title: Supportive interactions with primary care doctors are associated with better mental health among transgender people: results of a nationwide survey in Aotearoa/New Zealand.

authors: Treharne, Gareth J.

subjects: LGBTQ

abstract: BACKGROUND: Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people. OBJECTIVES: The 2 main aims of our analyses were: (i) to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and (ii) to examine the association of supportive experiences with mental health variables after controlling for demographic factors. METHODS: Data from the 2018 Counting Ourselves nationwide survey of transgender people were analysed using regression modelling. The 948 participants with a primary care doctor or general practitioner were included in analyses. Participants were aged 14-83 years old (mean 30.20). RESULTS: The most common supportive experiences involved primary care doctors treating transgender people equitably, with competence, and with respect. Participants with more negative healthcare experiences had higher psychological distress as well as higher likelihood of reporting nonsuicidal self-injury and suicidality. Conversely, participants with more experiences of supportive primary care doctors had lower psychological distress and were less likely to have attempted suicide in the past 12 months. CONCLUSION: When transgender people receive supportive care from their primary care providers they experience better mental health, despite ongoing negative healthcare experiences. Future research is needed to confirm ways of supporting positive trajectories of mental health for transgender people but these findings demonstrate the importance of positive aspects of care.

text: Supportive interactions with primary care doctors are associated with better mental health among transgender people: results of a nationwide survey in Aotearoa/New Zealand. BACKGROUND: Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people. OBJECTIVES: The 2 main aims of our analyses were: (i) to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and (ii) to examine the association of supportive experiences with mental health variables after controlling for demographic factors. METHODS: Data from the 2018 Counting Ourselves nationwide survey of transgender people were analysed using regression modelling. The 948 participants with a primary care doctor or general practitioner were included in analyses. Participants were aged 14-83 years old (mean 30.20). RESULTS: The most common supportive experiences involved primary care doctors treating transgender people equitably, with competence, and with respect. Participants with more negative healthcare experiences had higher psychological distress as well as higher likelihood of reporting nonsuicidal self-injury and suicidality. Conversely, participants with more experiences of supportive primary care doctors had lower psychological distress and were less likely to have attempted suicide in the past 12 months. CONCLUSION: When transgender people receive supportive care from their primary care providers they experience better mental health, despite ongoing negative healthcare experiences. Future research is needed to confirm ways of supporting positive trajectories of mental health for transgender people but these findings demonstrate the importance of positive aspects of care.

year: 2022

title: Protein Dynamics and its Correlation to Protein Activity and Stability

authors: Clement, David

subjects: Incoherent neutron scattering

abstract: The aim of this thesis is to investigate the role of fast protein dynamics (picosecond
timescale) in enzyme activity and stability, and specifically to test the
hypothesis that enzyme activity and stability are inversely related by their internal
dynamics.
Activity   Dynamics (flexibility)   1/Stability
In order to test this hypothesis, the well known anti-cancer drug: methotrexate
was used as an informative ligand in the network established between these
properties. A multidisciplinary approach combining neutron scattering, circular
dichroism, UV absorption, isothermal titration calorimetry and X-ray crystallography
was undertaken to examine the current paradigm using the enzyme: dihydrofolate
reductase as a model.
As inferred by neutron spectroscopy, the binding of MTX influences the
dynamical behavior of DHFR. Macromolecular dynamics such as the resilience: lt;kgt;
(i.e. structural rigidity) was found to be increased and, inversely, the flexibility
decreased upon MTX binding. In addition, as revealed by circular dichroism, this
dynamical dependency upon MTX binding was correlated with an enhanced thermal
stability. Compared to the free enzyme, the melting temperature was found to be
increased by 13.8  C in the presence of MTX. The inhibitory power of MTX was also
examined by steady state kinetics and isothermal titration calorimetry. The Ki for
MTX was found to be in the nanomolar range Ki= 10.9 nM. Using isothermal
titration calorimetry, the binding thermodynamic signature between MTX and DHFR
was characterized. The binding event was found to be largely favourable (DGb=-12.1
Kcal mol-1), enthalpy driven (DHb= -16.8 Kcal mol-1) with an unfavourable entropy
DSb=-15.6 cal K-1mol-1.
In conclusion, the modulation of the macromolecular dynamics may reflect
how specific conformations are favoured for subsequent protein function in response
of the binding of specific ligand and how conformational substates approach to
protein function. In this context the unprecedented power of transition state analogs
such as MTX on protein function might therefore be dependent on fast protein
dynamics.

