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Item Secondary School Students and Caffeine: Consumption Habits, Motivations, and Experiences.(MDPI (Basel, Switzerland), 2023-02-17) Turner S; Ali A; Wham C; Rutherfurd-Markwick K; Cornelis M; Tauler PAdolescents may be particularly vulnerable to the effects of caffeine due to a lack of tolerance, their small size, changing brain physiology, and increasing independence. Concerns about adolescent caffeine consumption relate to potentially serious physiological and psychological effects following consumption. Motivations driving caffeine intake are not well understood among adolescents but are important to understand to reduce harmful behavioural patterns. This study explored caffeine consumption habits (sources, amount, frequency) of New Zealand adolescents; and factors motivating caffeine consumption and avoidance. The previously validated caffeine consumption habits questionnaire (CaffCo) was completed by 216 participants (15-18 years), with most (94.9%) consuming at least one caffeinated product daily. Chocolate, coffee, tea, and kola drinks were the most consumed sources. The median caffeine intake was 68 mg·day-1. Gender (boy) and being employed influenced the source, but not the quantity of caffeine consumed. One-fifth (21.2%) of adolescents consumed more than the recommended European Food Safety Authority (EFSA) safe level (3 mg·kg-1·day-1). Taste, energy, and temperature were the main motivators for consumption, and increased energy, excitement, restlessness, and sleep disturbances were reported effects following caffeine consumption. This study provides information on caffeinated product consumption among New Zealand adolescents, some of whom consumed caffeine above the EFSA safe level. Public health initiatives directed at adolescents may be important to reduce potential caffeine-related harm.Item Intermediate and secondary school food environment in New Zealand : lunch food and drink menu assessment : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand(Massey University, 2023) Green, ShannonIntroduction: The combination of food insecurity and the increase in nutrition-related obesity among adolescents in New Zealand creates a need for collaborative action to improve the food environment. The school environment is ideal for encouraging a healthy lifestyle; however, the healthiness of food available to intermediate and secondary school students (years seven-13) is unknown. This study assessed how food and drink menus from a convenience sample of schools align with the Ministry of Health Food and Drink Guidance for Schools. Methods: New Zealand intermediate, composite, senior, and secondary schools' (years seven-13) food and drink menus were collected in 2020. Menus were classified using the traffic light criteria ('green', 'amber', and 'red'). A toolkit was developed by three nutritionists and one dietitian (with trained staff support) to aid with menu classification. Menu quality was evaluated against school characteristics and policy use. Results: Of the school menus assessed (n=60), 3.3% met the recommendation for the provision of 75% 'green' items. 'Red' items were the main contributors (mean=53.6%). Schools with high socioeconomic status (deciles 8-10; 14.3%; p<0.05) and of small school size (<749 students; 14.1%; p<0.025) were associated with a higher proportion of 'green' items. Community (19.3%) and in-house school (25.9%) food providers provided a lower percentage of 'amber' items than school providers (39.3%; p<0.001). In-house school providers (64.6%) had a greater percentage of 'red' items than contracted school providers (48.2%; p<0.017). Community providers had the highest proportion of 'green' items (16%; p>0.017). Conclusion: The food available in schools (years seven-13) tended to be unhealthy. A national nutrition policy could improve the school food environment, especially in schools with large populations and of low socioeconomic status. So what? Menu quality is a complex socioeconomic issue, and additional support should be considered in intermediate and secondary schools to improve equitable outcomes within school food environments.Item Development of a casual video game (Match Emoji) with psychological well-being concepts for young adolescents(SAGE Publications, 2021-10-04) Pine R; Te Morenga L; Olson M; Fleming TDigital interventions for mental health and well-being have been shown to be effective in trials, yet uptake and retention in real-world settings are often disappointing. A more significant impact may be achieved by building interventions that are closer to how target groups use technology to support their own psychological well-being. Casual video games may be poised to offer an opportunity in this area as they are a highly popular activity among young people. We propose that mental health content can be integrated into the explicit content and the implicit processes used in casual video games. In this paper, we describe the design and core processes of Match Emoji, a casual video game designed to support the development of psychological well-being via gameplay and micro-messages. The iterative development of Match Emoji involved various phases, including a systematic review of the literature, consultation with target users, clinicians, game developers, and close reading of the literature. Expert collaboration was sought throughout the process to ensure gameplay and messages matched behaviour change and learning theories. An acceptability and feasibility study of Match Emoji will inform a randomised controlled trial in the future.Item 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 GroupBACKGROUND: 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.Item An investigation of dietary iron intake and literacy among 11-14-year-old females in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand(Massey University, 2023) Jansen, ReneeBackground: Iron deficiency (ID) is the most prevalent micronutrient deficiency globally and is a common diagnosis in adolescent females. Physiological, dietary, and behavioural challenges all impact iron status in individuals. Causal factors of ID for adolescent females include low dietary iron intake, iron bioavailability, increased iron requirements and excessive iron losses. Up-to-date information on dietary iron intake and literacy in adolescent females is not