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Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries
(Elsevier Ltd, 2023-11-07) Hoteit M; Hoteit R; Aljawaldeh A; Van Royen K; Pabian S; Decorte P; Cuykx I; Teunissen L; De Backer C; Bergheim I; Staltner R; Devine A; Sambell R; Wallace R; Allehdan SS; Alalwan TA; Al-Mannai MA; Ouvrein G; Poels K; Vandebosch H; Maldoy K; Matthys C; Smits T; Vrinten J; DeSmet A; Teughels N; Geuens M; Vermeir I; Proesmans V; Hudders L; De Barcellos MD; Ostermann C; Brock AL; Favieiro C; Trizotto R; Stangherlin I; Mafra AL; Correa Varella MA; Valentova JV; Fisher ML; MacEacheron M; White K; Habib R; Dobson DS; Schnettler B; Orellana L; Miranda-Zapata E; Wen-Yu Chang A; Jiao W; Liu MT; Grunert KG; Christensen RN; Reisch L; Janssen M; Abril-Ulloa V; Encalada L; Kamel I; Vainio A; Niva M; Salmivaara L; Mäkelä J; Torkkeli K; Mai R; Risch PK; Altsitsiadis E; Stamos A; Antronikidis A; Henchion M; McCarthy S; McCarthy M; Micalizzi A; Schulz PJ; Farinosi M; Komatsu H; Tanaka N; Kubota H; Tayyem R; Al-Awwad NJ; Al-Bayyari N; Ibrahim MO; Hammouh F; Dashti S; Dashti B; Alkharaif D; Alshatti A; Al Mazedi M; Mansour R; Naim E; Mortada H; Gutierrez Gomez YY; Geyskens K; Goukens C; Roy R; Egli V; Te Morenga L; Waly M; Qasrawi R; Hamdan M; Sier RA; Al Halawa DA; Agha H; Liria Domínguez MR; Palomares L; Wasowicz G; Bawadi H; Tayyem R; Othman M; Pakari J; Abu Farha A; Abu-El-Ruz R; Petrescu DC; Petrescu Mag RM; Arion F; Vesa SC; Alkhalaf MM; Bookari K; Arrish J; Rahim Z; Kheng R; Ngqangashe Y; Mchiza ZJ-R; Gonzalez-Gross M; Pantoja-Arévalo L; Gesteiro E; Ríos Y; Yiga P; Ogwok P; Ocen D; Bamuwamye M; Al Sabbah H; Taha Z; Ismail LC; Aldhaheri A; Pineda E; Miraldo M; Holford DL; Van den Bulck H
Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic. Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households. Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125–1.426] [OR = 2.5; 95 % CI = [1.951–3.064], being a woman [OR = 1.2; 95 % CI = [1.117–1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292–1.709] were all linked to having a higher dietary diversity. Conclusion: The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.
User Experiences of the NZ COVID Tracer App in New School of ManagementZealand: Thematic Analysis of Interviews
(JMIR Publications, 2021-09-08) Tretiakov A; Hunter I
BACKGROUND: For mobile app-based COVID-19 contact tracing to be fully effective, a large majority of the population needs to be using the app on an ongoing basis. However, there is a paucity of studies of users, as opposed to potential adopters, of mobile contact tracing apps and of their experiences. New Zealand, a high-income country with western political culture, was successful in managing the COVID-19 pandemic, and its experience is valuable for informing policy responses in similar contexts. OBJECTIVE: This study asks the following research questions: (1) How do users experience the app in their everyday contexts? and (2) What drives the use of the app? METHODS: Residents of New Zealand's Auckland region, which encompasses the country's largest city, were approached via Facebook, and 34 NZ COVID Tracer app users were interviewed. Interview transcripts were analyzed using thematic analysis. RESULTS: Interviews ranged in duration from 15 to 50 minutes. Participants ranged in age from those in their late teens to those in their early sixties. Even though about half of the participants identified as White New Zealanders of European origin, different ethnicities were represented, including New Zealanders of South Pacific, Indian, Middle Eastern, South American, and Southeast Asian descent. Out of 34 participants, 2 (6%) identified as Māori (Indigenous New Zealanders). A broad range of careers were represented, from top-middle management to health support work and charity work. Likewise, educational backgrounds ranged broadly, from high school completion to master's degrees. Out of 34 participants, 2 (6%) were unemployed, having recently lost their jobs because of the pandemic. The thematic analysis resulted in five major themes: perceived benefits, patterns of use, privacy, social influence, and need for collective action. Benefits of using the app to society in general were more salient to the participants than immediate health benefits to the individual. Use, however, depended on the alert level and tended to decline for many participants at low alert levels. Privacy considerations played a small role in shaping adoption and use, even though the participants were highly aware of privacy discourse around the app. Participants were aware of the need for high levels of adoption and use of the app to control the pandemic. Attempts to encourage others to use the app were common, although not always successful. CONCLUSIONS: Appeals to civic responsibility are likely to drive the use of a mobile contact tracing app under the conditions of high threat. Under the likely scenario of COVID-19 remaining endemic and requiring ongoing vigilance over the long term, other mechanisms promoting the use of mobile contact tracing apps may be needed, such as offering incentives. As privacy is not an important concern for many users, flexible privacy settings in mobile contact tracing apps allowing users to set their optimal levels of privacy may be appropriate.