text: Protein Dynamics and its Correlation to Protein Activity and Stability The aim of this thesis is to investigate the role of fast protein dynamics (picosecond
timescale) in enzyme activity and stability, and specifically to test the
hypothesis that enzyme activity and stability are inversely related by their internal
dynamics.
Activity   Dynamics (flexibility)   1/Stability
In order to test this hypothesis, the well known anti-cancer drug: methotrexate
was used as an informative ligand in the network established between these
properties. A multidisciplinary approach combining neutron scattering, circular
dichroism, UV absorption, isothermal titration calorimetry and X-ray crystallography
was undertaken to examine the current paradigm using the enzyme: dihydrofolate
reductase as a model.
As inferred by neutron spectroscopy, the binding of MTX influences the
dynamical behavior of DHFR. Macromolecular dynamics such as the resilience: lt;kgt;
(i.e. structural rigidity) was found to be increased and, inversely, the flexibility
decreased upon MTX binding. In addition, as revealed by circular dichroism, this
dynamical dependency upon MTX binding was correlated with an enhanced thermal
stability. Compared to the free enzyme, the melting temperature was found to be
increased by 13.8  C in the presence of MTX. The inhibitory power of MTX was also
examined by steady state kinetics and isothermal titration calorimetry. The Ki for
MTX was found to be in the nanomolar range Ki= 10.9 nM. Using isothermal
titration calorimetry, the binding thermodynamic signature between MTX and DHFR
was characterized. The binding event was found to be largely favourable (DGb=-12.1
Kcal mol-1), enthalpy driven (DHb= -16.8 Kcal mol-1) with an unfavourable entropy
DSb=-15.6 cal K-1mol-1.
In conclusion, the modulation of the macromolecular dynamics may reflect
how specific conformations are favoured for subsequent protein function in response
of the binding of specific ligand and how conformational substates approach to
protein function. In this context the unprecedented power of transition state analogs
such as MTX on protein function might therefore be dependent on fast protein
dynamics.

