Holistic health for Pacific seniors from a weekly group gathering run by a Pacific health provider.

Introduction Manatu Hauora (Aotearoa New Zealand (NZ) Ministry of Health) recognises that respecting and listening to Pacific peoples' knowledge and skills in caring for their communities' wellbeing is a priority, and that novel approaches to care, particularly for chronic health conditions, are necessary. Allied health professionals have the potential to play important roles in primary care design and delivery. Pacific Trust Otago (PTO) provides a weekly seniors' group gathering that has evolved over the years and incorporates exercise, health information and cultural activities. Aim This study aims to explore what Pacific seniors are learning about their health and wellbeing, and what factors contribute to sustained engagement with this weekly group activity. Methods The research team conducted a qualitative study using the Kakala Research Framework and the pan-Pacific Talanoa Research Methodology to gather narratives in a relational and comfortable group space. Participants were recruited from the seniors group gathering. Group Talanoa were used to collect data, which were digitally voice-recorded, transcribed, translated, and de-identified. Ethical approval was granted by the University of Otago School of Physiotherapy Ethics Committee. Results Pacific seniors valued how these gathering The seniors recognised how interconnected and intertwined culture, spirituality, and family were and how this contributed to their sense of individual and collective health and wellbeing. The study highlights the need to consider health beyond the individual to the collective, embracing indigenous perspectives, and authentically nurturing relationships with Pacific health providers. The study recommends primary care funders are supported to understand what is important to Pacific people and partner with Pacific health providers to deliver care in ways that align with indigenous models of care. Discussion A weekly group gathering for Pacific seniors run by Allied Health professionals provides a welcoming, safe, and culturally meaningful environment where seniors can connect, share, and grow in health and wellbeing together. This study highlights the importance of adopting informed and inclusive approaches to promoting and addressing holistic health for Pacific people, especially in light of ongoing health reforms in Aotearoa NZ.

Further reductions in the prevalence of obesity in 4-year-old New Zealand children from 2017 to 2019.

OBJECTIVE: To examine whether the prevalence of age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles continues to decline in New Zealand preschool children, over time. METHODS: As part of a national screening programme, 438,972 New Zealand 4-year-old children had their height and weight measured between 2011 and 2019. Age- and sex-adjusted BMI was calculated using WHO Growth Standards and the prevalence of children at, or above, the 85th, 95th, and 99.7th percentiles and at, or below, the 2nd percentile were determined. Log-binomial models were used to estimate linear time trends of ≥85th, ≥95th and ≥99.7th percentiles for the overall sample and separately by sex, deprivation, ethnicity and urban-rural classification. RESULTS: The percentage of children at, or above, the 85th, 95th and 99.7th percentile reduced by 4.9% [95% CI: 4.1%, 5.7%], 3.5% [95% CI: 2.9%, 4.1%], and 0.9% [95% CI: 0.7%, 1.2%], respectively, between '2011/12' and '2018/19'. There was evidence of a decreasing linear trend (risk reduction, per year) for the percentage of children ≥85th (risk ratio (RR): 0.980 [95% CI: 0.978, 0.982]), ≥95th (RR: 0.966 [95% CI: 0.962, 0.969]) and ≥99.7th (RR: 0.957 [95% CI: 0.950, 0.964]) percentiles. Downward trends were also evident across all socioeconomic indicators (sex, ethnicity, deprivation, and urban-rural classification), for each of the BMI thresholds. Larger absolute decreases were evident for children residing in the most deprived compared with the least deprived areas, at each BMI threshold. There appeared to be no consistent trend for the percentage of children ≤2nd percentile. CONCLUSIONS: Reassuringly, continued declines of children with age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles are occurring over time, overall and across all sociodemographic indicators, with little evidence for consistent trends in the prevalence of children at, or below, the 2nd percentile.

Increased hippocampal shape asymmetry and volumetric ventricular asymmetry in autism spectrum disorder.

