Harti Hauora Tamariki: randomised controlled trial protocol for an opportunistic, holistic and family centred approach to improving outcomes for hospitalised children and their families in Aotearoa, New Zealand.

Background: Health and wellbeing inequities between the Indigenous Māori and non-Māori populations in Aotearoa, New Zealand continue to be unresolved. Within this context, and of particular concern, hospitalisations for diseases of poverty are increasing for tamariki Māori (Māori children). To provide hospitalised tamariki Māori, and their whānau (families) comprehensive support, a wellbeing needs assessment; the Harti Hauora Tamariki Tool (The Harti tool) was developed.

The Prevalence and Management of Atrial Fibrillation in New Zealand Māori Detected through an Abdominal Aortic Aneurysm Screening Program.

Background: Atrial fibrillation (AF) screening was incorporated into an abdominal aortic aneurysm screening (AAA) program for New Zealand (NZ) Māori.

Methods: AF screening was performed as an adjunct to AAA screening of Māori men aged 60-74 years and women aged 65-74 years registered with primary health care practices in Auckland, NZ. Pre-existing AF was determined through coded diagnoses or medications in the participant's primary care record.

Invitation methods for Indigenous New Zealand Māori in lung cancer screening: Protocol for a pragmatic cluster randomized controlled trial.

Lung cancer screening can significantly reduce mortality from lung cancer. Further evidence about how to optimize lung cancer screening for specific populations, including Aotearoa New Zealand (NZ)'s Indigenous Māori (who experience disproportionately higher rates of lung cancer), is needed to ensure it is equitable. This community-based, pragmatic cluster randomized trial aims to determine whether a lung cancer screening invitation from a patient's primary care physician, compared to from a centralized screening service, will optimize screening uptake for Māori.

Incidence and Outcomes of Abdominal Aortic Aneurysm Repair in New Zealand from 2001 to 2021.

Purpose: The burden of abdominal aortic aneurysms (AAA) has changed in the last 20 years but is still considered to be a major cause of cardiovascular mortality. The introduction of endovascular aortic repair (EVAR) and improved peri-operative care has resulted in a steady improvement in both outcomes and long-term survival. The objective of this study was to identify the burden of AAA disease by analysing AAA-related hospitalisations and deaths.

Impact of low-dose CT screening for lung cancer on ethnic health inequities in New Zealand: a cost-effectiveness analysis.

Objective: There are large inequities in the lung cancer burden for the Indigenous Māori population of New Zealand. We model the potential lifetime health gains, equity impacts and cost-effectiveness of a national low-dose CT (LDCT) screening programme for lung cancer in smokers aged 55-74 years with a 30 pack-year history, and for formers smokers who have quit within the last 15 years.

Design: A Markov macrosimulation model estimated: health benefits (health-adjusted life-years (HALYs)), costs and cost-effectiveness of biennial LDCT screening.

A targeted promotional DVD fails to improve Māori and Pacific participation rates in the New Zealand bowel screening pilot: results from a pseudo-randomised controlled trial.

Background: New Zealand's Bowel Screening Pilot (BSP) used a mailed invitation to return a faecal immunochemical test. As a pilot it offered opportunities to test interventions for reducing ethnic inequities in colorectal cancer screening prior to nationwide programme introduction. Small media interventions (e.

The population prevalence of undetected abdominal aortic aneurysm in New Zealand Māori.

Background: The prevalence of abdominal aortic aneurysm (AAA) in Polynesian populations such as the New Zealand Māori has not been characterized. We measured this in a large population-based sample.

Methods: A cross-sectional population-based prevalence study was conducted as part of an AAA screening pilot; 2467 Māori men aged 54 to 74 years and 1526 women aged 65 to 74 years registered with a primary care practice in Auckland (New Zealand) were invited to be screened by abdominal ultrasound between June 2016 and March 2018.

Variation in public-funded bariatric surgery intervention rate by New Zealand region.

