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Although the management of emerging environmental risks has received more attention recently, planning and public policy scholars have not yet generated consensus on management approaches for environmental and occupational risks that remain poorly described, unquantified, and may be potentially 'unknowable'. Our case study focuses on exposure to respirable mineral dust (RMD), a specific category of particulate air pollution which includes examples such as respirable crystalline silica and asbestos fibres, as an example of a risk that is emerging and that has often 'escaped' regulations in many countries. This article (i) reviews prevailing risk management strategies and (ii) discusses their limitations when applied to the unique characteristics of RMD. The aim of the paper is to examine the suitability of existing risk management approaches for the evaluation of emerging environmental risks, which are bounded by significant uncertainties in quantifying the likelihood of the occurrence and/or severity of the hazard. We identify potential improvements to these strategies, highlighting the value of different protection levels, strategies, measures, and proactive actions which are enabled within an adaptive management framework that responds more nimbly to future changes. • Synthesised the challenges of managing respirable mineral dust. • Seven risk management approaches are most useful for different risk characteristics. • Identified improvements to these strategies for emerging environmental risks. • Potential improvements of strategies that respond more nimbly to future changes. [ABSTRACT FROM AUTHOR]

Background: Most existing clinical prediction models do not allow predictions under interventions. Such predictions allow predicted risk under different proposed strategies to be compared and are therefore useful to support clinical decision making. We aimed to compare methodological approaches for predicting individual level cardiovascular risk under three interventions: smoking cessation, reducing blood pressure, and reducing cholesterol. Methods: We used data from the PREDICT prospective cohort study in New Zealand to calculate cardiovascular risk in a primary care setting. We compared three strategies to estimate absolute risk under intervention: (a) conditioning on hypothetical interventions in non-causal models; (b) combining existing prediction models with causal effects estimated using observational causal inference methods; and (c) combining existing prediction models with causal effects reported in published literature. Results: The median absolute cardiovascular risk among smokers was 3.9%; our approaches predicted that smoking cessation reduced this to a median between a non-causal estimate of 2.5% and a causal estimate of 2.8%, depending on estimation methods. For reducing blood pressure, the proposed approaches estimated a reduction of absolute risk from a median of 4.9% to a median between 3.2% and 4.5% (both derived from causal estimation). Reducing cholesterol was estimated to reduce median absolute risk from 3.1% to between 2.2% (non-causal estimate) and 2.8% (causal estimate). Conclusions: Estimated absolute risk reductions based on non-causal methods were different to those based on causal methods, and there was substantial variation in estimates within the causal methods. Researchers wishing to estimate risk under intervention should be explicit about their causal modelling assumptions and conduct sensitivity analysis by considering a range of possible approaches. [ABSTRACT FROM AUTHOR]

Background: Early access to care for carpal tunnel syndrome (CTS) can avoid higher rates of surgery and permanent harm yet is often delayed, particularly for populations more likely to underutilise care. Objective: We sought to explore patient experiences and perspectives of health service access for CTS to inform an equity-focussed co-design of a health service for improving early care access. Methods: In this Normalisation Process Theory (NPT)-informed qualitative study we conducted semistructured in-depth interviews with 19 adults with experience of CTS. Recruitment prioritised New Zealand Māori, Pasifika, low-income, and rural populations. Data were analysed using deductive then inductive thematic analysis. Results: We identified five major themes: (1) the 'Significant Impact of CTS' of the sense-making and relational work to understand the condition, deciding when to get care, compelling clinicians to provide care, and garnering help from others; (2) 'Waiting and Paying for Care'– the enacting, relational, and appraising work to avoid long wait times unless paying privately, particularly where quality of care was low, employment relations poor, or injury compensation processes faltered; (3) circumstances of 'Occupation and CTS Onset' whereby the burden of proof to relate onset of CT symptoms to occupation created excessive relational and enacting work; (4) the 'Information Scarcity' of good information about CTS and the high relational and appraising work associated with using online resources; (5) 'Negotiating Telehealth Perspectives' where telehealth was valued if it meant earlier access for all despite the challenges it held for many. Conclusion: Quality, culturally and linguistically responsive information and communication from clinicians and health services will improve equitable early access to CTS care including realising the potential of telehealth modes of care. Policy changes that reduce individual burden of proof in injury compensation claims processes, enable time off work to attend health appointments, and increase public funding for surgical resources would improve early access to CTS care particularly for Māori and Pacific populations and those in small and rural workplaces. NPT is valuable for understanding where opportunities lie to reduce inequitable delays to accessing care including the impact of racism, particularly for populations more likely to underutilise care. [ABSTRACT FROM AUTHOR]

The New Zealand Greenshell™ mussel (Perna canaliculus) is endemic to New Zealand and contributes to the success of the country's aquaculture industry. However, summer mortality and potential disease outbreak events are having an increasing effect on the growth of this industry. The cause of these mortalities remains unknown, and histopathological studies of the pathogen and parasites in mussels are still incomplete. In the present study, a histological approach was used to identify pathogens and parasites, as well as immunological tissue responses in unhealthy- and healthy-looking P. canaliculus during a summer mortality event in 2018. A highly significant association between health conditions and the presence of Perkinsus olseni in mussels was observed. A higher prevalence of P. olseni, Apicomplexan-X (APX), and bacterial (rods and cocci) infections were noted in the unhealthy-looking mussels than in the healthy-looking mussels. In an assessment of stains, hematoxylin and eosin (H&E) staining appeared to be the best method for general pathological and anatomical characterization, while Giemsa provided the clearest visual definition of bacteria. In this aspect, it was comparable to Ziehl–Neelsen (ZN) in apparent sensitivity. Although Gram and ZN staining revealed bacterial cells marginally better than with H&E, their differential staining could not be assessed as no Gram-positive or acid-fast bacteria were seen, and no mussel-positive controls were available for comparison. This study also provides an illustrated guide to some significant mussel health indicators. [ABSTRACT FROM AUTHOR]

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The study focused on the effects of a triply periodic minimal surface (TPMS) scaffolds, varying in porosity, on the repair of mandibular defects in New Zealand white rabbits. Four TPMS configurations (40%, 50%, 60%, and 70% porosity) were fabricated with β-tricalcium phosphate bioceramic via additive manufacturing. Scaffold properties were assessed through scanning electron microscopy and mechanical testing. For proliferation and adhesion assays, mouse bone marrow stem cells (BMSCs) were cultured on these scaffolds. In vivo, the scaffolds were implanted into rabbit mandibular defects for 2 months. Histological staining evaluated osteogenic potential. Moreover, RNA-sequencing analysis and RT-qPCR revealed the significant involvement of angiogenesis-related factors and Hippo signaling pathway in influencing BMSCs behavior. Notably, the 70% porosity TPMS scaffold exhibited optimal compressive strength, superior cell proliferation, adhesion, and significantly enhanced osteogenesis and angiogenesis. These findings underscore the substantial potential of 70% porosity TPMS scaffolds in effectively promoting bone regeneration within mandibular defects. [ABSTRACT FROM AUTHOR]

This paper proposes a surveillance model for plant pests that can optimally allocate resources among survey tools with varying properties. While some survey tools are highly specific for the detection of a single pest species, others are more generalized. There is considerable variation in the cost and sensitivity of these tools, but there are no guidelines or frameworks for identifying which tools are most cost‐effective when used in surveillance programs that target the detection of newly invaded populations. To address this gap, we applied our model to design a trapping surveillance program in New Zealand for bark‐ and wood‐boring insects, some of the most serious forest pests worldwide. Our findings show that exclusively utilizing generalized traps (GTs) proves to be highly cost‐effective across a wide range of scenarios, particularly when they are capable of capturing all pest species. Implementing surveillance programs that only employ specialized traps (ST) is cost‐effective only when these traps can detect highly damaging pests. However, even in such cases, they significantly lag in cost‐effectiveness compared to GT‐only programs due to their restricted coverage. When both GTs and STs are used in an integrated surveillance program, the total expected cost (TEC) generally diminishes when compared to programs relying on a single type of trap. However, this relative reduction in TEC is only marginally larger than that achieved with GT‐only programs, as long as highly damaging species can be detected by GTs. The proportion of STs among the optimal required traps fluctuates based on several factors, including the relative pricing of GTs and STs, pest arrival rates, potential damage, and, more prominently, the coverage capacity of GTs. Our analysis suggests that deploying GTs extensively across landscapes appears to be more cost‐effective in areas with either very high or very low levels of relative risk density, potential damage, and arrival rate. Finally, STs are less likely to be required when the pests that are detected by those tools have a higher likelihood of successful eradication because delaying detection becomes less costly for these species. [ABSTRACT FROM AUTHOR]

