School of Public Health and Interdisciplinary Studies
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The School of Public Health and Interdisciplinary Studies research institutes and centres play an important role in specialist teaching and research conducted by academic staff and postgraduate students. This places AUT students at the forefront of much of the ground-breaking research undertaken in New Zealand in the field of Biostatistics and Epidemiology, Psychology, Psychotherapy and Counselling, and Public Health.
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- ItemWhat Do Health Care Professionals Want To Know About Assisted Dying? Setting the Research Agenda in New Zealand(Springer Science and Business Media LLC, 2023-04-10) Young, Jessica; Snelling, Jeanne; Beaumont, Sophie; Diesfeld, Kate; White, Ben; Willmott, Lindy; Robinson, Jacqualine; Ahuriri-Driscoll, Annabel; Cheung, Gary; Dehkhoda, Aida; Egan, Richard; Jap, James; Karaka-Clarke, Te Hurinui; Manson, Leanne; McLaren, Cam; Winters, JanineBackground New Zealand recently introduced law permitting terminally ill people to request and receive assisted dying (AD) in specified circumstances. Given the nature and complexity of this new health service, research is vital to determine how AD is operating in practice. Objective To identify research priorities regarding the implementation and delivery of AD in New Zealand. Methods Using an adapted research prioritisation methodology, the researchers identified 15 potential AD research topics. A mixed-methods survey of health professionals was undertaken where respondents were asked to rate the 15 topics according to the relative importance for research to be conducted on each issue. Respondents could also suggest additional research areas, and were invited to participate in a follow-up interview. Results One hundred and nineteen respondents completed the survey. 31% had some experience with AD. The highest rated research topic was the ‘effectiveness of safeguards in the Act to protect people’; the lowest rated topic was research into the ‘experiences of non-provider (e.g., administrative, cleaning) staff where assisted dying is being provided’. Respondents suggested 49 other research topics. Twenty-six interviews were conducted. Thematic analysis of interview data and open-ended survey questions was undertaken. Six research themes were identified: general factors related to the wider health system; the experiences of health care providers at the bedside; medico-legal issues; the impact of AD; experiences on the day of dying; and the overall effectiveness of the AD system. Key issues for stakeholders included safety of the AD service; ensuring access to AD; achieving equity for ‘structurally disadvantaged’ groups; and ensuring the well-being of patients, families/whānau, providers and non-providers. Conclusions Based on early experiences of the implementation of the AD service, health professionals provide important insights into what research should be prioritised post-legalisation of AD. These findings can be used to shape the research agenda so that research may inform law, policy and best practice.
- ItemRoadmap for an Imaging and Modelling Paediatric Study in Rural NZ(Frontiers Media SA, 2023-03-10) Kumar, H; Green, R; Cornfeld, DM; Condron, P; Emsden, T; Elsayed, A; Zhao, D; Gilbert, K; Nash, MP; Clark, AR; Tawhai, MH; Burrowes, K; Murphy, R; Tayebi, M; McGeown, J; Kwon, E; Shim, V; Wang, A; Choisne, J; Carman, L; Besier, T; Handsfield, G; Babarenda Gamage, TP; Shen, J; Maso Talou, G; Safaei, S; Maller, JJ; Taylor, D; Potter, L; Holdsworth, SJ; Wilson, GAOur study methodology is motivated from three disparate needs: one, imaging studies have existed in silo and study organs but not across organ systems; two, there are gaps in our understanding of paediatric structure and function; three, lack of representative data in New Zealand. Our research aims to address these issues in part, through the combination of magnetic resonance imaging, advanced image processing algorithms and computational modelling. Our study demonstrated the need to take an organ-system approach and scan multiple organs on the same child. We have pilot tested an imaging protocol to be minimally disruptive to the children and demonstrated state-of-the-art image processing and personalized computational models using the imaging data. Our imaging protocol spans brain, lungs, heart, muscle, bones, abdominal and vascular systems. Our initial set of results demonstrated child-specific measurements on one dataset. This work is novel and interesting as we have run multiple computational physiology workflows to generate personalized computational models. Our proposed work is the first step towards achieving the integration of imaging and modelling improving our understanding of the human body in paediatric health and disease.
