NEW ZEALAND MEDICAL JOURNAL最新文献

{"title":"Hand grip strength and future hospitalisations in Māori and non-Māori New Zealand octogenarians: the LiLACS NZ cohort study.","authors":"Simon A Moyes, Vanessa Selak, Lindsay D Plank, Joanna Hikaka, Ngaire Kerse","doi":"10.26635/6965.7454","DOIUrl":"https://doi.org/10.26635/6965.7454","url":null,"abstract":"<p><strong>Aim: </strong>With the population ageing, age-related illness and hospitalisation are of concern. Chronic sarcopenia, low muscle strength and mass, and hand grip strength (HGS) are known to be associated with future hospitalisation in older people. The aim here was to determine the association of ethnicity and sex with these relationships in New Zealand octogenarians.</p><p><strong>Methods: </strong>This paper used data from the LiLACS NZ study, of 421 Māori and 516 non-Māori in 2010-2011 with follow-up hospitalisation data for 13 years. Generalised linear models tested the association between HGS or probable chronic sarcopenia (PCS; defined as a HGS of ≤27kg for men, ≤16kg for women) and hospitalisation rate and total time in hospital. These models were run separately for each ethnicity and sex.</p><p><strong>Results: </strong>Men had greater mean HGS at recruitment than women (30.8 [standard deviation 7.0] Māori men, 30.3 [6.2] non-Māori men, 20.0 [5.2] Māori women, 18.4 [4.5] non-Māori women). HGS was associated with the future hospitalisation rate for Māori women and non-Māori men (adjusted incidence rate ratio [95% confidence interval] of 0.968 [0.942-0.995] and 0.970 [0.951-0.991], respectively) but not for non-Māori women or Māori men. HGS was also associated with future time in hospital for Māori and non-Māori men. PCS was associated with an increased future hospitalisation rate for non-Māori men (1.439 [1.097-1.888]) and total time in hospital for Māori and non-Māori men.</p><p><strong>Conclusions: </strong>Investment in reducing PCS could reduce the frequency and total length of hospitalisation for older people and reduce inequities for Indigenous Māori in health outcomes.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1640","pages":"51-62"},"PeriodicalIF":1.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765342","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":"Moving the dial on out-of-hospital cardiac arrest survival in Aotearoa New Zealand.","authors":"Jon Moores","doi":"10.26635/6965.7429","DOIUrl":"https://doi.org/10.26635/6965.7429","url":null,"abstract":"<p><p>Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge in Aotearoa New Zealand, with 30-day survival plateauing at approximately 11% in recent years. Registry data demonstrate that early bystander cardiopulmonary resuscitation (CPR) and community defibrillation significantly increase survival, yet community defibrillation rates remain low, and inequities persist across ethnicity, gender, deprivation and rurality. International evidence shows that system-level improvements in early response and equitable access to post-arrest care can substantially improve outcomes. Improving OHCA survival in New Zealand requires a co-ordinated, equity-focussed strategy centered on universal CPR literacy, automated external defibrillator (AED) training, targeted AED deployment and maintenance of a national registry, strengthened community-responder systems and optimisation of cardiac arrest care pathways.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"86-88"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632158","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":"Aotearoa New Zealand's outdated low-risk drinking advice: the need for review.","authors":"Tasnima Akter, David Newcombe, Andy Towers, Mark Esekielu, Christina Severinsen, Felicity Ware, Antonia Lyons","doi":"10.26635/6965.7516","DOIUrl":"https://doi.org/10.26635/6965.7516","url":null,"abstract":"<p><p>Alcohol remains a major contributor to preventable morbidity and mortality in Aotearoa New Zealand, generating substantial health, social and economic harm. Current low-risk drinking advice, last updated in 2011, no longer reflects contemporary evidence on alcohol-related risk. Internationally, several countries have revised their guidance in response to strengthened evidence that even low levels of consumption increase the risk of disease. This viewpoint argues that Aotearoa New Zealand's low-risk drinking advice is now overdue for review. Updating national guidance is necessary to ensure that alcohol-related risk is communicated accurately and transparently and to provide a clearer foundation for clinical practice and policy. However, on its own, such advice cannot reduce alcohol-related harm, as information alone cannot address the structural conditions that produce it. The impact of evidence-based advice depends on the broader regulatory, commercial and social environments in which alcohol is produced, marketed and consumed. A review process must therefore be embedded within a wider strategy that addresses structural drivers of harm and prioritises equity, including obligations under Te Tiriti o Waitangi.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"78-85"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632275","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":"Workforce profile of Health New Zealand - Te Whatu Ora clinical nurse specialists and nurse practitioners working in the primary area of cardiology between 2024 and 2025.","authors":"Rebecca Eddington, Chris Aldridge, Melinda Copley, Sandra Hanchard, Erina Korohina, Jennifer Roberts, Marian Tuitama, Jo Wickham, Robert N Doughty","doi":"10.26635/6965.7416","DOIUrl":"10.26635/6965.7416","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to quantify the advanced nursing practice workforce status of clinical nurse specialists (CNSs) and nurse practitioners (NPs) in adult cardiology specialties within Health New Zealand - Te Whatu Ora.