year: 2009

title: Kūpapa ki raro, titiro ake

authors: Papa, Pānia Christine

abstract: Ko tā te kaituhi e manako nei i roto i tēnei tuhinga, kia āta tirohia he aha ngā huarahi i whāia ai e ngā iwi o Pōhara, hei kawe i a rātou mai i te pōharatanga ki te oranga tonutanga; mai i te noho marara ki te noho tahi; mai i te korekore ki te ao mārama. Ko te tuarua o ngā pātai kei mua i taku aroaro, he wānanga mena i tutuki pai ngā kaupapa i wawatahia ai e rātou. 
E rua ngā kōrero matua e toko ake ana i roto i ahau hei taumarumaru mō ngā whakaaro me ngā kōrero kua whakatakotoria i te tuhinga nei, hei whakautu i ngā pātai matua e rua ō runga ake nei. 
Tuatahi, 'Ko te amorangi ki mua, ko te hāpai ō ki muri'. E hāngai ana tēnei whakataukī ki te pūmautanga o ngā whakaaro o ngā tūpuna o Pōhara ki ngā kaupapa i kōkirihia ai e tō rātou rangatira, me te āhua o tā ngā tūpuna hāpai i aua kaupapa. I te tīmatanga, nā Piupiu Te Wherowhero rātou i arataki. I te rā nei, ko Te Arikinui, Te Atairangikaahu te manu whakataka pōkai i te ata hāpara, e ngāngahu tonu nei i ngā iwi o te marae o Pōhara. 
Tuarua, 'Kūpapa ki raro, Titiro ake.' Koia tēnei tētehi whakataukī whakahau i ngā uri whakatupu o te marae, o Pōhara, kua waihotia e rātou mā hei kupu ārahi i ngā uri i runga i te marae, i roto anō hoki i te ao hou. He hōhonutanga anō tō te whakataukī nei e tika ana kia whakamāramahia i roto i tēnei tuhinga, hei whāki atu i ngā rerenga kētanga o te āhua o te whakaaro o kui mā, o koro mā, me te āhua o tā rātou noho i te wā i a rātou. 
Ko te whakatau o ngā kōrero, i tutuki pai i ngā tūpuna o te marae o Pōhara ō rātou manako, nā tō rātou kaha ū ki te kaupapa o te Kāhui Ariki, me tō rātou ū ki te kaupapa o te tupuranga o te papakāinga o Pōhara hei marae mō ngā uri whakatupu. Ka noho mai tērā hei whakatohu i tō rātou pakaritanga, me ō rātou whakaaro rangatira hei tauira mā ngā uri whakaheke e whai ake ana i ngā tapuwae o ngā tūpuna. 
Ko ēnei tuhinga hei whakatinana i te ngākau nui kia waituhia ngā kōrero ā ngā rūruhi, ā ngā koroheke, mō te marae o Pōhara, kei ngaro katoa atu ngēnā kōrero e here nei i te ao kōhatu ki te ao hou. 
Nā te ngākau māhaki o ngā kaumātua i whakaae ai kia tuhia te kaupapa nei, kia puta ai ngā kōrero mō Pōhara ki te ao mārama hei painga mō ngā uri whakatupu. Nā rātou i whakatūwhera te kūaha ki tō rātou ao hei kuhu atu ki roto mā te hunga mahira. Ko ngā kongakonga kōrero i taka iho mai i ō rātou puna mahara, kua kohia-ā-rīpenehia hei taonga tuku iho mō ngā iwi o te marae. E tika ana kia puruhia te mauri o ērā kōrero e ngā whānau me ngā uri o te marae. 
