NEW ZEALAND MEDICAL JOURNAL最新文献

Aim: This study explores the semantic similarities between qualitative research transcripts produced by artificial intelligence (AI) and those transcribed manually, with a particular focus on challenges encountered when working with multicultural participants in health science research who are non-native English speakers.

Method: The analysis is based on an audio file from one representative participant in a qualitative study involving 20 participants. It compares transcripts generated by a professional audio transcriptionist with those produced by two AI platforms, Otter.ai and Avidnote.

Results: Findings reveal that while AI transcription has advantages in speed and cost-effectiveness, it can struggle with speaker differentiation and punctuation accuracy, necessitating manual review. Both platforms faced challenges with cultural terminology and accented speech, but Avidnote showed better performance in word recognition and comprehension. Limitations were primarily in the transcription of te reo Māori.

Conclusion: The study highlights the critical role of culturally competent researchers in reviewing transcripts to ensure accuracy and clarity. These findings contribute to a deeper understanding of the benefits and limitations of AI transcription tools in qualitative health research, especially when working with linguistically and culturally diverse populations.

Aim: Endoscopic submucosal dissection (ESD) has become a well-established treatment option for premalignant and early malignant lesions of the gastrointestinal tract. This study aimed to evaluate the recurrence rate following ESD in a single tertiary centre cohort of patients.

Methods: All consecutive patients who received ESD treatment for premalignant or early malignant lesions by a single endoscopist (AS) at Middlemore Hospital from 11 February 2019 to 6 October 2023 were included in this retrospective cohort study. The primary outcome was recurrence rate of premalignant and early malignant lesions of the gastrointestinal tract following ESD. Recurrence was defined as confirmed neoplasm on histopathology on first follow-up surveillance endoscopy. The target recurrence rate was less than or equal to 5%. Secondary outcome was recurrence stratified by location of the lesion, lesion size, en bloc resection status, R0 resection status and histopathological type of lesion.

Results: A total of 119 ESD procedures were completed during the study time frame, with 91 having a surveillance endoscopy with a median time of 231 days. Twenty-eight cases did not have surveillance endoscopy completed. Three (3.3%) had recurrence of disease, of which two were oesophageal squamous cell carcinoma and one was rectal sessile serrated adenoma. We were unable to ascertain any statistically significant associations with regard to our secondary outcome variables.

Conclusion: This study supports the efficacy of ESD in our centre as a curative treatment modality for premalignant and early malignant gastrointestinal lesions, demonstrating a recurrence rate within the acceptable international benchmark.

Aims: The primary objective of this study was to explore type 2 diabetes (T2D) awareness, knowledge, attitudes and risk factors among youth in Auckland.

Methods: We undertook convenience sampling of participants aged 16-25 years of Pacific and Māori descent recruited from South, Central and East Auckland through multiple community outreach events organised by the Tongan Health Society from 25 May to 31 July 2024. An additional three participants aged 26-31 years were assessed opportunistically to enhance our study power. Data were collected through a structured survey, an HbA1c point-of-care test, body composition assessments (using the TANITA RD-545 InnerScan PRO body composition scale) and height measurements.

Results: In a sample of 138 participants (aged 16-31 years; 58% female; 62% Tongan, 18% Samoan and 3% Māori), 51.9% were classified as obese, and one new case of diabetes was identified. Approximately 60.1% of participants reported awareness of T2D. Of these, 40% were made aware primarily through familial sources. High consumption of sugary drinks was common. Non-dietary risk factors included a first-degree family history of T2D (36%), smoking (39%) and alcohol consumption (45%). Most participants reportedly engaged in regular physical activity (41% males and 59% females). Participants suggested a multifaceted, youth-focussed care model, primarily lifestyle management for T2D prevention and management.

Conclusions: A significant proportion of young people aged 16-31 years were identified as obese and had a higher proportion of dietary and non-dietary risks for T2D. The results underscore the necessity for tailored prevention strategies, mainly aimed at Pacific and Māori youth, to mitigate the risk of future T2D development.

