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The document is an oration titled "Ka Pū Te Ruha, Ka Hao Te Rangatahi" delivered by Suzanne Pitama at the Royal Australasian College of Surgeons. The oration explores the role of Indigenous medical education in advancing Indigenous health. Pitama discusses the evolution of the Hauora Māori curriculum at the University of Otago and emphasizes the importance of cultural competency in surgical practice. She encourages the College to actively engage with Indigenous medical education and fulfill its obligations outlined in the Indigenous Health Position Paper. Pitama concludes by addressing new fellows and expressing high aspirations for their potential to address health inequities. [Extracted from the article]

Aims: The validity of diagnostic classification in early psychosis has important implications for early intervention; however, it is unknown if previously found disparities between Māori (Indigenous people of New Zealand) and non‐Māori in first episode diagnoses persist over time, or how these differences impact service use. Methods: We used anonymized routine mental health service data and a previously established cohort of over 2400 13–25‐year‐old youth diagnosed with FEP between 2009 and 2012, to explore differences in diagnostic stability of psychosis diagnoses, comorbid (non‐psychosis) diagnoses, and mental health service contacts between Māori and non‐Māori in the five‐year period following diagnosis. Results: Differences in schizophrenia and affective psychosis diagnoses between Māori and non‐Māori were maintained in the five‐year period, with Māori being more likely to be diagnosed with schizophrenia (51% vs. 35%), and non‐Māori with bipolar disorder (28% vs. 18%). Stability of diagnosis was similar (schizophrenia 75% Māori vs. 67% non‐Maori; bipolar disorder 55% Māori vs. 48% non‐Māori) and those with no stable diagnosis at FEP were most likely to move towards a schizophrenia disorder diagnosis in both groups. Māori had a lower rate of diagnosed co‐morbid affective and anxiety symptoms and higher rates of continued face to face contact and inpatient admission across all diagnoses. Conclusions: Indigenous differences in schizophrenia and affective psychosis diagnoses could be related to differential exposure to socio‐environmental risk or assessor bias. The lower rate of co‐morbid affective and anxiety disorders indicates a potential under‐appreciation of affective symptoms in Māori youth with first episode psychosis. [ABSTRACT FROM AUTHOR]

Objective: Lifetime prevalence rates in Te Rau Hinengaro (The New Zealand Mental Health Survey) suggest eating disorders are at least as common in the Māori population as the non‐Māori population, yet little is known at a population level about those accessing specialist mental health treatment for eating disorders in New Zealand. The aim of this study was to describe the population undergoing specialist mental health treatment for eating disorders and compare Māori and non‐Māori clinical characteristics and service use. Method: This study uses the Programme for the Integration of Mental Health Data data set, managed by the New Zealand Ministry of Health to describe the characteristics of people with eating disorders and their use of specialist mental health services from 2009 to 2016. Results: There were 3,835 individuals with a diagnosed eating disorder who had contact with specialist mental health services in this time period, 7% of whom were Māori. Within the cohort, Māori had a higher prevalence for a bulimia nervosa diagnosis, fewer diagnosed with anorexia nervosa, and a higher prevalence of other psychiatric comorbidity than non‐Māori. Discussion: There is discrepancy between the proportion of service users accessing specialist mental health services who are Māori and the assessed crude prevalence of eating disorders for Māori in national estimates. Once Māori are in specialist services; however, their use of services is comparable to non‐Māori. Further research is needed to highlight the experiences of those Māori with eating disorders and address barriers to accessing services for Māori with eating disorders. [ABSTRACT FROM AUTHOR]

Research surrounding access to surgical care between Maori and non-Maori has grown substantially (Fig. Despite a plethora of resources outlining how to conduct safe and responsive research for Maori, non-Maori researchers with little connection to Maori communities and people continue to lead and control research on or about Maori.1 Maori health clinicians and academics tirelessly challenge these researchers and attempt to protect Maori from research that is racist, exploitative and demeaning. Within these discourses, Maori are often framed within a deficit lens in health research.8 Such deficiencies are framed as either biological or cultural, or both, due to mainstream research methodologies lacking critical reflexivity of Western systems that maintain inequities.9 Furthermore, there is limited research examining the impact of sociocultural systems developed by the dominant group on Maori health. [Extracted from the article]

Maori and non-Maori health professional educators collaborate to ensure a culturally safe learning environment for Maori educators and Maori students. Each team member actively contributes to the Maori health curriculum, demonstrates clinical role-modelling and ensures a culturally safe learning environment for Maori and non-Maori staff and learners. The role of health professional education to deliver indigenous health and well-being is well documented.1,2 Indigenous health curricula have a key role within health professional education to support Maori health advancement; however, indigenous health professional education is a fragile ecology in terms of curriculum time, resource and institutional priorities.2 Colonisation and racism have caused prolonged health injustices for Maori, the Indigenous Peoples of Aotearoa/New Zealand manifested by reduced life expectancy and lower quality health care. [Extracted from the article]

