New Zealand European Research Articles

Predictive validity of the Psychopathy Checklist: Screening Version (PCL:SV) in a sample of New Zealand Māori and European male prisoners.

Numerous studies have investigated the predictive validity of the Hare Psychopathy Checklist (PCL), but the majority have used samples from North America. The PCL may inform important decisions about people's futures; recognition has been growing of the importance of ensuring that its psychometric properties are established in each jurisdiction where it is used, especially for Indigenous and non-European populations. The present study examined the predictive properties of the Hare Psychopathy Checklist: Screening Version (PCL:SV; Hart et al., 1995) in 371 New Zealand (NZ) male prisoners, including NZ European and NZ Māori subsamples. Discrimination analyses showed that PCL:SV total scores had moderate predictive accuracy for any new conviction within 5 years of release; no significant differences were detected for Māori versus NZ European on this outcome. PCL:SV Factor 2 (Lifestyle/Antisocial) scores were moderately predictive of violent recidivism within 5 years of release. In a second, independent sample of male prisoners (n = 102), both PCL:SV total and Factor 2 scores showed moderate predictive accuracy for serious institutional violence. Additionally, PCL:SV Facets 1 (Interpersonal) and 2 (Affective) scores were uniquely associated with time to sexual and violent recidivism, respectively. Understanding the predictive performance of clinical risk measures across diverse ethnic groups is an important step toward identifying and addressing ethnic disparities in criminal justice outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dietary Fibre Intake, Adiposity, and Metabolic Disease Risk in Pacific and New Zealand European Women.

To assess associations between dietary fibre intake, adiposity, and odds of metabolic syndrome in Pacific and New Zealand European women. Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45 years) were recruited based on normal (18-24.9 kg/m2) and obese (≥30 kg/m2) BMIs. Body fat percentage (BF%), measured using whole body DXA, was subsequently used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute (NCI) method, involving a five-day food record and semi-quantitative food frequency questionnaire. Fasting blood was analysed for glucose and lipid profile. Metabolic syndrome was assessed with a harmonized definition. NZ European women in both the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (low-BF%: median 23.7 g/day [25-75-percentile, 20.1, 29.9]; high-BF%: 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; and 17.8 [15.0, 20.8]; both p < 0.001). The main source of fibre was discretionary fast foods for Pacific women and whole grain breads and cereals for NZ European women. A regression analysis controlling for age, socioeconomic deprivation, ethnicity, energy intake, protein, fat, and total carbohydrate intake showed an inverse association between higher fibre intake and BF% (β= -0.47, 95% CI = -0.62, -0.31, p < 0.001), and odds of metabolic syndrome (OR = 0.91, 95% CI = 0.84, 0.98, p = 0.010) among both Pacific and NZ European women (results shown for both groups combined). Low dietary fibre intake was associated with increased metabolic disease risk. Pacific women had lower fibre intakes than NZ European women.

Standard of care and outcomes for Māori patients with neck of femur fractures - an Australia & New Zealand Hip Fracture Registry (ANZHFR) study.

This study aimed to compare the demographic differences between Māori and NZ Europeans with neck of femur fracture (NOF), identify any differences in management, surgical and post-op care and outcomes. All cases in New Zealand between 2018 and 2020 were collected from the Australia & New Zealand Hip Fracture Registry (ANZHFR). Basic demographics, management factors, and surgical factors were collected. Key outcomes at 120 days post-fracture included walking status, residential status and survival. Univariate analysis was performed to compare differences in demographics, and management factors between ethnicities. Multivariable analysis was conducted on key outcome comparisons and management differences. Data from 9432 patients were analyzed. 305 patients were Māori (3.2%). Age-standardized incidence between Māori and NZ European were similar (103 (95% CI 91-115) vs. 95 (95% CI 92-99)/100 000/year). Māori had a longer time to theatre (38.7 vs. 34.5 h, P = 0.01). The only difference between Māori and NZ European in the key outcomes was private residential status (67% vs. 62% P < 0.01). There was no difference in survival (87% vs. 87% P = 0.68) and decrease in walking status (0.43 vs. 0.41 P = 0.99). Following multivariable analysis, Māori ethnicity was an independent risk factor for time to theatre >48 hours after adjustment for other factors (OR 1.44 (95% CI 1.07, 1.93), P = 0.016). Although Māori were a small percentage of patients with NOFs, there was similar age-standardized incidence compared to NZ Europeans. While there were no differences in key outcomes, identifying reasons for longer time to theatre for Māori patients is required.

Anteroposterior cervical spine canal diameter: exploring ethnic variation between European and Polynesian populations.

