Podcasts about new zealand medical journal

A New Zealand Medical Journal article out on Friday calls for further research into former prime ministers who were unwell, but kept the extent of their impairment hidden from the public. One of the article's three authors Dr John Horrocks spoke to Ingrid Hipkiss.

I know for many people affirmative action programmes are a real sticking point. A new report in the New Zealand Medical Journal, has found that affirmative action programs at the University of Otago have however, significantly lifted Māori, Pacific, and rural enrolments over the last 30 years. Where they have failed is increasing the student numbers from poorer backgrounds. So people don't like them, but they do actually work. Māori made up 20% of enrolments at the university's medical school over the last four years, reaching parity with European and Asian enrolments for the first time. For a very long time, that wasn't the case. Ten years ago, 7.6% of new domestic medical students at Otago identified as Māori, 2.7% as Pasifika, so that shows up in the workforce in which only 3.4% are Māori, 1.8% Pasifika. However, after more robust affirmative action policies were implemented at our medical schools there was a big change. By 2016, Māori and Pasifika students entering Otago Medical School had increased by 179%. Māori were about 16% of domestic students, Pasifika about 5.6%, which is pretty much in line with how they're represented in the population. However, health profession courses at Otago are still dominated by students from wealthy backgrounds and top schools, despite rare efforts to recruit more people from poorer communities. So, if you're wealthy you're going to be fine if you want to be a doctor, you're going to be particularly fine if you're wealthy, comfortably middle class and Māori/Pasifika. Barack Obama famously said his two daughters, who have grown up in a privileged background, should not benefit from affirmative action programs when they are competing with students from poor white families. What's more important? Your ethnic identity or your background? It's easy to dismiss affirmative action as racist or lowering standards, but just remember that if you're a woman you have been able to benefit enormously from affirmative action in just about every sphere of society - law, engineering, medical school. There was a time when it was thought only men had the brains and the mettle to make it in medicine. Affirmative action opened the door to women and now it's no longer needed. Women can see it and know they can be it. Women now make up nearly 2/3 of all enrolments in health professional programs, up slightly from 1994. In fact, universities are starting to be concerned by the relative underrepresentation of young men in tertiary education and may well have to have a program encouraging young men to enrol at university in a number of courses. Places may well have to be kept for men in law school so that their profession is not flooded with women. When you look at people who have received scholarships, you cannot really go past Sir Peter Buck, and this was at a time when standards were phenomenally high for anybody entering the profession. He went to Te Aute College, the Māori secondary school, got a scholarship to Otago University, where he graduated in medicine. He was awarded so many degrees, from so many prestigious universities —Yale, Rochester, Hawaii— he received military medals for distinguished service in wars, he was an anthropologist, he worked in public health. This was a scholarship kid, he did okay. As did Māui Pōmare, which are from the young Māori Party who were a phenomenally talented group of young people and went on to equit themselves at the very highest level, with the very highest honours. Not every scholarship kid's going to be like that. Not everybody who is a recipient of affirmative action is going to be like that. Once you're in, you have to pass. And I don't know about you, but there are some incredibly clever, clever people who become doctors who probably shouldn't. They're smart, no doubt about that, they ace the exams. But when it comes to people? Not so much. Maybe they should go into pathology where they can just cut up dead things rather than deal with people one-on-one. In an ideal world, we'd all start the same, we'd all have the same opportunities, we'd all have the same choices. This is not an ideal world. So when it comes to affirmative action, I know ideally we'd all compete on the same level playing field, but as a woman, because I have seen so many of this gender benefit, to the point that we're now going to have to start thinking about offering affirmative action policies to young men, I can see its benefits. See omnystudio.com/listener for privacy information.

A programme aimed at getting more under-served groups into medical school is being scrutinised. New research in today's New Zealand Medical Journal has found Otago University's affirmative action initiatives haven't increased the number of students from poorer backgrounds. Māori now make up 20% of enrolments, reaching parity with European and Asian enrolments for the first time. But Auckland University Emeritus Professor of Medicine Des Gorman told Mike Hosking the programme wasn't designed to just lift Māori enrolment. He says when it was brought in 50 years ago, it was aimed at improving Māori health outcomes and access. LISTEN ABOVE See omnystudio.com/listener for privacy information.

Alarms are being raised over a shortfall in programmes aimed to lift medical school enrolment for under-served groups. A study in today's New Zealand Medical Journal has found Otago University's initiatives have lifted Māori, Pacific, and rural enrolments over the last 30 years. However, the number of students in health courses from poorer backgrounds hasn't actually increased. Otago University's Public Health Professor Peter Crampton told Kerre Woodham they shouldn't be missing out. He says efforts should be made to ensure everyone can make use of tertiary education opportunities. LISTEN ABOVE See omnystudio.com/listener for privacy information.

Cabinet Minister Shane Jones tells Newsable he's provocative to push the need for development, but what about the environment ? A new report in the New Zealand Medical Journal shows the use of ADHAD drugs is soaring, but the majority of those who need help are still not getting any. Established dog walkers are crying foul over cowboy recent arrivals and why it's a good idea to keep searching for a precious item even after 50 years.

We're in our ERAS era! Have you heard of Enhanced Recovery After Surgery? This approach to pre- and post-op care has been successful in reducing post-op complications, shortening recovery time, and improving patient satisfaction. Did you know there's a nutrition component in the ERAS protocol? Tune in to find out the details and how you can support this modern perioperative protocol.   Show Notes:   American Society of Anesthesiologists. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures. Anesthesiology. 2017;126(3):376-393.  Fearon KCH, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin. Nutr. 2005;24(3):466-477.  Sammour T, Zargar-Shashtari K, Bhat A, Kahokehr A, Hill A. A programme of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery. The New Zealand Medical Journal. 2010;123(1319):61-70.  Thiele RH, Rea KM, Turrentine FE, Friel CM, Hassinger TE,Goudreau BJ, et al. Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery. J Am Coll Surg. 2015;220:430-443.  Dietitians On Demand's ERAS blog series: https://dietitiansondemand.com/part-2-nutritions-role-in-eras-enhanced-recovery-after-surgery-series/   ERAS infographic: https://shop.dietitiansondemand.com/products/2332021?_pos=1&_sid=4c672d8cf&_ss=r   ERAS website: http://www.erassociety.org/  

Binge drinking, especially among older age groups, is increasing pressure on hospital emergency departments, with one ED seeing the percentage of alcohol-related presentations more than doubling over a decade. The study into alcohol-related ED admissions at Christchurch Hospital, released today, gives insight into who is presenting and how. By 2022, nearly a quarter were aged 54 or over. The research, published in the New Zealand Medical Journal, compared alcohol-related visits from 2013, 2017, and 2022. While the number of young drinkers in ED has fallen from one in three to just under one in five, over the decade, the percentage in the over-54 age group soared from 11.6 percent to nearly 24 percent. The University of Otago study provides a detailed snapshot of the Christchurch Hospital emergency department. Kathryn speaks to Dr Laura Joyce, a senior lecturer in emergency medicine and a specialist in the Emergency Department of Christchurch Hospital, and the study's lead researcher Dr Rose Crossin, an alcohol researcher at the University of Otago.

