Contemplative practices: The body as therapeutic site linking health and place.

During times of upheaval, supporting stability, health and wellbeing on all levels is essential. While literature regarding 'therapeutic landscapes' has burgeoned over the last 30 years, to date no studies have considered the therapeutic potential of embodied contemplative practices (CP), such as yoga and meditation, within the most accessible, ordinary environment - the body at home. Equally, the field of mobilities appears to have overlooked the spiritual and political nature of these deliberately immobilising acts of resistance. Our paper draws on narrative data collected over the course of three months of daily CP. We interpret the resulting autoethnography through thematic analysis. We conclude that within a fast-paced, hyper-connected world, CPs can be a therapeutic counterpoint, connecting health and place by nurturing an appreciation for the immaterial, interdependent aspects of life.

Coastal Communities, Leisure and Wellbeing: Advancing a Trans-Disciplinary Agenda for Understanding Ocean-Human Relationships in Aotearoa New Zealand.

Commentators are advocating for research to better understand relationships between healthy coastal ecosystems and human wellbeing. Doing so requires inter- and transdisciplinary approaches across humanities, arts, social sciences, and science and technology disciplines. These approaches include culturally diverse knowledge systems, such as indigenous ones, that locate sustainable use of and relationships to marine ecosystems. This paper contributes to this agenda through a case-study of relationships between coastal ecosystems and human wellbeing in Aotearoa New Zealand. This article highlights interconnected cultural and wellbeing benefits of, and socio-ecological relationships between, these coastal ecosystems drawing on a case study of one ocean-based, 'immersive' leisure activity, surfing. Further, it examines how these relationships impact human physical, emotional and spiritual wellbeing, and the wellbeing of communities and ecosystems. The research illustrates that surfing creates strong bonds between practitioners and coastal places, linking the health of marine environments and people. We demonstrate the value of a transdisciplinary place-based approach that integrates research across the humanities and social sciences and engages with Indigenous knowledge (Matauranga Maori). This argument for multicultural co-learning shows the value of Western and Maori vantage points for how we understand coastal blue spaces. Indigenous perspectives, we conclude, deepen appreciation, as well as equity considerations, of how we understand place, wellbeing, and long-term sustainable relationships with marine ecosystems.

What keeps an island community COVID-19 free in a global pandemic?

The COVID pandemic has offered opportunities for islands and other relatively isolated communities to establish pandemic-protection boundaries. A July 2020 survey of Waiheke Island residents sought views on how the island had remained COVID-19 free, despite proximity to a city of 1.6 million (Auckland, NZ). Many attributed that status to 'pure luck' or a 'moat' effect. However, many also attributed freedom from COVID-19 to reinforcing high-level community cohesiveness and shared values. The Waiheke community's response can be seen as a microcosm of New Zealand as an island nation and an exemplar of a response to pandemic threats uniquely possible for small islands.

Permeable boundaries? Patient perspectives on space and time in general practice waiting rooms.

This paper considers an under-examined space in primary health care - the reception area/waiting room. This space can be challenging to negotiate, particularly for those who experience social marginalisation. We begin by situating the significance of the 'entry into the health care setting' in the patient journey in terms of time as well as space. Through an analysis of interview and focus group data gathered in a New Zealand study, we highlight ways that patients view these spaces as firmly bounded and confronting. In reflecting on the data, we then identify the potential for these spaces to be more permeable. We conclude that this spatio-temporal context need not be one of constraint. Rather, there are ways in which the boundaries of this space can be potentially enabling to those required to pause in the process of enacting patienthood.

Placing therapeutic landscape as theoretical development in Health & Place.