</p><p><strong>Methods: </strong>A survey from the Cardiac Society of Australia and New Zealand was sent to all Health New Zealand - Te Whatu Ora cardiology departments in September 2024 requesting a report of advanced nursing practice workforce full-time equivalent (FTE), specifically roles that were CNSs or NPs. Aotearoa New Zealand population information was obtained from the Health New Zealand - Te Whatu Ora populations web tool. Workforce ethnicity and age-related data were obtained from the health workforce information programme. Advanced nursing practice workforce literature was sourced through website database searches and were compared and critiqued.</p><p><strong>Results: </strong>All hospital districts provided data representing the first complete cardiac CNS/NP workforce dataset. Within Health New Zealand - Te Whatu Ora there were 132 employees, of which 113 were CNSs and 19 NPs. The total FTE was 104.1, equating to 1.99 CNS/NP per 100,000 population. Significant geographic inequities were observed, with Central and South Island Regions notably underserved. The workforce was older and largely mono-cultural.</p><p><strong>Conclusions: </strong>New Zealand has insufficient advanced practice nurses working in cardiology, compounded by inequitable distribution, with some regions having minimal or no employed CNSs/NPs. The workforce is ageing and there are marked inequities in Māori and Pacific representation and senior workforce distribution. Targeted workforce strategies are required to strengthen, integrate and fully utilise advanced nursing practice within cardiac models of care, particularly in high-need populations and areas of unmet demand.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"24-34"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632330","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":"How to make effective health recommendations-implications for coronial practice: a narrative review.","authors":"Gabrielle McDonald, Peter Crampton, Sue Crengle","doi":"10.26635/6965.7359","DOIUrl":"10.26635/6965.7359","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to investigate the characteristics of health recommendations that are associated with implementation. In Aotearoa New Zealand many organisations and entities make recommendations. However, recommendations frequently fail to achieve traction. Guidance in the art of making effective recommendations is lacking.</p><p><strong>Methods: </strong>A narrative literature review was conducted to search for evidence to guide recommendation making, primarily through identifying characteristics of recommendations that are implemented. This review focussed on recommendations that were made in the context of independent reviews, such as coronial inquiries, mortality review committees and royal commissions of inquiry, where there was a mandate to make recommendations.</p><p><strong>Results: </strong>There were many similarities in the recommendations that were more likely to be implemented across different settings. We identified factors associated with successful implementation across these areas, including factors associated with content, delivery, timing and relationships.</p><p><strong>Conclusion: </strong>The quality and effectiveness of recommendations are important from both health and public policy perspectives, as there is a high opportunity cost to society when interventions that yield the highest health return on investment are not implemented. While the circumstances in which recommendations are made vary by setting and location, we believe that the issues explored in this paper have relevance to many settings where recommendations are made to improve health.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"67-77"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632132","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":"Patterns of smoking by age and ethnicity: an analysis of New Zealand Health Survey data between 2020 and 2022.","authors":"Richard Edwards, Jane Zhang, Janine Nip, James Stanley, Andrew Waa, Michaela Pettie","doi":"10.26635/6965.7426","DOIUrl":"https://doi.org/10.26635/6965.7426","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"96-103"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632338","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":"A rare case of gastric schwannoma.","authors":"Jeli Mendoza, Phillip Pybass","doi":"10.26635/6965.7293","DOIUrl":"https://doi.org/10.26635/6965.7293","url":null,"abstract":"","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"93-95"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632255","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":"Epidemiology, clinical characteristics and outcomes of patients with severe traumatic brain injury treated by emergency medical services in New Zealand: a retrospective observational study.","authors":"Ben Jones, Bridget Dicker, Graham Howie, Kelly Jones, Irene Zeng, Andrew Swain, Aroha Brett, Verity Todd","doi":"10.26635/6965.7373","DOIUrl":"10.26635/6965.7373","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to characterise the epidemiology, clinical features and outcomes of adults with severe traumatic brain injury (sTBI) managed by emergency medical services (EMS) in New Zealand. Objectives included describing demographics, event and clinical characteristics, estimating national incidence, and 30-day mortality.</p><p><strong>Methods: </strong>This retrospective observational study analysed EMS data from the Aotearoa New Zealand Paramedic Care Collection (ANZPaCC) between 1 January 2020 and 31 December 2022. Patients aged ≥16 years with head injury and a Glasgow Coma Scale score ≤8 were included. Descriptive statistics and age-standardised incidence rates were calculated by sex, ethnicity, age, rurality and socio-economic deprivation.