title: Mediation with a focus on discursive positioning

authors: Winslade, John

subjects: mediation

abstract: This article advances some alternative theoretical bases for understanding conflict and building mediation practice on the basis of constructionist social theory in general and on positioning theory in particular. It outlines some goals for a narrative practice in mediation that are distinctive from existing models of mediation.

text: Mediation with a focus on discursive positioning This article advances some alternative theoretical bases for understanding conflict and building mediation practice on the basis of constructionist social theory in general and on positioning theory in particular. It outlines some goals for a narrative practice in mediation that are distinctive from existing models of mediation.

year: 2006

title: The hydrodynamics of the southern basin of Tauranga Harbour

authors: Tay, H.W.

subjects: hydrodynamic model

abstract: The circulation of the southern basin of Tauranga Harbour was simulated using a 3-D hydrodynamic model ELCOM. A 9-day field campaign in 1999 provided data on current velocity, temperature and salinity profiles at three stations within the main basin. The tidal wave changed most in amplitude and speed in the constricted entrances to channels, for example the M2 tide attenuated by 10% over 500 m at the main entrance, and only an additional 17% over the 15 km to the top of the southern basin. The modelled temperature was sensitive to wind mixing, particularly in tidal flat regions. Residence times ranged from 3 to 8 days, with higher residence times occurring in sub-estuaries with constricted mouths. The typical annual storm events were predicted to reduce the residence times by 24%–39% depending on season. Model scenarios of storm discharge events in the Wairoa River varying from 41.69 m3/s to 175.9 m3/s show that these events can cause salinity gradients across the harbour of up to 4 PSU.

text: The hydrodynamics of the southern basin of Tauranga Harbour The circulation of the southern basin of Tauranga Harbour was simulated using a 3-D hydrodynamic model ELCOM. A 9-day field campaign in 1999 provided data on current velocity, temperature and salinity profiles at three stations within the main basin. The tidal wave changed most in amplitude and speed in the constricted entrances to channels, for example the M2 tide attenuated by 10% over 500 m at the main entrance, and only an additional 17% over the 15 km to the top of the southern basin. The modelled temperature was sensitive to wind mixing, particularly in tidal flat regions. Residence times ranged from 3 to 8 days, with higher residence times occurring in sub-estuaries with constricted mouths. The typical annual storm events were predicted to reduce the residence times by 24%–39% depending on season. Model scenarios of storm discharge events in the Wairoa River varying from 41.69 m3/s to 175.9 m3/s show that these events can cause salinity gradients across the harbour of up to 4 PSU.

year: 2013

title: Real world initiation of newly funded empagliflozin and dulaglutide under special authority for patients with type 2 diabetes in New Zealand

authors: Chepulis, Lynne Merran

subjects: GLP1RA

abstract: Background: Type 2 diabetes (T2D) is sub-optimally managed for many in Aotearoa New Zealand, and disproportionately affects Māori and Pacific peoples. In February 2021, SGLT2i/GLP1RA agents were funded for use for the first time with prioritisation for Māori, Pacific and those with cardiovascular and/or renal disease or risk (CVRD). This study evaluates the impact of health system factors on initiation of SGLT2i/GLP1RA therapy. 

Methods: Primary care data was collected for patients with T2D aged 18–75 years from four primary care organisations (302 general practices) in the Auckland / Waikato region of New Zealand (Feb 2021 – July 2022). Initiation of SGLT2i/GLP1RA therapy was reviewed by patient (age, gender, ethnicity, CVRD status) and health system variables (funding, provider type, staffing, patient numbers, rurality, after-hours access). Logistic regression was used to estimate the odds ratio of a patient being dispensed SGLT2i/GLP1RA. 

Results: Of 57,743 patients with T2D, 22,331 were eligible for funded SGLT2i/GLP1RA access and 10,272 of those (46.0%) were prescribed. Initiation of therapy was highest in Māori (50.8%) and Pacific (48.8%) patients (vs. 36·2–40·7% of other ethnic groups; P < 0.001), but was comparable in those with and without CVRD (47·1% vs. 48·9%; P = 0.2). Prescribing was highest in practices with higher doctor/patient numbers, low-cost fees, Māori health providers and clinics without after-hours access.

Conclusion: Prioritised access for SGLT2i/GLP1RA appears to be associated with a reduced health equity gap for Māori and Pacific patients with T2D in NZ, but work is required to improve prescribing for patients with CVRD.

text: Real world initiation of newly funded empagliflozin and dulaglutide under special authority for patients with type 2 diabetes in New Zealand Background: Type 2 diabetes (T2D) is sub-optimally managed for many in Aotearoa New Zealand, and disproportionately affects Māori and Pacific peoples. In February 2021, SGLT2i/GLP1RA agents were funded for use for the first time with prioritisation for Māori, Pacific and those with cardiovascular and/or renal disease or risk (CVRD). This study evaluates the impact of health system factors on initiation of SGLT2i/GLP1RA therapy. 

Methods: Primary care data was collected for patients with T2D aged 18–75 years from four primary care organisations (302 general practices) in the Auckland / Waikato region of New Zealand (Feb 2021 – July 2022). Initiation of SGLT2i/GLP1RA therapy was reviewed by patient (age, gender, ethnicity, CVRD status) and health system variables (funding, provider type, staffing, patient numbers, rurality, after-hours access). Logistic regression was used to estimate the odds ratio of a patient being dispensed SGLT2i/GLP1RA. 

Results: Of 57,743 patients with T2D, 22,331 were eligible for funded SGLT2i/GLP1RA access and 10,272 of those (46.0%) were prescribed. Initiation of therapy was highest in Māori (50.8%) and Pacific (48.8%) patients (vs. 36·2–40·7% of other ethnic groups; P < 0.001), but was comparable in those with and without CVRD (47·1% vs. 48·9%; P = 0.2). Prescribing was highest in practices with higher doctor/patient numbers, low-cost fees, Māori health providers and clinics without after-hours access.

Conclusion: Prioritised access for SGLT2i/GLP1RA appears to be associated with a reduced health equity gap for Māori and Pacific patients with T2D in NZ, but work is required to improve prescribing for patients with CVRD.

year: 2025