Indigenous Suicide in New Zealand

This article describes patterns of suicide and attempted suicide among the indigenous (Ma ̄ori) population of New Zealand using official data from the New Zealand Health Information Service (NZHIS). The majority of Ma ̄ori suicides (75%) occurr in young people aged \u3c35 years. Rates of suicide are higher among Ma ̄ori males and females aged \u3c25 than in their non-Ma ̄ori peers. Rates of hospitalization for attempted suicides are higher amongst Ma ̄ori males aged 15–24, compared to non-Ma ̄ori. In contrast, suicide is virtually unknown amongst older Ma ̄ori (60 years). This article reviews explanations for the observed rates of suicide in Ma ̄ori, and examines approaches to effective intervention to reduce rates of suicide in young Ma ̄ori

Connected Women: How Mobile Can Support Women's Economic and Social Empowerment

This report explores how mobile services provided by Vodafone and the Vodafone Foundation are enabling women to seize new opportunities and improve their lives. Accenture Sustainability Services were commissioned to conduct research on the services and to assess their potential social and economic impact if they were widely available across Vodafone's markets by 2020. It showcases the projects and the work of those involved and also poses the question -- what would the benefit to women and to society at large be if projects such as these were taken to scale and achieved an industrialscale of growth? This reflects the Foundation's commitment not solely to the development of pilots but rather the Trustees' ambition to see projects which lead to transformational change. In order to understand this more deeply, the Report looks at the benefits for women and society and providessome financial modelling for how the engagement of commercial players could achieve industrial, sustainable growth in these areas. Accenture has provided the modelling and, given the public benefit and understanding which the report seeks to generate, these are shared openly for all in the mobile industry to understand and share. It is the Trustees' hope that the collaboration with Oxford University and Accenture in the delivery of this Report will stimulate not only the expansion of existing charitable programmes but will also seed other philanthropic, social enterprise or commercial initiatives

Are antifibrinolytic drugs equivalent in reducing blood loss and transfusion in cardiac surgery? A meta-analysis of randomized head-to-head trials

BACKGROUND: Aprotinin has been shown to be effective in reducing peri-operative blood loss and the need for re-operation due to continued bleeding in cardiac surgery. The lysine analogues tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) are cheaper, but it is not known if they are as effective as aprotinin. METHODS: Studies were identified by searching electronic databases and bibliographies of published articles. Data from head-to-head trials were pooled using a conventional (Cochrane) meta-analytic approach and a Bayesian approach which estimated the posterior probability of TXA and EACA being equivalent to aprotinin; we used as a non-inferiority boundary a 20% increase in the rates of transfusion or re-operation because of bleeding. RESULTS: Peri-operative blood loss was significantly greater with TXA and EACA than with aprotinin: weighted mean differences were 106 mls (95% CI 37 to 227 mls) and 185 mls (95% CI 134 to 235 mls) respectively. The pooled relative risks (RR) of receiving an allogeneic red blood cell (RBC) transfusion with TXA and EACA, compared with aprotinin, were 1.08 (95% CI 0.88 to 1.32) and 1.14 (95% CI 0.84 to 1.55) respectively. The equivalent Bayesian posterior mean relative risks were 1.15 (95% Bayesian Credible Interval [BCI] 0.90 to 1.68) and 1.21 (95% BCI 0.79 to 1.82) respectively. For transfusion, using a 20% non-inferiority boundary, the posterior probabilities of TXA and EACA being non-inferior to aprotinin were 0.82 and 0.76 respectively. For re-operation the Cochrane RR for TXA vs. aprotinin was 0.98 (95% CI 0.51 to 1.88), compared with a posterior mean Bayesian RR of 0.63 (95% BCI 0.16 to 1.46). The posterior probability of TXA being non-inferior to aprotinin was 0.92, but this was sensitive to the inclusion of one small trial. CONCLUSION: The available data are conflicting regarding the equivalence of lysine analogues and aprotinin in reducing peri-operative bleeding, transfusion and the need for re-operation. Decisions are sensitive to the choice of clinical outcome and non-inferiority boundary. The data are an uncertain basis for replacing aprotinin with the cheaper lysine analogues in clinical practice. Progress has been hampered by small trials and failure to study clinically relevant outcomes

Competency, capability and professional identity: the case for advanced practice

In the last 40 years, a series of models and frameworks associated with competency, capability and identity have been advanced in the published literature. These models and frameworks have arisen at a time of fundamental shifts in both the type and nature of work in developed countries, for example shifts associated with changes to labour markets from a reliance on jobs in agriculture and manufacturing (in the industrial era) to a reliance on jobs in both traditional and novel service industries (in the post-industrial and service eras) along with a rise in demand for work which requires non-routine cognitive abilities and attributes. Moreover, an increasing demand for advanced practitioners and leaders in every field of work has led to the advent of the so-called ‘advanced practice professional’, a practitioner who contributes higher order cognitive, affective and conative inputs to organisations and the world of work more generally. These fundamental shifts in work now require practitioners to not only have the competencies and capabilities to perform at a high level, but also require a well-developed sense of professional identity and an ability to contribute, as a discipline leader, in innovative ways to enhance organisational performance and the world of work more generally. This paper explores these propositions. We advocate a model of advanced practice professionalism in relation to competency, capability, and professional identity, and show through two real-world examples how work-based learning and research, as practiced by University of Southern Queensland in its Professional Studies program, contribute to the development of advanced practice professionals in Australia