Inequitable access to bariatric surgery by geographical region has been reported internationally, but comparable data on provision of bariatric surgery have not previously been reported in New Zealand. We examined allocated funding and provision of bariatric surgery amongst different regions in New Zealand in the 2013/14 year, and found that there was large variation in both. This highlights that public funded bariatric surgery needs to take into account population prevalence of morbid obesity to reduce inequities by geographical region.

Developing a regional cancer service; lessons from the Waitemata Cancer Patient Experience Survey.

Aim: As part of a project developing cancer service capability, the National Health Service (NHS) Cancer patient experience survey was used to assess the currently available services at Waitemata District Health Board (WDHB).

Methods: Patients presenting with cancer to WDHB in the previous 12 months were mailed a copy of the survey, to the initial cohort in 2013 and to the second in 2015. Results were compared between survey periods and with the 2015 NHS Cancer Patient Experience Survey.

Mobile Technology for Primary Stroke Prevention: A Proof-of-Concept Pilot Randomized Controlled Trial.

Background and Purpose- Feasibility of utilizing the Stroke Riskometer App (App) to improve stroke awareness and modify stroke risk behaviors was assessed to inform a full randomized controlled trial. Methods- A parallel, open-label, 2-arm prospective, proof-of-concept pilot randomized controlled trial. Participants were randomized to usual care/control or App intervention group and assessed at baseline, 3, and 6 months.

Correcting for Body Surface Area Identifies the True Prevalence of Abdominal Aortic Aneurysm in Screened Women.

Objective: Recently, the prevalence of abdominal aortic aneurysm (AAA) using screening strategies based on elevated cardiovascular disease (CVD) risk was reported. AAA was defined as a diameter ≥30 mm, with prevalence of 6.1% and 1.

How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?

Objective: Use data envelopment analysis (DEA) to measure the efficiency of New Zealand's District Health Boards (DHBs) at achieving gains in Māori and European life expectancy (LE).

Methods: Using life tables for 2006 and 2013, a two-output DEA model established the production possibility frontier for Māori and European LE gain. Confidence limits were generated from a 10,000 replicate Monte Carlo simulation.

Are ethnic inequalities in 30-day ischaemic stroke survival emerging as treatment becomes more effective?

Aim: Studies of ethnic differences in stroke survival have produced inconsistent findings. As treatment becomes more effective, inequalities may increase. We examine time trends in ischaemic stroke case fatality in New Zealand.

Comparison of Australian and New Zealand referral rates for hyperbaric oxygen in oro-facial osteoradionecrosis: evidence-based, funding constraint or clinician whim?

Aim: To compare Australian and New Zealand (NZ) rates of referral to hyperbaric units for patients with, or at risk of developing mandibular or maxillary osteoradionecrosis (ORN) due to a history of radiotherapy for oro-pharyngeal cancer.

Method: Relevant patient treatment data from all hyperbaric units in Australia and NZ were collated and analysed.

Results: The rate of referral to hyperbaric units in Australia for treatment or prophylaxis of patients with, or at risk of oro-facial ORN, was 1.

Ethnic differences in coronary artery revascularisation in New Zealand: does the inverse care law still apply?

Background: In 2002 striking differences in cardiac revascularisation rates were reported between New Zealand Māori, Pacific and European ethnicities. This paper examines whether this inequity still exists, taking into account ethnic differences in need.

Methods: Age-standardised time trends in intervention rates for coronary artery bypass grafts (CABG), percutaneous coronary intervention (PCI) and ST elevation myocardial infarction (STEMI) were calculated by ethnicity.

Different needs or treated differently? Understanding ethnic inequalities in coronary revascularisation rates.

Background: Several studies have reported major ethnic inequalities in cardiac revascularisation. This paper attempts to explain why in New Zealand, Māori and Pacific patients may be less likely to receive cardiac revascularisation interventions than Europeans.