Reduced spinal canal anteroposterior (AP) diameter and AP-transverse diameter ratio have been linked to the development of spinal cord injury and myelopathy. Previously unpublished data has suggested Maori and Pacifica individuals may have narrower cervical spine canals than their NZ European counterparts. We evaluate the existence of potential differences in dimensions of the sub-axial cervical spine canal between New Zealand European, Māori and Polynesian individuals. A computed tomography (CT) analysis of 645 intact adult sub-axial cervical vertebrae from 129 patients. A total of 645 human sub-axial (C3-C7) cervical vertebrae were analysed radiographically, using 1 mm resolution CT scans to measure AP diameter, transverse diameter and AP:transverse ratio. CT data were obtained from normal trauma scans demonstrating no acute pathology. CT data was reformatted in digital software allowing multi-planar reconstruction (MPR) to increase accuracy of measurements. Statistical analysis was performed using analysis of variance (ANOVA). A total of 245 vertebrae were from Māori individuals, 245 from NZ European and 155 from Polynesians. There were 455 male vertebrae and 215 female vertebrae. Statistically significant differences were found in AP canal diameter between all ethnic groups, at all spinal levels. The average cervical spine canal was around 2.5 mm narrower in Polynesians and around 1.5 mm narrower in Māori than NZ Europeans. No differences in Transverse canal diameter were observed, however statistically significant differences were found in the AP:transverse ratio at all spinal levels. Our study, utilizing a normal patient cohort, confirms differences in canal dimensions between ethnic groups. Ethnic variation in cervical canal dimensions as herein described, must be considered when defining and diagnosing congenital stenosis. Neglecting to account for these differences may lead to misdiagnosis of congenital stenosis in normal individuals in certain ethnic groups.

The Relationship Between Academic Stress, Sleep Quality, and Psychological Wellbeing in Pasifika and New Zealand European Students at the University of Otago

Abstract Background Pasifika students in New Zealand are overrepresented in poor academic outcomes, and their academic challenges may potentially influence their wellbeing. We aim to: 1) compare the academic stress, sleep quality, and psychological wellbeing of Pasifika and New Zealand European (NZE) anatomy students at the University of Otago, and 2) determine if academic stress mediates the association between their psychological wellbeing and sleep quality. Methods We launched a brief online survey to Pasifika and NZE students in our department. The survey included basic demographics, Perception of Academic Stress Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, a short loneliness scale, a reduced morningness-eveningness scale, and the Epworth Sleepiness Scale. Results Perceived academic stress were comparable between NZE and Pasifika students, but Pasifika students reported poorer sleep quality than NZE students (t(113) = 14.41, P &lt; .001). In addition, Pasifika students reported more loneliness (t(119) = 8.933, P &lt; .001), less anxiety symptoms (t(120) = 2.469, P = .015), and less of a morning person (t(121) = 2.618, P = .010) than NZE students, but they had comparable depressive symptoms and daytime sleepiness. After controlling for age, ethnicity and gender, we found that academic stress fully mediated the relationship between anxiety or depressive symptoms and poor sleep quality. Furthermore, academic stress partially mediated the relationship between loneliness and poor sleep quality in our cohort. Conclusion Our findings highlight the importance for academic institutions to support students’ wellbeing, including ethnic minority students such as Pasifika students in New Zealand.

Ethnic Disparities for Survival and Mortality in New Zealand Patients With Head and Neck Cancer