available for health professionals in New Zealand. Aim: To determine dietary iron literacy and associations with dietary intakes of iron-rich foods in young adolescent females in New Zealand. Methods: Females (n=286) aged 11-14 years from all-girls schools around New Zealand were recruited to complete an anonymous online questionnaire. The questionnaire comprised of demographic questions, an iron literacy questionnaire adapted from previous research and a validated iron food frequency questionnaire. Results: The results suggest a moderate level of iron literacy in most participants (66.8%, n = 191), with 21.7% (n = 62) demonstrating low and 11.5% (n = 33) demonstrating high dietary iron literacy. Vegetarian, pescatarian, and vegan participants had higher iron knowledge scores than those not on a particular diet (P = 0.001). Age had a weak relationship with iron knowledge score category (x² = 6.27, P = 0.044). Significant differences were found between ethnic groups and food group consumption frequency. Seafood and legumes, eggs, nuts and seeds were eaten more frequently among Asian participants, while iron-fortified foods were eaten more frequently among Māori participants. Participants from higher decile schools were found to consume red meat (P = 0.009), seafood (P = 0.024) and fruit (P = 0.021) more frequently than those from moderate decile schools. There was no relationship between dietary iron literacy score and intake of iron-rich foods. Conclusion: Our results demonstrate that iron literacy is low-moderate among adolescent females within New Zealand and is not associated with current dietary iron intake behaviours. Recommendations for future studies include objective measures of iron status and intake via biochemical data and food recalls and their association with iron literacy. Educational nutrition interventions may also be considered to support iron intake behaviours.Item Non-suicidal self-injury in New Zealand secondary schools : an investigation of school staff attitudes, beliefs and knowledge of non-suicidal self-injury : a thesis presented in partial fulfilment of the requirements for the degree of MSc Psychology, Massey University, Wellington, New Zealand(Massey University, 2019) Wall, CourtneyNon-Suicidal Self-Injury (NSSI) is a self-destructive, maladaptive behaviour with high prevalence rates among adolescents. In New Zealand, prevalence of NSSI has been identified at high rates among our adolescent populations, which is cause for concern. Increasingly, calls for advocacy and action in supporting adolescents have turned towards schools, as adolescents spend much of their time in education settings and school staff are primed in an optimal position to support students. But how equipped are school staff for this additional job, and how do they feel about students engaging in NSSI? This research aimed to investigate staff’s current attitudes, beliefs and knowledge of NSSI throughout New Zealand Secondary Schools. An online survey-based design was used, which included a mixture of multi-choice, Likert scale and open-ended questions. Participants were 458 Secondary School staff from throughout New Zealand. School staff roles included senior and middle management, guidance teams and school nurses, teaching staff and support staff. Findings provide evidence of a mixtures of attitudes and beliefs towards students engaging in NSSI and reasonable levels of staff knowledge of NSSI as behaviour and how to identify signs of NSSI among students. In total, 77% of participating Secondary School staff had encountered at least one student engaging in NSSI, with results identifying relative levels of self-disclosures to staff and teaching staff as being in a valuable position to notice physical and behavioural signs of NSSI behaviour amongst students. Training was identified to be associated with increases in positive attitudes and beliefs and increases in knowledge across varying professional school staff roles. It was associated with increased competence and confidence in engaging in conversations regarding NSSI with students, and more positive attitudes towards supporting students engaging in NSSI. Results identified low levels of NSSI staff training in New Zealand, and a consequential call for action from staff for training in this area. Just 10.9% of participants had received training in the area of NSSI, with upwards of 85% of staff in most staff categories identifying they would benefit from further training in NSSI.Item Secondary school students and caffeine : consumption habits, motivations and experiences : a thesis presented in partial fulfilment of the requirements of the degree of Master of Science in Nutrition and Dietetics(Massey University, 2019) Turner, SophieBackground: Recently, concerns have been raised about adolescent caffeine consumption due to its potentially serious physiological and psychological effects. Adolescents are vulnerable to the effects of caffeine due to their lack of habituation, smaller body mass and changing brain physiology. Increasing independence also exposes adolescents to new caffeinated products and provides greater freedom in their food and beverage decision making. The motivations that drive caffeine intake among adolescents are not well understood, but they are important in order to develop and implement public health strategies to reduce any harmful behavioural patterns and potential adverse effects. Therefore, it is important to determine which groups of adolescents if any are at increased at risk of caffeine-related harm, particularly as previous studies investigating adolescent caffeine intake are limited and outdated, especially within the New Zealand context. Aim: The aim of this study is to explore the caffeine consumption habits of New Zealand adolescents 15 to 18 years; the factors that motivate consumption and reasons for avoiding caffeine, over a range of caffeinated products. Methods: A previously validated caffeine consumption questionnaire (CaffCo) was administered to 217 participants 15 to 18 years via the online survey software Qualtrics. Results: Most (94.9%) New Zealand adolescents consume at least one caffeinated product daily, the most commonly consumed sources being chocolate, coffee, tea and kola drinks. The median daily caffeine intake was 68 mg.day⁻¹. Gender and employment status influence the pattern, but not overall amount of caffeine consumed. Energy drink consumption has risen dramatically over the past decade. One fifth (21.2%) of adolescents consume above the European Food Safety Authority (EFSA) safe level for caffeine intake of 3 mg.kg.