title: Community influences on rural youth wellbeing: Young people's perspectives

authors: Simcock, Gillian Clare

subjects: Youth, community, wellbeing

abstract: This study considered rural young people’s perceptions of community factors involved in their wellbeing.  Two regional Waikato towns, Te Aroha and Otorohanga were used as the sites for the research project.  Four focus groups were conducted with students in their final year of senior school to obtain qualitative data.  The focus group participants were recruited via flyers placed in the two schools and there were two groups (one male and one female) from each college. Five further in-depth interviews and two less formal discussions with community members from these towns were used as additional information.  The data was considered from a social constructivist perspective.  Both towns provide opportunities for the members of the communities to come together which may engender a sense of community.  Te Aroha and Otorohanga’s students find that community-level events and, in particular, sport provides a good chance to meet with other sectors of the community.  These social processes provide opportunities where there may be some implicit endorsement of the adolescents which may enhance self-esteem and, in turn, sense of wellbeing.  The key findings are that sense of community cannot be the factor that directly determines wellbeing.  The study provided evidence to suggest that sense of community can encourage social capital which is likely to have a positive correlation with wellbeing.  Social capital is the “commodity” which can be accumulated by these community driven opportunities for interaction.

text: Community influences on rural youth wellbeing: Young people's perspectives This study considered rural young people’s perceptions of community factors involved in their wellbeing.  Two regional Waikato towns, Te Aroha and Otorohanga were used as the sites for the research project.  Four focus groups were conducted with students in their final year of senior school to obtain qualitative data.  The focus group participants were recruited via flyers placed in the two schools and there were two groups (one male and one female) from each college. Five further in-depth interviews and two less formal discussions with community members from these towns were used as additional information.  The data was considered from a social constructivist perspective.  Both towns provide opportunities for the members of the communities to come together which may engender a sense of community.  Te Aroha and Otorohanga’s students find that community-level events and, in particular, sport provides a good chance to meet with other sectors of the community.  These social processes provide opportunities where there may be some implicit endorsement of the adolescents which may enhance self-esteem and, in turn, sense of wellbeing.  The key findings are that sense of community cannot be the factor that directly determines wellbeing.  The study provided evidence to suggest that sense of community can encourage social capital which is likely to have a positive correlation with wellbeing.  Social capital is the “commodity” which can be accumulated by these community driven opportunities for interaction.

year: 2016

title: Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion

authors: Galante, J

abstract: Mindfulness-based programs (MBPs) are widely used to prevent mental ill health. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs and to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness modify the effect of MBPs on distress among adults in non-clinical settings. We conducted a systematic review and individual participant data (IPD) meta-analysis (PROSPERO CRD42020200117). Databases were searched in December 2020 for randomized controlled trials satisfying a quality threshold and comparing in-person, expert-defined MBPs with passive-control groups. Two researchers independently selected, extracted and appraised trials using the revised Cochrane Risk-of-Bias tool. IPD of eligible trials were sought from authors. The primary outcome was psychological distress (unpleasant mental or emotional experiences including anxiety and depression) at 1 to 6 months after program completion. Data were checked and imputed if missing. Pairwise, random-effects, two-stage IPD meta-analyses were conducted. Effect modification analyses followed a within-studies approach. Stakeholders were involved throughout this study. Fifteen trials were eligible; 13 trialists shared IPD (2,371 participants representing 8 countries. In comparison with passive-control groups, MBPs reduced average distress between 1 and 6 months post-intervention with a small to moderate effect size (standardized mean difference, −0.32; 95% confidence interval, −0.41 to −0.24; 0.001; no heterogeneity). Results were robust to sensitivity analyses and similar for the other timepoint ranges. Confidence in the primary outcome result is high. We found no clear indication that this effect is modified by the pre-specified candidates. Group-based teacher-led MBPs generally reduce psychological distress among volunteering community adults. More research is needed to identify sources of variability in outcomes at an individual level.

