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0000-0002-3361-8304
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The University of Auckland
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RACP
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Te Whatu Ora Counties Manukau District
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Publisher: Wiley
Date: 29-12-2021
DOI: 10.1111/JPC.15869
Abstract: To enable improvements in global child health, the focus must move beyond child survival to child wellbeing. In the Pacific Islands, the wellbeing of children has received little attention. This study aimed to investigate the wellbeing of children from three primary schools in Tonga. A cross‐sectional survey was completed in three primary schools in Nuku'alofa with children aged 5–15 years. The study participants (256 children, 143 caregivers) completed the Child Health and Illness Profile – Child Edition, CHIP‐CE (Version 1.0). On average, % of children and caregivers described home and school environments as positive. From the children's reports, boys had significantly lower scores for risk avoidance than girls (3.40 vs. 3.73, P 0.001). Children aged 5–7 versus 8–15 years had significantly lower scores for satisfaction (3.63 vs. 3.92, P = 0.002), resilience (3.34 vs. 3.56, P = 0.016) and achievement (3.25 vs. 3.62, P = 0.002). From the caregivers' report, girls had significantly lower scores for academic performance than boys (3.60 vs. 3.81, P = 0.04). Boys had significantly lower scores for in idual risk association compared to girls (3.93 vs. 4.29, P = 0.01). Overall CHIP‐CE scores were lower than those of comparable populations in the West, while at the same time protective factors were documented. Understanding child wellbeing in the Pacific is critical for strengthening protective factors known to mitigate poor child health outcomes. Continuing to base global child health success on child survival alone misses opportunities for improving the wellbeing of nations.
Publisher: Wiley
Date: 05-2023
DOI: 10.1111/JPC.16417
Abstract: Globally, the child health focus has been on reducing under‐5‐year mortality, with large populations in low‐resource regions prioritised. Children in older age groups, particularly in less populated regions such as the Pacific, have received limited attention. Child health research in the Pacific region has been lacking, and research approaches for the region have historically been from Western biomedical paradigms. We completed the study of primary school children's health over a period of 5 years. Firstly, we conducted a literature review, then we completed an audit of hospital admissions of primary school children, then we completed a two‐round Delphi process and finally, we piloted the survey in three primary schools. Our results found there were high levels of oral health problems, ear health, obesity and exposure to violence and poverty impacting on the quality of health of primary school‐age children. Identifying these indicators was made possible by the partnerships and trust established by the study team and provides specific and measurable targets for future work to improve the quality of child health outcomes. This paper describes key field work lessons learnt for research in the Pacific region. It must: (i) be on the platform of relationship, cultural safety and local ownership (ii) include consideration of holistic Pacific paradigms of health (iii) be adaptive to the context and environment and (iv) be committed to long‐term partnership and work.
Publisher: Elsevier BV
Date: 07-2013
Publisher: MDPI AG
Date: 15-11-2019
Abstract: 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 is to identify potentially modifiable risk factors for ARF to support effective disease prevention policies and programmes. A case-control design is used. Cases are those meeting the standard NZ case-definition for ARF, recruited within four weeks of hospitalisation for a first episode of ARF, aged less than 20 years, and residing in the North Island of NZ. This study aims to recruit at least 120 cases and 360 controls matched by age, ethnicity, gender, deprivation, district, and time period. For data collection, a comprehensive pre-tested questionnaire focussed on exposures during the four weeks prior to illness or interview will be used. Linked data include previous hospitalisations, dental records, and school characteristics. Specimen collection includes a throat swab (Group A Streptococcus), a nasal swab (Staphylococcus aureus), blood (vitamin D, ferritin, DNA for genetic testing, immune-profiling), and head hair (nicotine). A major strength of this study is its comprehensive focus covering organism, host and environmental factors. Having closely matched controls enables the examination of a wide range of specific environmental risk factors.
