New Zealand European Research Articles

Views of men with Parkinson's disease regarding physical activity health messaging

BackgroundMany men with Parkinson's Disease (PD) do not meet the recommended levels of physical activity (PA) for health benefits. Tailored, meaningful, and culturally sensitive PA health messages may be a catalyst to shape men's motivations toward participation. ObjectiveWe explored the views of New Zealand (NZ) men with PD about existing PA health messages, and how these could be adapted to be more effective. MethodsThis qualitative study recruited six community dwelling, regularly physically active, NZ European men with PD (aged 54–69 years, 2–18 years post-diagnosis) from a community exercise class in Canterbury, NZ. Participants engaged in semi-structured interviews which were audio-recorded, transcribed verbatim, and analyzed inductively for themes. ResultsParticipants expressed that effective PA health messages should reflect men's motivations for PA which included physical and mental well-being and social connection. Inclusive, positive, and relatable language and imagery were considered crucial PA message communication strategies. Participants viewed health professionals' PA advice as superficial and unhelpful; however, celebrities with PD were considered inspirational messengers. Messages endorsed by trustworthy sources, such as the Parkinson's Society, were perceived to enhance the credibility. ConclusionsEffective PA messages should be gain framed and tailored to the target audience. We recommend health professionals provide comprehensive PA advice or consider onward referral. Future research which uses a co-design participatory methodology to collaborate with men with PD from culturally diverse backgrounds and represent all stages of PA behaviour change is recommended to provide comprehensive insights for meaningful, effective, and culturally sensitive PA health messaging.

Indigenous adolescent health in Aotearoa New Zealand: Trends, policy and advancing equity for rangatahi Maori, 2001–2019

SummaryBackgroundRangatahi Māori, the Indigenous adolescents of Aotearoa New Zealand (NZ), have poorer health outcomes than Pākehā (NZ European /other European/“White”) adolescents. We explored the influence of policies for Indigenous youth by presenting health trends, inequities and contrasting policy case examples: tobacco control and healthcare access.MethodsCross-sectional representative surveys of NZ secondary school students were undertaken in 2001, 2007, 2012 and 2019. Health indicators are presented for Māori and Pākehā adolescents (relative risks with 95% CI, calculated using modified Poisson regression) between 2001–2019 and 2012–2019. Policy examples were examined utilising Critical Te Tiriti Analysis (CTA).FindingsRangatahi Māori reported significant health gains between 2001 and 2019, but an increase in depressive symptoms (13.8% in 2012 to 27.9% in 2019, RR 2.01 [1.65–2.46]). Compared to Pākehā youth there was a pattern of persistent Māori disadvantage, particularly for racism (RR 2.27 [2.08–2.47]), depressive symptoms (RR 1.42 [1.27–1.59]) and forgone healthcare (RR 1.63 [1.45–1.84]). Tobacco use inequities narrowed (RR 2.53 [2.12–3.02] in 2007 to RR 1.55 [1.25–1.93] in 2019). CTA reveals rangatahi Māori-specific policies, Māori leadership, and political support aligned with improved outcomes and narrowing inequities.InterpretationAge-appropriate Indigenous strategies are required to improve health outcomes and reduce inequities for rangatahi Māori. Characteristics of effective strategies include: (1) evidence-based, sustained, and comprehensive approaches including both universal levers and Indigenous youth-specific policies; (2) Indigenous and rangatahi leadership; (3) the political will to address Indigenous youth rights, preferences, priorities; and (4) a commitment to an anti-racist praxis and healthcare Indigenisation.FundingTwo Health Research Council of New Zealand Project Grants: (a) Fleming T, Peiris–John R, Crengle S, Parry D. (2018). Integrating survey and intervention research for youth health gains. (HRC ref: 18/473); and (b) Clark TC, Le Grice J, Groot S, Shepherd M, Lewycka S. (2017) Harnessing the spark of life: Maximising whānau contributors to rangatahi wellbeing (HRC ref: 17/315).

