Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Material Well-Being, Oral Health and Affordability of Dental Care in Late-Middle-Aged New Zealanders(Gerodontology Association and John Wiley and Sons Ltd, 2025-10-03) Nordin N; Thomson WM; Broadbent JM; Smith MB; Gibson RBackground: Little is known about oral health among New Zealanders in late middle age. Planning for the needs of older people should be informed by adequate information on the oral health and dental service use of those who will be entering old age. Accordingly, we investigated material well-being-related inequalities in self-reported oral health, self-care and dental care affordability among late-middle-aged New Zealanders. Method: This study was based on an analysis of data from the New Zealand Health, Work, and Retirement (HWR) 2016 study focused on its 6th biennial wave (2016–2018). There were 1952 participants (58% female) aged 55–64 years. Key dependent variables were self-reported oral health, chewing ability and the perceived affordability of dental care. The exposure variable of interest was material well-being, controlling for other socio-economic status (SES) measures (household income and educational qualifications). Cross-tabulations and logistic regression estimated the associations between financial and material well-being and the oral-health-related variables. Results: Approximately 90% of participants had retained at least one natural tooth, and over half had more than 20 teeth remaining (functional dentition). Approximately 70% reported having good oral health. There were consistent gradients in self-rated oral health and dentition status by education level, household income and material well-being, with higher proportions among those who were better off. Just under one third of participants (30%) reported experiencing issues with dental care affordability. Material well-being showed the strongest associations with the abovementioned aspects of oral health and access to dental care than the other SES measures. Conclusion: The findings provide important evidence of the association between material well-being in oral health and access to dental care.Item 'I'm doomed!': audience responses to media reporting on the link between sleep and Alzheimer's disease(Oxford University Press, 2025-07-01) Breheny M; Ross I; Gibson RThe media are influential in shaping beliefs and attitudes towards health practices and behaviours, and the science of sleep is often disseminated through online news media. This paper explores audience responses to media reporting on the link between disrupted sleep and Alzheimer’s disease. The news article analysed was based on a scientific publication reporting on the link between sleep disruption and Alzheimer’s disease and the institutional press release about that publication. The online news article and the 536 Facebook comments posted in response were analysed using thematic analysis. Although the scientific article and institutional press release were guarded about the implications of the research for human health, the media article used sensationalist reporting on the impact of a single night’s sleep disruption to emphasize the everyday implications of the findings. Audience members who identified as sleeping poorly responded fatalistically, whereas commentors who identified as sleeping well were reassured by the news article. The sensationalist framing provoked an affective response in audience members, which at times led to disbelief in the specific message or questioning of scientific research. Sensationalist media reporting of science has unintended consequences. Attempts to engage audiences with science communication that is simplistic and personal may encourage readers to reject scientific evidence as logically incoherent. This approach discounts the ability of audiences to weigh evidence and accept complexity.Item Sensationalising Sleep: Perspectives and Protocols for Understanding Discourses of Sleep Health in Aotearoa New Zealand(John Wiley and Sons Australia, Ltd on behalf of Australian Health Promotion Association, 2025-07) Gibson RSufficient sleep is a basic right, vital for functioning and wellbeing. Socioecological disparities in sleep status are increasingly highlighted. However, broader social and cultural factors, including beliefs and practicalities of sleep, are seldom considered. This is particularly important for bicultural countries such as Aotearoa New Zealand, where mainstream discourses and health promotion have been colonised. Media provides a platform for shaping beliefs and attitudes concerning sleep. Media messaging contributes to definitions of 'normal sleep' and sensationalised messages around sleep(lessness) and disease-seldom accounting for nuanced differences across the lifespan or Indigenous knowledge and practises concerning sleep and wellbeing. How messages concerning sleep are delivered, interpreted, and resisted varies and warrants exploring-particularly among populations predisposed to sleep disturbances. This paper provides a narrative review of the social and cultural factors influencing sleep and highlights the paucity of research in this space. Responding to these gaps, a current research agenda is presented concerning sleep-related discourses and practises in Aotearoa New Zealand. This includes explorations of media representations of sleep, key audience interpretations, and the development of a theoretical framework to inform appropriate sleep-related research and health promotion relevant to contemporary Aotearoa New Zealand and beyond.Item Public Health.