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Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building. [ABSTRACT FROM AUTHOR]

Census-based deprivation indices have been widely used in Aotearoa/New Zealand, Canada and UK to measure area-based socio-economic inequalities. This paper examines the indicators used in census-based area deprivation indices using a political ecology approach. We question whether the current indicators of deprivation derived from census data are meaningful for the all age groups and minority groups in the population, with a particular focus on deprivation indicators used in New Zealand, Canada and the United Kingdom. We comparatively reviewed methodological papers and reports that describe the indicators of deprivation in Aotearoa/New Zealand, Canada and the UK from 1975 to 2014. We consider the relationship between the notion of standards of living and measurements of deprivation and explore how hegemonic cultural constructs are implicit in measures of deprivation that privilege a Eurocentric, ageist and gender normative construction of statistics. We argue for more political ecological analyses to studying the relationship between social inequalities, geographies, health inequities and political economy to transform structures of oppression and inequality. This requires turning the analytical gaze on the wealthy and privileged instead of defaulting into deficit models to account for inequality. Studies of deprivation and inequality would benefit from understanding the processes and operations of power in the (re)production of socio-economic and health inequities to inform holistic strategies for social justice. [ABSTRACT FROM AUTHOR]

Introduction: The Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities.Methods: An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted using the Snowballing Method between September 2018 and February 2019. Participants were recruited via a non-random sampling technique to complete an online survey. Descriptive statistical and content analyses were conducted.Results: The data use priorities identified by 102 trauma professionals from a range of locations participated were clinical improvement and system/process improvement (86.3%). Participants reported that access to trauma data should primarily be for clinicians (93.1%) and researchers (87.3%). Having a standardised approach to review trauma cases across hospitals was a priority in trauma quality improvement.Conclusion: Trauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Abstract: Although New Zealanders have historically prided ourselves on being a country where everyone has a ‘fair go’, the systemic and longstanding existence of health inequities between Māori and non-Māori suggests something isn't working. This paper informed by critical race theory, asks the reader to consider the counter narrative viewpoints of Māori health leaders; that suggest institutional racism has permeated public health policy making in New Zealand and is a contributor to health inequities alongside colonisation and uneven access to the determinants of health. Using a mixed methods approach and critical anti-racism scholarship this paper identifies five specific sites of institutional racism. These sites are: majoritarian decision making, the misuse of evidence, deficiencies in both cultural competencies and consultation processes and the impact of Crown filters. These findings suggest the failure of quality assurance systems, existing anti-racism initiatives and health sector leadership to detect and eliminate racism. The author calls for institutional racism to be urgently addressed within New Zealand and this paper serves as a reminder to policy makers operating within other colonial contexts to be vigilant for such racism. [Copyright &y& Elsevier]

Abstract: Physical activity, through independent outdoor play, has come to the fore as a way to improve children's health through it fostering healthy mental and social as well as physiological development. However, in many high-income countries children's autonomous play opportunities have diminished due to urban intensification and declining parental license. Regardless of this trend, children's play varies across countries, cities, cultures and seasons. This paper offers new insights into the complexities of play as a vital aspect of children's wellbeing. Within the context of New Zealand – whose citizens generally regard themselves as outdoor people – this paper explores why ‘play’ might resonate differently across localities and seasons. We contrast the play affordances provided by Auckland's central city (dominated by apartment living) with Beach Haven, a suburban area. We employed a multi-method approach and included 20 children and their parents who were recruited through school and summer holiday programs embracing different gender and ethnicities to reflect the general cultural mix of the respective neighbourhoods. We advance two arguments. First, we suggest that the rarity of children playing outdoors unsupervised normalises supervised indoor play and reduces children's opportunities to see outdoor play as an alternative to interior or supervised pastimes. Second, we follow Bourdieu's theory of practice to argue that the regard parents and children have towards outdoor play reflects locally constituted beliefs about what is seasonally ‘appropriate’ children's activity. We found that extra-curricular activities and supervised excursions are undertaken in the central city all year around and only vary between social groups by the type of destination. In the suburb, independent outdoor play in summer represents children's main business after school in ways that enhance their environmental literacy and potential future health gain. For others these symbolic values were replaced by safety concerns. In contrast, it seems that even in a relatively mild climate winter is the time to relax and stay indoors unless children have an outdoor habitus. We find that the determinants of seasonal outdoor play transcend modifiable barriers such as traffic and unsuitable play spaces as well as the inevitable issue of inclement weather. [Copyright &y& Elsevier]

