title: Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand

authors: Gurney, Jason

subjects: Humans

abstract: In New Zealand, there are known disparities between the Indigenous Māori and the majority non-Indigenous European populations in access to cancer treatment, with resulting disparities in cancer survival. There is international evidence of ethnic disparities in the distance travelled to access cancer treatment; and as such, the aim of this paper was to examine the distance and time travelled to access surgical care between Māori and European liver and stomach cancer patients. We used national-level data and Geographic Information Systems (GIS) analysis to describe the distance travelled by patients to receive their first primary surgery for liver or stomach cancer, as well as the estimated time to travel this distance by road, and the surgical volume of hospitals performing these procedures. All cases of liver (ICD-10-AM 3rd edition code: C22) and stomach (C16) cancer that occurred in New Zealand (2007-2019) were drawn from the New Zealand Cancer Registry (liver cancer: 866 Māori, 2,460 European; stomach cancer: 953 Māori, 3,192 European), and linked to national inpatient hospitalisation records to examine access to surgery. We found that Māori on average travel 120km for liver cancer surgery, compared to around 60km for Europeans, while a substantial minority of both Māori and European liver cancer patients must travel more than 200km for their first primary liver surgery, and this situation appears worse for Māori (36% vs 29%; adj. OR 1.48, 95% CI 1.09-2.01). No such disparities were observed for stomach cancer. This contrast between cancers is likely driven by the centralisation of liver cancer surgery relative to stomach cancer. In order to support Māori to access liver cancer care, we recommend that additional support is provided to Māori patients (including prospective financial support), and that efforts are made to remotely provide those clinical services that can be decentralised.

text: Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand In New Zealand, there are known disparities between the Indigenous Māori and the majority non-Indigenous European populations in access to cancer treatment, with resulting disparities in cancer survival. There is international evidence of ethnic disparities in the distance travelled to access cancer treatment; and as such, the aim of this paper was to examine the distance and time travelled to access surgical care between Māori and European liver and stomach cancer patients. We used national-level data and Geographic Information Systems (GIS) analysis to describe the distance travelled by patients to receive their first primary surgery for liver or stomach cancer, as well as the estimated time to travel this distance by road, and the surgical volume of hospitals performing these procedures. All cases of liver (ICD-10-AM 3rd edition code: C22) and stomach (C16) cancer that occurred in New Zealand (2007-2019) were drawn from the New Zealand Cancer Registry (liver cancer: 866 Māori, 2,460 European; stomach cancer: 953 Māori, 3,192 European), and linked to national inpatient hospitalisation records to examine access to surgery. We found that Māori on average travel 120km for liver cancer surgery, compared to around 60km for Europeans, while a substantial minority of both Māori and European liver cancer patients must travel more than 200km for their first primary liver surgery, and this situation appears worse for Māori (36% vs 29%; adj. OR 1.48, 95% CI 1.09-2.01). No such disparities were observed for stomach cancer. This contrast between cancers is likely driven by the centralisation of liver cancer surgery relative to stomach cancer. In order to support Māori to access liver cancer care, we recommend that additional support is provided to Māori patients (including prospective financial support), and that efforts are made to remotely provide those clinical services that can be decentralised.

year: 2022

title: Whāingaroa/Raglan and positive youth development - Community-driven youth support in Whāingaroa: A case study of the Whāingaroa Youth Work Collective

authors: Semeraro, Gianluca

abstract: This research explores the development and impact of community-driven youth support in Whāingaroa, a rural community in Aotearoa/New Zealand, through an in-depth examination of a local youth work collective. By employing a qualitative, participatory research methodology, the study investigates the complex dynamics of youth empowerment, community engagement, and cultural responsiveness within a unique local context.

The study traces the evolution of the Whāingaroa Youth Work Collective (WYWC) from its inception to its status as a structured community organization. Data collection spanned two years, encompassing six WYWC collective meetings and three focus groups with key collective members. Through ethnographic observations and collaborative research methods, the study illuminates the processes of youth development and community support emerging from grassroots, volunteer-driven initiatives. Thematic analysis was employed to analyse the data, which was categorized into two primary themes: (1) the collective's purpose and operational methodology, and (2) necessary future steps to address gaps in local youth support. These themes were analysed in relation to two research questions:

•	How can Whāingaroa/Raglan services support youth at a community-based level?
•	What initiatives could be implemented to foster positive youth development in the future?

The findings are presented in two main sections. The first examines the collective's strategy, operational framework and current initiatives demonstrating the effectiveness of locally-based youth support. The second explores the collective's aspirations for future initiatives, specifically focusing on two key proposals: establishing a full-time youth connector position and developing a community youth hub.

 Key findings demonstrate the transformative potential of volunteer-driven, culturally responsive youth support strategies. The research highlights the importance of contextual understanding, community ownership, and holistic approaches to youth development. Particularly significant is the model's ability to navigate the bicultural landscape of Aotearoa, providing a nuanced approach that respects both indigenous and contemporary cultural frameworks.

Theoretically grounded in Positive Youth Development (PYD) frameworks and indigenous cultural perspectives, the research bridges Western psychological approaches with local cultural understanding. The study reveals how a community-centric model of youth support can effectively address the complex needs of rural youth, emphasizing cultural identity, collective empowerment, and local knowledge.

The study contributes to broader discussions on youth support, community development, and cultural resilience. It challenges traditional, standardized intervention models by showcasing the effectiveness of locally embedded, flexible support strategies. The research provides valuable insights for community organizations, policymakers, educational institutions, and social service providers seeking innovative approaches to youth engagement.
Further, the findings offer a replicable framework for understanding and supporting youth development in rural contexts, with broader implications for community support strategies that prioritize local knowledge, cultural responsiveness, and collective empowerment.

