Projected increases in the prevalence of diabetes mellitus in Aotearoa New Zealand, 2020-2044.

Background: The prevalence of diabetes has been increasing in Aotearoa New Zealand by approximately 7% per year, and is three times higher among Māori and Pacific peoples than in Europeans. The depth of the diabetes epidemic, and the expansive breadth of services required for its management, elevate the need for high-quality evidence on the projected future burden of this complex disease.

Methods: In this manuscript we have projected the prevalence of diabetes (type 1 and type 2 combined) out to 2040-2044 using age-period-cohort modelling.

Support for and likely impacts of endgame measures in the Smokefree Aotearoa Action Plan: findings from the 2020-2021 International Tobacco Control New Zealand (EASE) surveys.

Aim: In February 2024, the Aotearoa New Zealand Government repealed legislation to mandate very low nicotine cigarettes (VLNCs), greatly reduce the number of tobacco retailers and disallow sale of tobacco products to people born after 2008 (smokefree generation). We investigated acceptability and likely impacts of these measures among people who smoke or who recently (≤2 years) quit smoking.

Method: We analysed data from 1,230 participants from Wave 3 (conducted in late 2020 and early 2021) and 615 participants from Wave 3.

Ethnic Inequity in the Current Approach to H. pylori Testing and Treatment: Linked Data Cohort Analysis.

Background: As seen globally, there are up to sixfold differences in gastric cancer mortality by ethnicity in Aotearoa New Zealand, and H. pylori is the major modifiable risk factor. This study investigates whether current H.

Co-occurrence of cancer and diabetes in a high-income country: Age-period-cohort projections 2020-2044.

Background: Cancer and diabetes are increasingly prevalent, and it is not unusual for an individual to have both conditions at the same time. This occurrence has significant ramifications to the person, the clinical team providing care, and the broader health system.

Research Design And Methods: For the period 2006-2019, we used national-level diabetes (Virtual Diabetes Register) and cancer (New Zealand Cancer Registry) data on nearly five million individuals over 44 million person-years of follow-up.

Primary care experience in people with mental health conditions: results from a national patient experience survey.

Aim: The study explored whether the reported experience of primary healthcare differs for survey respondents in Aotearoa New Zealand who self-report having a mental health (MH) condition in comparison with those who do not.

Method: Responses to the New Zealand Health Quality & Safety Commission's adult primary care patient experience survey received from August 2020 to May 2022 were analysed. Comparative analysis of patient-reported experience measures were completed to contrast experiences reported by those with and without a MH condition, with results stratified by ethnicity (Māori/non-Māori), age group and gender.

Equity of access to pathological diagnosis and bronchoscopy for lung cancer in Aotearoa New Zealand.

Background: Māori are less likely to survive their lung cancer once diagnosed, but it remains unclear whether this is partially driven by poorer access to best-practice diagnostic services.

Methods: We examined all lung cancer registrations in Aotearoa New Zealand between 2007-2019 (n=27,869) linked to national administrative health datasets and further stratified by ethnicity, tumour type and stage of disease. Using descriptive and regression analyses, we compared ethnic groups in terms of the basis of diagnosis (e.

UK Foot and Ankle Thromboembolism (UK-FATE).

Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture.

Inequity in cardiometabolic hospital admissions and blood screening in New Zealand Indigenous Māori with psychosis.

Background: People with psychosis experience worse cardiometabolic health than the same-aged general population. In New Zealand, Indigenous Māori experiencing psychosis have greater risk of cardiometabolic and other physical health problems.

Aims: To identify a cohort of adults accessing secondary mental health and addiction services in New Zealand, with a previous psychosis diagnosis as of 1 January 2018, and compare odds of hospital admission outcomes, mortality and receipt of cardiometabolic blood screening between Māori and non-Māori in the following 2 years.

The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study.

Background: People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis.

Objective: Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis.

Racism and Health Among Aotearoa New Zealand Young People Aged 15-24 years: Analysis of Multiple National Surveys.

Purpose: This Aotearoa New Zealand-based study addresses a gap in literature focusing on individual experiences of racism among adolescents and young adults and its links to health.

Methods: This cross-sectional study uses data from multiple instances of the New Zealand Health Survey (2002/03, 2006/07, 2011/12, 2016/17) and General Social Survey (2008-2016) restricted to participants aged 15-24 years. Prevalence of reported experiences of racism are estimated.

Almost one in five emergency department presentations are by mental health clients: a secondary data analysis.

Aim: Mental health-related emergency department (ED) presentations are steadily increasing, including presentations for both mental health and non-mental health concerns by existing clients of mental health services. The study aim was to examine and compare mental health clients and non-clients' ED presentations, identify data and clinical gaps and make recommendations for improvement.

Method: De-identified 2017/2018 ED data were used to describe presentations for current and recent (within last 5 years) clients of specialist public mental health and addiction services, compared to presentations of non-mental health clients.

Cancer diagnosis after emergency presentations in people with mental health and substance use conditions: a national cohort study.

Background: Cancer survival and mortality outcomes for people with mental health and substance use conditions (MHSUC) are worse than for people without MHSUC, which may be partly explained by poorer access to timely and appropriate healthcare, from screening and diagnosis through to treatment and follow-up. Access and quality of healthcare can be evaluated by comparing the proportion of people who receive a cancer diagnosis following an acute or emergency hospital admission (emergency presentation) across different population groups: those diagnosed with cancer following an emergency presentation have lower survival.

