NEW ZEALAND MEDICAL JOURNAL最新文献

Aim: This study aimed to estimate rates and factors associated with eating disorder risk in transgender youth, and to explore the association between this risk and unmet need for gender-affirming hormone therapy (GAHT).

Methods: In a national cross-sectional survey of participants aged 14-24 years, the five-item Sick, Control, One stone, Fat, Food (SCOFF) instrument was used to assess eating disorder risk. GAHT demand was self-reported. Modified Poisson regressions were employed to assess risk.

Results: Overall, 1,401 participants were eligible, of whom 1,010 (72.1%) had valid SCOFF scores. Of these, 398 (38.4%) participants met the threshold for eating disorder risk. In adjusted analyses, those aged 14-18 years had an increased prevalence ratio (PR) of eating disorder risk compared with their counterparts aged 19-24 years (PR: 1.26; 95% confidence interval: 1.06-1.50). GAHT demand was reported by 645 participants, with 277 (42.9%) having unmet need. No statistical evidence was found relating unmet GAHT need with eating disorder risk (p=0.29).

Conclusion: Nearly two in five transgender youth are at eating disorder risk, and unmet GAHT need rates appear higher. While it is recognised that eating disorders are a global health concern, they have not received the priority they deserve. In the calls for urgent action, transgender youth deserve particular attention.

This paper addresses the evidence on the health impacts of climate change in Aotearoa New Zealand with particular attention to who, where and what activities are most vulnerable. Applying the Arksey and O'Malley scoping review framework, it consolidates academic and grey literature to identify gaps and future research priorities. The review-conducted from February to October 2024-included 61 papers from 2,265 that were initially screened. The results reveal that temperature and extreme precipitation are the main climate risks associated with health in Aotearoa New Zealand. These are associated with direct and indirect impacts, including heat-related illness and death, enteric diseases, poor mental health, access to safe drinking water/food supplies and access to healthcare. Most regions across Aotearoa New Zealand are susceptible to climate change-induced health risks, with unique pressures for coastal regions, metropolitan areas, rural areas and regions experiencing disproportionate socio-economic inequity. Workers in outdoor manual labour-exposed to heat stress, air pollution and sun damage-are vulnerable to climate change-induced health risks. The review also highlights key demographic characteristics-ethnicity, age, skin colour, occupation, gender, housing, disability and pre-existing health needs, and socio-economic deprivation-that affect vulnerability. In conclusion, the review underscores the importance of responses to climate change-induced health addressing the underlying, intersectional risk factors to protect vulnerable populations.

A novel theory speculates how trauma is stored in the brain, the physiology of traumatic reactions and identifies a molecular mechanism that may rapidly erase traumatic memories and reverse their consequences. This theory is the basis of Havening Techniques®, used by more than 1,000 certified mental health practitioners worldwide. While trauma therapies such as eye movement desensitisation and reprocessing (EMDR) are well validated by clinical trials, the underlying mechanism of action is unknown. The theory of Havening offers a potential unifying mechanism involving the role of delta brain waves in memory processing, initiated by lateral eye movements (EMDR) or specific forms of touch (Havening). If validated by further clinical trials, Havening Techniques may represent an important advance in mental health care as trauma is a significant but potentially reversable cause of chronic anxiety, depression, post-traumatic stress disorder (PTSD), phobias and addictions. Moreover, the theory includes precise diagnostic criteria for identifying traumatic events and predicting the mental and physical health consequences. Clinical experience suggests that erasing the specific traumatic memories may also lead to sudden relief of stress-induced illness and some cases of chronic pain.

Aim: In New Zealand, ophthalmologists encounter varying degrees of work stress, job satisfaction and burnout. Significant clinical demands, long work hours and high-pressure responsibilities increase the likelihood of burnout in this specialty. The present study aims to examine differences in ophthalmologists' work stress, job satisfaction and burnout across public hospital and private practice settings.

Method: A cross-sectional quantitative study was conducted using a modified Mini Z 2.0 Burnout Survey to assess workplace satisfaction, stress and burnout among 171 New Zealand ophthalmologists. Demographic and practice-related data were also collected.

Results: Out of 161 delivered surveys, 84 responses were received (52% response rate). Among respondents, 84.5% had public sector roles and 81% worked in the private sector. Twenty-one percent of public sector ophthalmologists reported a joyous workplace (Mini Z score ≥30) compared with 75% in the private sector. Public sector clinicians reported significantly higher burnout symptoms, stress levels and workplace disorder, as well as poorer workload control and misalignment with leadership, compared with their private sector counterparts.

Conclusion: The study highlights substantial disparities in job satisfaction and burnout between ophthalmologists working in the public and private sector. Factors such as excessive workload, bureaucratic inefficiencies and limited resource allocation in the public sector contribute to these differences. Adoption of private sector practices, including improved administrative support and autonomy, as well as public-private partnerships, may enhance retention and wellbeing in the public system.