I tutuki ai te taha rangahau i ngā kōrero kaumātua i te whakatū wānanga, me te uiui kaumātua. I whāia ngā huarahi e rua nei hei kohikohi i ngā kōrero-ā-waha mō te hītori o Pōhara. Arā noa atu ngā painga i kitea, o te noho tahi a ngā kaumātua i runga tonu i te marae, ki te whakawhitiwhiti whakaaro, kōrero hoki mō ngā rā o mua i waenganui i a rātou. Ā, hei whai ake i ngā kōrero i puta i ngā wānanga, i haere māua ko taku matua ki te torotoro i tēnā, i tēnā o ngā kaumātua e mōhio pai ana ki ngā kōrero, hei whakakīkī i ngā whārua, hei whakawhānui hoki i ngā kōrero. I ngāwari ake taku mahi i te haere tahitanga mai o taku matua, hei hoa mōku. Ko tāna, he āta whakamārama atu i te pūtake o te rangahau, he whakamārama hoki i te whakaaetanga o ngā kaumātua ki tērā mahi. I mōhio pai hoki ia ki ngā kōrero whānui mō te marae, ki ngā tāngata ka kōrerohia, ā, nā konā i taea e ia te whiu atu ētehi pātai, te whakamārama hoki i ahau i muri mai mō te āhua o ētehi o ngā kōrero kāore i tino mārama mai ki ahau. I tū hoki taku matua hei piriti i waenganui i te kaikōrero kaumātua me te kaiuiui rangatahi kia whakawhiti pai ai ngā pātai me ngā whakautu ki waenganui i ngā taha e rua. Koia tērā taku waimarie i roto i ngā mahi uiui kaumātua, ā, koia hoki i tutuki pai ai tērā taha o te rangahau. 
I tae mai ki aku ringa tētehi rīpene o tētehi wānanga i hopukina ai i te tau 1978. Nō taua tau, i haere ake ētehi akonga o te Tari Māori o Te Whare Wānanga o Waikato, i raro i te maru o Wharehuia Milroy ki te rapu i ngā kōrero mō te marae o Pōhara. Heoi anō, i tō rātou hokinga atu ki te kāinga, kāore te nuinga o ngā kōrero i hopukina. Ka waihotia te take nā kia tārewa, ā, tae rawa ki te tau 1990, kātahi ka riro i ahau te rīpene kotahi i ora mai, hei āwhina i aku mahi rangahau mō tōku marae. 
I rapu māramatanga ahau mō te āhua o te noho a te iwi Māori whānui i ngā rā o mua, i roto i ngā pukapuka maha kua tuhia kētia. Mō ngā kōrero mō te whenua e tū nei te marae ināianei, i haere ki te Kooti Whenua Māori, ki reira kimi ai i ngā kōrero mō te rohe o Maungatautari whānui, mō te marae o Pōhara hoki. Nā ēnei whaiwhainga, kua puta he kōrero, kua puta hoki he whakaaro hei whakawā i ērā kōrero, hei whakamārama rānei i ērā kōrero, ā, koia tēnei e takoto nei i roto i tēnei tuhinga. Ka huri ināianei ki te wetewetetanga o ngā wāhanga o roto i te tuhinga nei. 
Nō namata mai anō i tīkina atu ai te rākau i te Wao-nui-ā-Tāne hei tārai i te waka o ōku tūpuna. Tēnei au e tiki atu nei i te rākau hei tauira hanga kōrero mōku. Ko tō te rākau tupu, ki ngā whakaaro o tēnei e tuhi nei, e pērā ana ki te tupu o te kaupapa kia nohoia te marae o Pōhara e tū ana i raro i te maru o Maungatautari. 
Arā noa atu ngā tauritenga o te tupu o te rākau me tō te marae o Pōhara tupu, mai i ōna pūtakenga hei papakāinga, ki te puāwaitanga o te whakaaro kia tū hei marae mō te mokopuna a te motu, mō ngā uri whakatupu, otirā, mō te iwi whānui. 
E whitu anō ngā wāhanga o tō te rākau tupu e whakatauritehia nei i roto i ngā whārangi o tēnei tuhinga. Ko te whenua tonu hei papa mō te tupu o te rākau, mō te tupu hoki o te marae Nō reira, ka tīmata ake i konā.

