Intakes and food sources of dietary protein among New Zealand adolescents

Background: Adolescence is a nutritionally vulnerable period, characterised by rapid growth and development as an individual transitions from childhood to adulthood. Protein is necessary to support these rapid changes and is paramount to supporting immunity, bone health and hormone production. There is limited up-to-date data on the protein intakes among New Zealand (NZ) adolescents, as the last assessment was conducted over a decade ago. Objective: To assess the protein intakes and main food sources of protein among New Zealand adolescents aged 15-18 years. Furthermore, the present study aimed to compare intakes, sources and the prevalence of inadequacy between males and females. Design: The present thesis is part of a wider population-based cross-sectional study, the Survey of Nutrition, Dietary Assessment and Lifestyle, which was conducted over an 18-month period in NZ adolescents, aged 15-18 years. A convenience sample of adolescents, clustered by high schools were the study participants. Measurements were taken over three phases from February 2019 to April 2020. Two 24-hour diet recalls, taken on non-consecutive days, were undertaken to assess the protein intakes of adolescents using the ‘multiple pass method’. Participants also completed online questionnaires on demographics and dietary habits. Usual average protein intake was estimated using the multiple source method in absolute terms, as a percentage of total energy and per gram per kilogram of bodyweight. The Estimated Average Requirement (EAR) cut off method was used to determine the prevalence of inadequacy among adolescents. Body mass index (BMI) z-scores were calculated using standardised height and weight measurements. Results: The population comprised 66% females (n=266) and 34% males (n=135). Mean usual dietary protein intakes were significantly higher among males compared with females (109.5 g/day (95% CI: 104.1, 114.9) and 1.63 g/kg (95% CI: 1.54, 1.73) vs 73.0 g/day (95% CI: 70.6, 75.3) and 1.14 g/kg (95% CI: 1.09, 1.18)). The prevalence of inadequacy among females was low (0.3%) in absolute terms (g/day), although increased to 6.3% when body weight is accounted for (g/kg). Females who were Māori, resided in areas of high deprivation or were obese had the highest rates of inadequacy, while no male had inadequate mean protein intake. Contribution of protein to total energy was statistically 18% higher among males compared with females (18.6% total energy (TE) (95% CI: 18.1, 19.2) vs 15.4% TE (95% CI: 15.1, 15.7). Notably, mean contributions to total energy sit towards the lower end of the Acceptable Macronutrient Distribution Range (AMDR). A concerning 47.7% of females had intakes below the AMDR (15- 25% TE) while only 13.7% of males were below this limit. Main food sources for adolescents were similar between sexes, with poultry (12.8%), grains and pasta (10.0%), and bread (9.4%) contributing the main sources of protein. Conclusion: Protein intakes among the adolescent population in New Zealand are mostly sufficient to meet their physiological needs, and the prevalence of inadequacy appears to be low. Males consistently consume more dietary protein than females. In turn, females living in highly deprived areas or of Māori ethnicity are at higher risk of protein inadequacy. Increasing intakes to sit within the AMDR is an avenue in which adolescent health can be optimised on a population level by ensuring a balanced diet. Protein quality and the amino acid composition of foods should be assessed in future analyses to determine the contribution of protein-rich foods to overall diet quality. Larger, nationally representative studies are required to support the present findings

Revealing the lifestyles of local food consumers

Changing consumption patterns have led to a number of transformations throughout the food cycle, and understanding how and why people purchase local food is important. This paper aims to examine the characteristics of the people leading this phenomenon: those that prefer to buy locally produced food. In order to explore the characteristics of local food purchasers, a single item question, “I try to buy a lot of locally produced food”, was included in the food section of a New Zealand consumer lifestyles survey for which 3,556 responses were collected. The full survey included 600 questions across the full attitude, interest and opinion schedule. For people who express a strong intention to purchase local food, this behaviour is linked to the types of food they eat (e.g. unprocessed foods), where they buy it (e.g. at speciality stores), and how they cook it (e.g. follow recipes). A range of personality and other personal characteristics differ between local and non-local food buyers, with the former segment being more liberal, interested in quality, and frugal. Consumers who express an interest in purchasing local food are a demanding segment of the population whose interest in food makes them critical judges of produce. Local food must thus be fresh and value for money. Growing this sector requires making local food more accessible through mainstream retail outlets. While something is known about why people buy local food, less is known about other aspects of local food consumers, the range of attitudes they hold towards food or their food-related behaviours

A new way of being church : a case study approach to Cityside Baptist Church as Christian faith "making do" in a postmodern world

