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aims: The TMGH-Global COVID-19 Collaborative was a multinational, multicentre, cross-sectional survey assessing the awareness and preparedness of healthcare workers (HCWs) during the first wave of the pandemic across 57 countries. Here, we report the results from Aotearoa New Zealand. methods: This cross-sectional survey was conducted at Christchurch Hospital between February and May 2020. Data were collected from a convenience sample of HCWs and analysed using descriptive and multivariate regression to determine awareness (out of 40) and preparedness (out of 15) scores and influencing factors. results: Of the 158 participants (response rate 20.8%), most were women (73%) and doctors (58%) with a median age of 38 years (interquartile range [IQR] 29–49). The median awareness and preparedness scores were 33.6 (IQR 31.1–35.1) and 8 (IQR 6–8), respectively. Mainstream media was the primary source of information on COVID-19 among HCWs. The awareness score was significantly affected by gender and profession, whereas the preparedness score was influenced by age, profession, clinical experience duration and COVID-19 training. conclusions: Although frontline HCWs had high awareness levels, preparedness was low. Variables influenced awareness and preparedness differently. These findings identified gaps in pandemic readiness and factors that can be leveraged to enhance future pandemic preparedness and response in New Zealand.

Background and Aims The COVID‐19 pandemic exposed critical gaps in healthcare preparedness globally, including in Aotearoa New Zealand (NZ). This study explored healthcare workers' experiences during the initial COVID‐19 wave, identifying key areas to inform future policies and practices. Methods Frontline HCWs at Christchurch Hospital, NZ, who participated in an online survey on COVID‐19 awareness and preparedness, were invited to answer an open‐ended question about improving pandemic preparedness and response. Responses were analyzed using reflexive thematic analysis. Results Six major themes were identified, encompassing communication and information dissemination, training and preparation, resource availability, clear protocols and planning, staff engagement and support, and consistency and standardization. Participants highlighted the importance of transparent, regular updates through both email and face‐to‐face meetings, alongside simulations and standardized online modules to strengthen infection‐control training. They also emphasized the need for adequate resources such as PPE, negative pressure rooms, and ICU capacity, supported by clear guidelines for PPE use and patient management. Furthermore, healthcare workers underscored the value of inclusive decision‐making to enhance morale, as well as the need for uniform practices across regions and departments to ensure a cohesive and coordinated pandemic response. Conclusion The findings highlight the need for robust communication, comprehensive training, resource allocation, and inclusive planning to strengthen healthcare resilience. Addressing these areas can improve pandemic preparedness and response, protect HCWs, and ensure better patient outcomes.

aim: We aimed to investigate community systemic antibiotic dispensing in New Zealand across 2010–2019. methods: This longitudinal study utilised dispensing data from the National Pharmaceutical Collection and population data from the Health New Zealand – Te Whatu Ora populations web tool. Dispensing rates were measured as the number of defined daily doses/1,000 inhabitants per day (DIDs) and courses dispensed/1,000 inhabitants/year. Dispensing data were stratified by antibiotic group, AWaRe (Access, Watch, Reserve) categories, district health board (DHB) region and patient characteristics. results: Between January 1 2010 and December 31 2019, community systemic antibiotic dispensing in New Zealand declined, with courses dispensed dropping from 930 to 782 (average annual change [AAC] −1.9%) and DID from 20.9 to 19.6 (AAC −0.75%). Watch antibiotics decreased by 8% in courses dispensed/1,000 inhabitants/year, with quinolones showing the largest proportional reduction (−37 courses dispensed/1,000 inhabitants/year; AAC −13.4%). Conversely, first-generation cephalosporins increased significantly (+45 courses dispensed/1,000 inhabitants/year; AAC +56%), primarily due to cefalexin. Ethnic differences persisted, with Pacific people consistently exhibiting the highest dispensing rates. Most DHB regions experienced an overall decline in dispensing during this period. conclusions: The study identified encouraging trends in antibiotic dispensing, reflecting New Zealand’s antimicrobial stewardship initiatives, but also highlighted the rise in cefalexin and ongoing variations that require further investigation.

