title: The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study

authors: Monk, Nathan

subjects: First-episode psychosis, New Zealand, Māori, indigenous health, health equity, physical health, cardiometabolic health, premature mortality, cohort study

abstract: Background:
People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis.
Objective:
Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis.
Methods:
A cohort (N = 14,122) of young people (16–24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan–Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years.
Results:
In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan–Meier plots show hospitalisation and mortality inequities emerging approximately 4–7 years following first-episode psychosis diagnosis.
Conclusions:
Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.

text: The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study Background:
People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis.
Objective:
Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis.
Methods:
A cohort (N = 14,122) of young people (16–24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan–Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years.
Results:
In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan–Meier plots show hospitalisation and mortality inequities emerging approximately 4–7 years following first-episode psychosis diagnosis.
Conclusions:
Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early.

year: 2024

title: An Assessment of the Cognitive Ability and the Attitude to Rehabilitation of European and Maori Trainees at a Borstal Institution.

authors: Zimmerman, Malcolm Laird

subjects: Borstal Institution

abstract: The incidence of delinquency in New Zealand has risen and is a cause for serious concern for the future of the nation. "As in all fields of social inquiry it is much easier to specify the problem than it is to account for its occurrence ... In the case of delinquency, it is much easier to record what has occurred as opposed to why - it is even more difficult to prevent delinquency from occurring at all. Why should this be so?" (Blizard, 1967, p.i.)
There are no easy answers: there are no short cuts to understanding: there will never be an easily worked out, or easily administered programme for prevention. The road is hard, costly both in terms of men, money and time.

text: An Assessment of the Cognitive Ability and the Attitude to Rehabilitation of European and Maori Trainees at a Borstal Institution. The incidence of delinquency in New Zealand has risen and is a cause for serious concern for the future of the nation. "As in all fields of social inquiry it is much easier to specify the problem than it is to account for its occurrence ... In the case of delinquency, it is much easier to record what has occurred as opposed to why - it is even more difficult to prevent delinquency from occurring at all. Why should this be so?" (Blizard, 1967, p.i.)
There are no easy answers: there are no short cuts to understanding: there will never be an easily worked out, or easily administered programme for prevention. The road is hard, costly both in terms of men, money and time.

year: 1971

title: Robust mathematical programming for natural resource modelling under parametric uncertainty

authors: Doole, Graeme J.

subjects: parameter uncertainty

abstract: Inaccurate specification of model coefficients can lead to false or distorted findings in modeling investigations of natural resource management. Hence, this paper outlines a decision framework for optimization problems in which only the bounded set of outcomes for uncertain parameters is known. These models can be solved with standard mathematical programming software and are no larger than their deterministic equivalent. The robust approach is contrasted against deterministic analysis and is demonstrated for two applications regarding the management of natural resources. Deterministic plans are infeasible in at least 40% of cases when parameters vary from their point estimates. Inclusion of robust constraints immunizes against this infeasibility, thereby removing errors arising from false certainty. Additionally, incorporation of bounded parameters in the objective function yields interval-valued sets containing potential outcomes. However, this increase in the general relevance of model output introduces some degree of suboptimality as deterministic plans are buffered to proactively account for potential variability. The cost of robustness increases with the simulated spread of uncertain coefficients but may be reduced through accounting for the uncertainty aversion of decision makers.

text: Robust mathematical programming for natural resource modelling under parametric uncertainty Inaccurate specification of model coefficients can lead to false or distorted findings in modeling investigations of natural resource management. Hence, this paper outlines a decision framework for optimization problems in which only the bounded set of outcomes for uncertain parameters is known. These models can be solved with standard mathematical programming software and are no larger than their deterministic equivalent. The robust approach is contrasted against deterministic analysis and is demonstrated for two applications regarding the management of natural resources. Deterministic plans are infeasible in at least 40% of cases when parameters vary from their point estimates. Inclusion of robust constraints immunizes against this infeasibility, thereby removing errors arising from false certainty. Additionally, incorporation of bounded parameters in the objective function yields interval-valued sets containing potential outcomes. However, this increase in the general relevance of model output introduces some degree of suboptimality as deterministic plans are buffered to proactively account for potential variability. The cost of robustness increases with the simulated spread of uncertain coefficients but may be reduced through accounting for the uncertainty aversion of decision makers.

year: 2010