Ethnicity, sex, and socioeconomic disparities in the treatment of traumatic rotator cuff injuries in Aotearoa/New Zealand

Bolam, Scott M.; Konar, Subhajit; Gamble, Greg; Paine, Sarah‐Jane; Dalbeth, Nicola; Monk, A. Paul; Coleman, Brendan; Cornish, Jillian; Munro, Jacob T.; Musson, David S.

doi:10.1016/j.jse.2022.06.010

Cited by 2 publications

(4 citation statements)

References 38 publications

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“…5,6 In terms of surgical treatment, M aori have higher rates of surgical mortality, are less likely to undergo surgical treatment, and more likely to experience delays in receiving treatment. [7][8][9] The factors that drive ethnic inequities are complex, and include ongoing impacts stemming from colonization and marginalization of Indigenous populations through policies and processes that favour Western worldviews. 10,11 Achieving health equity for M aori is a key health policy in New Zealand.…”

Section: Introductionmentioning

confidence: 99%

“…Despite higher overall rates of disease and mortality, 3,4 Māori are less likely to access clinical intervention and more likely to experience poorer outcomes post‐intervention 5,6 . In terms of surgical treatment, Māori have higher rates of surgical mortality, are less likely to undergo surgical treatment, and more likely to experience delays in receiving treatment 7–9 . The factors that drive ethnic inequities are complex, and include ongoing impacts stemming from colonization and marginalization of Indigenous populations through policies and processes that favour Western worldviews 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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An exploratory study of acute analgesia in tibial shaft fractures: a comparison between Māori and Non‐Māori

Tan,

Coia,

Tay

et al. 2024

ANZ Journal of Surgery

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BackgroundPublished research suggests Indigenous peoples are less likely to receive analgesia in acute pain settings however there is limited data on the indigenous New Zealand Māori population. The aim of this exploratory pilot study was to compare management between Māori and non‐Māori for acute fracture pain in a regional trauma centre.MethodsA retrospective review was undertaken for 120 patients with isolated tibial shaft fractures presenting at a tertiary level trauma center between 2015 and 2020. Outcome measures reflected the patient journey including type of analgesia charted pre‐hospital, in the ED and on the ward.ResultsOut of 104 matched patients, 48 (46%) were Māori and 65% were male. Fewer Māori received pre‐hospital analgesia compared with non‐Māori (odds ratio 0.29, p = 0.006). Pain scores were similar on arrival to ED (6.1 ± 3.5 versus 5.4 ± 2.7, p = 0.2). Once at hospital, there were similar rates of prescribed analgesia (paracetamol, NSAIDs, synthetics, or opioids) both in ED and the ward. Time to analgesia were also similar for both groups (72 ± 71 min versus 65 ± 63 min, P > 0.9).DiscussionWe found differences in pre‐hospital administration of analgesia between Māori and non‐Māori patients with tibial shaft fractures. However once in hospital although there was a trend towards lower prescribing for Māori, there were no significant differences. Exploring the reasons underpinning this difference and the development of robust analgesic guidelines for tibial shaft fractures may help in reducing this inequity in care, particularly in the pre‐hospital setting.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An exploratory study of acute analgesia in tibial shaft fractures: a comparison between Māori and Non‐Māori

Tan,

Coia,

Tay

et al. 2024

ANZ Journal of Surgery

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“…3 With an aging population, as well as an increase in obesity around the globe, 4 the incidence of tendinopathy is increasing. 3,5,6 Tendinopathy results in pain, loss of mobility, and a reduced quality of life. Characteristic changes associated with tendinopathy include a disorganized collagen structure and reduced stiffness.…”

Section: Introductionmentioning

confidence: 99%

“…Tendinopathy is one of the most common musculoskeletal disorders. , In Aotearoa/New Zealand, the cases of tendon injuries increased by approximately 16% from 2010 to 2016, with a total cost of over $1.4 billion NZD and an annual cost of approximately $280 million NZD . With an aging population, as well as an increase in obesity around the globe, the incidence of tendinopathy is increasing. ,, Tendinopathy results in pain, loss of mobility, and a reduced quality of life. Characteristic changes associated with tendinopathy include a disorganized collagen structure and reduced stiffness. − Changes are also evident in tendon cells; as the tissue becomes hypercellular, the cells lose their typically elongated shape, and they become rounded .…”

Section: Introductionmentioning

confidence: 99%

Novel In Vitro Platform for Studying the Cell Response to Healthy and Diseased Tendon Matrices

Konar,

Leung,

Tay

et al. 2024

ACS Biomater. Sci. Eng.

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Current in vitro models poorly represent the healthy or diseased tendon microenvironment, limiting the translation of the findings to clinics. The present work aims to establish a physiologically relevant in vitro tendon platform that mimics biophysical aspects of a healthy and tendinopathic tendon matrix using a decellularized bovine tendon and to characterize tendon cells cultured using this platform. Bovine tendons were subjected to various decellularization techniques, with the efficacy of decellularization determined histologically. The biomechanical and architectural properties of the decellularized tendons were characterized using an atomic force microscope. Tendinopathy-mimicking matrices were prepared by treating the decellularized tendons with collagenase for 3 h or collagenase−chondroitinase (CC) for 1 h. The tendon tissue collected from healthy and tendinopathic patients was characterized using an atomic force microscope and compared to that of decellularized matrices. Healthy human tendon-derived cells (hTDCs) from the hamstring tendon were cultured on the decellularized matrices for 24 or 48 h, with cell morphology characterized using f-actin staining and gene expression characterized using real-time PCR. Tendon matrices prepared by freeze−thawing and 48 h nuclease treatment were fully decellularized, and the aligned structure and tendon stiffness (1.46 MPa) were maintained. Collagenase treatment prepared matrices with a disorganized architecture and reduced stiffness (0.75 MPa), mimicking chronic tendinopathy. Treatment with CC prepared matrices with a disorganized architecture without altering stiffness, mimicking early tendinopathy (1.52 MPa). hTDCs on a healthy tendon matrix were elongated, and the scleraxis (SCX) expression was maintained. On tendinopathic matrices, hTDCs had altered morphological characteristics and lower SCX expression. The expression of genes related to actin polymerization, matrix degradation and remodeling, and immune cell invasion were higher in hTDCs on tendinopathic matrices. Overall, the present study developed a physiological in vitro system to mimic healthy tendons and early and late tendinopathy, and it can be used to better understand tendon cell characteristics in healthy and diseased states.

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Ethnicity, sex, and socioeconomic disparities in the treatment of traumatic rotator cuff injuries in Aotearoa/New Zealand

Cited by 2 publications

References 38 publications

An exploratory study of acute analgesia in tibial shaft fractures: a comparison between Māori and Non‐Māori

An exploratory study of acute analgesia in tibial shaft fractures: a comparison between Māori and Non‐Māori

Novel In Vitro Platform for Studying the Cell Response to Healthy and Diseased Tendon Matrices

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