(2024-12) Röhr S; Gibson R; Alpass FBACKGROUND: High purpose in life - the extent of engagement in activities that are personally valued and give a sense of direction and meaning to life - has been associated with higher cognitive functioning and may protect against dementia. Less is known about gender differences in cognitive functioning regarding purpose in life. Understanding gender-specific links can inform tailored interventions aimed at promoting cognitive health. METHOD: A subsample (n = 875, aged 50-85 years) of the NZHWR study completed face-to-face cognitive assessments and postal surveys in 2012. Cognitive functioning was assessed with Addenbrooke's Cognitive Examination-Revised (ACE-R), adapted for culturally acceptable use in New Zealand. Purpose in life was measured with the Life Engagement Test. Linear regression analysis assessed associations of gender, purpose in life and their interaction with cognitive functioning, controlling for socioeconomic factors (age, age², education, ethnicity [Māori, Indigenous people of New Zealand, and Non-Māori, mostly of European descent], marital status, employment, individual-level economic hardship, area-based socioeconomic deprivation), lifestyle and health factors (smoking, alcohol consumption, physical activity, SF-12 physical and mental health, social engagement, social loneliness). RESULT: The analytical sample (n = 643) was M = 65.3 (SD = 7.4) years old; 53.3% women, 21.2% Māori. The ACE-R score was M = 92.9 (SD = 5.3). N = 55 (8.5%) scored ≥1.5SD below the mean, indicating cognitive impairment. Women had higher cognitive functioning (M = 93.7, SD = 4.6 vs. M = 92.0, SD = 5.8; Z = -3.88, p<.001) and purpose in life (M = 26.2, SD = 3.8 vs. M = 25.8, SD = 3.4; Z = -2.19, p = .029) than men. In the adjusted regression analysis (R² = 27.6%), higher purpose in life (B = 0.29, 95%CI = 0.12;0.46; p = .001) and female gender (B = 9.97, 95%CI = 4.71;15.24, p<.001) were associated with higher cognitive functioning. The association of purpose in life with cognitive functioning was less pronounced for women than men (B = -0.31, 95%CI = -0.51;-0.11; p = .003) (Fig. 1). Significant covariates included age², education, deprivation, and social loneliness. CONCLUSION: In this sample of older New Zealanders, a gender difference in cognitive functioning varied by level of purpose in life. Women had higher cognitive functioning than men, particularly at lower purpose in life, with the difference decreasing as purpose in life increases. Interventions to enhance purpose in life might particularly benefit men. Notably, cognitive functioning may also impact purpose in life, emphasising the need for longitudinal studies.Item Area-based socioeconomic deprivation is associated with cognitive decline in midlife to early late-life New Zealanders without cognitive impairment(Wiley Periodicals LLC on behalf of Alzheimer's Association, 2025-01-09) Röhr S; Gibson R; Alpass FBackground Research identified individual-level socioeconomic factors as key determinants of cognitive health. This study investigated the effect of area-based socioeconomic deprivation on cognitive outcomes in midlife to early late-life New Zealanders without cognitive impairment. Understanding geographical dimensions of socioeconomic determinants of cognitive health is important from an equity perspective. Method Data stemmed from a subsample of the New Zealand Health, Work and Retirement Study, a cohort study on ageing. In 2010, 1,001 participants aged 49-84 years completed face-to-face interviews and were reassessed two years later. Cognitive functioning was measured using Addenbrooke’s Cognitive Examination–Revised, adapted for culturally acceptable use in New Zealand. Area-based socioeconomic deprivation was assessed using the New Zealand Deprivation Index (NZDep2006). Linear mixed-effects models analysed the association between area-based socioeconomic deprivation and cognitive outcomes, controlling for individual-level socioeconomic (age, age², gender, education, ethnicity [Māori, Indigenous people of New Zealand, and Non-Māori, mostly of European descent], marital status, employment, net personal income), lifestyle and health variables (Lifestyle for Brain Health/LIBRA index, social loneliness). Result The analysis included 783 participants (54.7% female, mean age 62.7 years, 25.0% Māori). Individuals with cognitive impairment at baseline (n = 69) and older than 75 years were excluded (n = 79). Further attrition was due to missing data. At baseline, 39.7% resided in low deprivation areas, 39.0% in moderate, and 21.3% in