Overcrowding in hospital emergency departments is not being caused by people increasingly showing up with minor conditions, despite what some people may think. Senior doctors writing in Friday's issue of the New Zealand Medical Journal say patients presenting at EDs generally do require urgent care, but hospitals need to be adequately resourced to safely manage the workload. It comes amid growing concern about long waits in hospital emergency departments. New Zealand chair of the Australasian College of Emergency Medicine Dr Kate Allan spoke to Corin Dann.

The problem of people turning up to emergency departments with non-emergencies may have been overstated.  Medical experts writing in today's New Zealand Medical Journal says the pressure hospital EDs are under isn't due to too many people turning up unnecessarily.  They say it's mostly due to an actual increase in urgent cases.  One of the experts—Te Whatu Ora Acute Care Clinical Lead Peter Jones— told Mike Hosking that we have low numbers of presentations per head of population, compared with other countries.  He says our issue is mainly getting the people that should be there to the right place, to the care they need.  LISTEN ABOVE See omnystudio.com/listener for privacy information.

A fresh plea for a helping hand for primary care, to ease the pressure on hospital emergency departments.  An opinion piece in today's New Zealand Medical Journal suggests ED overcrowding may not be caused by unnecessary visits, but an increase in more urgent cases.  But Northcare Accident and Medical's Peter Boot says primary care is more efficient at dealing with small issues filing EDs, and it needs investment.  He told Tim Dower that 30% of General Practices are technically insolvent.  Boot says doctors are leaving, and about half of the workforce are older or planning to retire in the short term so there's a crisis in primary care.  LISTEN ABOVE See omnystudio.com/listener for privacy information.

A new study published in the New Zealand Medical Journal has found heart attack patients presenting at urban hospitals receive more timely care than those at rural or smaller urban hospitals. Monique Steele has the rural news.

And we just live in it. All about the hallucinogenic honey from the mountains of Turkey and Nepal.   Foot notes: UK article on Psilocybin therapy cost effectiveness: McCrone P, et al. Cost effectiveness of psilocybin assisted therapy for severe depression: exploratory findings from a decision analytic model. Psychological Medicine. 2 June 2023. https://www.cambridge.org/core/journals/psychological-medicine/article/costeffectiveness-of-psilocybinassisted-therapy-for-severe-depression-exploratory-findings-from-a-decision-analytic-model/8594CAC2F8D60F8C7B9A1CE3C3195B74 MDMA Assisted Therapy for Social Anxiety Disorder—Phase II trial being conducted at Portland (OR) Psychotherapy, link here for those interested in finding out more information or enrolling: https://portlandmdmatherapy.com/participate/ Krane, K. HHS Call to reschedule marijuana is a big deal: here's why. Forbes. 31 Aug 2023. https://www.forbes.com/sites/kriskrane/2023/08/31/hhs-call-to-reschedule-marijuana-is-a-big-deal-heres-why/?sh=af122092a4a7     Beasley M, et al. Poisoning due to tutin in honey—a report of an outbreak in New Zealand. The New Zealand Medical Journal. 2018; 131(1473): 59-71. https://pubmed.ncbi.nlm.nih.gov/29649198/ Bryce E. The Strange History of Mad Honey. Modern Farmer. 2014. https://modernfarmer.com/2014/09/strange-history-hallucinogenic-mad-honey/ Honey. Natural Medicines comprehensive database. Last updated 12 June 2023. Accessed 15 Oct 2023. How eating “Mad Honey” cost Pompey the Great 1000 soldiers. Texas A&M Research. 3 Nov 2014. https://research.tamu.edu/2014/11/03/how-eating-mad-honey-cost-pompey-the-great-1000-soldiers/ Jansen S, et al. Grayanotoxin poisoning: mad honey disease and beyond. Cardiovascular Toxicology. 2012; 12(3): 208-215. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404272/ Johnson S. “Mad Honey: the rare hallucinogen from the mountains of Nepal. Big Think. 26 Dec 2022. https://bigthink.com/health/mad-honey/ Ozhan H, et al. Cardiac emergencies caused by honey ingestion: a single centre experience. Emergency Medicine Journal. 2004; 21(6:) 742-744. https://pubmed.ncbi.nlm.nih.gov/15496712/ Ullah S, et al. Mad Honey: uses, intoxicating/poisoning effects, diagnosis, and treatment. RSC Advances. 2018; 8(33): 18635-18646.

Paid parental leave from work improves a new mother's health, according to findings in Friday's issue of the New Zealand Medical Journal. The conclusion is based on a literature review carried out by Otago University senior lecturer in psychological medicine Kate Eggleston, and others. Eggleston spoke to Corin Dann.

New Zealand's covid restrictions during the pandemic saved the lives of about 20,000 people. That's according to the first comprehensive analysis of the COVID-19 response, published in the New Zealand Medical Journal on Friday. Its authors - 16 leading doctors and scientists - are calling for all serious respiratory infections - including the flu and RSV - to be treated the same way. Ruth Hill reports.

A retired doctor is calling for changes to charity boxing matches, as more becomes known about the risk of death and injury from head trauma. In a newly-published piece for the New Zealand Medical Journal, Dr Pete Benny has questioned whether it's ethical for charities and corporates to benefit from people purposely attempting to concuss each other. He had a family member who died as a result of injuries sustained in a charity boxing match, and wants to see stronger rules introduced to protect novices in the ring. They include greater importance of head injury assessments in the event of suspected concussion, better matching of opponents in terms of size and strength, making the head sacrosanct - as the genital area already is and a stronger position on charity boxing by relevant medical authorities. Pete joins Kathryn to discuss this, along with Dr Rosamund Hill, an Auckland-based neurologist who's previously spoken out about banning charity boxing.

Screen time for children is a constant worry for many parents and caregivers. New research published in the New Zealand Medical Journal today has found our kids are spending about a third of after-school time on screens. CEO of the Parenting Place, Dave Atkinson.

Obesity, poor sleep and poor mental wellbeing are just some of the potential problems for children who spend too much time staring at their phones, according to research published today in the New Zealand Medical Journal. The new study shows that the average twelve-year-old spends at least a third of their spare time on their phone, and potential physical problems aren't the only issue. The University of Otago study notes that kids are being exposed to ads for vaping, alcohol, gambling and junk food. Louise Signal, a professor of public health at the University of Otago, joined Corin Dann in studio.