Developing One Health surveillance systems
(Elsevier B.V., 2023-12-01) Hayman DTS; Adisasmito WB; Almuhairi S; Behravesh CB; Bilivogui P; Bukachi SA; Casas N; Becerra NC; Charron DF; Chaudhary A; Ciacci Zanella JR; Cunningham AA; Dar O; Debnath N; Dungu B; Farag E; Gao GF; Khaitsa M; Machalaba C; Mackenzie JS; Markotter W; Mettenleiter TC; Morand S; Smolenskiy V; Zhou L; Koopmans M
The health of humans, domestic and wild animals, plants, and the environment are inter-dependent. Global anthropogenic change is a key driver of disease emergence and spread and leads to biodiversity loss and ecosystem function degradation, which are themselves drivers of disease emergence. Pathogen spill-over events and subsequent disease outbreaks, including pandemics, in humans, animals and plants may arise when factors driving disease emergence and spread converge. One Health is an integrated approach that aims to sustainably balance and optimize human, animal and ecosystem health. Conventional disease surveillance has been siloed by sectors, with separate systems addressing the health of humans, domestic animals, cultivated plants, wildlife and the environment. One Health surveillance should include integrated surveillance for known and unknown pathogens, but combined with this more traditional disease-based surveillance, it also must include surveillance of drivers of disease emergence to improve prevention and mitigation of spill-over events. Here, we outline such an approach, including the characteristics and components required to overcome barriers and to optimize an integrated One Health surveillance system.
Effectiveness of a Sodium-Reduction Smartphone App and Reduced-Sodium Salt to Lower Sodium Intake in Adults With Hypertension: Findings From the Salt Alternatives Randomized Controlled Trial.
(JMIR Publications, 2023-03-09) Eyles H; Grey J; Jiang Y; Umali E; McLean R; Te Morenga L; Neal B; Rodgers A; Doughty RN; Ni Mhurchu C; Buis LR; Eysenbach G
BACKGROUND: Even modest reductions in blood pressure (BP) can have an important impact on population-level morbidity and mortality from cardiovascular disease. There are 2 promising approaches: the SaltSwitch smartphone app, which enables users to scan the bar code of a packaged food using their smartphone camera and receive an immediate, interpretive traffic light nutrition label on-screen alongside a list of healthier, lower-salt options in the same food category; and reduced-sodium salts (RSSs), which are an alternative to regular table salt that are lower in sodium and higher in potassium but have a similar mouthfeel, taste, and flavor. OBJECTIVE: Our aim was to determine whether a 12-week intervention with a sodium-reduction package comprising the SaltSwitch smartphone app and an RSS could reduce urinary sodium excretion in adults with high BP. METHODS: A 2-arm parallel randomized controlled trial was conducted in New Zealand (target n=326). Following a 2-week baseline period, adults who owned a smartphone and had high BP (≥140/85 mm Hg) were randomized in a 1:1 ratio to the intervention (SaltSwitch smartphone app + RSS) or control (generic heart-healthy eating information from The Heart Foundation of New Zealand). The primary outcome was 24-hour urinary sodium excretion at 12 weeks estimated via spot urine. Secondary outcomes were urinary potassium excretion, BP, sodium content of food purchases, and intervention use and acceptability. Intervention effects were assessed blinded using intention-to-treat analyses with generalized linear regression adjusting for baseline outcome measures, age, and ethnicity. RESULTS: A total of 168 adults were randomized (n=84, 50% per group) between June 2019 and February 2020. Challenges associated with the COVID-19 pandemic and smartphone technology detrimentally affected recruitment. The adjusted mean difference between groups was 547 (95% CI -331 to 1424) mg for estimated 24-hour urinary sodium excretion, 132 (95% CI -1083 to 1347) mg for urinary potassium excretion, -0.66 (95% CI -3.48 to 2.16) mm Hg for systolic BP, and 73 (95% CI -21 to 168) mg per 100 g for the sodium content of food purchases. Most intervention participants reported using the SaltSwitch app (48/64, 75%) and RSS (60/64, 94%). SaltSwitch was used on 6 shopping occasions, and approximately 1/2 tsp per week of RSS was consumed per household during the intervention. CONCLUSIONS: In this randomized controlled trial of a salt-reduction package, we found no evidence that dietary sodium intake was reduced in adults with high BP. These negative findings may be owing to lower-than-anticipated engagement with the trial intervention package. However, implementation and COVID-19-related challenges meant that the trial was underpowered, and it is possible that a real effect may have been missed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619000352101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377044 and Universal Trial U1111-1225-4471.
