ORCID Profile
0000-0002-4337-7321
Current Organisations
Eastern Institute of Technology
,
The University of Auckland School of Population Health
,
Hawke's Bay Regional Council
,
The University of Auckland
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Publisher: Informa UK Limited
Date: 02-05-2022
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.CTRV.2013.01.007
Abstract: The majority of Non-Hodgkin's lymphoma (NHL) patients are over 65 years. Management is challenging, especially for aggressive lymphoma, and appropriate assessment of efficacy and tolerance specific to this population is crucial. To assess the representation of older patients in randomised controlled trials (RCT) in NHL, examining whether trial eligibility criteria prevent participation, and whether appropriate primary endpoints such as toxicity, quality of life, or geriatric assessment scores are used. We searched Medline for articles published in English or French between 1 January 2005 and 31 December 2011 reporting on phase II/III RCT evaluating therapeutic strategies for NHL. Articles were categorised as including or excluding (directly or indirectly) older adults, and features of RCT that included or excluded older patients are compared. We identified 87 relevant RCT: 9 (10.3%) focussed exclusively on patients >65 years, 22 (25.3%) directly excluded patients >65 years, 47 (54.0%) indirectly excluded older adults through selective inclusion criteria (ECOG status, liver or kidney function, and comorbidities), and 9 (10.3%) did not directly or indirectly exclude patients >65 years (although two excluded patients >70 years). Proportions of older patients included do not reflect incidence. Trials including older adults were published in journals with lower impact factors and few RCT used appropriate endpoints for older adults. Older adults are poorly represented in NHL RCT both due to direct age-based exclusion and restrictive inclusion criteria. This situation needs rapid correction to better represent older patients and thus improve cancer management in this highly prevalent population.
Publisher: Wiley
Date: 06-2002
Publisher: Elsevier
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 28-06-2023
DOI: 10.1007/S41055-023-00127-5
Abstract: Māori (Indigenous people of New Zealand (NZ)) suffer food insecurity disproportionately in New Zealand. Some research suggests that Māori value mātauranga Māori (traditional Māori knowledge) when it comes to the collection, preparation and eating of kai (food). This study explores the connections between mātauranga Māori and kai in regional NZ schools for potential pathways to impact food security for children. Semi-structured interviews were undertaken with five primary school principals in the Hawke’s Bay region. Principals were purposively selected on commitments to proactively incorporating mātauranga Māori into their school environment. Reflective thematic analysis was used to analyse the data. Three main themes were identified: teaching and learning around mātauranga Māori and kai environmental sustainability and the sustainability of kai initiatives and school values. A strong emphasis was placed on the learning of traditional Māori values around kai and the whenua (land) and the sustainability of teaching programs. School values were invariably bound in Te Ao Māori (a Māori worldview) however, schools felt challenged in aligning their values and their mātauranga Māori-bound teaching practices with the current food provision programme in their schools (Ka Ora, Ka Ako). The programme’s strict nutritional guidelines appeared to challenge traditional Māori approaches to kai. Schools remain an ideal environment for the incorporation of mātauranga Māori to support food security and food education, and future work should explore a demonstration project that incorporates the knowledge gained in this study and ways to integrate mātauranga Māori into Ka Ora, Ka Ako.