It is essential to identify inequitable cancer care for ethnic minority groups, which may allow policy change associated with improved survival and decreased mortality and morbidity. To investigate ethnic disparities in survival and mortality among New Zealand (NZ) patients with head and neck cancer (HNC) and the association of other variables, including socioeconomic status, tumor stage, and age at diagnosis, with survival rates. This retrospective cohort study was conducted among NZ patients diagnosed with specific HNCs from 2010 to 2020. Anonymized data were obtained from the NZ Cancer Registry, including patients diagnosed from International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes C00-C14 and C30-C32. Data were analyzed from July 2020 through January 2024. Censored Kaplan-Meier estimates were used to analyze survival distribution. Cox regression models were used to estimate the association of age, tumor stage at diagnosis, and socioeconomic status with survival rates. Age-standardized mortality rates were assessed. Among 6593 patients with HNCs (4590 males [69.6%]; 4187 patients aged 51-75 years [63.5%]), there were 706 Māori individuals (10.7%) and 5887 individuals with other ethnicity (89.3%), including 4327 NZ European individuals (65.6%; defined as New Zealanders of European descent). Māori individuals had a decreased survival proportion at all years after diagnosis compared with individuals with other ethnicity (eg, 66.1% [95% CI, 62.6%% to 69.8%] vs 71.2% [95% CI, 70.0% to 72.4%] at 2 years). At 1 year after diagnosis, Māori individuals did not have a significantly increased mortality rate compared with 5795 individuals with other ethnicity with data (193 deaths [27.3%] vs 1400 deaths [24.2%]; P = .06), but the rate was significantly increased at 5 years after diagnosis (277 deaths [39.3%] vs 2034 deaths [35.1%]; P = .03); there was greater disparity compared with NZ European individuals (1 year: 969 deaths [22.4%]; P = .003; 5 years: 1441 deaths [33.3%]; P = .002). There were persistent age-adjusted mortality rate disparities: 40.1% (95% CI, -25.9% to 71.2%) for Māori individuals and 18.8% (95% CI, -15.4% to 24.4%) for individuals with other ethnicity. Māori individuals were diagnosed at a mean age of 58.0 years (95% CI, 57.1-59.1 years) vs 64.3 years. (95% CI, 64.0-64.7 years) for individuals with other ethnicity, or 5 to 7 years younger, and died at mean age of 63.5 years (95% CI, 62.0-64.9 years) compared with 72.3 years (95% CI, 71.8-72.9 years) for individuals with other ethnicity, or 7 to 10 years earlier. Māori individuals presented with proportionally more advanced disease (only localized disease, 102 patients [14.5%; 95% CI, 12.0%-17.4%] vs 1413 patients [24.0%; 95% CI, 22.9%-25.1%]; P < .001) and showed an increase in regional lymph nodes (276 patients [39.1%; 95% CI, 35.5%-42.9%] vs 1796 patients [30.5%; 95% CI, 29.3%-31.8%]; P < .001) at diagnosis compared with individuals with other ethnicity. Socioeconomic status was not associated with survival. This study found that Māori individuals experienced worse survival outcomes and greater mortality rates from HNC in NZ and presented with more advanced disease at a younger age. These findings suggest the need for further research to alleviate these disparities, highlight the importance of research into minority populations with HNC globally, and may encourage equity research for all cancers.

Baseline lifestyle and biomedical stroke risk factors among New Zealand participants in the PERsonalised Knowledge to reduce the risk of Stroke (PERKS-International) randomised controlled trial –preliminary results

Stroke ranks as the world’s second leading cause of death and third in causing disabilities, a preventable disease affecting people of all demographics. Primary prevention is crucial to mitigate its impact by addressing modifiable risk factors such as poor diet, low physical activity (PA), obesity, smoking, high blood pressure (BP), elevated cholesterol, and blood glucose levels. This study evaluated quality of diet and other stroke modifiable risk factors among New Zealand (NZ) participants recruited at the baseline phase of the PERKS-International trial. PERKS is a Phase III, multicentre, prospective, pragmatic, open-label, single-blinded endpoint, two-arm randomised controlled trial conducted across Australia and NZ(1). Participants aged &gt;35 and ≤75 years with ≥2 modifiable risk factors for stroke were assessed using the Life’s Simple 7 (LS7) score. LS7 includes seven components (BMI, BP, total cholesterol, blood glucose, dietary pattern, smoking, and PA) categorising into ideal,intermediate, and poor level. Height, weight, and BP were measured. Total cholesterol and blood glucose were measured via CardioChek PA Analyser. An online FFQ and Physical Activity Questionnaire were administered. Descriptive analyses and correlation coefficients were used to examine the characteristics of participants at the baseline. In NZ, out of 395 targeted participants, 375 (Female = 230, mean age = 57yrs) from diverse ethnic groups (NZ European = 204, Māori = 35, Pacific = 17) were recruited and assessed. Among LS7 metrics, smoking had the highest proportion of those in the ideal category (88%), followed by blood glucose (62%), total cholesterol (49%), dietary pattern (34%), BP (22%) and BMI (13%). Nearly 64% consumed &lt;5 portions of fruits and vegetables per day. Almost half of the participants consumed beans and pulses less than once a week. About 43% and 31% consumed fibre-rich breakfast cereal and wholemeal bread less than once a week. Almost 10% drank fizzy drinks ≥4 times/week. Nearly 40% consumed sweets such as biscuits, cakes, and chocolate at least twice a week. Over half of the participants consumed red meat and chicken 2-3 times/week. In terms of other risk factors, over half of the participants were obese (BMI≥ 30 kg/m2). Only 12% were current smokers. About 10% drank alcohol 5-7 days/week. Physical activity expenditure (MET minutes/week) showed no significant sex difference. The LS7 factors correlated significantly were BMI and blood glucose (r = 0.157, p&lt;0.01), total cholesterol and smoking (r=-0.129, p&lt;0.01), BP and BMI (with a moderate correlation of r = 0.308, &lt;0.001). The NZ participants in the PERKS-International trial, had poor diets, along with suboptimal lifestyle and biomedical stroke risk factors, reflecting the inclusion criteria for the study. Urgent action is required for the primary stroke prevention at population-level. The results of the trial, expected in 2024, will show the benefit of a mobile phone app on reducing these stroke risk factors.