Parents and caregivers experience in managing children's medicines after discharge from a New Zealand hospital.

To investigate the level of understanding parents/caregivers have regarding prescribed medicines for their sick children, and how they manage these medicines at home following hospital discharge. English-speaking parents/caregivers of sick children were recruited if their child was admitted to Middlemore Hospital in New Zealand and prescribed two liquid medicines, specifically an analgesic and an antibiotic. A questionnaire was developed and used to interview parents/caregivers on three separate occasions. The questionnaire was firstly administered during their hospital stay; secondly, by telephone post-discharge; and thirdly via a home visit two to three days after the estimated completion date of the antibiotic course. Eighteen participants from the five main ethnic groups (Pacific Island n=7, NZ European n=5, Māori n=4, Asian n=2) completed all three interviews. Parents/caregivers had a reasonable understanding of the purpose of the medicines prescribed. Doctors, nurses and pharmacists provided variable medicines information to parents/caregivers on hospital discharge. Parents/caregivers used a variety of measuring equipment at home, but over a quarter (28%) were not supplied with an oral syringe to measure appropriate doses of medicines at home, and some lacked knowledge on safe storage and appropriate disposal of medicines. This study found variation and gaps in the information for medicines provided at discharge. To facilitate the safe use of medicines, consistent and clear information about the use, storage and disposal of medicines needs to be provided by all healthcare professionals involved; and accurate measuring equipment should be provided free of charge with instructions.

Motivators and barriers to general surgery as a career among junior doctors and medical students in New Zealand.

Increasing diversity among surgeons is a priority of the Royal Australasian College of Surgeons (RACS).1 This study aimed to identify motivators and barriers to general surgery among junior doctors (JD) and medical students (MS) to help guide the recruitment of under-represented minorities into surgical training. An online survey was sent to 2,170 participants-1,327 JD in New Zealand and 843 MS at The University of Auckland (UA). Participants were asked about motivators or barriers to a career in general surgery. Twenty-one percent (452/2170) completed the survey. Most were female (65.1%), NZ European (53.6%) and MS (62.4%). Factors guiding career decision include interest in clinical and practical aspects (weighted average 4.43 and 4.34, respectively) and work-life balance (weighted average 4.11). Barriers to training were long hours and feeling overwhelmed (weighted average 4.05 and 3.64, respectively). There were perceived biases with 79.7% reporting a gender bias and 99.7% reporting male over-representation. Similarly, 68.4% reported an ethnicity bias; 97% reporting NZ European over-representation. 92.2% considered mentorship important but only 15.3% have a mentor. This study identified motivators and barriers to general surgery and perceived gender and ethnicity biases. With demand for a diverse surgical workforce, there should be focus on recruitment of underrepresented minorities and mentorship.

Age, ethnicity, life events and wellbeing among New Zealand women

AbstractBy the year 2030, 19–21 per cent of the population of New Zealand (NZ) is projected to be aged 65 and over. Like many countries, life expectancy in NZ differs by gender but also ethnicity: in 2019, life expectancy for Māori (indigenous) women was 77.1 years compared with 84.4 years for non-Māori women. If Māori and NZ European women are to flourish in later life, examining the factors associated with their wellbeing is paramount. The current study draws on the Life Course Perspective to explore how wellbeing is associated with age-related life events among mid- to later-life NZ women. The women in this study (N = 19,624) are participants in the 2018 wave of the New Zealand Attitudes and Values Study, a national probabilistic 20-year longitudinal study (mean age = 55.62; Māori = 10.8%, NZ European = 89.2%). We found that stressful life events were negatively associated with life satisfaction but positively associated with meaning in life. Māori women exhibited lower levels of life satisfaction but there were no ethnic differences for meaning in life; however, Māori and NZ European women showed different patterns of significant correlates associated with meaning in life. Findings highlight the necessity of an intersectional approach to the study of mid- to later-life wellbeing and the utility of measuring wellbeing in more than one way within NZ's unique cultural-historical context.

