title: Exploring inequity in access to medications for Type 2 Diabetes in primary care in the Waikato region: Final report

authors: Lawrenson, Ross

abstract: Type 2 diabetes (T2D) is a growing health issue in New Zealand (NZ) that disproportionately affects twice as many Māori as non-Māori and an increasing number of younger people. T2D is associated with a range of microvascular and macrovascular complications, chronic kidney disease and cardiovascular disease (CVD), the latter being the greatest cause of morbidity and mortality in this patient group. However, complications are reduced in patients that have improved glycaemic control. To achieve optimal outcomes and reduce the chance of diabetes-related complications, patients should aim to have their glycated haemoglobin (HbA1c) measurement less than 53 mmol/mol if possible.

Diabetes is primarily managed in primary care, and a number of recent publications suggest that there is considerable inequity in the management of diabetes in New Zealand, particularly for Māori. In an earlier piece of work we have shown that Maori are significantly less likely than non-Maori to be prescribed metformin, but that once prescribed it they are equally likely to have the medication dispensed. This suggests that there may be issues that can be addressed within primary care that are influencing the use of diabetes medications.
Thus, the aim of this small piece of work was to characterise diabetes medication use in a Waikato primary care population, and to report on medication adherence and association with HbA1c levels.

text: Exploring inequity in access to medications for Type 2 Diabetes in primary care in the Waikato region: Final report Type 2 diabetes (T2D) is a growing health issue in New Zealand (NZ) that disproportionately affects twice as many Māori as non-Māori and an increasing number of younger people. T2D is associated with a range of microvascular and macrovascular complications, chronic kidney disease and cardiovascular disease (CVD), the latter being the greatest cause of morbidity and mortality in this patient group. However, complications are reduced in patients that have improved glycaemic control. To achieve optimal outcomes and reduce the chance of diabetes-related complications, patients should aim to have their glycated haemoglobin (HbA1c) measurement less than 53 mmol/mol if possible.

Diabetes is primarily managed in primary care, and a number of recent publications suggest that there is considerable inequity in the management of diabetes in New Zealand, particularly for Māori. In an earlier piece of work we have shown that Maori are significantly less likely than non-Maori to be prescribed metformin, but that once prescribed it they are equally likely to have the medication dispensed. This suggests that there may be issues that can be addressed within primary care that are influencing the use of diabetes medications.
Thus, the aim of this small piece of work was to characterise diabetes medication use in a Waikato primary care population, and to report on medication adherence and association with HbA1c levels.

year: 2021-08-17

title: ‘Pakeha Bill’: William John McClear, a Pakeha who lived at Te Aroha

authors: Hart, Philip

abstract: Born in Ireland to a Scottish soldier named McAleer, McClear, as he would re-name himself, was uncertain of his age, his birthplace, and the spelling of his name – for, like his parents, he was illiterate. After his drunken father, who abandoned his wife and family, sold him to unknown Maori at an unknown date, he was educated in a Maori school and was unable to speak English until the early 1870s, when he was living with Ngati Rahiri at Omahu pa, at Te Aroha. When Pakeha visitors first met him in 1877, he was a popular resident there and known as Pakeha Bill (or Pakeha William).
Possiby involved in mining before the Te Aroha rush, he both invested in and mined in several claims there from 1880 onwards, and at the end of that decade was one of a small group of Waiorongomai miners who took up a claim at Thames. When not mining, he took whatever jobs were available, struggling financially, in part because of a fondness for drink. As, unlike other Pakeha Maori, there was no evidence of his forming a close relationship with any Maori women, he did not benefit from a Maori wife’s landholdings, and he died in poverty.

text: ‘Pakeha Bill’: William John McClear, a Pakeha who lived at Te Aroha Born in Ireland to a Scottish soldier named McAleer, McClear, as he would re-name himself, was uncertain of his age, his birthplace, and the spelling of his name – for, like his parents, he was illiterate. After his drunken father, who abandoned his wife and family, sold him to unknown Maori at an unknown date, he was educated in a Maori school and was unable to speak English until the early 1870s, when he was living with Ngati Rahiri at Omahu pa, at Te Aroha. When Pakeha visitors first met him in 1877, he was a popular resident there and known as Pakeha Bill (or Pakeha William).
Possiby involved in mining before the Te Aroha rush, he both invested in and mined in several claims there from 1880 onwards, and at the end of that decade was one of a small group of Waiorongomai miners who took up a claim at Thames. When not mining, he took whatever jobs were available, struggling financially, in part because of a fondness for drink. As, unlike other Pakeha Maori, there was no evidence of his forming a close relationship with any Maori women, he did not benefit from a Maori wife’s landholdings, and he died in poverty.

year: 2016

title: Considering photographs never taken during photo-production projects

authors: Hodgetts, Darrin

subjects: homelessness

abstract: The visual medium is central to how most of us navigate daily life and come to know and interact with our social worlds. Recently, the role of visual dimensions of everyday life has surfaced in qualitative research in psychology. This paper explores some of the underlying processes foundational to participants' efforts to picture their worlds during photo-production projects. We draw on excerpts from a study of images of homelessness in London to exemplify various methodological issues surrounding the interpretation of photo-production materials. Emphasis is placed on the need to focus on photo-production because photographs taken never fully contain what is important to participants. Issues and events are often talked into the frame of photographs by participants. This process of presenting aspects of one's life extends to discussions of photographs not taken and reflections on processes of picturing everyday life. We argue that a consideration of photographs not taken is important if we are to maximise the utility of photo-production as a method and fully understand what it provides.

text: Considering photographs never taken during photo-production projects The visual medium is central to how most of us navigate daily life and come to know and interact with our social worlds. Recently, the role of visual dimensions of everyday life has surfaced in qualitative research in psychology. This paper explores some of the underlying processes foundational to participants' efforts to picture their worlds during photo-production projects. We draw on excerpts from a study of images of homelessness in London to exemplify various methodological issues surrounding the interpretation of photo-production materials. Emphasis is placed on the need to focus on photo-production because photographs taken never fully contain what is important to participants. Issues and events are often talked into the frame of photographs by participants. This process of presenting aspects of one's life extends to discussions of photographs not taken and reflections on processes of picturing everyday life. We argue that a consideration of photographs not taken is important if we are to maximise the utility of photo-production as a method and fully understand what it provides.

year: 2007