Dietary fibre intake, adiposity, and metabolic disease risk in Pacific and New Zealand European women

The aim of this study was to explore associations between habitual dietary fibre intake, adiposity, and biomarkers of metabolic health in Pacific and New Zealand European women who are known to have different metabolic disease risks. Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45years) were recruited to the PROMISE cross-sectional study(1) based on normal (18-24.9kg/m2) and obese BMI (≥30kg/m2). Body fat percentage (BF%), measured using whole body DXA, was used to stratify participants into low (&lt;35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute method, involving a 5-day-food-record and a semi-quantitative FFQ. Fasting blood was analysed for glucose, insulin, and lipid profile. NZ European women in the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (median 23.7g/day [25-75-percentile, 20.1, 29.9]; 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; 17.8 [15.0, 20.8]; both p&lt;0.001), respectively. Pacific women consumed a higher proportion of their total fibre intake from discretionary fast foods, in contrast NZ European women consumed more dietary fibre from wholegrains. Regression analysis controlling for ethnicity, age, socioeconomic deprivation, energy intake, protein, total carbohydrate, and fat intake showed significant inverse associations between higher dietary fibre intake and BF% and visceral fat% (β = −0.47, 95% CI = −0.62, −0.31, p&lt;0.001; β = −0.61, [−0.82, −0.40], p&lt;0.001, respectively) among both Pacific and NZ European women. LDL-C (β = −0.04, [−0.06, −0.01]) was inversely associated with fibre intake following further adjustment for BF%-groups in NZ European women. Despite differences in intake, dietary fibre was inversely associated with adiposity and metabolic disease risk in both Pacific and NZ European women. However younger woman living in areas of higher socio-economic deprivation who consumed a higher proportion of total dietary fibre intake from discretionary fast foods were more likely to have low dietary fibre intakes than older, wealthier women. These women were also more likely to be Pacific women. Increasing habitual dietary fibre intake could help to reduce adiposity and metabolic disease risk; so implementing policies that make health-promoting high fibre foods more affordable, ensuring households have sufficient income to purchase nutritious food and limiting the amount of unhealthy food marketing that low income communities are exposed to should be public health priorities.

The GUTFIT Cohort: Identifying dietary intake of Chinese New Zealanders with functional constipation

Distinct pathophysiology has been identified with disorders of gut-brain interactions (DGBI), including functional constipation (FC)(1,2), yet the causes remain unclear. Identifying how modifiable factors (i.e., diet) differ depending on gastrointestinal health status is important to understand relationships between dietary intake, pathophysiology, and disease burden of FC. Given that dietary choices are culturally influenced, understanding ethnicity-specific diets of individuals with FC is key to informing appropriate symptom management and prevention strategies. Despite distinct genetic and cultural features of Chinese populations with increasing FC incidence(3), DGBI characteristics are primarily described in Caucasian populations(2). We therefore aimed to identify how dietary intake of Chinese individuals with FC differs to non-Chinese individuals with FC, relative to healthy controls. The Gastrointestinal Understanding of Functional Constipation In an Urban Chinese and Urban non-Chinese New Zealander Cohort (GUTFIT) study was a longitudinal case-control study using systems biology to investigate the multi-factorial aetiology of FC. Here we conducted a cross-sectional dietary intake assessment, comparing Chinese individuals with FC (Ch-FC) against three control groups: a) non-Chinese with FC (NCh-FC) b) Chinese without FC (Ch-CON) and c) non-Chinese without FC (NCh-CON). Recruitment from Auckland, New Zealand (NZ) identified Chinese individuals based on self-identification alongside both parents self-identifying as Chinese, and FC using the ROME IV criteria. Dietary intake was captured using 3-day food diaries recorded on consecutive days, including one weekend day. Nutrient analysis was performed by Foodworks 10 and statistical analysis with SPSS using a generalised linear model (ethnicity and FC status as fixed factors). Of 78 enrolled participants, 66 completed the study and 64 (39.4 ± 9.2 years) completed a 3-day food diary at the baseline assessment. More participants were female (84%) than male (16%). FC and ethnicity status allocated participants into 1 of 4 groups: Ch-FC (n = 11), Ch-CON (n = 18), NCh-FC (n = 16), NCh-CON (n = 19). Within NCh, ethnicities included NZ European (30%), non-Chinese Asian (11%), Other European (11%), and Latin American (2%). Fibre intake did not differ between Ch-FC and NCh-FC (ethnicity × FC status interaction p&gt;0.05) but was independently lower overall for FC than CON individuals (21.8 ± 8.7 versus 27.0 ± 9.7 g, p&lt;0.05) and overall for Ch than NCh (22.1 ± 8.0 versus 27.0 ± 10.4 g, p&lt;0.05). Carbohydrate, protein, and fat intakes were not different across groups (p&gt;0.05 each, respectively). In the context of fibre and macronutrient intake, there is no difference between Ch-FC and NCh-FC. Therefore, fibre and macronutrients are unlikely to contribute to potential pathophysiological differences in FC between ethnic groups. A more detailed assessment of dietary intake concerning micronutrients, types of fibre, or food choices may be indicated to ascertain whether other dietary differences exist.

