Tauiwi general practitioners explanations of Maori health: Colonial relations in primary healthcare in Aotearoa/New Zealand?

This paper reports initial findings from qualitative research investigating how general practitioners talk about Maori health. Transcripts of semi-structured interviews with 25 general practitioners from urban Auckland were subjected to critical discursive analyses. Through this process of intensive, analytic reading, interpretative repertoires – patterns of words and images about a particular topic – were identified. This paper presents the main features of one such repertoire, termed Maori Morbidity, that the general practitioners used in accounting for poor Maori health status. Our participants were drawing upon a circumscribed pool of ideas and explaining the inequalities in health between Maori and Tauiwi in ways that gave primacy to characteristics of Maori and their culture. We discuss the implications of this conclusion for relations between Maori patients and Tauiwi doctors in primary healthcare settings

Media, racism and public health psychology

A growing literature has established that racism contributes to ill-health of migrants, minority group members and indigenous peoples. Racial discrimination has been shown to act at personal, institutional and societal levels, negatively affecting physical health as evidenced by heart disease and other stress related conditions and generally negating wellbeing, signalled by psychological and psychiatric disorders including depression. In our highly mediatized world, mass communications in diverse forms are decisive for people’s knowledge and understandings of the world and their place in it. From critical studies we know that the media consistently marginalize, denigrate and neglect particular ethnic and cultural groups. Where media do focus on such groups much of the reporting is negative and stereotyping. Achievements are ignored or minimized while representations of those groups as problems for and threats to the dominant are highlighted. In this paper we consider the particular case of media representations of the indigenous Maori of Aotearoa New Zealand. We review extant studies to argue that detailed and systematic study is necessary for the development of critical, local media scholarship. Such scholarship is necessary if the current media impact on Maori health and wellbeing is to be mitigated. While such considerations may not have been traditional concerns of health psychology we, following George Albee (2003), argue for them as affirming the need for critical public health psychology

Geographical Equity Effects Of The Homeowner Tax Subsidy

The purpose of this study is to provide exploratory evidence concerning the degree to which geographical cost of living differentials interact with homeownership tax incentives in affecting tax system equity. Incorporating both federal and state homeowner tax subsidies calculated using the 1991 Ernst & Young Tax Model File; the authors provide evidence concerning both horizontal and vertical equity in the system. Descriptive statistics and regression results provide findings which indicate positive and direct relationships between the homeowner tax subsidy and 1) taxpayer disposable income (increased regressivity in the tax system) and 2) taxpayer state of residence median housing values (decreased horizontal inequities between similarly situated homeowners in different states). These findings indicate that elimination of the homeowner tax subsidy accompanied by a direct subsidy would increase equity within the system. Furthermore, the findings suggest that the President’s Advisory Panel on Federal Tax Reform (2005) recommendation for a home credit, with a limit based on average cost of housing within a taxpayer’s area, will result in a more equitable distribution of the homeowner tax subsidy

CO2 ocean bistability on terrestrial exoplanets

Cycling of carbon dioxide between the atmosphere and interior of rocky planets can stabilize global climate and enable planetary surface temperatures above freezing over geologic time. However, variations in global carbon budget and unstable feedback cycles between planetary sub-systems may destabilize the climate of rocky exoplanets toward regimes unknown in the Solar System. Here, we perform clear-sky atmospheric radiative transfer and surface weathering simulations to probe the stability of climate equilibria for rocky, ocean-bearing exoplanets at instellations relevant for planetary systems in the outer regions of the circumstellar habitable zone. Our simulations suggest that planets orbiting G- and F-type stars (but not M-type stars) may display bistability between an Earth-like climate state with efficient carbon sequestration and an alternative stable climate equilibrium where CO2 condenses at the surface and forms a blanket of either clathrate hydrate or liquid CO2. At increasing instellation and with ineffective weathering, the latter state oscillates between cool, surface CO2-condensing and hot, non-condensing climates. CO2 bistable climates may emerge early in planetary history and remain stable for billions of years. The carbon dioxide-condensing climates follow an opposite trend in pCO2 versus instellation compared to the weathering-stabilized planet population, suggesting the possibility of observational discrimination between these distinct climate categories

CO2 Ocean Bistability on Terrestrial Exoplanets

Cycling of carbon dioxide between the atmosphere and interior of rocky planets can stabilize global climate and enable planetary surface temperatures above freezing over geologic time. However, variations in global carbon budget and unstable feedback cycles between planetary sub‐systems may destabilize the climate of rocky exoplanets toward regimes unknown in the Solar System. Here, we perform clear‐sky atmospheric radiative transfer and surface weathering simulations to probe the stability of climate equilibria for rocky, ocean‐bearing exoplanets at instellations relevant for planetary systems in the outer regions of the circumstellar habitable zone. Our simulations suggest that planets orbiting G‐ and F‐type stars (but not M‐type stars) may display bistability between an Earth‐like climate state with efficient carbon sequestration and an alternative stable climate equilibrium where CO(2) condenses at the surface and forms a blanket of either clathrate hydrate or liquid CO(2). At increasing instellation and with ineffective weathering, the latter state oscillates between cool, surface CO(2)‐condensing and hot, non‐condensing climates. CO(2) bistable climates may emerge early in planetary history and remain stable for billions of years. The carbon dioxide‐condensing climates follow an opposite trend in pCO(2) versus instellation compared to the weathering‐stabilized planet population, suggesting the possibility of observational discrimination between these distinct climate categories

In trials of physiotherapy for chronic low back pain, clinical relevance is rarely interpreted, with great heterogeneity in the frameworks and thresholds used:a meta-research study

QUESTIONS: How do authors of randomised controlled trials (RCTs) interpret the clinical relevance of the effects of physiotherapy interventions compared with no intervention on pain intensity, physical function and time to recovery in people with chronic low back pain (CLBP)? How can the clinical relevance be re-interpreted based on the available smallest worthwhile effect (SWE) threshold for this comparison? Are the studies in this field adequately powered?DESIGN: Cross-sectional meta-research study.PARTICIPANTS: People with CLBP.OUTCOME MEASURES: Pain intensity, physical function and time to recovery.RESULTS: This review included 23 RCTs with 1,645 participants. Twenty-two and 18 studies were included in the analysis of pain intensity and physical function, respectively. No studies investigated time to recovery. Sixteen studies reported varying thresholds to interpret clinical relevance for physical function and pain intensity. Discrepancies between interpretation using the minimal important difference and SWE values were observed in five studies. Study power ranged from 9% to 98%, with only four studies having a power &gt; 80%.CONCLUSION: Little attention is given to the interpretation of clinical relevance in RCTs comparing physiotherapy with no intervention in CLBP, with great heterogeneity in the frameworks and thresholds used. Future trials should inform patients and clinicians on whether the effect of an intervention is large enough to be worthwhile, using a reliable and comprehensive approach like available SWE estimates.REGISTRATION: medRxiv https://doi.org/10.1101/2022.12.14.22283454.</p