Indigenous injury outcomes: Life satisfaction among injured Māori in New Zealand three months after injury

Background: Māori, the indigenous population of New Zealand, experience numerous and consistent health disparities when compared to non-Māori. Injury is no exception, yet there is a paucity of published literature that examines outcomes following a wide variety of injury types and severities for this population. This paper aims to identify pre-injury and injury-related predictors of life satisfaction three months after injury for a group of injured Māori. Methods: The Māori sample (n = 566) were all participants in the Prospective Outcomes of Injury Study (POIS). POIS is a longitudinal study of 2856 injured New Zealanders aged 18–64 years who were on an injury entitlement claims’ register with New Zealand’s no-fault compensation insurer. The well-known Te Whare Tapa Whā model of overall health and well-being was used to help inform the selection of post-injury life satisfaction predictor variables. Multivariable analyses were used to examine the relationships between potential predictors and life satisfaction. Results: Of the 566 Māori participants, post-injury life satisfaction data was available for 563 (99%) participants. Of these, 71% reported satisfaction with life three months after injury (compared to 93% pre-injury). Those with a higher injury severity score, not satisfied with pre-injury social relationships or poor self-efficacy pre-injury were less likely to be satisfied with life three months after injury. Conclusions: The large majority of Māori participants reported being satisfied with life three months after injury; however, nearly a third did not. This suggests that further research investigating outcomes after injury for Māori, and predictors of these, is necessary. Results show that healthcare providers could perhaps put greater effort into working alongside injured Māori who have more severe injuries, report poor self-efficacy and were not satisfied with their pre-injury social relationships to ensure increased likelihood of satisfaction with life soon after injury

Indigenous injury outcomes: life satisfaction among injured Maori in New Zealand three months after injury

BACKGROUND: Māori, the indigenous population of New Zealand, experience numerous and consistent health disparities when compared to non-Māori. Injury is no exception, yet there is a paucity of published literature that examines outcomes following a wide variety of injury types and severities for this population. This paper aims to identify pre-injury and injury-related predictors of life satisfaction three months after injury for a group of injured Māori. METHODS: The Māori sample (n = 566) were all participants in the Prospective Outcomes of Injury Study (POIS). POIS is a longitudinal study of 2856 injured New Zealanders aged 18–64 years who were on an injury entitlement claims’ register with New Zealand’s no-fault compensation insurer. The well-known Te Whare Tapa Whā model of overall health and well-being was used to help inform the selection of post-injury life satisfaction predictor variables. Multivariable analyses were used to examine the relationships between potential predictors and life satisfaction. RESULTS: Of the 566 Māori participants, post-injury life satisfaction data was available for 563 (99%) participants. Of these, 71% reported satisfaction with life three months after injury (compared to 93% pre-injury). Those with a higher injury severity score, not satisfied with pre-injury social relationships or poor self-efficacy pre-injury were less likely to be satisfied with life three months after injury. CONCLUSIONS: The large majority of Māori participants reported being satisfied with life three months after injury; however, nearly a third did not. This suggests that further research investigating outcomes after injury for Māori, and predictors of these, is necessary. Results show that healthcare providers could perhaps put greater effort into working alongside injured Māori who have more severe injuries, report poor self-efficacy and were not satisfied with their pre-injury social relationships to ensure increased likelihood of satisfaction with life soon after injury

Environmental stochasticity and density dependence in animal population models

Biological management of populations plays an indispensable role in all areas of population biology. In deciding between possible management options, one of the most important pieces of information required by population managers is the likely population status under possible management actions. Population dynamic models are the basic tool used in deriving this information. These models elucidate the complex processes underlying the population dynamics, and address the possible consequences/merits of management actions. These models are needed to guide the population towards desired/chosen management goals, and therefore allow managers to make informed decisions between alternative management actions. The reliability that can be placed on inferences drawn from a model about the fate of a population is undoubtedly dependent on how realistically the model represents the dynamic process of the population. The realistic representation of population characteristics in models has proved to be somewhat of a thorn in the side of population biologists. This thesis focuses in particular on ways to represent environmental stochasticity and density dependence in population models. Various approaches that are used in building environmental stochasticity into population models are reviewed. The most common approach represents the environmental variation by changes to demographic parameters that are assumed to follow a simple statistical distribution. For this purpose, a distribution is often selected on the basis of expert opinion, previous practice, and convenience. This thesis assesses the effect of this subjective choice of distribution on the model predictions, and develops some objective criteria for that selection based on ecological and statistical acceptability. The more commonly used distributions are compared as to their suitability, and some recommendations are made. Density dependence is usually represented in population models by specifying one or more of the vital rates as a function of population density. For a number of reasons, a population-specific function cannot usually be selected based on data. The thesis develops some ecologically-motivated criteria for identifying possible function(s) that could be used for a given population by matching functional properties to population characteristics when they are known. It also identifies a series of properties that should be present in a general function which could be suitable for modelling a population when relevant population characteristics are unknown. The suitability of functions that are commonly chosen for such purposes is assessed on this basis. I also evaluate the effect of the choice of a function on the resulting population trajectories. The case where the density dependence of one demographic rate is influenced by the density dependence of another is considered in some detail, as in some situations it can be modelled with little information in a relatively function-insensitive way. The findings of this research will help in embedding characteristics of animal populations into population dynamics models more realistically. Even though the findings are presented in the context of slow-growing long-lived animal populations, they are more generally applicable in all areas of biological management