This paper presents experimental and numerical investigations into the web crippling behaviour and load-carrying capacity of stainless steel built-up I-section members under End-Two-Flange (ETF) concentrated transverse loading. An experimental programme was conducted on 23 austenitic and duplex stainless steel built-up I-section specimens, with each consisting of two identical press-braked channel sections assembled back-to-back by means of self-tapping screws. Following the experimental programme, a numerical modelling programme was performed, where finite element models were firstly developed to replicate the tests and then used to conduct parametric studies. Based on the test and numerical data, the existing design rules for stainless steel built-up I-section members failing by web crippling, as set out in the current European, American and Australian/New Zealand design standards, were assessed. The comparisons indicated that the European and Australian/New Zealand design standards resulted in overly conservative and rather scattered failure load predictions, while the American design standard led to less scattered failure load predictions, but with many predictions on the unsafe side. Therefore, an improved design approach was proposed and shown to provide substantially improved failure load predictions for stainless steel built-up I-section members under End-Two-Flange loading. • The web crippling behaviour of stainless steel built-up I-sections under ETF loading was studied. • Tests were conducted on 23 stainless steel built-up I-section specimens. • FE models were developed and validated against test results and then used for parametric studies. • The existing codified design rules were assessed and a new design approach was proposed. [ABSTRACT FROM AUTHOR]

Background: Digital contact tracing (DCT) was a central component of the global response to containing COVID‐19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID‐19 are typically underrepresented. Methods: The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants. Results: Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID‐19 interventions. Conclusions: The findings highlight how addressing communication inequality can assist in the development of contact‐tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. Patient or Public Contribution: Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors. [ABSTRACT FROM AUTHOR]

Neuromuscular blocking agents are a crucial pharmacological element of general anesthesia. Decades of observations and scientific studies have resulted in the identification of many risks associated with the uncontrolled use of neuromuscular blocking agents during general anesthesia or an incomplete reversal of neuromuscular blockade in the postoperative period. Residual relaxation and acute postoperative respiratory depression are the most serious consequences. Cyclic recommendations have been developed by anesthesiology societies from many European countries as well as from the United States and New Zealand. The newest recommendations from the American Society of Anesthesiologists and the European Society of Anesthesiology were published in 2023. These publications contain very detailed recommendations for monitoring the dosage of skeletal muscle relaxants in the different stages of anesthesia—induction, maintenance and recovery, and the postoperative period. Additionally, there are recommendations for various special situations (for example, rapid sequence induction) and patient populations (for example, those with organ failure, obesity, etc.). The guidelines also refer to pharmacological drugs for reversing the neuromuscular transmission blockade. Despite the development of several editions of recommendations for monitoring neuromuscular blockade, observational and survey data indicate that their practical implementation is very limited. The aim of this review was to present the professional, technical, and technological factors that limit the implementation of these recommendations in order to improve the implementation of the guidelines and increase the quality of anesthesiological procedures and perioperative safety. [ABSTRACT FROM AUTHOR]

Reliable flood damage models are informed by detailed damage assessments. Damage models are critical in flood risk assessments, representing an elements vulnerability to damage. This study evaluated residential building damage for the July 2021 flood in Westport, New Zealand. We report on flood hazard, exposure and damage features observed for 247 residential buildings. Damage samples were applied to evaluate univariable and multivariable model performance using different variable sample sizes and regression-based supervised learning algorithms. Feature analysis for damage prediction showed high importance of water depth variables and low importance for commonly observed building variables such as structural frame and storeys. Overfitting occurred for most models evaluated when more than 150 samples were used. This resulted from limited damage heterogeneity observed, and variables of low importance affecting model learning. The Random Forest algorithm, which considered multiple important variables (water depth above floor level, area and floor height) improved predictive precision by 17% relative to other models when over 150 damage samples were considered. Our findings suggest the evaluated model performance could be improved by incorporating heterogeneous damage samples from similar flood contexts, in turn increasing capacity for reliable spatial transfer. [ABSTRACT FROM AUTHOR]

Mt. Ruapehu is an active andesitic stratovolcano, consisting of several peaks with the summit plateau at 2,797 m, making it the tallest active volcano in New Zealand. The extent of the volcano spreads 40 km across with a series of complex faults encompassing almost the entire base of the volcano. A series of earthquakes occurring 20 km west of the summit of Mt. Ruapehu, near the small town of Erua, which preceded the 1995/1996 major volcanic eruption sequence has been proposed as a medium-term precursor for eruptions at Mt. Ruapehu. We use unsupervised machine learning clustering algorithms HDBSCAN and DBSCAN to define anomalous earthquake swarms in the region and determine whether the Erua swarm was unique by identifying key characteristics in space, time and magnitude distribution. HDBSCAN found six spatial cluster zones to the west of Mt. Ruapehu, which have temporal seismic bursts of activity between 1994 and 2023. DBSCAN identified the seismic swarm that preceded the 1995/1996 major eruption, along with one other similar cluster in the same region, which did not coincide with any documented magmatic unrest, suggesting distal seismic swarms at Mt. Ruapehu may not serve as a reliable eruption precursor when observed in isolation. We instead found that earthquake swarms are relatively common at Mt. Ruapehu and the temporal evolution of the earthquake clusters west of Mt. Ruapehu share similar characteristics to seismic swarms identified in other settings related to fluid migration, typical of fault-valve models. [ABSTRACT FROM AUTHOR]

This paper describes the instrumentation and the first results of an upper atmospheric observing project conducted in New Zealand. We operate an all-sky aurora camera and a 64-Hz sampling induction magnetometer at Middlemarch, as well as 1-Hz sampling fluxgate magnetometers which have been operative at three stations in New Zealand, Middlemarch, Eyrewell and Te Wharau. Green and red auroras corresponding to the 557.7 nm and 630.0 nm emissions, respectively, were observed on the night of 5 August 2019. Pc1 pulsations were observed in the frequency range of ~ 0.2–1 Hz before and after a small (minimum Dst = − 40 nT) geomagnetic storm during 4–6 October 2020. Before the geomagnetic storm, Pc1 pulsations with several center frequencies were observed regardless of local time. During the recovery phase, an IPDP (interval of pulsations of diminishing period) type of Pc1 and four subsequent intervals of Pc1s were detected. The Ionospheric Alfvén Resonator (IAR) was also identified with spectral resonance structures during this magnetic storm. Lower harmonic modes of the IAR were present throughout the local nighttime, but higher harmonic modes with frequency of 5–15 Hz seemed to disappear at the onset time of substorms. This is the first report of the IAR at such a high frequency range and this is the first IAR observation in the southern hemisphere. Examples of applying cross-phase analysis to observation data of fluxgate magnetometers are also given. [ABSTRACT FROM AUTHOR]