This paper investigates the emergence of lexicalized effects of word usage on word duration by looking at parallel changes in usage and duration over 130years in New Zealand English. Previous research has found that frequent words are shorter, informative words are longer, and words in utterance-final position are also longer. It has also been argued that some of these patterns are not simply online adjustments, but are incorporated into lexical representations. While these studies tend to focus on the synchronic aspects of such patterns, our corpus shows that word-usage patterns and word durations are not static over time. Many words change in duration and also change with respect to frequency, informativity and likelihood of occurring utterance-finally. Analysis of changing word durations over this time period shows substantial patterns of co-adaptation between word usage and word durations. Words that are increasing in frequency are becoming shorter. Words that are increasing/decreasing in informativity show a change in the same direction in duration (e.g. increasing informativity is associated with increasing duration). And words that are increasingly appearing utterance-finally are lengthening. These effects exist independently of the local effects of the predictors. For example, words that are increasing utterance-finally lengthen in all positions, including utterance-medially. We show that these results are compatible with a number of different views about lexical representations, but they cannot be explained without reference to a production-perception loop that allows speakers to update their representations dynamically on the basis of their experience. [ABSTRACT FROM AUTHOR]

The Midwifery Development Education Service was established in the Birthing Unit at Middlemore Hospital in South Auckland New Zealand in 2007. The service is unique in the New Zealand midwifery context for the way it operates as a collaboration between the education and health provider to optimise the clinical learning experience of student midwives. This paper reports on the evaluation of the Midwifery Development Education Service that was undertaken in 2015. The evaluation captured the views and experience of students and midwives who had been involved with, or had worked alongside, the service. A mixed-method approach was adopted for the evaluation study, comprising of an anonymous on-line survey, qualitative interviews and focus group discussion. Considerable satisfaction with the service was identified. This article draws attention to participants’ perceptions of the service as supporting student midwives; the significance of quality time in the provision of the clinical midwifery education; the situating of the service at a unique vantage point (overseeing the needs of the university and the hospital) and its impact upon the learning culture of education within the unit. A potential tension is also identified between the provision of a supportive learning environment and the assessment of student performance. [ABSTRACT FROM AUTHOR]

Summary Background This paper identifies positive aspects of nurse experiences during the Canterbury 2010–2011 earthquake sequence and subsequent recovery process. Methods Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of the longer term recovery process. The interview transcripts were analysed and coded using a grounded theory approach. Results The data analysis identified that despite the many challenges faced by the nurses during and following the earthquakes they were able to identify positives from their experience. A number of themes were identified that are related to posttraumatic growth, including; improvement in relationships with others, change in perspective/values, changed views of self and acknowledgement of the value of the experience. Conclusions The research indicates that nurses were able to identify positive aspects of their experiences of the earthquakes and recovery process, suggesting that both positive and negative impacts on wellbeing can co-exist. These insights have value for employers designing support processes following disasters as focusing on positive elements could enhance nurse wellbeing during stressful times. [ABSTRACT FROM AUTHOR]

This paper examines how bluespaces inform experiences of place, being aged, and wellbeing among seniors on Waiheke, an island within the greater Auckland area in northern New Zealand. We draw on photo-elicitation interviews with seniors aged 65-94 to argue that bluespaces shape metaphors of 'islandness' that, in turn, help maintain wellbeing. We conclude that, although island settings pose unique challenges for seniors, (e.g. potential isolation, and a lack of advanced care), drawing on the qualities of bluespaces helps maintain a secure sense of self anchored in strong affective ties to place. [ABSTRACT FROM AUTHOR]

Background: Death and dying are inevitable life encounters, but a nurse’s first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses. Method: A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants’ experiences. Thematic analysis was undertaken to identify emerging themes, with participants’ own words used as theme headings, where their phrases provided succinct or powerful descriptors. Results: A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings – some only a few months prior, others – more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. Conclusion: For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants’ experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards. [ABSTRACT FROM AUTHOR]

Abstract: Background: Death has been identified as a known stressor for nurses and has been extensively researched in nursing populations. However, very little is known about the impact of a specific stressful event; that of the novice nurse''s first encounter with patient death. Using a sequential quantitative-qualitative mixed methods design, a study was undertaken to explore the clinical circumstances, impact and challenges and rewards of nurses’ early experiences with patient death. This paper reports the findings of the first phase: an exploratory survey of nurses’ responses to this stressor. Method: A convenience sample of New Zealand Registered Nurses was recruited using email invitations; 174 respondents completed an online questionnaire exploring the clinical circumstances, preparedness, support mechanisms and impact of their earliest memorable patient death. Results: Most nurses reported that their earliest memory of patient death occurred during undergraduate training (61%) or in the first year of qualified practice (23%). Over 80% of these experiences occurred in acute medical, surgical or specialty settings in public hospitals, some involving paediatric or sudden unexpected deaths. Whilst some respondents described a rewarding, ‘learning experience’, others reported acute helplessness, guilt or marked on-going distress. Conclusions: Whilst little can be done to control the clinical circumstances of nurses’ early death encounters, by understanding more about the reactions to death, it may be possible to minimise negative factors such as unexpected elements, feelings of inadequacy, exclusion and role conflicts whilst facilitating coping, sharing of the experience, personal and professional growth, and other positive outcomes. Nurses’ early experiences with patient death appear to have a lasting impact on their professional and personal lives. [Copyright &y& Elsevier]