Methods: Angiograms of 55 Māori, 45 Pacific and 100 age-sex matched European patients with ST elevation myocardial infarction were reviewed by two cardiologists blinded to the patients' ethnicity to determine ethnic differences in actual and recommended revascularisation likelihood.

How many cancer deaths could New Zealand avoid if five-year relative survival ratios were the same as in Australia?

Aim: To determine how many Māori and non-Māori deaths might have been avoidable if cancer survival in New Zealand were as high as in Australia.

Methods: Age-sex-tumour specific five-year relative survival ratios were calculated for cancer patients diagnosed with 27 tumour sites (representing about 92% of all cancers) in 2006-10. These were used to estimate the number of Māori, non-Māori and total deaths (and proportion of excess deaths) that would have been avoidable within five years of diagnosis had New Zealand's relative survival been equivalent to Australia's.

Measuring unexplained variation in acute hospital use by patients enrolled with northern New Zealand general practices.

Introduction: There is increasing concern worldwide at the steady growth in acute inpatient admissions and emergency department (ED) attendances.

Aim: To develop measures of variation in acute hospital use between populations enrolled at different general practices that are independent of the sociodemographic characteristics of those populations.

Methods: Two consecutive years of hospital discharge and ED attendance data were combined with primary health organisation (PHO) registers from 385 practices of over 1.

The effect of Māori ethnicity misclassification on cervical screening coverage.

Aim: There is a large difference in the cervical screening coverage rate between Māori and European women in New Zealand. This paper examines the extent to which this difference is due to misclassification of ethnicity.

Methods: Data from Waitemata District Health Board's two Primary Health Organisations (PHOs) was used to identify the population of Waitemata domiciled women aged 25-69 years eligible for cervical screening.

Ethnic inequalities in incidence, survival and mortality from abdominal aortic aneurysm in New Zealand.

Background: Ethnic variation in abdominal aortic aneurysm (AAA) incidence, survival and mortality is not well documented and yet has important equity implications for screening programmes. This study quantifies ethnic differences in hospital incidence, mortality and survival from AAA among Māori, Pacific, Asian and European/other ethnicities in New Zealand (NZ).

Methods: Retrospective analysis of linked NZ hospital and death register records identified all patients admitted to a public hospital with a diagnosis of AAA and deaths from AAA from 1996 to 2007.

Getting back the missing men of Aotearoa: declining gender inequality in NZ life expectancy.

Introduction: Men's health is of increasing concern to policy makers worldwide. Although women generally live significantly longer than men, the difference in life expectancy in many countries is now narrowing.

Aim: To document the trend in sex differences in New Zealand (NZ) life expectancy at birth (LEB) over the last decades and to determine disease patterns which account for it.

Gender inequality in New Zealand life expectancy: decomposition by age and cause.

AIM To quantify gender inequality in life expectancy at birth (LEB) in New Zealand and the contribution to it made by different age groups and causes of death. To examine the response of the health sector.METHOD Determination of the trend in sex differences in LEB.

The cost-effectiveness of a competitive voucher scheme to reduce sexually transmitted infections in high-risk groups in Nicaragua.

Current evidence suggests that sexually transmitted infection (STI) interventions can be an effective means of human immunodeficiency virus (HIV) prevention in populations at an early stage of the epidemic. However, evidence as to their cost-effectiveness when targeted at high-risk groups is lacking. This paper assesses the cost-effectiveness of a competitive voucher scheme in Managua, Nicaragua aimed at high-risk groups, who could redeem the vouchers in exchange for free STI testing and treatment, health education and condoms, compared with the status quo (no scheme).

External quality assurance for cervical cytology in developing countries. Experience in Peru and Nicaragua.

Given interest from the professionals concerned, an external quality assurance scheme for cervical cytology can successfully be introduced in developing countries. This is a very important precondition if screening programs are to be expanded and decreases in mortality from cervical cancer are to occur in developing countries. Nicaragua and Peru have been experimenting with an external quality assurance system adapted from the Scottish and Northern Ireland scheme.