Background: We investigated breed and gender variations in the compositions of long-chain (≥ C20) omega-3 polyunsaturated fatty acids (LC omega-3 PUFA), fat melting point (FMP) and intramuscular fat (IMF) contents in biopsy samples of the M. longissimus dorsi muscle of grazing beef cattle. The hypothesis that biopsy compositions of health-beneficial LC omega-3 PUFA, FMP and IMF in a pasture-based production system will vary with breed, was tested. Muscle biopsies were taken from 127 yearling pasture-based Angus, Hereford, and Wagyu heifers and young bulls exclusive to the Australian Bowen Genetics Forest Pastoral breeding stud averaging 12 ± 2.43 months of age and under the same management routine. Results: Breed had a significant influence on IMF, FMP, and the compositions of oleic acid, α-linolenic acid (ALA), eicosapentaenoic (EPA), docosahexaenoic (DHA), docosapentaenoic (DPA), and total EPA + DHA + DPA in the M. longissimus dorsi muscle biopsies (P ≤ 0.03). The Wagyu breed had the highest (11.1%) and Hereford the lowest (5.9%) IMF (P = 0.03). The reverse trend was observed in FMP values where the Hereford breed had the highest (55 °C), Angus intermediate (46.5 °C), and Wagyu the lowest (33 °C) FMP. The Wagyu and Angus breeds had similar oleic fatty acid (18:1n-9) content, while the Hereford breed had the lowest (P < 0.01). The highest ALA, DPA, total EPA + DHA, total EPA + DHA + DPA and total ALA + EPA + DHA + DPA contents were detected in the Wagyu breed (P ≤ 0.03). The Hereford had similar EPA and DPA contents to the Angus (P ≥ 0.46). Total EPA + DHA + DPA contents in Wagyu, Angus, and Hereford were 28.8, 21.5, and 22.1 mg/100g tissue (P = 0.01), respectively. Sex was an important source of variation that influenced LC omega-3 PUFA composition, FMP and IMF, where yearling heifers had higher IMF (11.9% vs 5.3%), lower FMP (33°C vs 37°C), and higher LC omega-3 PUFA than bulls. Conclusion: All the results taken together indicate that the Wagyu breed at 28.8 mg/100g tissue, was the closest to meeting the Australia and New Zealand recommended source level threshold of 30 mg/100g tissue of health-beneficial ≥ C20 omega-3 FA content. Since gender was a significant determinant of LC omega-3 PUFA composition, IMF content and FMP, it should be factored into enhancement strategies of healthy meat eating quality traits in grazing cattle. These findings also suggest that the Bowen Genetics Forest Pastoral beef cattle studs are important sources of LC omega-3 PUFA that can be used to cover the deficit in these health claimable fatty acids in Western diets. [ABSTRACT FROM AUTHOR]

Background: Cannabis use disorder (CUD) is increasingly common and contributes to a range of health and social problems. Cannabidiol (CBD) is a non-intoxicating cannabinoid recognised for its anticonvulsant, anxiolytic and antipsychotic effects with no habit-forming qualities. Results from a Phase IIa randomised clinical trial suggest that treatment with CBD for four weeks reduced non-prescribed cannabis use in people with CUD. This study examines the efficacy, safety and quality of life of longer-term CBD treatment for patients with moderate-to-severe CUD. Methods/Design: A phase III multi-site, randomised, double-blinded, placebo controlled parallel design of a 12-week course of CBD to placebo, with follow-up at 24 weeks after enrolment. Two hundred and fifty adults with moderate-to-severe CUD (target 20% Aboriginal), with no significant medical, psychiatric or other substance use disorders from seven drug and alcohol clinics across NSW and VIC, Australia will be enrolled. Participants will be administered a daily dose of either 4 mL (100 mg/mL) of CBD or a placebo dispensed every 3-weeks. All participants will receive four-sessions of Cognitive Behavioural Therapy (CBT) based counselling. Primary endpoints are self-reported cannabis use days and analysis of cannabis metabolites in urine. Secondary endpoints include severity of CUD, withdrawal severity, cravings, quantity of use, motivation to stop and abstinence, medication safety, quality of life, physical/mental health, cognitive functioning, and patient treatment satisfaction. Qualitative research interviews will be conducted with Aboriginal participants to explore their perspectives on treatment. Discussion: Current psychosocial and behavioural treatments for CUD indicate that over 80% of patients relapse within 1–6 months of treatment. Pharmacological treatments are highly effective with other substance use disorders but there are no approved pharmacological treatments for CUD. CBD is a promising candidate for CUD treatment due to its potential efficacy for this indication and excellent safety profile. The anxiolytic, antipsychotic and neuroprotective effects of CBD may have added benefits by reducing many of the mental health and cognitive impairments reported in people with regular cannabis use. Trial registration: Australian and New Zealand Clinical Trial Registry: ACTRN12623000526673 (Registered 19 May 2023). [ABSTRACT FROM AUTHOR]

Western Pacific leatherback sea turtles (Dermochelys coriacea) are a priority bycatch mitigation concern due to the projected extinction of the population before the end of the 21st century. The species regularly occurs as bycatch in gillnet and surface longline fisheries. Here, we explore the potential for dynamic ocean management in an emerging hotspot of leatherback sea turtle bycatch in the New Zealand pelagic longline fishery. We compared spatial areas of different sizes built from single oceanographic covariates as well as built from a composite risk surface developed through ensemble random forests. We found that, individually, the Okubo-Weiss parameter, sea surface temperature (SST) anomaly, SST, moon phase, and distance to the SST front were important oceanographic covariates for leatherback sea turtle bycatch. However, the spatial areas built from the composite risk surface were the most effective at discriminating sets with and without bycatch across a range of risk cutoffs. When we also considered implementation metrics of spatial area and coherence as part of performance, the area derived from the composite risk surface with a risk of interaction per set greater than 52% performed best. This spatial area was ephemeral, occurring 1 or 2 weeks each year, and localized, occurring along the north coast of East Cape in the North Island of New Zealand. The apparent presence of discrete spatial areas with elevated risk may be useful to inform future management in the area. Considering implementation metrics in defining utility was useful for identifying tradeoffs between the total size and the underlying covariates delineating a spatial area. As such, we recommend these types of metrics to be included when designing spatial bycatch mitigation strategies elsewhere. [ABSTRACT FROM AUTHOR]

Introduction: Concurrent diagnosis of gestational diabetes mellitus and mental disorders is associated with adverse outcomes for mother and child, but there is limited information about prevalence or which women are at risk. Material and methods: This study was a prospective cohort study of women with gestational diabetes from 10 hospitals in New Zealand who reported anxiety (6‐item Spielberger State–Trait Anxiety Inventory), depression (Edinburgh Postnatal Depression Scale) and health‐related quality of life (36‐Item Short‐Form General Health Survey) at time of gestational diabetes diagnosis (baseline), 36 weeks' gestation, and 6 months postpartum. Potential predictors were assessed using multivariable logistic regression. Results: Among 414 respondents, 17% reported anxiety, 16% vulnerability to depression and 27% poor mental health‐related quality of life at time of gestational diabetes diagnosis. At 36 weeks' gestation, prevalence decreased for vulnerability to depression (8%) and poor mental health‐related quality of life (20%). Younger maternal age, Pacific ethnicity, previous history of gestational diabetes, and older gestational age at time of gestational diabetes diagnosis were associated with poorer mental health outcomes. At 6 months postpartum the prevalence of mental disorders did not differ from in late pregnancy and they were associated with later gestational age at time of gestational diabetes diagnosis and elevated 2‐hour postprandial glucose concentrations. Conclusions: Perinatal mental disorders are common at time of diagnosis among women with gestational diabetes in New Zealand and had decreased by late pregnancy and at 6 months after birth. These disorders are more common among women with specific risk factors who may therefore benefit from additional support. [ABSTRACT FROM AUTHOR]