Alarmed experts have sounded warning for the mental and physical wellbeing of Kiwi children after new research revealed our kids are spending about a third of after-school time on screens. The high rate of screen time is exposing youngsters to cyberbullying, harmful sexualised content and inappropriate advertising for sectors such as alcohol and gambling. YouTube and Netflix are the most popular websites, with one in three children under 14 using social media, most commonly TikTok, which is rated R13. Experts say the problem has worsened since the country was plunged into Covid-19 lockdowns as families' activities and schooling were thrown into disarray. They say regulations are urgently needed to protect children from harm in the largely unregulated online world. An Auckland mother of five says her family try to limit screen time and use of devices during the school week and has banned TikTok in the house due to inappropriate content and swearing. “When I heard that it was always ‘get off it'. We can't always control it, but none of them have social media.” In a University of Otago study, adolescents' habits were tracked by body cameras between 3.30pm and bedtime, with screen time exceeding the recommended level - less than two hours a day outside school hours. Kids were found to spend around 10 per cent of their time on two screens. Developing research says multiple screen use could be linked with poorer sleep (compared to single screen use). Photo / University of Otago The significant amount of time spent in front of screens raised health and wellbeing concerns, said senior researcher Dr Moira Smith, from the University of Otago's Department of Public Health in Wellington. “It is associated with obesity, poor mental wellbeing, poor sleep and mental functioning and lack of physical activity,” she said. “It also affects children's ability to concentrate and regulate their behaviour and emotions.” The findings, published in the New Zealand Medical Journal today, were likely to be an underestimate. The initial data collection was in 2014/15, and use of smartphones and online activity is believed to have increased since then - especially during the pandemic. It is not yet known whether habits formed during the Covid period have persisted, and this is the subject of further research. The Auckland mother said she and her husband were “pretty strict” about how much time the kids spent on electronic devices during the school week. “If they've got homework, or maybe a movie, then we'll let them on. Otherwise, they're pretty busy from Monday to Friday with school sport training. “In the weekend we're a bit more lenient, but they have to do their chores first and maybe do a bit of reading and then they can spend a bit of time on their devices.” A lot of her friends had kids who were already on social media. “It's scary, in case they're watching something inappropriate and rude that we don't know.” While screen time was reasonably easy to navigate at home as both parents were on the same page, she said it would be harder in a single-parent home where kids might get left on devices more often “so they can do housework or whatever”. The paper's authors said the amount of time young people spent online also raised concerns around cyberbullying, exposure to sexism and racism, and exposure to advertising for vapes, alcohol, gambling and junk food. New Zealand legislation was outdated and failed to adequately deal with the online world children were being exposed to, Smith said. “While screen use has many benefits, children need to be protected from harm in this largely unregulated space,” she said. Last month, the Government began consulting on changes to how online content is regulated in New Zealand. That could eventually mean social media companies with a presence in New Zealand have to sign codes of practice requiring them to proactively manage harmful content. The researchers applauded this work, which is being led by the Department of Internal Affairs. The Otago study involved placing body cameras on 108 children and analysing images, which were taken every seven seconds. A young person from the study wearing a body cam to track their screen time. Photo / University of Otago On average, children were in front of screens for 23 minutes of every hour outside school time. Boys were more likely to spend more time in front of screens, and Māori and Pacific adolescents had more screen time than young people of European descent. Around 10 minutes per hour were spent in front of more than one screen. Researchers said this could carry additional health risks to single-screen use, with preliminary studies indicating an association with poorer sleep. High rates of screen time raised health concerns because they displaced activities like active play and sleep. It also negatively affects a child's ability to focus their attention and regulate their behaviour and emotions. It was also problematic because of exposure to cyberbullying. New Zealand has high rates of cyberbullying, with around one in four parents reporting their children had been bullied online. Research by the University of Auckland concluded that blanket screen limits - such as the two-hour recommendation - did not reflect contemporary family life. Instead, the researchers called for a fresh approach, where parents and caregivers aimed to be more involved in their children's screen time by monitoring content, choosing interactive screen activities rather than passive watching, and balancing screen use with family time. The World Health Organization recommends school-aged children, up to 17, limit their recreational screen time. Children aged 2 to 4 should not have more than one hour of screen time per day and even less is better, the WHO advises. It also suggested kids younger than 2 should have zero screen time. In March, Health insurer nib New Zealand released findings from its annual State of the Nation Parenting Survey that showed technology use and the impact of screen time was the number one concern for 70 per cent of parents. Half of those parents surveyed said children spent too much time on devices, and 66 per cent admitted relying on screens as a bargaining chip and distraction tool for children. Seventy per cent of parents had taken action: limiting kids' screen time (52 per cent) and taking away devices as punishment (57 per cent). How much time should kids spend in front of screens? 0-2 years: Zero use 2-5 years: less than 1 hour a day 5-17 years: less than 2 hours (Ministry of Health statistics) - Isaac Davison, NZHSee omnystudio.com/listener for privacy information.

Paternal depression is often perceived to be solely experienced by women. But today, the New Zealand Medical Journal today has published a research letter about depression experienced by first-time dads. A study by the University of Otago found 5.4 percent of dads experience major depression within the first year of becoming a new dad. Jesse speaks to Dr Geraldine McLeod from the university's Department of Psychological Medicine.

Employing only clinicians with a tertiary level degree,  is a luxury our mental health system can no longer afford. That's the argument being made by three industry experts in an editorial in the latest New Zealand Medical Journal. Otago University Department of Psychological Medicine's Associate Professor James Foulds says 10 percent of funded positions in the sector are vacant. He says they're proposing an apprenticeship model - bringing people with the right attributes into the workforce and giving them on the paid job training. Foulds says they'd initially slot into roles such as healthcare assistants. LISTEN ABOVESee omnystudio.com/listener for privacy information.

Climate change isn't just harming the health of the planet, its also harming the health of people living on it.  That warning comes in an editorial published in the New Zealand Medical Journal arguing that climate change also creates major health problems.  One of the authors, Māori doctor and academic Rhys Jones, says storms like Cyclone Gabrielle have terrible impact on people's wellbeing and this will only get worse as severe storms become more frequent.

A new study published today shows how dangerously close Aotearoa New Zealand is to a national measles outbreak because of low immunisation rates in children. The Otago University research, published in the New Zealand Medical Journal, show  a decline in the number of children receiving the first vaccine at 12-months old is declining across the country and is now less than 90-percent in six locations - Bay of Plenty, Lakes, Northland, Tai Rāwhiti, West Coast and Whanganui Lead researcher Dr Nienke Hagedoorn says a nationwide catch-up immunisation programme is urgently needed.

Health experts are warning that schools without adequate Covid-19 safety measures could cause another outbreak of the virus. In an editorial published in the New Zealand Medical Journal today, researchers say schools are high-risk settings for infectious diseases and teachers are particularly vulnerable. In 2022, most school children caught Covid-19 and teachers had the highest infection rates among all occupational groups.  Professor Michael Baker was one of the authors. He spoke to Māni Dunlop.  