Context: The effectiveness of cultural competency education in improving health practitioner proficiency and addressing health inequities for minoritised patient groups is uncertain. Identification of institutional factors that shape or constrain development of indigenous health curricula may provide insights into the impact of these factors on the broader cultural competency curricula. Methods: We undertook a systematic review using actor–network theory to inform our interpretive synthesis of studies that reported indigenous health curricula evaluated within medical, nursing and allied health education. We searched the MEDLINE, OVID Nursing, Educational Resources Information Center (ERIC), PsycINFO, EMBASE, Web of Science and PubMed databases to December 2017 using exploded MeSH terms ‘indigenous’ and ‘medical education’ and ‘educational professional’ and ‘health professional education’. We included studies involving undergraduate or postgraduate medical, nursing or allied health students or practitioners. Studies were eligible if they documented indigenous health learning outcomes, pedagogical practices and student evaluations. Results: Twenty‐three studies were eligible for the review. In an interpretive synthesis informed by actor–network theory, three themes emerged from the data: indigenous health as an emerging curriculum (drivers of institutional change, increasing indigenous capacity and leadership, and addressing deficit discourse); institutional resource allocation to indigenous health curricula (placement within the core curriculum, time allocation, and resources constraining pedagogy), and impact of the curriculum on learners (acceptability of the curriculum, learner knowledge, and learner behaviour). Conclusions: Systemic barriers acting on and within educational networks have limited the developmental capacity of indigenous health curricula, supported and sustained hidden curricula, and led to insufficient institutional investment to support a comprehensive curriculum. Future research in health professional education should explore these political and network intermediaries acting on cultural competence curricula and how they can be overcome to achieve cultural competency learning outcomes. [ABSTRACT FROM AUTHOR]

Objective: Gout typically responds well to medications, but adherence might be improved by education that meets individuals' needs in a way that is inclusive of their ethnicity and rurality. The aim of this study was to compare education preferences of Māori and New Zealand European (NZEuropean) individuals with gout, and of those living in rural or urban areas.Methods: People with gout managed in primary care were recruited from 2 rural regions and 1 city within Aotearoa/New Zealand. Focus groups were held with 26 Māori and 42 NZEuropean participants (44 rural, 24 urban). Participants discussed education preferences for diet, medication, and ways of communicating. The nominal group technique was employed, whereby the group compiled a list of ideas and then participants individually ranked the 3 most important ideas for each topic.Results: The most frequently prioritized ideas for the 3 topics were knowing one's own food triggers, knowing side effects of medications, and communicating via a general practitioner (GP) or specialist. More Māori participants prioritized natural remedies, easy to understand information, and communicating via television. More NZEuropean participants prioritized knowing the kinds of alcohol that trigger gout, communicating via GP/specialist, and receiving written information. More urban participants prioritized knowing to stay hydrated and medication doses as important information.Conclusion: Māori and NZEuropean individuals with gout report different understandings and education preferences around personal triggers of gout, treatment options, and ways of receiving information about gout. Further research is required to develop ethnicity-specific gout education resources internationally. [ABSTRACT FROM AUTHOR]

This research reinforces the impact of systemic racism and bias that has been maintained in pre-COVID-19 health environments.11-16 This has bought into question how current curricula have not adequately challenged the role of health systems in maintaining health inequity within specific communities and the curricula's ongoing othering of these communities. Within the COVID-19 environment has also come a tsunami of health research that has highlighted how communities, traditionally impacted by inequitable health outcomes, have been most impacted by COVID-19. I It is time for parents to teach young people early on that in diversity there is beauty and there is strength. i Maya Angelou1 Welcome to this special issue - the second themed issue in the 18 years of I The Clinical Teacher's i publication. [Extracted from the article]

Effectively conceptualising impaired wellness for physicians requires review of the roles and responsibilities of teams, health service leadership and the health system as a whole. [ABSTRACT FROM AUTHOR]

Māori, like Indigenous Australians and other indigenous people world-wide, are simultaneously over-represented among those presenting with addiction-related problems and under-represented within various health professions. Providing the opportunity for individuals and whanau (family/extended family) to work with ethnically matched health workers is likely to increase service accessibility and to improve treatment outcomes. In New Zealand, a number of initiatives have been instigated to increase the capacity of the Māori health work-force and reduce related barriers to treatment. This article provides an analysis of relevant literature and policy documents, and identifies five strategic imperatives currently informing work-force development in the Māori alcohol and other drug (AOD) and gambling treatment sector. [ABSTRACT FROM AUTHOR]