Survey protocol for exploring video and phone use in Aotearoa New Zealand general practice: considerations for future telehealth
(BMJ Publishing Group Ltd and BCS, the Chartered Institute for IT, 2021-03-22) Day K; Hunter I; Rao V; Russell G; Roskvist R; Moir F; Gill E; van der Werf B
Introduction Telehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward? Methods and analysis A national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes. Ethics and dissemination Ethics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.
A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial.
(John Wiley and Sons, Inc., 2024-01-01) Zülke AE; Pabst A; Luppa M; Roehr S; Seidling H; Oey A; Cardona MI; Blotenberg I; Bauer A; Weise S; Zöllinger I; Sanftenberg L; Brettschneider C; Döhring J; Lunden L; Czock D; Haefeli WE; Wiese B; Hoffmann W; Frese T; Gensichen J; König H-H; Kaduszkiewicz H; Thyrian JR; Riedel-Heller SG
INTRODUCTION: We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial. METHODS: Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests). RESULTS: Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness. DISCUSSION: The intervention did not improve global cognitive performance. HIGHLIGHTS: Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic.
Perinatal mental health and women's lived experience of the COVID-19 pandemic: A scoping review of the qualitative literature 2020-2021.
(Elsevier B.V., 2023-05-09) Jin Y; Murray L
BACKGROUND: The COVID-19 pandemic resulted in global physical distancing restrictions and lockdown orders. Despite the clear documentation of increased mental distress amongst adult populations during the pandemic, there is limited evidence about the mental health challenges of people in the perinatal period (pregnancy, birth and postpartum). The aim of this review is to summarise the qualitative research about women's lived experience and emotional wellbeing during the COVID-19 pandemic. METHODS: A comprehensive search strategy was developed. Twenty peer-reviewed qualitative research articles published in English from January 1, 2020, to December 15, 2021, were included. Data synthesis outlined the evidence from common themes in a narrative format. RESULTS: Themes during pregnancy included: (1) information seeking: anxiety and fear; (2) experiencing isolation and disruptions to my social support; (3) 'Going it alone' in pregnancy care; (4) anticipatory grieving and despair; (5) finding 'silver linings' in social restrictions. One key theme during birth was "birthing in a crisis". Themes during postpartum included: (1) isolating 'Early motherhood is much like lockdown'; (2) breastfeeding: triumphs and tribulations; (3) facing disruptions during postpartum care; (4) 'Affecting us for years to come' - COVID-19 was not the only trauma; (5) 'silver linings' during postpartum care. CONCLUSIONS: This review provides important insights into how experiences of isolation, decreased social support and adaptions to maternity services affect women's mental health. Maternity services should consider how perinatal mental health support may be integrated into the care of women who may still be required to isolate or have reduced visitors during their perinatal care. STATEMENT OF SIGNIFICANCE: The restrictions and disruptions to maternity care due to the COVID-19 pandemic were likely to impact the mental health of women in the perinatal period (pregnancy, birth and postpartum). What is already known is that public health measures due to COVID-19 increased the prevalence of common perinatal mental disorders (CPMDs) and exacerbated common risk factors for CPMDs (i.e., poor social support). WHAT THIS PAPER ADDS: The qualitative research with women in the perinatal period during the pandemic provides unique insights into how these events impacted perinatal mental and emotional health. In particular, the ways that global physical distancing measures and maternity care adaptations contributed to women's feelings of distress, isolation, and depression/despair. Silver linings such as more uninterrupted time with immediate family were also identified.
Disabled people's experiences accessing healthcare services during the COVID-19 pandemic: a scoping review.
