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Background: Health disparity and under-utilization of health services is prevalent among Asian refugees and migrants in Western countries and can profoundly impact health outcomes. Cambodians who survived extreme physical and emotional trauma during the genocides enacted by the Khmer Rouge regime in the 1970's are particularly vulnerable to poor mental health outcomes decades later. Understanding the experiences of help-seeking and service use by displaced Cambodians in Western countries may help to design more effective and culturally safe healthcare services. Aims: To identify characteristics or factors associated with help seeking behaviours and service utilization of displaced Cambodians with mental health issues living in Western countries. Methods: This review followed the Arksey & O'Malley methodological framework for scoping reviews. Articles for review were identified through searches of nine electronic databases and manual searches. Relevant articles were selected, and data was extracted and synthesized into key themes. Results: This review included 15 articles. Most of the studies were conducted in the USA (n = 13) with one each conducted in Canada and New Zealand. Seven studies used qualitative interviews, five used a cross-sectional survey approach, two used a mixed-methods approach and one was a narrative review and case series. Key findings highlighted the impact of Cambodian cultural beliefs about mental health (guilt, shame and help-seeking stigma) on service utilization and the disconnect between Western models of service provision and preferred Cambodian ways of receiving support. Conclusion: Mental health services in Western countries are likely to be under-utilized by Cambodians due to a mismatch between health beliefs and Western models of care. Further investigation of the association between health beliefs and barriers to service utilization among adult Cambodian refugees is warranted. [ABSTRACT FROM AUTHOR]

Background: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning.Methods: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines.Results: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females).Conclusion: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning. [ABSTRACT FROM AUTHOR]

As an extension of recent results in generalized stable population theory, in this paper a new method for estimating age-specific transition rates for population sub-groups is developed, based on data from two successive demographic surveys. Simple modifications allow the method to work when the data are tabulated in irregular age groups and when the surveys are taken at irregular intervals. A test of the method based on detailed data on smoking behaviour from the 1976 and 1981 censuses of New Zealand shows that the method works well, even when the data are aggregated into a small number of irregular age groups. [ABSTRACT FROM AUTHOR]

Purpose: Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood. Methods: We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child–adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors. Results: Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child–adult social isolation. Conclusion: Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes. [ABSTRACT FROM AUTHOR]

Background: Burn injuries are a common subtype of trauma. Variation in models of care impacts clinical measures of interest, but a nation‐wide examination of these measures has not been undertaken. Using data from the Burns Registry of Australia and New Zealand (BRANZ), we explored variation between Australian adult burn services with respect to treatment and clinical measures of interest. Methods: Data for admissions July 2016 to June 2020 were extracted. Clinical measures of interest included intensive care admission, skin grafting, in‐hospital death, unplanned readmissions, and length of stay (LOS). Estimated probabilities, means, and corresponding 95% confidence intervals (CI) were calculated for each service. Results: The BRANZ recorded 8365 admissions during the study period. Variation between specialist burn services in admissions, demographics, management, and clinical measures of interest were observed. This variation remained after accounting for covariates. Specifically, the adjusted proportion (95% CI) of in‐hospital mortality ranged from 0.15% (0.10–0.21%) to 1.22% (0.9–1.5%). The adjusted mean LOS ranged from 3.8 (3.3–4.3) to 8.2 (6.7–9.7) days. Conclusions: A decade after its launch, BRANZ data displays variation between Australian specialist burn services. We suspect differences in models of care between services contributes to this variation. Ongoing research has begun to explore reasons underlying how this variation influences clinical measures of interest. Further engagement with services about models of care will enhance understanding of this variation and develop evidence‐based guidelines for burn care in Australia. [ABSTRACT FROM AUTHOR]

Abstract: Like many OECD countries New Zealand has experienced a large increase in the number of working-age people receiving incapacity benefits in the last 3 decades, despite apparent improvements in population health. This paper examines trends in mortality rates of people receiving sickness benefit or invalid’s benefit (SBIB) between 1981 and 2004 using repeated cohort studies (linking the 1981, 1986, 1991, 1996, and 2001 censuses to mortality data). Mortality rates, standardised for age and ethnicity, were calculated for each census cohort for 25–64 year olds by benefit receipt status. Standardised rate differences and rate ratios and 95% confidence intervals were calculated to measure disparities on both absolute and relative scales. Between 1981 and 2004 overall SBIB receipt increased from 2% to 5% of the working age population. Mortality rates were at least three times higher in the SBIB than the non-SBIB group at all points in time for men and women. Mortality rates declined in all groups, for example in men receiving SBIB, mortality decreased from 2354/100 000 in the 1981–84 cohort to 1371/100 000 in the 2001–04 cohort. Absolute inequalities between SBIB and non-SBIB declined in both men and women (for example in women standardised rate differences decreased from 954/100 000 to 688/100 000) but relative inequalities remained largely stable (for example in men the risk ratio increased from 4.27 to 4.54). Mortality rates declined more in sickness benefit than invalid’s benefit recipients. The substantial expansion of SBIB receipt in New Zealand has not been accompanied by any reduction in the excess mortality risk experienced by SBIB recipients. These findings are likely to reflect the changing nature of the economy, labour force and disability experience in New Zealand. [Copyright &y& Elsevier]