This commentary reviews the development and application of therapeutic landscape ideas as they have appeared and developed within issues of Health and Place to date. This framework builds on landscape ideas drawn from humanist and structuralist influences in the 'new' cultural geography and seeks to deepen interpretation of the therapeutic reputation of certain places. These ideas have gained particular traction within health geography. We identified 119 papers published within Health and Place that have invoked the term in their titles and/or key words. Close scrutiny of these papers identified three main themes: spaces of care, mobile experiences of therapeutic places; and applications reaching beyond the Anglo-American world. Drawing on extracts from a 2017 exchange with Wilbert Gesler, who developed the construct, we note that some work in this field has drifted significantly from the tripartite foundations of therapeutic landscape he initially identified. We highlight the importance of maintaining the integrity of this foundation while recognising the value of new thinking that has usefully extended the concept around relationality and enabling (human and non-human) resources. We conclude that some applications of therapeutic landscape thinking have reached well beyond its intended scope, resulting in a dilution of the construct's interpretive power. Nevertheless its influence within health geography has been potent. Specifically, it has been a theoretical pivot facilitating methodological experimentation and diversification; allowed a return of the idiographic tradition; and offered a platform from which deeper theorising has occurred.

'A level playing field': Young people's experiences of wheelchair basketball as an enabling place.

Using a novel case-study of a youth wheelchair basketball team in Auckland, New Zealand, we investigate the experiences of young people with physical disabilities in recreational sports places. We consider the 'enabling places' created by this sport, which can enhance disabled young people's wellbeing and social inclusion. Semi-structured interviews with the team's players and coordinators revealed logistical and societal challenges associated with facilitating youth-oriented sports, as well as those encountered by team members personally. They also identified physical health and social benefits experienced through involvement in wheelchair basketball. The material, social and affective dimensions of participants' experiences of wheelchair basketball elucidate the capacity for the sport, and its team members and settings, to affirm young people's identity and place-in-the-world. We conclude that youth-specific, inclusive sports generate enabling places that enhance young people's social inclusion, wellbeing and life enjoyment.

Precariously placed: Home, housing and wellbeing for older renters.

Older renters may encounter a wide range of challenges and constraints in their experiences of ageing, housing and community life that influence their wellbeing. We employ a two-part conceptualisation of precarity and resilience to investigate how housing-related precarities may impact upon experiences of ageing and home during later life. We draw on narratives collected through in-depth interviews with 13 older renters living in a particularly high-pressure housing market within the greater Auckland area. We ground our analysis in ideas of precarity and resilience evident in participants' experiences of being 'at home' at the scale of both the dwelling and wider community. Results show that experiences of renting and ageing can be complicated and compromised in diverse ways by interrelated aspects of precarity and resilience related to housing, community, health, financial and personal circumstances. Distance or isolation from services and healthcare, tourism-related infrastructural pressures, and community changes can intensify precarious experiences of home, and can have implications for older people's wellbeing, as well as their ongoing opportunities to age well in place. In addition to these potential precarities, older renters appear to draw strength from their familiarity with, attachment to, and enjoyment of, place and community. These responses demonstrate older renters' capacity for resilience to challenge and adversity when ageing in rented places.

Children's Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand.

Children's independent mobility is declining internationally. Parents are the gatekeepers of children's independent mobility. This mixed methods study investigates whether parent perceptions of the neighbourhood environment align with objective measures of the neighbourhood built environment, and how perceived and objective measures relate to parental licence for children's independent mobility. Parents participating in the Neighbourhood for Active Kids study (n = 940) answered an open-ended question about what would make their neighbourhoods better for their child's independent mobility, and reported household and child demographics. Objective measures of the neighbourhood built environment were generated using geographic information systems. Content analysis was used to classify and group parent-reported changes required to improve their neigbourhood. Parent-reported needs were then compared with objective neighbourhood built environment measures. Linear mixed modelling examined associations between parental licence for independent mobility and (1) parent neighbourhood perceptions; and (2) objectively assessed neighbourhood built environment features. Parents identified the need for safer traffic environments. No significant differences in parent reported needs were found by objectively assessed characteristics. Differences in odds of reporting needs were observed for a range of socio-demographic characteristics. Parental licence for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.

New Zealand children's health stamps: Ideological artefacts linking health and place.

This paper addresses a hitherto unexamined phenomenon in the geography of health promotion: the use of postage stamps. We 'read' health stamps as featuring imagery and exhortations that reflect temporally-specific understandings of children's health and wellbeing. As a case study, we examine examples of the stamps sold annually since 1929 as a fund-raiser for New Zealand Children's Health Camps Foundation. This government-supported voluntary sector agency sought to offer respite for children from unhealthy environments and enhance their wellbeing through offering opportunities in semi-rural locations focusing on nutrition and exercise. Recently, emphasis changed to concern with behavioural issues such as self-esteem. The annual stamp appeal continued until 2016 with nuanced themes (e.g., birds and butterflies, invoking associated ideas of children as vulnerable yet precious and needing protection). Our goal is two-fold: first, we seek to theorise the role of the postage stamp in mobilising health-promoting messages; and, second, we examine changing imaginaries associated with child health included in this annual series of stamps. Drawing on assemblage theory, we read the act of purchasing children's health stamps as offering a tacit seal of approval for child health. Through assembling resources, personnel and ideas about health, they reflected and reproduced the nation state and its goals for children's health while also crossing national boundaries.

Enabling participation for disabled young people: study protocol.

BACKGROUND: Participation in community life is vital for health and wellbeing, promoting a sense of belonging, networks of social support and opportunities for physical activity. Disabled young people have lower levels of mobility and participation in recreational activities (physical, social and cultural), education and employment, than their peers without disabilities. This has implications for their health and wellbeing and life course opportunities. Previous research on the participation levels of disabled young people has primarily relied on parent/caregiver reports and been oriented to home and school environments. This study investigates how physical and social environmental factors cohere to support or restrict the everyday mobility and participation of disabled young people. METHODS/DESIGN: The study is located in Auckland, Aotearoa/New Zealand (NZ). Participants comprise 35 young people aged 12-25 years with mobility, vision or hearing impairments. A mixed-methods research design combines objective (global positioning systems, accelerometers, geographical information systems) and self-report measures (travel diaries, and questionnaires) to assess young people's mobility and levels of participation in leisure/educational and employment activities with in-depth interviews exploring their everyday experiences of inclusion/exclusion, and factors enabling or constraining community participation. Parents/caregivers and disability sector key informant viewpoints on the community participation of disabled young people have also been gathered through in-depth interviews. Follow-up workshops with young people and parents/caregivers will identify pathways to increase participation and challenge current disabling practices. DISCUSSION: This study looks beyond barriers in the physical environment to the interplay of personal, social and physical factors that enable or constrain the community participation of disabled young people. In keeping with the study's overarching goal of increasing opportunities for effective community participation and full citizenship of disabled young people, research methods were applied flexibily - negotiated and adapted to maximise each young person's participation in light of their abilities and preferences.

What are the associations between neighbourhood walkability and sedentary time in New Zealand adults? The URBAN cross-sectional study.

OBJECTIVES: We estimated associations between objectively determined neighbourhood 'walkability' attributes and accelerometer-derived sedentary time (ST) by sex, city or type of day. DESIGN: A cross-sectional study. SETTING: The URBAN (Understanding the Relationship between Activity and Neighbourhoods) study was conducted in 48 neighbourhoods across four cities in New Zealand (August 2008 to October 2010). PARTICIPANTS: The response rate was 41% (2029 recruited participants/5007 eligible households approached). In total, 1762 participants (aged 41.4±12.1, mean±SD) met the data inclusion criteria and were included in analyses. PRIMARY AND SECONDARY OUTCOME MEASURES: The exposure variables were geographical information system (GIS) measures of neighbourhood walkability (ie, street connectivity, residential density, land-use mix, retail footprint area ratio) for street network buffers of 500 m and 1000 m around residential addresses. Participants wore an accelerometer for 7 days. The outcome measure was average daily minutes of ST. RESULTS: Data were available from 1762 participants (aged 41.4±12.1 years; 58% women). No significant main effects of GIS-based neighbourhood walkability measures were found with ST. Retail footprint area ratio was negatively associated with sedentary time in women, significant only for 500 m residential buffers. An increase of 1 decile in street connectivity was significantly associated with a decrease of over 5 min of ST per day in Christchurch residents for both residential buffers. CONCLUSION: Neighbourhoods with proximal retail and higher street connectivity seem to be associated with less ST. These effects were sex and city specific.

The care work of general practice receptionists.

INTRODUCTION The care work of general practice receptionists has received limited research attention, despite receptionists position at the beginning of patients' journeys in many health care systems. We examine receptionists' perceptions of their work and the opportunities and constraints they experience in caring for patients while providing administrative support to practices. METHODS Data were collected in focus group interviews with 32 receptionists from urban and rural general practices in the Auckland and Northland regions of New Zealand. We employed tools from inductive thematic analysis and Straussian grounded theory in interpreting the data. FINDINGS We found that the way receptionists identified with a caring role strongly challenged the pejorative view of them in public discourse. Receptionists provide care in two key ways: for the practice and for patients. The juggling they do between the demands of the practice and of patients creates considerable work tensions that are often invisible to other staff members. CONCLUSION Receptionists have a critical role as the first step in the patient care pathway, bridging health care system and community. For general practice to be patient-centred and improve accessibility for the most vulnerable, the care work of receptionists must be considered core. KEYWORDS Receptionists; general practice; care; New Zealand.

Neighbourhoods for Active Kids: study protocol for a cross-sectional examination of neighbourhood features and children's physical activity, active travel, independent mobility and body size.

INTRODUCTION: New Zealand children's physical activity, including independent mobility and active travel, has declined markedly over recent decades. The Neighbourhoods for Active Kids (NfAK) study examines how neighbourhood built environments are associated with the independent mobility, active travel, physical activity and neighbourhood experiences of children aged 9-12 years in primary and intermediate schools across Auckland, New Zealand's largest city. METHODS AND ANALYSIS: Child-specific indices of walkability, destination accessibility and traffic exposure will be constructed to measure the built environment in 8 neighbourhoods in Auckland. Interactive online-mapping software will be used to measure children's independent mobility and transport mode to destinations and to derive measures of neighbourhood use and perceptions. Physical activity will be measured using 7-day accelerometry. Height, weight and waist circumference will be objectively measured. Parent telephone interviews will collect sociodemographic information and parent neighbourhood perceptions. Interviews with school representative will capture supports and barriers for healthy activity and nutrition behaviours at the school level. Multilevel modelling approaches will be used to understand how differing built environment variables are associated with activity, neighbourhood experiences and health outcomes. DISCUSSION: We anticipate that children who reside in neighbourhoods considered highly walkable will be more physically active, accumulate more independent mobility and active travel, and be more likely to have a healthy body size. This research is timely as cities throughout New Zealand develop and implement plans to improve the liveability of intensifying urban neighbourhoods. Results will be disseminated to participants, local government agencies and through conventional academic avenues.

Exploring children's seasonal play to promote active lifestyles in Auckland, New Zealand.

Studies of seasonal barriers for outdoor activities seldom view families' play practices as grounded in the everyday experience of the natural elements. This paper brings 20 families' mundane outdoor play experiences in Auckland's temperate climate to the fore. Through drawings and interviews, families residing in both suburban detached houses and central city apartments revealed locally constituted beliefs about appropriate play spaces (e.g. garden, park). While the majority of participants retreated to indoor activities during winter, some children and their parents viewed the outdoors as the only opportunity for 'real fun'. We advocate the importance of a better understanding of children's seasonal outdoor play. In particular, we argue that in order to promote year-round healthy levels of outdoor activities it is necessary to understand variations in societal, neighbourhood and family values attributed to outdoor activities. Further, to develop a more nuanced understanding of the locational complexities of outdoor play it is important to understand the meanings of, and practices associated with, seasonal and weather conditions in different international locations.

Associations between the neighbourhood built environment and out of school physical activity and active travel: An examination from the Kids in the City study.

