NEW ZEALAND MEDICAL JOURNAL最新文献_第2页

Highlighting the push and the pull: a comparison of New Zealand and United Kingdom resident doctor contracts. 突出推动和拉动：新西兰和英国住院医生合同的比较。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-10-09 DOI: 10.26635/6965.7464

Alexander Bell, Alicia Schwarzenbach

{"title":"Highlighting the push and the pull: a comparison of New Zealand and United Kingdom resident doctor contracts.","authors":"Alexander Bell, Alicia Schwarzenbach","doi":"10.26635/6965.7464","DOIUrl":"https://doi.org/10.26635/6965.7464","url":null,"abstract":"The United Kingdom (UK) resident doctor workforce faces escalating pressures, including pay erosion, intense competition for training posts, rota instability and high burnout risk. While remuneration has dominated industrial disputes, comparatively less attention has been paid to the impact of contractual worker protections and day-to-day working conditions on morale and retention. Drawing on lived experience of working as resident doctors in both the UK and New Zealand, this article compares key elements of national employment contracts and collective agreements. We examine differences in annual leave autonomy, rota publication and enforcement mechanisms, staffing resilience through \"relief\" roles, cross-cover remuneration, access to personal medical appointments, reimbursement of mandatory professional expenses, meal provision and structured support for examination preparation and career progression. Although UK pay structures recognise antisocial hours, New Zealand contracts embed wider protections that promote flexibility, professional development and workforce wellbeing. We suggest that these comparatively low-cost, system-level interventions contribute meaningfully to higher reported satisfaction and improved retention among New Zealand resident doctors. Adopting similar contractual safeguards within the UK may represent an achievable and cost-effective strategy to enhance morale, reduce attrition and strengthen long-term workforce sustainability within the National Health Service.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1643","pages":"75-81"},"PeriodicalIF":1.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138812","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}

引用次数: 0

Improving uptake of routine antenatal anti-D prophylaxis: completion of the audit cycle in Capital & Coast. 改善常规产前抗- d预防：完成首都和海岸的审计周期。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-10-09 DOI: 10.26635/6965.7468

Maria Wojcik, Judy Ormandy

引用次数: 0

Comparing hookwire and wire-free localisation techniques in breast cancer surgery: oncological and patient-reported outcomes in a New Zealand cohort. 比较钩线和无线定位技术在乳腺癌手术中的应用：新西兰队列的肿瘤学和患者报告的结果。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7508

Yicheng Wei, Dhruvesh M Ramson, Magdalena A Biggar

{"title":"Comparing hookwire and wire-free localisation techniques in breast cancer surgery: oncological and patient-reported outcomes in a New Zealand cohort.","authors":"Yicheng Wei, Dhruvesh M Ramson, Magdalena A Biggar","doi":"10.26635/6965.7508","DOIUrl":"https://doi.org/10.26635/6965.7508","url":null,"abstract":"Aims: Hookwire localisation (HWL) is traditionally used to guide resection of non-palpable breast lesions but is associated with patient discomfort and logistical constraints due to same-day placement. Wire-free localisation (WFL) may overcome these limitations while maintaining oncological safety. This study aimed to pilot WFL adoption in a tertiary New Zealand centre and evaluate whether international findings comparing HWL and WFL are reproducible, focussing on reoperation rates and patient experience.Methods: A cohort study was conducted at Middlemore Hospital. HWL patients were identified retrospectively and compared with a prospectively recruited WFL cohort (Magseed n=17, Pintuition n=30, SAVI Scout n=26). The primary outcome was reoperation for margin inadequacy. Secondary outcomes included patient satisfaction assessed using a structured questionnaire. Clinical, operative, pathological and operator variables were also analysed.Results: A total of 216 patients were included (HWL n=143; WFL n=73). Reoperation rates were similar between groups (HWL 13% vs WFL 11%, p=0.8). There was a trend towards lower specimen weights with WFL. Patient-reported outcomes significantly favoured WFL across overall experience, pain, distress and peri-operative comfort.Conclusion: WFL demonstrated comparable reoperation rates to HWL, supporting oncological non-inferiority in this pilot New Zealand cohort, with significantly improved patient experience supporting wider adoption.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"81-89"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041344","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}

引用次数: 0

Response A to: "The impact of New Zealand's 2018 methamphetamine policy on residential contamination". 针对：“新西兰2018年甲基苯丙胺政策对住宅污染的影响”。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7700

Jai Whelan, Joseph Boden, Rose Crossin

引用次数: 0

Rural medicine in Aotearoa New Zealand: a narrative synthesis of the literature with a postgraduate focus. 新西兰奥特罗阿的乡村医学：以研究生为重点的文献叙事综合。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7546