Objective: To estimate the 12 month prevalence of DSM-IV disorders in New Zealand, and associated interference with life and severity. Method: A nationally representative face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper the outcomes reported are 12 month prevalence, interference with life and severity for individual disorders. Results: The prevalence of any disorder in the past 12 months was 20.7%. The prevalences for disorder groups were: anxiety disorders 14.8%, mood disorders 7.9%, substance use disorders 3.5%, eating disorders 0.5%. The highest prevalences for individual disorders were for specific phobia (7.3%), major depressive disorder (5.7%) and social phobia (5.1%). Interference with life was higher for mood disorders than for anxiety disorders. Drug dependence, bipolar disorder and dysthymia had the highest proportion of severe cases (over 50%), when severity was assessed over the disorder itself and all comorbid disorders. Overall, only 31.7% of cases were classified as mild with 45.6% moderate and 22.7% serious. Conclusions: Compared with other World Mental Health survey sites New Zealand has relatively high prevalences, although almost always a little lower than for the US. For all disorders, except specific phobia, interference with life was reported to be moderate, on average, which has lead to less than a third of cases being classified as mild. Most people who have ever met full DSM-IV criteria, including the impairment criterion, and who experience symptoms or an episode in the past 12 months find that their disorders impact on their lives to a non-trivial extent. [ABSTRACT FROM AUTHOR]

Objective: To estimate the lifetime prevalence and projected lifetime risk at age 75 years of DSM-IV disorders in New Zealand. Method: A nationwide face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0), was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are lifetime prevalence and projected lifetime risk at age 75 years. Results: The lifetime prevalence of any disorder was 39.5%. The lifetime prevalences for disorder groups were: anxiety disorders, 24.9%; mood disorders, 20.2%; substance use disorders, 12.3%; and eating disorders, 1.7%. The prevalences for all disorders were higher in the younger age groups. Females had higher prevalences of anxiety, mood and eating disorders compared with males; males had higher prevalences of substance use disorders. The estimated projected lifetime risk of any disorder at age 75 years was 46.6% with the median age of onset being 18 years. Adjustment for age, sex, education and household income did not remove all differences between Māori and the composite other ethnic group in the risk of disorder (hazard ratio = 1.1–1.4). After adjustment, hazard ratios for Pacific people ranged from 0.8 to 2.5. Conclusions: These results confirm those of other studies: mental disorders are relatively common and tend to have early onset. Females are more likely to experience anxiety, mood and eating disorders than males, who experience more substance use disorders. Adjustment for socioeconomic factors and demography does not explain all ethnic differences, although remaining differences are small relative to cohort and even sex differences. [ABSTRACT FROM AUTHOR]

Objective: To estimate the 12 month and lifetime use of health services for mental health problems. Method: A nationwide face-to-face household survey carried out in 2003–2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. Results: Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. Conclusions: A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries. [ABSTRACT FROM AUTHOR]

Socioeconomic status is a known determinant of health. In secondary data analyses, we assessed whether socioeconomic status affected health-related quality of life in a group of overweight (body mass index 25-30 kg/m2) middle-aged (45.9 ± 5.4 years) men, recruited in Auckland (New Zealand). Health-related quality of life was assessed with SF-36v2 three times: at baseline, and 12 and 30 weeks later. Socioeconomic status was determined by geo-coded deprivation scores derived from current address using the New Zealand Index of Deprivation 2006 (NZDep2006), as well as capital value of residence. Univariable and multivariable analyses showed no associations between measures of socioeconomic status and any mental or physical health domains. Our findings may reflect the fact that these men are not currently experiencing comorbidities associated with overweight. [ABSTRACT FROM AUTHOR]

BackgroundThere is limited information on long-term outcomes of adolescent depression. This study examines the associations between severity of depression in adolescence and a broad array of adult functional outcomes.MethodData were gathered as part of the Christchurch Health and Development Study, a 35-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand in 1977. Severity of depression at age 14–16 years was classified into three levels according to DSM symptom criteria for major depression (no depression/sub-threshold symptoms/major depression). This classification was related to adult functional outcomes assessed at ages 30 and 35 years using a generalized estimating equation modeling approach. Outcome measures spanned domains of mental disorder, education/economic circumstances, family circumstances and partner relationships.ResultsThere were modest but statistically significant bivariate associations between adolescent depression severity and most outcomes. After covariate adjustment there remained weak but significant (p < 0.05) associations with rates of major depression, anxiety disorder, illicit substance abuse/dependence, any mental health problem and intimate partner violence (IPV) victimization. Estimates of attributable risk for these outcomes ranged from 3.8% to 7.8%. For two outcomes there were significant (p < 0.006) gender interactions such that depression severity was significantly related to increased rates of unplanned pregnancy and IPV victimization for females but not for males.ConclusionsThe findings reinforce the importance of the individual/family context in which adolescent depression occurs. When contextual factors and probable maturational effects are taken into account the direct effects of adolescent depression on functioning in mature adulthood appear to be very modest. [ABSTRACT FROM PUBLISHER]