New Echocardiography Reference Ranges for Aotearoa (NewERA) Study: the application of international echocardiographic reference values to linear measurements of the hearts of healthy, young Māori and Pacific adults may not detect cardiac enlargement.

To develop ethnic-specific echocardiography reference ranges for Aotearoa, and to investigate the impact of indexation to body surface area (BSA). Current reference international ranges are derived from people of mostly NZ European ethnicity and may not be appropriate for Māori and New Zealanders of Pacific ethnicity, who both experience high rates of cardiovascular disease. Echocardiography was performed in a cross-sectional study of 263 healthy adults (18-50 years): Māori (N=71, 43 female), Pacific (N=53, 28 female), European (N=139, 74 female). Linear measurements of the left heart are reported and indexed to BSA. The upper/lower limit of normal (ULN/LLN) by ethnicity and sex were derived (quantile regression). Ethnic- and sex-specific differences were examined using ANOVA. The ULN was higher for all un-indexed dimensions in men compared to women, and for most indices the ULN was smallest in NZ Europeans and largest in Māori and Pacific peoples. Indexation reversed these relationships: NZ Europeans had higher ULN for many measurements. Indexing to BSA introduced bias that preferences the NZ European ethnicity by creating an upper limit reference threshold that far exceeds this sample's upper range. As a result, this may lead to under-recognition of cardiac enlargement in Māori and Pacific patients, and in particular for women. Unique reference ranges for all ethnic groups and sexes are required to optimally detect and manage cardiovascular diseases (CVD) in Aotearoa.

Revisiting congruence effects in diversity research: views of diversity initiatives and experiences of belonging in a New Zealand healthcare organization

PurposeThis study drew on person-organization fit and ideological psychological contract theories to test whether inclusiveness, operationalized as sense of belonging, could be explained by congruence/discrepancy between employees' personal value of diversity, equity and inclusion (DEI) initiatives and employees' views of perceived organizational commitment to these initiatives. The study also examined whether sense of belonging, and perspectives of DEI initiatives, differed between majority [New Zealand European (NZE)] and minority [Māori/Pasifika (MP)] workers.Design/methodology/approachA total of 771 employees from a New Zealand healthcare organization completed an online survey. Further to mean difference tests to contrast majority and minority group experiences, polynomial regressions with response surface methodology were conducted to examine congruence effects on sense of belonging.FindingsWhile MP workers attributed greater personal value to DEI initiatives and viewed the organization as prioritizing these initiatives compared to NZ European (NZE) workers, MP workers experienced a lower sense of belonging. Further, the authors' results show that congruence at higher levels of personal and organizational importance ascribed to DEI initiatives was associated with greater sense of belonging. Contrary to the deficiency-based discrepancy effect proposed, the lowest levels of belonging were experienced at low levels of organizational commitment to DEI, regardless of personal diversity value. Additionally, MP were more susceptible to ideological psychological contract breach than NZE workers.Practical implicationsThe authors' study highlights that while positive diversity climate perceptions are closely linked to perceptions of inclusion, organizations will discern the factors that contribute to or undermine inclusiveness by also gaging personal value DEI initiatives and the unique experiences of minority and majority groups.Originality/valueThis study is the first to examine the effect of diversity-related value congruence on employees' sense of belonging, and to uncover racioethnic differences in these effects.

Predicting vaginal birth after caesarean section: Validation of the Grobman model in a New Zealand population.

