adults are 2.5 times as likely to be obese as non-Pasifika adults.

Article
Vol 136 No 1577: 16 June 2023

Pacific patients’ reasons for attending the emergency department of Counties Manukau for non-urgent conditions

Catherine J Yang, Vanessa Selak, David Schaaf, Vili Nosa

Presentations to Emergency Departments (EDs) in New Zealand and internationally are increasing at an unprecedented rate. While most ED presentations are for urgent conditions, a substantial proportion is for conditions regarded as non-urgent.

Viewpoint
Vol 136 No 1577: 16 June 2023

What is affirmative action in tertiary education? An overview of affirmative action policies in health professional programmes, drawing on experience from Aotearoa and overseas

Sophia Barham, Jo Baxter, Peter Crampton

For almost six decades now, universities around the world have employed affirmative action policies for entry into health profession programmes in an effort to create health workforces that are representative of the communities they serve.

Clinical Correspondence
Vol 136 No 1577: 16 June 2023

End-stage hiatal hernia with cardiac complications

John Ahn, Gary Lau

We describe a case of a fatal cardiac complication from a large hiatus hernia in a centenarian.

Research Letter
Vol 136 No 1577: 16 June 2023

Paternal depression among fathers in the Christchurch Health and Development Study

Louise Rippin, Geraldine McLeod, Jacki Henderson, Joseph Boden

Paternal depression is a growing global health concern, as the mental health of fathers subsequently impacts the psychological, physical and mental health of the developing child.

Research Letter
Vol 136 No 1577: 16 June 2023

How far are we with Indigenising psychology training curriculum in Aotearoa New Zealand?

Waikaremoana Waitoki, Kyle Tan, Logan Hamley, Damian Scarf, Ottilie Stolte, Joanna Chan

The over-reliance on Western, Educated, Industrialised, Rich, and Democratic (WEIRD) paradigms and perspectives in psychology has concerned many scholars in Aotearoa New Zealand.

100 Years Ago in the NZMJ
Vol 136 No 1577: 16 June 2023

The Public Hospitals in New Zealand

The public hospital system in New Zealand has been the subject of investigation by various visitors, both lay and medical, and, on the whole has been commended, mainly, we think, for the reason that the financial stability of the hospitals is assured.

Proceedings
Vol 136 No 1577: 16 June 2023

Proceedings from the Te Whatu Ora – Waitematā, University of Auckland and AUT Collaborative Research Symposium 2023

Editorial
SUMMARY

Medical privilege in the law of evidence in Aotearoa New Zealand

Ruth Campbell

Te Aka Matua o te Ture | Law Commission is carrying out its third, and final, review of the Evidence Act 2006, which governs the admission and use of evidence in legal proceedings. One of the issues being explored in the review is the circumstances in which information obtained by a medical practitioner or clinical psychologist can be admitted and heard in court, and the Law Commission wants to hear from interested parties on whether the law should be change. The Issues Paper for the project sets out a more detailed analysis of the issues and options for reform, and is open for consultation until 30 June.

Article
SUMMARY

Inequities in the physical activity of disabled young people in Aotearoa New Zealand: a stakeholder SWOT analysis of the physical activity sector | OPEN ACCESS

Oliver WA Wilson, Justin Richards, Melody Smith, Robert C Townsend

Inequities contribute to persistent disparities in the physical activity participation of disabled young people in Aotearoa New Zealand. The genuine investment of Sport NZ Ihi Aotearoa and the establishment of Whaikaha – Ministry for Disabled People were perceived as strengths. Awareness of physical opportunities among disabled young people was identified as a weakness. Greater cohesion/coordination among physical activity providers was viewed as an opportunity. Overlap/competition among physical activity providers could pose a threat.

Article
SUMMARY

Attitudes towards the mixing of COVID-19 vaccinated and unvaccinated patients in multi-bed hospital rooms | OPEN ACCESS

Sylvi Low, Sonya Aum, Luke Nie, Jacob Ward, Khanh Nguyen, Leilani Pereira, Jenny Mi, Jocelyn Soti, Ben Harford, Robert J Hancox, John D Dockerty

At the height of the attempts to contain the COVID-19 pandemic in 2022, most public places required people to have been vaccinated against COVID-19 before they could enter. This did not apply to hospitals where patients could spend days sharing rooms with other patients without knowing their vaccination status. We asked staff and patients in Dunedin Public Hospital about their views on this: most patients and staff would prefer to keep vaccinated and unvaccinated in separate rooms, but recognised that there are practical and ethical difficulties in doing this. There was a range of views about the actual risks involved in mixing vaccinated and unvaccinated patients and vaccine mandates have now been withdrawn, but these issues should be considered in the planning for future outbreaks and pandemics.

