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Rethinking and establishing a dental collaboration in the Pacific region 重新思考并在太平洋地区建立牙科合作
Pub Date : 2018-09-29 DOI: 10.26635/PHD.2018.921
Leroy Tatui, J. McCool, V. Nosa
In the Pacific Island countries and territories (PICTs) challenge of limited human resource capacity and a corresponding low investment in maintaining access to high quality, accessible health services.2 We argue here that there are significant opportunities to build effective connectivity among the oral health sectors for the benefit of the PICTS. These will necessarily involve: building upon existing networks, sharing human and technology resources and growing leadership with the oral health sector to continue to advocate for oral health as a population health priority.
在太平洋岛屿国家和地区(PICTs),人力资源能力有限,在保持获得高质量、可获得的医疗服务方面的投资相对较低,这是一个挑战。2我们在这里认为,为了PICTs的利益,在口腔卫生部门之间建立有效连接有着重要的机会。这必然涉及:在现有网络的基础上,共享人力和技术资源,并与口腔卫生部门加强领导,继续倡导将口腔卫生作为人口健康的优先事项。
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引用次数: 0
Health literacy of Pacific mothers in New Zealand is associated with sociodemographic and non-communicable disease risk factors: surveys, focus groups and interviews. 新西兰太平洋地区母亲的卫生知识普及与社会人口和非传染性疾病风险因素有关:调查、焦点小组和访谈。
Pub Date : 2018-09-29 DOI: 10.26635/phd.2018.914
Losi Sa'ulilo, E. Tautolo, V. Egli, Melody Smith
Abstract Introduction: Pacific people living in New Zealand, suffer from inequitably high rates of non-communicable diseases and their associated risk factors. This disease burden may be compounded by low health literacy levels. The objectives of this research were: (1) measure relationships between health literacy, socio-demographic factors and non-communicable disease risk factors in a large sample of Pacific mothers living in New Zealand and (2) gain in-depth understanding of social and cultural factors contributing to these relationships. Methods: Logistic regression was employed to investigate health literacy and: acculturation, socioeconomic status, physical activity, education, smoking status, health status, and alcohol consumption. Semi-structured focus groups were conducted with Pacific mothers and interviews with Pacific health professionals adopting the culturally appropriate talanoa, and kakala methods, within the Fonofale framework. Findings: Associations between low health literacy and age, ethnicity, acculturation, employment, education, smoking status, and alcohol status were shown. Novel findings from the focus groups were: the use and comprehension of health information and what constitutes preferred information and health service delivery modes. Conclusions: Findings suggest current health related information is not being used to its fullest extent by Pacific mothers. This may be due to underlying socio-demographic factors. This is the first study to examine the factors related to health literacy among Pacific mothers in NZ. Findings should be used to inform future interventions and delivery of public health nutrition messages.
摘要简介:生活在新西兰的太平洋人患有非传染性疾病及其相关风险因素的不公平高比例。这种疾病负担可能因卫生知识普及水平低而加剧。这项研究的目标是:(1)在新西兰生活的太平洋母亲的大样本中衡量健康素养、社会人口因素和非传染性疾病风险因素之间的关系;(2)深入了解促成这些关系的社会和文化因素。方法:采用Logistic回归调查健康素养、文化适应、社会经济状况、体育活动、教育程度、吸烟状况、健康状况和饮酒情况。在Fonofale框架内,采用文化上适当的talanoa和kakala方法,对太平洋地区的母亲进行了半结构化焦点小组讨论,并对太平洋地区的保健专业人员进行了访谈。发现:低健康素养与年龄、种族、文化适应、就业、教育、吸烟状况和酒精状况之间存在关联。焦点小组的新发现是:卫生信息的使用和理解以及什么是首选信息和卫生服务提供模式。结论:研究结果表明,太平洋地区的母亲没有充分利用目前的健康相关信息。这可能是由于潜在的社会人口因素。这是第一个调查新西兰太平洋地区母亲健康素养相关因素的研究。调查结果应用于为未来的干预措施和提供公共卫生营养信息提供信息。
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引用次数: 6
A Short history of the post-graduate surgical training in Fiji - where to from here? 斐济研究生外科培训简史-从这里到哪里?