Some newly-graduated doctors warn the lack of hands-on learning during their training has left them feeling ill-prepared for the reality of dealing with emergencies. A study published Friday  in the New Zealand Medical Journal is calling for medical schools to put more focus on stress management skills to stop young doctors burning out. Ruth Hill reports.  

Pushes for systemic change, as high suicide rates among doctors are highlighted. Today's New Zealand Medical Journal editorial discusses burnout, depression and anxiety being extremely common in the profession. It suggests a reduction in workload and improved teamwork, appear to be most effective at improving doctors' mental health. Psychiatrist and co-author, Roger Mulder, says the creation of Te Whatu Ora is an ideal time to address this kind of culture. He says there's still a stigma around mental health - and sometimes people prefer to pretend everything's fine until they suddenly fall over. LISTEN ABOVESee omnystudio.com/listener for privacy information.

A hunt is on for new publishers for the New Zealand Medical Journal - with warnings it would be a big loss if it folded. The organisation that runs the journal, the New Zealand Medical Association, is set to go into liquidation after struggling financially for years. That puts the survival of the 135-year-old publication under threat. Health Correspondent Rowan Quinn has more.

Professor Harvey White is a Cardiologist and Director of the Cardiovascular Research Unit, Auckland City Hospital. He is an Honorary Professor of Medicine University of Auckland and Fellow of the Royal Society of New Zealand.  Harvey trained at Green Lane Hospital, Auckland and Harvard and Brigham and Women's Hospital, Boston. He is the John Neutze Scholar. In recognition of his work on end-systolic volumes as the most important modifiable prognostic factor following myocardial infarction, he was awarded DSc by Otago University. He was awarded the Prince Mahidol Award by the King of Thailand for introducing fibrinolytic therapy in developing countries, including China. He is a Matai (La'uli) in Samoa for services to Samoa, and has a “pou” in the Te Awamutu Walk of Fame recognising his contribution to decreasing heart disease. He is Co-chairman of the Redefinition of Myocardial Infarction Consensus group and defined the 5 types of MIs. He is senior author on the Bleeding Academic Consortium (BARC) to define bleeding.  He has been a member of numerous guideline groups. He is a member of the Cholesterol Treatment Trialists' (CTT) Collaboration and is on 16 editorial Boards. He has over 1000 publications and 77 editorials with an H Score 121.He gave the most prestigious International Society and Federation of Cardiology lecture at the European Society of Cardiology in 1993, and Paul Dudley White lectures at the American Heart Association in 2004 and at American College of Cardiology in 2011. Harvey is recognised in the top 1% of scientists worldwide and No 5 for publication of RCT-related articles in all high-impact-factor medical journals over the past five decades. He was also awarded the highest collaboration index.  He has been NZ Chairman and President of the combined Cardiac Society of Australia and New Zealand. He was awarded the Inaugural Gold Medal at the Cardiac Society of Australia and New Zealand Annual Scientific Meeting 2019 for outstanding contribution to Cardiology.He introduced the 10 year earlier screening for Mᾱori in the absolute risk assessment and has presented this to the Health Committee on doing that for colonic screening; published on  worse outcomes for Mᾱori  after bypass surgery; has a Pou in the Te Awamutu rose gardens; introduced the Mᾱori byline for the New Zealand Medical Association and as chairman of the New Zealand Medical Services Board is responsible for the New Zealand Medical Journal.  He has also had multiple visits to Samoa doing clinics, including a WHO report, attending the 50th annual meeting of the Samoan Medical association, and a matai title La'auli, the highest mountain,  for services to Samoa.In this episode, we discuss his extensive and prolific journey in research, his work in Samoa and Māori health, and his love for cardiology. As always, if you have any feedback or queries, or if you would like to get in touch with the speaker, feel free to get in touch at doctornos@pm.me.Audio credit:Bliss by Luke Bergs https://soundcloud.com/bergscloudCreative Commons — Attribution-ShareAlike 3.0 Unported — CC BY-SA 3.0Free Download / Stream: https://bit.ly/33DJFs9Music promoted by Audio Library https://youtu.be/e9aXhBQDT9YSupport the show

More staff is needed to help reduce growing violence at Christchurch Hospital's emergency department.Research in the New Zealand Medical Journal says each and every staff member has experienced the abuse.Emergency medicine specialist Dr John Bonning says more resource is needed across the health sector to reduce waiting times.He told Kate Hawkesby they've produced hospital access targets like shorter stays -  but that requires the whole system buying in.Bonning says with the transition into the new health authorities from July - it's still unknown what that means for those on the frontline.LISTEN ABOVE

Nicotine-free tobacco products could be the answer to helping us achieve our Smokefree 2025 goal. New research, published in today's New Zealand Medical Journal, has found the removal of nicotine could reduce smoking rates to well under five-percent by 2025.  It projects one fifth of smokers would quit, if only nicotine-free cigarettes were allowed from next year. Otago University researcher Richard Edwards told Tim Dower the move would have a real impact on smokers and those experimenting with smoking. “They don't get any hit from them, so they're much less likely to want to try them and if they do try them, they're not going to get addicted because the cigarettes will not be addictive.” LISTEN ABOVE 

Rapid antigen tests are being rolled out to pharmacies and businesses from next month as part of a raft of Covid-19 mitigation measures. These tests, which detect the presence of specific proteins rather than the virus's genetic material, can miss up to 44 percent of positive Covid-19 cases, according to a new study out in the New Zealand Medical Journal. In places with relatively little Covid-19 spread, a positive result from a rapid antigen test can in fact be more likely be a false positive than an actual case of the virus. In New Zealand, any positive result from a rapid antigen test will require confirmation with a PCR test. Rapid PCR tests, meanwhile, are just as accurate as the standard PCR tests which currently take between 24 to 72 hours to get results back. University of Otago microbiologist Dr James Ussher spoke to Guyon Espiner.

Rapid antigen tests are being rolled out to pharmacies and businesses from next month as part of a raft of Covid-19 mitigation measures. These tests, which detect the presence of specific proteins rather than the virus's genetic material, can miss up to 44 percent of positive Covid-19 cases, according to a new study out in the New Zealand Medical Journal. In places with relatively little Covid-19 spread, a positive result from a rapid antigen test can in fact be more likely be a false positive than an actual case of the virus. In New Zealand, any positive result from a rapid antigen test will require confirmation with a PCR test. Rapid PCR tests, meanwhile, are just as accurate as the standard PCR tests which currently take between 24 to 72 hours to get results back. University of Otago microbiologist Dr James Ussher spoke to Guyon Espiner.