Article
SUMMARY

How well do we support whānau with postpartum contraception? Comparison of two Auckland maternity hospitals

Jordon Wimsett, Lynn Sadler, Charlotte Oyston, Emelia Legget, Sue Tutty, Helen Roberts

The provision of postpartum contraception is an important part of reproductive health. Best practice is to discuss contraceptive options both during and after pregnancy. We found only small numbers of people recalled these conversations and less than half left hospital with a reliable method of contraception. We found differences in the contraceptive services between two large tertiary maternity services which suggests an opportunity for quality improvement around contraception provision.

Article
SUMMARY

Investigating the distribution of primary and secondary care referrals for public-funded bariatric surgery at Counties Manukau Health (CMH)

Kate Bradley, Sarah Cowan, Richard Babor, Jon Morrow, Andrew MacCormack, Jamie-Lee Rahiri, Rinki Murphy

This paper explores the patterns in referrals for public bariatric surgery in Counties Manakau DHB. Current evidence demonstrates that Māori and Pasifika are less likely to be referred and less likely to proceed to surgery. The inequity in bariatric surgery needs to be explored further and this paper is one step in this process.

Article
SUMMARY

Pacific patients’ reasons for attending the emergency department of Counties Manukau for non-urgent conditions

Catherine J Yang, Vanessa Selak, David Schaaf, Vili Nosa

A lot of money and time is being spent on educating people to stay out of Emergency Department unless it is a life threatening emergency. This is especially true for Pacific people, who appear to use Emergency Departments more than other ethnicities. In 2019, a survey was done of people who came to the Emergency Department at Counties Manukau Health with a medical condition that was considered by the Emergency Department nurse to be non-urgent, on why they had come to the Emergency Department. The most common reason for coming to the Emergency Department for Pacific people (as well as for other ethnicities) were that they were told to do so by a health professional, including their GPs. This is contrary to the belief that people are using Emergency Departments because they don’t know that they should see their GPs, and further studies should be done to make sure that programmes to discourage people from using Emergency Departments do not have unintended consequences.

Viewpoint
SUMMARY

What is affirmative action in tertiary education? An overview of affirmative action policies in health professional programmes, drawing on experience from Aotearoa and overseas

Sophia Barham, Jo Baxter, Peter Crampton

Both the universities of Auckland and Otago have had affirmative selection policies for entry into health professional programmes for a number of decades. These policies have been created and strengthened as a result of the leadership and advocacy of Māori leaders, academics and communities. The aims of this paper are to: 1) define affirmative action and outline the rationale for affirmative policies, 2) give examples of how affirmative action policies have been implemented in Aotearoa, and 3) give examples of legal challenges to affirmative action drawing on international experience.

Clinical Correspondence
SUMMARY

End-stage hiatal hernia with cardiac complications

John Ahn, Gary Lau

Extreme herniation of the stomach into the chest cavity can have life threatening complications on rare occasions.

Research Letter
SUMMARY

Paternal depression among fathers in the Christchurch Health and Development Study

Louise Rippin, Geraldine McLeod, Jacki Henderson, Joseph Boden

Paternal depression is a growing global health concern, as the mental health of fathers impacts the developing child and their family. Data for this study were collected by the University of Otago’s Christchurch Health and Development Study. This study has tracked the health and psychosocial development of 635 boys born in Christchurch in 1977 to age 40. These cohort members were assessed on symptoms of major depression within 1 year of becoming a first-time father; finding 9/168 (5.4%) were classified as having major depression during that time-period. All major depression cases were among fathers younger than 30 years. Doctors and health professionals should consider assessing both new mothers and fathers for depressive symptomology.

Research Letter
SUMMARY

How far are we with Indigenising psychology training curriculum in Aotearoa New Zealand?

Waikaremoana Waitoki, Kyle Tan, Logan Hamley, Damian Scarf, Ottilie Stolte, Joanna Chan

Our study assessed the professional programme psychology courses that are required to be completed at a satisfactory level prior to registration as a psychologist with the New Zealand Psychologists Board. The descriptors and learning outcomes of each course were carefully analysed to identify whether they adequately covered Māori content. Only four (2.9%) courses were specifically Māori-focussed and one-third (36.0%) included Māori-focussed content. Our findings raise questions regarding the existence of genuine institutional will to decolonise psychology and bolster the responsiveness of psychology for Māori. There is little evidence of meaningful integration of Māori psychology. Our research team, Working to End Racial Oppression (WERO), is conducting further research to identify barriers to Māori participation in psychology.

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