Introduction The (traditionally influenced) consumption of kava (Piper methysticum) has been associated with increased body sway, raising concerns about fall risk. However, studies typically utilise pill-styled kava extracts with a lack of understanding regarding experienced naturalistic kava drinkers. This pilot study investigated the effects of naturalistic kava consumption over a six-hour period on postural control. Methods Six experienced male kava drinkers consumed 100ml of kava every 10 minutes over six hours in a culturally responsive setting. Postural control was examined at three time points (Pre, Mid, and Post) using a 30-seconds eyes-closed feet-together postural balance test conducted on a 3D force plate. Centre of pressure path length, average velocity, and area of the 95th percentile ellipse data were extracted and compared between time points using a one-way repeated measures ANOVA. Findings There were no significant differences in the centre of pressure parameters. Based on the Pre and Post differences for path length and average velocity logged values, this study would require 19 participants to achieve an 80% power and 5% significance level. Discussion Irrespective of limited sample size, our preliminary results do not support that kava consumption negatively affects postural control, findings that appear to be corroborated by a recent neuroscience study. The perceived risks of naturalistic kava consumption with regards to falls may be overstated. Further study on the physiological implications of kava consumption in naturalistic settings is needed to quantify the actual risks.
 Highlights• Kava is a culturally significant drink for Pacific people• Anecdotal reports describe impaired balance following high traditional use volumes• Postural control was tested during and following kava use in a pilot study• Contrary to hypothesis, results do not show that kava negatively affects postural control

Aim The prevalence of Type 2 diabetes in Samoa has increased substantially over the last 30 years. Identifying common symptoms in those living with diabetes may be instrumental in directing those at risk to seek early evaluation, diagnosis, and treatment. Additionally, identifying associations between diabetes experiences and health-related quality of life is useful for understanding the lived experience of having diabetes in this setting. Here we present the first description of diabetes-related symptoms in an adult cohort of Samoans with diabetes and prediabetes and describe associations between symptom presence and sex, glycemic control (HbA1c ≥ 8.0%), and health-related quality of life (HRQL). We also assessed whether reported symptoms were independently associated, when adjusting for other factors, with increased odds of having diabetes. METHODS Analyses were conducted on n = 123 adult Samoan participants selectively sampled from the observational cohort Soifua Manuia study, and who were living with either prediabetes or diabetes. Participants completed a series of anthropometric, biochemical, and questionnaire measures including the Revised Diabetes Symptoms Checklist (DSC-R) questionnaire between 2017-2019. Differences in symptom presence by sex, diabetes status (prediabetes vs. diabetes), glycemic control (HbA1c < or ≥ 8.0%), and HRQL were assessed using Independent Sample T-tests, Mann Whitney U tests and Chi-square tests of association. Multivariate logistic regression was used to assess which symptoms, when controlling for other factors, were associated with increased odds of having diabetes. RESULTS In a small sample of adult Samoans, we observed high symptom burdens among those with prediabetes and diabetes, and sex differences in the reported impact of diabetes symptoms on health-related quality of life. We identified three specific symptoms – frequent urination, difficulty thinking clearly, and chest/heart pains – that may be useful indicators of diabetes in this setting. DISCUSSION A high prevalence of symptoms was observed among those with prediabetes and among those with diabetes. It is recommended that individuals experiencing any of the measured symptoms seek early evaluation and engage in diabetes self-care behaviors to prevent diabetes-related complications and/or progression to diabetes among those in the early stages of the disease.

Aim: By employing a multi-faceted approach in the disciplines of Theology and Pacific Studies; three key areas of investigation were examined and included: how young Pacific women perceived images of God and faith; how it impacted upon their mental resilience and their responses to mundane and significant life events; and their personal constructs of mental wellbeing.
 Method: Qualitative group interviews (talanoa) were conducted with participants aged between 17-24 years old; identified with multiple ethnicities, with at least one being Pacific; identified as Roman Catholic, with varying degrees of faith practice; and were based in Auckland, Aotearoa. The Praxis Model methodology was employed throughout the research process and speaks to the interdisciplinary nature of the project. The theory of Intersectionality was utilized as the lens to view each research participants’ multi-layered self-identities.
 Findings: There were a total of 64 research participants. Out of the 64 participants, 82% (n=52), generally agreed that their image of God aided a positive state of mental wellbeing, five women were unsure and six stated, that it was something else in their faith practice which primarily supported their mental wellbeing. Part of the reason women felt their image of God offered hope for their future, derived from their belief in an afterlife beyond physical death, which they felt, reduced anxiety about their family members who had died or experienced sickness and trauma throughout their lives
 Conclusions: There is a need for more denomination-specific and culturally responsive foci around mental wellbeing, therefore recognising the unique experiences of faith traditions and the challenges faced, particularly, by multi-ethnic young Pacific women.
 Key words: Mental wellbeing, Pacific, Theology