Background: This study aims to investigate the association between diabetes and periodontitis in the New Zealand (NZ) adult population. Methods: Data from two NZ national surveys (N = 2,048) were analyzed to compare estimates of the strength of the association between diabetes and periodontitis using two multivariate epidemiologic approaches (cohort and matched case-control studies). This was possible because the first survey provided participants for the second survey. Periodontitis cases were identified using 14 case definitions, including six severe definitions. The cohort study identified those with diabetes in 2006/07 and those with periodontitis in 2009 to determine the patients with diabetes odds of having periodontitis, using logistic regression modeling (adjusting for smoking status, sociodemo-graphic, and dental characteristics). The matched case-control study identified cases of severe periodontitis in 2009 and compared their 2006/07 diabetic status with that of controls (individually matched on age group, sex, and socioeconomic status). Conditional logistic regression modeling was used for the case-control study, adjusting for ethnicity, smoking status, and dental characteristics. Results: Overall, 3.6% of the periodontally examined adults reported having diabetes. There was no sex difference in diabetes prevalence, but it was greater in older age groups. Depending on the definition of periodontitis used, there were different estimates of risk for periodontitis, with odds ratios ranging from 1.91 (P= 0.01) to 3.51 (P = 0.22) using the cohort study approach. Diabetes was associated with a greater risk of having periodontitis using only two of the 14 periodontitis case definitions. No association was observed using the matched case-control study. Conclusions: The diabetes-periodontitis association in the NZ population remains unclear. This study demonstrates that the determination of the strength of a putative association is method dependent. [ABSTRACT FROM AUTHOR]

Aim: The availability of high-quality, validated food frequency questionnaires is useful for the conduct of robust population dietary iron-related research. This review aimed to evaluate the validation quality of recently validated food frequency questionnaires that measure iron intakes in Australian or New Zealand adults. Methods: Articles validating food frequency questionnaires that measured iron intakes in Australian or New Zealand adults, published from 1995, were sourced from a range of databases using standard search terms. Eligible validation studies were assessed for validation quality using recommendations from international reviews of food frequency questionnaire validation studies, and a quality score was calculated. Results: Nine studies validating food frequency questionnaires were located. Seven of the nine studies had achieved at least an acceptable quality validation score. More than half of the international validation recommendations were met in at least half of the eligible studies. Studies generally did not report or consider nutrient supplementation, did not validate the food frequency questionnaire against a biomarker, nor measured survey repeatability. Conclusions: The majority of food frequency questionnaire validation studies had achieved at least an acceptable quality validation score; however, some food frequency questionnaires had undergone a higher quality validation process than others. Applying the international validation recommendations to future validation studies may improve the quality of the food frequency questionnaire validation process and, potentially, population dietary iron-related research. [ABSTRACT FROM AUTHOR]

The article discusses a study on the identification of sedentary behavior and accelerometer nonwear time in a sample of adult university employees from Auckland, New Zealand. It mentions that paired t tests were used to identify differences between actual sedentary time and derived sedentary time. It shows that a threshold of 180 consecutive zero minutes and a one-minute allowance preceding or following the bout generated the most accurate assessment of accelerometer nonwear time.

Background: The burden of severe injury is an important health statistic. When accurate injury data are linked to census population data a reference dataset can be obtained. This information is vital to direct injury prevention and trauma system development. Methods: Severe injury was defined as death or injury severity score more than 15. Resident population projections for the Auckland region (2004) were provided by New Zealand Statistics. Combining data from coronial autopsy and four hospital trauma databases provided age, sex, mechanism, mortality and hospitalization information for severely injured Aucklanders. Mechanism groupings were both blunt, penetrating or burn; and activity based (motor vehicle related (occupant and pedestrian), falls, hanging, assault, burns, sports, playing, aircraft, boating and work related). Results: Four hundred and forty-eight Auckland residents had severe injuries of which 192 died. The mortality and severe injury rates (includes mortality) were 14.4/100 000 and 33.6/100 000, respectively. Groups that were overrepresented in the population were male sex, those aged 15–29, those aged >75. Injury rate was lowest in those aged 0–14 years. Injury causes were motor vehicle related (50%), falls (19%), hangings (15%), assault (11%) and other: burns, work related, sports, playing, aircraft and boating related (5%) and 3.8% of cases were from penetrating mechanism. Hangings, road traffic crashes, assaults and falls had at-scene mortality rates of 100, 26, 25 and 6% and inpatient mortality rates of 0, 11, 4 and 17%, respectively ( P < 0.05). Conclusion: Auckland has a severe injury rate that is lower than other similar studies. Contributing factors include: low interpersonal violence rates, the predominantly urban population, the data source and the inclusion of the paediatric age group. [ABSTRACT FROM AUTHOR]