</p><p><strong>Results: </strong>EMS attended 630 sTBI patients over 3 years; most were male (n=430, 68.3%) and of European/Other ethnicity (n=398, 63.2%). sTBI incidence was higher among Māori than non-Māori (44.5-68.7 versus 28.6-35.6 per 100,000 person-years). Younger adults (≤45 years) had the highest rates. sTBIs in urban areas (n=485, 77%) and the most deprived quintile (n=213, 33.8%) were over-represented. Falls (n=217, 34.4%) and road traffic incidents (n=196, 31.0%) were the leading mechanisms. Thirty-day mortality was 37.8% (n=238).</p><p><strong>Conclusion: </strong>EMS working diagnoses of sTBI provide a valuable perspective on patient needs at the point of injury, capturing cases that may be missed in hospital-based datasets yet still influence transport decisions, destination selection and tertiary healthcare capacity. The data indicate that sTBI disproportionately affects Māori, younger adults, individuals living in socio-economically deprived areas and urban populations, highlighting health inequities and the need for targeted interventions, informed service planning and further research.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"46-60"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632065","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":"When expectations clash: understanding the doctor-patient relationship among first-generation Chinese immigrants in New Zealand.","authors":"Weilu Chen","doi":"10.26635/6965.7348","DOIUrl":"10.26635/6965.7348","url":null,"abstract":"<p><strong>Aim: </strong>This research aims to investigate how the expectations held by first-generation Chinese immigrants influence their relationships with doctors. It identifies barriers and opportunities for enhancing the doctor-patient relationship (DPR) in culturally diverse contexts and offers insights for developing culturally sensitive health promotion strategies.</p><p><strong>Method: </strong>In-depth interviews were conducted with 11 participants in this study, from 7 August 2023 to 10 November 2023, to examine the medical experiences and perceptions of Chinese immigrants regarding their relationships with doctors.</p><p><strong>Results: </strong>The results revealed a persistent gap between what participants had come to expect from healthcare in mainland China and what they encountered in New Zealand. This misalignment-spanning expectations regarding decision making, guanxi-based networks (social connections often leveraged for better service), clinical practices and treatment approaches-frequently led to dissatisfaction and, over time, a strained DPR.</p><p><strong>Conclusion: </strong>This study underscores the role of cultural and systemic factors in shaping patient expectations and medical experiences, thereby influencing the DPR. It emphasises the need for healthcare services that are culturally sensitive and responsive to the prior experiences and expectations of immigrant patients. These findings offer practical insights for enhancing cross-cultural communication and strengthening the DPR in similar multicultural settings.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"15-23"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632322","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":"Accuracy of rheumatoid arthritis diagnosis coding in primary care: a validation study.","authors":"Jamal Roberton, Douglas White, Vicki Quincey, Joseph Scott-Jones, Andrew W Soepnel, Chunhuan Lao","doi":"10.26635/6965.7438","DOIUrl":"https://doi.org/10.26635/6965.7438","url":null,"abstract":"<p><strong>Aims: </strong>Accurate identification of rheumatoid arthritis (RA) within routinely collected health data is essential for disease surveillance, service planning and research. This study aims to determine the proportion of recorded RA diagnoses in primary care records that met predefined validation criteria for RA ascertainment.</p><p><strong>Methods: </strong>We conducted a retrospective diagnostic validation study of subjects with a SNOMED-coded RA diagnosis recorded in the Pinnacle Midlands Health Network primary care database in 2018-2025. RA status was assessed using a structured, hierarchical validation pathway incorporating rheumatology specialist involvement, disease-modifying antirheumatic drug (DMARD) exposure and RA-specific serology (rheumatoid factor [RF] and anti-cyclic citrullinated peptide [aCCP] antibodies), with independent review of equivocal cases by two senior rheumatologists. Positive predictive value (PPV) was calculated against this composite reference standard. Additional internal validation was performed in random samples of DMARD-exposed subjects with and without specialist involvement.</p><p><strong>Results: </strong>Among 3,831 subjects with a SNOMED-coded RA diagnosis, 3,306 were confirmed to have RA, corresponding to a PPV of 86.3% (95% confidence interval 85.2-87.4%). PPV was highest among subjects with documented rheumatology specialist involvement (94.4%). Misclassification was concentrated among subjects without specialist involvement, DMARD exposure or serological data, accounting for most false-positive diagnoses. Internal validation demonstrated modest residual misclassification when DMARD exposure alone was used, particularly in subjects without specialist involvement.</p><p><strong>Conclusions: </strong>SNOMED-coded RA diagnoses in primary care demonstrate high PPV, but reliance on coding alone may lead to misclassification. Adoption of validated case definitions, alongside refinement of diagnostic coding practices, is essential to support accurate epidemiology research and health service planning.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"139 1639","pages":"61-66"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632243","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}