Abstract: In this paper we consider the potential of autobiographical narratives for accessing ‘storied knowledge’ in research around geographies of health voluntarism. We firstly consider what is meant by elicited autobiography and how the narrative approach has been used in research more broadly. Drawing on fieldwork undertaken in Manchester, UK and Auckland, New Zealand we then demonstrate how this approach has helped us to map out and unpack the career journeys of mental health activists working within and across the voluntary and statutory sectors. Through our autobiographical narratives we illustrate how this approach has enabled us to elicit important insights into the triggers and trajectories underpinning mental health activism and how events and moments in time have provided critical junctures in these trajectories. We consider places as sites of significance in activist career paths; and as central to the researcher-participant gestalt within which the autobiography is elicited and recounted. The autobiographical process, we suggest, offers reflective insights into mental health activism that might not otherwise be gained using more conventional methodologies. [Copyright &y& Elsevier]

Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings. [ABSTRACT FROM AUTHOR]

Aims: To compare the policy positions of health and medical organisations across Australia, New Zealand, and the UK as they relate to sale and supply of nicotine vaping products (NVPs) and evaluate factors that have informed the differences in policy recommendations among these countries.Methods: We used mixed methods to analyse data from position or policy statements published by health and medical organisations regarding NVPs (n = 30) and consultation documents submitted to government committees regarding policy options for the regulation of NVPs (n = 26). Quality assessment of included documents was conducted using the six-item Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers, and findings were presented narratively. Qualitative data were coded using NVivo 12 software and analysed using thematic analysis.Results: An overwhelming majority of health bodies, charities and government agencies in the UK and New Zealand portrayed NVPs as a life-saving harm reduction tool. In contrast, concerns about addicting non-smoking youth to nicotine, a perceived lack of clear and convincing evidence of safety and efficacy and the potential to undermine tobacco control progress continues to define attitudes and recommendations towards NVPs among Australian health and medical organisations. Although the profoundly divided views among stakeholders seem to arise from empirical uncertainties and disagreements over the level and credibility of evidence, the source of most of these disagreements can be traced back to the fundamental and irreconcilable differences in the framing of the NVP debate, and varied tolerability of risk trade-offs associated with NVPs.Conclusion: Progress in resolving the controversy surrounding NVP policy requires stakeholders to be frame-reflective and engage in a meaningful dialogue of risk trade-offs, as well as both intended and unintended consequences of proposed policies. [ABSTRACT FROM AUTHOR]

• Work-based experience assists vulnerable youth to secure full-time work. • Supportive adults are important in employment outcomes for vulnerable youth. • Matching education to specific needs of these youth may assist in work transitions. • Risk behaviors do not appear to undermine chances vulnerable youth will secure work. • Neighborhood and family risks do not undermine employment prospects of these youth. Youth exposed to high levels of adversity during childhood face major challenges in achieving normative milestones such as securing employment. Effective support holds the potential to significantly change the long-term outcomes for these youth, but there is debate about what programme components are most effective in scaffolding these youth into work. This paper presents findings from a mixed-methods longitudinal study that collected survey data for three years followed by qualitative work with a representative subgroup of youth (n = 107) for a further three years. It explores a subset of data to identify factors associated with positive employment outcomes for these youth (aged 12–17 at study entry). A particular concern was to identify factors that were amenable to intervention in order to provide professionals and policy-makers with evidence concerning the most important programme components and policy settings. Factors that made the most difference to the employment outcomes for this ethnically diverse cohort of vulnerable youth were a history of employment, employment-related skills and access to ongoing support. In addition, male gender and older age played a role in these outcomes. Commonly identified risk factors (substance use, offending) did not play a role, neither did ethnicity, family nor neighbourhood characteristics nor individual strengths. The importance of early exposure to workplaces, opportunities to develop employment skills, and access to ongoing support from at least one positive adult, are key factors for programmes supporting the employment transitions of vulnerable youth. [ABSTRACT FROM AUTHOR]