New forms of liturgy and church have recently emerged in Western Protestantism. This includes "alternative worship"; defined as liturgical innovation characterised by communal participation, employment of popular cultural resources, a rediscovery of ancient liturgy and an appreciation of creativity and the arts. This thesis critically examines the claim that such "alternative worship" groups are an expression of postmodern religious life by exploring the practices of Cityside Baptist Church, in Aotearoa New Zealand. It situates their liturgical innovation as a "making do" - multiple transformative processes which creatively subvert their surrounding context. This "making do" is an application of the work of Michel de Certeau and his interpretive work on culture and context. This thesis employs a practical theology methodology to read communal practices as a body of theological data. This allows the critical excavation of a living theology from "down under." Cityside is located in relation to their surrounding context, firstly of religious decline and charismatic dominance and secondly of a postmodern fragmentation into an individualised search for meaning, an emergence of tribal communities and a re-negotiated relationship with the Other. Given this contextual siting, survey analysis and focus group interviews are employed to read Cityside as a group in rupture from Evangelical/Pentecostal/Charismatic religious dominance who identify themselves as postmodern. They have developed liturgical practices that value community, creativity and an engagement with culture. These three themes then guide an examination of Cityside's every[sun]day liturgical practices through participant observation. Firstly, the fault lines of Cityside are read as a "making do" with a communitarian hermeneutic. In response to experiences of rupture, Cityside offers a unique gathered community of choice in which the individual is invited to find meaning. This "making do" with a communitarian hermeneutic is then applied to re-read tradition as dialogue with other contextual communities one generation removed from Jesus. It is further argued that at Cityside Biblical text is read as a communal experience of shared rupture. Secondly, Cityside's "making do" with a communitarian hermeneutic creates an imaginative space that allows both a communal and individual "making do." Imagination as rupture, fragmentation and play are used to analyse selected liturgical practices - storytelling, art images and labyrinth as pilgrimage - at Cityside. Imagination is referenced as a play of natality that re-reads both Christian anthropology and the ironic deconstruction of much postmodern discourse. Thirdly, the ethics of relationship with the Other are a key dimension of postmodern discourse. The metaphor of DJing is introduced to argue that Cityside employs a "tactic" of sampling as a further dimension of its "making do." This allows Cityside a renegotiated relationship with the Other of gospel and culture. The practice of DJ sampling is then located within a tradition of marginal creative communities who produce marginalia as an authentic and creative re-reading of tradition. Hence, Cityside's life contains multiple transformative practices that are both continuous and discontinuous with reference to both postmodern culture and the Christian tradition. Cityside Baptist Church is read as Christian faith "making do" in a postmodern world

The role of emotions in the experiences of commercial high-altitude mountaineering guides who have guided above the death-zone

The body of tour guiding research has identified the importance of emotions and emotion management to guide’s experiences. However, there is a far less granular understanding of why, when, and how at each stage of a trip emotions change guide experiences. To date, studies of guides’ emotions have treated an entire experience as a single point of time, and do not provide a coherent picture of how emotions change guide experiences over the course of a trip. This generalised approach has hampered the dynamic and full interpretation of emotions in guides’ experience because emotions have different sets of appraisals, and each emotion of the same valence differs in their influence on people’s experiences over time. Therefore, a deeper insight into how emotions change an actual experience at the moment, as the guiding trip unfolds, is essential to optimising the overall guide’s experiences. This study seeks to fill these gaps by exploring the role of emotions in the experiences of commercial high-altitude mountaineering guides working above the death zone (i.e. over 8,000 meters). The work of commercial high-altitude mountaineering guides (HAMGs), which incorporates expeditions lasting for more than six weeks, provides an opportunity to analyse how emotions change participants’ experiences. This starts with the planning and preparation for the expedition, runs through the actual trip, and incorporates a post-expedition period. All these stages are associated with stress, pressure, and responsibilities to perform the day-to-day tasks that differ substantially across the experience. Data collection was undertaken in Kathmandu, Nepal, where the researcher spent 90 days interviewing (online and in-person) commercial high-altitude mountaineering guides (16 participants: seven female and nine male) from eight countries. Thematic analysis was used to explore how emotions change HAMGs’ experiences across the expedition. Focusing on high-altitude mountaineering guiding, the findings revealed that emotions play a key role in all three main phases of the HAMGs experience. At the pre-guiding stage, the themes individual reasons, social influences, occupational difficulties, and occupational opportunities link to elicited emotions. During the expedition, the experiences of emotions varies in intensity from the time when the expedition team meet in the base camp, throughout the climb, and until the team returns to the base camp safely. In the post-guiding phase, the themes occupational barriers, social influences, and individual reasons represent the complex role of emotions in participants’ experiences. The discussion is bounded by various reasons to continue and discontinue guiding. All of these phases demonstrate how emotions change commercial high-altitude mountaineering guides overall experiences. This study expands the tour guiding, hospitality and emotional labour literature by: (1) providing a coherent picture of how emotions change guides experiences throughout participation; (2) shedding light on the working reality of frontline service employee experiences influenced by emotions; (3) suggesting that commercial high-altitude mountaineering guides perform emotion management acts at every stage of the expedition; (4) translating the findings into recommended practices for mountaineering tourism expedition operators and mountaineering guiding associations