text: Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion Mindfulness-based programs (MBPs) are widely used to prevent mental ill health. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs and to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness modify the effect of MBPs on distress among adults in non-clinical settings. We conducted a systematic review and individual participant data (IPD) meta-analysis (PROSPERO CRD42020200117). Databases were searched in December 2020 for randomized controlled trials satisfying a quality threshold and comparing in-person, expert-defined MBPs with passive-control groups. Two researchers independently selected, extracted and appraised trials using the revised Cochrane Risk-of-Bias tool. IPD of eligible trials were sought from authors. The primary outcome was psychological distress (unpleasant mental or emotional experiences including anxiety and depression) at 1 to 6 months after program completion. Data were checked and imputed if missing. Pairwise, random-effects, two-stage IPD meta-analyses were conducted. Effect modification analyses followed a within-studies approach. Stakeholders were involved throughout this study. Fifteen trials were eligible; 13 trialists shared IPD (2,371 participants representing 8 countries. In comparison with passive-control groups, MBPs reduced average distress between 1 and 6 months post-intervention with a small to moderate effect size (standardized mean difference, −0.32; 95% confidence interval, −0.41 to −0.24; 0.001; no heterogeneity). Results were robust to sensitivity analyses and similar for the other timepoint ranges. Confidence in the primary outcome result is high. We found no clear indication that this effect is modified by the pre-specified candidates. Group-based teacher-led MBPs generally reduce psychological distress among volunteering community adults. More research is needed to identify sources of variability in outcomes at an individual level.

year: 2023

title: The use of trastuzumab in New Zealand women with breast cancer

authors: Lawrenson, Ross

subjects: Breast Neoplasms

abstract: Aim

Trastuzumab was first funded in New Zealand for use in HER2+ve stage I–III breast cancer in 2007. This observational study aims to ascertain the patterns of use of trastuzumab in women with invasive HER2+ve breast cancer, and assess the effectiveness of adjuvant trastuzumab in women with stage I–III HER2+ve breast cancer.
Methods

The Waikato and Auckland Breast Cancer Registries have clinical details of 12 372 women diagnosed with invasive breast cancer between June 2000 and May 2013. The proportion of women with HER2+ve breast cancer treated with trastuzumab was examined by age, ethnicity, stage and year of diagnosis. Differences in outcomes including the development of metastases and death were assessed for women with stage I–III HER2+ve breast cancer treated with both chemotherapy and trastuzumab, compared to women treated with chemotherapy alone.
Results

Among the 1587 HER2+ve breast cancer patients, 888 (56.0%) women received trastuzumab. The probability of having trastuzumab decreased with higher age and comorbidity score and increased with year of diagnosis, tumor size and cancer stage. Māori and Pacific women were less likely to be treated with trastuzumab. After adjustment for potential confounding factors, the treatment with trastuzumab improved breast cancer-specific mortality (adjusted hazard ratio 0.57, 95% CI: 0.35–0.93).
Conclusion

Overall, this observational study has shown a substantial improvement in survival for women with HER2+ve stage I–III breast cancer, and much of this improvement can be attributed to the introduction of trastuzumab. Changes in chemotherapy also appear to have led to improved outcomes.

text: The use of trastuzumab in New Zealand women with breast cancer Aim

Trastuzumab was first funded in New Zealand for use in HER2+ve stage I–III breast cancer in 2007. This observational study aims to ascertain the patterns of use of trastuzumab in women with invasive HER2+ve breast cancer, and assess the effectiveness of adjuvant trastuzumab in women with stage I–III HER2+ve breast cancer.
Methods

The Waikato and Auckland Breast Cancer Registries have clinical details of 12 372 women diagnosed with invasive breast cancer between June 2000 and May 2013. The proportion of women with HER2+ve breast cancer treated with trastuzumab was examined by age, ethnicity, stage and year of diagnosis. Differences in outcomes including the development of metastases and death were assessed for women with stage I–III HER2+ve breast cancer treated with both chemotherapy and trastuzumab, compared to women treated with chemotherapy alone.
Results

Among the 1587 HER2+ve breast cancer patients, 888 (56.0%) women received trastuzumab. The probability of having trastuzumab decreased with higher age and comorbidity score and increased with year of diagnosis, tumor size and cancer stage. Māori and Pacific women were less likely to be treated with trastuzumab. After adjustment for potential confounding factors, the treatment with trastuzumab improved breast cancer-specific mortality (adjusted hazard ratio 0.57, 95% CI: 0.35–0.93).
Conclusion

Overall, this observational study has shown a substantial improvement in survival for women with HER2+ve stage I–III breast cancer, and much of this improvement can be attributed to the introduction of trastuzumab. Changes in chemotherapy also appear to have led to improved outcomes.

year: 2017