Variation of the Risk Associated With Potentially Modifiable Risk Factors for Dementia Between Ethnic Groups Within One Country. A Retrospective Cohort Study Using Routinely Collected Health Data in Aotearoa New Zealand.

Introduction: While risk factor prevalence of individual risk factors for dementia varies between ethnic groups in New Zealand (NZ), it is not known whether the effect of these risks is the same in each group.

Methods: This retrospective cohort study identified incident cases of dementia. Cox regression models calculated the hazard ratio for dementia for each of the risk factors, after adjustment for age and sex.

Accuracy of ethnicity records at primary and secondary healthcare services in Waikato region, Aotearoa New Zealand.

Aims: Ethnicity is an important variable, and in Aotearoa New Zealand it is used to monitor population health needs, health services outcomes and to allocate resources. However, there is a history of undercounting Māori. The aim of this study was to compare national and primary care ethnicity data to self-reported ethnicity from a Kaupapa Māori research cohort in the Waikato region.

Elevated glucose promotes MMP13 and ADAMTS5 production by osteoarthritic chondrocytes under oxygenated but not hypoxic conditions.

Type 2 diabetes is linked with increased incidence and severity of osteoarthritis. The purpose of this study was to determine the effect of extracellular glucose within the normal blood glucose and hyperglycemic range on catabolic enzyme production by chondrocytes isolated from osteoarthritic (OA) and macroscopically normal (MN) human cartilage under oxygenated (18.9% oxygen) and hypoxic (1% oxygen) conditions.

Examining the impact of COVID-19 on Māori:non-Māori health inequities in Aotearoa, New Zealand: an observational study protocol.

Introduction: The COVID-19 pandemic has had both direct and indirect impacts on the health of populations worldwide. While racial/ethnic health inequities in COVID-19 infection are now well known (and ongoing), knowledge about the impact of COVID-19 pandemic management on non-COVID-19-related outcomes for Indigenous peoples is less well understood. This article presents the study protocol for the Health Research Council of New Zealand funded project 'Mā te Mōhio ka Mārama: Impact of COVID-19 on Māori:non-Māori inequities'.

Audit of antimicrobial stewardship in medical inpatients in Waikato, New Zealand 2021.

Aims: Given the threat of rising antimicrobial resistance (AMR), 10 audit standards were selected to audit antimicrobial stewardship (AMS) in secondary care to assess guideline adherence and establish quality improvement initiatives in antimicrobial prescribing.

Methods: Patients were included if they received intravenous (IV) antibiotics across seven medical wards in Waikato or Thames hospitals, New Zealand, in November 2021. Audit standards were defined from the regional antimicrobial prescribing policy and adult antimicrobial guidelines.

Phenotype and energy metabolism differ between osteoarthritic chondrocytes from male compared to female patients: Implications for sexual dimorphism in osteoarthritis development?

Objectives: The prevalence and severity of knee osteoarthritis (OA) are greater in females than males. The purpose of this study was to determine whether there is an underlying difference in the biology of OA chondrocytes between males and females.

Methods: Chondrocytes were obtained following knee arthroplasty from male and female patients with primary OA.

Using Days Alive and Out of Hospital to measure inequities and possible pathways for them after cardiovascular surgery in Aotearoa New Zealand: study protocol for a secondary data analysis.

Introduction: In Aotearoa New Zealand (NZ), socioeconomic status and being of Māori ethnicity are often associated with poorer health outcomes, including after surgery. Inequities can be partially explained by differences in health status and health system biases are hypothesised as important factors for remaining inequities. Previous work identified inequities between Māori and non-Māori following cardiovascular surgery, some of which have been identified in studies between 1990 and 2012.

Creating an environment to inform, build, and sustain a Māori health research workforce.

Ensuring the growth and development of the Māori health research workforce is key to achieving health equity for Māori and enabling positive change for all New Zealanders. The purpose of this study was to identify enablers and barriers to research for Māori staff in a large health organisation, and to understand how research is developed and undertaken. A Kaupapa Māori mixed-methods study was undertaken, using an electronic survey comprised of quantitative data and open-ended responses delivered to all Māori staff at the Waikato District Health Board.

Differential Effects of Hypoxia versus Hyperoxia or Physoxia on Phenotype and Energy Metabolism in Human Chondrocytes from Osteoarthritic Compared to Macroscopically Normal Cartilage.

Chondrocyte phenotype and energy metabolism are altered in osteoarthritis (OA). However, most studies characterising the change in human chondrocyte behaviour in OA have been conducted in supraphysiological oxygen concentrations. The purpose of this study was to compare phenotype and energy metabolism in chondrocytes from macroscopically normal (MN) and OA cartilage maintained in 18.

Ethnic differences in patients undergoing thyroidectomy for non-toxic multinodular goitre.

Background: Māori have an increased incidence of thyrotoxicosis when compvared to non-Māori, however there are limited data on benign non-toxic nodular thyroid disease.

Aims: The aims of this study were to determine the rates of non-toxic multinodular goitre (NTMNG) surgery for Māori and non-Māori and to determine if there were differences in thyroid size between Māori and non-Māori undergoing total thyroidectomy for NTMNG.

Methods: Single centre study of patients undergoing thyroidectomy for NTMNG from 1 December 2006 to 30 November 2016.

Midwifery awareness of diabetes in pregnancy screening guidelines in Aotearoa New Zealand.