Ethnic inequities in use of breast conserving surgery and radiation therapy in Aotearoa/New Zealand: which factors contribute?

PurposeAotearoa/New Zealand (NZ) faces ethnic inequities with respect to breast cancer survival and treatment. This study establishes if there are ethnic differences in (i) type of surgery and (ii) receipt of radiotherapy (RT) following breast conserving surgery (BCS), among women with early-stage breast cancer in NZ.MethodsThis analysis used Te Rēhita Mate Ūtaetae (Breast Cancer Foundation National Register), a prospectively maintained database of breast cancers from 2000 to 2020. Logistic regression models evaluated ethnic differences in type of surgery (mastectomy or BCS) and receipt of RT with sequential adjustment for potential contributing factors. Subgroup analyses by treatment facility type were undertaken.ResultsOf the 16,228 women included, 74% were NZ European (NZE), 10.3% were Māori, 9.4% were Asian and 6.2% were Pacific. Over one-third of women with BCS-eligible tumours received mastectomy. Asian women were more likely to receive mastectomy than NZE (OR 1.62; 95% CI 1.39, 1.90) as were wāhine Māori in the public system (OR 1.21; 95% CI 1.02, 1.44) but not in the private system (OR 0.78; 95% CI 0.51, 1.21). In women undergoing BCS, compared to NZE, Pacific women overall and wāhine Māori in the private system were, respectively, 36 and 38% less likely to receive RT (respective OR 0.64; 95% CI 0.50, 0.83 and 0.62; 95% CI 0.39, 0.98).ConclusionA significant proportion of women with early-stage breast cancer underwent mastectomy and significant ethnic inequities exist. Modern guidelines encourage BCS + RT. In NZ, this outcome must be carefully monitored by ethnicity to facilitate equitable surgical management of early-stage breast cancer.

A retrospective cohort study of incidental abdominal aortic aneurysms on routine abdominal computed tomography scans in Te Tairāwhiti (2018-2019).

Ruptured abdominal aortic aneurysm (rAAA) is associated with a high mortality rate which, is especially significant in rural and provincial regions. In Aotearoa New Zealand, Māori experience higher rates of AAA and worse overall medium-term survival following AAA repair. This study aimed to understand the prevalence of incidental AAA on routine abdominal computed tomography (CT) scans over 12 months. A retrospective review of all abdominal CT scans performed on patients ≥50 years at Gisborne Hospital between 1 December 2018-1 December 2019 was performed. A total of 811 scans were reviewed, with 42 incidental AAA detected (5.2%). The majority of incidental AAA were in males aged ≥65 (65.8%), with a higher prevalence for Māori compared to New Zealand European (NZE) (16.2% vs 8.1%, p=0.052). This pattern was also seen in females, aged ≥65 (10.9% in Māori vs 3.8% in NZE, p=0.047). The detection of AAA on routine abdominal CT scans appears to be a useful adjunct in lieu of targeted AAA screening in our region. A high prevalence of incidental AAA (5.2%) over 12 months, with a significantly higher prevalence noted in Māori males and females ≥65 years (16.2% and 10.9%), was observed.

All-cause, premature, and cardiovascular death attributable to socioeconomic and ethnic disparities among New Zealanders with type 1 diabetes 1994–2019: a multi-linked population-based cohort study

