PROTOCOL: Association of Antenatal Cytokine Concentrations With Neurodevelopmental Disorders of the Offspring: A Scoping Review.

Objective: The aim of this scoping review is to identify and map the available evidence on the association of antenatal cytokine concentrations with neurodevelopmental disorders (NDDs) of the offspring and to inform future research avenues.

Introduction: NDDs are a heterogeneous group of conditions with onset in childhood which affect functioning due to altered brain development. NDDs have a multifactorial aetiology with genetic, epigenetic, and environmental factors, including the foetal intrauterine environment.

Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice.

Introduction Fundus examination by direct ophthalmoscopy is widely used in general practice; however, it offers limited field of view, requires close approximation to the patient, has a steep learning curve and is a difficult skill to master and maintain. Non-mydriatic fundus photography (NMFP) offers an alternative with a wider field of view, ability for image analysis and transmission, and is able to be conducted by allied healthcare staff. Aim This study aimed to compare the use of direct ophthalmoscopy with smart-phone NMFP in a large rural general practice.

Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis.

Introduction Rural Māori experience inequities in heart health outcomes compared to rural non-Māori and urban Māori. Access to health care is a significant contributor to these inequities. There is a wealth of literature that explores Māori access to health care; however, the voice of rural Māori within the literature is limited.

The role of the primary healthcare research community in addressing the social and structural determinants of health: a call to action from NAPCRG 2023.

The need for effective primary healthcare to address social and structural determinants of health and to mitigate health inequalities has been well established. Here, we report on the international forum of the 2023 NAPCRG (formerly known as North American Primary Care Research Group) Annual Meeting. The aim of the forum was to develop principles for action for the primary healthcare research community on addressing social and structural determinants of health.

Drivers of access to cardiovascular health care for rural Indigenous Peoples: a scoping review.

Introduction: Māori (the Indigenous Peoples of Aotearoa New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD health care. Rural Māori experience additional barriers to treatment access, poorer health outcomes and a greater burden of CVD risk factors compared to Non-Māori and Māori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous Peoples in other nations impacted by colonisation.

Development of a rural strategy for an urban-based medical program: a pragmatic reality.

Introduction: Health disparities between rural and urban areas in Aotearoa New Zealand are exacerbated by rural workforce issues. Traditionally, undergraduate medical programs are urban-based, and reconfiguring the curriculum to meet the needs of rural communities is challenging. The aim of this project is explore how urban-located universities might develop and implement a rural strategy.

A novel methodological approach to participant engagement and policy relevance for community-based primary medical care research during the COVID-19 pandemic in Australia and New Zealand.

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic.

Rural secondary school leaver attainment inequities for students entering medical programmes in Aotearoa New Zealand.

The education literature suggests that there are rural-urban differences in educational achievement. Lower educational achievement in rural schools may impact entry into highly competitive medical programmes and disadvantage rural students. Within this study, the National Certificate of Educational Achievement (NCEA) and University Entrance (UE) attainment rates are compared across Aotearoa New Zealand secondary schools for 2012-2021.

Teaching medical students in general practice when conducting remote consults: a qualitative study.

Background: Telehealth involves real-time communication (telephone or video-call) between patients and health providers. The COVID-19 pandemic propelled general practitioners to conduct most consultations remotely, seeing patients face-to-face only when required. Placement opportunities and experience for medical students were reduced.

Envisioning a Tiriti-responsive New Zealand Health Plan: lessons from district health boards' annual plans.

Aims: Over recent decades, a body of research has established the presence of pervasive health inequities experienced by Māori. Work to identify the root causes of inequities has focused on the unequal distribution of the determinants of good health, access to healthcare, and racism. This study contributes to a small but growing field of work which engages with Te Tiriti o Waitangi to critique key health documents, focusing on district health boards' (DHBs) annual plans.

Treatment Harms in Paediatric Primary Care.