- ItemRespiratory Health of Pacific Youth: Nutrition Resilience and Risk in Childhood(MDPI, 2023-03-23) Zhai, Siwei; Vandal, Alain C; Jalili-Moghaddam, Shabnam; Byrnes, Catherine A; Wong, Conroy; Iusitini, Leon; Tautolo, El-ShadanIn New Zealand, 7% of deaths are related to respiratory diseases, and Pacific people are at higher risk. This work investigated the causal effects of early-life nutritional factors on early-adulthood lung function among Pacific Islands Families Study cohort members, who consist of the 1398 individuals born from Pacific Island families in Middlemore Hospital between March and December 2000.A total of 466 people from the cohort participated in the respiratory study. The primary outcome was the forced expiratory volume in 1 s (FEV1) z-score at age 18 years. FEV1 and healthy lung function (HLF), defined as the z-score being larger than −1.64, were secondary outcomes. Nutrition and other information were previously collected in 4 measurement waves at ages 4, 6, 9, and 14 years. Food portions consumed daily were totaled within each of the 12 food categories at each measurement wave. Exploratory and multi-group confirmatory factor analyses identified 4 eating patterns represented by nutritional factor scores (NFS), identified as “Occasional”, “Seafood”, “Fruit and vegetables”, and “Meat”. The NFS were scaled to portions per day. Confounders were identified using a causal-directed acyclical graph. Semi-parametric linear and relative risk regression models were fitted to estimate the causal effects of NFS on respiratory outcomes, using estimated weights compensating for attrition-induced selection bias. The population-attributable fractions of HLF for each NFS were estimated for each measurement wave. HLF cohort prevalence was estimated at 90% (95% confidence interval [CI] [0.86, 1.00]), lower than the expected 95%. Only the “Fruit and vegetables” eating pattern at 9 years was found to have a statistically significant causal effect on the FEV1 z-score in early adulthood (change in FEV1 z-score: +0.25, 95%CI [0.00, 0.43]). The proportion of HLF attributable to the “Fruit and vegetables” eating pattern at 9 years was estimated at 11% (95%CI [0.00, 0.19]). Results suggest a positive impact of consuming more fruit and vegetables during childhood on respiratory health later in life. There is a need to support healthier food environments for Pacific children and provide access to healthier food choices.
- ItemOnline but Disconnected: Student Connectedness in Online Remote Learning in Higher Education in New Zealand(2023-04-01) Brown, StephenNew Zealand university students in the online learning environment may have feelings of disconnectedness, isolation, and suffer a lack of personal attention. Perhaps these universities are at a junction, where they can choose to offer students immersion into a virtual learning environment devoid of a physical presence, or a pathway which nurtures students’ learning in a hands-on, face-to-face, physical space. Understanding student online connectedness, or their sense of belonging with the online virtual learning environment, may help navigate a path through this junction as the emergence of online remote learning becomes commonplace in New Zealand. This article suggests that universities should foster a virtual place of learning by developing an online social presence and promote open communication between faculty and students, and between students and their peers. Students are more likely to value online courses that foster a high degree of connectedness, and they are more likely to complete these courses. In this article, online student connectedness is defined and tools to measure it are described. Strategies to promote student connectedness in the online learning environment are suggested, for example, comprising social media and social networking sites which facilitate communication and increase social presence.
- ItemNational Cross-Sectional Study of the Sociodemographic Characteristics of Aotearoa New Zealand’s Regulated Health Workforce Pre-Registration Students: A Mirror on Society?(BMJ, 2023-03-13) Crampton, P; Bagg, W; Bristowe, Z; Brunton, P; Curtis, E; Hendry, C; Kool, B; Scarf, D; Shaw, S; Tukuitonga, C; Williman, J; Wilson, DObjectives To provide a sociodemographic profile of students enrolled in their first year of a health professional pre-registration programme offered within New Zealand (NZ) tertiary institutions. Design Observational, cross-sectional study. Data were sought from NZ tertiary education institutions for all eligible students accepted into the first ar of a health professional programme for the 5-year period 2016-2020 inclusive. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. Analyses were carried out using the R statistics software. Setting Aotearoa NZ. Participants All students (domestic and international) accepted into the first ar of a health professional programme leading to registration under the Health Practitioners Competence Assurance Act 2003. Results NZ's health workforce pre-registration students do not reflect the diverse communities they will serve in several important dimensions. There is a systematic under-representation of students who identify as Māori and Pacific, and students who come from low socioeconomic and rural backgrounds. The enrolment rate for Māori students is about 99 per 100 000 eligible population and for some Pacific ethnic groups is lower still, compared with 152 per 100 000 for NZ European students. The unadjusted rate ratio for enrolment for both Māori students and Pacific students versus Other' students is approximately 0.7. Conclusions We recommend that: (1) there should be a nationally coordinated system for collecting and reporting on the sociodemographic characteristics of the health workforce pre-registration; (2) mechanisms be developed to allow the agencies that fund tertiary education to base their funding decisions directly on the projected health workforce needs of the health system and (3) tertiary education funding decisions be based on Te Tiriti o Waitangi (the foundational constitutional agreement between the Indigenous people, Māori and the British Crown signed in 1840) and have a strong pro-equity focus.