ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 49 – 2014

Maori Health Review
Maori Health Review

Reducing the pain of intramuscular benzathine penicillin injections in the rheumatic fever population of Counties Manukau District Health Board

Authors: Russell K et al.

Summary: Outcomes are reported in this paper from a survey involving patients with rheumatic fever treated with four weekly intramuscular (IM) benzathine penicillin injections in the Counties Manukau District Health Board (CMDHB) region. The survey evaluated the effectiveness of 0.25 mL of lignocaine 2% and a vibrating device with cold pack (Buzzy) for pain management of their injections. Patients were also questioned about their fear. The lignocaine was mixed in with the benzathine penicillin prior to administration. Pain scores were assessed during, at 2 min and 1 hour after administration and the following day. Pain at injection delivery and fear scores were higher for participants aged ≤13 years. Overall pain scores were significantly reduced with lignocaine and Buzzy over all four time points and there was a corresponding significant reduction in fear of the injections. Lignocaine and Buzzy resulted in a greater reduction in pain than lignocaine alone, only when the injection was being administered to those ≤13 years. Results of a file audit undertaken five months later showed that 66% of all rheumatic fever patients of CMDHB were choosing to use lignocaine and 43% were choosing to use Buzzy. In total, 71% of all rheumatic fever patients were choosing one or both of these analgesic interventions.

Comment: A great example of research that is not only driven by a local health issue but reports on implementation

Reference: J Paediatr Child Health 2014;50(2):112-7


The cost of a healthy and sustainable diet – who can afford it?

Authors: Barosh L et al.

Summary: These researchers recorded the cost of both a typical basket of food and a hypothetical healthy and sustainable (H&S) basket in five neighbourhoods that differed by food sub-systems, socioeconomic levels and household income levels in Greater Western Sydney, Australia. The affordability of the baskets was determined across household income quintiles. In all five neighbourhoods, the cost of the H&S basket was more than the typical basket. The most socioeconomically disadvantaged neighbourhood spent proportionately more (30%) to buy the H&S basket. Within household income levels, the greatest inequity was found in the middle income neighbourhood, with households in the lowest income quintile having to spend up to 48% of their weekly income to buy the H&S basket, while households in the highest income quintile would have to spend significantly less of their weekly income (9%).

Comment: A really interesting paper confirming what many of us suspected. Perhaps such robust evidence will inform appropriate policies?

Reference: Aust N Z J Public Health 2014;38(1):7-12


Sites of institutional racism in public health policy making in New Zealand

Authors: Came H

Summary: This paper critically evaluated public health policy making in New Zealand during the period 2009 through 2011. Using a mixed methods approach and critical anti-racism scholarship, the study author identified compelling evidence from multiple sources confirming institutional racism within five specific sites of Crown policy making. These sites include majoritarian decision making, the misuse of evidence, deficiencies in both cultural competencies and consultation processes and the impact of Crown filters. The paper concludes that “these findings suggest the failure of quality assurance systems, existing anti-racism initiatives and health sector leadership to detect and eliminate racism”.

Comment: It was great to see Heather, the author of this paper, at the recent Nga Pae o te Māramatanga hui held at Waipapa Marae. For more information on the hui, and the call to take action on the cuts to its funding as a centre of excellence in rangahau Māori, check out the website: future-m-ori-research

Reference: Soc Sci Med 2014;106:214-220


Maori Health Review