Ministry of Health Library

Health Improvement and Innovation Digest

Issue 205 - 5 December 2019

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@health.govt.nz.

Article access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Māori Innovation

A culturally derived framework of values-driven transformation in Māori economies of well-being (Ngā hono ōhanga oranga)
This article, published in AlterNative, is based on current research investigating Māori economies of well-being.

Health Equity (New Zealand)

Equity by 2030: achieving equity in survival for Māori cancer patients
Māori diagnosed with cancer are more likely to die—and to die sooner—than non-Māori with cancer. If we accept that these inequities are unfair and avoidable, then we need a well-resourced and focused approach to eliminating them for Māori. Closing this gap will require significant action and sustained resourcing; but first, it requires an aspirational objective to enable collective ownership and navigation. At the Cancer Care at a Crossroads conference held in Wellington in early 2019, the wider cancer sector accepted a tabled goal: to achieve equity in cancer survival for Māori by the year 2030. In this viewpoint, published in the New Zealand Medical Journal, the authors provide rationale for this goal, provide some recommendations for how it might be achieved, and address its likely criticisms.

Hospital Productivity (New Zealand)

Length of Hospital Stay for Osteoarthritic Primary Hip and Knee Replacement Surgeries in New Zealand
This study, published in the International Journal of Environmental Research and Public Health, aims to explore the length of stay (LOS) of publicly funded osteoarthritic primary hip and knee replacement surgeries in New Zealand.

Cancer Services (International)

Follow‐up strategies following completion of primary cancer treatment in adult cancer survivors
Most cancer survivors receive follow‐up care after completion of treatment with the primary aim of detecting recurrence. Traditional follow‐up consisting of fixed visits to a cancer specialist for examinations and tests are expensive and may be burdensome for the patient. Follow‐up strategies involving non‐specialist care providers, different intensity of procedures, or addition of survivorship care packages have been developed and tested. The objective of this Cochrane Review was to compare the effect of different follow‐up strategies in adult cancer survivors, following completion of primary cancer treatment, on the primary outcomes of overall survival and time to detection of recurrence. Secondary outcomes are health‐related quality of life, anxiety (including fear of recurrence), depression and cost.

Shorter Stays In Emergency Departments (International)

Internet search query data improve forecasts of daily emergency department volume
Emergency departments (EDs) are increasingly overcrowded. Forecasting patient visit volume is challenging. Reliable and accurate forecasting strategies may help improve resource allocation and mitigate the effects of overcrowding. Patterns related to weather, day of the week, season, and holidays have been previously used to forecast ED visits. Internet search activity has proven useful for predicting disease trends and offers a new opportunity to improve ED visit forecasting. This study, published in the Journal of the American Medical Informatics Association, tests whether Google search data and relevant statistical methods can improve the accuracy of ED volume forecasting compared with traditional data sources.

Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review
The growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review, published in BMC Emergency Medicine, was to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions.

Cardiovascular Disease and Diabetes (International)

Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis
Diabetes in young adulthood has been associated with poor outcomes. Self‐management is fundamental to good diabetes care, and self‐management interventions have been found to improve outcomes in older adults. This systematic review and meta‐analysis, published in Diabetic Medicine, assessed the effectiveness of self‐management interventions in young adults (aged 15–39 years) with type 1 or type 2 diabetes.

Primary Health Care (New Zealand)

Risk Factors for Acute Rheumatic Fever: Literature Review and Protocol for a Case-Control Study in New Zealand
Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), have largely disappeared from high-income countries. However, in New Zealand (NZ), rates remain unacceptably high in indigenous Māori and Pacific populations. The goal of this study, published in the International Journal of Environmental Research and Public Health, was to identify potentially modifiable risk factors for ARF to support effective disease prevention policies and programmes.

Primary Mental Health (New Zealand)

Development of MyTeen Text Messaging Program to Support Parents of Adolescents: Qualitative Study
Parents play an important role in the lives of adolescents, and supporting and addressing the needs of families continue to be the focus of many researchers and policy makers. Mobile health interventions have great potential for supporting parents at a population level because of their broad reach and convenience. However, limited evidence exists for such interventions for parents of adolescents. This study, published in JMIR Mhealth Uhealth, reports on the formative work conducted with parents and/or primary caregivers to identify their needs and preferences for the development of MyTeen—an SMS text messaging program on promoting parental competence and mental health literacy for parents of adolescents (aged 10-15 years).

