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Background In Aotearoa New Zealand, co-payments to see a general practitioner (GP, family doctor) or collect a prescription are payable by virtually all adults. Objective To examine the extent to which these user co-payments are a barrier to accessing health care, focussing on inequities for indigenous Māori. Methods Pooled data from sequential waves (years) of the New Zealand Health Survey, 2011/12 to 2018/19 were analysed. Outcomes were self-reported cost barriers to seeing a GP or collecting a prescription in the previous year. Logistic regression was used to estimate odds ratios (ORs) of barriers to care for Māori compared with non-Māori, sequentially adjusting for additional explanatory variables. Results Pooled data included 107,231 people, 22,292 (21%) were Māori. Across all years, 22% of Māori (13% non-Māori) experienced a cost barrier to seeing a GP, and 14% of Māori (5% non-Māori) reported a cost barrier to collecting a prescription. The age- and wave-adjusted OR comparing Māori/non-Māori was 1.71 (95% confidence interval [CI]: 1.61, 1.81) for the cost barrier to primary care and 2.97 (95% CI: 2.75, 3.20) for the cost barrier to collecting prescriptions. Sociodemographics accounted for about half the inequity for both outcomes; in a fully adjusted model, age, sex, low income, and poorer underlying health were determinants of both outcomes, and deprivation was additionally associated with the cost barrier to collecting a prescription but not to seeing a GP. Conclusions Māori experience considerable inequity in access to primary health care; evidence supports an urgent need for change to system funding to eliminate financial barriers to care. [ABSTRACT FROM AUTHOR]

This article interrogates historical photographs exhibited at public heritage sites in Aotearoa New Zealand. The analysis reveals that – by portraying 19th-century environmental change as a 'heroic' narrative of 'progress' – the photographs construct New Zealand national identity in opposition to nature, rather than promote a sense of connectedness with the natural environment. The article thus makes three important contributions to the literature on the visualization of environmental and climate change. First, the empirical case study demonstrates that visual narratives shape our social identities in relation to nature. Second, the article adds a rare socio-semiotic analysis to the environmental communication literature, highlighting that photographs have to be examined through multimodal methods and in relation to wider discursive processes of meaning making. Third, by borrowing ideas from the literature on collective memory, the article shows that, even though they depict scenes that are set in the distant past, historical photographs can still influence environmental attitudes and behaviours in the present. [ABSTRACT FROM AUTHOR]

In November 2020, the first woman Indigenous Minister of Foreign Affairs, Nanaia Mahuta, was appointed in Aotearoa New Zealand. Mahuta has reinforced the message of taking a values-based Indigenous-centred approach to foreign policy and development. She has also recognised the mana of wāhine (the unique spiritual authority of women), "not defined by western feminist thinking, but the values that have long underpinned our culture, histories and traditions". Her appointment reflects the complicated intersections of Indigeneity, colonialism, Western feminist discourse, and foreign policy in a settler-hegemonic state, and the possibilities (and constraints) for reimagined futures. How, then, can the teaching of gender and development (GAD) be attentive to these politics of settler-colonialism in Aotearoa? How can the complexities of the colonial project be reflected in GAD, and how can GAD be responsive to settler-hegemonic and Indigenous spaces? This paper will explore these questions and look at GAD's role in perpetuating or unsettling settler-colonialism. [ABSTRACT FROM AUTHOR]

Located within feminist scholarship on sport, leisure and physical cultures, this article explores our attempts to understand what conducting 'research with responsibility' means as White, settler-coloniser, immigrant women researching surfing, place and community in Aotearoa New Zealand. Taking inspiration from Hamilton's 'intersectional reflexivity' and Māori feminist scholars' discussion of (de)colonizing methodologies, we discuss the development of our intersectional, collaborative methodology to understand our relationships to place, community and surfing. This co-ethnographic approach helped us navigate the ethics and challenges of knowledge production in Aotearoa New Zealand, and enabled us to be aware of, and open to, different worldviews and ways of knowing. We argue this methodology has value in developing better recognition of our own privileges; understanding of the intersectional politics-of-place we are part of as researchers, and as community members; and of the assumptions, motivations and values that inform our research practices. [ABSTRACT FROM AUTHOR]

The GeoNet programme at GNS Science has monitored and managed data for volcanoes, earthquakes, landslides, and tsunami in Aotearoa New Zealand since 2001. Volcano monitoring data are collected from seismometers, acoustic sensors, GNSS receivers, webcams, remote gas monitoring sensors, and a range of environmental sensors, as well as manually during visits to volcanoes. The primary user of volcano data is the internal cross-specialised Volcano Monitoring Group (VMG), which fulfils the role of the national volcano observatory. GeoNet concentrates on automatic data collection and analysis, while supporting members of the VMG with manual data collection and interpretation. The application of open-data principles to both data and metadata has always been a core aspect of GeoNet; responses have been overwhelmingly positive, despite concerns regarding some high value, manually collected datasets. The website www.geonet.org.nz represents the primary data access portal. Data analysis and delivery applications are organised by data type rather than hazard, with no volcano-specific data applications. Most datasets have web-based and API delivery application options; both provide standard data formats from a cloud-based archive. One of the challenges for volcano data collection and management has been shifting from a reliance on manually collected data to automatic collection. Additionally, awareness of important questions related to Indigenous Māori data governance is increasing, although the associated impact is not yet understood. Overall, the current centralised, cooperative volcano monitoring and data collection and management system, which benefits from improved efficiency, interoperability, and data quality, has proved effective in Aotearoa New Zealand. Ongoing work aims to ensure optimal data collection and management for volcano monitoring and downstream activities. [ABSTRACT FROM AUTHOR]

This research provides insight into current te reo Māori (the Indigenous language of Aotearoa, New Zealand) use in English-medium ECE settings. We videoed naturalistic conversations between kaiako (educators) and tamariki (aged 15–28 months) at 24 English-medium BestStart ECE centres. Te reo Māori was quantitatively assessed across five routines: kai (food) time, book time, group time, free play, and nappy change. The highest rates of te reo Māori use per minute were observed during the kai time, book time, and group time routines, respectively, and lowest during free play and nappy change. Although scripted/prepared te reo Māori use (e.g. karakia and waiata; prayer and song) were well used, opportunities for more complex and elaborate te reo Māori use remain. This research provides insight into the current use of te reo Māori in English-medium ECE settings, an enhanced understanding of kaiako contributions to te reo Māori revitalisation goals, and applications for practice. [ABSTRACT FROM AUTHOR]

Through narrative interviews with 15 women with histories of imprisonment in Aotearoa New Zealand, this article explores the role of housing and 'home' in women's desistance. The article argues that safety and control are key psycho-social benefits of 'home' that support women's ontological security. The women's 'homes' – as sites of safety and control – could provide a space for them to construct drug and crime free identities and ultimately 'do' desistance. Moreover, their 'homes' became a physical manifestation or 'expression' of their changing identities which served to motivate and further reinforce their desistance. [ABSTRACT FROM AUTHOR]