Objective: Effective and timely management of gestational diabetes mellitus (GDM) requires early detection. However, screening rates have been shown to be relatively low in New Zealand, despite the introduction of national screening guidelines in 2014 which indicate that all pregnant women should be screened. Thus, the aim of this study was to explore the awareness of the New Zealand Ministry of Health Diabetes in Pregnancy screening guidelines by New Zealand midwives.

He Pikinga Waiora Kimi Ora lifestyle programme: case study of a successful community-based Indigenous diabetes intervention.

Aim: To co-design and implement a whānau-centred, community-based lifestyle programme (Kimi Ora) intended to ensure no worsening of HbA1c and to improve wellbeing for Māori whānau and communities with diabetes or pre-diabetes.

Methods: Māori healthcare providers, community members, research advisors and wider stakeholders used a co-design process underpinned by He Pikinga Waiora to collaboratively develop and implement Kimi Ora Control group comparisons and participants were recruited from Te Kōhao Health. Multi-method monitoring and collection captured individual, whānau and community data.

Letter on an iceberg.

In the public sphere, issues are like icebergs. This somewhat hackneyed metaphor illustrates that, while one facet of an issue is perceived, what is not seen is the hidden substructure of power and culture that form and reinforce it, buoying the issue to prominence above the surface.

Ethnic inequities in screening for diabetes in pregnancy in New Zealand-adherence to national guidelines.

Aim: The aim of this study was to assess adherence to the 2014 Ministry of Health (MoH) screening guidelines for diabetes in pregnancy (DiP) by Māori and non-Māori in the Waikato region.

Methods: Clinical records were reviewed for women without known diabetes before pregnancy who delivered in hospitals or community birth centres in the Waikato region during June-August 2017. Screening rates for DiP were assessed using HbA1c, glucose challenge and/or glucose tolerance tests.

Glycaemic control across the lifespan in a cohort of New Zealand patients with type 1 diabetes mellitus.

Background: It is well known that tight glycaemic control reduces all-cause mortality and the development of microvascular complications in patients with type 1 diabetes mellitus (T1D), but that effective glycaemic control is difficult to achieve in different age groups. Currently, the state of glycaemic control across the lifespan in patients with T1D in New Zealand is not known.

Aim: To determine the differences in glycaemic control with age, gender, rurality and ethnicity in patients with T1D in the Waikato region of New Zealand.

Thyrotoxicosis in an Indigenous New Zealand Population - a Prospective Observational Study.

Background: Reported international incidence rates of thyrotoxicosis vary markedly, ranging from 6 to 93 cases per 100 000 per annum. Along with population demographics, exposures, and study design factors, ethnicity is increasingly being recognized as a potential factor influencing incidence. This study aimed to document the epidemiology and clinical presentation of thyrotoxicosis for Māori, the indigenous population in New Zealand.

Inequitable Long-Term Outcomes for an Indigenous Population After Definitive Treatment of Patients With Graves Disease.

Background: Māori, the indigenous people of Aotearoa/New Zealand, have an increased incidence of Graves disease and often require more than one radioiodine (RAI) dose, raising the question as to whether surgery may be preferable in this population. However, there is a lack of outcome data after definitive therapy in an indigenous population.

Aim: To assess ethnic differences in thyroid status after definitive therapy for Graves disease.

Should antenatal corticosteroids be considered in women with gestational diabetes before planned late gestation caesarean section.

Babies born to mothers with gestational diabetes mellitus (GDM) are at a greater risk of developing respiratory complications and hypoglycaemia than those born to mothers without diabetes. However, there is currently insufficient evidence as to whether these risks are altered by antenatal corticosteroids after 37 weeks gestation. This retrospective study suggests that antenatal corticosteroids probably reduce respiratory admissions to the newborn intensive care unit with a mild increase in neonatal hypoglycaemia in women with GDM who deliver via caesarean section after 37 weeks gestation.

Treatment choice, satisfaction and quality of life in patients with Graves' disease.

Background: Thyrotoxicosis, most often caused by Graves' disease (GD), when treated inadequately may result in premature mortality. There is little consensus as to which of the 3 treatment options available - antithyroid drugs (ATD), radioactive iodine (RAI) and surgery, is better.

Aims: (i) To assess factors involved in treatment choice and treatment satisfaction in patients treated for Graves' disease; (ii) To assess quality of life (QoL) following treatment of Graves' disease.

Increased Admissions Due to Cardiac Complications of Thyrotoxicosis in Māori.

Background: As thyrotoxicosis is a risk factor for atrial fibrillation, current guidelines recommend measuring a thyroid-stimulating hormone level in patients with this disorder. Hyperthyroidism may also be associated with other heart diseases including cardiac ischaemia and cardiac failure. Currently, the prevalence of thyrotoxicosis in cardiac admissions in the absence of a rhythm disorder is unknown.

Rates of unsuspected thyroid cancer in multinodular thyroid disease.

Background: Previously the risk of concomitant thyroid cancer in multinodular goitre (MNG) has been reported as approximately 4%. Cancer risk in toxic MNG was often considered lower than for non-toxic MNG, due to a possible protective effect of TSH suppression. However, recent American data suggest an approximately 18% risk of occult malignancy in both toxic and non-toxic MNG.

Response to Radioiodine Therapy for Thyrotoxicosis: Disparate Outcomes for an Indigenous Population.

Despite 70 years of experience treating thyrotoxic patients with radioiodine not all patients are successfully treated by a single dose. Multiple factors predicting radioiodine efficacy have been reported. The aim of this study was to assess whether ethnicity was associated with radioiodine response.