Publisher: Oxford University Press (OUP)
Date: 10-09-2007
DOI: 10.1093/IJE/DYM171
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JPEDS.2017.04.058
Abstract: To estimate associations between factors recorded in pregnancy and the first week of life and subsequent abusive head trauma. Multicenter, retrospective case-control study of perinatal records from 142 cases of abusive head trauma and 550 controls, matched by date and hospital of birth from 1991 to 2010. Multiple logistic regression assessed the relationship between perinatal exposures and abusive head trauma. The risk of abusive head trauma decreased with increasing maternal age (OR, 0.91 per year 95% CI 0.85-0.97) and increasing gestational age at birth (OR 0.79 per week 95% CI 0.69-0.91). Mothers of cases were more likely to be Māori (OR 4.61 95% CI 1.98-10.78), to be single (OR 5.10 95% CI 1.83-14.23), have recorded social concerns (OR 4.29 95% CI 1.32-13.91), and have missing data for antenatal care, partner status, social concerns, and substance abuse (OR 13.53 95% CI 2.39-76.47). Case mothers were more likely not to take supplements in pregnancy (OR 3.53 95% CI 1.30-9.54), to have membrane rupture longer than 48 hours before delivery (OR 13.01 95% CI 2.84-59.68), and to formula feed (OR for mixed breast and formula feeding 6.06 95% CI 2.39-15.36) before postnatal discharge (median 3 days). Factors associated with subsequent abusive head trauma can be identified from routine perinatal records. Targeted interventions initiated perinatally could possibly prevent some cases of abusive head trauma. However, any plans for targeted prevention strategies should consider not only those with identified risk factors but also those for which data are missing.
Publisher: Elsevier BV
Date: 29-05-2006
DOI: 10.1016/J.VACCINE.2006.02.050
Abstract: Pacific children have had consistently evidenced low rates for routine childhood immunisations. Using the Pacific Islands Families: First 2 Years of Life cohort study, we investigated the immunisation rate of Pacific infants residing in New Zealand at 24-months postpartum. Full immunisation was reported for 89% of infants, substantially increased from the 53% found in the 1992 national survey and closer to the New Zealand Ministry of Health's target of 95%. Increased parity and maternal smoking were associated with incomplete child immunisation status. Initiatives to increase immunisation rates amongst Pacific children appear to be succeeding and warrant continuation.
Publisher: BMJ
Date: 03-2019
DOI: 10.1136/BMJOPEN-2018-024199
Abstract: First, to investigate whether there is a relationship between a family being known to child protective services or police at the time of birth and the risk of abusive head trauma (AHT, formerly known as shaken baby syndrome). Second, to investigate whether data from child protective services or police improve a predictive risk model derived from health records. Retrospective case control study of child protective service and police records. Nine maternity hospitals. 142 consecutive cases of AHT admitted to a tertiary children’s hospital from 1991 to 2010 and born in one of the nine participating maternity hospitals. 550 controls matched by the date and hospital of birth. Abusive head trauma. There is a relationship between families known to child protective services or police and the risk of AHT. Notification to child protective services: univariable OR 7.24 (95% CI 4.70 to 11.14). Involvement with youth justice: univariable OR 8.94 (95% CI 4.71 to 16.95). Police call-out for partner violence: univariable OR 3.85 (95% CI 2.51 to 5.91). Other violence offence: univariable OR 2.73 (95% CI 1.69 to 4.40). Drug offence: univariable OR 2.82 (95% CI 1.63 to 4.89). However, in multi-variable analysis with data from perinatal health records, notification to child protective services was the only one of these variables to remain in the final model (OR 4.84 95% CI 2.61 to 8.97) and had little effect on overall predictive power. The area under the receiver operating characteristic curve was 89.5% (95% CI 86.6 to 92.5) using variables from health data alone and 90.9% (95% CI 88.0 to 93.7) when notification was added. Family involvement with child protective services or police is associated with increased risk of AHT. However, accessing such data at the time of birth would add little predictive power to a risk model derived from routine health information.
Publisher: BMJ
Date: 24-02-2020
DOI: 10.1136/THORAXJNL-2019-213142
Abstract: Hospitalisation with severe lower respiratory tract infection (LRTI) in early childhood is associated with ongoing respiratory symptoms and possible later development of bronchiectasis. We aimed to reduce this intermediate respiratory morbidity with a community intervention programme at time of discharge. This randomised, controlled, single-blind trial enrolled children aged years hospitalised for severe LRTI to ‘intervention’ or ‘control’. Intervention was three monthly community clinics treating wet cough with prolonged antibiotics referring non-responders. All other health issues were addressed, and health resilience behaviours were encouraged, with referrals for housing or smoking concerns. Controls followed the usual pathway of parent-initiated healthcare access. After 24 months, all children were assessed by a paediatrician blinded to randomisation for primary outcomes of wet cough, abnormal examination (crackles or clubbing) or chest X-ray Brasfield score ≤22. 400 children (203 intervention, 197 control) were enrolled in 2011–2012 mean age 6.9 months, 230 boys, 87% Maori/Pasifika ethnicity and 83% from the most deprived quintile. Final assessment of 321/400 (80.3%) showed no differences in presence of wet cough (33.9% intervention, 36.5% controls, relative risk (RR) 0.93, 95% CI 0.69 to 1.25), abnormal examination (21.7% intervention, 23.9% controls, RR 0.92, 95% CI 0.61 to 1.38) or Brasfield score ≤22 (32.4% intervention, 37.9% control, RR 0.85, 95% CI 0.63 to 1.17). Twelve (all intervention) were diagnosed with bronchiectasis within this timeframe. We have identified children at high risk of ongoing respiratory disease following hospital admission with severe LRTI in whom this intervention programme did not change outcomes over 2 years. ACTRN12610001095055.
