Epidemiology of major trauma in New Zealand: a systematic review

Background: Physical injuries are one of the major causes of disability and death worldwide and have an immense impact on population health. In New Zealand, an estimated 8% of total health loss from all causes is attributed to injuries. aim: To describe the incidence and characteristics of major trauma in New Zealand. methods: A systematic review based on a MEDLINE search strategy was performed using the databases PubMed, EMBASE, CINAHL and Scopus. Search terms included: “Wounds and Injuries,” “Fatal Injuries,” “Injury Severity Score,” “Major Trauma,” “Severe Trauma,” “Injury Scale,” “Epidemiology,” “Incidence,” “Prevalence” and “Mortality.” Studies published in English up to September 2021 reporting the incidence of major trauma in New Zealand were included. The quality of studies was assessed using the GATE LITETM tool. results: Thirty-nine studies fulfilled the inclusion criteria. The majority of studies were descriptive observational studies (n=37). The incidence of fatal trauma was highest among those injured from motor vehicle crashes (MVCs) or falls, Māori males and those sustaining head injuries. The incidence of non-fatal major trauma was highest among young Māori males. MVCs and falls were the most common mechanism of injury among trauma patients across all age groups. Length of hospital stay was greatest in patients with the highest Injury Severity Scores. conclusions: The incidence of major trauma varies by age, sex and ethnicity. This review highlights the need for further analytical studies that can explore factors that may impact survival from major trauma.

Online worship: a learning experience

To explore both the range and the implications of online worship, this article takes four very different examples, all of which originated in the Diocese of Exeter between March and July 2020. These were: a national service to mark the end of Mental Health Awareness Week;a range of cathedral worship;the experiences of an urban parish church;and a university chaplaincy. A short conclusion draws the threads together, sets them in a broader context, and asks what can be learned from these very varied experiences. © The Author(s) 2020.