Search

Vietnam has achieved near-universal access to compulsory schooling over the past two decades. However, inequalities between ethnic majority and minority students are stark at post-compulsory levels...

Objective To determine the association between dietary protein intake and change in grip strength (GS) over time among Māori and non-Māori of advanced age. Methods Protein intake was estimated from 2×24h multiple pass recall (MPR) in 554 participants, and GS was measured yearly over five years. Anthropometric, physical activity and health data were collected. Results The median weight-adjusted protein intake was low (for Māori and non-Māori men 1.05 and 0.98g/kg/day; for Māori and non-Māori women 0.87 and 0.91g/kg/day, respectively). There was a general decrease in GS over five years (mean % change of -2.38 ± 15.32 and -4.49 ± 21.92 for Māori and non-Māori women and -5.47 ± 16.09 and -1.81 ± 13.16 for Māori and non-Māori men yearly). Intake of protein was not related to GS at any of the five-year assessment points nor was it related to change over time. Conclusion Protein intake was low in this cohort of octogenarians and was not protective against loss of GS over five years.

Background. Each year, approximately 5000 New Zealanders are admitted to hospital with first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a prospective longitudinal cohort study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry in six hospitals. The objective of MENZACS is to examine the relationship between clinical, genomic, and cardiometabolic markers in relation to presentation and outcomes post-ACS. Methods. Patients with first-time ACS are enrolled and study-specific research data is collected alongside the ANZACS-QI registry. The research blood samples are stored for future genetic/biomarker assays. Dietary information is collected with a food frequency questionnaire and information about physical activity, smoking, and stress is also collected via questionnaire. Detailed family history, ancestry, and ethnicity data are recorded on all participants. Results. During the period between 2015 and 2019, there were 2015 patients enrolled. The mean age was 61 years, with 60% of patients aged Conclusion. MENZACS represents a cohort with optimal contemporary management and will be a significant epidemiological bioresource for the study of environmental and genetic factors contributing to ACS in New Zealand’s multi-ethnic environment. The study will utilise clinical, nutritional, lifestyle, genomic, and biomarker analyses to explore factors influencing the progression of coronary disease and develop risk prediction models for health outcomes.

To provide knowledge and recommendations for researchers, health professionals and policymakers on navigating between science and mātauranga (knowledge) Māori when using co-design methodologies.It is well known that the health system in Aotearoa/New Zealand does not provide culturally responsive services, programmes or approaches. Indigenous, remote and vulnerable populations that are not well served by medical and scientific models would be better served by the underlying premise of co-design methodology. However, co-design is a Western methodology. Mahitahi is presented here as a culturally responsive method of co-design that builds approaches by utilising the worldview of the people that the health system most needs to have impact upon. Co-design and mahitahi have synergies, and working at the interface between Western and Māori knowledge systems can provide innovative solutions that draw on the strengths of both approaches.Authors will outline the benefit co-design processes have for improving health outcomes for remote and vulnerable populations. Mahitahi will be described and the synergies with co-design emphasised with important distinctions also highlighted. The use of Indigenous knowledge systems, using Māori as the case example, will be outlined.Recommendations will be provided to guide researchers, health professionals and policy makers when planning a co-design approach with remote and vulnerable communities.

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.

While critical thinking is widely regarded as a key outcome of higher education, research has shown that in practice it is only developed when certain conditions are in place, relating to the pedag...

EastPack was a New Zealand cooperative providing post-harvest services for its kiwifruit and avocado growers. EastPack was New Zealand’s largest kiwifruit postharvest company with a packing capacity of more than 40 million trays 1 of kiwifruit. It was forecasted that New Zealand kiwifruit volumes would increase by about 50% by 2025. While this was great news for the growers and Zespri – the marketer, it presented a challenge to post-harvest operators like EastPack since they would need to increase their capacity in order to cope with this growth. EastPack needed to develop strategies to manage the strong kiwifruit growth prospects, fund capacity expansion and ensure its growers remained at the heart of their growth.

India’s informal economy accounts for more than half the country’s GDP but is characterised by low levels of skills, and considerable barriers to skills development for workers. The Government of I...

To date, there is little research focusing on the role of culture and Indigenous ways of knowing in Western science-dominated high performance sporting environments. This paper takes inspiration from the emerging field of Postcolonial Science Studies and feminist Indigenous scholars to explore how Aotearoa (New Zealand) Black Ferns Sevens players from Māori and Samoan descent make meaning of their bodies within Westernized high performance sporting spaces. Drawing upon a thematic analysis of semi-structured interviews with 18 members of the Black Ferns Sevens squad, we illustrate how players navigate divergent cultural value systems within and across various aspects of the high performance sport environment, including training, nutrition, menstruation, and the everyday quantification of their bodies. This paper also reveals some of the important considerations, learnings, and vulnerabilities experienced during this cross-cultural research collaboration, and highlights the need for more research by/with/for Indigenous women in high performance sport environment.

Māori in Aotearoa have higher incidence, prevalence and mortality from chronic disease. The dominant narrative in Aotearoa about the reasons for Māori ill health neglects to acknowledge the history of colonisation and failures of the health system, alongside the holistic view of health taken by Māori focusing on collective, whānau-based outcomes. In this article, we review health interventions for chronic disease that have a kaupapa Māori philosophical basis. Our findings demonstrate that there is no clear process in health service design, delivery, research and funding that values and understands mātauranga Māori. Western knowledge systems are inadequate for collecting and presenting Māori knowledge. Overall, we highlight that the tension between acknowledging that a “by Māori, for Māori” approach is best, and the difficulty in defining appropriate evidence collection methodology and outcome measures when funders and policy makers continue to require Western-centric interventions is an obstacle to improving Māori health outcomes.