(BioMed Central, 2023-04-06) McBride-Henry K; Nazari Orakani S; Good G; Roguski M; Officer TN
BACKGROUND: Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people's experiences with accessing these services. A scoping review was undertaken to identify and explore research on the experience of disabled people in accessing healthcare services between 2020 and 6 February 2023. METHODS: PubMed, Web of Science, CINAHL, and OVID were employed to search for research that included the voice of disabled people, or their parents or caregivers. Over two distinct phases, a total of 2,201 articles were reviewed according to article titles, keywords, and abstracts. Eighty-one studies were identified that met the inclusion criteria; these were reviewed in full. RESULTS: Eighteen studies specifically described the experiences of accessing healthcare or disability services, and sixty-three raised healthcare challenges as a secondary consideration. Many disabled people struggled to access healthcare services and felt they were invisible; as a result, individuals' mental health was negatively affected. Disabled people with compounding vulnerabilities were at the most risk of experiencing a lack of healthcare access. CONCLUSIONS: There is an urgent need for research and policy that is responsive to disabled people's access to healthcare during the pandemic; currently many health policies are 'disability-blind' and exclude these members of the global community. Furthermore, to assist in creating disability-responsive research, funding needs to prioritise researchers within the disabled community.
Depression and Anxiety in Old Age during the COVID-19 Pandemic: A Comparative Study of Individuals at Cardiovascular Risk and the General Population.
(MDPI (Basel, Switzerland), 2023-02-08) Gerhards SK; Luppa M; Röhr S; Pabst A; Bauer A; Frankhänel T; Döhring J; Escales C; Zöllinger IR; Oey A; Brettschneider C; Wiese B; Hoffmann W; Gensichen J; König H-H; Frese T; Thyrian JR; Kaduszkiewicz H; Riedel-Heller SG; Miettunen J
Our study aims to examine the associations of sociodemographic factors, social support, resilience, and perceptions of the COVID-19 pandemic with late-life depression and anxiety symptoms in a cardiovascular risk group and a matched sample from the German general population during the beginning of the pandemic and draw a comparison regarding psychosocial characteristics. Data of n = 1236 participants (aged 64-81 years) were analyzed, with n = 618 participants showing a cardiovascular risk profile, and n = 618 participants from the general population. The cardiovascular risk sample had slightly higher levels of depressive symptoms and felt more threatened by the virus due to pre-existing conditions. In the cardiovascular risk group, social support was associated with less depressive and anxiety symptoms. In the general population, high social support was associated with less depressive symptoms. Experiencing high levels of worries due to COVID-19 was associated with more anxiety in the general population. Resilience was associated with less depressive and anxiety symptoms in both groups. Compared to the general population, the cardiovascular risk group showed slightly higher levels of depressive symptomatology even at the beginning of the pandemic and may be supported by addressing perceived social support and resilience in prevention programs targeting mental health.
Home drinking practices among middle-class adults in midlife during the COVID-19 pandemic: Material ubiquity, automatic routines and embodied states.
(John Wiley and Sons, Inc., 2023-07-01) Lyons AC; Young J; Blake D; Evans P; Stephens C
INTRODUCTION: Harmful drinking is increasing among mid-life adults. Using social practice theory, this research investigated the knowledge, actions, materials, places and temporalities that comprise home drinking practices among middle-class adults (40-65 years) in Aotearoa New Zealand during 2021-2022 and post the COVID-19 pandemic lockdowns. METHODS: Nine friendship groups (N = 45; 26 females, 19 males from various life stages and ethnicities) discussed their drinking practices. A subset of 10 participants (8 female, 2 male) shared digital content (photos, screenshots) about alcohol and drinking over 2 weeks, which they subsequently discussed in an individual interview. Group and interview transcripts were thematically analysed using the digital content to inform the analysis. RESULTS: Three themes were identified around home drinking practices, namely: (i) alcohol objects as everywhere, embedded throughout spaces and places in the home; (ii) drinking practices as habitual, automatic and conditioned to mundane everyday domestic chores, routines and times; and (iii) drinking practices intentionally used by participants to achieve desired embodied states to manage feelings linked to domestic and everyday routines. DISCUSSION AND CONCLUSIONS: Alcohol was normalised and everywhere within the homes of these midlife adults. Alcohol-related objects and products had their own agency, being entangled with domestic routines and activities, affecting drinking in both automatic and intentional ways. Developing alcohol policy that would change its ubiquitous and ordinary status, and the 'automatic' nature of many drinking practices, is needed. This includes restricting marketing and availability to disrupt the acceptability and normalisation of alcohol in the everyday domestic lives of adults at midlife.

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