text: Kūpapa ki raro, titiro ake Ko tā te kaituhi e manako nei i roto i tēnei tuhinga, kia āta tirohia he aha ngā huarahi i whāia ai e ngā iwi o Pōhara, hei kawe i a rātou mai i te pōharatanga ki te oranga tonutanga; mai i te noho marara ki te noho tahi; mai i te korekore ki te ao mārama. Ko te tuarua o ngā pātai kei mua i taku aroaro, he wānanga mena i tutuki pai ngā kaupapa i wawatahia ai e rātou. 
E rua ngā kōrero matua e toko ake ana i roto i ahau hei taumarumaru mō ngā whakaaro me ngā kōrero kua whakatakotoria i te tuhinga nei, hei whakautu i ngā pātai matua e rua ō runga ake nei. 
Tuatahi, 'Ko te amorangi ki mua, ko te hāpai ō ki muri'. E hāngai ana tēnei whakataukī ki te pūmautanga o ngā whakaaro o ngā tūpuna o Pōhara ki ngā kaupapa i kōkirihia ai e tō rātou rangatira, me te āhua o tā ngā tūpuna hāpai i aua kaupapa. I te tīmatanga, nā Piupiu Te Wherowhero rātou i arataki. I te rā nei, ko Te Arikinui, Te Atairangikaahu te manu whakataka pōkai i te ata hāpara, e ngāngahu tonu nei i ngā iwi o te marae o Pōhara. 
Tuarua, 'Kūpapa ki raro, Titiro ake.' Koia tēnei tētehi whakataukī whakahau i ngā uri whakatupu o te marae, o Pōhara, kua waihotia e rātou mā hei kupu ārahi i ngā uri i runga i te marae, i roto anō hoki i te ao hou. He hōhonutanga anō tō te whakataukī nei e tika ana kia whakamāramahia i roto i tēnei tuhinga, hei whāki atu i ngā rerenga kētanga o te āhua o te whakaaro o kui mā, o koro mā, me te āhua o tā rātou noho i te wā i a rātou. 
Ko te whakatau o ngā kōrero, i tutuki pai i ngā tūpuna o te marae o Pōhara ō rātou manako, nā tō rātou kaha ū ki te kaupapa o te Kāhui Ariki, me tō rātou ū ki te kaupapa o te tupuranga o te papakāinga o Pōhara hei marae mō ngā uri whakatupu. Ka noho mai tērā hei whakatohu i tō rātou pakaritanga, me ō rātou whakaaro rangatira hei tauira mā ngā uri whakaheke e whai ake ana i ngā tapuwae o ngā tūpuna. 
Ko ēnei tuhinga hei whakatinana i te ngākau nui kia waituhia ngā kōrero ā ngā rūruhi, ā ngā koroheke, mō te marae o Pōhara, kei ngaro katoa atu ngēnā kōrero e here nei i te ao kōhatu ki te ao hou. 
Nā te ngākau māhaki o ngā kaumātua i whakaae ai kia tuhia te kaupapa nei, kia puta ai ngā kōrero mō Pōhara ki te ao mārama hei painga mō ngā uri whakatupu. Nā rātou i whakatūwhera te kūaha ki tō rātou ao hei kuhu atu ki roto mā te hunga mahira. Ko ngā kongakonga kōrero i taka iho mai i ō rātou puna mahara, kua kohia-ā-rīpenehia hei taonga tuku iho mō ngā iwi o te marae. E tika ana kia puruhia te mauri o ērā kōrero e ngā whānau me ngā uri o te marae. 
I tutuki ai te taha rangahau i ngā kōrero kaumātua i te whakatū wānanga, me te uiui kaumātua. I whāia ngā huarahi e rua nei hei kohikohi i ngā kōrero-ā-waha mō te hītori o Pōhara. Arā noa atu ngā painga i kitea, o te noho tahi a ngā kaumātua i runga tonu i te marae, ki te whakawhitiwhiti whakaaro, kōrero hoki mō ngā rā o mua i waenganui i a rātou. Ā, hei whai ake i ngā kōrero i puta i ngā wānanga, i haere māua ko taku matua ki te torotoro i tēnā, i tēnā o ngā kaumātua e mōhio pai ana ki ngā kōrero, hei whakakīkī i ngā whārua, hei whakawhānui hoki i ngā kōrero. I ngāwari ake taku mahi i te haere tahitanga mai o taku matua, hei hoa mōku. Ko tāna, he āta whakamārama atu i te pūtake o te rangahau, he whakamārama hoki i te whakaaetanga o ngā kaumātua ki tērā mahi. I mōhio pai hoki ia ki ngā kōrero whānui mō te marae, ki ngā tāngata ka kōrerohia, ā, nā konā i taea e ia te whiu atu ētehi pātai, te whakamārama hoki i ahau i muri mai mō te āhua o ētehi o ngā kōrero kāore i tino mārama mai ki ahau. I tū hoki taku matua hei piriti i waenganui i te kaikōrero kaumātua me te kaiuiui rangatahi kia whakawhiti pai ai ngā pātai me ngā whakautu ki waenganui i ngā taha e rua. Koia tērā taku waimarie i roto i ngā mahi uiui kaumātua, ā, koia hoki i tutuki pai ai tērā taha o te rangahau. 
I tae mai ki aku ringa tētehi rīpene o tētehi wānanga i hopukina ai i te tau 1978. Nō taua tau, i haere ake ētehi akonga o te Tari Māori o Te Whare Wānanga o Waikato, i raro i te maru o Wharehuia Milroy ki te rapu i ngā kōrero mō te marae o Pōhara. Heoi anō, i tō rātou hokinga atu ki te kāinga, kāore te nuinga o ngā kōrero i hopukina. Ka waihotia te take nā kia tārewa, ā, tae rawa ki te tau 1990, kātahi ka riro i ahau te rīpene kotahi i ora mai, hei āwhina i aku mahi rangahau mō tōku marae. 
I rapu māramatanga ahau mō te āhua o te noho a te iwi Māori whānui i ngā rā o mua, i roto i ngā pukapuka maha kua tuhia kētia. Mō ngā kōrero mō te whenua e tū nei te marae ināianei, i haere ki te Kooti Whenua Māori, ki reira kimi ai i ngā kōrero mō te rohe o Maungatautari whānui, mō te marae o Pōhara hoki. Nā ēnei whaiwhainga, kua puta he kōrero, kua puta hoki he whakaaro hei whakawā i ērā kōrero, hei whakamārama rānei i ērā kōrero, ā, koia tēnei e takoto nei i roto i tēnei tuhinga. Ka huri ināianei ki te wetewetetanga o ngā wāhanga o roto i te tuhinga nei. 
Nō namata mai anō i tīkina atu ai te rākau i te Wao-nui-ā-Tāne hei tārai i te waka o ōku tūpuna. Tēnei au e tiki atu nei i te rākau hei tauira hanga kōrero mōku. Ko tō te rākau tupu, ki ngā whakaaro o tēnei e tuhi nei, e pērā ana ki te tupu o te kaupapa kia nohoia te marae o Pōhara e tū ana i raro i te maru o Maungatautari. 
Arā noa atu ngā tauritenga o te tupu o te rākau me tō te marae o Pōhara tupu, mai i ōna pūtakenga hei papakāinga, ki te puāwaitanga o te whakaaro kia tū hei marae mō te mokopuna a te motu, mō ngā uri whakatupu, otirā, mō te iwi whānui. 
E whitu anō ngā wāhanga o tō te rākau tupu e whakatauritehia nei i roto i ngā whārangi o tēnei tuhinga. Ko te whenua tonu hei papa mō te tupu o te rākau, mō te tupu hoki o te marae Nō reira, ka tīmata ake i konā.

year: 1997