Autism spectrum disorder (ASD) is a prevalent and fast-growing pervasive neurodevelopmental disorder worldwide. Despite the increasing prevalence of ASD and the breadth of research conducted on the disorder, a conclusive etiology has yet to be established and controversy still exists surrounding the anatomical abnormalities in ASD. In particular, structural asymmetries have seldom been investigated in ASD, especially in subcortical regions. Additionally, the majority of studies for identifying structural biomarkers associated with ASD have focused on small sample sizes. Therefore, the present study utilizes a large-scale, multi-site database to investigate asymmetries in the amygdala, hippocampus, and lateral ventricles, given the potential involvement of these regions in ASD. Contrary to prior work, we are not only computing volumetric asymmetries, but also shape asymmetries, using a new measure of asymmetry based on spectral shape descriptors. This measure represents the magnitude of the asymmetry and therefore captures both directional and undirectional asymmetry. The asymmetry analysis is conducted on 437 individuals with ASD and 511 healthy controls using T1-weighted MRI scans from the Autism Brain Imaging Data Exchange (ABIDE) database. Results reveal significant asymmetries in the hippocampus and the ventricles, but not in the amygdala, in individuals with ASD. We observe a significant increase in shape asymmetry in the hippocampus, as well as increased volumetric asymmetry in the lateral ventricles in individuals with ASD. Asymmetries in these regions have not previously been reported, likely due to the different characterization of neuroanatomical asymmetry and smaller sample sizes used in previous studies. Given that these results were demonstrated in a large cohort, such asymmetries may be worthy of consideration in the development of neurodiagnostic classification tools for ASD.

The use of high-throughput small RNA sequencing reveals differentially expressed microRNAs in response to aster yellows phytoplasma-infection in Vitis vinifera cv. 'Chardonnay'.

Phytoplasmas are cell wall-less plant pathogenic bacteria responsible for major crop losses throughout the world. In grapevine they cause grapevine yellows, a detrimental disease associated with a variety of symptoms. The high economic impact of this disease has sparked considerable interest among researchers to understand molecular mechanisms related to pathogenesis. Increasing evidence exist that a class of small non-coding endogenous RNAs, known as microRNAs (miRNAs), play an important role in post-transcriptional gene regulation during plant development and responses to biotic and abiotic stresses. Thus, we aimed to dissect complex high-throughput small RNA sequencing data for the genome-wide identification of known and novel differentially expressed miRNAs, using read libraries constructed from healthy and phytoplasma-infected Chardonnay leaf material. Furthermore, we utilised computational resources to predict putative miRNA targets to explore the involvement of possible pathogen response pathways. We identified multiple known miRNA sequence variants (isomiRs), likely generated through post-transcriptional modifications. Sequences of 13 known, canonical miRNAs were shown to be differentially expressed. A total of 175 novel miRNA precursor sequences, each derived from a unique genomic location, were predicted, of which 23 were differentially expressed. A homology search revealed that some of these novel miRNAs shared high sequence similarity with conserved miRNAs from other plant species, as well as known grapevine miRNAs. The relative expression of randomly selected known and novel miRNAs was determined with real-time RT-qPCR analysis, thereby validating the trend of expression seen in the normalised small RNA sequencing read count data. Among the putative miRNA targets, we identified genes involved in plant morphology, hormone signalling, nutrient homeostasis, as well as plant stress. Our results may assist in understanding the role that miRNA pathways play during plant pathogenesis, and may be crucial in understanding disease symptom development in aster yellows phytoplasma-infected grapevines.

Evaluating the effectiveness of a programme for improving the participation and academic success of an underrepresented minority group in New Zealand.

Pacific peoples are a minority under-represented ethnic group in higher education in New Zealand. This article explores the effectiveness of a specific programme, which sought to improve outcomes of Pacific students in the tertiary environment. The aim of the evaluation was to determine the effectiveness of an intervention programme (2013-2015) to increase the participation and academic success of Pacific students in the first year in Health Sciences. The study found the academic results of Pacific students who participated in the intervention programme were significantly better compared to those who did not. The findings inform future research, suggesting that, when assessing the effectiveness of a programme, it is useful to explore the performance of the whole cohort separately to those who declared intention or interest to attend the programme. Strategies to support participation of each of these groups are likely to be different. Having a standardised approach when comparing groups will adjust for any confounding factors or prior differences. This will allow a more accurate assessment of the effectiveness of the programme being evaluated. This paper presents the importance of a robust approach to the delivery and evaluation of intervention programmes for improving outcomes for underrepresented students in the tertiary environment.

