New Zealand Medical Journal

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AIM: This observational study aimed to investigate temporal trends in transport-related injuries in New Zealand by mode of transport and explore whether specific population groups and localities have a relatively higher incidence of injury. These trends provide insight into changes in injury patterns from road trauma. METHODS: A retrospective study of hospitalised road trauma in New Zealand was conducted between 1 July 2017 to 30 June 2021. Data were obtained from the National Minimum Dataset of hospital admissions, and the New Zealand Trauma Registry (NZTR)...

AIMS: Giant cell arteritis (GCA) is the most common primary vasculitis in adults over 50 years of age. To facilitate early diagnosis and reduce harms from corticosteroids and temporal artery biopsies, fast-track pathways have been established. We review the benefits of the fast-track pathway set up in Waikato, Aotearoa New Zealand. METHODS: Patients were collected prospectively as part of the fast-track pathway from 2014 to 2022. Their records were then reviewed retrospectively to collect data on clinical features, investigations and treatment...

AIM: Optimised dietary thresholds for type 2 diabetes prevention exist; however, they likely have additional benefits beyond diabetes prevention. We have modelled the effects of the proposed dietary thresholds on Health-Adjusted Life Years (HALY), health inequities and health system cost in Aotearoa New Zealand. METHODS: We created a national diet scenario using the optimised thresholds and compared it with current intakes using an established multistate life table...

AIM: Giant cell arteritis (GCA) is the most common primary vasculitis in adults over 50 years of age. Our primary objective was to assess the incidence and prevalence of GCA in Waikato in a bid to deepen our understanding of the epidemiology of GCA in Aotearoa New Zealand. METHODS: From January 2014 to December 2022, cases of GCA were identified prospectively and retrospectively through temporal artery ultrasound request lists and temporal artery biopsy histology reports...

The international migration of health professionals has been an ongoing issue with the medical workforce in Aotearoa New Zealand. There are many reasons why New Zealand-trained doctors choose to leave. Often it has been to gain overseas experience, with many eventually returning to New Zealand; however, this has now changed, with increasing numbers not returning. Little has been done to combat this developing problem, amidst an increasingly competitive global market for health professionals. There is public and political concern about the current shortage and uneven distribution of doctors, particularly because this has fostered unsustainable working conditions, which diminishes the provision of safe healthcare in this country...

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Medical simulation has become an integral aspect of modern healthcare education and practice. It has evolved to become an essential aspect of teaching core concepts and skills, common and rare presentations, algorithms and protocols, communication, interpersonal and teamworking skills and testing new equipment and systems. Simulation-based learning (SBL) is useful for the novice to the senior clinician. Healthcare is a complex adaptive system built from very large numbers of mutually interacting subunits (e...

AIM: To synthesise the literature describing experiences of chronic pain and pain management for Māori, and to understand how this experience could inform service delivery and clinical practice. METHOD: We systematically searched for qualitative research on Māori chronic pain experiences (Scopus, Medline, APA PsycINFO, NZ Research, Research Square). Data extracted were coded and synthesised using thematic analysis. RESULTS: Seven studies were included...

AIMS: We observed modern spring-loaded air rifles reaching velocities similar to small-bore rifles, raising concerns about their potential lethality. After encountering two life-threatening thoracic injuries in our practice, we conducted a study to assess the injuries that a commonly available air rifle could cause in a porcine cadaver model. METHODS: We conducted shooting experiments from 5 and 10 metres away using a .22 calibre spring-loaded airgun, firing five shots into the anterolateral chest on the left side at both distances...

AIM: To explore the change in emergency department (ED) attendances for persistent pelvic pain (PPP) following laparoscopic treatment of endometriosis. METHODS: A retrospective service evaluation was conducted on a convenience sample of 1 calendar year of elective gynaecological laparoscopies for PPP. Data were collected on ED visits for surgical complications, and for PPP in the 12 months prior to and following surgery. RESULTS: Of the 195 women undergoing laparoscopy, 30 had attended the ED owing to their PPP in the preceding year...

AIM: Oral health conditions are highly prevalent among former refugees; however, little is known about their experiences of accessing dental care. We aimed to explore Syrian former refugees' experiences of oral healthcare in New Zealand. METHOD: Thirty-nine Syrian former refugees resettled in Dunedin, New Zealand participated in nine focus group discussions. The interviews were audio-recorded, transcribed verbatim and thematically analysed. RESULTS: Almost all participants reported motivation to care for their teeth but multiple factors facilitated or hindered their ability to address their oral health needs, including financial factors, communication issues and dental care provider cultural safety...

AIM: Ruptured abdominal aortic aneurysm (rAAA) is associated with a high mortality rate which, is especially significant in rural and provincial regions. In Aotearoa New Zealand, Māori experience higher rates of AAA and worse overall medium-term survival following AAA repair. This study aimed to understand the prevalence of incidental AAA on routine abdominal computed tomography (CT) scans over 12 months. METHOD: A retrospective review of all abdominal CT scans performed on patients ≥50 years at Gisborne Hospital between 1 December 2018-1 December 2019 was performed...

AIM: In Aotearoa New Zealand, primary care is organised by enrolling patients with a primary care provider. However, the benefits of this arrangement are frustrated when providers "close their books" due to insufficient capacity for new patients. We investigated the extent, evolution and impact of this situation on health access and equity in access to primary healthcare. METHOD: We distributed a survey for general practice personnel in 2022, yielding 227 valid responses...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Heart failure affects 1-3% of the population and remains a major public health problem, with high rates of hospitalisation and mortality. Health inequities in the incidence of heart failure have widened over the last 13 years in Aotearoa New Zealand. Urgent action is required to address the inequitable burden of heart failure among Māori and Pasifika. Regional and international heart failure guidelines now provide clear and consistent guidance on the contemporary approach to management for patients with heart failure...

Electrosurgery is commonly used during a range of operations in order to maintain effective haemostasis. This can cause electromagnetic interference (EMI) with cardiac implanted electronic devices (CIEDs), which prevents normal device function. CIEDs include pacemakers (PPM), implantable cardiac defibrillators (ICD), cardiac resynchronisation therapy devices-both pacemakers and defibrillators (CRT-P/CRT-D)-and implantable loop recorders (ILRs). Damage to the generator, inhibition of pacing, activation of asynchronous pacing and ventricular fibrillation can all be induced by electrocautery...