NEW ZEALAND MEDICAL JOURNAL最新文献_第9页

Equity of access to pathological diagnosis and bronchoscopy for lung cancer in Aotearoa New Zealand. 新西兰奥特亚罗瓦地区肺癌病理诊断和支气管镜检查的公平性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-11-08 DOI: 10.26635/6965.6422

Jason Gurney, Anna Davies, James Stanley, Jesse Whitehead, Laird Cameron, Shaun Costello, Paul Dawkins, Jonathan Koea

{"title":"Equity of access to pathological diagnosis and bronchoscopy for lung cancer in Aotearoa New Zealand.","authors":"Jason Gurney, Anna Davies, James Stanley, Jesse Whitehead, Laird Cameron, Shaun Costello, Paul Dawkins, Jonathan Koea","doi":"10.26635/6965.6422","DOIUrl":"10.26635/6965.6422","url":null,"abstract":"Background: Māori are less likely to survive their lung cancer once diagnosed, but it remains unclear whether this is partially driven by poorer access to best-practice diagnostic services.Methods: We examined all lung cancer registrations in Aotearoa New Zealand between 2007-2019 (n=27,869) linked to national administrative health datasets and further stratified by ethnicity, tumour type and stage of disease. Using descriptive and regression analyses, we compared ethnic groups in terms of the basis of diagnosis (e.g., histology, cytology), receipt of bronchoscopy and travel distance and time to access bronchoscopy.Results: We found no differences in access to a pathological diagnosis between ethnic groups regardless of cancer type or stage. We found that Māori within the cohort were marginally more likely to access bronchoscopy than the majority European group; however, we also found that Māori had lower odds of living close to the location of their bronchoscopy, and correspondingly higher odds of living 100-200km (adjusted odds ratio [adj. OR] 1.46, 95% confidence interval [CI] 1.26-1.69) or more than 200km away (1.36, 95% CI 1.15-1.61) than Europeans.Conclusion: Interventions that aim to further support Māori to overcome the systematic and cumulative disadvantages in access to cancer care should be broadly supported and resourced.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1605","pages":"40-58"},"PeriodicalIF":1.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606972","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

Holding a mirror to society? The socio-demographic characteristics of students commencing health professional programmes, and all courses, at Ōtākou Whakaihu Waka (the University of Otago), 1994-2023. 社会的一面镜子？1994-2023年奥塔哥大学（Ōtākou Whakaihu Waka）健康专业课程和所有课程学生的社会人口特征。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-11-08 DOI: 10.26635/6965.6685

Andrew Sise, Sam Feeney, Griffin Manawaroa Leonard, Gabrielle McDonald, Greg Murray, Peter Crampton

{"title":"Holding a mirror to society? The socio-demographic characteristics of students commencing health professional programmes, and all courses, at Ōtākou Whakaihu Waka (the University of Otago), 1994-2023.","authors":"Andrew Sise, Sam Feeney, Griffin Manawaroa Leonard, Gabrielle McDonald, Greg Murray, Peter Crampton","doi":"10.26635/6965.6685","DOIUrl":"10.26635/6965.6685","url":null,"abstract":"Aim: To present selected key findings from a longitudinal analysis of the socio-demographic characteristics of students entering all courses at Ōtākou Whakaihu Waka (the University of Otago), all health professional programmes combined, and 11 individual health professional programmes between 1994 and 2023.Method: Data sources: 1) university electronic collections of student data (programme details, demographics, schooling, home address), and 2) publicly available datasets (some socio-demographic variables). Analyses included counts and proportions of commencing students, disaggregated by time period and socio-demographic variables, and commencement rates per 100,000 population aged 18-29 years.Results: During this 30-year period, there was a notable increase in the overall proportion of domestic health professional programme students who were Māori or Pacific, and an increase in enrolments of students from rural backgrounds. The socio-economic profile of incoming students remained unchanged, with students being highly skewed towards those from more socio-economically privileged backgrounds. The proportion of domestic health professional programme students who were female increased across all years, reaching nearly two-thirds by the study end.Conclusion: While efforts to enhance health professional student diversity have had a positive impact, the university's vision of a health workforce that represents Māori and the diverse contexts of Aotearoa New Zealand's society will require long-term ongoing commitment.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1605","pages":"77-91"},"PeriodicalIF":1.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606984","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

Urban-rural geographic distribution of Otorhinolaryngologist, Head and Neck surgeons in Aotearoa New Zealand. 新西兰奥特亚罗瓦耳鼻喉科、头颈外科医师的城乡地理分布。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-11-08 DOI: 10.26635/6965.6608

