title: Monitoring pre-hospital transport of severely injured patients in the Midland Region of New Zealand.

authors: Whitehead, Jesse

subjects: Humans

abstract: AIM: Pre-hospital triage strategies aim to identify the type and extent of patient injuries and ensure that they are transferred to the most appropriate trauma centres. Despite the importance of appropriate pre-hospital transport, there is little evidence base to assist medical staff on optimal destination policy for emergent pre-hospital transport. This paper explores the spatial relationship of patient transfers prior to the implementation of the Midland Pre-Hospital Trauma Destination Matrix in New Zealand, and is a retrospective view of practice against a destination policy that was applied after the study period. METHODS: We use data obtained from the Midland Trauma Registry merged with Global Positioning System (GPS) data from St John and Land Information New Zealand Data Service on major trauma occurring in 2014 and 2015. Using ArcGIS, data were analysed for spatial relationships between factors associated with major trauma events and pre-hospital transportation. RESULTS: In the retrospective analysis of 162 major trauma patients, 107 (66%) were transported to a hospital that matched the destination specified in the Matrix, and 55 (34%) were transported to a non-Matrix designated hospital. CONCLUSION: Approximately one-third of patients were not directly transported to the preferred definitive care hospital subsequently defined in the Midland Pre-Hospital Trauma Destination Matrix. Ongoing monitoring of the pre-hospital transportation system and the implementation of a formal pre-hospital transport policy may improve the efficiency of the Midland Trauma System. Future studies should examine the possible reasons for variations in triage decisions across the Midland Region.

text: Monitoring pre-hospital transport of severely injured patients in the Midland Region of New Zealand. AIM: Pre-hospital triage strategies aim to identify the type and extent of patient injuries and ensure that they are transferred to the most appropriate trauma centres. Despite the importance of appropriate pre-hospital transport, there is little evidence base to assist medical staff on optimal destination policy for emergent pre-hospital transport. This paper explores the spatial relationship of patient transfers prior to the implementation of the Midland Pre-Hospital Trauma Destination Matrix in New Zealand, and is a retrospective view of practice against a destination policy that was applied after the study period. METHODS: We use data obtained from the Midland Trauma Registry merged with Global Positioning System (GPS) data from St John and Land Information New Zealand Data Service on major trauma occurring in 2014 and 2015. Using ArcGIS, data were analysed for spatial relationships between factors associated with major trauma events and pre-hospital transportation. RESULTS: In the retrospective analysis of 162 major trauma patients, 107 (66%) were transported to a hospital that matched the destination specified in the Matrix, and 55 (34%) were transported to a non-Matrix designated hospital. CONCLUSION: Approximately one-third of patients were not directly transported to the preferred definitive care hospital subsequently defined in the Midland Pre-Hospital Trauma Destination Matrix. Ongoing monitoring of the pre-hospital transportation system and the implementation of a formal pre-hospital transport policy may improve the efficiency of the Midland Trauma System. Future studies should examine the possible reasons for variations in triage decisions across the Midland Region.

year: 2018

title: The use of manuka honey to promote wound healing

authors: Molan, Peter C.

subjects: manuka honey

abstract: When wounds are not healing, or the healing is slow, this is usually because the wound is inflamed. Inflammation in a wound is also responsible for unsightly scars after a wound has eventually healed. The use of honey as a wound dressing prevents these problems through its potent antibacterial and anti-inflammatory activity. Another action of honey, its rapid debridement of wounds, also aids healing by removing bacteria-harbouring slough which gives rise to inflammation. With the use of Manuka honey, selected to have the right type and level of antibacterial activity, and with an appropriate dressing protocol that keeps honey present on the wound bed at all times, uncomplicated wounds will heal rapidly, painlessly, and without a visible scar. With complicated wounds, including ones failing to heal with any form of best-practice modern treatments, if Manuka honey is used appropriately it can be expected to have complete healing, with a cosmetically good outcome, within six to twelve weeks.

text: The use of manuka honey to promote wound healing When wounds are not healing, or the healing is slow, this is usually because the wound is inflamed. Inflammation in a wound is also responsible for unsightly scars after a wound has eventually healed. The use of honey as a wound dressing prevents these problems through its potent antibacterial and anti-inflammatory activity. Another action of honey, its rapid debridement of wounds, also aids healing by removing bacteria-harbouring slough which gives rise to inflammation. With the use of Manuka honey, selected to have the right type and level of antibacterial activity, and with an appropriate dressing protocol that keeps honey present on the wound bed at all times, uncomplicated wounds will heal rapidly, painlessly, and without a visible scar. With complicated wounds, including ones failing to heal with any form of best-practice modern treatments, if Manuka honey is used appropriately it can be expected to have complete healing, with a cosmetically good outcome, within six to twelve weeks.

