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: Te Mata Ira—Faces of the Gene: Developing a cultural foundation for biobanking and genomic research involving Māori

authors: Hudson, Maui

abstract: Te Mata Ira was a three-year research project (2012–2015) that explored Māori views on genomic research and biobanking for the development of culturally appropriate guidelines. A key component of this process has been to identify Māori concepts that provide cultural reference points for engaging with biobanking and genomic research. These cultural cues provide the basis for describing the cultural logic that underpins engagement in this context in a culturally acceptable manner. This paper outlines the role of two wānanga (workshops) conducted as part of the larger project that were used to make sense of the Māori concepts that emerged from other data-collection activities. The wānanga involved six experts who worked with the research team to make sense of the Māori concepts. The wānanga process created the logic behind the cultural foundation for biobanking and genomic research, providing a basis for understanding Māori concepts, Māori ethical principles and their application to biobanking and genomic research.

text: Te Mata Ira—Faces of the Gene: Developing a cultural foundation for biobanking and genomic research involving Māori Te Mata Ira was a three-year research project (2012–2015) that explored Māori views on genomic research and biobanking for the development of culturally appropriate guidelines. A key component of this process has been to identify Māori concepts that provide cultural reference points for engaging with biobanking and genomic research. These cultural cues provide the basis for describing the cultural logic that underpins engagement in this context in a culturally acceptable manner. This paper outlines the role of two wānanga (workshops) conducted as part of the larger project that were used to make sense of the Māori concepts that emerged from other data-collection activities. The wānanga involved six experts who worked with the research team to make sense of the Māori concepts. The wānanga process created the logic behind the cultural foundation for biobanking and genomic research, providing a basis for understanding Māori concepts, Māori ethical principles and their application to biobanking and genomic research.

year: 2016

title: 'He is a gentleman. I am a gentleman’s daughter. So far we are equal’: Gender performance in twenty-first century adaptations of Jane Austen’s Emma and Pride and prejudice

authors: Hodgson, Laura

abstract: The core focus of this thesis is gender performance in two of Jane Austen’s novels, Pride and Prejudice and Emma, and twenty-first-century adaptations of these novels. The thesis revolves around six key texts: Austen’s novel Pride and Prejudice, its 2005 film adaptation of the same name directed by Joe Wright, and the transmedia modernisation, The Lizzie Bennet Diaries; as well as Austen’s novel Emma, its 2020 film adaptation of the same name directed by Autumn de Wilde, and the transmedia web series, Emma Approved. There have undoubtedly been shifts in gender performance over the two hundred years since Austen published her novels, but these are not always reflected in the adaptations. In part this is due to the surprisingly progressive nature of some of Austen’s meditations on gender, with Elizabeth Bennet from Pride and Prejudice presenting as a pre-feminist and George Knightley from Emma performing as a pre-feminist man. These aspects of gender performance are extended by Keira Knightley’s portrayal of Elizabeth Bennet in Wright’s film, which reframes the character as a Romantic feminist, and Johnny Flynn’s performance of Mr. Knightley as a hero positioned under the female gaze in de Wilde’s film. 

Yet, the thesis also reveals that Austen’s feminist precursors are not always developed in contemporary adaptations. Indeed, Lizzie Bennet in The Lizzie Bennet Diaries is a postfeminist who is far from being an autonomous twenty-first century woman and is dependent on family and male suitors to provide her with opportunities. Likewise, the opportunity to reimagine Austen’s characters in a twenty-first-century gender context is also ignored in some adaptations, particularly the transmedia web series, with Emma in Emma Approved continuing to endorse patriarchal structures in the same way that she does in Austen’s original novel. The dandyism of Frank Churchill in Austen’s Emma is also undercut in Emma Approved through a performance of heteronormativity that sidelines the queer potential initiated by previous adaptations, such as the 1995 film Clueless. Most striking is the stagnant gender performance of Mr. Darcy from Pride and Prejudice who remains the embodiment of hegemonic gentry masculinity in both the film and the web series. This thesis reveals that the lack of change in gender performance in some contemporary Austen adaptations demonstrates the persistence of hegemonic masculinity in the twenty-first century, while postfeminist performances of gender at times seem regressive.

text: 'He is a gentleman. I am a gentleman’s daughter. So far we are equal’: Gender performance in twenty-first century adaptations of Jane Austen’s Emma and Pride and prejudice The core focus of this thesis is gender performance in two of Jane Austen’s novels, Pride and Prejudice and Emma, and twenty-first-century adaptations of these novels. The thesis revolves around six key texts: Austen’s novel Pride and Prejudice, its 2005 film adaptation of the same name directed by Joe Wright, and the transmedia modernisation, The Lizzie Bennet Diaries; as well as Austen’s novel Emma, its 2020 film adaptation of the same name directed by Autumn de Wilde, and the transmedia web series, Emma Approved. There have undoubtedly been shifts in gender performance over the two hundred years since Austen published her novels, but these are not always reflected in the adaptations. In part this is due to the surprisingly progressive nature of some of Austen’s meditations on gender, with Elizabeth Bennet from Pride and Prejudice presenting as a pre-feminist and George Knightley from Emma performing as a pre-feminist man. These aspects of gender performance are extended by Keira Knightley’s portrayal of Elizabeth Bennet in Wright’s film, which reframes the character as a Romantic feminist, and Johnny Flynn’s performance of Mr. Knightley as a hero positioned under the female gaze in de Wilde’s film. 

Yet, the thesis also reveals that Austen’s feminist precursors are not always developed in contemporary adaptations. Indeed, Lizzie Bennet in The Lizzie Bennet Diaries is a postfeminist who is far from being an autonomous twenty-first century woman and is dependent on family and male suitors to provide her with opportunities. Likewise, the opportunity to reimagine Austen’s characters in a twenty-first-century gender context is also ignored in some adaptations, particularly the transmedia web series, with Emma in Emma Approved continuing to endorse patriarchal structures in the same way that she does in Austen’s original novel. The dandyism of Frank Churchill in Austen’s Emma is also undercut in Emma Approved through a performance of heteronormativity that sidelines the queer potential initiated by previous adaptations, such as the 1995 film Clueless. Most striking is the stagnant gender performance of Mr. Darcy from Pride and Prejudice who remains the embodiment of hegemonic gentry masculinity in both the film and the web series. This thesis reveals that the lack of change in gender performance in some contemporary Austen adaptations demonstrates the persistence of hegemonic masculinity in the twenty-first century, while postfeminist performances of gender at times seem regressive.

year: 2023