The decision regarding mode of birth following a primary caesarean section is important. Women may choose an elective repeat caesarean section or a trial of labour in an attempt to achieve a vaginal birth after caesarean (VBAC). The highest morbidity and mortality is associated with those who have an emergency caesarean section following a trial of labour. Therefore, the ability to accurately predict successful VBAC is important in antenatal counselling. To test the validity of the Grobman prediction nomogram in a New Zealand (NZ) population. A retrospective cohort study was performed of women carrying a singleton, cephalic pregnancy at term and who had one previous lower segment caesarean section in Northland, NZ. The probabilities of successful VBAC were calculated using the variables in the Grobman model and compared with observed VBAC rates using a calibration curve. The predictive ability of the model was assessed using area under the receiver operating characteristic curve (AUC). Of the 421 eligible women, 354 elected to undergo a trial of labour, of whom 69.5% had a successful VBAC. The AUC for the Grobman model was 0.72 (95% CI 0.67-0.78) with predicted and actual outcomes being similar when predicted success was over 50%. The predictive ability of the model appeared more accurate for Māori and Pacifika women compared to the NZ European population. The Grobman model predicts successful VBAC reasonably well in a NZ population and can be used as an antenatal counselling aid.

How socially cohesive was New Zealand’s first lockdown period from the perspective of culturally diverse older New Zealanders?

ABSTRACT Aotearoa, New Zealand’s (NZ) initial pandemic response has been held up internationally as a model of social cohesion and compassion, made salient by the ‘team of five million’ messaging promoted by the New Zealand government. This paper considers whether the first New Zealand COVID-19 lockdown was viewed and experienced as socially cohesive from the perspective of diverse older New Zealanders. This study presents a deductive analysis based on 44 individual or group interviews with Māori, Pacific, Chinese, Korean and New Zealand European (NZE) people aged 60 and over. This paper presents a critical, intersectional discussion around social cohesion experienced by older New Zealanders during lockdown, by considering their views and experiences of belongingness, legitimacy, recognition, inclusion and participation. We suggest that New Zealand European participants benefited most from national appeals for solidarity and reported enhanced feelings of belongingness and inclusion. Māori, Chinese, Korean and Pacific experienced belongingness and inclusion primarily on a community level owing to the culturally-specific support they received. We conclude that future pandemic planning should aim to strengthen targeted culturally-specific community initiatives already in action whilst improving aspects of inclusion and participation for all older New Zealanders.

Iris melanocytic tumours in New Zealand/Aotearoa: presentation, management and outcome in a high UV exposure environment

Background/ObjectivesIris melanoma, a rare intraocular malignancy, represents the smallest subgroup of uveal melanoma. This first, comprehensive study of iris melanocytic lesions in the high ultraviolet environment in New Zealand/ Aotearoa (NZ) examines diagnosis, management and outcomes.Subjects/MethodsRetrospective study of iris melanocytic tumours referred to tertiary referral centres in Auckland, NZ, over 20 years (1999-2018). Data analysed include demographics, tumour characteristics, histology, genetic analyses, treatment modalities, recurrence, metastasis, 5-year and overall survival.ResultsCohort (N = 51) was predominantly NZ European (98.0%) with no indigenous Māori, or Pasifika. Median age at presentation was 58 years. Tumours involved a median of two clock hours of iris. The posterior tumour margin extended to the anterior chamber angle in 22 patients (45.8%). Management included initial observation 54.9%, iridectomy/excision biopsy 29.4%, irido-cyclectomy 7.8%, plaque radiotherapy 7.8%, proton beam radiotherapy 7.8%, and ultimately enucleation 17.6%. Histology was performed in 19 cases (37%) with 16 confirmed melanomas (84%). Mean follow-up 4.2 years with median visual acuity of 6/7.5 two years post intervention. Melanoma-related metastasis and mortality occurred in two cases with five-year melanoma-related mortality of 2.0%.ConclusionIn a climate with high ultraviolet exposure iris melanocytic tumours occurred almost exclusively in NZ Europeans, however, the majority of cases were category T1, possibly reflecting early diagnosis in the NZ health system. Nonetheless, >50% underwent surgery or radiotherapy, often utilising more than one modality. A high index of suspicion and early referral of iris melanocytic lesions should be considered in regions with high UV exposure.