As New Zealand readies for more Covid-19 cases, warnings about the ability of public hospitals to cope, are escalating. There are 289 Intensive Care Unit or High Dependency Unit beds at the moment, with minister Andrew Little insisting that could be ramped up to 550 if needed. But that's been roundly questioned by clinicians and ICU experts, including a recent New Zealand Medical Journal article that concluded fully staffed, extra capacity would be more like 67 beds. A shortage of highly trained specialist ICU nurses is also flagged as a major problem. Political editor Jane Patterson reports.

As New Zealand readies for more Covid-19 cases, warnings about the ability of public hospitals to cope, are escalating. There are 289 Intensive Care Unit or High Dependency Unit beds at the moment, with minister Andrew Little insisting that could be ramped up to 550 if needed. But that's been roundly questioned by clinicians and ICU experts, including a recent New Zealand Medical Journal article that concluded fully staffed, extra capacity would be more like 67 beds. A shortage of highly trained specialist ICU nurses is also flagged as a major problem. Political editor Jane Patterson reports.

Research is suggesting rural hospitals are being ignored in the Covid-19 pandemic. A study published in today's New Zealand Medical Journal says DHBs have a poor understanding of rural hospitals and facilities, and feel uncertain on managing Covid patients.  Otago University researcher Garry Nixon told Kate Hawkesby part of the problem is around the physical resources available and workforce shortage. “There's also the inevitable issue, whereby, the DHB is going to be largely focused on their large-based hospital”  LISTEN ABOVE  

On Christmas Eve December 2020, the World Health Organisation named Antimicrobial Resistance (AMR) and health inequities as 2 of the 10 global health threats to track in 2021. In 2019, we worked with the Health Quality and Safety Commission (HQSC) and PHARMAC to see how we can tackle both in Aotearoa New Zealand. The results of this work have just been published in the New Zealand Medical Journal, so we wanted to dedicate this episode of Inside the Nudge Unit to it.  Peer-reviewed articles allow us to present the rigorous work that goes into running a Behavioural Insights (BI) project. However, journal articles often remove the work from its broader context and leave little space for describing the tribulations that go into running BI trials. In this episode, we cover the story of how the trial developed, and how it built on our earlier work in the UK and the work done by the Behavioural Economics Research Team in the Australian Department of Health (BERT) and the Behavioural Economics Team of the Australian government (BETA).  We discuss how health inequities in Aotearoa New Zealand meant that we couldn't just copy the letters used in the UK and Australia, and take a quick detour into the replication crisis. You'll hear from Michael Hallsworth, who led the work in the UK, Janice Wilson, the CEO of the HQSC, Rawiri Jansen, a GP and member of the project's working group, and Nathan Chapell, who developed the letters we used in the project.  Further reading If you would like to read more about health inequities in New Zealand, you can read the paper mentioned by Rawiri Jansen here, as well as its follow up here. You can also read about the follow up to the UK study here, and the follow up to the Australian study here.  If you are interested in learning more about the replication crisis, we would recommend this article. And if you would like to learn more about issues related to generalising studies from one area to another, we recommend you read this. Chapter 5 of Behavioral Insights, which was co authored by Michael Hallsworth (along with Elspeth Kirkman) also gives an overview of the issues discussed.  Thanks to the large team of people who were involved in the project, especially Janice Wilson, Catherine Gerard, Richard Hamblin, Carl Shuker, Janet Mackay, Rawiri McKree Jansen, Richard Medlicott, Aniva Lawrence, Sally Roberts, Jan White and Leanne Te Karu.  Music by Rich O'Brien https://open.spotify.com/playlist/1m3zn3SHmMh3vuR13hkLCP?si=e9e2193372664b6b Production by Alex Gyani.  Editing by Pixelife Studios. 

A mismatch in the workload, structure and staffing numbers of the country's Emergency Departments.They're revealed in a study published in today's New Zealand Medical Journal.The problems differ between bigger and smaller hospitals.Staffing is the main issue at larger urban hospitals - having enough doctors on at any one time; while at regional ones - space and ED beds are the biggest problem - then staffing if there's an ED surgeMedian wait times range from 13 minutes to more than an hour and a half.College of Emergency Nurses chair Sandy Richardson told Tim Dower we need to recognise EDs are under incredible pressure.“And there is variability in terms of waiting times, and it's not just the geographical location, it's also the fluctuations in work load across those EDs.”LISTEN ABOVE

Māori children are three and a half times more likely to die from accidents than Pakeha children. That's according to a study of ACC data, which has just been published in the New Zealand Medical Journal. 66 children die each year from accidents - the leading cause of death for children. Dr Mike Shephard, an emergency pediatrician at Starship Hospital, spoke to Corin Dann.

A new article in the New Zealand Medical Journal has found Pasifika are most likely to be hospitalised for Covid-19; three times more likely than any other ethnic group to be hospitalised.

The World Health Organisation has been accused of sexism after releasing a draft report that pushed for women of "child-bearing age" to be prevented from drinking alcohol.The controversial advice was laid out in WHO's draft of its Global Alcohol Action Plan 2022-2030, which urges countries to raise awareness among the public about the risks and harms associated with alcohol consumption, with particular focus on how children are impacted when exposed to alcohol while still in the womb.In order to lessen these impacts, the organisation suggests preventing not only pregnant women from drinking alcohol, but any woman of "child-bearing age"."Appropriate attention should be given to prevention of the initiation of drinking among children and adolescents, prevention of drinking among pregnant women and women of child-bearing age," the report states.Under this advice, steps would be taken to prevent millions of women from drinking alcohol, just because they are considered to be in their peak child-bearing years.The report sparked instant backlash, with Matt Lambert, CEO of the Portman Group, the social responsibility and regulatory body for alcohol in the UK, branding the advice "sexist and paternalistic"."We are extremely concerned by the WHO calling on countries to prevent drinking among women of child-bearing age in their latest action plan. As well as being sexist and paternalistic, and potentially restricting the freedoms of most women, it goes well beyond their remit and is not rooted in science," Lambert said."It is wrong to scaremonger in this irresponsible way and associate women's alcohol-related risks with those of children and pregnant people."Social media users were quick to lash out at the organisation, with many branding the suggestion "disturbing"."Tied to that is a rather disturbing thought that the point of 'women of child-bearing age' is to have children. What if some of those women choose not to … or cannot? Will they need to carry a permission slip to get a drink, or will they be banned anyway?" one Twitter user wrote.Another user wrote: "Just to be safe, better lock all women of child-bearing age on 'health ranches' where they are not allowed to ride in cars, ascend to altitudes above 8500 feet above sea level, take hot showers, eat raw oysters, or use the acne drug Accutane."A 2018 study, published in the New Zealand Medical Journal, found 23 per cent of women who took part in the Growing Up in New Zealand study continued to drink in their first trimester - when the risk of damage to nerve tissue was the highest - despite knowing they were pregnant. Thirteen per cent continued drinking after the first three months.Up to 3000 New Zealand children are born every year with Fetal Alcohol Spectrum Disorder as a result of their mother drinking alcohol during pregnancy.The Ministry of Health says there is no safe level of alcohol consumption while pregnant.Chief executive of Alcohol Change UK, Dr Richard Piper, told The Telegraph: "Drinking alcohol in the early stages of pregnancy, even before many people realise they're pregnant, can be very damaging for a foetus.""It's important that people understand these risks, but also vital that we balance this against each adult's right to make informed decisions about what we do with our bodies, no matter our age or sex."