Simple Summary: This research is the first comprehensive study in New Zealand to categorise and examine the characteristics of breast cancer based on HER2 status. We explored three HER2 categories: HER2-zero, HER2-low, and HER2-positive, in women diagnosed with invasive breast cancer. Utilising Te Rēhita Mate Ūtaetae (Breast Cancer Foundation NZ National Register), our study analysed data spanning 21 years, revealing that most women underwent HER2 testing. Significantly, many cases previously not recognised as having significant HER2 levels were in fact HER2-low, qualifying them for newer, targeted drug therapies. These findings are particularly crucial as they suggest that newer therapies could benefit a larger segment of patients, notably those with advanced breast cancer; approximately 60% of these women might now benefit from these innovative HER2-targeted treatments. The study underscores the urgent need for standardised HER2 testing to personalise and optimise treatment, enhancing outcomes for patients with invasive breast cancer. Objectives: To perform the first national analysis of demographic and clinicopathological features associated with the HER2 positive, HER2-low, and HER2-zero invasive breast cancers in New Zealand. The study will reveal the proportion of women who may benefit from new HER2-targeted antibody drug conjugate (ADC) therapies. Methods: Utilising data from Te Rēhita Mate Ūtaetae (Breast Cancer Foundation NZ National Register), the study analysed data from women diagnosed with invasive breast cancer over a 21-year period. The HER2 status of tumours was classified into three categories—HER2-zero, HER2-low, HER2-positive. Results: From 2009–2021, 94% of women underwent HER2 testing, with 14% diagnosed with HER2-positive breast cancer. For advanced-stage disease, 38% of those formerly classified as HER2-negative were reclassified as HER2-low. Including HER2-positive breast cancers, this indicates that 60% of women with advanced breast cancer may potentially benefit from the new HER2-directed ADCs (approximately 120 women per year). Conclusions: The findings suggest a significant proportion of women with invasive breast cancer in New Zealand could benefit from new HER2-targeted treatments. There is a need to standardise HER2 testing to enhance personalised treatment and improve outcomes. [ABSTRACT FROM AUTHOR]

Background/Objectives: Chronic limb-threatening ischaemia (CLTI) is a significant life and limb-threatening condition. Two recent seminal trials, BEST-CLI and BASIL-2, have provided seemingly conflicting results concerning the optimal treatment modality for patients with CLTI. We sought to investigate the outcomes of patient undergoing infrainguinal bypass at two centres in Aotearoa New Zealand. Methods: A cross-sectional retrospective review of all patients who underwent infrainguinal bypass grafting for CLTI at Auckland City Hospital and Waikato Hospital between January 2020 and December 2021 was performed. The primary outcome was a composite of death, above-ankle amputation, and major limb reintervention. The secondary outcome was minor limb reintervention. Kaplan–Meier survival analysis was performed to determine time to the primary and secondary endpoints. Demographic factors were examined using the log-rank test to examine the effect on the outcome. Results: One hundred and nineteen patients who underwent infrainguinal bypass for CLTI in the study period were identified. Of these, 93 patients had a bypass with ipsilateral or contralateral GSV. The median follow-up time was 1.85 years. The most common indication for surgery was tissue loss (69%, n = 63), with the most common distal bypass target being the below-knee popliteal artery (45%, n = 41). The primary composite outcome occurred in 42.8% of the cohort (n = 39). Death was the most common component of the primary outcome (26%, n = 24). Male sex (HR 0.48, 95% CI 0.26–0.88, p = 0.018) and statin use (HR 0.49, 95% CI 0.24–0.98, p = 0.044) were independent predictors of protection from the composite outcome on multivariate analysis. Dialysis dependence (HR 3.32, 95% CI 1.23–8.99, p = 0.018) was an independent predictor for patients meeting the composite outcome. Conclusions: This study's results are consistent with the published outcomes of BEST-CLI. The patient cohorts examined, anatomical disease patterns, and conduit use may explain some of the differences observed between this study, BEST-CLI and BASIL-2. Further work is required to define the specific patient populations who will benefit most from an open surgical or endovascular first approach to the management of CLTI. [ABSTRACT FROM AUTHOR]

Growing evidence reports that social work students experience financial hardship and negative impacts on their health and wellbeing as they juggle study, paid work, and family commitments. Social work qualifying programmes require extended compulsory field placements, which increase students' financial stress and potentially exacerbate mental health vulnerabilities. A national survey of social work students and recent graduates in Aotearoa New Zealand, was conducted in 2019, gaining 353 responses, augmented by 31 semi-structured interviews. We report the analysis of both open-question survey and interview data related to students' experience of mental distress. The survey revealed that 58.4% of respondents had sought medical advice on mental health while a social work student. At the same time, 60% of participants who experienced significant anxiety, stress, or depression chose not to seek medical advice for their mental health. Cost and access were among the main reasons for not seeking help. However, more than one in four (28%) identified stigma and fear of career consequences as reasons for not seeking help. This finding has implications for social work education and needs further research and policy development. [ABSTRACT FROM AUTHOR]

This paper reviews tourism-relevant advances in climate science and tourism policy in the Australasia region over the past 20 years, focusing particularly on the seven years (2015–2021) since the IPCC Fifth Assessment Report. Within the Australasia region, Australia and New Zealand have a complicated relationship with climate change, as both countries are dependent upon stable climates for tourism while contributing to high tourism greenhouse gas emissions. Both are economically reliant on their respective tourism industries, which market environmental products to predominantly long-haul tourism markets. In this paper we critically address the climate change context in Australasia, reviewing the tourism systems, climate risks and carbon risks in the region. We critique the (dis)connection of climate change and tourism policy at the national scale in the region, and find that the extent of climate responses in relation to tourism are generally limited to descriptive (Generation 1) and normative (Generation 2) approaches. We conclude that serious deficiencies remain in the climate science – tourism policy translation required to transform the tourism systems of Australia and New Zealand in response to climate change. [ABSTRACT FROM AUTHOR]

Aim: Investigating the extent of insular invasions by non‐native species (i.e., the number of islands they occupy) is central to island conservation. However, interrelationships among plant life history traits, naturalization histories, and island characteristics in determining island occupancy by non‐native plant species are poorly understood. We investigated whether island occupancy by different non‐native plant species declines in relation to their year of first naturalization and whether periods of first naturalization differ among growth forms, dispersal modes, and biogeographic origins. Then, we asked if non‐native plants that naturalized more recently occur more frequently on islands that are large, less isolated, and close to urban areas. We contrasted trends across growth forms, dispersal modes, and biogeographic origins. Location: 264 offshore islands in northern Aotearoa New Zealand. Taxa: Vascular plant species. Methods: We combined field surveys and published data for 767 non‐native plant species on the islands. We categorized each species according to its growth form (n = 3), dispersal mode (n = 4) and biogeographic origin (n = 5) and identified its year of first naturalization in Aotearoa New Zealand. We tested our hypotheses using ANCOVA and generalized linear models (GLMs). Results: There were similar declines in island occupancy in relation to the year of first naturalization in Aotearoa New Zealand across all trait and biogeographic origin categories. First naturalization times of herbaceous species, those with unspecialized dispersal modes, and those originating from Eurasia and the Mediterranean basin were disproportionately earlier than other categories. Non‐native plants with more recent first naturalization occur more frequently on large islands close to urban areas, but not on less isolated ones. Relationships with island characteristics did not differ among trait and biogeographic origin categories. Main Conclusions: Overall, time of first naturalization was more important than trait and biogeographic origin categories in explaining non‐native plant invasion patterns on islands. Since there were similar relationships between island occupancy and the year of first naturalization in Aotearoa New Zealand for all categories, management bodies should focus on non‐native plant species of trait and biogeographic origin categories that have naturalized recently (e.g., woody species from other regions within Oceania), and on large islands close to urban areas. Introduction and naturalization histories provide essential context for interpreting the role of plant traits and biogeographic origin in understanding plant invasions on islands. [ABSTRACT FROM AUTHOR]