BackgroundNew Zealand (NZ) research into type 1 diabetes mellitus (T1DM) mortality can inform policy and future research. In this study we aimed to quantify the magnitude to which ethnicity and socioeconomic disparities influenced mortality at the population level among people with Type 1 diabetes (T1DM) in Auckland, New Zealand (NZ).MethodsThe cohort data were derived from the primary care diabetes audit program the Diabetes Care Support Service (DCSS), and linked with national primary care, pharmaceutical claims, hospitalisation, and death registration databases. People with T1DM enrolled in DCSS between 1994–2018 were included. All-cause, premature, and cardiovascular mortalities were estimated by Poisson regression models with adjustment for population-level confounders. The mortality rates ratio (MRR) was standardized against the DCSS type 2 diabetes population. Mortality rates were compared by ethnic group (NZ European (NZE) and non-NZE) and socioeconomic deprivation quintile. The population attributable fraction (PAF) was estimated for ethnic and socioeconomic disparities by Cox regression adjusting for demographic, lifestyle, and clinical covariates. The adjusted slope index inequality (SII) and relative index of inequality (RII) were used to measure the socioeconomic disparity in mortalities.ResultsOverall, 2395 people with T1DM (median age 34.6 years; 45% female; 69% NZE) were enrolled, among whom the all-cause, premature and CVD mortalities were 6.69 (95% confidence interval: 5.93–7.53), 3.30 (2.77–3.90) and 1.77 (1.39–2.23) per 1,000 person-years over 25 years. The overall MRR was 0.39 (0.34–0.45), 0.65 (0.52–0.80), and 0.31 (0.24–0.41) for all-cause, premature and CVD mortality, respectively. PAF attributable to ethnicity disparity was not significantly different for mortality. The adjusted PAF indicated that 25.74 (0.84–44.39)% of all-cause mortality, 25.88 (0.69–44.69)% of premature mortality, 55.89 (1.20–80.31)% of CVD mortality could be attributed to socioeconomic inequality. The SII was 8.04 (6.30–9.78), 4.81 (3.60–6.02), 2.70 (1.82–3.59) per 1,000 person-years and RII was 2.20 (1.94–2.46), 2.46 (2.09–2.82), and 2.53 (2.03–3.03) for all-cause, premature and CVD mortality, respectively.ConclusionsOur results suggest that socioeconomic disparities were responsible for a substantial proportion of all-cause, premature and CVD mortality in people with T1DM in Auckland, NZ. Reducing socioeconomic barriers to management and self-management would likely improve clinical outcomes.

Exploring older people’s attitudes and preferences around the use of their routinely collected healthcare data in brain health research

AbstractBackgroundOver 50% of dementia in NZ may be due to high prevalence of risk factors such as hypertension, diabetes and cardiovascular disease. If so, a better understanding of the relationships may present ways to mitigate the risk of dementia. Community‐based epidemiological studies would provide definitive evidence but are resource‐intensive so we need to explore alternative sources of data such as routinely collected health information.The overarching aim of our research is to use a machine learning model to identify population groups at high risk of cognitive decline and/or dementia. But first we need to gauge the appetite of service users to have their personal data used in this way. This study aimed to explore the attitudes and preferences of people aged 55+ living in Counties Manukau regarding the use of their de‐identified health data and understanding their concerns and degree of comfort in different scenarios.MethodAn anonymous online survey was conducted with people aged 55+ from NZ European, Māori, Pacific, Chinese and Indian communities currently engaged with older adult health services in Counties Manukau District in 2022. We offered service users the opportunity to complete the survey by telephone if preferred, and the opportunity to be interviewed in languages other than English to ensure adequate representation of the local population.ResultOver 85% of the participants were aware of how their health information was used for service development and assessing population trends, and about 80% were comfortable or very comfortable with data being used in this way, assuming data were stored securely and confidentiality was assured. Participants generally felt that patients’ permission was required if data were being analysed by people other than health professionals or being used by commercial companies, and that there should be transparency about these uses. There were some specific cultural concerns about patients’ data being used after their death.ConclusionThis study supports the idea that the local population are generally supportive of researchers using their de‐identified routinely collected data for research purposes that will benefit the population from which the data were taken, but specific cultural concerns need to be addressed.

Ethnic-specific prevalence rates of intimate partner violence against women in New Zealand

ObjectiveThis study presents age-standardised ethnic-specific prevalence rates of intimate partner violence against women in New Zealand, by physical and/or sexual intimate partner violence, psychological intimate partner violence, controlling behaviours and economic abuse. MethodsData are from 1,431 ever-partnered women in the representative and cross-sectional He Koiora Matapopore, the 2019 New Zealand Family Violence Study. ResultsHigh lifetime prevalence of intimate partner violence is present across all ethnic groups in NZ, with over half of all women reporting any intimate partner violence (55.8%). Substantial ethnic disparities exist in intimate partner violence rates, with Māori women reporting the highest prevalence of intimate partner violence (64.6%), followed by NZ European women (61.6%). ConclusionsIntimate partner violence prevention and intervention services are needed at the population-level, and services must be culturally responsive and attuned to the needs of communities that bear the greatest burden. Implications for Public HealthEthnic differences in intimate partner violence prevalence likely contribute to health disparities at the population-level, reinforcing calls for prevention and necessitating healthcare systems to be culturally informed and mobilised to address intimate partner violence as a priority health issue.

Inequities in colonoscopy access: a retrospective audit of accepted referrals in Te Whatu Ora Counties Manukau.