Publisher: Wiley
Date: 14-10-2012
DOI: 10.1111/J.1440-1754.2010.01969.X
Abstract: Disadvantaged children of Māori and Pacific origin in New Zealand carry an inequitable burden of infectious diseases, many of which are preventable, some by vaccine. Immunisation is recognised in the developing world as a cheap, effective and efficient means of reducing inequalities. The MeNZB immunisation programme delivered in 2004-2006 towards the expected natural end of a projected 15-year epidemic appears to have had an effect (difficult to prove conclusively) on reducing the disproportionate burden of meningococcal disease carried by this group of children. It was delayed by the late engagement of the New Zealand Ministry of Health, fully briefed from 1996, leading to unnecessary and potentially avoidable deaths and sequelae, many lifelong. Further, failure to adequately assess vaccine effectiveness means that the contribution of MeNZB to the observed reduction in disease, particularly in those aged less than five years, will never be reliably known. However, the MeNZB c aign has at least left a legacy: the National Immunisation Register, which should enable New Zealand to minimise the 'vaccine inverse care law' and contribute to reducing ethnic inequity in the burden of vaccine preventable diseases.
Publisher: Springer Science and Business Media LLC
Date: 20-09-2022
DOI: 10.1007/S00246-022-03006-8
Abstract: The experience of diagnosis, decision-making and management in critical congenital heart disease is layered with complexity for both families and clinicians. We synthesise the current evidence regarding the family and healthcare provider experience of critical congenital heart disease diagnosis and management. A systematic integrative literature review was conducted by keyword search of online databases, MEDLINE (Ovid), PsycINFO, Cochrane, cumulative index to nursing and allied health literature (CINAHL Plus) and two journals, the Journal of Indigenous Research and Midwifery Journal from 1990. Inclusion and exclusion criteria were applied to search results with citation mining of final included papers to ensure completeness. Two researchers assessed study quality combining three tools. A third researcher reviewed papers where no consensus was reached. Data was coded and analysed in four phases resulting in final refined themes to summarise the findings. Of 1817 unique papers, 22 met the inclusion criteria. The overall quality of the included studies was generally good, apart from three of fair quality. There is little information on the experience of the healthcare provider. Thematic analysis identified three themes relating to the family experience: (1) The diagnosis and treatment of a critical congenital heart disease child significantly impacts parental health and wellbeing. (2) The way that healthcare and information is provided influences parental response and adaptation, and (3) parental responses and adaptation can be influenced by how and when support occurs. The experience of diagnosis and management of a critical congenital heart disease child is stressful and life-changing for families. Further research is needed into the experience of minority and socially deprived families, and of the healthcare provider, to inform potential interventions at the healthcare provider and institutional levels to improve family experience and support.
Publisher: American Chemical Society (ACS)
Date: 30-04-2013
DOI: 10.1021/JA312030E
Abstract: The structure of SnO2 nanoparticles (avg. 5 nm) with a few layers of water on the surface has been elucidated by atomic pair distribution function (PDF) methods using in situ neutron total scattering data and molecular dynamics (MD) simulations. Analysis of PDF, neutron prompt gamma, and thermogravimetric data, coupled with MD-generated surface D2O/OD configurations demonstrates that the minimum concentration of OD groups required to prevent rapid growth of nanoparticles during thermal dehydration corresponds to ~0.7 monolayer coverage. Surface hydration layers not only stabilize the SnO2 nanoparticles but also induce particle-size-dependent structural modifications and are likely to promote interfacial reactions through hydrogen bonds between adjacent particles. Upon heating/dehydration under vacuum above 250 °C, nanoparticles start to grow with low activation energies, rapid increase of nanoparticle size, and a reduction in the a lattice dimension. This study underscores the value of neutron diffraction and prompt-gamma analysis, coupled with molecular modeling, in elucidating the influence of surface hydration on the structure and metastable persistence of oxide nanomaterials.
Publisher: SAGE Publications
Date: 17-12-2011
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/HC13160
Publisher: Wiley
Date: 19-09-2013
DOI: 10.1002/PPUL.22661
Abstract: Severe lower respiratory infection (LRI) is believed to be one precursor of protracted bacterial bronchitis, chronic moist cough (CMC), and chronic suppurative lung disease. The aim of this study was to determine and to describe the presence of respiratory morbidity in young children 1 year after being hospitalized with a severe LRI. Children aged less than 2 years admitted from August 1, 2007 to December 23, 2007 already enrolled in a prospective epidemiology study (n = 394) were included in this second study only if they had a diagnosis of severe bronchiolitis or of pneumonia with no co-morbidities (n = 237). Funding allowed 164 to be identified chronologically, 131 were able to be contacted, and 94 agreed to be assessed by a paediatrician 1 year post index admission. Demographic information, medical history and a respiratory questionnaire was recorded, examination, pulse oximetry, and chest X-ray (CXR) were performed. The predetermined primary endpoints were (i) history of CMC for at least 3 months, (ii) the presence of moist cough and/or crackles on examination in clinic, and (iii) an abnormal CXR when seen at a time of stability. Each CXR was read by two pediatric radiologists blind to the in iduals' current health. Results showed 30% had a history of CMC, 32% had a moist cough and/or crackles on examination in clinic, and in 62% of those with a CXR it was abnormal. Of the 81 children with a readable follow-up X-ray, 11% had all three abnormal outcomes, and 74% had one or more abnormal outcomes. Three children had developed bronchiectasis on HRCT. The majority of children with a hospital admission at <2 years of age for severe bronchiolitis or pneumonia continued to have respiratory morbidity 1 year later when seen at a time of stability, with a small number already having sustained significant lung disease.
Publisher: Wiley
Date: 17-07-2018
DOI: 10.1111/APA.14431
Abstract: To examine the sudden unexpected death in infancy (SUDI) disparity between Māori and non-Māori in New Zealand. A nationwide prospective case-control study ran from March 2012 to February 2015. Exposure to established SUDI risk factors was analysed to investigate the disparity experienced by Māori. Infant ethnicity was based on mother's ethnicity. Māori ethnicity was prioritised. Non-Māori includes Pacific, Asian, NZ European and Other. There were 137 cases and 649 controls. The Māori SUDI rate was 1.41/1000 live births compared to 0.53/1000 for non-Māori. Parents/caregivers of 132 cases (96%) and 258 controls (40%) were interviewed. Smoking in pregnancy was associated with an equally increased SUDI risk for Māori (adjusted OR = 8.11, 95% CI = 2.64, 24.93) and non-Māori (aOR = 5.09, 95% CI = 1.79, 14.47), as was bed-sharing (aOR = 3.66, 95% CI = 1.49, 9.00 vs aOR = 11.20, 95% CI = 3.46, 36.29). Bed-sharing prevalence was similar however, more Māori controls smoked during pregnancy (46.7%) than non-Māori (22.8%). The main contributor relating to increased SUDI risk for Māori/non-Māori infants is the combination of smoking in pregnancy and bed sharing. The association between known SUDI risk factors, including bed sharing and/or smoking in pregnancy and SUDI risk, is the same regardless of ethnicity. Māori infants are exposed more frequently to both behaviours because of the higher Māori smoking rate.
Publisher: SAGE Publications
Date: 12-08-2017
Abstract: This qualitative project was the first to study values and practices about sexual assault among migrant communities from the Cook Islands, Fiji, Niue, Samoa, Tokelau, Tonga, and Tuvalu in New Zealand. It aimed to identify customs, beliefs, and practices among these ethnic groups that were protective and preventive factors against sexual violence. Researchers were ethnically matched with 78 participants from the seven ethnic communities, and conducted in idual interviews and one female focus group using protocols that were culturally appropriate for each ethnic group. Interviews were thematically analyzed. The study identified the brother–sister covenant and the sanctity of women as strong protective and preventive factors against sexual violence, expressed differently in each culture. Most participants viewed sexual violence as involving their extended families, village, and church communities, rather than solely the in iduals concerned. However, the communal values and practices of these seven Pacific cultures raise questions about the in idualistic assumptions and the meaning of violence underlying the Power and Control Wheel and the Duluth Model of domestic violence. It also raises questions about how such an in idualized model can help services effectively support women in these collective societies who are experiencing violence, and how it can contribute to Pacific community prevention of violence. This study is therefore relevant to countries with significant populations of Pacific peoples and other collective cultures.
