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The Material Costs of Claiming International Human Rights: Australia, Adani and the Wangan and Jagalingou
No full textThis article presents a materialist account of Indigenous peoples’ international legal human rights claims. It argues that appeals to the global legal system as well as pluralistic approaches to Indigenous peoples’ rights depend on international law to make a convincing case and yet fail to account for the material construction of human rights claimants as subjects of international law. To explain this intervention, this article theorises that when international human rights law and national laws clash, human rights claimants constitute and transform themselves into international legal subjects and become identifiable Indigenous peoples. In support of this international legal constructivist approach to Indigenous peoples’ human rights claims, this article re-articulates the development of Indigenous peoples as subjects that emerged from international law and then examines the development of Australia’s native title regime. An exposition of international and then state laws reveals that the codification of different standards for participation enables those who subject themselves to international law as Indigenous peoples to claim human rights. It then provides a case study on the Wangan and Jagalingou Family Council, which constructed itself as Indigenous peoples to assert human rights, as they engage with Australia’s native title regime in the case against Adani Mining Pty Ltd’s Carmichael Coal Mine and Rail Project. A central aspect of this argument is that becoming identifiable Indigenous peoples through claiming human rights provides benefits as well as potentially deleterious political, economic and legal costs.Peer Reviewe
Re-historicising dissolved identities: Deskaheh, the League of Nations and the international legal discourse on Indigenous peoples
No full textIn 1923, Levi General Deskaheh sought recognition from the League of Nations of the Six Nations’ sovereignty and right to self-determination. Although scholars have good reasons for retroactively identifing Deskaheh as a representative of Indigenous peoples, doing so dissolves the identities of historical and present-day subjects, which has a number of invidious consequences.Peer Reviewe
Dietary folate intake and adequacy of male and female adolescents in New Zealand
No full textBackground: Folate is a B vitamin involved in the synthesis and methylation of deoxyribonucleic acid (DNA). Green leafy vegetables, citrus fruits, liver, yeast extracts and whole grains are rich sources of natural folate. Synthetic folic acid is commonly added to foods including cereals, breads and beverages. Inadequate folate intake is common amongst females, particularly in countries that do not allow, or only permit voluntary folic acid fortification. Currently, New Zealand permits folic acid fortification on a voluntary basis, however, the debate over mandatory versus voluntary fortification is ongoing.
Objective: To investigate and compare the dietary intake of, and major food group contributors of folate (including folic acid) among adolescent males and females aged 15- 18 years in New Zealand.
Design: This study is part of SuNDiAL (Survey of Nutrition, Dietary Assessment and Lifestyle), a New Zealand-wide observational, cross-sectional survey. Participants aged 15-18 years were recruited from 19 high schools across New Zealand in 2019 and 2020.
Socio-demographic, anthropometric and dietary data, including food frequency and dietary habits questionnaires, were collected. Usual dietary folate intakes were assessed using two 24-hour diet recalls completed on non-consecutive days. Dietary folate was reported as total folate (dietary folate equivalents, DFEs), natural food folate and folic acid. The EAR cut off of 330 µg/day DFE was used to determine the prevalence of inadequacy. Lastly, the major food groups that contributed to total dietary folate intake were assessed and ranked.
Results: Four-hundred and two participants enrolled in the study comprised of 266 females and 135 males, with a mean (SD) age of 17 (0.8) years. The majority of participants identified as New Zealand European and other (NZEO) (71%) followed by Maori, Asian and Pacific. The median (IQR) of total usual dietary folate intake of male participants was 453.9 (334.1,714.9) µg DFEs/day and for females was 408.7 (299.4, 585.8) µg DFEs/day, resulting in a prevalence of inadequate intake of 25% and 33%, respectively. Male participants had nearly double the intake of folic acid compared to that of females (77.0 and 41.6 µg/day, respectively). Differences in total folate intake and prevalence of inadequacy between males and females were more apparent in the older age groups (17-18 years) with females having double the risk of inadequacy compared to their male counterparts (32% vs 16% respectively). For all females, the highest prevalence of inadequacy was reported in participants classified as Asian (67%) and those from higher socio-economic neighbourhoods (44%).