Hb Kirikiriroa [α57(E6)Gly→Cys; HBA1: c.172G>T]: A Novel Unstable α-Globin Variant with Oxidized Derivatives Interfering with Hb A1c

We report the identification of a novel hemoglobin (Hb) variant [α57(E6)Gly→Cys; HBA1: c.172G>T], to be referred to as Hb Kirikiriroa. The variant was detected in five subjects from two families, with familial relationship established between the families following diagnosis. A persistently elevated Hb A1c over a 1-year period prompted hemoglobinopathy screening in an adolescent male of New Zealand (NZ) European descent (case 1). Capillary electrophoresis (CE) revealed the variant was negatively charged and susceptible to oxidation, with multiple abnormal peaks detected (0.4–5.1% total Hb). Hb A1c analysis by cation exchange high performance liquid chromatography (HPLC) was the first indication of the variant in a pregnant female of NZ European descent (case 2). Cases 1 and 2 had normal complete blood counts. Isopropanol stability testing provided evidence the variant was unstable. We herein describe the characterization of Hb Kirikiriroa and clinical significance of the variant for interference with Hb A1c analysis by CE and cation exchange HPLC.

Evidence of suboptimal maternal vaccination coverage in pregnant New Zealand women and increasing inequity over time: A nationwide retrospective cohort study

BackgroundAdequate maternal vaccination coverage is critical for the prevention and control of infectious disease outbreaks such as pertussis, influenza, and more recently COVID-19. To guide efforts to increase vaccination coverage this study examined the extent of vaccination coverage in pregnant New Zealand women over time by area-level deprivation and ethnicity. MethodsA retrospective cohort study was used consisting of all pregnant women who delivered between 01 January 2013 and 31 December 2018, using administrative health datasets. Outcomes were defined as receipt of influenza or pertussis vaccination in any one of the relevant data sources (National Immunisation Register, Proclaims, or Pharmaceutical collection) during their eligible pregnancy. Ethnicity was prioritised as Māori (NZ indigenous), Pacific, Asian, and Other or NZ European and deprivation was defined using New Zealand Index of Multiple Deprivation (IMD). ResultsBetween 2013 and 2018, Asian women had the highest maternal vaccination coverage (36%) for pertussis, while Māori and Pacific women had the lowest, 13% and 15% respectively. Coverage of pertussis vaccination during pregnancy in low deprivation Māori women was 24% and 28% in Pacific women. This is in comparison to 30% and 25% in high deprivation Asian and European/Other women, respectively. Similar trends were seen for influenza. ConclusionBetween 2013 and 2018 maternal vaccination coverage increased for pertussis and influenza. Despite this coverage remains suboptimal, and existing ethnic and deprivation inequities increased. There is an urgent need to focus on equity, to engage and support ethic communities by creating genuinely accessible, culturally appropriate health services.

Epidemiological, clinical, pathological and genetic characteristics of epidermolysis bullosa in New Zealand.

To establish the epidemiological, clinical, pathological and genetic characteristics of epidermolysis bullosa (EB) in New Zealand (NZ). Participants were recruited through the Dystrophic Epidermolysis Bullosa Research Association of New Zealand (DEBRA NZ). Dedicated EB nurse medical records, Genetic Health Service NZ (GHSNZ) records and, where available, public hospital records were manually reviewed for relevant clinical data. Ninety-two participants took part in the study (56% participation rate). Forty-nine (53%) participants had EB simplex (EBS), 40 (43%) had dystrophic EB (DEB), and 3 (3%) had junctional EB (JEB). Point prevalence for EB of all types was 19.5 per million, and 10.4, 8.6 and 0.9 per million for EBS, DEB and JEB, respectively. Thirty-four participants had intermediate or severe EB. There were 29 paediatric cases and almost even numbers of males and females. Compared to NZ European and Māori, prevalence rates were lower for Pacific and Asian people and higher in the Middle Eastern/Latin American/African population. Eight out of 14 skin biopsy results were informative, and 14 of 15 genetic test results were informative. New Zealand has similar prevalence rates of EB compared with other national cohorts. This is likely to be an underestimate due to methodological limitations. Recent advancements in genomic testing have resulted in an improved diagnostic rate in our population. Further research into ethnic differences in prevalence, and exploring the characteristics of lethal forms of EB, is warranted. A dynamic registry may be helpful for the EB community in NZ.