Publisher: Wiley
Date: 12-2006
DOI: 10.1111/J.1440-1754.2006.00978.X
Abstract: To explore risk factors that are associated with preterm birth and full-term small-for-gestational-age (SGA) birth for a Pacific population. Data were gathered from the Pacific Islands Families Study. Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand during 2000 were interviewed when their infants were 6 weeks old. Mothers were questioned regarding maternal health, antenatal care and life-style behaviours. Data regarding birth outcomes were obtained from hospital records. Analyses focused on 1324 biological mothers who gave birth to a singleton and had valid data for birth outcomes. Of 1324 singleton infants, the mean birthweight was 3.60 kg with standard deviation of 0.60 kg. Fifty-two (3.9%) had birthweight less than 2500 g. Ninety-four (7.1%) were born at less than 37 weeks of gestation. Most socio-demographic factors were not associated with poor birth outcomes. Primiparous birth, less frequent attendance of antenatal care and mother's history of high blood pressure were associated with preterm birth and SGA. Smoking during pregnancy increased the odds of having an SGA but not preterm birth. On the other hand, unplanned/unsure pregnancy and prior early pregnancy loss were associated with preterm birth but not SGA. Corroborating research conducted with other populations, most of the internationally and nationally recognised risk factors for preterm birth and SGA are also important for Pacific people. Smoking seems to explain more poor birth outcomes in Pacific Islands than in the New Zealand population as a whole.
Publisher: Informa UK Limited
Date: 12-2010
DOI: 10.3109/17477160903568439
Abstract: The objectives of the current study are: to describe the prevalence of overweight/obesity among New Zealand adolescents and to describe the demographic characteristics, including neighbourhood deprivation, associated with overweight/obesity. Data for the current study were collected as part of Youth'07, a national survey of the health and well-being of 9 107 New Zealand secondary school students (approximate ages 13 to 17 years). Students answered a comprehensive, multimedia survey about their health and wellbeing and were weighed and measured for height. Small area deprivation was measured by the New Zealand Deprivation Index, based on the student's residential address. One in ten adolescents was obese and an additional 24% were overweight. Body size was significantly associated with small area deprivation (p<0.001) and ethnicity (p<0.001). Furthermore, the association between socioeconomic deprivation and body mass index (BMI) was moderated by ethnicity (p=0.035 for interaction term.) A positive association between BMI and socioeconomic deprivation was observed for Pacific students, Māori students and European students, but not for Asian students and students of other ethnicities. Our findings demonstrate a high prevalence of overweight/obesity among New Zealand adolescents, particularly for Pacific Island adolescents, Māori adolescents, and those living in areas of high deprivation.
Publisher: SAGE Publications
Date: 04-12-2014
Abstract: Pacific Island and Māori youth are disproportionately overrepresented in Aotearoa/New Zealand in violent offending. To date, research has not examined Pacific Island violent youth offenders in comparison with other ethnic populations. This study compared Pacific Island violent youth offenders with Māori and European violent youth offenders to determine whether similarities or differences existed in their offending, social, and demographic characteristics. Findings showed that Pacific Island violent youth offenders, in comparison with Māori and European violent youth offenders, were more likely to have grown up in the lowest socioeconomic deprivation areas in New Zealand, were more likely to be older when they first started offending, and their first offence was more likely to be of a serious, violent nature. Family violence was present among all three ethnic groups highlighting the ongoing importance of intervention in this area. The findings of the current study are likely to have implications for government department policy makers, along with program providers and practitioners. Recommendations are made regarding clinical implications and future research on this population.
