Browsing by Author "Robertson S"

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    A better start national science challenge: supporting the future wellbeing of our tamariki E tipu, e rea, mō ngā rā o tō ao: grow tender shoot for the days destined for you
    (Taylor and Francis Group, 2023-02-22) Maessen SE; Taylor BJ; Gillon G; Moewaka Barnes H; Firestone R; Taylor RW; Milne B; Hetrick S; Cargo T; McNeill B; Cutfield W; Moton TM; King PT; Dalziel S; Merry S; Robertson S; Day A
    The majority of children and young people in Aotearoa New Zealand (NZ) experience good health and wellbeing, but there are key areas where they compare unfavourably to those in other rich countries. However, current measures of wellbeing are critically limited in their suitability to reflect the dynamic, culture-bound, and subjective nature of the concept of ‘wellbeing’. In particular, there is a lack of measurement in primary school-aged children and in ways that incorporate Māori perspectives on wellbeing. A Better Start National Science Challenge work in the areas of Big Data, Healthy Weight, Resilient Teens, and Successful learning demonstrates how research is increasing our understanding of, and our ability to enhance, wellbeing for NZ children. As we look ahead to the future, opportunities to support the wellbeing of NZ young people will be shaped by how we embrace and mitigate against potential harms of new technologies, and our ability to respond to new challenges that arise due to climate change. In order to avoid increasing inequity in who experiences wellbeing in NZ, wellbeing must be monitored in ways that are culturally acceptable, universal, and recognise what makes children flourish.
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    Asthma inflammatory phenotypes on four continents: most asthma is non-eosinophilic
    (Oxford University Press on behalf of the International Epidemiological Association, 2023-04) Pembrey L; Brooks C; Mpairwe H; Figueiredo CA; Oviedo AY; Chico M; Ali H; Nambuya I; Tumwesige P; Robertson S; Rutter CE; van Veldhoven K; Ring S; Barreto ML; Cooper PJ; Henderson J; Cruz AA; Douwes J; Pearce N; WASP Study Group
    BACKGROUND: Most studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK). METHODS: We conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum. RESULTS: Of 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda. CONCLUSIONS: This is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally.