Tuwhera Research Repository

The Tuwhera Research Repository provides sustainable open access and archiving to a broad range of AUT produced research - theses, research outputs and datasets.

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Recent Submissions

Access status: Open Access ,
Factors Associated With Variability in Recovery After Mild Traumatic Brain Injury Among Adults Referred to Outpatient Concussion Clinics
(CSIRO Publishing, 2026-09-14) Snell, Deborah; Williman, Jonathan; Faulkner, Josh; Silverberg, Noah D; Theadom, Alice; Surgenor, Lois; Siegert, Richard; Simpson, Grahame
BACKGROUND: To understand factors associated with symptom and disability recovery trajectories among adults referred to outpatient clinics after mild traumatic brain injury. METHODS: Adults (n = 110; mean age 39 years, 36% men), were assessed at clinic intake (baseline mean 6.5 weeks), and monthly thereafter for 6 months. Validated questionnaires assessed distress, fear avoidance and catastrophising at baseline, and mild traumatic brain injury symptoms and disability. Using correlations and linear mixed modelling, we explored associations between demographic characteristics (age, gender), baseline psychological factors and recovery as a function of time. RESULTS: The models predicted improvement in symptoms (R2 = 0.22) and disability (R2 = 0.37). After adjusting for baseline severity of symptoms and disability, higher distress was associated with slower recovery and greater variability for symptoms (P = 0.06) and disability (P < 0.01). Higher baseline catastrophising predicted less symptom improvement (P = 0.02). Those with higher fear avoidance behaviour at baseline showed greater variability in disability outcomes (P = 0.02), even when other psychological variables were accounted for. CONCLUSIONS: Participants showed improvements on average, in both symptoms and disability. Variability and rates of recovery were associated with distress, catastrophising and fear avoidance. Clinicians can target such psychological factors in treatment and anticipate recovery fluctuations, normalising these while maintaining cautiously optimistic messaging regarding expected good prognosis after mild traumatic brain injury.
Access status: Open Access ,
Whitia Kia Ora: A Culturally Responsive Model of Bicillin L-A® Delivery for People With Rheumatic Fever in the Waikato Region of Aotearoa New Zealand
(Pasifika Medical Association Group, 2026-08-14) Anderson, Anneka; Ikiua, Monleigh; Brown, Rachel; Arrowsmith, Kim; Phillipson-Puna, Tira; Leilua, Shannon; Rhinds, Manawa; Cooper, Julie; Harwood, Matire; Mckree-Jansen, Rawiri; Ahu, Alison; Thompson, Dave; Bennett, Julie
AIM: Acute rheumatic fever (ARF) is an autoimmune response to group A Streptococcus (Strep A) infection that can lead to rheumatic heart disease (RHD). To prevent Strep A infection for people with ARF or RHD, clinical guidelines recommend monthly intramuscular penicillin (Bicillin L-A®) injections for at least 10 years. However, multiple barriers to accessing healthcare affect adherence. This research aimed to improve adherence by developing a Māori and Pacific–centred model of care. METHODS: Qualitative, Kaupapa Māori and Kakala methodology underpinned the research. Data collection from people in the Waikato region with ARF, their whānau and healthcare providers included interviews, wānanga and fono. Data were analysed using a general inductive approach. RESULTS: Forty-seven participants were included: nine people with ARF, 10 whānau, eight health professionals and 21 whānau navigators. Three themes were identified: impacts of a colonial health system on Indigenous whānau; life defined by a disease status; and catalysts of healthcare engagement. A community informed, Whānau Ora model of care was also developed. CONCLUSION: Indigenous methodologies are effective methods to develop community informed, culturally responsive models of care. Although designed for ARF in Waikato, there is potential to adapt this approach for other health conditions and different regions of Aotearoa New Zealand.
Access status: Open Access ,
Effects of Behaviour Change Interventions Combined With Exercise on Device-measured Physical Activity in People With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis
(Wiley, 2026-08-17) Meiring, Rebecca M.; Campbell, Mitchell; Sood, Abhishta; O’Brien, Daniel; Watson, Estelle D.; Kaushik, Shashank
Behaviour change techniques (BCTs) are recommended as core components of physical activity (PA) interventions for people with lower limb osteoarthritis (OA), and identifying effective BCTs is an emerging research priority. This systematic review aimed to evaluate the effects of combined behaviour change and exercise interventions on objectively measured total PA (primary outcome) and other device-measured activity behaviours, including moderate-to-vigorous physical activity (MVPA), steps and sedentary behaviour, in people with hip or knee OA (secondary outcomes). Five databases were searched from inception until September 2025. The titles of identified randomised controlled trials (n = 907) were screened by two reviewers, and 12 studies involving 1162 participants with OA were included. Study quality was assessed using the SIGN checklist, and certainty of evidence was evaluated using the GRADE approach. Most studies were rated as low quality, and the certainty of evidence was low to very low across all outcomes. Random-effects meta-analyses found little to no difference for the use of behaviour change and exercise interventions for our primary outcome of total PA postintervention (3 studies, n = 246; MD 21.25 min/day, 95% CI -26.11–68.61) or at 12-month follow-up (3 studies, n = 221; MD 30.52 min/day, 95% CI -25.42–86.45). A meta-analysis of four studies (n = 307) found a small increase in device-measured MVPA at short-term follow-up (MD 2.53 min/day, 95% CI 0.18 to 4.88; I<sup>2</sup> = 21%). No significant effects were observed for any of the other outcomes (long-term MVPA, steps or sedentary behaviour). The existing evidence is limited, and findings should be interpreted cautiously given the low to very low certainty of the evidence and the small number of studies available. This highlights the need for higher quality studies with clear BCT reporting and fidelity procedures to establish whether behaviour change combined with exercise improves PA behaviours.
Access status: Open Access ,
Investments Promising Social or Environmental Benefits Need Tougher Anti‑Greenwashing Rules
(The Conversation, 2026-09-07) Islam, Syrus
Access status: Open Access ,
Dividend Policy Determinants in New Zealand-listed Companies: Financial Performance, Board Gender Diversity, and Firm Operational Scope
(MDPI AG, 2026-08-19) Adhikari, Rajesh; Alam, Shafiq; Dai, Bing; Sun, Jishuo Jimmy; Badshah, Ihsan
Among developed-market stock exchanges, the NZX is distinctive. Its imputation credit system and capital-gains-tax exemption create financial incentives for firms to distribute earnings that have no close parallel elsewhere, yet what actually drives payout decisions at the firm level has never been tested in a multivariate panel framework. We analyzed 116 NZX-listed companies from 2017 to 2023. The results show that revenue and net profit prove to be the dominant positive predictors of dividend payout; cash flow and shareholders’ equity are negatively associated with the payout, suggesting that the firms prioritize capital retention in a manner consistent with the pecking order theory. Market capitalization adds nothing once earnings quality is accounted for in the model. Firms in which women occupied more than half of board seats paid, on average, seventeen times more in dividends than those with minimal female representation, a gap sustained without exception across all seven years. Domestic firms outpaid multinational firms throughout and, by 2023, had exceeded their own pre-period baseline, while multinationals had not. Our findings have implications for income-focused investors, for boards weighing payout strategies, and for policymakers assessing the case for diversity requirements.