Māori are more likely to have colorectal cancer (CRC) diagnosed in the emergency setting.[[1]] CRC patients diagnosed in the emergency setting have a higher stage, increased surgical complications and worse survival than those diagnosed elsewhere.[[2]] Access to colonoscopy is crucial to diagnosing CRC prior to an emergency presentation. This study aims to assess inequities in access to symptomatic and surveillance colonoscopies. A retrospective audit of all accepted referrals for symptomatic and surveillance colonoscopies made in Te Whatu Ora Counties Manukau in 2018 (n=7,184) with analysis by multivariate logistic regression. Of the 751 Māori patients, 33.4% were removed off the waiting list and therefore did not have their colonoscopy performed, compared to 24.1% of the 4,047 NZ European patients. Māori patients were significantly more likely to be removed off the waiting list than NZ European patients with an adjusted odds ratio of 1.68 (95% confidence interval [CI] 1.40-2.02). Pasifika patients were significantly more likely to be removed off the waiting list than NZ European patients with an adjusted odds ratio of 2.30 (95% CI 1.92-2.75). Māori have significantly less access to colonoscopies than NZ Europeans. We suggest improvements to referral systems locally and nationally to facilitate equitable access.

O051 Comparison of standard CPAP therapy and the RACer airway device for the treatment of obstructive sleep apnoea: A randomised clinical trial

Abstract The nasal cycle is a normal ultradian physiological phenomenon where each nasal airway alternates conducting dominance. The nasal cycle occurs in obstructive sleep apnoea (OSA). Rest-Activity-Cycler positive airway pressure (RACer-PAP) is a novel treatment aiming to maintain the innate nasal cycle. Methods PAP naïve OSA patients were randomly assigned in a crossover design to 4 weeks RACer or control humidified CPAP (3 day wash-out). Treatment pressure determined by in-lab Auto-titration. Adherence, Epworth Sleepiness Score (ESS), quality of life (SF 36), nasal symptoms, side effects, sleep quality compared by SAS 9.4 or Likert scale. Results 40 subjects (of 44 recruited) (29 M, 11 F) with a mean BMI 37.7kg/m2 aged 45 yrs (range 22-70 yrs) with severe OSA (mean AHI 56.4/ hr), ESS 13.6 (range 3-21) completed the study. Ethnicity included Maori (17 %), NZ European (67%), and Pacific (12.5%). The prescribed mean pressure 12.2 (range 8-18 cmH20). Adherence was greater in the humidified CPAP control than RACer- PAP arm (4:57h/night verse 4:14h/night p &amp;lt; 0.01). Both devices similarly improved subjective sleepiness, quality of life and adverse upper airway symptoms. Humidified CPAP improved to a greater extent nasal symptom scores (baseline – final: control CPAP 2.8 vs. RACer 2.3, p = 0.03), sleep quality and was preferred (55% vrs 22 %). Conclusion RACer PAP improved OSA symptoms and quality of life but adherence was lower and nasal symptoms more common. This could be explained by not using humidification, technical issues with prototype machine or the use of set nasal cycle length.

Relationship between vitamin D, iron, and hepcidin in premenopausal females, potentially confounded by ethnicity

PurposeTo investigate the associations between vitamin D, hepcidin, and iron status in premenopausal females of different ethnic cohorts residing in Auckland, New Zealand (NZ).MethodsA total of 160 females aged 18–45 years participated in a cross-sectional study. Demographics, body composition, serum 25(OH)D, inflammatory markers (C-reactive protein and interleukin-6, IL-6), and iron biomarkers (serum ferritin, haemoglobin, soluble transferrin receptor, and hepcidin) were measured. Comparisons between parametric, non-parametric, and categorical variables were completed by using one-way ANOVA, Kruskal–Wallis, and Chi-squared tests, respectively. ANCOVA was used to compare serum 25(OH)D across iron parameter categories.ResultsOf the 160 participants, 60 were NZ European, 67 were South Asian, and 33 were from the ‘other’ ethnic groups. South Asians had significantly higher body fat percentage (BF%) and IL-6 concentration (38.34% and 1.66 pg·mL−1, respectively), compared to NZ Europeans (27.49% and 0.63 pg·mL−1, respectively, p < 0.001). South Asians had significantly lower 25(OH)D concentrations compared to NZ Europeans (33.59 nmol·L−1 vs 74.84 nmol·L−1, p < 0.001). In NZ Europeans, higher 25(OH)D concentration was seen in those with lower (≤ 3.5 nM) hepcidin concentration, p = 0.0046. In South Asians, higher 25(OH)D concentration was seen in those with higher (> 3.5 nM) hepcidin concentrations, p = 0.038. There were no associations between serum 25(OH)D and serum ferritin.ConclusionWithin South Asian women, an unexpected positive relationship between 25(OH)D and hepcidin concentration was observed which may be due to significantly higher IL-6 concentrations, BF%, and lower 25(OH)D concentrations. Future research is required to confirm these observations in this ethnic cohort.