Publisher: Wiley
Date: 27-10-2022
DOI: 10.1002/HPJA.549
Abstract: Hawke's Bay has one of the highest rates of childhood obesity in New Zealand. While several initiatives exist aiming to decrease obesity through physical activity, there are few nutritional interventions. This study adopted a systems science and mātauranga Māori approach to identify and target underlying drivers of rising childhood obesity and engage the community to improve the food environment. Cognitive mapping interviews (CM) with local stakeholders (school principals, Iwi and district health board representatives, education managers and local councillors) were conducted. The aim was to map participants’ mental models of the causes of rising childhood obesity and to identify key principles for engaging with the local community in a meaningful, impactful and culturally appropriate way for future action. Eleven interviews were conducted face‐to‐face and cognitive maps were constructed. Follow‐up interviews were carried out online, due to COVID restrictions, to present the maps and for interviewees to make any adjustments. Four composite themes emerged through centrality and cluster analysis of the resulting cognitive maps: the importance of building in mātauranga Māori (Māori knowledge and ways of being), the “hauora” of children, working with the community and integrating existing initiatives. Two contextual factors are also considered: the growing need for food security in our communities and the opportunity to start interventions in the school setting. Cognitive mapping can produce useful insights in the early stages of community engagement. The six “pou” (pillars) underscore the importance of incorporating indigenous knowledge when embarking on public health interventions, particularly around obesity and in regional communities. When designing a public health initiative with a community with a high indigenous population, indigenous knowledge should be promoted to focus on holistic health, working with the community and creating opportunities for cohesion. These founding principles will be used to structure future community actions to improve children's food environments in regional New Zealand.
Publisher: Oxford University Press (OUP)
Date: 08-2023
Abstract: In 2020, a government-funded healthy school lunch program was introduced in a quarter of New Zealand schools, selected due to high levels of socio-economic barriers. This study assesses the impact of the introduction of the school lunch program from family (whānau), student and school principal perspectives. Across four schools, we conducted five focus groups (two with secondary students and three with family members) and four school principal interviews. Participating schools represented a range of contexts: primary and secondary, schools with cooks in on-site kitchens and schools receiving meals delivered by external caterers. Thematic analysis was used to develop themes describing the health, wellbeing and nutritional impact of the program. Family participants were 82% Indigenous Māori and self-identified as having ‘borderline’ (73.5%) or no financial security (8.8%). Seven positive impact themes were identified: improved food security, enhanced equity, increased appreciation of healthy foods for students, enhanced mana (wellbeing) for all, reduced financial hardship/stress for families, opportunities for nutritional learning and recognition that appreciation and uptake happen over time. Four negative impact themes were identified: low uptake that created food waste, perception that healthy food is not palatable for students, lack of knowledge of the program and loss of agency for students. This is the largest intervention in nutrition and food security for children implemented in New Zealand since the 1930's. The first 2 years have offered wellbeing and financial benefits for students and families, particularly when school environments promote uptake. More involvement of students and family members in the program planning is essential.
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.EJSO.2013.08.028
Abstract: Liver metastases (LM) in close contact to hepatic veins (HV) are a frequent cause of unresectability. Reconstruction of hepatic veins is technically difficult and outcomes are poor. Intra-operative radiofrequency ablation (IRFA) with vascular exclusion (VE) may be a useful approach. Out of 358 patients operated for LM, 22 with LM close to a HV treated by IRFA under VE with at least one year of follow-up were included in this retrospective study. Technical success was evaluated at four months by CT scan of the ablated lesion. Complications local, hepatic and extra-hepatic recurrence rates, and overall survival are reported. The median number of metastases was 4.5 [range: 1-12]. Seventeen patients had bilateral metastases. The median size of ablated lesions was 2 cm [range: 1-5.5]. Seven complications occurred (1 Grade 1, 2 Grade 3b and 4 Grade IVa), with no mortality. No recurrence of ablated lesions was detected at four months or during follow-up. Seventeen patients had new or extra-hepatic lesions. Median overall survival for colorectal patients was 40 months 95%CI[17.5-not reached]. IRFA plus VE for LM in close contact to a HV is a novel approach, appearing to be a safe and effective technique which can extend the applications of liver metastases surgery.
Publisher: SAGE Publications
Date: 27-08-2022
DOI: 10.1177/11771801221119266
Abstract: Systems Thinking is increasingly applied to address complex societal and public health issues in Aotearoa, New Zealand and has been proposed as a good fit with traditional wisdom and Mātauranga Māori (Indigenous knowledge) from Aotearoa, New Zealand. In this article, we delve into the theoretical underpinnings of Systems Thinking approaches used in Community-Based System Dynamics research and find parallels with Indigenous narratives and knowledge. The synergy created by combining these two knowledge systems and practices is proposed as an effective way to approach public health issues that emerge from complex adaptive systems, particularly in communities with large numbers of Indigenous peoples. Ex les are given from an initiative to engage community to improve food security and nutrition in regional Aotearoa, New Zealand.