Among males, participants who identified as Asian (35%) and Pacific (33%) had the highest prevalence of inadequate intake. The top food groups contributing to folate intake in males was breakfast cereals at 25% and bread in females at 17%.
Conclusion: Overall, both males and females were at risk of inadequate folate intakes although the prevalence of inadequacy was concerningly higher among females. The major food groups contributing to dietary folate intakes were predominantly fortified food products although folic acid intakes were moderate. Further food fortification measures may be needed to meet the intake requirements of this lifecycle group, however, nationally representative survey data would enable better modelling and risk assessment
Access to medicines and use of medicines by Māori with type 2 diabetes in Tairāwhiti
No full textType 2 diabetes and its associated co-morbidities have a significant impact on Māori and other indigenous populations. The prevalence of type 2 diabetes in Tairāwhiti was far greater for Māori than non-Māori (11% vs 4%). Māori experience poor diabetes related outcomes: premature mortality, co-morbidities, greater severity of disease and complications, poorer access to health services and diabetes related care and poorer management and treatment of diabetes. This thesis reviews the literature on diabetes amongst Māori and other indigenous peoples; medicines use and access for Māori, other indigenous people and those living in rural areas. The literature review found that, in common with other indigenous peoples, Māori shared a greater prevalence of diabetes, modifiable and non-modifiable risk factors for diabetes, and diabetes-related complications, particularly in the younger population.
This thesis includes three inter-related studies to investigate access to medicines and use of medicines by Māori with type 2 diabetes in Tairāwhiti, within a Te ao Māori world view.
The first, quantitative, study uses data from pharmacy dispensing computers to explore whether patterns of medicines use match the pattern of need for medicines. This study found that there was inequity and disparity in medicines used in the treatment and management of type 2 diabetes between Māori and non-Māori in Tairāwhiti. The rest of the thesis explores potential reasons for these inequities.
The second, qualitative, study explored the lived experience of Māori people with diabetes in Tairāwhiti. People have different health beliefs and attitudes, but this should not be a barrier for them to receive the best care. Communication is a key element at all levels of care. Whānau and health professionals are encouraged to engage in healthy conversations to improve whānau outcomes. The traditional biomedical model of disease and recommended best practice for management of diabetes focuses on self- management, which is not consistent with a te ao Māori view, which is a collective whānau approach. The relationship between whānau and health professionals determines and shapes whānau attitudes and behaviours, and when health professionals connect with whānau in a meaningful way, they enable whānau to make and work towards positive change.
The Tairāwhiti context shapes people’s access to medicines in many ways. These are outlined and explored in the third study which looks at how medicines are distributed in the Tairāwhiti region and reports on interviews with people who picked up their medicines from pharmacy depots in the region. This highlights the challenges for those living in remote rural areas of Tairāwhiti to accessing quality medicines and health services.
The thesis ends with recommendations, including the need to improve communication and relationships between whānau and health professionals. These are key to improving knowledge and achieving positive outcomes. Health professionals must have an awareness and understanding of different health beliefs and attitudes and the value this brings to their practice. Additional research and action are needed regarding the cost of medicines, accessibility and the quality of medicines in rural areas. Key stakeholders need to work together to improve the management and treatment of diabetes in Tairāwhiti, and focus on whānau outcomes not disease
Making meaning: Informal craft communities as sites of learning and identity development
No full textSituated in the field of adult learning, this thesis examines why individuals choose to engage in non-credentialed learning outside of formal education institutions, and explores how the individual’s sense of self is affected by participation in a Community of Practice where activity is the mediating factor. The study focuses on soft material craft activity, specifically, how learning is accessed and mediated in online and physical craft groups. This study seeks to both respond to, and advance, existing research into adult learning and making communities.