Impact of the first wave of COVID-19 on the health and psychosocial well-being of Māori, Pacific Peoples and New Zealand Europeans living in aged residential care.

To investigate the impact of New Zealand's (NZ) first wave of COVID-19, which included a nationwide lockdown, on the health and psychosocial well-being of Māori, Pacific Peoples and NZ Europeans in aged residential care (ARC). interRAI assessments of Māori, Pacific Peoples and NZ Europeans (aged 60years and older) completed between 21/3/2020 and 8/6/2020 were compared with assessments of the same ethnicities during the same period in the previous year (21/3/2019 to 8/6/2019). Physical, cognitive, psychosocial and service utilisation indicators were included in the bivariate analyses. A total of 538Māori, 276Pacific Peoples and 11,322NZ Europeans had an interRAI assessment during the first wave of COVID-19, while there were 549Māori, 248Pacific Peoples and 12,367NZ Europeans in the comparative period. Fewer Māori reported feeling lonely (7.8% vs. 4.5%, p=0.021), but more NZ Europeans reported severe depressive symptoms (6.9% vs. 6.3%, p=0.028) during COVID-19. Lower rates of hospitalisation were observed in Māori (7.4% vs. 10.9%, p=0.046) and NZ Europeans (8.1% vs. 9.4%, p<0.001) during COVID-19. We found a lower rate of loneliness in Māori but a higher rate of depression in NZ European ARC populations during the first wave of COVID-19. Further research, including qualitative studies with ARC staff, residents and families, and different ethnic communities, is needed to explain these ethnic group differences. Longer-term effects from the COVID-19 pandemic on ARC populations should also be investigated.

Comparison of the sociodemographic and clinical characteristics and level of care home placement in Asian and European people with moderate to severe cognitive impairment living in New Zealand

AbstractBackgroundDue to the ageing population in New Zealand (NZ), there will be more people with dementia in need of long‐term care. As a culturally diverse country, the characteristics of different ethnicities need to be understood in order to provide culturally appropriate care. This study aims to compare: 1) the sociodemographic and clinical characteristics, and 2) the level of care home placement in Asian and NZ European people with moderate to severe cognitive impairment living in long‐term care facilities.MethodThe sample included individuals aged≥65 and self‐identified as Asian or NZ European who had received the Long‐Term Care Facility version of interRAI, a standardised and comprehensive geriatric assessment, in 2018. All participants had moderate to severe cognitive impairment defined by a score of ≥ 3 in the Cognitive Performance Scale (range 0‐6). The analysis examined the association of ethnic group with sociodemographic and clinical variables and level of care home placement.ResultThe sample included 7298 older adults (441 Asians, 6857 NZ Europeans). The average age of the sample was 84.1 SD±8.7 (Asian= 83.7 SD±7.7, European= 84.1 SD±8.8, p=0.29), and 57.5% were female (Asian=62.6%, European=57.2%, p=0.08). Logistic regression showed that, compared with NZ Europeans, Asians were more likely to have untreated diabetes (OR=2.14, 95%CI=1.55–2.96); less likely to be overweight/obese (BMI 25–29: OR=0.54, 95%CI=0.41–0.73; BMI 30–40: OR=0.25, 95%CI=0.13–0.46), have hearing loss (OR=0.55, 95%CI=0.44–0.69) and had fewer medical comorbidities (OR=0.39, 95%CI=0.24–0.65). Despite lower comorbidity, Asians with cognitive impairment were more likely to be placed in hospital level care (OR=1.60, 95%CI=1.23–2.08) and less likely to be placed in dementia level of care (OR=0.53, 95%CI=0.36–0.77).ConclusionThe study results demonstrate differences in clinical characteristics and level of care home required for Asians and NZ Europeans living in NZ. Despite lower comorbidity, Asians with cognitive impairment were more likely to be placed in hospital level of care and less likely to be placed in dementia level of care. Additional studies are needed to understand this relationship, and the results may help to generate more culturally tailored health services aimed for people with cognitive impairment.