Thomas Napier, David Waterhouse

{"title":"Urban-rural geographic distribution of Otorhinolaryngologist, Head and Neck surgeons in Aotearoa New Zealand.","authors":"Thomas Napier, David Waterhouse","doi":"10.26635/6965.6608","DOIUrl":"10.26635/6965.6608","url":null,"abstract":"Aim: We identified geographic distribution of Otorhinolaryngologist, Head and Neck surgeons in Aotearoa New Zealand. To identify the future workforce pipeline, we explored trainee intentions for specialist practice.Method: A survey was distributed to all New Zealand Society of Otolaryngology, Head and Neck Surgery (NZSOHNS) members and all current New Zealand Otolaryngology, Head and Neck surgery trainees. Data were gathered on work location and patterns of work, including on-call commitments and full-time equivalent hours worked. Trainees were asked about future career plans.Results: An 88% response rate was achieved encompassing senior medical officers (SMOs) and trainees. A total of 64.8% (68) of respondents reported primarily working in a metropolitan hospital and 26.7% (28) reported working in a regional centre. Rates of internationally trained surgeons were significantly higher in regional centres compared to metropolitan hospitals (64.3% vs 32.4%, p<0.05). Regional respondents had higher after hours on-call burden, a higher full-time equivalent (FTE) worked and higher average hours worked per week. Retirement intentions within the next 10 years were high in both groups (64% regional and 52.9% metropolitan, p<0.05).Conclusions: The regional workforce in ORLHNS work longer hours, are older and are reliant on internationally trained surgeons. Current training of ORLHNS surgeons is unlikely to keep pace with expected retirements.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1605","pages":"59-66"},"PeriodicalIF":1.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606994","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

The incidence of atrial fibrillation and its impact on the length of stay following valvular heart surgery. 心房颤动的发生率及其对心脏瓣膜手术后住院时间的影响。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-11-08 DOI: 10.26635/6965.6606

Yeu-Shiuan Fu, Lesley Doughty, Rachael Parke

{"title":"The incidence of atrial fibrillation and its impact on the length of stay following valvular heart surgery.","authors":"Yeu-Shiuan Fu, Lesley Doughty, Rachael Parke","doi":"10.26635/6965.6606","DOIUrl":"10.26635/6965.6606","url":null,"abstract":"Aim: There is minimal evidence regarding predictors, preventative measures and treatments of new onset of post-operative atrial fibrillation (POAF) in patients undergoing valvular heart surgery. This study aimed to determine the incidence of new onset atrial fibrillation (AF) and its impact on outcomes and length of stay (LOS) for patients following valvular heart surgery.Methods: A single-centre, retrospective study was conducted.Results: New onset AF was observed in 51/120 (42.5%) patients. Baseline and surgical characteristics were similar between patients who did and did not develop AF, although suggestive older age may increase the risk of developing POAF (p=0.06). New onset AF was significantly associated with longer intensive care unit (ICU) LOS-median increase of 2 days (p=0.002)-and overall hospital LOS-median increase of 1.5 days (p=0.006). Patients who received double valve surgery spent 2.5 times longer in the ICU compared to patients who had an aortic valve replacement (AVR) (p=0.033).Conclusion: The incidence of new onset AF following valvular heart surgery was high, with associated prolonged ICU and hospital LOS. Patients undergoing double valve surgery were more likely to have a longer ICU LOS compared with those who received an AVR.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1605","pages":"12-21"},"PeriodicalIF":1.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606992","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

The alarming trend of off-label quetiapine use in New Zealand: an ongoing public health crisis. 新西兰标签外使用喹硫平的惊人趋势：一场持续的公共卫生危机。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-11-08 DOI: 10.26635/6965.6761

Pablo Richly

引用次数: 0

Early pregnancy high normal HbA1c: a high risk group? 孕早期 HbA1c 高正常值：高风险人群？

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6599

Megan J Chatfield, Lisa Woods, Ella Sussock, Rosalie E Elder, Rosemary M Hall

{"title":"Early pregnancy high normal HbA1c: a high risk group?","authors":"Megan J Chatfield, Lisa Woods, Ella Sussock, Rosalie E Elder, Rosemary M Hall","doi":"10.26635/6965.6599","DOIUrl":"10.26635/6965.6599","url":null,"abstract":"Aim: To determine if high normal early pregnancy HbA1c (35-40mmol/mol), in the absence of diabetes, was associated with increased risk of adverse perinatal outcomes compared to normal HbA1c (<35mmol/mol).Method: A retrospective chart review was carried out on all singleton births in the Wellington region from 1 July 2019 to 31 December 2019. Exclusion criteria were participants domiciled outside the Wellington region, HbA1c ≥50mmol/mol, pre-existing diabetes, gestational diabetes in current pregnancy, no HbA1c performed <20 weeks or the first HbA1c was taken at ≥20 weeks. Baseline characteristics, HbA1c and pregnancy outcomes were obtained. The primary outcome was birth weight and was analysed using multiple linear regression.Results: There were 1,067 participants in the normal HbA1c (nHbA1c) group and 186 in the high normal HbA1c (hnHbA1c) group. There was no difference in birth weight between hnHbA1c and nHbA1c. hnHbA1c had significantly lower odds of post-partum haemorrhage and composite maternal adverse outcomes compared to nHbA1c (OR 0.52, 95% CI 0.35-0.76) and (OR 0.64, 95% CI 0.46-0.89).Conclusion: High normal HbA1c was not associated with increased risk of adverse perinatal outcomes in pregnant people who did not develop gestational diabetes.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"13-21"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477840","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