Publisher: Wiley
Date: 08-10-2012
DOI: 10.1111/J.1440-1754.2012.02587.X
Abstract: The study aims to describe the prevalence of weight loss behaviours and weight-related concerns among a nationally representative s le of adolescents in New Zealand. Data for this study were collected as part of Youth'07, a nationally representative survey of the health and well-being of 9107 secondary school students in New Zealand. More than one third of males and 65% of females tried to lose weight in the past year. Approximately 10% of males and 29% of females reported using at least one of the unhealthy weight control behaviours in the past year (fasted, skipped meals, smoked, vomited, diet pills). Among females and males, using unhealthy weight control behaviours was most prevalent among those who were older, overweight and lived in high-deprivation areas. Unhealthy weight control behaviours among New Zealand adolescents are common and warrant future research and discussion to understand why so many young people use unhealthy weight loss strategies.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Springer Science and Business Media LLC
Date: 04-05-2023
DOI: 10.1186/S12939-023-01893-8
Abstract: Primary care in Aotearoa New Zealand is largely delivered by general practices, heavily subsidised by government. Te Tiriti o Waitangi (1840) guarantees equal health outcomes for Māori and non-Māori, but differences are stark and longstanding. Seven models of primary care have evolved. We hypothesised that patient health outcomes would differ between models of care and that Māori, Pacific peoples and those living in material deprivation would have poorer outcomes from primary care. We conducted a cross-sectional study of patient-level data from national datasets and practices, at 30 September 2018, using multilevel mixed effects regression analyses (patients clustered within practices). Primary outcomes, considered to be measures of unmet need for primary care, were polypharmacy (≥ 65 years), HbA1c testing in adults with diabetes, childhood immunisations (6 months), ambulatory sensitive hospitalisations (0–14, 45–64 years) and emergency department attendances. Explanatory variables adjusted for patient and practice characteristics. Equity, by model of care, ethnicity and deprivation, was assumed if they showed no significant association with patient outcomes. Patient characteristics included: age, ethnicity, deprivation, multi-morbidity, first specialist assessments and practice continuity. Practice characteristics included: size, funding and doctor continuity. Clinical input (consultations and time with nurses and doctors) was considered a measure of practice response . The study included 924 general practices with 4,491,964 enrolled patients. Traditional practices enrolled 73% of the population, but, on average, the proportion of Māori, Pacific and people living with material deprivation was low in any one Traditional practice. Patients with high health needs disproportionately enrolled in Māori, Pacific and Trust/NGO practices. There were multiple associations between models of care and patient health outcomes in fully adjusted regressions. No one model of care out-performed others across all outcomes. Patients with higher health need received more clinical input but this was insufficient to achieve equity in all outcomes. Being a Māori or Pacific patient, or living in material deprivation, across models of care, remained associated with poorer outcomes. Model-level associations with poor patient outcomes suggest inequity in measures that might be used to target investment in primary care.
Publisher: Elsevier BV
Date: 2021
Publisher: Cambridge University Press (CUP)
Date: 09-2006
DOI: 10.1079/PHN2005925
Abstract: To present current breast-feeding rates for Pacific infants resident in New Zealand. Reasons for the introduction of complementary liquid foods were also explored. A longitudinal study using hospital discharge summary records and maternal home interviews undertaken at 6 weeks, 12 and 24 months postpartum. Turnbull's non-parametric survival analysis was used to model exclusive breast-feeding rates. Auckland, New Zealand. The cohort comprised 1376 infants at 6 weeks, 1223 infants at 12 months and 1142 infants at 24 months. Exclusive breast-feeding rates at hospital discharge, 6 weeks, 3 and 6 months postpartum were 84% (95% confidence interval (CI): 80–88%), 49% (95% CI: 43–55%), 37% (95% CI: 32–42%) and 9% (95% CI: 7–11%), respectively. Significant ethnic difference existed, with Samoan mothers having higher exclusive breast-feeding rates than Tongan mothers ( P = 0.002). The percentage of infants receiving any breast milk at hospital discharge, 6 weeks, 12 and 24 months was 96% (95% CI: 94–97%), 95% (95% CI: 94–96%), 31% (95% CI: 28–34%) and 15% (95% CI: 13–17%), respectively. Again ethnic differences emerged. Common reasons cited for discontinuation of exclusive breast-feeding included uncertainty of breast milk supply (56%), problems with breasts (30%) and difficulties breast-feeding in work or educational environments (26%). However, 691 (50%) mothers sought no advice about their breast-feeding concerns within the first six weeks of life. Exclusive breast-feeding rates for Pacific infants are ethnically heterogeneous, have declined since the 1990s and fall short of the World Health Organization recommendations. The principal reasons cited for exclusive breast-feeding discontinuation echo those reported over a decade ago.