Comparative Analysis of Lumbar Spine Vertebral Morphology Between Māori and New Zealand Europeans: A Computed Tomography Study.

Most existing studies of lumbar anatomy do not consider ethnic influence and recruit mostly white participants. Recent studies have considered other populations; however, none have assessed Māori, the indigenous people of New Zealand (NZ). A computed tomography study of vertebral body (VB) and canal dimensions was performed for lumbar vertebrae of Māori and NZ European patients to evaluate for ethnic variation. Lumbar vertebrae from 196 patients were measured using computed tomography. After interrater and intrarater reliability analyses, a single trained examiner measured VB heights, VB lengths, segmental angle, pedicle height and width, and vertebral canal length (VCL) and vertebral canal width for each level. Canal:body ratio was calculated. Demographic data recorded included age, sex, and ethnicity. VCL remained relatively constant through the lumbar spine; canal width increased to a maximum of 28.2 mm at L5. Canal:body ratios and pedicle height decreased while pedicle width increased to a maximum of 16.1 mm at L5. There were few differences between Māori and NZ Europeans except at the L5 level, where VCL and canal:body ratio were larger in NZ Europeans (P < 0.05), and pedicle height, width, and VB pediculolaminar length were larger in Māori (P < 0.05). Females had generally smaller measurements and age was a positive predictor of measured values (P < 0.05). This study is the first to characterize lumbar anatomy in a Māori cohort. Adequately powered results demonstrated few differences between Māori and NZ Europeans. Isolated differences observed at L5 may be due to sacropelvic differences, which represent an area for further investigation. 3. Diagnosis, surgical planning, ethnic differences.

The prevalence of chronic kidney disease in Samoans living in Auckland, New Zealand.

Pacific peoples have higher rates of chronic kidney disease (CKD) and are five times more likely to commence kidney replacement therapy compared with New Zealand (NZ) Europeans. As the majority live Auckland, this study looked at the prevalence of CKD in two Auckland Pacific Island health providers caring for a large proportion of Pacific peoples, of which almost 50% are Samoan, as well as NZ Europeans. De-identified information was requested on individuals who had two or more CKD tests (serum creatinine and urinary albumin creatinine ratios) more than 3 months apart. CKD prevalence across different demographic groups was determined. Logistic regression was used to look at associations of known risk factors and CKD. Data from 25 127 patients was evaluated. Of the total sample, 7451 individuals identified as Samoans. The prevalence of CKD amongst all Samoans in this sample was 17.8% increasing to 36.3% in those Samoans that had been tested for CKD. The prevalence of CKD in this total sample was 13% increasing to 27.5% considering only those who had CKD testing. The odds of Samoans having CKD (adjOR: 1.9 [95%CI 1.7, 2.2]), all other Pacific Island ethnicities identified and NZ Maori (adjOR:1.5 [95%CI 1.3, 1.8]), were increased compared with non-Māori-non-Pacific (likelihood p value <.001). We report the high prevalence of CKD (15.9%-33.4%) in Samoans living in New Zealand. This reveals an urgent need for further studies to develop strategies to prevent or reduce the development of kidney failure and premature death.

Sex ratios and ‘missing women’ among Asian minority and migrant populations in Aotearoa/New Zealand: a retrospective cohort analysis

ObjectivesRecent research from the UK, USA, Australia and Canada point to male-favouring sex ratios at birth (SRB) among their Asian minority populations, attributed to son preference and sex-selective abortion within...