Sex-specific analysis of acute alcohol use in suicides and reporting of alcohol as a contributor to suicide deaths in New Zealand 2007-2020: a cross-sectional study of coronial data. 2007-2020 年新西兰自杀者急性酒精中毒的性别分析以及将酒精作为自杀死亡诱因的报告：对验尸数据的横断面研究。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6552

Rose Crossin, Jaimie Dikstaal, Christina McKerchar, Lana Cleland, Annette Beautrais, Katrina Witt, Joseph M Boden

{"title":"Sex-specific analysis of acute alcohol use in suicides and reporting of alcohol as a contributor to suicide deaths in New Zealand 2007-2020: a cross-sectional study of coronial data.","authors":"Rose Crossin, Jaimie Dikstaal, Christina McKerchar, Lana Cleland, Annette Beautrais, Katrina Witt, Joseph M Boden","doi":"10.26635/6965.6552","DOIUrl":"10.26635/6965.6552","url":null,"abstract":"Aim: Acute alcohol use (AAU) can increase suicide risk. It is unknown if this effect differs by population sub-group in New Zealand, and what characteristics are associated with alcohol being coded as contributory to death, when AAU is identified. This study aimed to answer: 1) are the characteristics associated with suicide involving AAU different between females and males, and 2) among suicides that involved AAU, what factors are associated with alcohol being coded as a contributory factor?Method: Secondary analysis was conducted of suicide data from 2007-2020, from the National Coronial Information System. Binomial regression models for females and males were used to estimate sex-specific differences in risk of suicide involving AAU. Poisson regression modelling was used to estimate the relative risk of alcohol being coded as contributory where AAU was identified.Results: Suicide was more likely to involve AAU among Māori females (adjusted risk ratio [ARR] 1.35, 95% confidence interval [CI] 1.08-1.68) and Pacific females (ARR 1.75, 95% CI 1.22-2.51), compared to European females. Compared to males who were employed, all other employment statuses had significantly lower risk of suicide that involved AAU. Those who died by hanging (ARR 0.75, 95% CI 0.62-0.92) or firearms (ARR 0.55, 95% CI 0.38-0.90) were less likely to have alcohol coded as contributory, compared to those who died by poisoning.Conclusion: Targeted public health interventions designed by and for specific demographic groups (particularly Māori and Pacific females) are needed, alongside universal interventions that address social and structural determinants. Data systems and coding must accurately reflect the association between AAU and suicide in New Zealand.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"62-72"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477848","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

Implementation of the Medicinal Cannabis Scheme in New Zealand: six emerging trends. 新西兰药用大麻计划的实施情况：六大新趋势。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6666

Marta Rychert, Chris Wilkins

{"title":"Implementation of the Medicinal Cannabis Scheme in New Zealand: six emerging trends.","authors":"Marta Rychert, Chris Wilkins","doi":"10.26635/6965.6666","DOIUrl":"10.26635/6965.6666","url":null,"abstract":"Aim: To evaluate the implementation of the New Zealand Medicinal Cannabis Scheme (MCS), including how products, prices, prescribing and patient access have evolved since 2020.Method: Analysis of administrative data obtained via Official Information Act (OIA) requests and publicly available information on products and prices.Results: Six emerging trends were identified: 1) quarterly supply of medicinal cannabis products has increased fourteenfold since the implementation of the Scheme in 2020, 2) most products are now THC-dominant rather than CBD, 3) most products are in the form of dried cannabis flower rather than oral liquids/oils, 4) prices of products have declined to be comparable to the illegal market, 5) specialised private cannabis clinics have expanded patient access, and 6) inequities persist due to expense, and disproportionately affect Māori and those on lower incomes.Conclusions: The New Zealand MCS successfully established a domestic medicinal cannabis production sector, reduced prices and expanded the range of products to provide alternatives to illegal supply. It has also inadvertently created the conditions for the emergence of specialised cannabis clinics that have enhanced access. However, the increasing supply of THC-dominant and flower products, and the privatisation of prescribing via cannabis clinics, may have unintended negative consequences.","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1604","pages":"73-86"},"PeriodicalIF":1.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477841","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

Re: Towards equitable access in bowel screening. 关于实现肠道筛查的公平性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6749

Chey G Dearing, Georgia C Dearing

引用次数: 0

Towards equitable access in bowel screening. 实现肠道筛查的公平性。

IF 1.2

NEW ZEALAND MEDICAL JOURNAL Pub Date : 2024-10-18 DOI: 10.26635/6965.6749

Susan Parry, Cathy Whitehouse, John McMenamin, Bronwyn Rendle

引用次数: 0