The aim of this study was to describe the epidemiology in children of harms detectable from general practice records, and to identify risk factors. The SHARP study examined 9076 patient records from 44 general practices in New Zealand, with an enrolled population of 210,559 patients. "Harm" was defined as disease, injury, disability, suffering, and death, arising from the health system.

Understanding the barriers and facilitators that influence access to quality cardiovascular care for rural Indigenous peoples: protocol for a scoping review.

Introduction: Māori (the Indigenous peoples of New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD healthcare. Rural Māori experience additional barriers to treatment access, poorer health outcomes and a more significant burden of CVD risk factors compared with non-Māori and Māori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous peoples in other nations impacted by colonisation.

Understanding barriers to diabetes eye screening in a large rural general practice: an audit of patients not reached by screening services.

Introduction Diabetes is a leading cause of blindness in New Zealanders, yet a significant proportion of patients with diabetes are not reached by diabetes eye screening. Aim Our study audited patients with diabetes in a large New Zealand rural general practice, to identify addressable barriers preventing patients from attending diabetes eye screening. Methods All patients who had missed a diabetes eye screening appointment at the Dargaville Hospital Eye Screening Clinic between 2018 and 2021 were identified.

Understanding and experience of climate change in rural general practice in Aotearoa-New Zealand.

Background: Climate change is already affecting Aotearoa New Zealand (Aotearoa-NZ). The public health effects are varied and complex, and rural primary care staff will be at the front line of effects and responses. However, little is known about their understanding and experience.

Disruption to the doctor-patient relationship in primary care: a qualitative study.

Background: Starfield described the importance of system-level components of primary care (first contact, continuous, comprehensive, coordinated), on countries' health systems. It is postulated that, at the individual level, interpersonal interactions and relationship-centred care are central to primary care.

Aim: To explore the impact of COVID-19 on disruption to the doctor-patient relationship and subsequent development of new models of care.

Scope and activities of Māori health provider nurses: an audit of nurse–client encounters.

Introduction The activities and consultations undertaken by Māori health provider nurses are likely broad and operate within a Māori nursing model of care. However, there is little quantitative evidence to document and describe these encounters with clients. The Omaha coding system provides a mechanism in which to quantify nursing encounters through classifying client problems by domain, interventions and specific targets relating to interventions.

A place-based evaluation of a healthy homes initiative.

Issue Addressed: Limited qualitative evaluations of healthy homes initiatives exist in the literature and even fewer look past physical health benefits to wider health outcomes. A qualitative evaluation of Manawa Ora, a healthy homes initiative implemented by a Māori health provider in Northland, New Zealand, was conducted to ascertain the wider health benefits a healthy homes initiative.

Methods: Participants of Manawa Ora were recruited; their experiences were analysed through qualitative semi-structured interviews.

COVID-19 impact on New Zealand general practice: rural-urban differences.

Introduction: In countries such as New Zealand, where there has been little community spread of COVID-19, psychological distress has been experienced by the population and by health workers. COVID-19 has caused changes in the model of care that is delivered in New Zealand general practice. It is unknown, however, whether the changes wrought by COVID-19 have resulted in different levels of strain between rural and urban general practices.

The whitewashing of contracts: Unpacking the discourse within Māori health provider contracts in Aotearoa/New Zealand.

Māori health providers emerged in Aotearoa/New Zealand in the 1980s as a mechanism to achieve self-determination for Māori communities. However, the contracts funding Māori health providers limit expressions of self-determination and fail to reflect Te Tiriti O Waitangi, the founding treaty of Aotearoa/New Zealand. Significant health reforms are proposed in Aotearoa/New Zealand, including the creation of a Māori Health Authority that will commission services from Māori health providers.

Epidemiology of healthcare harm in New Zealand general practice: a retrospective records review study.

Objectives: To determine the epidemiology of healthcare harm observable in general practice records.

Design: Retrospective cohort records review study.

Setting: 72 general practice clinics were randomly selected from all 988 New Zealand clinics stratified by rurality and size; 44 clinics consented to participate.