Pseudoaneurysms of the brachial artery have been reported in the literature, with aetiologies including iatrogenic causes, trauma and intravenous drug use. Among traumatic causes, blunt trauma is the most common, and the incidence of brachial artery pseudoaneurysms due to penetrating injuries is approximately 0.04%. The presentations are usually late, mainly after months or years, but the presentation within a week is rare. The management includes computed tomography (CT) angiography as the modality for diagnosis and endovascular or surgical approaches-the surgery is either graft or end-to-end repair. However, well-defined protocol-based management, as well as the keen suspicion of such a rare entity, is necessary for trauma or vascular surgeons to prevent further morbidities or mortality.

Aim: With the phase one Royal Commission COVID-19 report published, it is an opportune time to reflect on the various public health interventions used to consider if they were effective and how they could be improved. As we look to the future, it is important to understand if digital contact tracing (DCT) was an effective public health intervention during the COVID-19 pandemic and how it could be improved.

Method: We summarise a series of articles detailing the population and public uptake of the various DCT technologies implemented in Aotearoa New Zealand during the COVID-19 pandemic.

Results: New Zealand had one of the highest population uptakes of DCT in the developed world. However, there were additional barriers to the full implementation of these tools that likely reduced their efficacy.

Conclusion: DCT was just one of many interventions aiming to eliminate, and then suppress, COVID-19. This context makes it difficult to isolate and conclude that the efficacy of DCT during this pandemic would translate to future pandemic conditions, especially if there is improved design and implementation. However, this research shows that the self-service survey approach worked better than expected, and that there is some promise in automating notification processes.

Introduction: Human civilisation faces global catastrophic risks such as: nuclear war, bioengineered pandemics, major solar storms and a volcanic winter. For some of these catastrophes, island nations may have relative survival potential but any collapse in international trade could also end critical imported goods such as pharmaceuticals. We aimed to explore the latter in New Zealand, a highly trade-dependent island nation.

Methods: We identified the 10 most extensively prescribed pharmaceuticals in New Zealand that can be used for acute treatment (by annual prescription numbers). Based on modern synthesis pathways for these pharmaceuticals in the literature, we identified ingredients and then determined if these ingredients were currently produced in New Zealand.

Results: The results suggest that none of these 10 pharmaceuticals could be produced in New Zealand in a trade-ending catastrophe: paracetamol, omeprazole, amoxicillin, ibuprofen, aspirin, metoprolol succinate, salbutamol, prednisone, cetirizine hydrochloride and amlodipine. This is primarily because New Zealand does not refine petrochemicals. For seven of these 10 pharmaceuticals the relevant catalysts or other specific chemical ingredients are also not mined or otherwise produced in New Zealand. There may, however, be some scope for the post-catastrophe scavenging of minerals for producing some catalysts.

Conclusions: This preliminary analysis suggests that none of the 10 most extensively prescribed pharmaceuticals that can be used for acute treatments could be manufactured in New Zealand after a trade-ending global catastrophe. To address this and other domains lacking in resiliency (e.g., liquid fuel supply), planning for building shared resiliency with other neighbouring nations (e.g., Australia) could be considered.

Aim: Previous research suggested that Māori patients have a lower incidence of pulmonary embolism (PE) compared to Europeans.5-7 The aim of this study was to re-examine this in the Bay of Plenty (BOP) region of Aotearoa New Zealand.

Method: This retrospective study analysed all computed tomography pulmonary angiography (CTPA) scans completed from 1 February 2024 to 31 July 2024. Age-standardised rates for CTPA and PE in Māori were calculated using indirect standardisation to the European population.

Results: Of the scans completed, 719 CTPA scans met inclusion criteria. When age standardised, Māori received more CTPAs than Europeans, with an incidence ratio of 1.50 (95% CI [confidence interval] 1.34 to 1.68, p <0.0001). The age-standardised incidence of PE for Māori was 82.0 (95% CI 69.6 to 108) per 100,000 person years, and for Europeans was 87.0 (95% CI 65.1 to 102) per 100,000 person years, with an incidence ratio of 1.06 (95% CI 0.77 to 1.46, p=0.70).

Conclusion: This study demonstrates no ethnic difference in the age-adjusted incidence of PE. These findings suggest that ethnicity should not be used in isolation for clinical decision making. Higher rates of CTPA in Māori suggest an equitable approach to CTPA scan requesting.