Music and place are linked through many different interrelationships. Album covers play a part in these connections, influencing the experience of the music within by frequently evoking place. In Aotearoa New Zealand a sense of place is significant in music, but academic attention to the role of album covers in this sense of place is overdue. This research note addresses this gap and introduces themes and examples from a survey of Aotearoa album covers. Future attention and lines of enquiry are warranted, aided by the durability and indeed resurgence of vinyl as a musical format. [ABSTRACT FROM AUTHOR]

Effective volcanic impact and risk assessment underpins effective volcanic disaster risk management. Yet contemporary volcanic risk assessments face a number of challenges, including delineating hazard and impact sequences, and identifying and quantifying systemic risks. A more holistic approach to impact assessment is required, which incorporates the complex, multi-hazard nature of volcanic eruptions and the dynamic nature of vulnerability before, during and after a volcanic event. Addressing this need requires a multidisciplinary, integrated approach, involving scientists and stakeholders to co-develop decision-support tools that are scientifically credible and operationally relevant to provide a foundation for robust, evidence-based risk reduction decisions. This study presents a dynamic, longitudinal impact assessment framework for multi-phase, multi-hazard volcanic events and applies the framework to interdependent critical infrastructure networks in the Taranaki region of Aotearoa New Zealand, where Taranaki Mounga volcano has a high likelihood of producing a multi-phase explosive eruption within the next 50 years. In the framework, multi-phase scenarios temporally alternate multi-hazard footprints with risk reduction opportunities. Thus, direct and cascading impacts and any risk management actions carry through to the next phase of activity. The framework forms a testbed for more targeted mitigation and response planning and allows the investigation of optimal intervention timing for mitigation strategies during an evolving eruption. Using 'risk management' scenarios, we find the timing of mitigation intervention to be crucial in reducing disaster losses associated with volcanic activity. This is particularly apparent in indirect, systemic losses that cascade from direct damage to infrastructure assets. This novel, dynamic impact assessment approach addresses the increasing end-user need for impact-based decision-support tools that inform robust response and resilience planning. [ABSTRACT FROM AUTHOR]

Aims: Inflammatory bowel disease (IBD) management entails long‐term medication therapy. Worse disease outcomes and reduced quality of life might arise from poor medication adherence (MA). This study is the first to investigate patients with IBD's adherence across Aotearoa New Zealand and its relationship with disease outcomes. Methods: Dispensing claims data (Pharmaceutical Collection) were used to calculate (3‐ and 5‐year) adherence, using daily polypharmacy possession ratio. Using hospitalization data (National Minimum Dataset), the relationship between adherence and the numbers of hospitalizations and corticosteroid dispensings was investigated. Results: In total, 4654 patients (53% female; 55% Crohn's disease [CD], 45% ulcerative colitis [UC]; median age‐at‐first‐dispensing, 43 years) and 3148 patients (54% female; 55% CD, 44% UC; median age‐at‐first‐dispensing, 44 years) were in the 3‐ and 5‐year cohorts, respectively. The 3‐ and 5‐year cohorts had mean 4.6 and 4.2 IBD‐related hospitalizations and 6.9 and 9.2 corticosteroid dispensings, respectively. Average adherence estimates were 77.4% (95% confidence interval: 76.9–78.0%) and 74.9% (95% confidence interval: 74.1–75.6%; 3 and 5 years), while 54% and 51% of patients, respectively, had good adherence (MA ≥ 80%). There was no correlation between adherence and the numbers of hospitalizations (Pearson's R = −.0007; P =.65 and R = −.04; P =.02 [3 and 5 years]) and corticosteroid dispensings (R =.08; P = <.0001 and R =.08; P = <.0001, respectively). Conclusion: MA of Aotearoa New Zealand patients with IBD is moderately high but just over half of patients meet the adherent threshold. There was no correlation between adherence and hospitalizations or corticosteroid dispensings; hence, research into longitudinal adherence patterns and associated factors is needed. [ABSTRACT FROM AUTHOR]

Purpose: This paper argues for the inclusion of Indigenous research methodologies in diversity scholarship to (1) adequately account for and value the identity, lived experiences and concerns of Indigenous Peoples and (2) to enrich diversity theorising and scholarship by proposing new ways to think about and conduct research on difference, inclusion and belonging. We further highlight the roles non-Indigenous researchers can play in supporting Indigenous methodologies. Design/methodology/approach: We introduce EDI readers to Indigenous research methodologies through explicating two Indigenous (Maori) methodologies from Aotearoa New Zealand and demonstrating points of convergence and divergence from existing methodologies evident in diversity scholarship. Findings: The application of Eurocentric methodologies, including postcolonial approaches, can inaccurately theorise Indigenous experience through a Western lens compounding the ongoing impacts of colonialism. Conversely, drawing primarily from cultural knowledge and traditions, Indigenous methodologies place considerable value on people and place, relationships and relational accountabilities, each underpinned by an explicit intent to produce research with positive transformative potential for participant communities. Using Kaupapa Maori and Mana Wahine research as examples, we highlight how elements of "resistance" aligns with critical theories, but the "difference" inherent in Indigenous methodologies enables a more authentic engagement with people and place that is critical to understanding issues of significance to Indigenous Peoples. Originality/value: This paper addresses the lack of engagement with Indigenous research methodologies and priorities of Indigenous communities within diversity scholarship. We argue that Indigenous priorities make broader contributions to the diversity agenda by attributing deeper meaning to difference and resistance as enacted through the context specificity of the Indigenous world. We contend Indigenous methodologies illuminate unique perspectives and priorities that can make powerful contributions to broader discussions of equity, inclusion and belonging. [ABSTRACT FROM AUTHOR]

