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Services offering on-demand delivery of unhealthy commodities, such as fast food, alcohol and smoking/vaping products have proliferated in recent years. It is well known that the built environment can be health promoting or harmful to health, but there has been less consideration of the digital environment. Increased availability and accessibility of these commodities may be associated with increased consumption, with harmful public health implications. Policy regulating the supply of these commodities was developed before the introduction of on-demand services and has not kept pace with the digital environment. This paper reports on semi-structured interviews with health policy experts on the health harms of the uptake in on-demand delivery of food, alcohol and smoking/vaping products, along with their views on policies that might mitigate these harms. We interviewed 14 policy experts from central and local government agencies and ministries, health authorities, non-Government Organisations (NGOs) and university research positions in Aotearoa New Zealand using a purposive sampling strategy. Participants concerns over the health harms from on-demand services encompassed three broad themes—the expansion of access to and availability of unhealthy commodities, the inadequacy of existing restrictions and regulations in the digital environment and the expansion of personalized marketing and promotional platforms for unhealthy commodities. Health policy experts' proposals to mitigate harms included: limiting access and availability, updating regulations and boosting enforcement and limiting promotion and marketing. Collectively, these findings and proposals can inform future research and public health policy decisions to address harms posed by on-demand delivery of unhealthy commodities. [ABSTRACT FROM AUTHOR]

Stable, healthy families are the loto or heart of strong Pacific communities. This paper addresses the problem of a decline in the strength of Pacific families. It introduces and discusses the Tongan concept of O'ofaki , as the way in which shared, core relational commitments can bring Pasifika peoples together to support one another for health and community development. This process is based on a reciprocal sharing of social capital to promote cultural solidarity and social justice. We describe two studies by the lead author, through which the concept of O'ofaki emerged. The first study utilized an action research model while the second study focused on two Pasifika-centric research approaches: talanga , which is a Tongan word for interactive talking for a purpose, and the kakala (Tongan garland) research approach. The latter approach is incorporated within a general inductive methodology as well as luva— the dissemination of the results. Finally, the paper focuses on the components of O'ofaki and its application to Pasifika communities. [ABSTRACT FROM AUTHOR]

We examined the importance of understanding and incorporating cultural context within Aotearoa/New Zealand when engaging in clinical research and practice. This paper reports on the qualitative findings of a mixed methods study aimed at determining what effect a cardiac risk reduction exercise and lifestyle management programme, embedded within a kaupapa Māori methodological approach, had on Māori participants. This methodology saw participants able to redevelop a western model cardiac risk reduction programme by introducing a Māori worldview. Our study revealed how the kaupapa Māori approach empowered participants to examine and evaluate not only their own health and lifestyle choices, but those of family and the wider community. Combining biomedical and kaupapa Māori components into the programme was found to benefit participants' mental, physical, spiritual and family well-being. [ABSTRACT FROM AUTHOR]

Within the software engineering community, deciding how to collect, store and use personal data has become about more than just understanding our users. This paper considers ethical data use that includes cultural considerations and data ownership rights. We discuss indigenous data sovereignty as a concept and how it potentially impacts technological solutions that gather personal data from users. We propose an extension to typical user-centred design processes, which we call participatory data design. This incorporates the use of frameworks and tools that specifically focus on managing data within the cultural context it is gathered from. We also present a specific example of how we have used this approach in the context of a data collection project from Māori workers in New Zealand forestry. We conclude with a discussion of the wider implications of this approach. [ABSTRACT FROM AUTHOR]

