{"title":"An update on Helicobacter pylori diagnosis in New Zealand.","authors":"Jan Kubovy, Murray Barclay","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"107-111"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why psychiatrists choose to leave public mental health services.","authors":"Benjamin McBreen, Jenni Manuel, Matthew Tennant","doi":"10.26635/6965.6977","DOIUrl":"https://doi.org/10.26635/6965.6977","url":null,"abstract":"<p><strong>Aim: </strong>Our aim was to explore why psychiatrists are choosing to leave publicly funded mental health services in New Zealand.</p><p><strong>Method: </strong>A qualitative descriptive design was employed. Twelve psychiatrists who had left permanent positions in public mental health services in the last 5 years were recruited. Semi-structured interviews were recorded, transcribed and analysed using thematic analysis.</p><p><strong>Results: </strong>Four themes were identified: \"a burnout job\", \"responsibility and accountability but without authority\", \"a lot of near misses\" and \"inertia\". Participants reported an excessive workload in an under-resourced and inefficient system. They reported that their role within the multidisciplinary team had changed, and that their professional skills were undervalued. They felt accountable for poor patient outcomes but unable to improve the quality of care provided. Participants were concerned about their safety at work and reported a desire to improve efficacy, safety and quality of care but believed that the system was non-responsive and resistant to change. Consequently, they reported feeling no option but to leave.</p><p><strong>Conclusion: </strong>Retention of psychiatrists in public mental health services may be improved by increasing resourcing, embracing innovative change, recognising the unique role of a psychiatrist within the multidisciplinary team and promoting positive organisational culture and medical leadership.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"75-82"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darren Ritchie, Terry Creagh, Andrew McCombie, Laura R Joyce, Christopher Wakeman
{"title":"Hospital resource utilisation for two mass-casualty incidents in New Zealand.","authors":"Darren Ritchie, Terry Creagh, Andrew McCombie, Laura R Joyce, Christopher Wakeman","doi":"10.26635/6965.6887","DOIUrl":"https://doi.org/10.26635/6965.6887","url":null,"abstract":"<p><strong>Aim: </strong>To analyse hospital resource utilisation at Christchurch Hospital in New Zealand during two mass-casualty incidents (MCIs) in 2019: the Christchurch mosque shootings and the Whakaari (White Island) volcanic eruption.</p><p><strong>Methods: </strong>A cross-sectional retrospective analysis was conducted to assess hospital resource utilisation during the two MCIs.</p><p><strong>Results: </strong>A total of 45 patients from the mosque MCI and eight patients from the Whakaari MCI were admitted to Christchurch Hospital. The total length of stay was mosque MCI: 15,054 hours (average 335 hours per patient) and Whakaari MCI: 1,841 hours (average 230 hours per patient). Mean surgeon time (operative length multiplied by number of surgical staff) was mosque MCI: 6.5 hours and Whakaari MCI: 14.7 hours. Burns represented a significantly greater surgical workload per operative event. There were notable differences in staffing, investigations, consumables, blood products, theatre time and the number of operative events between the MCI cohorts.</p><p><strong>Conclusion: </strong>The studied MCIs had significant effects on hospital resource utilisation. Burn trauma was more resource intensive than non-burn trauma, despite most patients being repatriated within days of the index event. An analysis of resourcing, surge capacity and funding models in New Zealand is required to ensure trauma centres can effectively respond to future crises.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"83-95"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Equitable access to psilocybin-assisted psychotherapy in New Zealand.","authors":"Cameron Lacey","doi":"10.26635/6965.e1618","DOIUrl":"https://doi.org/10.26635/6965.e1618","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"9-11"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelson Tu'akoi, Janice Wong, Ha Nguyen, Chunhuan Lao, Mark Elwood, Mark McKeage, Ross Lawrenson