As opposed to Western ideologies that promote unrestrained consumption of environmental resources, Indigenous or Traditional Ecological Knowledge (TEK) encourages a more beneficial relationship with nature. In order to address underrepresented subjects and contexts, this article investigates the integration of TEK within political discourse by examining a corpus of speeches given by Aotearoa New Zealand former Minister of Foreign Affairs, Nanaia Mahuta, between 2020 and 2022. The study refers to the frameworks of ecolinguistics and Positive Discourse Analysis (PDA) to understand how Māori culture shapes Mahuta's linguistic choices. Particularly, it focusses the attention on lexical and figurative items, drawing on the concepts of metaphor, framing, and intertextuality. Results show a considerable concern over the state of the environment in Mahuta's speeches. Furthermore, they reveal the presence of an adaptation framing inspired by Indigenous thinking that acknowledges nature's agency and complexity. The latter is used to conceptualise current environmental challenges and international cooperation directed at tackling them. Mahuta's language ultimately supports the idea of interconnectedness within nature and offers as an instance of positive discourse in institutional settings. [ABSTRACT FROM AUTHOR]

Climate anxiety and worry about a changing climate have the potential to reduce individual well-being. We test for this possibility using a national survey sample of farmers, foresters, and growers in Aotearoa New Zealand. This group is of particular interest because changing climate has the potential to radically change their commercial operations. We find that survey respondents who express climate worry report substantially lower subjective well-being. Our estimates are robust to the inclusion of a wide range of controls. Our findings point to the importance of mitigating and adapting to climate change for well-being. [ABSTRACT FROM AUTHOR]

This paper presents outcomes for a Housing First (HF) cohort in Aotearoa, New Zealand. Using integrated governmental administrative data, we analysed outcomes for a cohort of 357 people, comparing health, justice, income, and social welfare indicators the year prior to HF and five years after being housed. In the fifth year after being housed, improved outcomes across each of these sectors were noted, with particularly impressive improvements found in income levels (+38%) and mental health. These results demonstrate the efficacy of this HF programme in improving well-being. Despite such notable improvements, there is room for HF to have a greater impact in the context of wider system changes that support overall well-being, as well as the goal of making homelessness rare, brief, and non-recurring. [ABSTRACT FROM AUTHOR]

The Plant Variety Rights Act of Aotearoa New Zealand (PVR Act), recently reformed in 2022, adopts new protections for Indigenous relations with native and culturally significant plants, and for traditional knowledge. The Act specifically aims to protect kaitiaki (guardian or caretaker) relationships that Māori have with taonga (treasured, culturally significant) plant species and mātauranga Māori (Indigenous knowledge) in the PVR system. By taking these reforms into account and examining how they may operate in practice, this article considers whether the PVR Act fulfils the constitutional obligations the government owes to Māori under the Treaty of Waitangi | Te Tiriti o Waitangi framework. In addition to conducting a doctrinal assessment of the revised statute, the article undertakes an intellectual property landscape analysis, revealing how PVR systems, both domestically and overseas, have been used by non‐Māori entities to assert ownership claims to varieties of taonga plants in the past. The article further draws upon a third research methodology, presenting initial results from qualitative interviews conducted with Māori and non‐Māori experts in intellectual property, taonga plants, and mātauranga Māori. Synthesising the results of these three forms of investigation, the article argues that while some of the changes made in the PVR Act support the exercise of partial Māori authority in relation to taonga, it remains to be seen whether the Treaty promise of tino rangatiratanga (chieftainship, sovereignty, or self‐determination) can be fully achieved in the PVR system. [ABSTRACT FROM AUTHOR]

Takatāpui/LGBTIQ + people's experiences of homelessness remain poorly understood in Aotearoa New Zealand. Using data from semi-structured interviews with eight people who identified as Takatāpui/LGBTIQ + and had experienced homelessness, this paper explores their experiences while homeless. The analysis showed the necessity of strength of character, how Takatāpui/LGBTIQ + people presented a different self in order to be accepted, the different strategies used to survive, the importance of implementing boundaries for self-protection, and missed points of intervention and support. Our findings show how participants were failed by the housing support system, and had to rely on themselves and their communities during periods of homelessness. [ABSTRACT FROM AUTHOR]

Background: The Aotearoa New Zealand COVID-19 pandemic response has been hailed as a success story, however, there are concerns about how equitable it has been. This study explored the experience of a collective of Māori health and social service providers in the greater Wellington region of Aotearoa New Zeland delivering COVID-19 responses. Methods: The study was a collaboration between a large urban Māori health and social service provider, Tākiri Mai Te Ata whānau ora collective, and public health researchers in Aotearoa New Zealand. Two online workshops were held with staff of the Māori service provider, collectively developing a qualitative causal loop diagram and generating systemic insights. The causal loop diagram showed interactions of various factors affecting COVID-19 response for supporting whānau (Māori family/households) at a community level. The iceberg model of systems thinking offered insights for action in understanding causal loop diagrams, emphasizing impactful changes at less visible levels. Results: Six interacting subsystems were identified within the causal loop diagram that highlighted the systemic barriers and opportunities for effective COVID-19 response to Māori whānau. The medical model of health service produces difficulties for delivering kaupapa Māori services. Along with pre-existing vulnerability and health system gaps, these difficulties increased the risk of negative impacts on Māori whānau as COVID-19 cases increased. The study highlighted a critical need to create equal power in health perspectives, reducing dominance of the individual-focused medical model for better support of whānau during future pandemics. Conclusions: The study provided insights on systemic traps, their interactions and delays contributing to a relatively less effective COVID-19 response for Māori whānau and offered insights for improvement. In the light of recent changes in the Aotearoa New Zealand health system, the findings emphasize the urgent need for structural reform to address power imbalances and establish kaupapa Māori approach and equity as a norm in service planning and delivery. [ABSTRACT FROM AUTHOR]

Despite the inclusion of both individual interventions and population-based measures in the Aotearoa New Zealand (Aotearoa NZ) Tobacco Control Programme, the gap between Māori, Pacific peoples and European/Asian/Other (EAO) populations in tobacco use has not decreased significantly. Tobacco control interventions that focus on individual behaviour change have produced little impact towards reducing tobacco smoking inequities for Māori and Pacific peoples in Aotearoa NZ. Using data from the New Zealand Health Survey (NZHS), this research investigates the impact of the wider determinants of health and individual-level factors on inequities in tobacco use between Māori, Pacific peoples and EAO. A conceptual framework was developed to support the theoretical positioning of this research and to inform data categorization, framing, discourse, analyses and interpretation. We conducted hierarchical regression to examine the effect of factors from each domain on ethnic inequities in tobacco use. We found that socioeconomic factors accounted for a significant amount of the disparity in adults currently smoking between Māori and Pacific peoples and EAO. Our results suggest that socioeconomic factors may be a more effective target of intervention than individual behaviours for reducing tobacco-related inequities. Addressing the broader determinants of health through comprehensive cross-agency cooperation to reduce ethnic inequities in tobacco use in Aotearoa NZ is likely to be more effective than individual behaviour change approaches. [ABSTRACT FROM AUTHOR]