A team of researchers say the Southern DHB should never have been granted permission to join the National Bowel Screening Programme in 2018. An investigation using the Official Information Act found that permission was granted prematurely, without following due process and in spite of concerns raised by Ministry of Health staff about the DHB's capacity. The paper published in the New Zealand Medical Journal today outlines how the decision was made at a a time when the Southern DHB was even struggling to provide colonoscopy services for symptomatic patients and would be unprepared to deal with the increase in demand that screening would cause. Kathryn speaks with Phil Bagshaw, chairman of the Canterbury Charity Hospital Trust.

A team of researchers say the Southern DHB should never have been granted permission to join the National Bowel Screening Programme in 2018. An investigation using the Official Information Act found that permission was granted prematurely, without following due process and in spite of concerns raised by Ministry of Health staff about the DHB's capacity. The paper published in the New Zealand Medical Journal today outlines how the decision was made at a a time when the Southern DHB was even struggling to provide colonoscopy services for symptomatic patients and would be unprepared to deal with the increase in demand that screening would cause. Kathryn speaks with Phil Bagshaw, chairman of the Canterbury Charity Hospital Trust.

According to today's New Zealand Medical Journal, the bowel screening system is quite the mess.And what’s worse, the Ministry of Health knows and has tried to cover its tracks.It took an intervention by the Ombudsman to get to the truth.Surgeon Professor Phil Bagshaw joined Tim Dower."What we found was, people with symptoms were finding it very hard to get a colonoscopy."LISTEN ABOVE

A pair of prominent researchers say there's little hope the reforms proposed by the Heather Simpson report will make a difference. A paper published in the New Zealand Medical Journal this morning notes that there have been more than 50 reforms of the public health service since it was established, and its authors argue that, without fail, all of these have been essentially pointless. Professor Des Gorman from the University of Auckland is one of the paper's co-authors. He spoke to Guyon Espiner.

There are calls to bring in new rules around e-scooters - after it was found users were more likely to be hospitalised than cyclists. Research published in the New Zealand Medical Journal compares the injuries of e-scooter riders and cyclists treated and Auckland City Hospital. They found e-scooter users had significantly higher levels of alcohol in their system and were less likely to wear protective gear. Reporter Karoline Tuckey has more.

People jumping on a scooter drunk, and late at night, are ending up in hospital after hours. That's a trend noted by a New Zealand Medical Journal paper comparing the injuries from e-scooter users and cyclists between 2018 and 2019 at Auckland City Hospital. One of the authors of the report, Dr Savitha Bhagvan says there should be a zero tolerance policy for alcohol and escooters, mandatory protective gear and stronger road rules. Dr Bhagvan is a trauma and general surgeon at Auckland City Hospital. She spoke to Corin Dann.

New research is proposing a risk-based system to allow some international travellers into the country.A study published in today's New Zealand Medical Journal,funded by the aviation sector, has suggested a new model for relaxing border restrictions, based on each country's Covid 19 risk level.The "traffic light" system would allow restrictions to be increased or decreased, based on the changing situation in each country.Arthur Morris is one of the scientists proposing the system. He told Tim Dower Covid is far less likely to come from countries like Taiwan and Vietnam, than from other countries."If you apply screening when they depart and when they arrive, you can mitigate the risk.Many experts are criticising the proposal, saying it creates too much risk for community outbreaks and doesn't account for new strains of the virus.LISTEN ABOVE

Some GPs are making decisions on who should get cheap contraception, and who doesn't.The New Zealand Medical Journal says Māori and Pacific women are being targeted for the Ministry of Health's $4.5 million fund for free or low-cost contraception.It's for women at risk of an adverse outcome, as a result of an unintended pregnancy.Auckland University's Orna McGinn told Tim Dower all women should be able to benefit from cheap access to contraception.“Figures show one in four women in New Zealand will have an abortion in their life time – which is more likely than having your tonsils out.”McGinn says several DHBs are targeting Māori and Pacific women, those at risk of family violence, or mental health issues.She says that's not the way a population health measure should be rolled out.“Access to contraception should be even, throughout the country.”LISTEN ABOVE

A group of medical experts say the way diabetes is treated in New Zealand is racist - but a solution at hand. The co-authors of an editorial in the New Zealand Medical Journal, published today, are calling for the drug-buying agency Pharmac to fund two drugs that could dramatically improve the lives of people with diabetes. They argue the failure to acquire the drugs until now is a symptom of intrinsic racial inequity. Co-authors Dr Rawiri Jansen speaks to Susie Ferguson.

A new study shows a number of pregnant women eat foods they know are risky.A survey published in today's New Zealand Medical Journal shows nearly 80-percent of women know a pre-prepared salad is unsafe, but almost half eat them anyway.Nutritionist Claire Turnbull told Kate Hawkesby the perceived risk of listeria and bacterial contamination is low - but it can cause serious problems including miscarriage."A lot of people don't necessarily know somebody that's had an issue, therefore they think 'you know what, probably not that common', but if it does happen, the effects can be catastrophic."a pregnant woman's immune system is lower, so it comes down to food quality control. "When your buying food from somewhere else, you don't know who's hands have been on that, and if it's been prepared in a way and stored in a way that is completely safe."Pregnant women are told to avoid pre-prepared salads, including rice or pasta salad, coleslaw and green salads. 