high deprivation areas. The unadjusted model indicated a significant association between higher area-based socioeconomic deprivation and lower cognitive functioning (B = -0.16, 95%CI: -0.22,-0.10; p < .001) and cognitive decline (B = -0.12, 95%CI: -0.21;-0.03; p = .015). The adjusted model yielded similar results for cognitive functioning (B = -0.08, 95%CI: -0.15;-0.01; p = .050) and cognitive decline (B = -0.12, 95%CI: -0.20;-0.04, p = .013) (Fig. 1). Influential covariates included gender, education, and lifestyle (LIBRA). Conclusion This study demonstrated a relationship between higher area-based socioeconomic deprivation and lower cognitive functioning, along with cognitive decline, in cognitively unimpaired New Zealanders aged 48 to 75 years. These findings emphasize the importance of considering neighbourhood characteristics and broader socioeconomic factors in strategies aimed at mitigating cognitive health disparities and reducing the impact of dementia in disadvantaged communities.Item Multi-modal sleep intervention for community-dwelling people living with dementia and primary caregiver dyads with sleep disturbance: protocol of a single-arm feasibility trial(PeerJ Inc., 2023-01-01) Verma S; Varma P; Brown A; Bei B; Gibson R; Valenta T; Pietsch A; Cavuoto M; Woodward M; McCurry S; Jackson ML; Keogh JBackground. Disturbed sleep is common among people living with dementia and their informal caregivers, and is associated with negative health outcomes. Dyadic, multi-modal interventions targeting caregiver and care-recipient sleep have been recommended yet remain limited. This protocol details the development of a singlearm feasibility trial of a multi-modal, therapist-led, six-week intervention targeting sleep disturbance in dyads of people living with dementia and their primary caregiver. Methods. We aim to recruit 24 co-residing, community-dwelling dyads of people living with dementia and their primary informal caregiver (n D 48) with sleep concerns (Pittsburgh Sleep Quality Index ≥5 for caregivers, and caregiver-endorsed sleep concerns for the person living with dementia). People who live in residential care settings, are employed in night shift work, or are diagnosed with current, severe mental health conditions or narcolepsy, will be excluded. Participants will wear an actigraph and complete sleep diaries for two weeks prior, and during the last two weeks, of active intervention. The intervention is therapist-led and includes a mix of weekly small group video sessions and personalised, dyadic sessions (up to 90 min each) over six weeks. Sessions are supported by a 37-page workbook offering strategies and spaces for reflections/notes. Primary feasibility outcomes are caregiver: session attendance, attrition, and self-reported project satisfaction. Secondary outcomes include dyadic self-reported and objectively-assessed sleep, depression and anxiety symptoms, quality of life, and social support. Self-report outcomes will be assessed at pre- and postintervention. Discussion. If feasible, this intervention could be tested in a larger randomised controlled trial to investigate its efficacy, and, upon further testing, may potentially represent a non-pharmacological approach to reduce sleep disturbance among people living with dementia and their caregivers.Item Māori perspectives on sleep and aging(Frontiers Media S.A., 2024-06-05) Gibson R; Lowe H; Korohina E; Rolleston A; Sharkey KIntroduction: Sleep is vital for health in older adulthood. Ethnic disparities have been noted with regards to sleep health. However, culturally appropriate approaches to sleep as a broader social experience are lacking. Methods: Here, sleep-related group interviews were conducted in the form of hui (group meetings and discussions) with eleven participants of a health service intervention for older Māori (the Indigenous people of New Zealand) and their whānau (extended family). Notes were collated and analyzed thematically. Results: Four key themes were constructed that represent the key conversations and ideas. These concerned the conceptualizing of sleep—including appreciation for its somatic role but also the spiritual properties of sleep states; the changing obligations around sleep and wake—including individual and communal time use and changing cultural and familial obligations with advancing age; and the barriers and facilitators for supporting sleep—including the social and spiritual nature of communal sleeping, the schedules and sleep of others, as well as holistic and environmental methods for relaxation. Findings demonstrate the multifaceted nature of sleep and aging among Māori. Culturally relevant interpretations of sleep practices and disturbances were offered and are beyond typical Western models which are predominantly medicalized. Discussion: This work aids the understanding and representation of sleep as a social and cultural perspective within the New Zealand context. This provides foundations for future participatory research to design culturally appropriate approaches to assessing and supporting sleep health in