Publisher: Elsevier BV
Date: 2018
DOI: 10.2139/SSRN.3234910
Publisher: Cambridge University Press (CUP)
Date: 04-02-2015
DOI: 10.1017/S1368980014003255
Abstract: To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. New Zealand. Forty-two parents rimary caregivers of obese children who were randomised in the intervention weight-management programme. Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants delivery of the programme in small group settings at local community venues enabling trustworthy and accountable relationships providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.
Publisher: Wiley
Date: 05-2007
DOI: 10.1111/J.1440-1754.2007.01085.X
Abstract: To report infant care practice prevalence for known modifiable sudden infant death syndrome (SIDS) risk factors among a generally disadvantaged yet low-SIDS rate population of mothers with Pacific infants. The Pacific Islands Families study follows a cohort of Pacific infants born at a large tertiary hospital in South Auckland, between 15 March and 17 December 2000. Maternal self-report of infant care practices was undertaken at interview 6 weeks post-partum. Overall, 1376 mothers self-reported upon their care practices for infants with median age of 7 weeks. Current maternal smoking was reported by 29%. Of infants: 50% were fully breastfed 1% were placed prone to sleep 50% usually bed-shared with their mother and 12% usually bed-shared with a mother who smoked and 94% usually and 1% occasionally slept in the same room as their mother. Except for room sharing (P = 0.09), there were significant differences in these practices between the three major Pacific Island ethnic subgroups (all P < 0.001). Adoption of bed-sharing and room-sharing practices appears to be saving Pacific infants' lives, even though the New Zealand Cot Death Association has discouraged bed-sharing and not actively promoted room sharing. Mothers need to receive adequate information antenatally about the risks and benefits of room-sharing, bed-sharing and safe-sleeping practices and environments should they decide or have no option but to bed-share.
Publisher: Springer Science and Business Media LLC
Date: 04-04-2014
Publisher: Cambridge University Press (CUP)
Date: 25-06-2010
DOI: 10.1017/S1368980010001898
Abstract: The aim of the present study was to investigate the relationship between area-level socio-economic status and healthy and less healthy eating behaviours among adolescents and to determine whether the relationship between area-level socio-economic status and dietary behaviours was related to the relevant attitudes and environments. Data were collected as part of Youth’07, a nationally representative survey of the health and well-being of New Zealand youth. New Zealand secondary schools, 2007. A total of 9107 secondary-school students in New Zealand. Students from more deprived areas perceived more supportive school environments and cared as much about healthy eating as students in more affluent areas. However, these students were significantly more likely to report consuming fast food, soft drinks and chocolates. Addressing area-level socio-economic disparities in healthy eating requires addressing the availability, affordability and marketing of unhealthy snack foods, particularly in economically deprived areas.
Publisher: Public Library of Science (PLoS)
Date: 15-07-2022
DOI: 10.1371/JOURNAL.PONE.0271114
Abstract: Knowledge of the challenges unpaid caregivers faced providing care to older people during the COVID-19 pandemic is limited. Challenges may be especially pronounced for those experiencing inequitable access to health and social care. This participatory action research study, located in New Zealand, has four main objectives, (i) to understand the challenges and rewards associated with caregiving to older care recipients during the COVID-19 pandemic restrictions (ii) to map and collate resources developed (or mobilised) by organisations during the pandemic (iii) to co-produce policy recommendations, identify useful caregiver resources and practices, prioritise unmet needs (challenges) and, (iv) to use project results in knowledge translation, in order to improve caregivers access to resources, and raise the profile and recognition of caregivers contribution to society. Māori, Pacific and rural-dwelling caregivers to 30 older care-recipients, and 30 representatives from organisations supporting caregivers in New Zealand will be interviewed. Combining data from the interviews and caregivers letters (from an archive of older people’s pandemic experiences), framework analysis will be used to examine the interrelated systems of the human ecological model and the impact on caregiving experiences during the pandemic. Resources that service providers had created or used for caregivers and older people will be collated and categorised. Through co-production with caregivers and community partners we will produce three short films describing caregivers’ pandemic experiences identify a suite of resources for caregivers to use in future events requiring self-isolation, and in everyday life and generate ideas to address unresolved issues.
Publisher: Wiley
Date: 03-2006
DOI: 10.1111/J.1440-1754.2006.00810.X
Abstract: Child injury is the leading cause of mortality and morbidity in developed countries. While Pacific infant death rates are relatively high in New Zealand, little is known about non-fatal injury rates. We seek to describe maternally reported injury in Pacific infants aged between 0-24 months. A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. Maternal home interviews were conducted at 6 weeks, 12 months and 24 months postpartum and injury events were recalled. Marginal models using generalized estimating equations (GEEs) were used to analysis the longitudinal data. The inception cohort included 1398 infants at 6 weeks, 1241 infants at 12 months and 1161 infants at 24 months. The age-specific injury incidence per 1000 person-years exposure was estimated at 48 (95% CI: 23, 88) injuries for infants aged 0-6 weeks, 106 (95% CI: 88, 127) injuries for infants aged 7 weeks-12 months and 174 (95% CI: 151, 199) injuries for infants aged 13-24 months. In the multivariable GEE model, older infants (P < 0.001), infants who were male (P = 0.01), born to Pacific Island fathers and non-Pacific Island mothers (P < 0.001), and in higher or unknown income groups (P = 0.01) were significantly more likely to suffer injury events. No significant two-factor interaction with infant age was identified. Among Pacific infants, non-fatal injury is common and injury incidence rates are considerably higher than national levels. Male infants and those born into ethnically mixed families, where the father was of Pacific Island ethnicity and the mother was non-Pacific, were at increased relative risk of injury and might benefit from specific injury prevention targeting. However, given the high injury incidence levels found, we advocate that investigation and targeting of culturally appropriate prevention strategies for all Pacific families with young children is required to reduce injury rates for Pacific infants in New Zealand.
Publisher: Wiley
Date: 04-2010
DOI: 10.1111/J.1440-1754.2010.01699.X
Abstract: Children are particularly vulnerable to the health effects of climate change, the biggest global health threat of the 21st century. However, the worst effects on child health can be avoided, and well-designed climate policies can have important benefits for child health and equity. We call on child health professionals to seize opportunities to prevent climate change, improve child health and reduce inequalities, and suggest useful actions that can be taken.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2017
Publisher: BMJ
Date: 03-2019
DOI: 10.1136/ARCHDISCHILD-2018-315887
Abstract: To investigate the relationship between ethnicity and health outcomes among fetuses and infants with congenital left heart obstruction (LHO). A retrospective population-based review was conducted of fetuses and infants with LHO including all terminations, stillbirths and live births from 20 weeks’ gestation in New Zealand over a 9-year period. Disease incidence and mortality were analysed by ethnicity and by disease type: hypoplastic left heart syndrome (HLHS), aortic arch obstruction (AAO), and aortic valve and supravalvular anomalies (AVSA). Critical LHO was diagnosed in 243 fetuses and newborns. There were 125 with HLHS, 112 with AAO and 6 with isolated AVSA. The incidence of LHO was significantly higher among Europeans (0.59 per 1000) compared with Māori (0.31 per 1000 p .001) and Pacific peoples (0.27 per 1000 p=0.002). Terminations were uncommon among Māori and Pacific peoples. Total case fatality was, however, lower in Europeans compared with other ethnicities (42% vs 63% p=0.002) due to a higher surgical intervention rate and better infant survival. The perinatal and infant mortality rate was 82% for HLHS, 15% for AAO and 2% for AVSA. HLHS carries a high perinatal and infant mortality risk. There are ethnic differences in the incidence of and mortality from congenital LHO with differences in mortality rate suggesting inequities may exist in the perinatal management pathway.
Publisher: Springer International Publishing
Date: 2023
Publisher: Elsevier BV
Date: 18-03-2005
DOI: 10.1016/J.VACCINE.2005.01.061
Abstract: New Zealand has been affected by an epidemic of group B meningococcal disease dominated by a strain defined as, B:4:P1.7b,4. Over 5550 cases and 222 deaths have been reported since 1991 in a population of 4 million people. Meningococcal disease cases notified on EpiServ database operated by Institute of Environmental Science and Research Limited through to 30 September 2004. Through the collaborative efforts of a government agency, vaccine company, university and laboratory institute, clinical trials of the Chiron produced outer membrane vesicle (OMV) strain-specific MeNZB vaccine were run in rapid succession. The delivery of MeNZB will be New Zealand's largest immunisation programme with three doses given at 6-week intervals to over 1 million people aged 6 weeks-19 year olds inclusive. Planning, co-ordinating and delivering the immunisation programme is a challenging project for the New Zealand Health Sector.
Publisher: Springer International Publishing
Date: 2023
No related grants have been discovered for Teuila Percival.