Publisher: MDPI AG
Date: 17-10-2022
DOI: 10.3390/NU14204336
Abstract: As part of the COVID-19 economic recovery package, the Aotearoa New Zealand Government rolled out a universal free and healthy lunch programme to the 25% least advantaged schools nationwide. This study explored experiences of school lunch providers in the Hawke’s Bay region. The aim was to create a systems map identifying points of intervention through which the lunch programme could be improved to meet the goal of reducing child food insecurity. Twelve lunch providers were interviewed to generate casual loop diagrams which were examined and integrated to form a single systems map. Seven themes arose during analysis: teacher support, principal support, nutrition guidelines and government support, supply chain, ingredient suppliers, student feedback and food waste. Teacher support was important for getting students to try new foods and eat the nutritious lunches. Principal support was a strong theme impacting opportunities for broader student engagement. This study employed systems science to highlight the importance of support from different stakeholders within the lunch programme to achieve the goal of reduced child food insecurity. Further work is needed to ensure the programme meets the wider goals of the government and community, and to determine the potential broader benefits of the programme.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1111/HPB.12274
Publisher: Nga Pae o te Maramatanga
Date: 29-06-2021
DOI: 10.20507/MAIJOURNAL.2021.10.1.3
Abstract: Interviews with stakeholders in deprived Hawke’s Bay schools early in the COVID-19 lockdown documented exacerbated food insecurity among school whānau. Our enquiry highlights the support role played by well-informed teacher aides and school–whānau networks, which were easily and inexpensively resourced, intuitive, proactive and collaborative, ensuring whānau access to appropriate support according to need. We expect our findings to further inform such initiatives in any further lockdown. Additionally, we posit that such school-based operations could become the nexus of a primary foodsecurity hub, alongside the Lunches in Schools programme, working in a tailor-made fashion bespoke to whānau without a charity or welfare label. Given the recent well-resourced COVID-19-related investment into the business world and the ongoing lack of progress in the reduction of child poverty, in the post-COVID-19-lockdown environment, simple structural rearrangements for the chronically food insecure are likely to become politically acceptable to the nation.
Publisher: MDPI AG
Date: 19-04-2022
Abstract: Children’s nutrition is highly influenced by community-level deprivation and socioeconomic inequalities and the health outcomes associated, such as childhood obesity, continue to widen. Systems Thinking using community-based system dynamics (CBSD) approaches can build community capacity, develop new knowledge and increase commitments to health improvement at the community level. We applied the formal structure and resources of a Group Model Building (GMB) approach, embedded within an Indigenous worldview to engage a high deprivation, high Indigenous population regional community in New Zealand to improve children’s nutrition. Three GMB workshops were held and the youth and adult participants created two systems map of the drivers and feedback loops of poor nutrition in the community. Māori Indigenous knowledge (mātauranga) and approaches (tikanga) were prioritized to ensure cultural safety of participants and to encourage identification of interventions that take into account social and cultural environmental factors. While the adult-constructed map focused more on the influence of societal factors such as cost of housing, financial literacy in communities, and social security, the youth-constructed map placed more emphasis on in idual-environment factors such as the influence of marketing by the fast-food industry and mental wellbeing. Ten prioritized community-proposed interventions such as increasing cultural connections in schools, are presented with the feasibility and likely impact for change of each intervention rated by community leaders. The combination of community-based system dynamics methods of group model building and a mātauranga Māori worldview is a novel Indigenous systems approach that engages participants and highlights cultural and family issues in the systems maps, acknowledging the ongoing impact of historical colonization in our communities.