Introduction There has been a growing interest in addressing the surgical disease burden in low- and middle-income countries (LMICs). Assessing the current state of global surgery research activity is an important step in identifying gaps in knowledge and directing research efforts towards important unaddressed issues. The aim of this bibliometric analysis was to identify trends in the publication of global surgical research over the last 30 years. Methods Scopus ® was searched for global surgical publications (1987–2017). Results were hand-screened, and data were collected for included articles. Bibliometric data were extracted from Scopus ® and Journal Citation Reports. Country-level economic and population data were obtained from the World Bank. Descriptive statistics were used to summarise data and identify significant trends. Results A total of 1623 articles were identified. The volume of scientific production on global surgery increased from 14 publications in 1987 to 149 in 2017. Similarly, the number of articles published open access increased from four in 1987 to 68 in 2017. Observational studies accounted for 88.7% of the included studies. The three most common specialties were obstetrics and gynaecology 260 (16.0%), general surgery 256 (15.8%), and paediatric surgery 196 (12.1%). Over two times as many authors were affiliated to an LMIC institution than to a high-income country (HIC) institution (6628, 71.5% vs 2481, 28.5%, P  < 0.001). A total of 965 studies (59.5%) were conducted entirely by LMIC authors, and 534 (32.9%) by collaborations between HICs and LMICs. Conclusion The quantity of research in global surgery has substantially increased over the past 30 years. Authors from LMICs seemed the most proactive in addressing the global surgical disease burden. Increasing the funding for interventional studies, and therefore the quality of evidence in surgery, has the potential for greater impact for patients in LMICs.

Cold atmospheric pressure plasma (CAPP) is an innovative energy‐based therapy which has gained momentum in recent years for its wide array of therapeutic applications. This systematic review aims to evaluate the effectiveness and safety of CAPPs in treating diabetic foot ulcers. We conducted systematic literature searches on Embase, Ovid Medline, Scopus, Cochrane Central Register of Controlled Trials, The Cochrane Database of Systematic Reviews and Clinicaltrials.gov using PRISMA guidelines. We searched for randomised controlled trials (RCTs) and observational studies conducted on patients with diabetic foot ulcers in which CAPP therapy was compared with a control treatment. The risk of bias was assessed using the Cochrane Collaboration tool. Four RCTs from two countries analysing a total of 153 patients were included in the review. Three studies reported a significant reduction in ulcer area in the CAPP group, one study reported a significant decrease in inflammatory markers, and mixed results were reported regarding the reduction of bacterial load. All studies reported no adverse side effects or concerns with the safety profile of CAPP. Current evidence supports CAPP's potential as safe and effective adjunctive therapy that may accelerate wound healing, reduce wound size, promote tissue regeneration and lower infection risks. However, the limited number and size of trials, variability in treatment protocols and short follow‐up periods highlight the preliminary nature of these findings. Further large‐scale, well‐designed studies with standardised protocols and long‐term follow‐up are needed to confirm CAPP's efficacy and safety, as well as to determine its cost‐effectiveness in diverse healthcare settings.

The Oman Medical Specialty Board (OMSB) Internal Medicine Residency Program addressed challenges like fatigue, burnout, and academic stress by implementing programmatic changes. These interventions aimed to improve certification exam pass rates, scholarly productivity, and work-life balance, ultimately enhancing academic performance and resident well-being within the program. To evaluate the impact of four integrated programmatic interventions-reduced duty hours (24-hour to 12-hour shifts), restructured academic days, simulation-based workshops, and enhanced research mentorship-on academic performance, scholarly productivity, well-being, and resident satisfaction in an IM residency program. A mixed-methods study was conducted in the OMSB IM Residency Program during the 2022/23 academic year. Interventions included: (1) restructuring Internal Medicine Academic Days (IMAD) into full-day structured learning incorporating dedicated lectures (8 am-1 pm) and simulation-based workshops (1-3 pm), (2) reducing duty hours from 24-hour to 12-hour shifts, and (3) enhancing research training and mentorship. The quantitative component analyzed 78 residents in the pre-intervention period and 114 residents in the post-intervention period, measuring OMSB Part 1, Part 2, and Objective Structured Clinical Examination (OSCE) pass rates, as well as annual peer-reviewed resident publications. Independent z-tests compared outcomes between periods (p < 0.05). The qualitative component included semi-structured interviews with 13 purposively selected residents (third and fourth-year trainees), analyzed using Braun and Clarke's thematic framework. Part 2 exam pass rates significantly improved (85.0% to 98.0%,  = 0.014), and resident publications doubled (10.5 to 21.0 annually,  = 0.007). Interviews revealed reduced fatigue, better work-life balance, and improved satisfaction with academic days and simulations. However, concerns were raised regarding scheduling conflicts and continuity of care. Structured educational and wellness-focused interventions improved academic outcomes, scholarly output, and resident well-being. These findings support integrating similar strategies into residency programs, though further research is needed to assess long-term sustainability and broader applicability.