Holding New Zealand's testing rate at 5,500 per day could catch imported cases of coronavirus before its spreads too far, newly-published modelling shows.The Otago University scientists behind the research, featured in today's New Zealand Medical Journal, also say smarter approaches like targeting border workers, or screening city wastewater, could allow for lower testing levels.In the study, the scientists modelled one scenario where a single, undetected infection made it through our borders and into an environment where the virus' reproduction number was as high as two - meaning one case could lead to an average two others.To detect the outbreak rapidly, the researchers said an "ongoing programme" involving some 5,580 tests per day - equivalent to 1,120 per million people - would be needed.Their modelling estimated that the hypothetical outbreak - and nearly all others they explored - would be extremely likely to be detected within 36 hours if testing was that high.By that point, their scenario estimated there'd be a median five cases in the community.They said the vast majority of this testing would be of symptomatic cases in primary care settings, and the rest in hospitals.That optimal level of 5,580 daily tests was higher than the average 4,200 carried out each day in early May - and slightly above the current, rolling seven-day average of 5,034.On Wednesday, laboratories completed 7,403 tests, bringing the total number completed to date to 1,083,230.The researchers also suggested other tweaks to the testing regime.They included prioritising community testing for people with relevant symptoms in cities that were most exposed to border failures - such as Auckland, Hamilton, Rotorua, Wellington and Christchurch."And also, you could think that the people who live with workers at the border, they should also have a heightened awareness of the need to be tested, if they develop any symptoms at all," study co-author Professor Nick Wilson said."So if you're living with someone who works at our quarantine facility, there should be targeted messaging towards those groups - and they should have a very low threshold for getting testing."Wilson also argued New Zealand was proving slow to begin regularly testing samples at wastewater stations."Sydney used that to identify a community outbreak before there was any testing results," he said."So we should be speeding up the process of wastewater testing in all of our cities, as another early-warning type of platform."A Ministry of Health spokesperson said regular reviews of the Covid-19 surveillance and testing strategy were carried out, and the new paper would be considered."While the number of tests is important, it is also about ensuring that the highest risk people are being tested," they said."We regularly test those who have been identified as higher risk who work at the border, including those who work at ports and at managed isolation and quarantine facilities."The spokesperson noted ESR had been awarded a Government grant of $1.6m to look at how it could deliver cost-effective, community-level monitoring of Covid-19 - including wastewater sampling.By: Jamie Morton

A sexual abuse survivor group believes research about sexual assaults on university students is conservative. A study by the New Zealand Medical Journal found 28 percent of students surveyed had experienced at least one form of sexual assault. Many of those had never told anyone about what had happened to them. Charlotte Cook filed this report.

A third of sexual assaults on New Zealand university students go unreported, according to new research published in The New Zealand Medical Journal. In a survey of 1500 students, 28 percent reported at least one form of sexual assault, including 15 percent who reported rape. In nearly a third of those cases, survivors didn't tell anyone about their experience. Associate Professor Melanie Beres, from the University of Otago sociology department, speaks to Corin Dann.

Māori are 50 per cent more likely to die from Covid-19 than Pākehā, a groundbreaking new study has found - with institutional racism partly to blame.Researchers - including sociology, statistics, physics and cultural history experts - linked existing demographic and health data for ethnic groups in New Zealand with international Covid-19 data to reach the findings.International data was used was because the number of cases in New Zealand alone is too small to provide a sufficient sample size.The alarming results, published in today's New Zealand Medical Journal, come as the current Auckland cluster disproportionately affects Pacific NZers (more than 60 per cent of cases) and Māori (about 20 per cent of cases).Factors that researchers say can explain the difference in risk by ethnicity include:• More Māori live with multiple underlying health conditions (comorbidities) compared to New Zealand Europeans. Those with comorbidities are at greater risk of dying from Covid-19.• Hospitalisation and fatality rates for Māori and Pacific from the H1N1 influenza pandemic in 2009 were significantly higher than for New Zealand Europeans.• Avoidable hospitalisations are higher for Māori and Pacific populations due to structural disadvantages.• Māori are at greater risk of exposure to the disease due to higher involvement in high-risk occupations and environments and larger social networks.Risk factors for accelerated transmission included crowded housing, which affects about 25 per cent of Māori and 45 per cent Pacific.Rapid spread of Covid-19 would "place unprecedented stress on the healthcare system" and almost certainly amplify existing racism, the researchers concluded.Mike Plank - one of the authors of the paper and a professor in the School of Mathematics and Statistics at the University of Canterbury - said overseas there were already horrible reports of doctors faced with the awful decision of choosing which Covid-19 patient to save."If a patient has a pre-existing health condition then they have less chance of surviving, so the doctor would more likely prioritise the healthier patient," he said.Plank said the worse health outcomes for Māori and Pacific people "stem from widespread inequities in the healthcare system, and the ongoing impacts of systemic racism and colonisation."Given the speed at which Covid-19 can spread, there was an urgent need to prepare healthcare services and establish measures to protect at risk groups.The researchers said better transparency was needed in the risk factors and weightings used to guide decision-making about healthcare service provision - and more work was needed to incorporate these findings into the Ministry of Health disease transmission models that are used to inform New Zealand's Covid-19 response.The New Zealand data showed the level of pre-existing health conditions in Māori and the international data revealed that pre-existing health conditions meant greater risk of dying from Covid-19.Researchers adjusted the age-specific infection fatality rates (IFR) from international data for differences in unmet healthcare need, and comorbidities by ethnicity.They also altered the life expectancy rate for each ethnicity due to evidence that Covid-19 amplifies existing death rates.The research comes as additional studies, conducted by separate researchers, have revealed major ethnic inequalities within our country across the board, including mental health, heart attacks and prostate cancer.READ MORE: The key issues behind racism within our healthcare system.About the study's authors:• Professor Shaun Hendy is Director of Te Pūnaha Matatini, a research centre focused on the study of complex systems and networks, based at the University of Auckland.• Dr Alex James and Nicholas Steyn also work for Te Pūnaha Matatini.• Tahu Kukutai specialises in Māori and Indigenous population research. She is affiliated with the University of Waikato and the National Institute of Demo...

A researcher modelling Covid-19 death rates for different ethnicities estimates 600 Māori and over 900 Pasifika would die in the Counties Manukau district alone if the disease was allowed run rampant.  Research published in the New Zealand Medical Journal today, which is a continuation of study findings first published in April, estimates the rate of Maori deaths would be double that non-Māori.  The report's co-author Andrew Sporle says they also found Māori and Pacific are also more likely to be hospitalised with the virus due to poorer health and are more likely to get infected because of overcrowded housing. Cabinet will decide today whether or not to ease Covid-19 restrictions next week.   

Navy veterans who witnessed the French atmospheric nuclear explosions in 1973 have higher rates of cancer while many of their children are also suffering fertility problems. That's the conclusion of new University of Otago research published today in the New Zealand Medical Journal. The study focused on members and family of the crews of HMNZS Otago and HMNZS Canterbury who were sent to witness the nuclear explosions at French Polynesia's Mururoa atoll. The survey found 37 percent of the veterans who took part had suffered some form of cancers while 40 percent of the veteran's children reported issues with getting or staying pregnant. Recruitment to the study was voluntary and only received 148 responses. Gavin Smith, President of the Mururoa Nuclear Veterans Group, says there now needs to be wider research.