Environmental stochasticity and density dependence in animal population models

Biological management of populations plays an indispensable role in all areas of population biology. In deciding between possible management options, one of the most important pieces of information required by population managers is the likely population status under possible management actions. Population dynamic models are the basic tool used in deriving this information. These models elucidate the complex processes underlying the population dynamics, and address the possible consequences/merits of management actions. These models are needed to guide the population towards desired/chosen management goals, and therefore allow managers to make informed decisions between alternative management actions. The reliability that can be placed on inferences drawn from a model about the fate of a population is undoubtedly dependent on how realistically the model represents the dynamic process of the population. The realistic representation of population characteristics in models has proved to be somewhat of a thorn in the side of population biologists. This thesis focuses in particular on ways to represent environmental stochasticity and density dependence in population models. Various approaches that are used in building environmental stochasticity into population models are reviewed. The most common approach represents the environmental variation by changes to demographic parameters that are assumed to follow a simple statistical distribution. For this purpose, a distribution is often selected on the basis of expert opinion, previous practice, and convenience. This thesis assesses the effect of this subjective choice of distribution on the model predictions, and develops some objective criteria for that selection based on ecological and statistical acceptability. The more commonly used distributions are compared as to their suitability, and some recommendations are made. Density dependence is usually represented in population models by specifying one or more of the vital rates as a function of population density. For a number of reasons, a population-specific function cannot usually be selected based on data. The thesis develops some ecologically-motivated criteria for identifying possible function(s) that could be used for a given population by matching functional properties to population characteristics when they are known. It also identifies a series of properties that should be present in a general function which could be suitable for modelling a population when relevant population characteristics are unknown. The suitability of functions that are commonly chosen for such purposes is assessed on this basis. I also evaluate the effect of the choice of a function on the resulting population trajectories. The case where the density dependence of one demographic rate is influenced by the density dependence of another is considered in some detail, as in some situations it can be modelled with little information in a relatively function-insensitive way. The findings of this research will help in embedding characteristics of animal populations into population dynamics models more realistically. Even though the findings are presented in the context of slow-growing long-lived animal populations, they are more generally applicable in all areas of biological management

Factors influencing trends in trauma-associated orbital cavity reconstruction procedures and time delay: New Zealand national data 2000–2014

Aim Surgical reconstructions of orbital fractures due to trauma are increasing worldwide. This study identifies characteristics of patients facing such procedures, possible causes for increasing trends, and factors associated with the duration from trauma to surgical procedures. Methods Trauma-related orbital reconstruction procedures in New Zealand over a 15-year period were identified from Ministry of Health hospital discharge data. Age-standardised rates for each year and age-specific rates for each gender were calculated using age, sex and year-specific population data from New Zealand population censuses. The contribution of these procedures to total trauma-related maxillofacial procedures was assessed. Descriptive statistics were used to identify demographic, trauma-related, and procedure-related characteristics associated with higher frequency and increasing trends. Characteristics independently associated with time delay from trauma to surgery were identified by multivariable Cox regression modelling. Results Orbital procedures are most common among males and the young to middle aged, and trends in frequency and rates of procedures are sharply increasing outnumbering other types of trauma-related maxillofacial procedures, with interpersonal violence being a major contributor to this increase. Younger age and higher number of injuries are associated with less time delay from injury to procedure while Asian ethnicity, motor vehicle accidents, non-maxillofacial primary diagnoses, and higher number of medical comorbidities are associated with longer delay. Conclusion The first three findings are consistent with international literature, and could be considered by policy makers when deriving preventive measures. The findings related to time delay are new and could contribute information towards forming clinical guidelines if similar patterns were identified elsewhere. </jats:sec

Older Drivers and Their Future Mobility: Views and Involvement of Their Adult Children

In car-dependent societies like New Zealand, getting the right balance between mobility and safety could improve outcomes for older people but will require changes to policy and practice. Driving cessation is a major life transition with many impacts, and adult children are frequently involved in both the transition to non-driving and maintaining mobility afterward. This cross-sectional study ( N = 675) sought perspectives of family members of drivers aged 65 or older enrolled in a longitudinal study. Most (94%) were adult children, two thirds were women, and 19% were moderately to extremely anxious about their parent’s driving. Loss of independence, driving’s role in identity, and reluctance to rely on family were recognized as important barriers to driving cessation. Most (80%) felt that families, as well as older drivers, would be adversely affected by driving cessation. Families identified accessible local information and services, alternative transport, and community-based programs for drivers and families as assistance most needed. </jats:p