The study is located within a social constructivist paradigm, drawing on Anna Stetsenko’s Cultural Historical Activity Theory, Etienne Wenger’s Communities of Practice, and Barbara Rogoff’s model of Learning by Observing and Pitching In. The study contains four data sets. The first focuses on the intra-personal effects of learning a new activity in an unfamiliar context through analysis of an autoethnographic narrative detailing the researcher’s personal experience learning traditional crafts in Peru. The remaining three data sets examine the inter-personal aspects of group learning. These include in-depth interviews with eight participants in online and physical craft groups, analysis of 345 posts and 2038 comments harvested from two online craft groups, and field notes detailing participant observations of four physical craft group meet-ups. Constructivist Grounded Theory and a General Inductive approach are employed in the analysis of data.
Analysis of the four data sets resulted in three key findings. Firstly, that participants are motivated to engage in non-credentialed learning activity by a desire to align with desirable social narratives. Secondly, that previous experience in related Communities of Practice, particularly formal education, influences how individuals respond to, and make meaning from, unfamiliar activities. Thirdly, that the boundaries between Communities of Practice are critical to the development and performance of identity.
These findings lead to the development of a holistic model for adult learning which articulates the multiple and overlapping contexts in which learning occurs, and the role these contexts, and the boundaries between them, play in the development of identity and the qualified self. I argue that participation in formal education results in the construction of meaning schema that influence how individuals make meaning from experience and I consider how this impacts on the learning that occurs in informal and non-formal contexts. The thesis concludes by considering the implications for adult learners, tertiary education institutions and education policy makers and suggesting directions for future research
The MOA Programme
No full textThe research outputs featured in this abridged selection provide evidence regarding the burdent of osteoarthritis in the NZ adult population, and the effectiveness, cost-effectiveness, and stakeholder acceptability of treatments for osteoarthritis.
The evidence we provide ranges from primary randomised controlled trials, clinical trials, systematic literature reviews, health economics and stakeholder preferences research, to computer simulation modelling using our bespoke NZ-MOA state transition microsimulation model of the progression, costs and consequences of osteoarthritis and its treatments in the NZ population.
This evidence culminates in a Policy Brief, that recommends actions for the management of osteoarthritis in the NZ public health system.
Professor J. Haxby Abbott
Principal Investigator, Management of Ostoearthritis programme
& Director, Centre for Musculoskeletal Outcomes Researc
Optimising medicine information for patients in New Zealand
No full textBackground
Patients must receive sufficient information about their medicines to be able to take them safely, to make informed choices, and to understand the benefits of adherence. Providing written information alongside verbal communication is best-practice to ensure comprehension and aid recall. However, leaflet provision is not mandatory in New Zealand.
Automated provision of information in a digital format may support informing people about their medicines in practice. Internationally, digital tools have allowed self-reporting of chemotherapy side-effects (Patient Reported Outcomes) to provide medicines information and self-management advice. However, such systems are not yet available in New Zealand and it is not known how they would be received.
Aim
To investigate how patients are provided with information about their medicines in New Zealand practice and explore potential solutions to optimise quality and provision.
Methods
This study was conducted in four stages:
1. A description of patients’ views on what content should be included in medicine information leaflets and how they should be designed to improve usability and usefulness.
2. Surveys to examine a) pharmacists’ and general practitioners’ (GPs’) medication counselling practices, b) their opinions and use of written information, and c) patients’ opinions and experiences of receiving written medicine information.
3. Feasibility study to determine the viability of producing a medicines information tool (automatic leaflet-tailoring and prompting system) for GPs and pharmacists: a survey of vendors of prescribing and dispensing software in New Zealand.
4. Focus groups and interviews with former oncology/haematology patients to determine their opinions regarding the information provided about their chemotherapy, and their views of the possible use of an online digital tool to report side-effects and receive information.
