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Success in sport can provide a source of national pride for a society, and vast financial and personal rewards for an individual athlete. It is therefore not surprising that many athletes will go to great lengths in pursuit of success. The provision of healthcare for elite sports people has the potential to create many ethical issues for sports doctors; however there has been little discussion of them to date. This study highlights these issues. Respondents to a questionnaire identified many ethical matters, common to other areas of medicine. However they also raised problems unique to sports medicine. Some of these ethical difficulties arise out of the place of the sports doctor within the hierarchy of sport. Yet others arise out of the special relationship between sports doctors and individual players/athletes. This study raises some important questions regarding the governance of healthcare in sport, and what support and guidance is available to sports doctors. As medical and scientific intervention in sport escalates, there is a risk that demands for enhanced performance may compromise the health of the athlete, and the role the sports doctor plays remains a critical question. [ABSTRACT FROM AUTHOR]

Aims: Identify the experiences of Māori nurses and priorities for a Māori model of relational care working with Māori patients and their whānau (extended family network) in acute hospital services., Background: Māori, the Indigenous peoples of Aotearoa (New Zealand), have a relational and holistic worldview fundamental to establishing relationships with Māori patients and their whānau. Increasing the Indigenous Māori nursing workforce can improve Māori patient experiences but is challenged by ongoing recruitment and retention issues., Design: A qualitative Māori-centred research methodology with 12 Māori nurses., Methods: Data were collected using wānanga (learning through discussion, deliberation and consideration) using he aha ō hikoi (journey mapping) and kōrero mai (storytelling). Inductive thematic analysis was undertaken using a mahi a roopū (group process) approach. This study was conducted between May 2022 and June 2022., Results: Three key themes: (1) Māori first, nurse second, (2) Cultural loading and (3) Compromised realities were identified. Māori nurses' praxis used their complex cultural and clinical intelligence to engage in a mana-enhancing way (strengths-based) to improve the care delivery for whānau Māori during their hospitalization journey. Cultural loading meant Māori nurses were often burdened with unrecognized workloads as they provided care for Māori patients and whānau, which often compromised their cultural integrity., Conclusion: Nurses' commitment to care for whānau and their assigned patient load created extra burdens and threatened their cultural integrity. Their experiences highlighted modes of practice rather than models of care required to improve healthcare delivery for Māori entering the hospital. These findings signal issues and areas nursing leaders need to heed, necessary for addressing the retention of Māori in nursing and improving workload equity., Patient or Public Contribution: Māori nurses and service users were involved in the interpretation of the data., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Competing Interests: Dr Hamilton reports non-financial support from High Performance Sport NZ during the conduct of the study; Dr Gerrard is the Chair of the Therapeutic Use Exemption Committee (TUEC) Drug-Free Sport New Zealand; Chair, World Anti-Doping Agency (WADA) TUE Expert Group; Chair, TUEC, World Rugby; Vice-Chair, Sports Medicine Committee, International Swimming Federation (FINA); Dr Fulcher reports personal fees from New Zealand Football during the conduct of the study; medical director for New Zealand Football; member of the FIFA Medical Committee; Dr Exeter is a contractor to High Performance Sport NZ; Dr Coleman is a contractor for medical services.

This article describes recent changes to years 2 and 3 of undergraduate medical education at the University of Otago, now termed 'Early Learning in Medicine'. These changes focus on learning that is contextually relevant, student centred, horizontally and vertically integrated, and community based. Three new programmes have been introduced to the course; Integrated Cases, Clinical Skills, and Healthcare in the Community. Innovative teaching and learning activities have been implemented to prepare students for a greater level of interaction with patients, carers, health professionals, and community organisations. This curriculum also aims to increase the relevance of their theoretical learning within and across years, and foster an early appreciation of professional responsibilities. Challenges to facilitating this direction are described and framed by an evolutionary approach that builds upon the strong features of the previous course.