Public health problems are often complex and 'wicked' in nature. Wicked problems have multi-factorial causation, are dynamic and often understood and acted upon differently by different actors. Multi-sectoral collaboration is increasingly emphasized for tackling wicked problems through developing a strategic multi-sectoral plan and then taking collective action. Critical systems thinking can support the development of a shared perspective of the problem, strengthen participation in collective action and foster reflective practices to continuously improve both problem understanding and action. In this paper, we present a critical collaboration model, drawing together two complementary theoretical frameworks, as well as insights from three case studies from New Zealand, to offer a systematic approach to adopting a critical systems perspective in public health collaboration. The model provides six questions to make explicit individuals' understandings or assumptions about how others perceive an issue, problem or evidence, and the process of identifying answers strengthens the dialogical and reflective aspects of the collaboration. We indicate some potential areas for the application of the model to integrate critical systems thinking in collaborative practices. [ABSTRACT FROM AUTHOR]

As well as serving as a critic and conscience for societies, universities are elite sites of privilege which, at a surface level, are unlikely locations for health promotion interventions. This paper provides a critical review of the existing health promoting universities (HPU) approaches which is informed by health promotion values. It explores the silence in the global literature around issues of structural discrimination such as the sexism, homophobia and institutional racism that can thrive within university settings. The existing literature also reveals a very limited engagement about positive mental health or indigeneity. In response, this paper brings together these three factors—structural discrimination, mental health, and indigeneity—all of which the authors consider are criterial to health and its promotion. The authors introduce the New Zealand university landscape, in which there are eight Western universities and three whare wānanga (Māori universities), and, drawing on a survey of their Charters and other official statements, offer a moemoeā (vision or dream) of an HPU that addresses structural discrimination, is based on holistic conceptions of health, and is centred on indigenous worldviews and concerns. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of middle class Indian migrants to New Zealand. Using qualitative data from interviews with this under-researched group the paper analyses their migratory strategies, labour market experiences and reasons for choosing New Zealand over other potential destinations. In the New Zealand labour market they experience an under valuation of their Indian qualifications, and interviewees reported taking low level service employment, and only sometimes progressing to middle class forms of employment. In addition, data from the interviews suggests that there is evidence of a 'brain drain' from India to New Zealand rather than a circulation of talent that has been the focus of recent theories. Unlike other studies of migration of highly qualified Indian labour this study finds that they are attracted by the environment and family friendly lifestyle of New Zealand as marketed by the New Zealand government to potential immigrants. Contrary to many previous studies, the findings suggest that migration is a family rather than an individual strategy. [ABSTRACT FROM AUTHOR]

To the best of our knowledge, this paper reports the first set of nationally representative results on the importance of 'absorptive capacity' (generally defined as a firm's ability to internalise external knowledge) for firms. Using data principally from the Business Operations Survey 2005–15, we measure absorptive capacity in New Zealand (NZ) firms across a 10-year period and investigate if it remains stable in the long term. This is followed by considering how firms' characteristics vary across levels of absorptive capacity and most importantly whether such capacity determines firms' productivity performance across the primary, manufacturing and service sectors. Our results show that relative to other influences, absorptive capacity as measured here—net of the impact of, for example, foreign-ownership and human capital—has a substantial influence on exporting, innovation and undertaking R&D, and thus consequently firm-level productivity. Set against relatively poor productivity performance, the paper concludes with a discussion of how government should consider helping firms to boost their levels of absorptive capacity in NZ. [ABSTRACT FROM AUTHOR]

Consumer trust in the modern food system is essential given its complexity. Contexts vary across countries with regard to food incidents, regulation and systems. It is therefore of interest to compare how key actors in different countries might approach (re)building consumer trust in the food system; and particularly relevant to understanding how food systems in different regions might learn from one another. The purpose of this paper is to explore differences between strategies for (re)building trust in food systems, as identified in two separate empirical studies, one conducted in Australia, New Zealand and the UK (Study 1) and another on the Island of Ireland (Study 2). Interviews were conducted with media, food industry and food regulatory actors across the two studies (n  = 105 Study 1; n  = 50 Study 2). Data were coded into strategy statements, strategies describing actions to (re)build consumer trust. Strategy statements were compared between Studies 1 and 2 and similarities and differences were noted. The strategy statements identified in Study 1 to (re)build consumer trust in the food system were shown to be applicable in Study 2, however, there were notable differences in the contextual factors that shaped the means by which strategies were implemented. As such, the transfer of such approaches across regions is not an appropriate means to addressing breaches in consumer trust. Notwithstanding, our data suggest that there is still capacity to learn between countries when considering strategies for (re)building trust in the food system but caution must be exercised in the transfer of approaches. [ABSTRACT FROM AUTHOR]