Pub Date : 2018-09-29 DOI: 10.26635/PHD.2018.918
J. Cama, S. Nagra
Post-graduate surgical training at the Fiji National University (FNU), previously known as the Fiji School of Medicine) has recently been updated by incorporating elements from the Royal Australasian College of Surgeons (RACS) training curriculum. The revised curriculum maintains strong contextual relevance to the needs and pathologies of the Pacific Island nations.  This paper outlines why the FNU surgical postgraduate training programme should be applauded as a successful programme in the training of surgeons for the region.
斐济国立大学(FNU)(前身为斐济医学院)的研究生外科培训最近进行了更新,纳入了澳大利亚皇家外科学院(RACS)培训课程的元素。修订后的课程与太平洋岛屿国家的需要和状况保持着强烈的背景相关性。本文概述了为什么民族力量外科研究生培训方案应被视为该地区外科医生培训的成功方案。
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引用次数: 1
The impact of living with type 2 diabetes: a descriptive qualitative case study with four Pacific participants 2型糖尿病患者的影响:一项有四名太平洋地区参与者的描述性定性案例研究
Pub Date : 2018-09-29 DOI: 10.26635/phd.2018.915
Darlene Pupi, T. Sullivan, K. Coppell
Introduction: Diabetes is a common among Pacific peoples. The personal cost of diabetes is substantial with the indirect costs shown to outweigh the direct costs in some instances.  The aim of this case study was to identify and describe the personal cost to four Pacific people living with type 2 diabetes in New Zealand. Methods: Two Pacific men and two Pacific women with type 2 diabetes were recruited with the assistance of the Pacific Island Centre and the Pacific Research Student Support Unit, University of Otago, Dunedin, New Zealand. The participants were interviewed (three in Samoan and one in English) using an open question approach. Appropriate cultural protocols were observed, and interviews were audio-recorded and transcribed. Samoan interviews were translated into English. A thematic analysis was undertaken using an inductive approach. Findings: Participants’ ages ranged from the mid-30s to 75 years. The two retired participants had difficulty paying their prescription fees and three participants considered healthy food expensive. Other costs included time off work and family members moving towns to take care of participants and their diabetes. Pacific community members provided time, gifts and money at times when participants were less well. At the same time, participants considered they had a role in educating their community about diabetes prevention. A diagnosis of diabetes triggered healthful lifestyle changes for one participant. Conclusions: The personal cost associated with diabetes is broad and complex, with particular implications for roles and responsibilities among Pacific communities.
糖尿病是太平洋地区人民的常见病。糖尿病的个人成本是巨大的,在某些情况下,间接成本超过了直接成本。本案例研究的目的是确定并描述新西兰四名太平洋地区2型糖尿病患者的个人成本。方法:在新西兰达尼丁奥塔哥大学太平洋岛屿中心和太平洋研究学生支持单位的协助下,招募了两名患有2型糖尿病的太平洋男性和两名太平洋女性。与会者接受了开放式问题方式的访谈(三人用萨摩亚语,一人用英语)。遵守了适当的文化规程,并对采访进行了录音和转录。萨摩亚的采访被翻译成英语。采用归纳方法进行了专题分析。研究发现:参与者的年龄从35岁到75岁不等。两名退休的参与者难以支付处方费用,三名参与者认为健康食品很贵。其他费用包括休假和家庭成员搬到城镇照顾参与者和他们的糖尿病。太平洋社区成员在参与者身体状况不佳时提供时间、礼物和金钱。与此同时,参与者认为他们在教育社区预防糖尿病方面发挥了作用。糖尿病的诊断促使一名参与者改变了健康的生活方式。结论:与糖尿病相关的个人成本是广泛而复杂的,对太平洋社区的角色和责任具有特别的影响。
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引用次数: 0
Mental health and wellbeing of Pacific students starting University in New Zealand 在新西兰开办大学的太平洋学生的心理健康和幸福感
Pub Date : 2018-09-29 DOI: 10.26635/PHD.2018.916
F. Sopoaga, J. Meer, S. Nada-Raja, T. Wilkinson, Sarah Jutel