Peatlands store disproportionally large amounts of carbon per unit area, a function that is dependent on maintaining high and stable water tables. Climate change is likely to negatively impact carbon storage in peatlands, in part due to increases in vapour pressure deficit (VPD) driving higher evaporation (E) rates. However, the response of E to increasing VPD depends on the dominant vegetation type within peatlands. In this study, we used multiple years of eddy covariance (EC) measurements to compare E regimes at two peatlands with contrasting vegetation types – Kopuatai bog in Aotearoa / New Zealand, dominated by the vascular wire rush Empodisma robustum, and Mer Bleue bog in Canada, a "typical" shrub- and moss-dominated Northern Hemisphere peatland. We examined seasonal variability in E and equilibrium E (Eeq), energy balance partitioning, and the response of E , evaporative fraction (EF), and canopy conductance (gc) to VPD. Mean annual E was 45 % lower than mean annual Eeq at Kopuatai but only 16 % lower at Mer Bleue, demonstrating much greater limitations on E at Kopuatai. In addition, the mean midday (10:00–14:30 local standard time) dry-canopy Bowen ratio (β) at Kopuatai was 2.0 compared to 0.8 at Mer Bleue; therefore, the sensible heat flux (H) dominated over the latent heat flux (LE) at Kopuatai and vice versa at Mer Bleue. The responses of E , EF, and gc to increasing VPD at Kopuatai demonstrated stronger limitations on evaporative water loss for VPD > 0.7 kPa compared to Mer Bleue. The observed limitations at Kopuatai were attributed to strong stomatal control by E. robustum due to the rapid decrease in gc with increasing VPD; however, surface E could also be limited by its dense standing litter. At Mer Bleue, however, E was only weakly limited at VPD > 2 kPa, likely due to weak stomatal control over transpiration by the sparse shrub canopy and relatively large surface E from Sphagnum carpets. As such, the results of this study suggest that E. robustum drives a greater "hydrological resistance" to increasing VPD than the vegetation at Mer Bleue, leading to greater water retention at Kopuatai. This may enable greater resilience of the carbon sink function at Kopuatai to climatic warming and drying than at Mer Bleue. [ABSTRACT FROM AUTHOR]

Purpose: Chemical eye injury is an acute emergency that can result in vision loss. Neurotrophic keratitis (NK) is the most common long-term manifestation of chemical injury. NK due to alkali burn affects ocular surface health and is one of its most common causes. Here, we established a rabbit model of corneal alkali burns to evaluate the severity of NK-associated changes. Material methods: Alkali burns were induced in NZ rabbits by treating the cornea with (i) a 5 mm circular filter paper soaked in 0.75 N NaOH for 10 s (Mild NK) and (ii) trephination using a guarded trephine (5 mm diameter and 150-micron depth), followed by alkali burn, with a 5 mm circular filter paper soaked in 0.75 N NaOH for 10 s (a severe form of NK). Immediately after, the cornea was rinsed with 10 mL of normal saline to remove traces of NaOH. Clinical features were evaluated on Day 0, Day 1, Day 7, Day 15, and Day 21 post-alkali burn using a slit lamp, Pentacam, and anterior segment optical coherence tomography (AS-OCT). NK-like changes in epithelium, sub-basal nerve plexus, and stroma were observed using in vivo confocal microscopy (IVCM), and corneal sensation were measured using an aesthesiometer post alkali injury. After 21 days, pro-inflammatory cytokines were evaluated for inflammation through ELISA. Results: Trephination followed by alkali burn resulted in the loss of epithelial layers (manifested using fluorescein stain), extensive edema, and increased corneal thickness (550 µm compared to 380 µm thickness of control) evaluated through AS-OCT and increased opacity score in alkali-treated rabbit (80 compared to 16 controls). IVCM images showed complete loss of nerve fibers, which failed to regenerate over 30 days, and loss of corneal sensation—conditions associated with NK. Cytokines evaluation of IL6, VEGF, and MMP9 indicated an increased angiogenic and pro-inflammatory milieu compared to the milder form of NK and the control. Discussion: Using clinical parameters, we demonstrated that the alkali-treated rabbit model depicts features of NK. Using IVCM in the NaOH burn animal model, we demonstrated a complete loss of nerve fibers with poor self-healing capability associated with sub-basal nerve degeneration and compromised corneal sensation. This pre-clinical rabbit model has implications for future pre-clinical research in neurotrophic keratitis. [ABSTRACT FROM AUTHOR]

Introduction: Traditional, complementary and alternative medicine (TCAM) are popular healthcare choices among consumers globally. The latest national data on the use of TCAM practitioners in New Zealand (NZ) were collected over a decade ago. Robust data on the use of natural health products (NHPs) and TCAM practices alongside conventional medicines are not yet available in NZ. Objectives: This study aimed to develop and test a bespoke questionnaire (All-MedsNZ) that included comprehensive data collection elements exploring NHPs' and conventional medicines' use. Methods: This was a questionnaire design study involving expert panel feedback, and engagement with TCAM users, in the development process. This work comprised questionnaire development (stage 1) followed by a questionnaire-testing study (stage 2). The questionnaire was developed on the basis of literature review findings and the research team's expertise. The questionnaire content was then validated by an expert panel comprising practitioners in TCAM and conventional medicine. Then, a two-phase study was utilised to test the questionnaire. Phase 1 involved participants (NHP users) completing the web-based questionnaire and providing feedback by answering probing questions added throughout the questionnaire to evaluate users' comprehension of the questions and to identify issues with the questionnaire. In phase 2, selected participants were interviewed online to gain in-depth insights into issues identified in phase one. Based on these findings, the questionnaire was revised. Results: The expert panel (n = 9) confirmed the questionnaire had high face and content validity; most original questions were retained. In the questionnaire-testing study, 95 and 27 participants completed the phase 1 and 2 studies, respectively. Most questions achieved a high response rate of ≥ 90%, and participants had no major issues understanding and answering the questionnaire. Problematic questions were those relating to providing product barcodes and photographs, and information on product costs. Most of the NHPs data entered by participants included the brand/generic name, manufacturer/company name, main ingredient(s) and dose form. Generally, these NHP-related data were of acceptable quality. However, information on the main ingredient(s) of products entered by participants was less satisfactory: approximately one-third of the 143 NHPs recorded in the study had the main ingredient(s) missing or incorrectly stated. Interviews with participants reiterated the issues identified in the phase 1 study. The low response rates for some of the questions were partly due to participants' unpreparedness (i.e. not having NHPs/medicines on hand) to complete the questionnaire. In addition, a lack of clarity for the term 'natural health practitioner' led to confusion among some participants. Conclusion: Overall, no major design-, method- or questionnaire-related issues were identified in this development and testing work. The questionnaire demonstrated adequate face and content validity and acceptability among participants. The data collected were reasonably complete and of sufficient quality for analysis. Future studies should pilot the revised All-MedsNZ questionnaire with a larger, nationally representative sample to ascertain its feasibility and utility. [ABSTRACT FROM AUTHOR]

Middle leaders are important conduits for school policy and are often required to lead, champion and monitor change initiatives in their departments. This paper examines secondary school middle leaders' self-reported theories, promotion and leadership of culturally responsive teaching approaches for student equity. The study participants (n = 170) are curriculum leaders in state secondary schools throughout New Zealand, serving a range of diverse populations, including Indigenous Māori students. The quantitative and qualitative data for this project were thematically analysed to inquire into middle leaders' articulation of their culturally responsive theories, practices, and pedagogical and curriculum leadership to assist members of their departments in supporting Māori student educational success. The study found that although middle leaders could clearly articulate culturally responsive, sustaining and revitalising pedagogies and leadership in alignment with government policies and expectations, they were less clear about the measures they used to evidence these practices. In addition, less than 30% of the middle leader participants mentioned academic achievement as an element of Māori student success, and few mentioned the importance of systematic monitoring of achievement data, or using them to support better learning outcomes for Māori students (184). [ABSTRACT FROM AUTHOR]