Publisher: Oxford University Press (OUP)
Date: 07-2013
DOI: 10.1634/THEONCOLOGIST.2013-0380
Abstract: Identify the features typical of triple-negative breast cancers on mammography, ultrasound, and magnetic resonance imaging. Identify this aggressive subtype to accelerate diagnosis and treatment and improve outcomes. Compare typical imaging features of triple-negative breast cancers with typical imaging features of HR+/HER- breast cancers.
Publisher: MDPI AG
Date: 13-04-2022
Abstract: Healthy food environments in early childhood play an important role in establishing health-promoting nutritional behaviours for later life. We surveyed Early Learning Services (ELS) in the Hawke’s Bay region of New Zealand and describe common barriers and facilitators to providing a healthy food environment, through descriptive survey analysis and thematic analysis of open-ended questions. We used a policy analysis tool to assess the strength and comprehensiveness of the in idual centre’s nutrition policies and we report on the healthiness of menus provided daily in the centres. Sixty-two centres participated and 96.7% had policies on nutrition compared to 86.7% with policies on drinks. Of the 14 full policies provided for analysis, identified strengths were providing timelines for review and encouraging role modelling by teachers. The main weaknesses were communication with parents and staff, lack of nutrition training for staff and absence of policies for special occasion and fundraising food. With regard to practices in the ELS, food for celebrations was more likely to be healthy when provided by the centre rather than brought from home. Food used in fundraising was more likely to be unhealthy than healthy, though % of centres reported using food in fundraising. Only 40% of menus analysed met the national guidelines by not including any ‘red’ (unhealthy) items. Centre Managers considered the biggest barriers to improving food environments to be a lack of parental support and concerns about food-related choking. These results highlight the need for future focus in three areas: policies for water and milk-only, celebration and fundraising food increased nutrition-focused professional learning and development for teachers and communication between the centre and parents, as a crucial pathway to improved nutrition for children attending NZ early childhood education and care centres.
Publisher: Springer Science and Business Media LLC
Date: 20-10-2016
DOI: 10.1038/NRCLINONC.2015.176
Abstract: Conducting high-quality prospective clinical trials in surgical oncology remains a challenge, and many seemingly well-designed trials lack this high quality because of inadequate recruitment accrual, lack of clinician interest, or evolution of treatment strategy during the many years over which such trials are conducted. In this Perspectives we examine some of the failures in published surgical oncology trials and discuss why they failed, and we make a critical assessment of the established prospective trial methodology in oncological practice (that is, phase 0, I, II, III and IV trials, and large prospective comparative audits) and how these methods might be used more effectively in future evaluation of cancer-surgery practice.
Publisher: MDPI AG
Date: 31-05-2022
Abstract: The school food environment plays an important role in shaping students’ dietary choices, which often influence future dietary behaviours. We surveyed primary and secondary schools in Hawke’s Bay, New Zealand, to measure the comprehensiveness and strength of food policies, describe the culture of food provision, and identify barriers to improving school food environments. Fifty-one schools were included in the final analysis, with 58.8% having a food policy, most of which used a generic template. Schools with food policies and those participating in the free and healthy lunch programme were more likely to have a strong culture around healthy eating. Common barriers to healthy eating were food outlets near school and resistance from students. Secondary schools reported facing more barriers to implementing healthy eating cultures, were more likely to use food as classroom rewards and to sell food to students, most of which was unhealthy. Hawke’s Bay schools participating in food provision programmes are successfully improving their food environments through improved culture and delivery of healthy food however, more action is needed to strengthen the wording and guidance in food policies and reduce the provision of unhealthy food in schools before effective change can be achieved.