In traditional tight integration of high-rate GNSS and strong motion sensors, an appropriate process variance is crucial for obtaining accurate broad-band coseismic deformations. In this paper, instead of using a subjectively empirical value, we present an approach for determining the process variance adaptively based on the adaptive Kalman filter for real-time use. The performance of the approach was validated by the colocated stations collected during the 2010 M w 7.2 earthquake in El-Mayor, 2016 M w 7.8 earthquake in New Zealand and 2016 M w 6.5 earthquake in central Italy. The results show that this method complements the advantages of GNSS and strong motion accelerometers and can provide more accurate coseismic waveforms especially during the strong shaking period, due to the ability of the method to adjust the process variance in real time according to the actual status of the station. In addition, this method is also free from the influence of the baseline shift. Testing of the new method for the integration of strong motion and multi-GNSS indicates that multi-GNSS has an obvious improvement in the precision while single GPS has a poor observation condition. [ABSTRACT FROM AUTHOR]

Neuropsychological tests are routinely used to assess Māori, the indigenous people of New Zealand, yet very few investigations of the psychometric properties of these tests with this population have been conducted. This paper focuses on factors that may impact performance of Māori adults on neuropsychological testing. The Wechsler Adult Intelligence Scale-IV (WAIS-IV) was administered to a sample of 284 Māori stratified for age (between 16 years and 90 years) and gender in order to establish a Māori normative data set. The sample who primarily spoke English as their first language were recruited from a range of urban, regional and rural areas in New Zealand to obtain representation of the main Māori Iwi (tribes). Analysis of test results suggests acculturation, education, income, and, "a culturally positive experience" may have accounted for some of the variance in test performance. [ABSTRACT FROM AUTHOR]

Wearable cameras have been used to study health behaviours, but their utility in assessing third-party behaviours and the built environment is uncertain. This paper reports on the feasibility of using wearable cameras for this purpose in a study of sun-protective behaviours and shade availability during school lunch-breaks. The Kids'Cam study provided 168 children (aged 11–13 years), recruited from 16 randomly selected schools in the Wellington region of New Zealand, with wearable cameras. The devices automatically captured images every 7 s from the child's perspective. Images captured during school lunch-breaks by a random sample of 15 children who took part during terms 4 and 1 (October 2014–April 2015) were selected and assessed for usability. The feasibility of studying third-party sun-protective behaviours and school shade availability was assessed for a subset of 320 images. Of the 3492 eligible lunch-break images, 96.4% were useable; the remainders were excluded due to obstruction, blurriness or unsuitable camera position. Overall, 1278 children and 108 shade structures were observed in the sample images. The use of shade, hats, sleeves, collars and sunglasses could be determined for 97.0%, 77.2%, 74.4%, 47.6% and 54.9% of children, respectively. All shade structures could be classified according to type, and canopy composition could be assessed for 95.4% of structures. Wearable cameras are a feasible tool for assessing sun-safety, particularly shade availability, hat wearing and shade use. This methodology could be used to objectively study other third-party health-related behaviours, and other features of the built environment. [ABSTRACT FROM AUTHOR]