Aims: To estimate the number of New Zealand children who have a physical disability, and to describe this group in relation to sex, age, ethnic group and severity., Methods: We used data collected by Statistics New Zealand's Household Disability Survey 2001. Within the estimated 90 000 children aged 0-14 years with a disability as described in Disability Counts 2001, we identified a subgroup using information on the use of equipment suggestive of mobility disability, the numbers estimated to be in receipt of or in need of physiotherapy and/or occupational therapy, and the small number needing ramps or similar modifications., Results: An estimated 14 500 children had a physical disability. This equates to an estimated 1.7% of the New Zealand population of children aged 0-14 years. Fifty-seven per cent were boys. An estimated 9600 were New Zealand-European, 3800 Maori and 600 Samoan. Approximately half were of moderate severity as defined by Statistics New Zealand. An estimated 9500 had a multiple disability., Conclusions: The rate is somewhat higher than in studies from countries where only locomotor disability is described, but similar to rates where other types of disability such as dexterity disability are included. This may reflect the fact that within our group are children who in other countries would have been described as having a dexterity or a self-help disability. It would be useful if future New Zealand data collection could attempt to separate these subgroups in order to allow better forward planning of health, education and family support services.

This study investigated the incidence, site, nature and causes of injuries sustained in the New Zealand national rugby league sevens tournament. A total of 218 players competing in 47 matches were studied. All injuries sustained within the tournament were prospectively recorded. Injuries were categorised according to the severity assessment at the time of the injury. Information obtained included the time, site, nature and cause of the injury. The incidence of injury was 497.6 per 1000 playing hours. More than 40% (216.1 per 1000) of injuries sustained occurred within the lower limbs. The shoulder was the single most commonly injured site (78.6 per 1000). Sprains were the most common injury type (189.9 per 1000). The ball-carrier sustained significantly more (p<0.05) injuries than the tackling player (216.1 per 1000 [43.4%] versus 117.8 per 1000 [23.7%]). There were significantly more injuries on the first day of competition than on the second day of competition (600.4 per 1000 [76.3%] versus 320.9 per 1000 [23.7%]). The findings of higher injury rates on the first day of competition and during the second period of matches suggest that playing intensity and player fatigue may contribute to injuries in rugby league sevens.

Objective: To describe the incidence, nature, and circumstances of injury experienced by a cohort of rugby union players during a full competitive club season., Methods: A prospective cohort study followed up 356 male and female rugby players throughout the 1993 competitive club season. Players were interviewed by telephone each week to obtain information on the amount of rugby played and the injury experienced., Results: Detailed information was collected for 4403 player-games and 8653 player-practices. A total of 671 injury events were reported, of which 569 were rugby related. The injury rate for games was higher than that for practices (rate ratio 8.3). At 10.9 injuries per 100 player-games, males had a higher rate of injury than females at 6.1 injuries per 100 player-games (p<0.001). Injury rates varied by position, with male locks (13.0 injuries per 100 player-games) and female inside backs (12.3 injuries per 100 player-games) having the highest rate in their respective sexes. The lower limb was the body region most often injured in games (42.5%) and practices (58.4%). Sprains/strains were the most common type of injury in games (46.7%) and practices (76.1%). In games the tackle was the phase of play in which the most injuries occurred (40%), followed by rucks (17%) and mauls (12%). Thirteen per cent of game injury events were the result of foul play., Conclusions: Rugby injury was common among the study subjects and varied according to grade and gender. Identifying the causes of injuries in the tackle, lower limb injuries, and dealing with the issue of foul play are priority areas for the prevention of rugby injury.

The Rugby Injury and Performance Project (RIPP) is a prospective cohort study by a multidisciplinary research group. Rugby injuries constitute an important area for research because rugby union is New Zealand's national sport and because of the considerable cost of all sports injury acknowledged by the Accident Rehabilitation and Compensation Insurance Corporation (ACC). The initial phase of data collection in the RIPP involved a pre-season questionnaire which, among other things, sought to establish variables relating to the past injury experience of players. The influence of previous injury, the use of safety equipment and the availability and significance of medical advice were among the variables identified by individual questionnaires. This paper analyses the responses to pre-season questions about injury experience in the previous 12 months. In so doing, it identifies baseline data which will be used to address a possible relationship between past injury experience and the prediction of injury during the season.

Increasing numbers of children are becoming involved in competitive sport. International trends in pre-adolescent sports participation are mirrored in New Zealand, where promising young athletes are being exposed to high-intensity training from an earlier age. As a consequence, overuse injuries which were traditionally described in more mature athletes are now becoming recognized in pre-adolescents. The immature musculoskeletal system is less able to cope with repetitive biomechanical stress. Sites of overuse injury reflect the sites of rapid musculoskeletal development. It therefore behoves all medical practitioners, but particularly those in primary care, to be aware of the young athlete at risk. Inherent in the presentation of such musculoskeletal insult there often lurks an over-enthusiastic parent. We are all well reminded of the covert pressures adults may bring to bear upon children. Psychological, as well as physical injury often results.