forms that are meaningful for aging well across cultures.Item Changes in indicators of well-being on moving from home to long-term care for Māori in Aotearoa New Zealand: A retrospective cohort study(John Wiley & Sons Australia, Ltd on behalf of AJA Inc., 2024-08-12) Hikaka J; Abey-Nesbit R; Wu Z; Jamieson HA; Parsons M; Kerse N; Gibson ROBJECTIVE: To investigate changes in well-being measures for older Māori after moving from community to long-term care (LTC). METHODS: We undertook a retrospective cohort study of older Māori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later. Odds ratios (OR) and 95% confidence interval (CI) were calculated to determine the difference in proportion of variables of interest (indicative of movement, socialising, sleep and nutrition, alongside general physical and mental health status) between participants' HC and subsequent LTCF assessments. RESULTS: Changes in well-being measures were investigated among 1531 Māori (mean age 76.2 years, 61% female). Odds of having a fall (OR: 0.40 [95% CI 0.34, 0.48]), being lonely (OR: 0.13 [95% CI 0.09, 0.18]), sleeping difficulty (OR: 0.74 [95% CI 0.60, 0.91]) and fatigue (OR: 0.18 [95% CI 0.14, 0.23]) reduced on moving to LTC. However, the presence of depression (OR 3.96 [95% CI 2.58, 6.09]) and dependence with locomotion (OR 1.56 [95% CI 1.23, 1.97]) significantly increased when moving from home to LTC. CONCLUSION: Despite some indicators of functional and health-related decline, significant improvements are also apparent across multiple domains of well-being. Further investigation of resident and family perceptions of well-being in association with a move to LTC is warranted.Item Kei te moe te tinana, kei te oho te wairua–As the body sleeps, the spirit awakens: exploring the spiritual experiences of contemporary Māori associated with sleep(Informa UK Limited, trading as Taylor & Francis Group, 2024-08-13) Haami D; Gibson R; Lindsay N; Tassell-Matamua NFor Aotearoa New Zealand Māori, sleep and wairua (spirit) are closely intertwined. During sleep the wairua awakens and journeys across multiple dimensions of time and space to attain the tools and knowledge the individual needs to navigate waking life. While this function of sleep is understood within Mātauranga Māori (bodies of knowledge regarding everything within the universe) (Hikuroa D. 2017. Mātauranga Māori—the ūkaipō of knowledge in New Zealand. Journal of the Royal Society of New Zealand. 47(1):5–10.), it has yet to be explored within psychological sleep research. This qualitative study contributes to addressing this gap by exploring nine Māori participants’ personal experiences of wairua during sleep. A whakapapa thematic analysis identified two interconnected layers. The first layer contributed to a spiritual explanatory framework for sleep, developed to encompass participants’ beliefs regarding wairua, which were utilised to interpret their sleep experiences. The second layer describes these interpretations, comprised of three central themes: (1) Tohu/Guidance; (2) Ako/Space and time for learning; and (3) Tau/Attaining a state of stability, peace, and purpose. These findings suggest that the spiritual experience of sleep supported participants in navigating their waking lives safely, purposefully, and meaningfully, contributing to Indigenous and Māori scholarship regarding the spiritual and cultural purpose of sleep, and with important implications for clinical, social, and academic approaches to understanding and supporting sleep.Item Trauma or Transcendence? The Relationship Between Near-Death Experiences and Dreaming(American Psychological Association, 2024-08-01) Lindsay N; Tassell-Matamua N; O'Sullivan L; Gibson RNear-death experiences (NDEs) are exceptional states of consciousness reported by many individuals who come close to death. Unusual dream phenomena such as more intense and vivid dreams, higher dream recall, and increased lucid dreaming have been purported to occur after NDEs, however, a comprehensive assessment of the dream experiences and attitudes of NDE survivors remains unexplored. Moreover, it remains unknown whether anomalous dream experiences stem from the actual NDE or the traumatic experience of coming close to death. In this study, 138 NDE survivors, 45 participants who experienced a life-threatening event but without NDE, and 129 participants who had never come close to death completed a quantitative questionnaire assessing trauma symptoms and a range of dream-related variables. The NDE group reported significantly more lucid dreams, creative and problem-solving dreams, precognitive dreams, and out-of-body experiences during sleep than both other groups of participants. Furthermore, these experiences appeared to be primarily related to the NDE rather than trauma symptomology. Findings continue to suggest a relationship between nonordinary states and expanded awareness more broadly—whether experienced during sleep or wakefulness—offering further insights into the phenomenon of consciousness in general.
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