Pre-emptive kidney transplantation is the recommended strategy for patients with end-stage renal failure in all guidelines [Kidney Disease: Improving Global Outcomes (KDIGO), The Australian and New Zealand Dialysis and Transplantation Registry (ANZDATA), European Renal Best Practice Guideline (ERBP), British Transplant Society (BTS)]. This recommendation is intuitive and based on few older studies with considerable limitations. In addition, there is conflicting evidence as to whether the duration of dialysis vintage impacts on graft and patient survival after transplantation. The objective of this structured review was to critically review the published evidence on dialysis vintage and outcomes by including the most recent papers on that topic. We searched Medline using keywords for kidney transplantation, pre-emptive, dialysis vintage and relevant outcomes, and found 14 eligible cohort studies. The best evidence was found for pre-emptive transplantation, which was found to be associated with a lower risk of actual graft loss (including death as event) compared with non-pre-emptive transplantation. When only patients were considered that have been registered pre-emptively but then received or did not receive a pre-emptive transplant, the association with functional graft survival (excluding death as event) was only marginal. Dialysis vintage had a graded association with patient survival in most of the studies, but an unclear estimate with functional graft survival. Older studies also found an association of dialysis vintage with death-censored graft survival, but this association is likely confounded by selection and the competing risk of death and was no longer observed in recent eras, i.e. in transplants performed in the last decade. In summary, the recommendation for pre-emptive kidney transplantation for optimal patient and graft survival remains valid even in recent periods but the association of dialysis vintage after dialysis initiation with death-censored graft survival is less clear. The association of dialysis vintage with mortality after transplantation depends on the median duration of dialysis of the wait-listed population as well as acceptance rates for transplantation, and may thus be country specific. Nevertheless, it is reasonable to advocate pre-emptive kidney transplantation in all age groups. What remains unsolved is the selection issues since the reasons for longer waiting time on dialysis are difficult to capture in retrospective observational studies, and lead time as well as immortal time bias may have confounded the mortality data. [ABSTRACT FROM AUTHOR]

Rangatahi Tū Rangatira (R2R) is a national health promotion programme in Aotearoa New Zealand which aims to promote cultural and physical wellbeing for rangatahi (young people) and their whānau (family). Grounded in tikanga Māori, the programme focuses on total wellbeing, leadership and cultural awareness providing rangatahi opportunities to increase their participation in physical activity and cultural knowledge through ngā taonga tākaro (Māori ancestral games). This paper focuses on an evaluation of this innovative health promotion programme focussing on the delivery of R2R by a local iwi provider in a rural area. Kanohi ki te kanohi (face-to-face) interviews and focus groups were used to collect data from a range of stakeholders including rangatahi, whānau, programme developers, and collaborating community organizations. A whānau ora (holistic) framework incorporating five core outcomes and key indicators specific to the programme was developed to assess the impact of delivery. Results demonstrated that rangatahi and their whānau were living healthier lifestyles through being more physically active; had gained an increased desire to succeed in their education and extra curriculum activities; and felt more connected to their community and te ao Māori. This demonstrates the importance of incorporating cultural elements to support improved lifestyle changes for rangatahi and their whānau and the connection between enhanced cultural identity and good health. [ABSTRACT FROM AUTHOR]