A transport export says any regulation around drink driving on e-scooters would be extremely complex. A study by Auckland City Hospital on e-scooter injuries has prompted another call for a zero alcohol limit for people riding them.The study, published in today's New Zealand Medical Journal, reveals 180 patients were admitted to the hospital's emergency department in the first five months of e-scooter use in Auckland.Senior Transport Engineer for Transport Consultancy firm Viastrada Glen Koorey told Simon and Phil the regulation around low powered vehicles is broad, and changes around intoxication would have widespread ramifications for other transport modes. LISTEN ABOVE

Booze is a factor in nearly one in 10 cases dealt with by Auckland City Hospital's emergency department, new research shows.A study published today in the New Zealand Medical Journal found that, in the space of just a year, more than 5000 people showed up at the ED with alcohol-related injuries.These patients were most likely to be men in their 20s and 30s, and to turn up at nights during weekends, public holidays and over the summer months.The study showed how they were often brought in by emergency services and stayed longer in hospital than other patients.Yet they also frequently walked out before a doctor could treat them – and in other cases, they had to be forcibly removed.One recent survey found 92 per cent of ED staff were encountering verbal and physical aggression from drunk patients; for two-thirds of them, that was at least a weekly occurrence."EDs have recognised for a long time that alcohol is an issue for their patients and it's always useful if we have some solid data about the size of the problem," said the study's leader, Professor Bridget Kool of the University of Auckland."It also means we can monitor trends to tell if things are getting worse or better, or if initiatives are working or not."Of more than 70,000 cases that Auckland Hospital's ED saw, about 7 per cent were alcohol-related.And of those patients, two-thirds were men, about half were in their 20s and 30, and 28 per cent came from deprivation.Māori were also over-represented, accounting for 17 per cent of those cases, despite making up just 8 per cent of Auckland District Health Board's population.The cases made up 6 per cent of all those seen in evenings, and then 18 per cent of those treated between 11pm and 7am.Half turned up via emergency services – yet just 8 per cent were classified as having life-threatening injuries.Once at ED, they stayed there an average five hours – two hours longer than the median stay time.Kool said some past interventions, such as St John setting up stations in the city, had led to fewer of these cases reaching ED.Waikato Hospital ED doctor John Bonning said drunk patients continue to be a major problem for his colleagues. Photo / Supplied"That's not solving the problem, but it's saying that maybe some of these people don't need to go to hospital, because they're a burden on emergency departments."While the solution to binge drinking largely lay in public health and community efforts, Kool said EDs had run screening trials with patients."This is where staff will ask patients about their drinking while they're sitting in an ED and thinking, 'God, that was stupid'."They just give them some brief advice and that's been shown to be effective in people's drinking, but these things need to be resourced – and currently, our EDs are already over-burdened."John Bonning, Australasian College for Emergency Medicine (ACEM) president and Waikato Hospital emergency doctor, said alcohol was likely the most preventable public health issue facing EDs."It's an ongoing problem, it's constant and it's certainly not getting better," he said."You're just trying to do your best for patients … and to get these drunk people come in with what's essentially a preventable condition, and get physically and verbally abused, it's really, really challenging."

So this morning another call has been made to adapt and strengthen our alcohol laws.Excuse me while I yawn because we all know where this goes because we’ve been here before. It goes nowhereIn the past 10 years we have had four government initiated reports into alcohol and our politicians have managed to ignore every single one.In 2010 we had the big one helmed by Sir Geoffrey Palmer. The Law Commission Review came up with 153 recommendations including raising the price of alcohol by 10 per cent, raising the drinking age to 20 and making sure communities had more say in where alcohol was sold. As Sir Geoffrey said at the time you can buy a can of RTDs in the suburbs for one or two dollars and that’s less than you’ll pay for bottled water.Simon Power the minister in charge of booze at the time was so keen for it that he asked for it to be presented to Parliament early, which it was, and then duly ignored with a vote to raise the drinking age defeated. The report disappeared and so did Simon Power.Now in the past nine years there’s been three other reports that have come to roughly the same conclusion and suffered roughly the same fate. We’ve had a ministerial forum on alcohol advertising. Ignored. A Ministry of Justice report on alcohol pricing. Ignored. Now the latest is from the Mental Health Inquiry.That inquiry says the government should enact all the stuff from the previous 3 inquiries. And that looks like it’s going to be ignored as well. They're too busy wanting to legalise marijuana.This is all sadly ironic taken that this government brays all over the shop that it’s about wellbeing. A government that can ban guns in a heartbeat yet ignore the most harmful drug in our society. It’s notable that all the government’s over the past decade have been more than happy to tax tobacco into the stratosphere. Yet kids can still pop down to a suburban booze barn and pick up a woody for a song.It’s got to the point where a group of health experts have written in the New Zealand Medical Journal saying that it almost seems like the governments over the past decade have had vested interests involved in the debate. Big call.Well I’ll go further than that and say of course there are vested interests. No government wants to be seen as a wowser nanny state. No government wants to upset 18 to 20 year olds by telling them they can vote, marry and fight for our country but you can’t drink. All government’s are scaredy cats.I have long said this. 20 for a off licence drinking age, 18 for licensed premises. Raise the price. Travel and you wont find booze cheaper than in New Zealand. And bring in more civil cost recovery mechanisms, basically drunk and disorderly, for all those people who hurt themselves and hurt others because they’re off their face on our only legal recreational drug.  Just do it. How many times do you have to be asked

Our kids are getting fatter. While the Otago University research published today by the New Zealand Medical Journal isn’t surprising, it is significant in that it confirms what most of us would’ve thought. And that is, children today are bigger than their parents were at the exact same age.Specifically, we’re talking 15-year olds. Almost 350 Kiwis were tested in the 1980s and here we are, 30 years on and there’s been a 25% decline in fitness in the girls compared to their mothers and a 15% decline for the boys compared to their dads. The study was done in Dunedin.My first reaction is that it’s cold in Dunedin! Too cold to be outside playing, but the truth is that irrespective of climates, in the developed, a similar trend is being noticed. And it’s not like Dunedin was any warmer in the 80s.There are some obvious conclusions: kids are hooked on their electronic devices and their health is suffering as a result. But what the research shows is that their parents have gotten bigger too.Currently, New Zealand has a life expectancy of 81.46 and while that’s about 10 years higher than in was in the 1960s, it’s rate of growth has slowed in recent years. Unless something is done, there’s the prospect that at some point this century, life expectancy could potentially drop. This notion would have been unheard until recently.So is this a time for despair or a time to reset? The opportunities are exciting. If we now have inarguable evidence of the expanding waistlines not just of our adults, but of the very children of a people who were once fit themselves, then surely we can do something about it.Schools can be a massive part of this. I miss PE. PE was so much fun. As a lifelong cricket and tennis fan, the last time I played softball or did a beep test was in school PE. I miss the softball but I think I even miss the beep tests too!A greater emphasis on PE and after school sport programs is one strategy, but so too is a de-emphasis on after school homework. If we’re dealing in research-based policy, the international research about the benefits of homework is hardly glowing.The other shift in our thinking should come with what we can do with limited money. Build homemade back-boards for kids to bowl cricket balls against. Buy secondhand trampolines. Find an old basketball hoop and put it up. If we move away from the notion that gifts to friends and family have to cost money, we’ve got a greater shot in everyone – regardless of income – being able to be more inclined to play outside rather than in.None of this touches of diet and the expense of healthy food options, but it is a start.