High-risk antenatal women's perceptions of dietitian appointments and information

Problem: The dietitian service at a metropolitan health service in Queensland, Australia has a non-engagement rate for high-risk antenatal women of 50%. Aim: Determine which attributes are related to non-attendance at dietitian appointments, and women's perceptions and attitudes towards dietitian appointments during pregnancy. Methods: An explanatory mixed-methods design was utilised, with first phase including 103 antenatal women referred to a dietitian in 2021 and compared the attributes of those who attended with those who did not engage. Queensland Health electronic databases were used to collect attribute data, which were then analysed with Jamovi (version 1.6) for descriptive, correlational, multivariate analyses of variance MANOVA. Second phase included seven semi-structured interviews with women attending a dietitian appointment, and subsequently analysed through thematic analysis. Results: Distance from clinic was not related to clinic attendance, and women reported they would attend regardless of distance or work status. Non-attendance was related to higher gravidity, parity, and if referred for obesity, but not previous gastric sleeve or underweight referral. Six themes were identified from the interview data: “Women want to be treated like an individual,” “It's all about expectations,” “Midwives hold the key,” “Preferences in receiving dietary information,” “Weight has been a long-term problem and is a sensitive topic,” and “Barriers to attendance.” Conclusion: Antenatal services can adjust service delivery to improve engagement in weight management services during pregnancy. Telehealth appointments may reduce non-engagement due to distance from clinic. Demystifying the dietitian appointment, ensuring non-judgemental referral processes and collaboration between midwives and dietitians will ensure that women value the service

Suicidal behaviour in adolescence and subsequent mental health outcomes in young adulthood

Background. The aim of this study was to examine the linkages between suicidal ideation and attempt in adolescence and subsequent suicidal behaviours and mental health in young adulthood. Method. Data were gathered during the course of a 25-year longitudinal study of a birth cohort of 1265 New Zealand children. The information collected included: (a) measures of suicidal thoughts and attempts in adolescence (< 18 years); (b) measures of suicidal ideation, suicide attempt, major depression, anxiety disorders, and substance use disorders in young adulthood (18-25 years); and (c) measures of childhood and family background, individual characteristics, and mental disorders in adolescence. Results. After statistical adjustment for confounding factors, suicide attempt in adolescence was associated with increased risks of subsequent suicidal ideation (OR 5.7) suicide attempt (OR 17.8) and major depression (OR 1.5). Those reporting suicidal ideation without suicide attempt showed moderate increases in risks of later suicidal ideation (OR 2.5), suicide attempt (OR 2.0) and major depression (OR 1.6). In addition, there was evidence of an interactive relationship in which suicidal behaviour in adolescence was associated with increased risks of later substance use disorders in females but not males. Conclusions. Young people reporting suicidal ideation or making a suicide attempt are an at-risk population for subsequent suicidal behaviour and depression. Further research is needed into the reasons for suicidal adolescent females being at greater risk of later substance use disorder

Sexual orientation and mental health in a birth cohort of young adults

Background. This paper sought to examine the relationship between sexual orientation and mental health in a New Zealand birth cohort studied to age 25 years. Method. The analysis is based on a sample of 967 participants (469 males; 498 females) in the Christchurch Health and Development Study. As part of this study information was gathered on: (a) measures of sexual orientation, same-sex behaviour and sexual attraction obtained at ages 21 and 25 years; (b) measures of mental disorders and suicidal behaviours over the interval 21-25 years; (c) measures of childhood and family background. Results. Latent class analysis was used to combine indicators of sexual orientation, same sex behaviour and attraction to form an empirically based classification of sexual orientation. The best-fitting model classified the sample into three groups: exclusively heterosexual orientation (87.6%); predominantly heterosexual but with same-sex inclinations or experience (9.6%); predominantly homosexual (2.8%). Proportionately more women than men were classified as predominantly heterosexual (14.2% v. 4.8% respectively) or predominantly homosexual (3.9% v. 1.5% respectively). Cohort members with a predominantly homosexual orientation had rates of mental disorder and suicidal behaviours that were between 1.5 and 12 times higher than for those with an exclusively heterosexual orientation. These associations persisted after adjustment for confounding. The associations between sexual orientation and mental health were more marked for males than females. Conclusions. The findings suggest a continuum of sexual preferences amongst young adults. Variations in sexual orientation were clearly associated with mental health. These associations tended to be stronger for males

Magnetic Properties of Iron(II) Near the ⁵T₂-₁A₁ Crossover

A series of iron(II) complexes which lie near the high spin-low spin crossover (FeL2X2,nH2O, where X is NCS or NCSe and L is a ring-substituted analogue of 1,10-phenanthroline or 2,2′-bipyridyl) have been prepared and their magnetic and spectroscopic properties investigated. Small modifications in the molecules are found to produce starting effects on the properties, and the various members of the series illustrate many kinds of “crossover” behaviour. Some of the complexes have nearly equienergetic high spin and low spin states, both of which are thermally populated while some exhibit complete transitions between the two spin states within very narrow temperature ranges; the behaviour of some of the complexes falls in between these two extremes, while others have temperature independent moments, intermediate between high and low spin values, attributable to a triplet ground state