⁻¹day⁻¹. Taste, energy and cold temperature were the main motivators for adolescent caffeine consumption. Increased energy, feeling excited, restlessness and sleep disturbances were frequently reported effects following caffeine consumption. Conclusions: This study gives an updated and more detailed view of caffeinated product consumption among New Zealand adolescents. A subset of adolescents consumes caffeine above the EFSA safe level and may benefit from public health strategies to reduce caffeine-related harm. Potential strategies may include education to improve “caffeine literacy” and improved regulations for labelling and advertising.Item New Zealand National Standards assessment: Social justice issues for adolescent learnersPoskitt, JMInternationally, as adolescent learners move into higher stakes assessments their influence on selection and interpretation of assessment declines, despite their increasing capacity for self-regulated learning. Equity and access issues are implicit in New Zealand National Standards data for Years 7 and 8 (aged 11-13 years) students. Data analysis reveals the percentage of students in this age group achieving ‘at’ or ‘above’ the National Standard is, on average, 8% less in writing and 9% less in mathematics compared with students from Years 1-6. Concerns are raised about the accuracy and appropriateness of the assessments, as well as the alignment of curriculum, pedagogical content knowledge and assessment practice. National Standards in New Zealand are based on overall teacher judgments (OTJs) in which teachers aggregate data from a range of sources (informal and formal assessments) to judge students’ achievement in reading, mathematics and writing in relation to prescribed National Standards (NS), derived from The New Zealand Curriculum (2007). Results of OTJs are submitted to the Ministry of Education towards the end of the academic year (November). Although this system respects teachers’ professionalism and validity of classroom assessments (Poskitt and Mitchell, 2012), it has omitted formal input of learners. Gathered primarily for summative assessment purposes, in order for the Ministry of Education to ascertain shifts in achievement for groups of students (by year level, gender, ethnicity, region, socio-economic level, diverse and special needs), and determine national initiatives for improvement, National Standards data also serve accountability and potentially formative assessment purposes. Accountability concerns caused considerable angst amongst teacher unions during the implementation phases of NS in schools, particularly for schools situated in lower socio-economic areas, or containing higher proportions of students of Māori, Pasifika descent, or students with English as a second language; all of whom have traditionally performed below other student groups. Apprehension about implications for potential league tables, labelling students, possible teacher performance pay and resource allocation to schools in accordance with NS results prevail. Using NS for formative assessment purposes, at classroom, school and system level is occurring sporadically. Whilst national attention has focused on equity issues related to achievement of students of Māori or Pasifika descent, achievement levels of Years 7 and 8 students have not been the subject of widespread educational or political debate. These adolescent students are not achieving at a level comparable with other school year levels. Social justice necessitates investigation of possible reasons and actions to overcome unfairness to enable equitable access to educational resources. A range of possible factors are briefly examined at system level such as curriculum and NS expectations, primary teacher preparation and professional learning in aggregating assessment information. Student level factors are explored, with particular attention given to alignment of curriculum, pedagogy and assessment to adolescent student needs; and the role of student voice. It is argued assessments are misaligned for this age group, creating inequities of access. Adolescent learners deserve to have their voices listened to and heard through learner participation in the equitable interpretation of assessment information. The NS system needs to be given a jolt to transform OTJs to JOLT (judgments [from] overall learner and teacher [deliberations], thus authorising learner views. Internationally, social justice requires adolescent learners have a right to access and active participation not only in self-regulated learning but also the assessment of such learning, particularly in higher stakes summative assessments.Item Making subject choices: Influences on adolescents' decision making(Adolescent Success, 2016) Poskitt JM; Bonney IMiddle Years students are required to make critical educational decisions with respect to subject choices. These decisions occur in adolescence - a period of intense identity formation, strong emotions, living in the moment and peer affiliation - characteristics which may affect decision making. Subject choices either broaden or narrow future pathways, so what influences adolescent student decisionmaking? A case study research investigation at one middle school involved teachers, students and their parents/caregivers through the use of questionnaires, interviews and document analysis to reveal various influences. Significant others (family, friends, older students and subject teachers), website sources and course information booklets were among the most frequently cited influences, although there were gender, ethnic and year-level variations. Structural issues related to school resourcing and timetabling affected some students’ choices. Of concern was inadequate awareness of: subject information, subjects required for entry to particular tertiary courses or career options, how to access information or who to approach. The school careers’ advisor was rarely sought, and subject teachers sometimes had little knowledge of progression in their field or career options. Implications arise from the study about effective ways to support adolescents in making appropriate subject choices.