Background and aims Diabetic foot and lower limb problems are among the most neglected complications during the Syrian armed conflict due to the absence of a functioning health infrastructure, including early detection and timely management of limb‐threatening wounds. This study aimed to determine self‐reported diabetes‐related foot disease (DRFD), adherence to recommended foot self‐care (FSC) practices, and associated factors among people with diabetes in war‐torn Northwest Syria (NWS). Methods This was a cross‐sectional study conducted at six primary care clinics in Idlib, NWS, between March 27 and April 17, 2022, utilizing the validated interviewer‐administered Diabetes Foot Disease and Foot Care Questionnaire. Data on demographic characteristics, DRFD, and FSC practices were collected. FSC score was determined by adding the points from all 12 FSC items, with a maximum score of 48, and were categorized into very poor (≤12), poor (13–24), moderate (25–36), and good (37–48). A convenience sample of 331 consecutive Syrians, aged ≥18 years, with diabetes, were invited. Multiple linear regression was used to identify variables associated with FSC practices. Results A total of 328 patients completed the questionnaire (response rate: 99.1%). The overall FSC score was average (mean total score 27.24, SD 7.03). Over one‐third (37.8%) had a very poor/poor score, 50.3% had an average score, and 11.9% had a good score. Household income/month of ≥51 USD (β = 2.6, 95% confidence interval [95% CI]:1.06–4.1, p = 0.001) and diabetes duration of ≥10 years (β = 1.8, 95% Cl: 0.2–3.4, p = 0.027) significantly predicted better FSC practice. Conclusion A significant proportion of participants had inadequate adoption FSC behaviors. Higher socioeconomic status was associated with better FSC practices. Future research should evaluate diabetic foot education and professional foot care in this population. Key points The absence of a functioning healthcare service infrastructure in war‐torn NWS made DRFD among the most devastating and neglected complications of diabetes. Overall, the adherence to recommended FSC practices was average. Over a third were in the poor/very poor category. Household income/month of ≥51 USD and diabetes duration of ≥10 years independently predicted improved FSC practices. Enhancing socioeconomic standards may facilitate better adoption of FSC practices.

Background There is a paucity of data regarding the long-term outcomes of research intercalation during under-graduate medical studies, and the long-term academic effects it can have for such students. This study aimed to investigate the associations with longer-term academic success for students who undertook a BMedSc(Hons) degree intercalated within a medical degree. Methods The study used a matched cohort design. Cases were medical students who completed a BMedSc(Hons) degree at our institution between 1995 and 2006; controls were matched for gender and graduation year. Our primary outcome was the association of completing a BMedSc(Hons) with three academic success variables: quantity of post-graduation peer-reviewed publications, completion of higher academic degrees, and attainment of faculty/academic positions post-graduation. Results We found that students completing a BMedSc(Hons) were more than seven times as likely to have at least one peer-reviewed journal publication post-graduation compared with matched controls (77.7% vs. 37.2%, OR 7.3 (CI: 3.13–13.17.21), P  < 0.001). They were also more likely to have a greater number of publications ( n  = 577 vs. n  = 140), more likely to complete a higher academic degree (18.1% vs. 6.4%, OR 3.2 (CI: 1.17–8.74), P  = 0.023) including a PhD (13.8% vs. 1.1%, OR 13.0 (CI: 1.70-99.38), P  = 0.013), but they were not significantly more likely to attain a faculty position (17% vs. 11.7%, OR 1.6 (CI: 0.67–3.59), P  = 0.301). Conclusion Medical students completing a research degree go on to have successful academic careers. We hypothesize that building research networks early in a student’s career is associated with their ability to participate in research in the future, although attaining faculty/academic positions may be influenced by other factors.

Background The aim of this bibliometric study was to examine trends in the quality and quantity of published diabetes-related foot disease (DRFD) research in Aotearoa/New Zealand (NZ) over the past five decades. Method In July 2021, the Scopus® database was searched for DRFD-related publications (1970–2020) using predetermined search and inclusion criteria. Bibliometric data were extracted from Scopus® and Journal Citation Reports. Retrieved bibliometric indicators were analysed in Biblioshiny, an R Statistical Software interface and reported using descriptive statistics. Results Forty-seven DRFD-related articles were identified. The annual number of publications showed a significant upward trend increasing from one in 1988 to a peak of six in 2018 ( P  < 0.001). The majority of identified articles ( n  = 31, 66%) were published in the last decade (2011–2020). Basic/clinical research accounted for 87% ( n  = 41) of publications and 14 (30%) investigated the screening and/or prevention of DRFD. The average citation per article was 20.23 (range: 0–209) and the median impact factor was 4.31 (range, 1.82–79.32). Over a third of articles (36%) had an international authorship network. Funding was reported in 15 (32%) articles; 12 (26%) were supported by public national grants vs. three (6%) reporting industry-sponsorship. Conclusion DRFD articles authored by NZ researchers have increased over the past five decades. Despite NZ researchers having increased their global impact through collaborative networks, most of the research was classified as low-level evidence, with limited focus on Indigenous Māori and limited financial support and funding. Increased funding for interventional research is required to enable a higher level of evidence-based and practice-changing research to occur. With rates of diabetes-related amputations higher in Māori future research must focus on reducing inequalities in diabetes-related outcomes for Māori by specifically targeting the prevention and screening of DRFD in primary care settings in NZ.