Ticks are vectors of several disease agents affecting human and animal health. The ability of ticks to acquire, maintain, and transmit disease agents are factor determining the competence of ticks as vectors of etiologic agents. The present study investigates the ability of five ixodid tick species, Hyalomma dromedarii, H. excavatum, H. impeltatum, H. analoticum and Rhipicephalus annulatus to acquire, transstadially and transovarially maintain and transmit Borrelia sp. isolated from their population in nature to a laboratory animal. Although the five ixodids successfully acquired the borrelial infection by feeding on infected New Zealand rabbits, only four of the ixodids showed the ability to transstadially transfer Borrelia from the Larval-nymphal stage to the adult male, and female. Also, only R. annulatus, H. dromedarii, H. impeltatum succeed in transovarially transferring Borrelia from adult females to their progeny. Rhipicephalus annulatus was the most efficient species in acquiring borrelial infection in the laboratory (69.17%) and in transstadially transferring their natural Borrelia sp. from the infected nymphs to the emerged adult males and females with infection rates of 60 and 80%, respectively All infected females R. annulatus transovarially transmitted their natural Borrelia species to the highest percentage of the unfed larval progeny in each of F1 and F2. This was followed by H. dromedarii and H. impeltatum with 54.58% and 39.17% acquisition infection rates, and transstadially transfer Borrelia to males and females (50, 70%, and 30, 50%), respectively. Infected females of both species transmit Borrelia to the F1 and F2 (100,90%), respectively. No transovarial transmission was observed in H. impeltatum and H. analoticum. In each tick species, the transmission of Borrelia to uninfected rabbits increased by increasing the number of feeding infected stages per rabbit. Generally, female ticks were more efficient than males and adults than immatures in transmitting borrelial infection. [ABSTRACT FROM AUTHOR]

In geotechnical engineering, an appreciation of local geological conditions from similar sites is beneficial and can support informed decision-making during site characterization. This practice is known as "site recognition", which necessitates a rational quantification of site similarity. This paper proposes a data-driven method to quantify the similarity between two cross-sections based on the spatial variability of one soil property from a spectral perspective. Bayesian compressive sensing (BCS) is first used to obtain the discrete cosine transform (DCT) spectrum for a cross-section. Then DCT-based auto-correlation function (ACF) is calculated based on the obtained DCT spectrum using a set of newly derived ACF calculation equations. The cross-sectional similarity is subsequently reformulated as the cosine similarity of DCT-based ACFs between cross-sections. In contrast to the existing methods, the proposed method explicitly takes soil property spatial variability into account in an innovative way. The challenges of sparse investigation data, non-stationary and anisotropic spatial variability, and inconsistent spatial dimensions of different cross-sections are tackled effectively. Both numerical examples and real data examples from New Zealand are provided for illustration. Results show that the proposed method can rationally quantify cross-sectional similarity and associated statistical uncertainty from sparse investigation data. The proposed method advances data-driven site characterization, a core application area in data-centric geotechnics. • A novel method is proposed for quantifying 2D cross-sectional similarity of soil property spatial variability • An efficient formulation of 2D auto-correlation function is derived for a unified representation of 2D spatial variability • The challenges of sparse investigation data, non-stationarity, and inconsistent cross-sectional dimensions are tackled • The proposed method facilitates the quasi-regional clustering of geotechnical data [ABSTRACT FROM AUTHOR]

This paper presents experimental and numerical investigations into the post-fire cross-section compressive behaviour and resistances of circular recycled aggregate concrete-filled stainless steel tube (RACFSST) stub columns. Twelve stub column specimens, fabricated from concretes with three recycled coarse aggregate replacement ratios (0%, 35% and 70%), were tested after exposure to the ISO-834 standard fire for 0 min (i.e. at ambient temperature), 15 min, 30 min and 45 min. The experimental investigation included heating and cooling of specimens, cylinder tests and post-fire tensile coupon tests and stub column tests. The test results, including load–end shortening curves, failure loads and failure modes, were fully reported and the initial compressive stiffnesses and confinement effect were discussed. The numerical investigation was subsequently conducted, where thermal and mechanical finite element models were developed and validated against the test results and then used to perform parametric studies to generate further numerical data. Given the absence of design codes for stainless steel–recycled aggregate concrete composite structures after exposure to fire, the relevant design rules for circular natural aggregate concrete-filled carbon steel tube stub columns at ambient temperature, as set out in the European code, Australia/New Zealand standard and American specification, were assessed, using post-fire material properties, for their applicability to circular RACFSST stub columns after exposure to fire, based on the test and numerical data. The assessment results generally revealed that the European code and the Australian/New Zealand standard led to an acceptable level of design accuracy and consistency, while the American specification resulted in rather conservative and scattered post-fire cross-section compression resistance predictions. • The compressive behaviour of circular RACFSST stub columns after exposure to fire is investigated. • Post-fire compression tests on twelve circular RACFSST stub column specimens are conducted. • The influences of heating durations and RCA replacement ratios are analysed. • Thermal and mechanical FE models are validated against test results and then used to conduct parametric studies. • The relevant design codes are assessed against the test and FE data. [ABSTRACT FROM AUTHOR]

The Hikurangi Margin east of New Zealand's North Island hosts an extensive gas hydrate province with numerous gas hydrate accumulations related to the faulted structure of the accretionary wedge. One such hydrate feature occurs in a small perched upper‐slope basin known as Urutī Basin. We investigated this hydrate accumulation by combining a long‐offset seismic line (10‐km‐long receiver array) with a grid of high‐resolution seismic lines acquired with a 600‐m‐long hydrophone streamer. The long‐offset data enable quantitative velocity analysis, while the high‐resolution data constrain the three‐dimensional geometry of the hydrate accumulation. The sediments in Urutī Basin dip landward due to ongoing deformation of the accretionary wedge. These strata are clearly imaged in seismic data where they cross a distinct bottom simulating reflection (BSR) that dips counterintuitively in the opposite direction to the regional dip of the seafloor. BSR‐derived heat flow estimates reveal a distinct heat flow anomaly that coincides spatially with the upper extent of a landward‐verging thrust fault. We present a conceptual model of this gas hydrate system that highlights the roles of fault‐controlled fluid flow at depth merging into strata‐controlled fluid flow into the hydrate stability zone. The result is a layer‐constrained accumulation of concentrated gas hydrate in the dipping strata. Our study provides new insight into the interplay between deep faulting, fluid flow and gas hydrate formation within an active accretionary margin. Plain Language Summary: Gas hydrates are ice‐like substances in which natural gas molecules are trapped in a cage of water molecules. They exist where the pressure is high, temperature is cold, and enough methane is present. These conditions exist in the marine environment at water depths greater than 300–500 m near sediment‐rich continental margins and in polar regions. It is important to study gas hydrates because they represent a significant part of the Earth's carbon budget and influence the flow of methane into the oceans and atmosphere. In this study, we use the seismic reflection method to generate images of gas‐hydrate‐bearing marine sediments east of New Zealand. Our data reveal an intriguing relationship between deep‐sourced fluid flow upward along a tectonic fault, and shallower flow through dipping sediments. This complex fluid flow pattern has led to disruption of the gas hydrate system and the formation of concentrated gas hydrate deposits within the dipping sediments. Our study highlights the relationships between relatively deep tectonic processes (faulting and fluid flow) and the shallow process of gas hydrate formation in an active subduction zone. Key Points: A distinct gas‐hydrate to free‐gas transition is mapped using high‐ and low‐frequency seismic dataGas and hydrate accumulations in the Urutī Basin are controlled by the structural setting, ongoing deep‐sourced fluid flow, and near surface stratigraphyRegions of high modeled heat flow can be directly related to accumulations of gas and gas hydrates [ABSTRACT FROM AUTHOR]