Introduction Aim : To explore the mental health and factors that impact on the wellbeing of Pacific students in their first year at University. Methods : Twenty Pacific students who enrolled to study in the Health Sciences First Year at a University in New Zealand in 2015 were randomly selected to participate in this research. Participants were interviewed three times during their first year at University. The Pacific research methodology Talanoa was used for the data collection process. Of the 60 planned interviews, 59 were able to be completed. Interviews were recorded, transcribed and uploaded to NVivo to assist data management. Data was analysed using a thematic approach. Results Pacific students reported on their experiences of various stresses during the year. Some stress was related to their own personal expectations and others due to expectations of others. Students experienced a range of emotions and symptoms in response to these stresses. Many had developed skills or effective management strategies to deal with these stresses. For many, resilience contributed to maintaining wellbeing. In addition, families, friends, peers, mentors, supportive staff and targeted Pacific support services played critical roles in supporting the mental health and wellbeing of Pacific students in the first year at University. Conclusion There is increasing concern worldwide about students’ mental health and wellbeing in higher education. Pacific students felt stressed for many reasons which affected their mental health in the first year at University. Their resilience and other coping skills and connecting to a wide support network enabled them to maintain wellness. Pacific students or those from minority groups are likely to require different and or more support to enable them to adapt to the higher education environment. Strengthening and facilitating access to support networks and culturally relevant services, and increasing connectedness and sense of belonging, are important for Pacific students’ mental health and wellbeing in the tertiary environment.  
前言目的:探讨太平洋大学新生的心理健康状况及其影响因素。方法:随机抽取20名2015年在新西兰某大学健康科学一年级学习的太平洋学生参与本研究。参与者在大学第一年接受了三次面试。数据收集过程使用了太平洋研究方法Talanoa。在计划的60次面谈中,有59次能够完成。访谈被记录、转录并上传到NVivo,以协助数据管理。数据采用专题方法进行分析。结果太平洋大学的学生报告了他们在这一年中所经历的各种压力。一些压力与他们自己的个人期望有关,而另一些压力则与他人的期望有关。面对这些压力,学生们经历了一系列的情绪和症状。许多人已经掌握了应对这些压力的技能或有效的管理策略。对许多人来说,适应力有助于维持幸福感。此外,家庭、朋友、同辈、导师、支持性工作人员和有针对性的太平洋支助服务在支持太平洋大学一年级学生的心理健康和福祉方面发挥了关键作用。结论:高等教育中学生的心理健康和幸福受到越来越多的关注。太平洋大学的学生在大学一年级的时候因为很多原因感到压力,这些原因影响了他们的心理健康。他们的适应力和其他应对技能以及与广泛支持网络的联系使他们能够保持健康。太平洋地区的学生或来自少数群体的学生可能需要不同的或更多的支持,以使他们能够适应高等教育环境。加强和便利获得支持网络和与文化相关的服务,增强联系和归属感,对太平洋地区学生在高等教育环境中的心理健康和福祉至关重要。
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引用次数: 2
Identifying and overcoming barriers to healthier lives 确定和克服妨碍健康生活的障碍
Pub Date : 2018-09-29 DOI: 10.26635/PHD.2018.913
Riz Firestone, Tevita Funaki, S. Dalhousie, Akarere Henry, M. Vano, J. Grey, A. Jull, R. Whittaker, L. T. Te Morenga, C. N. Mhurchu
Understanding the key determinants of health from a community perspective is essential to address and improve the health and wellbeing of its members.  This qualitative study aimed to explore and better understand New Zealand-based Pasifika communities’ sociocultural experiences and knowledge of health and wellbeing. Fifty-seven participants were involved in six separate focus groups. Community coordinators co-facilitated and transcribed the discussions and conducted thematic analysis. The findings suggested two overarching themes: (1) ‘Pasifika experiences on poor health and well-being’: were based on sub-themes: (i) ‘recognisable issues’ (e.g., poor diet and lifestyle behaviours); (ii) ‘systemic issues’ that support the perpetual health issues (e.g., lack of knowledge and education) and; (iii) ‘profound issues’ that are often unspoken of and create long-term barriers (e.g., cultural lifestyle and responsibilities).  (2) ‘Hopes and dreams’ to improve health and well-being requires: (i) a family-centric approach to health; (ii) tackling systemic barriers; and (iii) addressing community social justice issues.  This study provides deepened insights on Pasifika communities’ understanding healthier living in the context of their cultural environment and family responsibilities. If we are to develop effective, sustainable programmes that prioritises health and well-being based on the needs of Pasifika communities, the findings from this study highlight their needs as step forward in overcoming barriers to healthier lives.