HELL Pizza's advertising is characterized by its provocative art, audacious copy and bold tactics that relishes in its hellish reputation. Rather than merely relying on attention-grabbing stunts, the brand employs strategies that tap into the deep-seated cultural norms of its audience. Often deemed controversial, HELL's advertising elicits strong public reactions, serving as a mirror reflecting the evolving cultural and moral sensitivities and the place of Christianity in Aotearoa New Zealand. This article critically examines the official complaints about the use of religious references in HELL's advertising to the Advertising Standards Authority (ASA) in Aotearoa New Zealand. Using thematic analysis, we analyse how 'offense' and references to Christianity are navigated by the public complainant, the ASA and the brand, in 79 rulings between 2005 and 2021. We conclude that while the brand consistently negotiates a fine line between edgy humour and potential offense, the ASA rulings suggest a societal trend leaning towards freedom of artistic expression, even when intertwined with religious undertones, particularly when a brand has a well-established identity. [ABSTRACT FROM AUTHOR]

This paper explores the effectiveness of existing conceptions of digital citizenship education (DCE) to address the challenges and issues of postdigital societies. Current conceptions of DCE aim to develop learners who are capable of using digital technologies to their advantage or for the betterment of society. However, existing DCE approaches do not fully acknowledge the relational space between humans and digital technologies. Applying postdigital theory to DCE forefronts sociotechnical relations and the issues citizens face in postdigital societies. Using the Aotearoa New Zealand context as an example, digital citizenship policies and guidelines are unpacked to reveal the shortcomings of the guidance schools and teachers are offered. The analysis suggests ways to update current DCE approaches to reflect the realities of citizenship in continuously developing, complex postdigital societies. [ABSTRACT FROM AUTHOR]

Aims: To survey the national workforce that manages children and adolescents with type 1 diabetes (T1D) in Aotearoa New Zealand and compare with glycaemic outcomes for 2021. Methods: A representative from each tertiary and regional diabetes service in Aotearoa New Zealand was asked to participate in an online survey assessing health‐care professional (HCP) workforce numbers operating for the 2021 calendar year. Regional full‐time‐equivalent (FTE), glycaemic outcomes and population demographics were compared to a previously reported workforce surveys (2015 and 2019). Results: Seventeen sites responded – including all four large tertiary centres – serving >99% of children and adolescents with T1D in Aotearoa New Zealand. HCP resourcing varied across sites, with median (range) HCP/100 patient ratios of: doctors: 0.40 (0.16–1.11), nurses: 1.19 (0.29–5.56), dietitians: 0.25 (0–1.11) and psychologist/social workers: 0 (0–0.26). No site met all of the International Society of Paediatric and Adolescent Diabetes (ISPAD) recommendations of HCP/100 patient ratios. Measures of socio‐economic deprivation predicted HbA1c, rather than the diabetes clinic attended. Overall, only 15.1% (240/1585) of patients had an HbA1c less than the recommended 53 mmol/mol. Conclusions: The Aotearoa New Zealand workforce for children and adolescents with T1D is under‐resourced and no site meets the ISPAD recommendations. There has been no significant increase in HCP/100 patient ratios compared to previous workforce surveys over the last decade. Few children and adolescents with T1D meet the recommended HbA1c. Resourcing according to recommended clinical need is required if equity in outcomes for young people with T1D is to be addressed. [ABSTRACT FROM AUTHOR]

Introduction. Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies. The specific analysis in this paper probes primary health care leaders' assessments of progress towards more collaboration with other health and non-health agencies, and communities. Aim. This study aimed to investigate how ideas for more integration and joinedup care have found their way into the practice of primary health care in Aotearoa New Zealand. Methods. Applying a realist logic of inquiry, data from semi-structured interviews with primary health care leaders were analysed to identify key contextual characteristics and mechanisms. Explanations were developed of what influenced leaders to invest energy in joined-up and integrated care activities. Results. Our findings highlight three explanatory mechanisms and their associated contexts: a willingness to share power, build trusting relationships and manage task complexity. These underpin leaders' accounts of the success (or otherwise) of collaborative arrangements. Discussion. Such insights have import in the context of the current health reforms for stakeholders charged with developing local approaches to the planning and delivery of health services. [ABSTRACT FROM AUTHOR]

Introduction. Around 5% of the people in Aotearoa New Zealand (NZ) are not enrolled with a general practice. Aim. This study aimed to explore the utilisation of general practice by enrolment status and subsequent use of an emergency department. Methods. We compared a cohort of respondents from New Zealand Health Surveys (2013/14-2018/19) on self-reported general practice utilisation and their substitutes, according to their enrolment status (enrolled and not enrolled). They were then followed up to examine their subsequent use of an emergency department. Time to an emergency department presentation was modelled with proportional hazards regression models with enrolment status as the explanatory variable. Confounding variables used were sex, age group, prioritised ethnicity, the New Zealand Deprivation Index and self-rated health. Results. Those not enrolled were more likely to be young, male, Asian, more socioeconomically deprived and with better health status than those enrolled. Generally, those not enrolled utilised general practice services less. Those not enrolled who had used an emergency department were more likely to have used it as a substitute for general practice (40% vs 26%). Modelling showed that those not enrolled took longer to access an emergency department. Adjusting for confounding variables did not change that interpretation. Discussion. Those not enrolled were younger and healthier and may have a perception that enrolment isn't necessary. As a group, they were more likely to be socioeconomically deprived and to use an emergency department, which is free at a public hospital in NZ, as a substitute for primary care which suggests that cost may influence their choices. [ABSTRACT FROM AUTHOR]

Introduction. The inability to afford a consultation with a general practitioner may lead to delays in accessing care pathways. Aim. This study aimed to explore the characteristics of people by their unmet need for a general practitioner consultation because of cost, and the characteristics of subsequent inpatient hospitalisations. Methods. From the New Zealand Health Surveys (2013/14-2018/19), two groups were formed based on their unmet need for a general practitioner consultation due to cost. These groups were compared by socio-demographic factors and subsequent inpatient hospitalisation characteristics during follow-up. Time to an inpatient hospitalisation was the outcome in a proportional hazards regression model with need status as the key variable. The model was expanded to include confounding variables: sex, age group, ethnicity, the New Zealand Deprivation Index and self-rated health. Results. The need group, characterised by having a higher proportion of females, younger adults, Māori, increased socioeconomic deprivation and poorer self-rated health experienced a greater chance of hospitalisation, a similar number of visits during follow-up, shorter stays and a quicker time to hospitalisation compared to the no-need group. Proportional hazards survival models gave a 28% higher hazard rate for the time to an inpatient hospitalisation for the need group compared to the no-need group. The inclusion of all the confounders in the model gave a similar hazard ratio. Discussion. Although consultation fees vary across general practices, it is evident that this may not eliminate the cost barriers to accessing care for some groups. Needing multiple consultations may contribute to persistent unmet needs. [ABSTRACT FROM AUTHOR]