Introduction: Pasifika young people of Aotearoa New Zealand are known to experience higher rates of mental health and addiction conditions (especially anxiety and depression), compared with young non-Māori/non-Pasifika (NMNP). However, there is little information about how well these issues are identified by mental health services.
 Aim: We compared rates of diagnosis of common mental health and substance use-related conditions between Pasifika and NMNP young people (aged 10-24 years) and examined how these diagnoses varied with deprivation.
 Method: This national, cross-sectional study was undertaken using 2017/18 fiscal year data from a national database known as the Integrated Data Infrastructure. Specialist mental health service use, hospitalisations and pharmaceutical dispensing for any mental health condition, emotional condition (depression and/or anxiety), substance use-related conditions, and self-harm were examined.
 Results: A total of 982,305 young people (12.4%, Pasifika and 63.9%, NMNP) were identified. Compared with NMNP, Pasifika young people were significantly less likely to be diagnosed by specialist mental health services with any mental health condition (adjusted Risk Ratio (aRR) = 0.77, 95% CI = 0.75 to 0.78); any emotional condition (aRR= 0.44, 95% Confidence Interval (CI) = 0.43 to 0.45); or to be hospitalised for self-harm (aRR = 0.88, 95% CI = 0.82 to 0.94). However, they were significantly more likely than NMNP to be diagnosed with substance use-related conditions (aRR = 1.68, 95% CI = 1.63 to 1.74). Although the overall rate of mental health issues remained relatively stable across deprivation levels, emotional conditions were much less frequently diagnosed in those with greater deprivation.
 Discussion: Discrepancies between expected and identified rates of diagnoses of common mental health and substance use-related conditions might indicate different patterns of service access by Pasifika young people, or they may reflect the bias of an inequitable and less than culturally appropriate health system.

The annual Pasifika Medical Association (PMA) Conference was held at the Te Papa Museum, Wellington from the 4th to the 6th of September 2022. The Pasifika Medical Association celebrated 26 years of successful navigation and the conference with a theme of ‘Reconnect, Reflect, Reframe and Reenergise’ was attended by about 500 participants. Most were Pacific health workers from across the Pacific Islands, New Zealand and Australia. Abstracts from the Conference are published here.

Introduction: Autism is a lifelong neurodevelopmental condition that is estimated to impact 1 in 44 children. In Aotearoa New Zealand, the rate of autism among Pasifika children and young people (38.6 per 10,000 people) is substantively lower than other ethnic groups (67.5 for European and 47.2 for Māori); however, the complexities associated with Autism diagnosis in Pasifika is unknown.
 Aim: We compared rates of Autism and co-occurring diagnoses of conditions as a proxy for Autism case complexity between Pasifika and NMNP young people (aged 0-24 years) in Aotearoa New Zealand.
 Methods: This national, cross-sectional study was undertaken using data from a national database; the Integrated Data Infrastructure (IDI). Three separate indicators were created to reflect different types of complexity for someone with autism: Asperger’s syndrome (identifies those with lower complexity with fewer demands on support services); intellectual disability (higher needs/greater complexity); ORS funding (higher needs/greater complexity).
 Findings: In this present study, Pasifika in Aotearoa New Zealand had much lower autism identification rates in comparison to Non-Māori Non-Pasifika (NMNP) (53.3 per 10,000 vs 83 per 10,000). After adjusting for socioeconomic differences, Pasifika had significantly lower odds (Odds Ratio (OR) = 0.47) of having an Asperger’s syndrome diagnosis. However, Pasifika had significantly higher odds of having an intellectual disability (OR = 2.23) and being Ongoing Resources Scheme funded (OR = 2.18).
 Conclusions: Using this method within the IDI, Pasifika children in Aotearoa continue to have lower rates of Autism diagnosis; however, they are more likely to have a higher complexity of autism diagnosis.

Historically, alcohol and tobacco use has been the main substance use for Pacific people in New Zealand (NZ).1,2,3 However, more recently, illicit drug use is a new emerging concerning trend amongst Pacific people in New Zealand. Illicit drugs refer to highly addictive and illegal substances such as cannabis, synthetic cannabinoids, heroin, marijuana and methamphetamine. Importantly, Pacific youth have been identified as having higher prevalence rates than other age groups in the Pacific population in New Zealand. 4 Although, Pacific people have higher rates of substance abuse, they tend to have lower rates of accessing health service access compared with the New Zealand general population.5 Very little research has examined illicit drug use for Pacific people. With the emergence of rising illicit drug use, there is an urgent needed to identify why illicit drugs will become an issue for Pacific people in the future.