year: 2013

title: Intellectual Property, Mātauranga Māori

authors: Sterling, Rogena

abstract: This literature review has been conducted to consider the various national legislation and international agreements that comprise New Zealand’s Intellectual Property Rights (IP) regime. It will evaluate if and how such legislation and agreements protect and enable Māori IP rights and interests with respect to Māori data, genomic data and mātauranga Māori. The review also identifies some mechanisms that might also enhance Māori control of these types of data. The Westminster approach of legislation in New Zealand and its approach to IP protection based on Copyrights, Patents and Trade Marks are juxtaposed against traditional Maori approaches of communally held ancestral knowledge (mātauranga) passed down through generations (whanaungatanga) based on guardianship and protection (kaitiakitanga) and the self-determination of use of such knowledge (rangatiratanga). Attempting to align tikanga concepts to the Westmionster model of law is challenging as the two share completely different notions of ownership and responsibility. Expectations of protection, to prevent misappropriation and commercialisation by non- Māori of mātauranga Māori and Māori data, extend beyond the parameters of existing IP law, creates a similar disjunct. Genomic Research generates data, some of which can be protected by IP, however researchers working with genetic/genomic data from taonga species have often failed to acknowledge the non-IP interests of Maori. As a result, Maori have taken it upon themselves to advocate for their rights to data through Māori data sovereignty discourse as well as create guidelines for culturally appropriate genomic research with explicit references to data security and management (e.g. Te Mata Ira, Te Nohonga Kaitiaki). Other extra-legal options, such as Biocultural Labelling to alert users where particular data has Māori rights and/or interests, are emerging to maintain create durable provenance data and connect next users of data with the responsible Indigenous communities. Though the intellectual property regime in New Zealand may provide some protections, there are still significant areas where the legal system does not provide sufficient protections for Māori data, taonga species and mātauranga. The UN Declaration on the Rights of Indigenous Peoples provides a framework of international support for Indigenous rights, but local government and other home-grown mechanisms are important to enable Māori governance of data. Local approaches Māori Data Sovereignty and Māori Data Governance afford Maori the opportunity to be directly involved as kaitiaki of their mātauranga and assert rangatiratanga over data and its use.

text: Intellectual Property, Mātauranga Māori This literature review has been conducted to consider the various national legislation and international agreements that comprise New Zealand’s Intellectual Property Rights (IP) regime. It will evaluate if and how such legislation and agreements protect and enable Māori IP rights and interests with respect to Māori data, genomic data and mātauranga Māori. The review also identifies some mechanisms that might also enhance Māori control of these types of data. The Westminster approach of legislation in New Zealand and its approach to IP protection based on Copyrights, Patents and Trade Marks are juxtaposed against traditional Maori approaches of communally held ancestral knowledge (mātauranga) passed down through generations (whanaungatanga) based on guardianship and protection (kaitiakitanga) and the self-determination of use of such knowledge (rangatiratanga). Attempting to align tikanga concepts to the Westmionster model of law is challenging as the two share completely different notions of ownership and responsibility. Expectations of protection, to prevent misappropriation and commercialisation by non- Māori of mātauranga Māori and Māori data, extend beyond the parameters of existing IP law, creates a similar disjunct. Genomic Research generates data, some of which can be protected by IP, however researchers working with genetic/genomic data from taonga species have often failed to acknowledge the non-IP interests of Maori. As a result, Maori have taken it upon themselves to advocate for their rights to data through Māori data sovereignty discourse as well as create guidelines for culturally appropriate genomic research with explicit references to data security and management (e.g. Te Mata Ira, Te Nohonga Kaitiaki). Other extra-legal options, such as Biocultural Labelling to alert users where particular data has Māori rights and/or interests, are emerging to maintain create durable provenance data and connect next users of data with the responsible Indigenous communities. Though the intellectual property regime in New Zealand may provide some protections, there are still significant areas where the legal system does not provide sufficient protections for Māori data, taonga species and mātauranga. The UN Declaration on the Rights of Indigenous Peoples provides a framework of international support for Indigenous rights, but local government and other home-grown mechanisms are important to enable Māori governance of data. Local approaches Māori Data Sovereignty and Māori Data Governance afford Maori the opportunity to be directly involved as kaitiaki of their mātauranga and assert rangatiratanga over data and its use.

year: 2021