Previous research identified that a review of the current industry New Zealand lamb survival trait was necessary as its recording accuracy was reliant on farmers notifying their Sheep Improvement Limited bureau of lamb deaths. This paper reports the decision rules and genetic parameters for a new lamb survival trait for the New Zealand sheep industry. These rules define the new lamb survival trait (NEWSUR) using lamb birth fate (BFATE) codes and the presence/absence of lamb weight measurements. Six univariate animal models were tested and used to estimate variance or covariance components and the resulting direct and maternal heritabilities for NEWSUR. The models differed in the way they adjust for the effect of day of birth, the exclusion or inclusion of a litter (dam/year of birth) random effect, and the application or not of a logit transformation of the phenotypes. For both the linear and logistic methods, models including the random effect of litter provided the best fit for NEWSUR according to log-likelihood values. Log-likelihoods for the linear and logistic models cannot be compared; therefore, a cross-validation method was used to assess whether the logit transformation was appropriate by analyzing the predictive ability of the models. The mean square errors were slightly lower for the linear compared with the logistic model, and therefore, the linear model was recommended for industry use. The heritability attributed to direct effects ranged from 2 to 5.5%. A direct heritability of 5.5% resulted from a linear model without litter effect and omitting the effect of day of birth on survival, whereas a direct heritability of 2% resulted from the logistic model fitting a random litter effect. The heritability attributed to maternal genetic effects ranged from 1.9 to 7.7%. A maternal genetic heritability of 7.7% resulted from the logistic model omitting the litter effect, whereas a maternal genetic heritability of 1.9% resulted from the linear model fitting a random litter effect. The addition of the litter random effect substantially decreased the maternal heritabilities in all cases and was recommended for industry use to avoid overestimation of the maternal genetic variance. Sheep Improvement Limited has implemented NEWSUR and the associated genetic evaluation model based on information described in this paper. Industry-wide implementation will enable sheep breeders to produce more accurate genetic evaluations to their commercial clients. [ABSTRACT FROM AUTHOR]

Introduction: New Zealand has implemented a series of seven annual increases in tobacco tax since 2010. All tax increases, except for the first in the series, were preannounced. It is unusual for governments to introduce small, persistent, and predictable increases in tobacco tax, and little is known about the impact of such a strategy. This paper evaluates the impact of the fifth and sixth annual increases.Methods: Smokers' behaviors were self-reported during the 3-month period before, and the 3-month period after, the two annual increases. Responses to the two increases were analyzed separately, and generalized estimating equations models were used to control for sociodemographic variables, recent quit attempts, and the research design.Results: Findings were consistent across years. The proportion of participants who made a smoking-related (54%-56% before and after each tax increase) or product-related change (fifth tax increase: 17%-19%; sixth tax increase: 21%-22%) did not significantly alter from before to after each tax increase. However, it should be noted that the proportion of participants making smoking-related changes was generally high, even prior to each increase. For example, before the 2015 tax increase, 1% reported quitting completely, 21% trying to quit, and 53% cutting down.Conclusions: In New Zealand, with its series of annual tobacco tax increases since 2010, there were no significant changes in smoking- or product-related behavior associated with the fifth and sixth increases. Nevertheless, overall cessation-related activity was high, with a majority of participants reporting either quitting and/or cutting down recently.Implications: Little is known about the impact of small, persistent, predictable tobacco tax increases on smoking behavior. This study evaluated the impact of the fifth (in 2014) and sixth (2015) tax increases in an annual series implemented in New Zealand. Although there were no detectable changes in smoking behaviors from before to after each tax increase, self-reported cessation-related activity was high overall (i.e., even prior to each increase). Given that there are multiple possible interpretations for these findings, more in-depth time-series analyses are needed to understand how such a tax strategy influences smoking behavior. [ABSTRACT FROM AUTHOR]

In low- and middle-income countries (LMICs)--when there are available data--a 'health divide' exists between indigenous and non-indigenous populations living in the same society. Despite the limited available evidence suggesting that indigenous populations have high levels of health needs, there is scant research on indigenous health, especially in Africa, China and South Asia. Pursuing research, however, is clouded by the prior negative experiences that indigenous populations have had with researchers. In this paper, we describe the current evidence base on indigenous health in LMICs, propose practical strategies for undertaking future research, and conclude by describing how global health researchers can contribute to improving the health of indigenous populations. [ABSTRACT FROM AUTHOR]

Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Focus of Presentation Cohort study recruitment can be complex, often requiring extensive pre-screening to recruit sufficient numbers of exposed and unexposed participants. We discuss a prospective study of the impact of racism on adult health in New Zealand (NZ), with emphasis on propensity-score based sampling and recruitment methods accessing participants from a national survey (NZ Health Survey 2017/18, n = 12,530 eligible adults). Discussion will cover sampling design, response rate, and confounder balance in the final sample. Key empirical results will be summarised. Findings The NZHS provided a sampling frame with complete baseline exposure and covariate data, giving n = 2,099 exposed individuals (reported racial discrimination on NZHS). A propensity-score model (stratified by ethnicity) allowed invitation of unexposed individuals balanced on key sociodemographic confounders. Recruitment used postal invitations with telephone follow-up: individuals could respond by paper survey, online questionnaire or telephone interview. Response rate was 54%, with comparable rates in exposed/unexposed individuals, with key sociodemographic factors well-balanced by exposure status. Conclusions/Implications Racism is an important determinant of health inequity, with limited prospective research in New Zealand. Our approach enabled appropriate recruitment from a sampling frame with baseline exposure status (NZHS), including allowance for exposure variability by ethnicity. Propensity-score matching on baseline covariates allowed for balance on key confounders at invitation, with balance maintained in the final sample. Key messages Secondary sampling from large national surveys can provide efficient recruitment for prospective studies. We achieved a highly satisfactory response rate, and propensity-score based sampling substantially balanced confounders between exposed and unexposed groups, enhancing study validity. [ABSTRACT FROM AUTHOR]

This paper reports genetic parameters for lamb survival and mortality traits on sheep farms in New Zealand. Lamb survival and mortality records were obtained from 38 flocks (103,357 lambs) from 5 yr of lambing data (2007 to 2011) and include many breeds and their crosses (predominantly Romney, Perendale, Coopworth, and Texel). A number of models were tested, all including environmental weather effects and investigating the random environmental effect of dam and litter (dam/year) as well as logit transformation for binary traits. Total heritability (direct + maternal) estimates were low for lamb viability at birth (0.01), lamb death risk to dystocia (0.01), and lamb death risk to starvation exposure (0.01) from birth to 3 d of age in an analysis accounting for direct and maternal genetic effects and the maternal environmental effects. Lamb survival heritabilities reported are very low (total heritabilities range from 0.02 to 0.06). The total heritabilities for the lamb death risk traits are lower than reported estimates of survival to 3 d of age or to weaning suggesting selection for the postmortem traits are not warranted at this time within these flocks. The total heritability for lamb birth weight was moderate (0.38) and the genetic correlations with the lamb death risk traits suggested that directional selection on lamb birth weight would have an effect on survival, although it is likely to have a nonlinear effect and therefore an optimum birth weight at which survival is maximized. This study has also shown that the total heritabilities may be overestimated when not accounting for maternal genetic and environment effects and in particular not accounting for the random environmental effect of litter (dam/year). [ABSTRACT FROM AUTHOR]

Background Australia has eight state-based ambulance services and New Zealand (NZ) has two. Significant variation between their datasets compromises cross-border research opportunities and translation of research to improve patient care. Ambulance data harmonisation has occurred in the United States and United Kingdom however, to-date no data harmonisation has occurred in Australia. This study aims to compare ambulance service variables in Australia and NZ to identify opportunities and barriers for harmonisation. Method Available 2019 variables were mapped to each other and several international standardized terminology systems to identify variations and similarities in variable names and definitions, and harmonisation opportunities. Results Four Australian ambulance services used one electronic patient care record (ePCR) system, three used other ePCR systems, one used paper-based records and both NZ services used one ePCR system. Only the NZ services had mapped their variables to two international standardised terminology systems. Barriers to harmonisation included the variables collected, the variable definitions and the variable naming convention. The core variables available for mapping varied and numbered from 27-69. Differences included similar variable names having different definitions, variables that should have different definitions having the same, and naming convention for similar/same variables differing between services. Conclusions Ambulance service data harmonisation in Australia and NZ is possible and presents significant opportunities for improvement in patient outcomes and performance audit. It would facilitate quality, large-scale, high-impact collaborative national and international research. Key Message There is an opportunity for Australian and NZ ambulance services to harmonise their data to conduct large scale international research. [ABSTRACT FROM AUTHOR]