Introduction. The pursuit of health care equity is a fundamental objective for Aotearoa New Zealand, and patient co-payments in primary care challenge this goal. Aim. This study aimed to investigate the relationship between primary health care co-payments and the sociodemographic variables in areas where general practices provide health care. Methods. Using census data, facilities information from the Ministry of Health, and socioeconomic deprivation indices, linear regression models were used to explore the relationship between weighted average fees charged by general practices and various sociodemographic variables in statistical area 2 regions. Results. The study finds that areas with higher proportions of males and economically deprived individuals are associated with lower weighted average fees. Conversely, areas with higher proportions of retirement-aged and European individuals are linked with higher weighted average fees. The inclusion of the Very-Low-Cost-Access variable, indicating a subsidy scheme at the general practice level, made all the sociodemographic variables practically insignificant, suggesting Very- Low-Cost-Access practices are in the right geographical location to target high needs groups. Discussion. The findings affirm the complexity of health care inequities in Aotearoa New Zealand, influenced not only by financial factors but also by demographic variables as they play out geographically. While subsidy schemes like the Very-Low-Cost-Access scheme appear to reach groups with greater need, a high level of unmet need due to cost suggests that the fees are still too high. Policymakers need to consider disparities in the on-going health care reforms and make further changes to subsidy schemes to reduce unmet need. [ABSTRACT FROM AUTHOR]

Ascidians are marine filter-feeder chordates. Botrylloides ascidians possess diverse biological properties such as whole-body regeneration (WBR), hibernation/aestivation, blastogenesis, metamorphosis, and natural chimerism. However, the absence of distinctive morphological features often makes identification difficult. Botrylloides diegensis is an ascidian that has been misidentified in previous studies and is recorded in GenBank as Botrylloides leachii owing to the high morphological similarity between the sister species. More available sequences and strategies for identification would help resolve some of the confusion surrounding its ambiguous nature. We collected several Botrylloides samples from seven locations in Aotearoa New Zealand (Dunedin, Christchurch, Picton, Nelson, Whangateau, New Plymouth, and Invercargill) and barcoded the species based on Cytochrome Oxidase I, Histone 3, 18S, and 28S ribosomal RNA markers. Network and Bayesian trees confirmed the presence of three Botrylloides species: B. diegensis, Botrylloides jacksonianum, and Botrylloides affinis anceps. [ABSTRACT FROM AUTHOR]

This article discusses the decolonization of trans-affirming language in Aotearoa (New Zealand). The author, a Pākehā (non-Māori of European origin), cisgender, and queer sociolinguist and activist, highlights the issues associated with using Western-origin terms to refer to groups with experiences of colonization. They also address the challenge of de-centering whiteness in trans-affirming spaces and the rise of Indigenous efforts to decolonize language and gender. The article emphasizes the importance of including Indigenous and non-white perspectives in research on language and gender and calls for the decolonization of trans-affirming language. [Extracted from the article]

The bicultural nation that is Aotearoa New Zealand is now a multi-ethnic society, home to many non-indigenous ethnic minority communities. This study explored the perceptions and experiences of four self-identifying non-indigenous ethnic minority psychotherapists living in this country. Specifically, it answers the question: "What are the predominant themes that can be identified in the accounts of non-Māori ethnic minority psychotherapists, residing and practicing within the bicultural context of Aotearoa New Zealand?" Semi-structured interviews with participants explored their lived everyday experiences in both personal and professional spheres. Data were analysed using thematic analysis and yielded three themes: (1) "Acculturation to mainstream" captures the personal challenges participants encountered as immigrants in relocating and adapting to mainstream Aotearoa New Zealand culture; (2) "Encountering Indigenous culture" describes participants' experiences of coming into contact with indigenous Māori culture, and ensuing perceptions and understandings; (3) "Relating to biculturalism" describes how the participants understand and make meaning of biculturalism in Aotearoa New Zealand. Understanding these participants' experiences can help non-indigenous ethnic minority psychotherapists become better informed and politically aware, and may empower them to negotiate a more meaningful position in a bicultural nation. [ABSTRACT FROM AUTHOR]

Indigenous Peoples throughout the world have been displaced from their ancestral territories through colonial land use management. Indigenous Peoples have pushed settler-colonial governments to shift their policy frameworks to better support Indigenous rights and leadership across land management, but particularly in conservation. In Canada, this has recently involved the development of Indigenous Protected and Conserved Areas. Combined with pressure from international organizations, Canada's Federal Government has dedicated substantial funds to support the establishment of these areas and to achieve conservation and reconciliatory goals. In Aotearoa New Zealand, Māori groups have shaped new legislation that recognizes legal personality status for natural features, which contrasts with Western understandings of land ownership. Indigenous-led conservation in Canada faces many interrelated barriers grounded in colonial histories that complicate land jurisdictions, reconciliation, and protected area networks. This research reveals some of this complexity by examining how Indigenous-led conservation can contribute to more equitable and consensus-based decision-making frameworks in land use management. Policy and legal analyses of Canadian, Aotearoa New Zealand, and international conservation and human rights documents inform our results. We affirm that Indigenous-led conservation can foster relationships between Indigenous Nations and Crown governments. They can also provide steps towards reconciling colonial injustices, supporting Indigenous self-determination, and advancing more sustainable land use systems. [ABSTRACT FROM AUTHOR]

Background: Methylenedioxymethamphetamine (MDMA) is a popular drug worldwide and use is prevalent in Aotearoa New Zealand. Although associated with some significant harms, including fatalities, MDMA is ultimately less harmful than other commonly consumed drugs. We aimed to expand the understanding of MDMA harm and harm reduction strategies from a consumer perspective so that national harm reduction efforts can be better informed. Methods: We conducted 14 semi-structured focus group discussions including 60 people (aged 18–67, median = 21) who use MDMA in the Southern region of Aotearoa New Zealand to explore their thoughts and experiences regarding MDMA associated harm and harm reduction. Reflexive thematic analysis was conducted from a critical realist perspective. Results: Five themes were generated; (1) Mindset and setting matters; (2) Looking after your body and mind, not overdoing it; (3) Other substances increase risk and harm; (4) Trusted friends and peers are protective; and (5) Valid information is key for healthy self-determination; and one subtheme 5.1) Drug checking is essential harm reduction. Conclusions: We discuss the implications for MDMA consumers and aim to inform national drug policy and the harm reduction practices of consumers and organisations, for the ultimate purpose of reducing MDMA-related harm in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

With increasing urbanisation, there is a growing disconnect between soil, food, and people, centred around those relying on Western food production models. This 'wicked' problem is challenging sustainable soil use and food insecurity. Knowledge of soils through scientific studies alone are unable to address this problem, and we need to extend the boundaries of soil science for real progress to be made. We present a conceptual framework for understanding the reciprocal connections between soil, food, and people in local food production systems in Aotearoa New Zealand, applying principles and practices from a transdisciplinary research methodology. The resultant Food‐Landscape Networks framework consists of seven factors that support understanding the inherent connections between soil, food, and people. The factors are: soil health, land suitability, climate, productivity, food quality, well‐being, and engagement. These factors have been identified from weaving together mātauraka (the Kāi Tahu mita [dialect] is used in this text, where the 'ng' diagraph is replaced with 'k', e.g., mātauranga = mātauraka) Māori (Māori knowledge, culture, worldview, and values) and soil science using the He Awa Whiria, Braided Rivers, epistemological framework. Mātauraka Māori guides the traditionally reductionist discipline of soil science into a more holistic space, in an Aotearoa New Zealand context. [ABSTRACT FROM AUTHOR]