Publisher: Victoria University of Wellington Library
Date: 31-05-2023
Abstract: Ka Ora, Ka Ako provides free, healthy lunches for 220,000 learners in low-equity New Zealand schools. Costing over $260 million annually, it represents the largest government investment in child nutrition in generations. Early evaluations indicate success in achieving programme aims of delivering nutritious food, improving learners’ wellbeing, and easing financial stress for families. However, international evidence and emerging local data indicate the programme can achieve the above and more. This article presents a programme logic model drawing on local data and a review of relevant international literature on universal school food provision with the aim of identifying potential long-term outcomes and impacts at multiple levels: for learners, wh`ānau, schools, communities, and food systems. Findings indicate that the Ka Ora, Ka Ako programme has the potential to:• improve children’s nutrition and educational outcomes, as well as improve child and wh`ānau food security • enrich school learning environments • boost local economies (through creation of jobs paying a living wage) and enhance local foodscapes (including availability and affordability of healthy foods) through food system engagement in schools, with whänau and communities and• increase food system resilience (e.g., shorter supply chains and relationship building), and encourage broader food system transformation (e.g., reformulation, waste and packaging solutions) with leverage from new procurement models.While Ka Ora, Ka Ako can contribute to these pathways, some implementation areas within the programme demand further attention to achieve optimal results. Recognised areas for improvement include ensuring high quality of food, providing more avenues for engagement from children and parents, addressing perceived challenges to integrate Ka Ora, Ka Ako effectively with mātauranga Māori, and improving waste management. Given the high potential for Ka Ora, Ka Ako to contribute to multiple beneficial outcomes, continued investment and expansion of the programme is warranted.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.CLINRE.2022.101912
Abstract: The high sensitivity of PET-CT can identify hypermetabolic mediastinal adenopathies during cancer management, but specificity is low and a biopsy is sometimes required to eliminate benign adenopathies. This prospective diagnostic accuracy study included patients with hypermetabolic mediastinal lymphadenopathies revealed on PET-CT during either the initial management of a cancer, treatment evaluation, or monitoring. All patients underwent EUS-FNA. Diagnoses of malignancy based on cytological analysis following EUS-FNA were compared with clinical and radiological follow-up information. The treatment strategy decided before the results of the EUS-FNA pathology reports (Multidisciplinary Team Meeting [MTM-1]) was recorded and compared to the treatment strategy decided once pathological data from EUS-FNA were available (MTM-2). Between 2013 and 2018, 75 patients were included with 47 eligible and evaluable patients. Sensitivity, specificity, and positive and negative predictive values of EUS-FNA were 93%, 100%, 100% and 90%, respectively. The concordance value between the therapeutic strategies determined for MTM-1 and MTM-2 was 44.7%. There were no significant differences in the intensity of fixation on PET-CT between malignant and benign lesions. The diagnostic accuracy of the minimally invasive EUS-FNA procedure is sufficiently robust to avoid the need for diagnostic surgery. The combination of PET-CT and EUS-FNA may alter the therapeutic strategy that would be considered after PET-CT alone. NCT01892501.
Publisher: Acoustical Society of America (ASA)
Date: 05-2014
DOI: 10.1121/1.4870701
Abstract: The primary aim of this study was to determine whether late French/English bilinguals are able to utilize knowledge of bilabial stop contrasts that exist in each of their separate languages to discriminate bilabial stop contrasts from a new language (Thai). Secondary aims were to determine associations between bilabial stop consonant production in the L1 and the L2, between language learning factors and production and discrimination, and to compare English bilinguals' and monolinguals' discrimination. Three Thai bilabial stop consonant pairs differentiated by Voice Onset Time (VOT) (combinations of [b], [p], and [ph]) were presented to 28 French-English bilinguals, 25 English-French bilinguals, and 43 English monolinguals in an AX discrimination task. It was hypothesized that L2 experience would facilitate discrimination of contrasts that were phonemic in the L2 but not in the L1 for bilinguals. Only limited support for this hypothesis was found. However, results indicate that high production proficiency bilinguals had higher discrimination of the phonemic L2 contrasts (non-phonemic in L1). Discrimination patterns indicate lasting L1 influence, with similarity between unknown foreign language contrasts and L1 contrasts influencing discrimination rates. Production results show evidence for L2 influence in the L1. Results are discussed in the context of current speech perception models.
Publisher: MDPI
Date: 20-04-2022
Location: New Zealand
Location: France
No related grants have been discovered for Pippa McKelvie-Sebileau.