Comparing liking and attitudes of Chinese immigrants in New Zealand towards drinkable yoghurt: an exploratory study

Whilst food choices may change when exposed to a new culture, the time and extent of the acculturation process is not clear. Focus groups (FGs) were used to explore whether recent Chinese immigrants to New Zealand (NZ) could be representative of consumer product opinions in China and whether these could be associated with residence time. Four population groups - Chinese in Beijing (BJ), Chinese in NZ for less (CH < 3y) or more (CH > 3y) than 3 years, and NZ Europeans in NZ (NZE) - were recruited to consider drinking yoghurt. FGs were conducted in Chinese or English using the same discussion guide. Transcripts were uploaded into NVivo software to extract key themes using an interpretive coding approach. CH < 3y described a liking for sweet yoghurt with low sourness, aligning with BJ. However, CH > 3y closely matched NZE, particularly for sweetness intensity. The only attribute that was not affected across immigrants was “thickness”, where thick drinking yoghurt was liked more, in line with BJ, compared to NZE. Reasons, type and temperature of consumption described by CH < 3y closely matched BJ, but some habits had changed, particularly regarding consumption at breakfast time. In contrast, CH > 3y mainly consume chilled yoghurt closely aligning with NZE, indicating that habits were associated with residence time. This exploratory study revealed that, for English speaking Chinese immigrants, the acculturation processes could take at least 3 years to affect immigrant attribute liking, but liking for some attributes was maintained, even after a longer time of residence. This understanding suggests that, with caution, recent immigrants may be an option to mimic overseas consumers in initial consumer product evaluations, especially when travelling is not possible in pandemic situations.

Objectively Measured Physical Activity Is Associated With Body Composition and Metabolic Profiles of Pacific and New Zealand European Women With Different Metabolic Disease Risks.

Objective: To assess associations between physical activity (PA), body composition, and biomarkers of metabolic health in Pacific and New Zealand European (NZE) women who are known to have different metabolic disease risks.Methods: Pacific (n = 142) or NZE (n = 162) women aged 18–45 years with a self-reported body mass index (BMI) of either 18.5–25.0 kg⋅m–2 or ≥30.0 kg⋅m–2 were recruited and subsequently stratified as either low (<35%) or high (≥35%) BF%, with approximately half of each group in either category. Seven-day accelerometery was used to assess PA levels. Fasting blood was analysed for biomarkers of metabolic health, and whole body dual-energy X-ray absorptiometry (DXA) was used to estimate body composition.Results: Mean moderate-to-vigorous physical activity (MVPA; min⋅day–1) levels differed between BF% (p < 0.05) and ethnic (p < 0.05) groups: Pacific high- 19.1 (SD 15.2) and low-BF% 26.3 (SD 15.6) and NZE high- 30.5 (SD 19.1) and low-BF% 39.1 (SD 18.4). On average Pacific women in the low-BF% group engaged in significantly less total PA when compared to NZE women in the low-BF% group (133 cpm); no ethnic difference in mean total PA (cpm) between high-BF% groups were observed: Pacific high- 607 (SD 185) and low-BF% 598 (SD 168) and NZE high- 674 (SD 210) and low-BF% 731 (SD 179). Multiple linear regression analysis controlling for age and deprivation showed a significant inverse association between increasing total PA and fasting plasma insulin among Pacific women; every 100 cpm increase in total PA was associated with a 6% lower fasting plasma insulin; no significant association was observed in NZE women. For both Pacific and NZE women, there was an 8% reduction in fasting plasma insulin for every 10-min increase in MVPA (p ≤ 0.05).Conclusion: Increases in total PA and MVPA are associated with lower fasting plasma insulin, thus indicating a reduction in metabolic disease risk. Importantly, compared to NZE, the impact of increased total PA on fasting insulin may be greater in Pacific women. Considering Pacific women are a high metabolic disease risk population, these pre-clinical responses to PA may be important in this population; indicating promotion of PA in Pacific women should remain a priority.