NZDep2018 analysis of census 2018 variables - DHB13: Hutt Valley

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - TA002: Whangarei District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - DHB06: Lakes

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

"We need to discuss surgery": A multimodal conversation analytic study of intersubjectivity during surgeons' information provision to patients

Providing patients with information, such that they are able to understand the consequences of treatment decisions, is an ethical and legal requirement in New Zealand and many other jurisdictions. While research from the disciplines of bioethics, law, and medicine has shown that patients’ recall and understanding of what they have been told is often limited, such research has focused on the “what” rather than the “how” of informing. While some health communication and health literacy research has addressed the how of informing, such research has relied on observation and coding strategies. By contrast, this thesis project addresses the how of informing via situated interactional analysis. Information provision creates many challenges for both patients and surgeons. One of the greatest challenges is epistemic asymmetry, which is exacerbated by low health literacy and numeracy. To provide context for my findings in the analytic chapters, I describe the conflicting institutional, social, and psychological demands that surgeons face when providing information to patients. In addition to epistemic asymmetry, these include adherence to legal precepts, upholding bioethical principles, establishing and maintaining social relations, dealing with uncertainty, countering the “curse of expertise”, and forming a mutually acceptable plan for next steps within the circumscribed time frame of a surgical consultation. In this thesis, I use multimodal conversation analysis to investigate participants’ management of intersubjectivity during surgeons’ extended tellings. Drawing on prior conversation analytic research on intersubjectivity and repair, the structure of storytellings, epistemics, and turn taking, I show that surgeons’ information provision takes the form of extended tellings during which patients say little. Although the content of these tellings varies widely, the content categories, namely Problem, Process, Alternatives, and Risks, which are familiar to me as a former clinician, are similar across most of these tellings. Furthermore, the ordering of these content categories appears designed to scaffold patient understanding. On the one hand, while structural aspects of extended tellings generally inhibit floor-taking turns by patients, my research reveals that some surgeons use recycling of previous talk to create “unit ends”. Some patients orient to these unit ends by providing full turns-at-talk that initiate repair or display their stance. Furthermore, their full turns (can) provide demonstrations of their understanding. In the event that they reveal misunderstandings, such demonstrations allow surgeons to tailor their repairs. Notwithstanding the sequential implicativeness of repeats as unit ends, patients’ floor-taking turns are rare in the mid-telling environment. However, patients can claim they are following surgeons’ talk via head nods and minimal vocal responses in the vicinity of TCU completions. In keeping with prior research, my findings show that, providing there is mutual gaze, surgeons in my data usually treat the absence of such on-time acknowledgements as interactional trouble. This orientation is evidenced by progressivity disruptions in the form of post-positioned expansions, reformulations, understanding checks, increments, response pursuits, or reassurances. While demonstrations of understanding are rare during these extended tellings, patients can upgrade their claims of epistemic access via complex multimodal gestalts, either to claim new understanding or to claim epistemic antecedence. In this regard, analysis shows that the timing of patients’ modal moves (such as nods), in relation both to other modal moves (such as gaze continuation or withdrawal) and to surgeons’ TCU completions, is key to the epistemic affordances created. Prior research has shown that gaze is central to intersubjectivity management because of its roles in mutual monitoring and in interactional engagement/disengagement. In keeping with this research, my findings emphasise the role of gaze in creating the accountability of patients’ acknowledgements at surgeons’ TCU completions. Furthermore, in keeping with prior research, surgeons in my data use gaze both for response pursuit and recipient selection. Finally, my analysis shows that the epistemic affordances of patients’ complex multimodal gestalts depend on gaze withdrawal or continuation. In addition to the above theoretical contributions, my multimodal transcription method makes a methodological contribution by facilitating reader access to the simultaneous unfolding of modal moves and gaze direction. Moreover, this thesis has the potential to contribute to training of surgeons and other experts involved in information provision to laypersons. The essence of my thesis argument, which is based on a combination of empirical multimodal conversation analytic research and the ethnographic insights of a former clinician, is that the central issue with informing for informed decision making is the ever-present tension between interactional intersubjectivity and progressivity. However, despite surgeons doing nearly all the talking during extended tellings for information provision, these tellings are co-operatively constructed by the interactional participants

NZDep2018 analysis of census 2018 variables - TA023: Tauranga City

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/

NZDep2018 analysis of census 2018 variables - TA015: Matamata-Piako District

For further information about data sources, interpretation of the graphs, and cautions, please see the separate Introduction Chapter All data relating to the 2018 census is provided by Stats NZ, https://www.stats.govt.nz/