• Develops and tests a conceptual framework of seasonal culture as rhythmic patterns. • Perceived seasonal patterns shift with climatic, environmental and social changes. • People maintain, recalibrate or detach from their seasonal patterns of activities. • Recalibrating seasonal cultures to shifting rhythms is sustainable adaptation. There is a growing literature on the cultural capacities influencing communities' adaptation to environmental and social change, including the temporal frameworks they draw on for timely action. This paper focuses on seasonal cultures, and how they enable communities on the Coromandel Peninsula to interpret and adapt practical timings to disrupted patterns of seasonal rhythms. The paper develops and applies a conceptual framework of seasonal cultures as perceived rhythmic patterns practiced by communities as cultural repertoires for action, emphasising the ways cultures evolve as patterns are contested and change. This concept steered critical, mixed-method ethnographic study with communities on the peninsula over two years. The research found that Coromandel communities' cultures make seasonal change visible as long-term shifts and asynchrony between rhythmic patterns, which they linked to climatic change, environmental degradation, colonisation and globalisation, and shifting relations between society and the environment. As seasonal patterns fail to hold, communities deploy a combination of strategies for re-configuring seasonal rhythms through their practices: (i) maintaining established, institutionalised schemas of activity while coping with seasonal variability; (ii) season-proofing activities from environmental rhythms; or (iii) re-learning and recalibrating cultures to mutable configurations of rhythms in a highly modified environment. [ABSTRACT FROM AUTHOR]

Background Emotional symptoms are recognized as a key feature in individuals with major depressive disorder. Previously, emotional blunting has been described both as a side effect of antidepressant treatment and as a symptom of depression. Little is known about the change of emotional blunting during antidepressant treatment. Methods The PREDDICT trial is a randomized, placebo-controlled, 6-week trial on the augmentation of vortioxetine with the anti-inflammatory agent celecoxib or placebo. Presently we report on exploratory secondary outcomes of changes in emotional blunting in depression assessed with the Oxford Depression Questionnaire (ODQ) total score and subscores from baseline to 8-week, 3-month, and 6-month follow-up assessments. Results In the whole group, there was a significant improvement in the ODQ total score and all subscores after 8 weeks. After stratification of participants into the treatment groups, the ODQ total score as well as subscores related to emotional blunting as a symptom of depression (reduction in positive emotions, not caring) improved between baseline and all follow-up time points in both treatment groups. Changes in subscores considered as a side effect of antidepressants (general reduction in emotions, emotional detachment) were inconclusive in both treatment groups. Overall, the placebo-augmented group showed slightly better results in changes of emotional blunting scores than the celecoxib group as did those with elevated inflammation at screening, regardless of treatment group. Conclusions This analysis suggests favorable effects of vortioxetine on emotional blunting in both short- and long-term course. The beneficial impact of vortioxetine on emotional blunting was weaker in celecoxib-augmented patients compared with placebo, possibly due to pharmacokinetic interactions. Clinical Trials Registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617000527369p. Registered on 11 April 2017, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000527369p. [ABSTRACT FROM AUTHOR]

Introduction: Patients undergoing radiation therapy have a diverse range of information needs, however, there is a lack of data specific to the needs of New Zealand patients. This cross‐sectional survey captured New Zealand cancer patients' preferences for radiation treatment information. Preferences were assessed regarding the scope of information needs and the satisfaction with which these needs were being met. Methods: A custom survey was offered to 275 eligible patients undergoing radiation treatment at six of 10 departments across New Zealand over a 2‐day period. The survey captured patient demographics as well as information needs and satisfaction across five distinct domains using Likert scales and one free‐text question. Responses were analysed using descriptive statistics and directed content analysis. Results: Over 80% of participants rated all information domains as extremely or very important. Over 90% of participants were extremely satisfied or very well satisfied in four of the five domains. Information on what happens after radiation treatment had the lowest satisfaction at 78%. No demographic subcategories were clearly associated with differences in information needs or satisfaction. 59% of participants indicated their willingness to engage in online education. The qualitative analysis strongly corroborated the quantitative results. Conclusion: The New Zealand cancer patients surveyed in this study demonstrated high levels of importance and satisfaction with the information provided during radiation treatment. Information on what happens after completing radiation treatment had the lowest satisfaction. These findings support further exploration of New Zealand cancer patients' information needs following radiation treatment as well as strategies to address them. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) refer to infections in the incision, organ, or postoperative space. As common healthcare-associated infections, SSIs correlate with prolonged hospital stay, additional procedures, ICU stay, and higher mortality rates. Around 8–10% of gynecologic surgery patients may experience infectious complications, influenced by microbial contamination, surgical nature, and patient factors. The goal of this narrative review is to compare and merge recommendations from globally published guidelines concerning the utilization of antibiotics in the perioperative phase. A comparative descriptive/narrative review of the guidelines issued by the American College of Obstetrics and Gynecology (ACOG), Society of Obstetricians and Gynecologists of Canada (SOGC), Royal College of Obstetricians and Gynecologists (RCOG), National Institute for Health and Care Excellence (NICE), Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG), European Society of Gynecologic Oncology (ESGO), Société Française d' Anésthesie et de Réanimation (SFAR), Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and Hellenic Society of Obstetrics and Gynecology (HSOG) was conducted. For hysterectomy, first/second-generation cephalosporins are suggested, with metronidazole as an option. Laparoscopy without entering the bowel or vagina typically does not require prophylaxis. Uterine evacuation and hysteroscopy may involve doxycycline or azithromycin based on risk factors, whereas, for vulvectomy, cefazolin is recommended. Urogynecology procedures may include cefazolin with metronidazole. In cases of penicillin allergy, cephalosporins are suggested, and, for obese patients, adjusted doses are advised. Additional doses may be needed for prolonged procedures or excessive blood loss. Timing recommendations are 15–60 min before incision, adjusting for specific antibiotics. Clear indications exist for certain surgeries like hysterectomy, termination of pregnancy, and urogynecologic procedures. Conversely, procedures such as intrauterine device insertion, hysteroscopy, and laparoscopy typically do not necessitate antibiotic prophylaxis. For several other procedures, the evidence is inconclusive, while considering dose, timing, and indications can mitigate infectious complications and provide benefits for the healthcare system. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including uncertainties in New Zealand's health system, challenges in primary care training, and barriers to diabetes management and skin condition treatment.

Introduction. This study presents an innovative model of integrated dermatology service delivery. Kauri HealthCare (KHC) is a general practice serving around 19 000 patients in Palmerston North, New Zealand. A 'mini clinic' is provided by an on-site dermatologist that is available for patients of KHC. Referring practitioners are required to attend with the patient to present their case and seek dermatologist input. This allows for patients to receive a specialist opinion, as well as for the referrer to receive practical and academic teaching, record findings, and arrange any further investigations, follow-up, or management. Aim. To describe the nature of patient presentations and clinical outcomes of a novel dermatologist-general practitioner integrated clinic based in a provincial healthcare practice. Methods. Descriptive analysis of all referrals to the Kauri HealthCare dermatology mini clinic from April 2017 to December 2022. Results. During the study period, 964 diagnoses were recorded across 806 patients booked into the mini clinic. The most common presenting conditions were: (1) eczema; (2) psoriasis; (3) actinic keratoses; (4) naevi; and (5) seborrheic keratosis. Practitioners sought dermatology opinion on the diagnosis and/or management of skin conditions. Further referral to secondary care was not required for 86% of patients. Discussion. Improvements could be made to better serve those of Māori and Pacific ethnicity, or living in high socioeconomic deprivation. Results indicate where teaching could be prioritised for practitioners, postgraduates, and medical students. Overall, this is an innovative clinic model, which seeks to provide equitable care, medical education, and collaboration between primary and secondary services. [ABSTRACT FROM AUTHOR]