Main findings
1. Both summary and comprehensive medicine information leaflets should be readily available. Leaflet content requirements were identified, including names of the medicine, dose, benefits of treatment, and potential harms of therapy. The guidance provided by the New Zealand regulatory agency about how to design written medicine information does not align with patients’ stated needs.
2. Patients may not be receiving all the information they want or need to know about their medicines during verbal communication with GPs and pharmacists.
3. GPs and pharmacists do not routinely provide written medicines information leaflets. Facilitators to encourage provision included having summary and tailored leaflets available, more time with patients, and automatic computer prompts. GPs, pharmacists, and patients believe it is important that leaflets are given with new medicines.
4. At this time, it is not feasible to build an automatic leaflet-tailoring and prompting system within prescribing and dispensing management software used in New Zealand.
5. Oncology/haematology patients consider the way they are given information about their treatment could be improved. Many thought having a digital system available to report side-effects and receive information about management would be beneficial.
Conclusion
We need to improve the way we give people information about their medicines in New Zealand. Providing verbal and written information is not mandatory at present and may sometimes result in suboptimal practice.
Patients and health professionals thought digital technology could be used to help provide medicines information. Furthermore, online digital tools utilising Patient Reported Outcomes might help patients better manage their medicines’ side-effects
A sociocultural approach to language teacher identity: Iranian public school and private language institute EFL teachers
No full textThe story of English language education in Iran has long been politicized. Political decision-makers considered English as the language of the enemy, which has been reflected in the inadequate attention to English language teaching and learning in public schools. However, something radically different has escalated at the grassroots level of society—the popularity of English language learning among the youth. This transformation from below has increased the number and role of private language institutes where youth (among others) can develop cultural and communicative competence in English. This trend compelled the Ministry of Education to engage in English language education reform in public schools in 2012. These events illustrate that transformation does not necessarily come from above, but can come from below, showing that the actions of individuals have an impact on socio-economic and socio-political structures.
Teachers constitute significant characters in this story, and therefore it is important to understand how they navigate their professional worlds in these two educational contexts—public school and private language institutes. Their identity is at the heart of this navigation. This thesis contributes to the current research on language teacher identity (LTI) by investigating the professional identity development of Iranian English language teachers working in public schools and private language institutes. The study aims to explore the contradictions that teachers encounter in their work and how these contradictions contribute to their expansive learning and identity professional development. Two theoretical frameworks guided the study: Gee’s (2000) identity framework and Engeström’s (2015) activity theory, particularly expansive learning.
The study was conducted with six in-service teachers, four teaching in private language institutes and two in public schools. Data collection occurred over a period of 14 months and included narrative frames, semi-structured interviews, teaching journals, and classroom observations.
The findings showed that the contradictions that the teachers experienced in their teaching activity systems arose between (a) the teachers as the subject of their teaching activity systems and the object, (b) the subject and the division of labour, (c) the subject and the rules, and (d) the object and the mediating tools. The contradictions contributed to teachers’ expansive learning. The outcome of expansive learning was not only change and development in the teachers’ professional identities, but also innovations and transformations in their teaching activity systems and even in the wider institutional activity system. However, for the two teachers, the contradictions in their activity systems were not resolved, with consequences for their professional identities.
The study has implications for English language education in these two contexts. Teachers at private language institutes can benefit from professional development activities that historically evolve in their teaching context and respond to their needs and challenges. It is also important to offer courses in teacher education programs with a focus on English language education in public schools of the country, as the macro, meso, and micro levels are not aligned, which contributed to contradictions and conflicts in the teaching activity of teachers
Te Tautarinui o Matariki: a whānau health compass
No full textIn 2019 a historic claim was lodged with the Waitangi Tribunal under the Health and Service Outcomes Kaupapa Enquiry. Two main findings emerged; firstly, Māori have the poorest outcomes of any ethnic group in New Zealand, and secondly, Māori have suffered persistent inequities within the New Zealand health system (Waitangi Tribunal 2019). This research project aimed to address these findings by developing an iwi (tribal) whānau (family) model of health and well-being.