Background and aims: Quantifying the health burden of alcohol has largely focused upon harm to drinkers, which is an underestimate. There is a growing literature on alcohol's harm to others (HTO), but it lacks the systematic transfer of HTO into a comparative risk assessment framework. This study calculated disability‐adjusted life years (DALYs) for fetal alcohol spectrum disorder (FASD), interpersonal violence and traffic injury due to another's drinking. Design: This study is a disease burden analysis, using modelling of DALYs for New Zealand in 2018. Setting and participants: The study took place among the Aotearoa/New Zealand population in 2018. Measurements The involvement of others' drinking was obtained from prevalence, alcohol‐attributable fraction studies and administrative data. Disability weights (DW) for FASD were adapted from fetal alcohol syndrome (FAS) weights using a Beta–Pert probability distribution; for interpersonal injury, DWs used hospital events linked with injury compensation; for traffic injury, DWs used hospital events. Populations were stratified by ethnicity, age group and gender. A descriptive comparison was made with a previous estimate of DALYs for drinkers. Findings In 2018, 78 277 healthy life years were lost in Aotearoa/New Zealand due to alcohol's HTO. The main contributor (90.3%) was FASD, then traffic crashes (6.3%) and interpersonal violence (3.4%). The indigenous population, Māori, was impacted at a higher rate (DALYs among Māori were 25 per 1000 population; among non‐Māori 15 per 1000 population). The burden of HTO was greater than that to drinkers (DALYs HTO = 78 277; DALYs drinkers = 60 174). Conclusions: Disability from fetal alcohol spectrum disorder (FASD) appears to be a major contributor to alcohol's harm to others in Aotearoa/New Zealand. Taking FASD into account, the health burden of harm to others is larger than harm to the drinker in Aotearoa/New Zealand, and ethnicity differences show inequity in harm to others. Quantification of the burden of harm informs the value of implementing effective alcohol policies and should include the full range of harms. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic brought to the fore the everyday and exceptional challenges for mothers. Rarely, however, did research or social commentary acknowledge the multiplicities of motherhood during this prolonged period of risk, disruption, and uncertainty. This paper draws upon interviews with 24 mothers living in Aotearoa New Zealand during the pandemic, including women who were pregnant and gave birth during lockdowns, teenage mothers, single and low-income mothers, and working mothers. The sample was intentionally diverse, including M?aori, Pacific, Asian and migrant mothers. Engaging an intersectional lens on motherhood and women's health, this paper builds upon and extends feminist research on mothers' experiences during the pandemic, highlighting the many different challenges facing mothers of diverse social, cultural, and economic positionalities and during various stages of motherhood. Across the sample, we reveal the significant emotional toll on mothers, particularly with the absence of critical social, medical and health support systems during lockdown periods and sustained social restrictions. Many of the women described how the pandemic affected their feelings about motherhood, prompting newreflections on their relationships with the home, family, work, and broader society. Despite some similarities, the pandemic experiences of M?aori, Pacific, migrant and single mothers were further intensified by various forms of isolation, judgement, and discrimination. In this way, the pandemic shed light on the gendering of everydaymaternal life, but also the need formore intersectional culturally and gender-responsive policies that acknowledge the multi-layered complexities of mothers' lives. [ABSTRACT FROM AUTHOR]

This article investigates how the eight universities in Aotearoa New Zealand are responding to climate change. It employs a mixed methods approach and involves a detailed analysis of the documentation that universities have produced in relation to climate change, supported by a critical discourse analysis and interviews with key actors in universities' climate change response. All universities in Aotearoa New Zealand were found to be mobilising in response to climate change, with targets set for reducing emissions, plans developed, and work programmes underway. These targets are not limited to decarbonization but include ambitions to embed sustainability values across teaching, research and campus life. While these climate change responses contain positive and aspirational narratives grounded in indigenous values, the primary discourses perpetuate neoliberal ideas of reconciliation that suggest no radical change is needed. Universities are further constrained by the impacts of neoliberalism and their need to financially survive within an unsustainable economic paradigm. The research concludes that it seems unlikely that transformational change will be led by universities in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Large‐scale housing developments (LHD) are increasingly being used to accommodate population growth in (sub)urban Aotearoa, but their market‐oriented and delivery‐focused approach raises questions about whether resulting housing supplies meet residents' expectations for a healthy living environment. Based on a mixed‐methods survey with expert and non‐expert residents in the Wellington Region, this research critically examines LHD and underscores the pressing need for a stronger emphasis on health promotion in rapidly growing (sub)urban environments. The study reveals a strong desire among study participants for more social infrastructure in LHD and greater responsibility on the part of LHD developers towards communal values and community engagement. [ABSTRACT FROM AUTHOR]

Te Tiriti o Waitangi (Te Tiriti) signed in 1840 by the British Crown and a number of indigenous hapū (subtribes) collectively named Māori has been widely positioned as the foundation document for the colonial state of Aotearoa New Zealand. Devastating consequences of breaches of Te Tiriti form an injustice perpetuated through overt and covert institutional racism. Such racism undermines Māori sovereign status, harms the wellbeing of contemporary Māori, contradicts a justice aspired to among democratic nations, and diminishes the justification of ourselves as a just people. As authors the demand to eradicate such racism is influenced by many Māori leaders whose efforts to honour Te Tiriti have never waned. We describe Decol2020 as a creative collaboration among community and scholarly activists intent on transforming racism. We offer this paper as a contribution to how such collaborations may be invigorated wherever any institutionalized injustice requires redress. [ABSTRACT FROM AUTHOR]

Curriculum innovation occurs throughout the early childhood education (ECE) sector. This article reports on the results of a survey conducted in Aotearoa New Zealand, during Phase 1 of a two-phase mixed-methods study. The research examines the factors that shape the way teachers use curriculum innovation and seeks to understand how teachers' interactions with other teachers, families, and learners affect their innovative practices. In this study, 193 ECE teachers from throughout Aotearoa New Zealand responded to an online quantitative survey on these topics. The initial findings show that teachers' innovation is informed by self-belief, relationships, and contextual factors, and how these all work to shape curriculum innovation. It is anticipated that this research will spark new thinking, new practices, and new collaborations across the ECE sector. Phase 2 qualitative case studies are currently underway across multiple locations in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

The field of memory studies has, in recent years, experienced a 'nonhuman turn' that extends the analytical focus beyond anthropocentric functions of collective remembering. However, while this growing literature has considerably enhanced our understanding of how memories of environmental change may promote a stronger sense of connectedness with nature, the different arguments – developed mainly through critical readings of cultural texts – have yet to be investigated empirically. By means of an original survey of 1,100+ adults in Aotearoa New Zealand, the paper here provides a first step towards addressing the empirical gap in the 'nonhuman turn' literature. Two main findings emerge from this analysis. First, knowing about historical environmental change and overestimating the extent of environmental change make it more likely that individuals see themselves as part of nature. Second, the survey demonstrates that the relationship between memories of environmental change and closeness to nature interacts with wider political conflicts over how to remember the colonial past. In particular, the question of who to blame for historical environmental change shapes the effect of ecological memories in different ways, depending on whether respondents identify as European New Zealanders or Indigenous Māori. [ABSTRACT FROM AUTHOR]