Ultimately, the research presents a compelling argument for understanding youth development as a collaborative, contextually embedded process. It demonstrates that meaningful community support emerges from within, driven by local aspirations, cultural understanding, and collective investment in young people's potential.

text: Whāingaroa/Raglan and positive youth development - Community-driven youth support in Whāingaroa: A case study of the Whāingaroa Youth Work Collective This research explores the development and impact of community-driven youth support in Whāingaroa, a rural community in Aotearoa/New Zealand, through an in-depth examination of a local youth work collective. By employing a qualitative, participatory research methodology, the study investigates the complex dynamics of youth empowerment, community engagement, and cultural responsiveness within a unique local context.

The study traces the evolution of the Whāingaroa Youth Work Collective (WYWC) from its inception to its status as a structured community organization. Data collection spanned two years, encompassing six WYWC collective meetings and three focus groups with key collective members. Through ethnographic observations and collaborative research methods, the study illuminates the processes of youth development and community support emerging from grassroots, volunteer-driven initiatives. Thematic analysis was employed to analyse the data, which was categorized into two primary themes: (1) the collective's purpose and operational methodology, and (2) necessary future steps to address gaps in local youth support. These themes were analysed in relation to two research questions:

•	How can Whāingaroa/Raglan services support youth at a community-based level?
•	What initiatives could be implemented to foster positive youth development in the future?

The findings are presented in two main sections. The first examines the collective's strategy, operational framework and current initiatives demonstrating the effectiveness of locally-based youth support. The second explores the collective's aspirations for future initiatives, specifically focusing on two key proposals: establishing a full-time youth connector position and developing a community youth hub.

 Key findings demonstrate the transformative potential of volunteer-driven, culturally responsive youth support strategies. The research highlights the importance of contextual understanding, community ownership, and holistic approaches to youth development. Particularly significant is the model's ability to navigate the bicultural landscape of Aotearoa, providing a nuanced approach that respects both indigenous and contemporary cultural frameworks.

Theoretically grounded in Positive Youth Development (PYD) frameworks and indigenous cultural perspectives, the research bridges Western psychological approaches with local cultural understanding. The study reveals how a community-centric model of youth support can effectively address the complex needs of rural youth, emphasizing cultural identity, collective empowerment, and local knowledge.

The study contributes to broader discussions on youth support, community development, and cultural resilience. It challenges traditional, standardized intervention models by showcasing the effectiveness of locally embedded, flexible support strategies. The research provides valuable insights for community organizations, policymakers, educational institutions, and social service providers seeking innovative approaches to youth engagement.
Further, the findings offer a replicable framework for understanding and supporting youth development in rural contexts, with broader implications for community support strategies that prioritize local knowledge, cultural responsiveness, and collective empowerment.

Ultimately, the research presents a compelling argument for understanding youth development as a collaborative, contextually embedded process. It demonstrates that meaningful community support emerges from within, driven by local aspirations, cultural understanding, and collective investment in young people's potential.

year: 2025

title: Recognition of foot strike pattern in Asian recreational runners.

authors: Patoz, Aurélien

subjects: asymmetry

abstract: Close to 90% of recreational runners rearfoot strike in a long-distance road race. This prevalence has been obtained from North American cohorts of runners. The prevalence of rearfoot strikers has not been extensively examined in an Asian population of recreational runners. Therefore, the aim of this study was to determine the prevalence of rearfoot, midfoot, and forefoot strikers during a long-distance road race in Asian recreational runners and compare this prevalence to reported values in the scientific literature. To do so, we classified the foot strike pattern of 950 recreational runners at the 10 km mark of the Singapore marathon (77% Asian field). We observed 71.1%, 16.6%, 1.7%, and 10.6% of rearfoot, midfoot, forefoot, and asymmetric strikers, respectively. Chi-squared tests revealed significant differences between our foot strike pattern distribution and those reported from North American cohorts (P < 0.001). Our foot strike pattern distribution was similar to one reported from elite half-marathon runners racing in Japan (Fisher exact test, P = 0.168). We conclude that the prevalence of rearfoot strikers is lower in Asian than North American recreational runners. Running research should consider and report ethnicity of participants given that ethnicity can potentially explain biomechanical differences in running patterns.

text: Recognition of foot strike pattern in Asian recreational runners. Close to 90% of recreational runners rearfoot strike in a long-distance road race. This prevalence has been obtained from North American cohorts of runners. The prevalence of rearfoot strikers has not been extensively examined in an Asian population of recreational runners. Therefore, the aim of this study was to determine the prevalence of rearfoot, midfoot, and forefoot strikers during a long-distance road race in Asian recreational runners and compare this prevalence to reported values in the scientific literature. To do so, we classified the foot strike pattern of 950 recreational runners at the 10 km mark of the Singapore marathon (77% Asian field). We observed 71.1%, 16.6%, 1.7%, and 10.6% of rearfoot, midfoot, forefoot, and asymmetric strikers, respectively. Chi-squared tests revealed significant differences between our foot strike pattern distribution and those reported from North American cohorts (P < 0.001). Our foot strike pattern distribution was similar to one reported from elite half-marathon runners racing in Japan (Fisher exact test, P = 0.168). We conclude that the prevalence of rearfoot strikers is lower in Asian than North American recreational runners. Running research should consider and report ethnicity of participants given that ethnicity can potentially explain biomechanical differences in running patterns.

year: 2019