Celebrities and spiritual gurus: Comparing two biographical accounts of kidney transplantation and recovery.

BACKGROUND: As a kidney transplant recipient I have long been exposed to a shortage of renal narratives and to a dominant theme in those that exist: transplant as restitution or redemption. My lived experience has, however, shown me that post-transplant life is more complex. Even after transplantation, chronic kidney disease requires lifelong health care with varying degrees of impairment, resulting in ongoing liminality for those who experience it. Nonetheless, as a transplant recipient I find the restitution or redemptive narrative pervasive and difficult to escape. OBJECTIVE: I examined two seemingly very dissimilar insider renal biographies, Janet Hermans's Perfect match: A kidney transplant reveals the ultimate second chance, and Steven Cojocaru's Glamour, interrupted: How I became the best-dressed patient in Hollywood, to explore how the narrators treat chronic kidney disease and transplantation. METHODS: In addition to a close textual reading of the biographies, I used my own experience of meaning-making to problematize concepts around restitution or redemptive narratives. RESULTS: I found that the two biographies are, despite appearances and despite the attempts of one author to escape the redemptive form, very much the same type of narrative. The accounts end with the transplant, as is common, but the recipients' lives continue after this, as they learn to live with their transplants, and this is not addressed. CONCLUSIONS: Emphasising restitution or redemption might prevent an understanding of post-transplant liminality that has unique characteristics. The narrator evading this narrative form must come to terms with a changed identity and, sometimes, fight to evade the pervasive narratives others impose.

Is the food environment surrounding schools associated with the diet quality of adolescents in Otago, New Zealand?

Using a sample of adolescents from schools in Otago, New Zealand, associations between food outlets around schools and dietary quality were investigated. Food outlet environment data were derived using GIS data. Multivariate regression analysis results showed that outlet density, in an 800m buffer around schools, of cafes and restaurants, supermarkets and takeaways was associated with higher Diet Quality Index scores in boys, and distance to nearest outlet for convenience stores, cafes and restaurants and supermarkets with lower scores for girls. Effect sizes were small, suggesting that the food environment around schools plays a minor role in adolescent diet quality.

Perspectives on psychosocial and spiritual cancer support services in New Zealand.

In New Zealand, support services have been developed in response to patient need but are variable. The benefits of psycho-social-spiritual care in reducing distress and enhancing quality of life for people with cancer and their families are well established yet unmet needs continue to feature. This project aimed to examine how health care professionals assessed for psycho-social-spiritual distress and unmet need, decisions on appropriate support, and identification of barriers in the referral process. A mixed-methods approach was used for this research. The qualitative phase entailed semistructured interviews with health care professionals working in cancer care. The quantitative phase was an online survey of oncologists and nurses. Thematic analysis was carried out by performing a side-by-side analysis of both sets of data. Nurses were most likely to assess for psycho-social-spiritual need and to refer to support services. Despite a clear mandate to provide regular psycho-social-spiritual assessment, there is no consistency of assessment and referral across New Zealand. There are clearly unmet psycho-social-spiritual needs among people affected by cancer in New Zealand, with health care professionals in this study noting structural impediments to adequate supportive care. There is a mismatch between the importance placed on such care and the capacity that is currently available. The results of this study provide evidence that can be used to argue for improvements in the infrastructure, funding allocation and policy that would allow for better psycho-social-spiritual care within the challenging context of increasing numbers of those affected by cancer.

Writing the othered self: autoethnography and the problem of objectification in writing about illness and disability.

The individual's experience of kidney failure, transplantation, and recovery is not as well documented as might be expected. Often it is written about by outsiders (medical practitioners, care providers, academics), whereas the insider's (patient's) expertise is occluded. This conforms to the experience of many people living with illness and disability. The rendering of people as other (not like the norm) comes at a cost to their humanity. People who are ill or disabled can themselves succumb to a way of writing that simplifies their experience and objectifies themselves. I consider what it means to tell the story of oneself against a background of illness autoethnography, my own story of growing up medicalized and living with end-stage renal disease. I identify three types of illness autoethnography, one of which creates a tension between researcher as agent and researcher as object of research, and compels the reader to constantly realign himself or herself.