从社区角度了解健康的主要决定因素对于解决和改善其成员的健康和福祉至关重要。本定性研究旨在探索和更好地了解新西兰帕西菲卡社区的社会文化经验和健康与福祉知识。57名参与者参与了六个独立的焦点小组。社区协调员共同促进和记录讨论,并进行专题分析。调查结果提出了两个总体主题:(1)"关于不良健康和福祉的Pasifika经验":基于次级主题:(i) "可识别的问题"(例如,不良饮食和生活方式行为);㈡支持永久性健康问题的"系统性问题"(例如,缺乏知识和教育);(iii)通常未被提及并造成长期障碍的“深刻问题”(例如,文化生活方式和责任)。(2)改善健康和福祉的"希望和梦想"需要:(i)以家庭为中心的保健办法;(ii)解决体制障碍;(三)解决社区社会正义问题。这项研究加深了对帕西菲卡社区在其文化环境和家庭责任背景下对健康生活的理解。如果我们要根据帕西菲卡社区的需要制定有效的、可持续的方案,优先考虑健康和福祉,那么这项研究的结果突出表明,他们的需要是克服健康生活障碍的一步。
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引用次数: 8
Cytisine as an alternative smoking cessation product for Pacific smokers in New Zealand Cytisine作为新西兰太平洋地区吸烟者的替代戒烟产品
Pub Date : 2018-09-29 DOI: 10.26635/phd.2018.919
V. Nosa, Kotalo Leau, Natalie Walker
ABSTRACT Introduction: Pacific people in New Zealand have one of the highest rates of smoking.  Cytisine is a plant-based alkaloid that has proven efficacy, effectiveness and safety compared to a placebo and nicotine replacement therapy (NRT) for smoking cessation.  Cytisine, like varenicline, is a partial agonist of nicotinic acetylcholine receptors, and blocks the rewarding effects of nicotine. Cytisine is naturally found in some plants in the Pacific region, and so may appeal to Pacific smokers wanting to quit. This paper investigates the acceptability of cytisine as a smoking cessation product for Pacific smokers in New Zealand, using a qualitative study design. Methods: In December 2015, advertisements and snowball sampling was used to recruit four Pacific smokers and three Pacific smoking cessation specialists in Auckland, New Zealand. Semi-structured interviews where undertaken, whereby participants were asked about motivations to quit and their views on smoking cessation products, including cytisine (which is currently unavailable in New Zealand). Interviews were recorded and transcribed verbatim, with thematic analysis conducted manually. Findings: Pacific smokers reported wanting to quit for loved ones and family, but did not find currently available smoking cessation products effective. Almost all participants had not previously heard of cytisine, but many of the Pacific smokers were keen to try it. Participants identified with cytisine on a cultural basis (given its natural status), but noted that their use would be determined by the efficacy of the medicine, its cost, side-effects, and accessibility. They were particularly interested in cytisine being made available in liquid form, which could be added to a “smoothie” or drunk as a “traditional tea”.  Participants thought cytisine should be promoted in a culturally-appropriate way, with packaging and advertising designed to appeal to Pacific smokers. Conclusions: Cytisine is more acceptable to Pacific smokers than other smoking cessation products, because of their cultural practices of traditional medicine and the natural product status of cytisine.