Methods: National mental health service use datasets (2002-2018) were linked to national cancer registry and hospitalisation data (2006-2018), to create a study population of people aged 15 years and older with one of four cancer diagnoses: lung, prostate, breast and colorectal.

Tailored Prompting to Improve Adherence to Image-Based Dietary Assessment: Mixed Methods Study.

Background: Accurately assessing an individual's diet is vital in the management of personal nutrition and in the study of the effect of diet on health. Despite its importance, the tools available for dietary assessment remain either too imprecise, expensive, or burdensome for clinical or research use. Image-based methods offer a potential new tool to improve the reliability and accessibility of dietary assessment.

Does diabetes affect breast cancer survival?

Objectives: The objective of this study is to investigate the influence of diabetes on breast cancer-specific survival among women with breast cancer in Aotearoa/New Zealand.

Methods: This study included women diagnosed with invasive breast cancer between 2005 and 2020, with their information documented in the Te Rēhita Mate Ūtaetae-Breast Cancer Foundation National Register. Breast cancer survival curves for women with diabetes and those without diabetes were generated using the Kaplan-Meier method.

Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand.

Purpose: Centralisation of lung cancer treatment can improve outcomes, but may result in differential access to care for those who do not reside within treatment centres.

Methods: We used national-level cancer registration and health care access data and used Geographic Information Systems (GIS) methods to determine the distance and time to access first relevant surgery and first radiation therapy among all New Zealanders diagnosed with lung cancer (2007-2019; N = 27,869), and compared these outcomes between ethnic groups. We also explored the likelihood of being treated at a high-, medium-, or low-volume hospital.

Access to and Timeliness of Lung Cancer Surgery, Radiation Therapy, and Systemic Therapy in New Zealand: A Universal Health Care Context.

Purpose: Lung cancer is the biggest cancer killer of indigenous peoples worldwide, including Māori people in New Zealand. There is some evidence of disparities in access to lung cancer treatment between Māori and non-Māori patients, but an examination of the depth and breadth of these disparities is needed. Here, we use national-level data to examine disparities in access to surgery, radiation therapy and systemic therapy between Māori and European patients, as well as timing of treatment relative to diagnosis.

The growing cancer burden: Age-period-cohort projections in Aotearoa New Zealand 2020-2044.

Background: Cancer is a major cause of premature death and inequity, and global case numbers are rapidly expanding. This study projects future cancer numbers and incidence rates in Aotearoa New Zealand.

Methods: Age-period-cohort modelling was applied to 25-years of national data to project cancer cases and incidence trends from 2020 to 2044.

The impact of racism on subsequent healthcare use and experiences for adult New Zealanders: a prospective cohort study.

Background: Racism is an important determinant of health and driver of racial/ethnic health inequities. Experience of racism has been linked to negative healthcare use and experiences although most studies have been cross-sectional. This study examines the relationship between reported experience of racism and subsequent use and experience of health services.

Addressing Intergenerational Inequity in Tobacco-Harm: What Helps Children of Smokers to Remain Nonsmokers?

Introduction: Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken.

Aims And Methods: This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14-15 years) who had at least one caregiver who smoked.

Support for and potential impacts of key Smokefree 2025 strategies among Māori who smoke.

Aim: The recently passed Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act has the potential to profoundly reduce smoking prevalence and related health inequities experienced among Māori. This study examined support for, and potential impacts of, key measures included within the legislation.

Method: Data came from Wave 1 (2017-2019) of the Te Ara Auahi Kore longitudinal study, which was conducted in partnership with five primary health organisations serving Māori communities.

Watching the watchers: assessing the nature and extent of children's screen time using wearable cameras.

Aim: Children's screen use has increased rapidly in recent years, yet little is known about this use in real-time due to reliance on self-report or proxy data sources. Screens provide benefits such as educational content and social connection, but also pose health risks including obesity, depression, poor sleep and poor cognitive performance. In this cross-sectional observational study, we aimed to determine the nature and extent of children's after-school screen time using wearable cameras.

Systematic Review of Models of Effective Community Specialist Palliative Care Services for Evidence of Improved Patient-Related Outcomes, Equity, Integration, and Health Service Utilization.

The benefits of palliative care programs are well documented. However, the effectiveness of specialist palliative care services is not well established. The previous lack of consensus on criteria for defining and characterizing models of care has restrained direct comparison between these models and limited the evidence base to inform policy makers.

Controlled Hookworm Infection for Medication-free Maintenance in Patients with Ulcerative Colitis: A Pilot, Double-blind, Randomized Control Trial.

Background: Human hookworm has been proposed as a treatment for ulcerative colitis (UC). This pilot study assessed the feasibility of a full-scale randomized control trial examining hookworm to maintain clinical remission in patients with UC.

Methods: Twenty patients with UC in disease remission (Simple Clinical Colitis Activity Index [SCCAI] ≤4 and fecal calprotectin (fCal) <100 ug/g) and only on 5-aminosalicylate received 30 hookworm larvae or placebo.