The research question “can the underpinning tikanga and mātauranga of way-finding navigation transfer into whānau health context?” was informed by kaupapa Māori theory and methodology, research tools that assume tikanga Māori (customs, values), te reo Māori (language) and mātauranga Māori (knowledge, skills) are legitimate ways for Māori to conduct research with and for their own. Participants (individual and collectives) were deemed experts in their respective fields and included three master way-finding navigators, two waka and tikanga experts, one whānau collective who were experts in maramataka (Māori lunar calendar) and 12 whānau collectives.
The aka matua (vine upon which everything hangs) of the research was based on the five key components that align to connectedness: whakapapa (origins and layers), pūrākau (narratives and stories), way-finding (voyaging), the maramataka, and tikanga. These layers were each built into Te Tautarinui o Matariki modelled on the way-finding star compass that was developed alongside and used in whānau domains.
Te Tautarinui o Matariki reflects the origins of Māori health where subsequent layers of whakapapa – namely knowledge and meanings including the researcher’s own – were added. The model supports whānau whakamana (empowerment) and tino rangatiratanga (self-determination) enabling whānau to both individually and collectively self-identify and monitor their health needs. Moreover, the model provides a potential mechanism for whānau to foster their own solutions by providing culturally familial resources, knowledge and tools.
The main findings of this research highlighted that whānau consistently drew upon whakanoa (the state of transition) as a strategy for their health and well-being. Whakanoa (transition) examples ranged from large to small and included karakia (incantations), meals and coffee, water (ocean, river, pool or bath), exercise, waiata (music) and breathing. Strategies were used for different transitions, such as to start and finish their day, or to transition between work and home.
The maramataka also had a significant impact on whānau health and well-being, identifying patterns of highs and lows in the likes of mood, energy a food consumption. Whānau reported that observation of various cycles helped them to identify circumstances, behaviour and products that would either enhance or decrease their well-being.
Outcomes from the research confirmed that Māori continue to be disproportionally affected by the burden of disease as a result of systemic inequities. Access to tools that are whānau-inspired, culturally informed and easy obtainable can help greatly in examining and improving Māori whānau health outcomes.
Te Tautarinui o Matariki was mainly used in this piece of research to identify particular health and well-being patterns for whānau. Further research will help refine its use so whānau not only identify but also generate suitable and appropriate strategies that ultimately improve Māori whānau health and well-being outcomes.
Perfected yet still "disabled": continuity of diverse embodiment in the resurrection body
No full textThe risen Christ presented his wounded hands and side to the disciples as evidence of his identity and the reality of his physical resurrection. Despite this, the picture of eschatological life in the popular Christian imagination is often one of flawless persons living in normalised and idealised resurrection bodies. In this thesis, I argue that persons with disabilities could retain in their post-resurrection bodies some of those features of diverse embodiment that have contributed to the experience of impairment and disability in pre-resurrection life. This is likely not the case for all persons with disabilities, but only for those persons for whom their diverse embodiment is identity-forming, so that the retention of those features safeguards the continuity of identity through the transformation of resurrection. In these cases, the physical transformation of the old creation and the redeemed sociality of resurrected persons will ameliorate the impairment and disability that diverse embodiment often entails in pre-resurrection life. Thus, the retention of diverse embodiment presents no threat to God’s goodness nor to the eschatological flourishing of the person in question and the full realisation of her humanity. This proposal is consonant with a reassessment of Scripture and theology from a disability perspective rather than through the prevailing normate bias, and it gives due attention to the persisting wounds of the risen Christ. I suggest that the possibility of persons with diverse embodiment enjoying fullness of life in the new creation can function as an eschatological parable to subvert the powers of this age which idolise success, mastery, and autonomy to the neglect of theologies of weakness, limitation, and dependency