摘要简介:新西兰是太平洋地区吸烟率最高的国家之一。Cytisine是一种植物生物碱,与安慰剂和尼古丁替代疗法(NRT)相比,已被证明具有戒烟的疗效、有效性和安全性。Cytisine和varenicline一样,是烟碱乙酰胆碱受体的部分激动剂,可以阻断尼古丁的奖励作用。Cytisine天然存在于太平洋地区的一些植物中,因此可能会吸引想要戒烟的太平洋吸烟者。本文采用定性研究设计,调查了胞嘧啶作为新西兰太平洋吸烟者戒烟产品的可接受性。方法:2015年12月,在新西兰奥克兰,采用广告和雪球抽样的方法招募了四名太平洋吸烟者和三名太平洋戒烟专家。进行半结构化访谈,询问参与者戒烟的动机以及他们对戒烟产品的看法,包括胞苷(目前在新西兰没有)。访谈被逐字记录和转录,并由人工进行专题分析。调查结果:太平洋地区的吸烟者报告说,他们想为亲人和家人戒烟,但没有发现目前可用的戒烟产品有效。几乎所有参与者以前都没有听说过胞苷,但许多太平洋地区的吸烟者都热衷于尝试它。参与者在文化基础上(鉴于其自然状态)认同胞苷,但指出其使用将取决于药物的疗效、成本、副作用和可及性。他们对以液体形式提供胞嘧啶特别感兴趣,胞嘧啶可以添加到“奶昔”中,也可以作为“传统茶”饮用。参与者认为应该以符合文化的方式推广胞嘧啶,包装和广告旨在吸引太平洋地区的吸烟者。结论:Cytisine比其他戒烟产品更容易被太平洋吸烟者接受,这是因为他们的传统医学文化实践和Cytisine的天然产物地位。
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引用次数: 0
The Health Impacts of Climate Change 气候变化对健康的影响
Pub Date : 2018-09-28 DOI: 10.26635/PHD.2018.920
C. Tukuitonga
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引用次数: 8
Climate change – transitions, tipping points and typhoons 气候变化——转变、临界点和台风
Pub Date : 2018-09-16 DOI: 10.26635/PHD.2018.912
A. Woodward
As I write Hurricane Florence is approaching the east coast of the US. Here is a storm out of the ordinary. It is most uncommon for such a powerful hurricane to reach so far north. The projected rainfall (up to 1.2 meters) is unprecedented. The tidal surge, which may be as high as 5.5 metres, has been experienced only twice since 1851. On no other occasion has a hurricane combined all these features.1
就在我写这篇文章的时候,飓风佛罗伦萨正在逼近美国东海岸。这是一场不同寻常的风暴。如此强大的飓风到达如此遥远的北方是非常罕见的。预计降雨量(高达1.2米)是前所未有的。自1851年以来,潮涌可能高达5.5米,只经历过两次。在其他任何情况下,飓风都没有将所有这些特征结合在一起。1
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引用次数: 0
Traditional Medicine Use in the Dunedin Pacific Community in New Zealand 新西兰达尼丁太平洋社区的传统医学使用
Pub Date : 2018-02-27 DOI: 10.26635/PHD.2018.903
E. Wilson, Ben Grant, Rosa Tobin-Stickings, H. Lewthwaite, G. Franklin, Sarah Oh, Simon Guan, Thomas Borowsky, K. Thwaites, Timothy Leaper, Jun Lee, J. Susan, F. Sopoaga
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引用次数: 1
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Pacific health dialog
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