Addressing Indigenous rights and interests in genetic resources has become increasingly challenging in an open science environment that promotes unrestricted access to genomic data. Although Indigenous experiences with genetic research have been shaped by a series of negative interactions, there is increasing recognition that equitable benefits can only be realized through greater participation of Indigenous communities. Issues of trust, accountability and equity underpin Indigenous critiques of genetic research and the sharing of genomic data. This Perspectives article highlights identified issues for Indigenous communities around the sharing of genomic data and suggests principles and actions that genomic researchers can adopt to recognize community rights and interests in data.

This paper is intended to inform the work of the Intellectual Leadership Team of the Research on Improving Systems of Education (RISE) programme. It draws on data and analysis from the Young Lives project to compare four education systems at various stages of development with respect to the transition from meeting the challenge of providing for ‘mass access’ to that of providing for ‘mass learning’. Success in making this transition, that is, escaping a low-level equilibrium of educational quality in the longer term and once resources are no longer severely constrained by access expansion, is crucial if the benefits of the extension of the right to basic education are to be realised in less developed nations. The paper examines learning outcomes in Peru, Vietnam, Ethiopia and India in the light of indicative frameworks for analysing progress with respect to ‘education quality’ at the systems-level. It intends to contribute to broader aims of RISE in terms of the emerging field of education systems analysis, making use of the insights from Young Lives.

ObjectiveThe Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) was established to investigate the drivers of secondary events after first-time acute coronary syndrome (ACS), including addressing inequitable outcomes by ethnicity. Herein, the first clinical outcomes and prognostic modelling approach are reported.MethodsFirst, in 28 176 New Zealanders with first-time ACS from a national registry, a clinical summary score for predicting 1-year death/cardiovascular readmission was created using Cox regression of 20 clinical variables. This score was then calculated in the 2015 participant MENZACS study to represent clinical risk. In MENZACS, Cox regression was used to assess N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a prognostic marker for death/cardiovascular readmission in four models, adjusting for (1) age and sex; (2) age, sex, ethnicity; (3) clinical summary score; (4) clinical summary score and ethnicity.ResultsOf the 2015 MENZACS participants (mean age 61 years, 79% male, 73% European, 14% Māori, 5% Pacific people), 2003 were alive at discharge. Of the 2003, 416 (20.8%) experienced all-cause death/cardiovascular readmission over a median of 3.5 years. In a simple model, age, male sex, Māori ethnicity and NT-proBNP levels were significant predictors of outcome. After adjustment for the clinical summary score, which includes age and sex, NT-proBNP and ethnicity were no longer statistically significant: log2(NT-proBNP) hazard ratio (HR) 1.03, 95% confidence interval (95% CI) 0.98 to 1.08, p=0.305; Māori ethnicity HR 1.26, 95% CI 0.97 to 1.62, p=0.084.ConclusionsIn 2015 patients with first-time ACS, recurrent events were common (20.8%). Increasing NT-proBNP levels and Māori ethnicity were predictors of death/cardiovascular readmission, but not after adjustment for the 20 clinical risk factors represented by the clinical summary score.Trial registration numberACTRN12615000676516.

Refereed/Peer-reviewed

Although te reo Māori is an official language of Aotearoa New Zealand, translation of research material such as information sheets, consent forms and questionnaires into te reo Māori remains highly variable. Translation tends to occur in research projects where Māori lead the work and that exclusively focus on Māori communities and topics. Translations are not offered or undertaken as a matter of course for all research. As a team of Māori and Indigenous researchers working within the health sector, we believe that there are important questions that need to be explored around the practice of using Indigenous languages, rich in similes and metaphors, to convey English/Western concepts/constructs/ideologies. In this paper, we draw on the story of one project to deconstruct and challenge the hegemonic terms through which translation of research material occurs. We explore the messages that translated material sends to potential research participants. We contend that the choice about whether to translate research material into te reo Māori is one that should be undertaken within a robust decision-making framework that considers the reasons for a translation and its impact on the participants. Translation should not be undertaken primarily to attract Māori participants, but should reliably signal that the research is being undertaken in a way that honours a Māori worldview.

Māori and Pacific women in New Zealand and Aboriginal and Torres Strait Islander women in Australia are recognised as nurturers and leaders within their families and communities. However, women’s wellbeing, and that of their communities, are affected by a high burden of cardiovascular disease experienced at a younger age than women from other ethnic groups. There has been little focus on the cardiovascular outcomes and strategies to address heart health inequities among Māori, Pacific, Aboriginal and Torres Strait Islander women. The factors contributing to these inequities are complex and interrelated but include differences in exposure to risk and protective factors, rates of multi-morbidity, and substantial gaps within the health system, which include barriers to culturally responsive, timely and appropriate cardiovascular care. Evidence demonstrates critical treatment gaps across the continuum of risk and disease, including assessment and management of cardiovascular risk in young women and time-critical access to and receipt of acute services. Cardiovascular disease in women impacts not only the individual, but their family and community, and the burden of living with disease limits women’s capacity to fulfil their roles and responsibilities which support and sustain families and communities. Our response must draw on the strengths of Māori, Pacific, Aboriginal and Torres Strait Islander women, acknowledge health and wellbeing holistically, address the health and social needs of individuals, families and communities, and recognise that Indigenous women in New Zealand, Australia and across the Pacific must be involved in the design, development and implementation of solutions affecting their own health. Refereed/Peer-reviewed