Introduction. Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting about 7% of those aged up to 12 years, 5% of teenagers and 3% of adults. It is associated with poor academic performance, substance abuse, criminality, poor social functioning and other negative outcomes. Psychotherapeutic treatment is moderately successful, whereas pharmacotherapy with stimulant medication is more efficacious and is recommended in many international guidelines. Anecdotal evidence suggests underuse of these medications in Aotearoa, New Zealand. Aim. To estimate how many patients with ADHD are prescribed psychostimulants in Aotearoa, New Zealand. Methods. National prescribing data for dexamphetamine and methylphenidate in 2022 were obtained and matched against estimated prevalence of ADHD by age. Results. There is a significant treatment gap for which inability to access firstline medication is likely to be the predominant explanation. Discussion. The data suggest failure of our health system to provide reasonable health care for a significant number of people with ADHD, and results in inequity in outcomes. New approaches are needed that will increase access to first-line medication, yet maintain appropriateness of diagnosis and limit risk of medication diversion. [ABSTRACT FROM AUTHOR]

Introduction. The value of family health history as a means to understanding health risk has been long known. Its value in a precision medicine context is also now becoming apparent. General practitioners (GPs) are considered to play a key role in the collection, and investigation, of family health history, but it remains widely reported as being both poorly and infrequently undertaken. Little is known about this practice in Aotearoa New Zealand (NZ). Aim. This study aimed to explore current practices in relation to the ascertainment of family health history, with a view towards precision medicine. Methods. Semi-structured interviews were conducted with 10 GPs recruited from one urban area of NZ. The interviews were subjected to a thematic analysis. Results. Family health history information was used to varying degrees in four areas - risk ascertainment, patient engagement with a diagnosis, social context and building relationships. Patient cultural considerations were rarely mentioned. Reliability of information provided by patients, resource constraints, context driven consults and electronic health record limitations are potential indicators of current limits of family health history. Discussion. Our findings present a baseline of current practice and echo larger studies from overseas. As precision medicine is not yet routine, a unique opportunity exists for consideration to be given to establishing specific roles within the NZ health system to enable equitable practice of, and subsequent health gains from, the use of family/whānau health history information as part of precision medicine. [ABSTRACT FROM AUTHOR]

Introduction. Regular diabetic foot checks, at least annually, are important for early identification of risk factors and prevention of ulceration and amputation. To ensure this, most general practices in Aotearoa New Zealand (NZ) offer free annual diabetes reviews (ADRs) which include a comprehensive foot evaluation. However, attendance rates at these ADRs are low. Aim. To explore patients' perspectives on the barriers to attending ADRs and foot checks. Methods. Semi-structured interviews with people with type 2 diabetes who were overdue their ADR (n = 13; 7 women, 6 Māori) from two urban practices were conducted. Interviews were audio recorded and transcribed verbatim and then analysed using an inductive thematic analysis approach. Results. We identified three key themes demonstrating barriers to attendance: healthcareassociated factors (suboptimal clinician-patient relationship, not having a consistent general practitioner (GP)); patient-related factors (co-morbid health conditions, issues surrounding identity, and logistical issues); and systemic factors (COVID-19 pandemic, travel distance to the practice, unawareness of available foot care services). Participants' feedback focused on patient-centred approaches for improvements to service delivery, for example using online educational materials, and utilising culturally appropriate models of health including Te Whare Tapa Whā and Whānau Ora approach. Discussion. We identified several barriers to attendance, some of which are potentially modifiable. Addressing modifiable barriers and incorporating suggestions made by participants may improve access to the ADR and reduce non-attendance. Further participatory action research could explore these insights in ways that facilitate tino rangatiratanga (self-determination) and palpable action. [ABSTRACT FROM AUTHOR]

Introduction. In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim. This study aims to explore the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods. Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results. In total, 11 participants aged 19-65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion. Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau. [ABSTRACT FROM AUTHOR]

Introduction. The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middleincome countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim. This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods. The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results. Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion. This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems. [ABSTRACT FROM AUTHOR]

Introduction. The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim. The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods. A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results. Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion. E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion. This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response. [ABSTRACT FROM AUTHOR]

The article focuses on New Zealand's reluctance to embrace carbohydrate reduction (CR) in type 2 diabetes management despite global guidelines endorsing it. Topics discussed include the scientific evidence supporting CR, its inclusion in international guidelines, and the disparity in New Zealand's approach, despite successful outcomes reported in clinical trials and primary care practices.

The article focuses on the debate over carbohydrate intake in type 2 diabetes management, particularly regarding the endorsement of low carbohydrate diets in New Zealand. Topics discussed include the confusion between 'carbohydrate reduction' and 'very low carbohydrate' diets, the importance of personalized dietary approaches, and the need for adequate support and resources for optimal outcomes in diabetes management.

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]

Aotearoa New Zealand provides differential settlement support to forced migrants, primarily determined by how they receive protection status – as asylum seekers, refugees, or through other visa pathways. Despite these differences, there is limited quantitative evidence of their settlement outcomes related to work, social welfare, education and housing. In response, this study presents administrative data of adults from refugee backgrounds composed of four distinct subgroups (quota refugee, convention refugee, family reunification, and asylum seeker) to explore their access to these main services post-settlement and ascertain longitudinal income trajectories. Using the Integrated Data Infrastructure (IDI), we identified 24,894 working-age adults from refugee backgrounds who first received refugee recognition, an asylum-seeker visa or a family reunification visa between 1997 and 2020. We describe these cohorts' demographic and socioeconomic characteristics and access to services by drawing from a range of government and census datasets. We then present a mixed model regression to illustrate the association of longitudinal income with years from arrival and other settlement indicators: controlling for age, gender, and refugee subgroups. Findings show outcome disparities between refugee groups and highlight the policy implications for supporting positive settlement outcomes, particularly emphasising the first five years of settlement. [ABSTRACT FROM AUTHOR]

Major controversies in moral and political theory concern the rights, if any, Indigenous peoples should have over their traditional knowledge. Many scholars, including me, have tackled these controversies. This Article addresses a highly important practical issue: Can we come up with a solid framework for resolving disputes over actual or proposed intellectual property rights in traditional knowledge? Yes, we can. The framework suggested here starts with a preliminary distinction between control rights and income rights. It then moves to four categories that help to understand disputes: nature of the traditional knowledge under dispute; dynamics between named parties to disputes; unnamed Indigenous claimants; and the various normative systems (for example, custom, U.N. documents, treaties, statutes, administrative regulations) within which disputes are decided. Throughout, examples that inform the framework come principally from Indigenous peoples in the Pacific rim. Lastly the Article tests the framework against some disputes over traditional knowledge in Samoa and New Zealand. This framework is comprehensive and sensitive to context. It is flexible regarding which normative systems are best suited to settling disputes. A test run shows that the framework helps to resolve practical legal issues. [ABSTRACT FROM AUTHOR]

Xerostomia (severe dry mouth) is a debilitating and often permanent side effect experienced by head and neck cancer patients due to radiation injury to salivary glands. In this study, we evaluated the potential of ultrasound (US)-guided photoacoustic imaging (PAI) to non-invasively assess early changes in salivary gland hemodynamics following radiation therapy (RT). US-guided PAI was performed in New Zealand white rabbits to visualize and quantify the hemoglobin concentration (HbT) and oxygen saturation (%sO2) of parotid glands before and after RT. The imaging findings were validated with histology and sialometry. An early increase in parotid gland HbT and %sO2 was seen following RT. Consistent with the PAI observations, histology of salivary glands revealed dilated blood vessels, along with hemorrhaging and fibrosis. Sialometric analysis confirmed a significant reduction in stimulated saliva secretion in irradiated rabbits compared to controls. Collectively, our findings demonstrate the translational utility of US-guided PAI as a valuable tool for label-free functional imaging of salivary gland hemodynamics in vivo. [ABSTRACT FROM AUTHOR]