Anatomical sciences education needs to promote academic excellence of ethnic minority students-Evidence from Pasifika students at the University of Otago.

The Department of Anatomy at the University of Otago offers anatomical sciences education for various programs, but currently, little information is available on how the academic performance of anatomy students differ based on ethnicities. Here, we aim to determine if there is an ethnic disparity in academic performance among anatomy students at the University of Otago. We conducted a 5-year review of academic performance of New Zealand European (NZE) and Pasifika students in 10 undergraduate anatomy courses, including clinical anatomy, neuroscience, reproduction, cell biology, and biological anthropology. NZE students achieved higher marks than Pasifika students in each academic year for four courses and in 3-4 of 5 academic years for the remaining courses. In eight courses, there were higher proportions of Pasifika students than NZE students who repeated the courses (in 4-5 of 5 academic years for two courses, in 1-2 of 5 academic years for six courses). Multiple regression analyses showed that Pasifika students were more likely to achieve lower marks than NZE students in all courses. Other predictors for academic marks included year of study for five courses, age for three courses, international student status for two courses, major specialization for eight courses, home location for one course, and gender for one course. Data from this research provide evidence that ethnic inequity may exist in anatomical sciences education, and can be used by institutions globally to justify evaluating their anatomy programs, with the aim to better support ethnic minority students who may be struggling academically.

Ethnic group differences in patient satisfaction with GP services: findings from the New Zealand Attitudes and Values Study.

To identify key predictors of general practitioner (GP) satisfaction and increase insight into the mechanisms behind ethnic health inequities in New Zealand. Regression analyses were conducted using data from the 2019 New Zealand Attitudes and Values Study (n=38,465). Initially, Māori and Asian peoples showed lower, and Pasifika peoples showed no significant difference in GP satisfaction level relative to New Zealand (NZ) Europeans. However, after accounting for differences in patient-perceived GP cultural respect and GP ethnic similarity, Māori and Pasifika peoples showed higher and Asian peoples showed no difference in GP satisfaction level relative to NZ Europeans. These effects continued to hold when adjusting for a range of demographic factors. Subsequent regression analyses were conducted to investigate the impact of GP perceptions, GP satisfaction and demographic factors on healthcare access satisfaction and health status across ethnic groups. For all ethnic groups, GP satisfaction was the strongest predictor of satisfaction with access to healthcare. Higher GP satisfaction was also a significant predictor of higher self-rated health and lower psychological distress. Lack of GP cultural respect is a key contributor to lower GP satisfaction among ethnic minorities, which can further exacerbate inequities in healthcare access and health outcomes. Interventions to enhance GPs' provision of culturally respectful and safe healthcare services may help reduce ethnic health inequities and improve population health.

1330-P: Adverse Clinical Outcomes Attributable to Socioeconomic and Ethnic Disparities among People with Impaired Glucose Tolerance in New Zealand over 25 Years

Aim: Future premature death and cardio-renal disease are common with impaired glucose tolerance (IGT). We aimed to quantify contributions of socioeconomic and ethnic disparities to outcomes in IGT in New Zealand (NZ). Methods: IGT enrolments 01/01/1994-31/07/2018 into the Diabetes Care Support Service (DCSS), an NZ primary care programme linked with national databases were followed up until death or 31/12/2019. Incident outcomes included premature mortality (PM), myocardial infarction (MI), stroke, heart failure (HF), and end-stage renal disease (ESRD). Attributable fraction (AF)s for the entire population and specific groups compared with the least deprived groups or NZ Europeans (NZE) were estimated with adjustment for covariates. Results: Among 26,031 people with IGT (mean age 57.2 years; 53.8% female), adjusted population AF to deprivation was significant for ESRD (18.90 (0.65-33.80)%) and to ethnicity was significant for MI (8.19 (0.18-15.56)%), stroke (10.33 (1.63-18.26)%), HF (12.15 (5.03-18.74)%) and ESRD (8.18 (0.65-33.80)%), respectively. Compared with NZE with the least socioeconomic deprivation, group-specific AF was higher in the most deprived NZE, Māori, and Pasifika for PM, stroke and ESRD; higher in more deprived NZE and Māori for MI and HF. Conclusions: Ethnic and socioeconomic disparities are responsible for a substantial proportion of adverse outcomes those with IGT. Disparities were common among Māori irrespective of socioeconomic status and NZE with the most socioeconomic deprivation. Preventative policies need to address both ethnic and socioeconomic disparities. Disclosure D.Yu: None. D.Simmons: Consultant; Sanofi, Speaker's Bureau; Abbott Diabetes. Dcss study group: n/a. J.Baker: None. R.G.Cutfield: Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance. K.A.Pickering: None. B.J.Orr-walker: None. U.L.Osuagwu: None. Y.Cai: None. Z.Wang: None. Z.Zhao: None.