We observed 1,000 3-year-old children who exhibited five temperament types: Undercontrolled, Inhibited, Confident, Reserved, and Well-adjusted. Twenty-three years later, we reexamined 96% of the
Previous studies examining blood pressure change over time have modelled an “average” population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors and early midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32 and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify four distinct trajectory groups via group-based trajectory modeling: ‘normal’ (21.8%), ‘high-normal’ (43.3%), ‘prehypertensive’ (31.6%), and ‘hypertensive’ (4.2%). The categories refer to blood pressure beginning at age 7 and most recently measured at age 38. Family history of high blood pressure (OR=43.23, 95% CI 5.27, 354.65), male gender (OR=109.48, 95% CI=26.82, 446.96), being first born (OR=2.5 95% CI=1.00, 8.69) and low birthweight (OR=2.79, 95% CI 2.49, 3.09) were associated with hypertensive group membership (compared to the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection, subsequent targeted prevention and/or intervention may reduce the lifecourse burden associated with higher blood pressure.
We examine the academic ‘pipeline’ for Māori and Pasifika graduates and illustrate the chronic under-representation of Māori and Pasifika in permanent academic positions in New Zealand universities. We identify areas within higher education where significant opportunities are being lost for the recruitment and retention of Māori and Pasifika. The narratives of Māori and Pasifika post-doctoral researchers, research associates and professional teaching fellows provide further insight into the advantages and disadvantages of these positions. Lastly, we propose a Pacific alternative metaphor ‘Pacific Navigation of Academic Pathways’ based on Pacific navigation, as opposed to the more commonly used term ‘pipeline’, in order to capture the nuances of Pasifika and Māori experiences.
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