Unravelling slow ecosystem migration patterns requires a fundamental understanding of the broad-scale climatic drivers, which are further modulated by fine-scale heterogeneities just outside established ecosystem boundaries. While modern Unoccupied Aerial Vehicle (UAV) remote sensing approaches enable us to monitor local scale ecotone dynamics in unprecedented detail, they are often underutilised as a temporal snapshot of the conditions on site. In this study in the Southern Alps of New Zealand, we demonstrate how the combination of multispectral and thermal data, as well as LiDAR data (2019), supplemented by three decades (1991–2021) of treeline transect data can add great value to field monitoring campaigns by putting seedling regeneration patterns at treeline into a spatially explicit context. Orthorectification and mosaicking of RGB and multispectral imagery produced spatially extensive maps of the subalpine area (~4 ha) with low spatial offset (Craigieburn: 6.14 ± 4.03 cm; Mt Faust: 5.11 ± 2.88 cm, mean ± standard error). The seven multispectral bands enabled a highly detailed delineation of six ground cover classes at treeline. Subalpine shrubs were detected with high accuracy (up to 90%), and a clear identification of the closed forest canopy (Fuscospora cliffortioides, >95%) was achieved. Two thermal imaging flights revealed the effect of existing vegetation classes on ground-level thermal conditions. UAV LiDAR data acquisition at the Craigieburn site allowed us to model vegetation height profiles for ~6000 previously classified objects and calculate annual fine-scale variation in the local solar radiation budget (20 cm resolution). At the heart of the proposed framework, an easy-to-use extrapolation procedure was used for the vegetation monitoring datasets with minimal georeferencing effort. The proposed method can satisfy the rapidly increasing demand for high spatiotemporal resolution mapping and shed further light on current treeline recruitment bottlenecks. This low-budget framework can readily be expanded to other ecotones, allowing us to gain further insights into slow ecotone dynamics in a drastically changing climate. [ABSTRACT FROM AUTHOR]

(1) Background: Fall injuries in the home present a major health burden internationally for all age groups. One effective intervention to prevent falls is home modification, but safety is only increased if opportunities to install safety modifications are taken up. This study sought to identify factors that may lead to a higher uptake of no-cost home modifications when these are offered to people living in the community. (2) Methods: We studied 1283 houses in the New Zealand cities of New Plymouth and Wellington. Using logistic regression, we modelled the odds of uptake according to the number of access steps, the provider who was undertaking the modifications, occupant ethnicity, prior fall injury history, and age group. (3) Results: Homes with older residents (age 65+) had higher uptake rates (35% vs. 27% for other homes). Larger numbers of access steps were associated with higher uptake rates. There was indicative evidence that homes with Indigenous Māori occupants had a higher uptake of the modifications for one of the two providers, but not the other. (4) Conclusions: No-cost home safety modifications offered via cold calling are likely to have relatively low uptake rates but the households that do consent to the modifications may be those who are more likely to benefit from the concomitant increased safety. [ABSTRACT FROM AUTHOR]

Background: Health assessment tools developed using mainstream or Western concepts have been widely used in clinical practice worldwide. However, even culturally adapted or culturally based tools may not be relevant in other social contexts if they are grounded in Western beliefs and perspectives. The application of mainstream assessment tools, when used in Indigenous populations, can lead to the inappropriate application of normative data and inaccurate or biased diagnosis of conditions as Indigenous concepts of health differ from Western biomedical concepts of health. Thus, considering the need for culturally meaningful, sensitive, safe, and unbiased health assessment approaches and instruments over recent years, tools have been developed or adapted by and with Indigenous populations in Australia, Aotearoa/New Zealand, Canada, and the United States. However, there is no existing systematic or scoping review to identify the methods and approaches used in adapting or developing health assessment tools for use with the Indigenous population in Australia, Aotearoa/New Zealand, Canada, and the United States. Methods: In response to these gaps, we are working with a First Nations Community Advisory Group in Northern Ontario, Canada, to undertake a scoping review following the 2020 JBI methodology for scoping reviews. A systematic search will be conducted in PubMed, APA PsychINFO, CINAHL, MEDLINE, Web of Science, Bibliography of Native North Americans, Australian Indigenous Health info data set, and Indigenous Health Portal. Two reviewers will independently screen all abstracts and full-text articles for inclusion using criteria co-developed with an advisory group. We will chart the extracted information and summarize and synthesize the data. The summarized findings will be presented to a Community Advisory Group, including First Nations community partners, an Elder, and community members, and their feedback will be incorporated into the discussion section of the scoping review. Discussion: This scoping review involves iterative consultation with the Indigenous and non-Indigenous scholars, First Nations Community Advisory Group, and community partners throughout the research process. This review aims to summarize the evidence on standard ethical approaches and practices used in Indigenous research while adapting or developing health assessment tools. It will inform the larger study focused on developing an Indigenous Functional Assessment tool. Further, it will seek whether the Indigenous ways of knowing and equitable participation of Indigenous people and communities are incorporated in the Indigenous research process. Systematic review registration: Open Science Framework https://osf.io/yznwk. [ABSTRACT FROM AUTHOR]

This paper reports experimental and numerical investigations into the structural behaviour and resistances of high strength concrete-filled stainless steel tube (HCFSST) beam-columns under combined compression and bending. An experimental investigation was conducted on sixteen HCFSST beam-columns specimens fabricated from stainless steel tubes with two cross-section sizes and high strength concretes with four material grades, and included concrete cylinder tests, tensile coupon tests, initial global geometric imperfection measurements and eccentric compression tests. The test setups and procedures were fully reported and the experimental observations were discussed and analysed in detail. It was found that the plane cross-section assumption was valid for eccentrically loaded HCFSST sections and the lateral deflection distribution patterns for HCFSST beam-columns were approximately half-sine wave shapes. The test results were used in a subsequent numerical investigation for the validation of finite element models, which were then employed to conduct parametric studies to generate additional numerical data over a wide range of cross-section dimensions, member lengths and loading combinations. Based on the experimental and numerical results, the relevant design rules, as set out in the European code, American specification and Australian/New Zealand standard, were evaluated for their applicability to HCFSST beam-columns. The evaluation results revealed that the European code provided accurate but scattered failure load predictions when used for HCFSST beam-columns, while the American specification and Australian/New Zealand standard resulted in conservative and scattered failure load predictions. • The behaviour of high strength concrete-filled stainless steel tube (HCFSST) beam-columns is investigated. • Eccentric compression tests on sixteen HCFSST beam-column specimens are conducted. • The ductility, strength, longitudinal strain development and lateral deflection distribution are analysed. • FE models are developed to validate against the test results and then used to conduct parametric studies. • The applicability of relevant design codes is assessed against test and FE data. [ABSTRACT FROM AUTHOR]

Semi-structured interviews are useful for exploring participants experiences, understandings, and opinions on a particular issue. Traditionally, interviews have taken place in-person however, because of in-person restrictions with Covid-19, and with the changing landscape of online connection, opportunities have arisen for how to conduct interviews using an online platform. The purpose of this article is to highlight the first author's experiences with using an online platform to conduct face-to-face interviews and the valuable contribution that online interviewing could offer as a valid research tool that differs to that of in-person face-to-face interviews. Online semi-structured interviews were conducted with fourteen midwives and five pregnant people from New Zealand using Microsoft Teams. Interviews were videorecorded and conducted as part of a larger mixed methods multiphase study to explore participants experiences with how they use communication technology to connect with one another. The interviews took place between September 2022 – May 2023. Two key areas which highlight the benefits and challenges with online interviews were identified. These were around the potential to 'capture the essence of the person' and through the flexibility of the technology in enabling FTF connections. Challenges were also noted around connectivity issues. Videorecording online interviews offered an ability to capture the 'essence of the person' through visual and auditory cues. These same cues were shown to assist with lipreading when transcribing inaudible words which can assist in the analysis of data. There were disruptions to some interviews due to interviewing taking place in the person's home and connectivity issues, however, these were felt to be minimal. Online interviewing should not be considered a 'poor relation' to in-person face-to-face interviews, but instead, a valuable option that contributes towards the growing body of knowledge around online interviewing as a valid research tool that is different from face-to-face. [ABSTRACT FROM AUTHOR]