This study's aim was to examine selected objectively-measured and child specific built environment attributes in relation to proportion of out-of-school time spent in moderate-to-vigorous physical activity (%MVPA) and active travel in a group of ethnically and socio-economically diverse children (n=236) living in Auckland, New Zealand. Street connectivity and distance to school were related to the proportion of trips made by active modes. Ratio of high speed to low speed roads and improved streetscape for active travel were related to %MVPA on weekdays only. Inconsistent results were found for destination accessibility. Local destinations (particularly schools) along a safe street network may be important for encouraging children's activity behaviours.

Neighbourhood built environment associations with body size in adults: mediating effects of activity and sedentariness in a cross-sectional study of New Zealand adults.

BACKGROUND: The aim of this study was to determine the associations between body size and built environment walkability variables, as well as the mediating role of physical activity and sedentary behaviours with body size. METHODS: Objective environment, body size (body mass index (BMI), waist circumference (WC)), and sedentary time and physical activity data were collected from a random selection of 2033 adults aged 20-65 years living in 48 neighbourhoods across four New Zealand cities. Multilevel regression models were calculated for each comparison between body size outcome and built environment exposure. RESULTS AND DISCUSSION: Street connectivity and neighborhood destination accessibility were significant predictors of body size (1 SDchange predicted a 1.27 to 1.41 % reduction in BMI and a 1.76 to 2.29 % reduction in WC). Significantrelationships were also observed for streetscape (1 SD change predicted a 1.33 % reduction in BMI) anddwelling density (1 SD change predicted a 1.97 % reduction in BMI). Mediation analyses revealed asignificant mediating effect of physical activity on the relationships between body size and street connectivity and neighbourhood destination accessibility (explaining between 10.4 and 14.6 % of the total effect). No significant mediating effect of sedentary behaviour was found. Findings from this cross-sectional study of a random selection of New Zealand adults are consistent with international research. Findings are limited to individual environment features only; conclusions cannot be drawn about the cumulative and combined effect of individual features on outcomes. CONCLUSIONS: Built environment features were associated with body size in the expected directions. Objectively-assessed physical activity mediated observed built environment-body size relationships.

Reprint of: A healthy island blue space: From space of detention to site of sanctuary.

Island blue spaces are associated with restorative potential, but few studies examine this proposition when an island's use has changed over time. We examine Rotoroa Island (near Auckland, New Zealand) where, for almost a century, the Salvation Army ran an alcohol treatment facility. The island's relative isolation was central to its mixed therapeutic and carceral roles. Following change in treatment ideologies, the facility closed in 2005. It subsequently re-opened as a reserve for recreation, remembrance and environmental restoration. Our analysis focuses on the enabling resources at Rotoroa across these two eras, in the context of different constructions of healthy island blue space.

Urban inclusion as wellbeing: Exploring children's accounts of confronting diversity on inner city streets.

The diversity of people living in a city is often most visible on inner city streets. These streets are also the neighbourhood environment of children who live in the central city. In the past, the wellbeing and sensibilities of children have been marginalised in planning practices in western cities but this is beginning to change with child-friendly and inclusive city discourses now more common. In this paper we report on children's experiences confronting diversity in inner-city Auckland. In 2012, 40 inner-city children, 9-12 years, participated in walking interviews in their local streets and school-based focus group discussions. As the children talked about their lives, moving and playing around neighbourhood streets, many described distress and discomfort as they confronted homelessness, drunkenness, and signs of the sex industry. A few older children also described strategies for coping with these encounters, an emerging acceptance of difference and pride in becoming streetwise. New Zealand (NZ) has a history of progressive social policy. In 2003, it became the first country in the world to decriminalise all forms of prostitution. Securing the health and human rights of sex workers were the primary drivers of the reforms. Similar concerns for health and rights underpin broadly inclusive local policies towards homelessness. To promote the health and wellbeing of inner city children their presence on city streets, alongside those of other marginalised groups, needs to be at the forefront of planning concerns. However we conclude that there are inherent tensions in promoting a child-friendly city in which diversity and inclusiveness are also valued.