{"title":"Systemic anti-cancer treatment for Māori with stage III and IV non-small cell lung cancer in Aotearoa New Zealand.","authors":"Kelson Tu'akoi, Janice Wong, Ha Nguyen, Chunhuan Lao, Mark Elwood, Mark McKeage, Ross Lawrenson","doi":"10.26635/6965.6917","DOIUrl":"10.26635/6965.6917","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to assess the frequency of systemic anti-cancer therapy (SACT) use in patients with advanced non-small cell lung cancer (NSCLC), comparing Māori and non-Māori. Secondary aims were to assess predictive factors for patients managed with SACT, SACT agent regimens and lung cancer-specific mortality.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with incident advanced NSCLC in the Aotearoa New Zealand Midland Region between 1 January 2011 to 31 December 2021 was undertaken. Data were primarily derived from the Midland Lung Cancer Registry.</p><p><strong>Results: </strong>The study cohort comprised 2,549 patients with incident advanced NSCLC. A total of 775 patients were Māori (30%). SACT was received by 942 patients (37%). There was no difference in overall SACT rate between Māori and non-Māori: adjusted odds ratio (OR) 0.88 (95% confidence interval [CI] 0.71-1.09), p-value >0.05. For patients who received SACT, Māori were less likely to receive targeted therapy first-line (8.5% vs 16.1%, p-value <0.01). Māori had higher cancer-specific mortality: adjusted OR 1.19 (95% CI 1.08-1.32), p-value <0.001.</p><p><strong>Conclusion: </strong>In this pre-funded immunotherapy era, no difference was observed in overall SACT rate for Māori patients with advanced NSCLC. Māori were less likely to receive targeted therapy first-line, for which the underlying reasons require investigation. Our data suggest other factors, beyond overall SACT use rate, influence the higher cancer-specific mortality in Māori.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"15-29"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frank Frizelle, Kamran Abbasi, Vivienne C Bachelet, Christopher Baethge, Sabine Kleinert, Jin-Hong Yoo, Lilia Zakhama
{"title":"Global cost of silencing science: editors and publishers have a duty to resist.","authors":"Frank Frizelle, Kamran Abbasi, Vivienne C Bachelet, Christopher Baethge, Sabine Kleinert, Jin-Hong Yoo, Lilia Zakhama","doi":"10.26635/6965.ee1618","DOIUrl":"https://doi.org/10.26635/6965.ee1618","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"12-14"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miriama K Wilson, Fiona Pienaar, Ruth Large, David Codyre, Verity F Todd
{"title":"Understanding mental health risk in Aotearoa: an analysis of the 1737 Need to Talk telehealth service.","authors":"Miriama K Wilson, Fiona Pienaar, Ruth Large, David Codyre, Verity F Todd","doi":"10.26635/6965.6729","DOIUrl":"10.26635/6965.6729","url":null,"abstract":"<p><strong>Aim: </strong>The 1737 Need to Talk telehealth service (mental health call and text helpline) was launched in Aotearoa New Zealand in June 2017, providing the public with the ability to call or text when they need mental health support. The aim of this research is to describe the utilisation of the 1737 Need to Talk telehealth service. We describe the patterns of 1737 contacts over time and describe the contact users, including the most at-risk contacts (defined as those contacts who trigger the \"Break Glass\" procedure).</p><p><strong>Methods: </strong>This is a retrospective observational study analysing 1737 Need to Talk data over 5 years and 7 months from June 2017 through to December 2022. A total of 719,904 contacts to the service were analysed.</p><p><strong>Results: </strong>This research found that contacts to the 1737 Need to Talk service (by call or text) increased until the end of 2021 and then plateaued from 2022. The average proportion of at-risk service users was 0.43% of 1737 Need to Talk contacts, and this grew minimally over the period investigated. Service users most at risk were found to be of the female gender, in the 13-19-year-old age group, and those residing in Whanganui and MidCentral districts.</p><p><strong>Conclusion: </strong>This study details the growth in the number of specific demographics reaching out for mental health support to 1737 and may be indicative of the need for increasing mental health support.