Katharina Blattner, Lynne Clay, Rory Miller, Garry Nixon, Tim Stokes

{"title":"Rural medicine in Aotearoa New Zealand: a narrative synthesis of the literature with a postgraduate focus.","authors":"Katharina Blattner, Lynne Clay, Rory Miller, Garry Nixon, Tim Stokes","doi":"10.26635/6965.7546","DOIUrl":"https://doi.org/10.26635/6965.7546","url":null,"abstract":"Aim: This review synthesised Aotearoa New Zealand rural medicine literature on postgraduate training and academic activity to inform the current and future development of the discipline.Methods: A search of PubMed and Ovid MEDLINE databases was undertaken for articles relating to rural health/medicine and New Zealand. Articles with a focus on medical education or wider academic activity were included in the narrative synthesis.Results: Thirty-six articles described the past 30 years of rural medicine literature in New Zealand, from its early development (1999-2004), through calls for, and establishment of, rural-specific postgraduate training pathways, to developing the academic discipline of rural medicine. Findings include repeated calls for rural medicine to be recognised as a distinct speciality; the need for rural-specific postgraduate pathways, especially for general practice; increased support for academic leadership; rurally based research; and strong community and service partnerships.Conclusion: While rurally targeted postgraduate clinical pathways are essential, they alone are insufficient to support the growth of rural medicine as a distinct discipline, suggesting the need for broader strategies to support academic capability, long-term sustainability and rural health equity.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"141-149"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041354","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}

引用次数: 0

Response to the letters re: "The impact of New Zealand's 2018 methamphetamine policy on residential contamination". 对“新西兰2018年甲基苯丙胺政策对住宅污染的影响”的回复。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7706

Muhammad Irfan, Ushan Indika Goonawardane, Craig Robertson, Michael P Cameron

引用次数: 0

Oil on the brain: dementia in the popular press prior to the 1906 Alzheimer case report. 大脑上的油：1906年阿尔茨海默病病例报告之前的流行媒体中的痴呆症。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7443

Yoram Barak, Susan M Cheer, Richard Mullen

{"title":"Oil on the brain: dementia in the popular press prior to the 1906 Alzheimer case report.","authors":"Yoram Barak, Susan M Cheer, Richard Mullen","doi":"10.26635/6965.7443","DOIUrl":"https://doi.org/10.26635/6965.7443","url":null,"abstract":"Background and aims: Concepts of dementia precede the description published by Alzheimer. Historically, the term was misunderstood and misused by the published newspapers of the nineteenth century. We aimed to describe the historical use of the term dementia in New Zealand newspapers.Method: Papers Past is a project of the National Library of New Zealand that aims to digitise all New Zealand newspapers from 1839 onwards. There are 96,022,840 newspaper articles in this dataset.Results: There were 1,521 newspaper articles between 1839 and 1906 in which the word dementia appeared in the content or title. Of these, 165 met the inclusion criteria. Of included articles, 87 had a description of the condition, 92 mentioned a cause of dementia and 25 included a description of management. Categories were not mutually exclusive. The common cause of dementia described was mental impairment (N=44), with special emphasis on mania, postpartum depression and intellectual disability. This was followed by environmental factors (N=34) and alcohol use (N=26). The common form of management for dementia was incarceration within an asylum or a gaol, occurring in 18 of 25 reported cases. Specific treatments for dementia included: a blister to the neck, rheumatic balsam, milk with lime water, marine serum and cranial surgery.Conclusion: The descriptions of dementia from newspaper articles were consistent with nineteenth century Western concepts of the disease, and the causes and treatment of dementia reflected the New Zealand environment and Pākehā culture during colonial times.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"15-20"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041321","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}

引用次数: 0

Challenges in diagnosis and management of traumatic diaphragmatic injuries: experiences from a regional New Zealand trauma centre. 在诊断和管理创伤性横膈膜损伤的挑战：从新西兰区域创伤中心的经验。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7515

Ahmed Abdinoor Abdile, Damien Ah Yen, Sheena Moosa, Ishani Soysa, Grant Christey

{"title":"Challenges in diagnosis and management of traumatic diaphragmatic injuries: experiences from a regional New Zealand trauma centre.","authors":"Ahmed Abdinoor Abdile, Damien Ah Yen, Sheena Moosa, Ishani Soysa, Grant Christey","doi":"10.26635/6965.7515","DOIUrl":"https://doi.org/10.26635/6965.7515","url":null,"abstract":"Background: Diaphragmatic injury is a rare but serious consequence of thoraco-abdominal trauma, often overlooked due to its subtle initial presentation. Early recognition and surgical intervention of traumatic diaphragmatic injury (TDI) are paramount to treat life-threatening injuries, yet the diagnosis remains challenging due to the non-specific nature of symptoms and the limitations of conventional imaging techniques. This study aims to examine the burden of TDI among trauma patients of all injury severities presenting to the Level 1 trauma centre in New Zealand and evaluate the utility of pre-operative imaging in detecting patients who require operative repair of TDI.Method: A retrospective review of the Te Manawa Taki (TMT) Region's trauma registry from 2014 to 2023, with TDIs identified using Abbreviated Injury Scale diagnosis codes 440602, 440604, 440606, 440608, 440610 and 440699, was conducted. This is complemented by a review of clinical records of TDI patients admitted to the Level 1 trauma centre in the TMT Region to evaluate pre-operative imaging techniques used.Results: The diagnosis of TDI was made pre-operatively in 29 of 43 patients (67.4%). The injury was visible on chest X-ray (CXR) in 19 patients (44%) and on computed tomography (CT) alone in 26 patients (81%). In 14 patients (32.5%) the diagnosis was only made intraoperatively. The detection rate of radiological imaging is significantly lower than intraoperative detection (rate ratios for CXR and CT are 0.44 and 0.81, respectively; p<0.05).Conclusion: TDI remains a rare and challenging diagnosis to establish solely through radiological imaging. Since TDI is often linked with other injuries, a low threshold for surgical intervention could be considered.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"32-41"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041412","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}

