RANGATAHI MAORI AND THE WHANAU CHOCOLATE BOX: Rangatahi wellbeing in whanau contexts.

Whanau (Maori understandings of family) are comprised of unique and vital relationships that support and scaffold rangatahi (youth) wellbeing, yet are often reduced to nuclear family structures within individualised notions of wellbeing. While rangatahi contend with racialised discourses in a colonial socio-cultural context, their whanau can be an important site for mitigating these challenges, supporting rangatahi agency and wellbeing. This article explores how whanau practices inform rangatahi wellbeing, drawing upon photo-projects and interviews with 51 rangatahi and their whanau. Interviews were thematically analysed, informing four themes that drew on Maori (the Indigenous people of Aotearoa) concepts and whakatauki: te haerenga whakamua, kotahitanga, he toa takitini and tatai hono. These themes speak to the significance of vitalising relationships between rangatahi, their whanau and beyond. We outline a strengths-based activity with rangatahi and their whanau, identifying and drawing from the delightful array of whanau relationships, qualities and characteristics that may be likened to a 'whanau chocolate box' for rangatahi to derive influence, systems of support and inspiration for future identities and inspiration.

Teeth are for chewing: a critical review of the conceptualisation and ethics of a controversial intraoral weight-loss device.

We are a diverse collective of researchers who are committed to improving the health and wellbeing of marginalised individuals. This article is a response to, and critique of, the DentalSlim Diet Control research. This device revises a controversial 1970s weight-loss technology connected to poor health outcomes, which is indicative of a culture that consistently promotes harm to fat and other marginalised communities.We address the historical context in which unruly bodies, particularly fat, and Indigenous bodies have been the site of unethical investigation conducted under the auspices of medical research. Existence outside the normative white, male, cis physical ideal demands regulation, and disciplinary measures. We demonstrate how Brunton et al.'s research is underpinned by anti-fat attitudes and assumptions which impose this punitive physical intervention onto healthy people in a way that should not be acceptable in medical research.Further, we address a range of harms, giving attention to Maori and to individuals with eating disorders, along with issues of research integrity. We argue that no ethics committee should have approved this research, no academic journal should have published it, and no member of the dental and medical community should promote or prescribe this device.

Enhancing responsiveness to Maori in a publicly funded bariatric service in Aotearoa New Zealand.

BACKGROUND: Health equity is a fundamental right afforded to all regardless of ethnicity. However, in New Zealand (NZ), health inequities are most compelling for Indigenous Maori who experience inadequate access to services, poorer quality of care and poor health outcomes as a result. Bariatric surgery is the most effective intervention for weight loss and remission of obesity-related disease where all other interventions have been exhausted. This Kaupapa Maori qualitative study presents Maori perspectives of bariatric surgery from the largest public bariatric centre in NZ and offers solutions for enhancing bariatric service responsiveness to Maori. METHODS: This qualitative study was informed by Kaupapa Maori methodology and involved a general inductive thematic analysis of 31 semi-structured interviews with Maori patients who had bariatric surgery at Counties Manukau Health in South Auckland, NZ. RESULTS: Four key themes were identified following analysis: (i) Kaupapa Maori standards of health; (ii) bariatric mentors; (iii) bariatric psychologists; and (iv) community-integrated support. These themes offer four tangible solutions for optimizing bariatric pathways for Maori from the perspectives of Maori bariatric patients. CONCLUSION: Kaupapa Maori, community-centred and greater non-surgeon aspects of bariatric supportive mechanisms comprise key areas of opportunity for public bariatric pathways in NZ. Surgical leadership is required to advance health equity and service responsiveness to Maori.

Portrayal of bariatric surgery in the New Zealand print news media.

BACKGROUND: Bariatric surgery has become topical in the media worldwide, influencing wider societal attitudes towards obesity and obesity management. This study aims to explore the media portrayal of bariatric surgery in all print news articles published in New Zealand (NZ) over a decade. METHODS: An electronic search of two databases (Proquest Australia/NZ Newsstream and Newztext) and two NZ news media websites (Stuff and the NZ Herald) was performed to retrieve print news articles reporting stories, opinion pieces or editorials regarding bariatric surgery published between January 2007 to June 2017. Qualitative thematic analysis was performed on all included articles. RESULTS: From January 2007 to December 2017, 252 articles related to bariatric surgery were published. Seven major themes emerged centred around barriers to accessing bariatric surgery, deficit attitudes towards obesity and social justice. These views were driven by articles that debated the limited number of publicly funded bariatric procedures offered in NZ. In addition, healthcare professionals used the media as a platform to challenge discriminatory attitudes towards obesity and bariatric surgery. CONCLUSION: The NZ media is a powerful tool that still bolsters binary perspectives of obesity and bariatric surgery which may work against addressing the obesity epidemic.

Media portrayal of Maori and bariatric surgery in Aotearoa/New Zealand.

AIM: Media constructs in Aotearoa, New Zealand naturalise the dominant Western culture. Conversely, mainstream news about Maori is rare and prioritises negative stereotypical constructs that are often centred on Maori as economic threats via resource control and political activism. These narratives influence continued discrimination against Maori in New Zealand. Media representations of bariatric surgery in New Zealand are not widely understood. We explored the portrayal of Maori and bariatric surgery in print and online news media articles in New Zealand using an inductive approach to thematic analysis. METHOD: An electronic search of two databases (Proquest Australia/ New Zealand Newsstream and Newztext) and two New Zealand news media websites (Stuff and the New Zealand Herald) was performed to retrieve news articles reporting stories, opinion pieces or editorials concerning Maori and bariatric surgery published between January 2007 to June 2017. Articles were scored using a five-point scale to assess the level of reporting as either very negative, negative, neutral, positive or very positive. Included articles were then subjected to inductive thematic analysis using the NVIVO 11 to identify and explore common themes surrounding Maori and bariatric surgery. RESULTS: Of 246 articles related to bariatric surgery over the 10-year study period, 31 (13%) were representative of Maori. Articles were scored as 'neutral' to 'positive' with a mean reporting score of 3.7 (Kappa score of 0.72 [95% CI, 0.66-0.78, p<0.0001]). Five main themes were identified, these were: Attitudes towards bariatric surgery; complexity of obesity and weight loss; access to bariatric surgery; Maori advocacy and framing of Maori. Of the five themes, access to bariatric surgery and attitudes towards bariatric surgery were most prevalent. Maori advocacy was another common theme that arose largely due to the support of public funding of bariatric surgery championed by Dame Tariana Turia. Aside from this, narratives describing equity of bariatric surgery provision and equitable outcomes following bariatric surgery for Maori were sparse. CONCLUSION: There was limited reporting on Maori health inequalities and equitable access to publicly funded bariatric surgery in New Zealand. We argue that this lack of coverage may work against addressing disparities in obesity prevalence and access to publicly funded bariatric surgery for Maori in New Zealand.