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"30-47"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of a facility-specific, prehospital transport policy for trauma patients in a health region of New Zealand.","authors":"Alastair Smith, Sheena Moosa, Grant Christey","doi":"10.26635/6965.6875","DOIUrl":"10.26635/6965.6875","url":null,"abstract":"<p><strong>Aim: </strong>A facility-specific, prehospital trauma destination matrix has been implemented in the Te Manawa Taki (TMT)/Midland Region of Aotearoa New Zealand to support decisions on the most appropriate destination hospital for injured patients. This study evaluates the implementation of this policy.</p><p><strong>Methods: </strong>Injury data obtained from the TMT Trauma Registry were linked with Global Positioning System (GPS) data from Hato Hone St John and Land Information New Zealand Data Service for trauma events within the region from 1 January to 31 December 2023. Analysis of spatial relationships between injury location, specific injuries and hospital admission was performed using ArcGIS and R statistical programming.</p><p><strong>Results: </strong>A total of 214 trauma events met the TMT Matrix criteria, of which 163 (76.1%) were transported to a hospital consistent with the destination specified. Lowest consistency (43.8%) of prehospital transport was seen with severe traumatic brain injury likely to require neurosurgery among adults aged >15 years. Approximately 32% of patients with matrix conditions requiring direct transport were lower severity (Injury Severity Score [ISS] <13). When the specified destination was that closest to the incident, there was 93.9% TMT Matrix consistency. Patients with a TMT Matrix condition who did not go directly to the defined facility and had a subsequent transfer took a median 10.5 hours to reach the defined facility.</p><p><strong>Conclusions: </strong>The majority of trauma patient transports were consistent with the TMT prehospital matrix. A primary influence on compliance was the distance from point of injury to designated facility. This study prompts further exploration of factors associated with appropriate prehospital triage and refinement of TMT prehospital destination policy.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"48-59"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Low-density lipoprotein cholesterol management after acute coronary syndrome in Aotearoa New Zealand: opportunities for improvement (ANZACS-QI 81).","authors":"Jack L He, Mildred Lee, Andrew J Kerr","doi":"10.26635/6965.6818","DOIUrl":"https://doi.org/10.26635/6965.6818","url":null,"abstract":"<p><strong>Aim: </strong>Our aims are to describe low-density lipoprotein (LDL) management in the year after a first acute coronary syndrome (ACS) hospitalisation and identify opportunities to further improve management.</p><p><strong>Methods: </strong>Thirteen thousand two hundred and two patients aged over 20 years of age presenting with their first ACS (2014 to 2019), who underwent coronary angiography in the Northern Region of Aotearoa New Zealand, were identified from the All New Zealand All Cardiology Services Quality Improvement (ANZACS-QI) registry. De-identified linkage with Northern Region TestSafe and National Pharmaceutical databases enabled tracking of LDL levels and statin dispensing. Statin adherence in the year post-discharge was estimated using a medication possession ratio (MPR) with an MPR=1 defined as optimal coverage.</p><p><strong>Results: </strong>Seventy-eight percent (n=10,395) of patients had a repeat lipid study within 12 months. Of these, 78.6% received post-discharge dispensing of high-intensity statin. Mean LDL fell from 2.691.14mmol/L in-hospital to 1.920.85mmol/L post-discharge. A total of 2,484 (23.9%) patients achieved LDL <1.4mmol/L. Among patients with optimal adherence who were dispensed high-intensity statins, 29% of patients achieved LDL <1.4 (mean LDL 1.70.63mmol/L). After repeat LDL testing, statin therapy was intensified in 7% but reduced in 11.2%.</p><p><strong>Conclusion: </strong>Although lipid management was appropriately intensified in-hospital, only a quarter of patients achieved the current guideline LDL target. Improvements in lipid management require use of these more intensive therapies in combination with lifestyle interventions and more regular lipid testing.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"60-74"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}