Reports on Aotearoa New Zealand's research, science, and innovation (RSI) system suggest the sector could improve its social responsibility and create more social value. However, researchers and innovators within the sector find this challenging. Through qualitative interviews and a national survey of RSI system participants, this study explores the current perceptions, practices enacted, and support given around responsible research and innovation practices. Findings indicate that researchers and innovators have diverse understandings of what responsible research and innovation entails, viewing anticipation and reflexivity-aligned practices as the most important aspects of responsible research and innovation. Participants feel most supported by research organisations and funding bodies to enact such aspects of responsible practice. However, they perceive a discrepancy, across all dimensions explored, between what researchers and innovators should do, and what they actually do in terms of enacting responsible practices. Thus, significant room for improvement is identified, particularly regarding practices that align with researchers' and innovators' obligations under Te Tiriti o Waitangi, and requirements under Vision Mātauranga. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the values, resilience and innovation of four food businesses during the COVID-19 pandemic and their responses to the chaotic environment they find themselves in. It also evaluates whether there is evidence of a thriving food in tourism environment propelling these businesses forward within an innovative regenerative tourism system. Design/methodology/approach: A descriptive and comparative case study approach is used using a holistic design with four in-depth interviews for each business over 18 months. A thematic analysis of the qualitative data provides answers to the key research questions and informs our understanding of the ecosystems in which food businesses reside. Findings: The findings indicate that an internal business ecosystem with a strong value base and effective networks across a range of stakeholders enhances resilience. The crisis refocused and stimulated a variety of innovations. Practical implications: An ethos of collaboration and cooperation for food businesses provides opportunities for a shared future where it is implemented. Social implications: A values-based food in tourism system that gives back to communities potentially creates an external environment that better supports small food businesses; however, the place of food in tourism and the food story of Aotearoa New Zealand continues to lack clarity. Originality/value: The exploration of four food businesses in the time of crisis provides new insights into the multidirectional inter-related factors that either drive success or hinder it. [ABSTRACT FROM AUTHOR]

The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Background: Health intervention implementation in Aotearoa New Zealand (NZ), as in many countries globally, usually varies by ethnicity. Māori (the Indigenous peoples of Aotearoa) and Pacific peoples are less likely to receive interventions than other ethnic groups, despite experiencing persistent health inequities. This study aimed to develop an equity-focused implementation framework, appropriate for the Aotearoa NZ context, to support the planning and delivery of equitable implementation pathways for health interventions, with the intention of achieving equitable outcomes for Māori, as well as people originating from the Pacific Islands. Methods: A scoping review of the literature to identify existing equity-focused implementation theories, models and frameworks was undertaken. One of these, the Equity-based framework for Implementation Research (EquIR), was selected for adaptation. The adaptation process was undertaken in collaboration with the project's Māori and consumer advisory groups and informed by the expertise of local health equity researchers and stakeholders, as well as the international implementation science literature. Results: The adapted framework's foundation is the principles of Te Tiriti o Waitangi (the written agreement between Māori rangatira (chiefs) and the British Crown), and its focus is whānau (extended family)-centred implementation that meets the health and wellbeing aspirations, priorities and needs of whānau. The implementation pathway comprises four main steps: implementation planning, pathway design, monitoring, and outcomes and evaluation, all with an equity focus. The pathway is underpinned by the core constructs of equitable implementation in Aotearoa NZ: collaborative design, anti-racism, Māori and priority population expertise, cultural safety and values-based. Additionally, the contextual factors impacting implementation, i.e. the social, economic, commercial and political determinants of health, are included. Conclusions: The framework presented in this study is the first equity-focused process-type implementation framework to be adapted for the Aotearoa NZ context. This framework is intended to support and facilitate equity-focused implementation research and health intervention implementation by mainstream health services. [ABSTRACT FROM AUTHOR]

Indigenous entrepreneurial ecosystem development is not addressed in research. We define and characterise Indigenous entrepreneurial ecosystems and their evolution based on a qualitative study comparing Indigenous entrepreneurship in Chile and in Aotearoa New Zealand. We draw on interviews with 10 Mapuche entrepreneurs in Araucanía and 10 Māori entrepreneurs in the Bay of Plenty, observation, and a literature review to address the question – how does an Indigenous entrepreneurial ecosystem develop along with the social, economic, and political development of mainstream society? We find that Indigenous entrepreneurial ecosystems evolve with the economic and social environments of their countries because of an internal imperative towards cultural continuity and the resilience of culture to change. We find that mature Indigenous entrepreneurial ecosystems are associated with higher states of development and support a broader range of business models. Implications for policy, practice, and research are discussed. [ABSTRACT FROM AUTHOR]

Children are valued in all societies although the specific framing of that value differs. Several societies frame the value of children through the lens of investment. For instance, children are worth having and financially and emotionally investing in because children may grow up to be economically productive citizens offering financial and emotional support to aging parents. Drawing on interviews with 18 Muslim participants in Aotearoa New Zealand, we show that the act of investing in children is emotional, financial and religious. However, while would-be-parents talked most strongly about children being a form of religious investment for the future, investment as money was forced upon participants as they engaged with assisted reproductive technologies (ARTs). We explore how Muslim women and couples navigate terrain around children as investment showing a tangible tension between investment as money and investment as accruing religious capital. We thus develop the concept of children as religious investment to better understand Muslims' journeys through ARTs. [ABSTRACT FROM AUTHOR]

Introduction. For many countries, primary health care (PHC) serves as the gateway for individuals to access healthcare services. It has been shown to not only improve health but also health equity. To maximise this benefit, a substantial proportion of the population needs to be connected with PHC. The aim here was to assess the degree and evolution of enrolment in light of the coronavirus disease 2019 (COVID-19) pandemic in Aotearoa New Zealand. Methods. We examined data on the enrolment of people in PHC organisations between 2016 and 2023. This analysis included breakdowns by sex, age groups, ethnicity, and socioeconomic deprivation levels. Poisson regression models were used to explore whether enrolment changed because of the COVID-19 pandemic. Results. In 2016, Māori, young people and the most deprived had lower enrolment rates relative to their peers. Although young people's enrolment rate increased over time, especially during the COVID-19 pandemic, the Māori enrolment rate declined, as did the rate for Pacific people, and those who were the most deprived. The groups who had increases in enrolment rates were those with the lowest levels of socioeconomic deprivation and those in the 'Other' ethnic category, predominantly made up of European New Zealanders. Conclusion. Enrolment statistics reveal disparities across sociodemographic lines. The COVID-19 pandemic was associated with changed patterns of enrolment that appear to have consequences for population health. [ABSTRACT FROM AUTHOR]