Primary Mental Health (International)

Psychological interventions for co‐occurring depression and substance use disorders
Comorbid depression and substance use disorders are common and have poorer outcomes than either disorder alone. While effective psychological treatments for depression or substance use disorders are available, relatively few randomised controlled trials (RCTs) have examined the efficacy of these treatments in people with these comorbid disorders. The objective of this Cochrane Review was to assess the efficacy of psychological interventions delivered alone or in combination with pharmacotherapy for people diagnosed with comorbid depression and substance use disorders.

Increased Immunisation (New Zealand)

Influential factors in patient uptake of influenza vaccination during pregnancy; a survey-based audit in a tertiary hospital setting
The aim of this study, published in the New Zealand Medical Journal, was to determine the key influential factors for pregnant or recently pregnant women in deciding on influenza vaccination.

Better Help for smokers to Quit (New Zealand)

Factors influencing smoking among Indigenous adolescents aged 10-24 years living in Australia, New Zealand, Canada and the United States: A systematic review
Smoking rates are higher among Indigenous populations in most high-income countries with initiation primarily occurring in adolescence for all population groups. This review, published in Nicotine & Tobacco Research aims to identify protective and risk factors for smoking behaviour among Indigenous adolescents and young adults.

Electronic cigarette online marketing by New Zealand vendors
The aim of this study, published in the New Zealand Medical Journal, was to examine the characteristics of the online marketing environment and the presence of safeguards to protect children from e-cigarette (ENDS) experimentation and uptake in New Zealand.

Childhood Obesity (International)

The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action
This article, published in BMC Medicine, discusses the worldwide burden of childhood obesity. In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025.

Relationship Between Early Childhood Non-Parental Childcare and Diet, Physical Activity, Sedentary Behaviour, and Sleep: A Systematic Review of Longitudinal Studies
The rising prevalence of childhood obesity is a global public health concern. Evidence suggests that exposure to non-parental childcare before age six years is associated with development of obesity, diet, and activity behaviours (physical activity, sedentary behaviour, and sleep). However, findings are inconsistent and mostly from cross-sectional studies, making it difficult to identify the direction of causation in associations. This review, published in the International Journal of Environmental Research and Public Health, identified and synthesised the published research on longitudinal associations between non-parental childcare during early childhood, diet, and activity behaviours.

Oral Health (International)

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries
Dental caries is one of the most common chronic diseases of childhood and is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). The objective of this Cochrane Review, was to assess the effects of interventions with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years of age).

Management of gag reflex for patients undergoing dental treatment
The gag reflex is an involuntary defence mechanism to protect the pharynx and throat from foreign objects. Gagging is a common problem encountered during dental treatment, making therapeutic procedures distressing and often difficult or even impossible to perform. Various interventions can be used to control the gag reflex: anti‐nausea medicines, sedatives, local and general anaesthetics, herbal remedies, behavioural therapies, acupressure, acupuncture, laser, and prosthetic devices. The objective of this Cochrane Review was to assess the effects of pharmacological and non‐pharmacological interventions for the management of gagging in people undergoing dental treatment.

Key Ministry of Health Publications

Suicide Facts: Data tables 1996−2016
These tables present data about suicide deaths in New Zealand for the period 1996 to 2016. The tables include numbers and rates by common demographic breakdowns, such as age, sex, ethnicity, district health board (DHB) of residence and neighbourhood deprivation. High level key findings describe statistics and time trends.

District Health Board Initiative

Encouraging more Māori into the Hawke’s Bay health sector
A group of Māori medical students are getting hands-on work experience thanks to a new initiative called Tuakana Teina, led by the Māori Health Team at the Hawke’s Bay District Health Board (HBDHB). Seven university students will spend their summer working on projects with the region’s health professionals that aim to improve Māori health outcomes.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.