引用次数: 0

Beyond prescribing rights: designing equitable and sustainable attention-deficit/hyperactivity disorder care pathways in Aotearoa New Zealand. 超越处方权利：在新西兰奥特罗阿设计公平和可持续的注意力缺陷/多动障碍护理途径。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7381

Steven Lillis, Lara Oertly, Belinda Wheaton, Byron Rangiwai, Nicholas Bowden, Stephanie D'Souza

{"title":"Beyond prescribing rights: designing equitable and sustainable attention-deficit/hyperactivity disorder care pathways in Aotearoa New Zealand.","authors":"Steven Lillis, Lara Oertly, Belinda Wheaton, Byron Rangiwai, Nicholas Bowden, Stephanie D'Souza","doi":"10.26635/6965.7381","DOIUrl":"https://doi.org/10.26635/6965.7381","url":null,"abstract":"Aim: From February 2026, vocationally trained general practitioners and nurse practitioners in Aotearoa New Zealand are authorised to initiate stimulant medication for adults with attention-deficit/hyperactivity disorder (ADHD), marking a shift from a predominantly secondary care model. This viewpoint article examines the clinical, ethical and service-level implications of this regulatory change, with particular attention to equity, diagnostic quality, cost and sustainability in primary care.Methods: This viewpoint draws on Aotearoa New Zealand policy documents, international clinical guidance and selected peer-reviewed literature to inform a policy and equity-focussed analysis of expanded stimulant prescribing authority.Results: The policy change has the potential to improve access to ADHD treatment; however, the absence of mandated training, competency standards or operational guidance raises concerns about diagnostic quality, management of comorbidity and prescribing safety. The time-intensive nature of adult ADHD assessment presents workload and resourcing challenges for primary care, and multiple service delivery models are likely to emerge with variable equity implications.Conclusion: Expanded prescribing authority may improve access, but without appropriate training, resourcing and implementation frameworks, benefits may be unevenly realised. Clear standards and equity-centred service design are essential.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"156-161"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041397","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}

引用次数: 0

Community prevalence of multimorbidity in Aotearoa New Zealand based on linked general practice and hospitalisation records. 基于相关全科实践和住院记录的新西兰奥特罗阿多病社区患病率

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2026-09-25 DOI: 10.26635/6965.7481

Susan Wells, Yeunhyang Catherine Choi, Vanessa Selak, James Stanley, Claris Chung, Allan Moffitt, Ruth Teh, Rachel Roskvist, Katrina Poppe

{"title":"Community prevalence of multimorbidity in Aotearoa New Zealand based on linked general practice and hospitalisation records.","authors":"Susan Wells, Yeunhyang Catherine Choi, Vanessa Selak, James Stanley, Claris Chung, Allan Moffitt, Ruth Teh, Rachel Roskvist, Katrina Poppe","doi":"10.26635/6965.7481","DOIUrl":"https://doi.org/10.26635/6965.7481","url":null,"abstract":"Aim: The aim of this study was to quantify the community prevalence of multimorbidity from both hospital and general practice (GP) records.Method: Using encrypted health identifiers, electronic health record data from 374,071 patients aged ≥18 years, enrolled in ProCare primary health organisation in January 2014, were linked to national hospitalisation records. We identified the prevalence of multimorbidity (two or more long-term conditions [LTCs]) recorded within hospitalisation data (based on 61 ICD-10-AM LTC categories from the M3 multimorbidity index) and the same conditions matched to Read codes, Read terms or free text from GP records.Results: Multimorbidity was identified in 31% of patients; under half of this group, 52,867 (14%), were identified from hospital records and 62,453 (17%) exclusively from GP records. Multimorbidity increased markedly with age, affecting over 60% of both sexes by 65-74 years. Under-estimation using hospitalisation data alone was greater for women, older people, Chinese and Europeans.Conclusion: Multimorbidity prevalence is substantially under-estimated if relying solely on hospital discharge data, capturing under half of the total multimorbidity burden found when GP-level data are included. These data sources need to be combined to properly recognise the complexity of care and health-system resources required to meet patient needs.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1642","pages":"42-61"},"PeriodicalIF":1.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041415","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}

引用次数: 0