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Since all policies address problems, they necessarily include implicit or explicit constructions of these problems. This paper explores how child maltreatment has been constructed in New Zealand's child protection policies. It questions the underlying assumptions of this problem construction and seeks to shed light on what has been omitted. Utilizing a qualitative content analysis of eight key policy documents, this study reveals the construction of child maltreatment has been dominated primarily by a child-centric, risk-focused approach. This approach assigns blame and shifts responsibilities onto parents and families. In addition, the vulnerability discourse and social investment approach underpinning this perspective have allowed important structural factors, such as poverty and inequality, to remain unaddressed. This paper also highlights the one-dimensional focus on the lower social class to control future liabilities. We suggest that the harm inflicted by corporations on children's well-being is another form of child exploitation currently omitted from the problem construction. We suggest that child abuse should be defined and understood in policy as harm to children's well-being and argue that the state should prevent and mitigate harm by addressing structural forces of the problem as well as protecting children against corporate harms. [ABSTRACT FROM AUTHOR]

Mental health inpatient units can provide a sanctuary for people to recover from mental illness. To support a therapeutic environment, the safety and well‐being of service users and staff need protection through reduced conflict and containment rates. The Safewards model identifies 10 interventions to prevent conflict and containment. This paper aims to present barriers and enablers to implementing Safewards by analysing current literature on the Safewards model. It will also compare the Safewards model to New Zealand's Six Core Strategies. In a systematic search of 12 electronic databases following the PRISMA flow chart, 22 primary studies were included in this analysis. JBI tools were used for quality appraisal and deductive content analysis was used to organize and interpret data. Four categories were identified: (a) designing the Safewards interventions and implementation; (b) staff participation and perception of Safewards; (c) healthcare system influences on Safewards implementation; (d) service user participation and perception of Safewards. To support successful Safewards implementation in future practice, this review recommends that Safewards implementation is enabled through robust design of the Safewards interventions and implementation methods; staff participation and positive perception of the Safewards model; a resourced healthcare system that prioritizes Safewards implementation; service user awareness and participation in Safewards interventions. Interactionist perspectives may support the implementation of Safewards. This analysis is limited by research settings mostly being inpatient adult services and inadequate capturing of the service user voice. An ongoing review of barriers and enablers is important for supporting future Safewards implementation. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]

Background: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. Methods: Aim: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020–21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. Results: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. Conclusion: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the nature of wellbeing as multidimensional and complex provides a policy window to generate a strengths-based policy orientation to promote wellbeing in education settings. The purpose of this exploratory paper is to map how wellbeing is interpreted across public education policy documents in Aotearoa New Zealand. Method: To explore the narrative that this group of documents weave, we draw on models of holistic wellbeing, ecological systems and appreciative inquiry. Policy documents were analysed using text mining software to track notions of wellbeing; their occurrence and co-occurrence with related concepts. Results: Key findings include the predominance of wellbeing, the interrelatedness of wellbeing with relationships, and the predominance of student wellbeing over the wellbeing of other stakeholders, highlighting that current education policy does not interpret wellbeing as relational, complex or contextual. Conclusion: We argue that interpreting such documents through a wellbeing lens demonstrates the complexity and disparity of the conceptualization and contextualization. We assert that it is critical to explore possibilities for deliberate and ecological wellbeing connections within educational policy and practice for the good of all stakeholders. [ABSTRACT FROM AUTHOR]

In the aftermath of a terrorist attack on an Islamic community in New Zealand, how has the stigma and perceptions of the West about Islam impacted the reaction of audiences? Drawing on Tweets (Twitter) and the statements of Prime Minister, Jacinda Ardern, this paper explores how individuals construct their messages to establish a discourse that aspires to blend Islam into the "norm" of Western ideas and values. Applying the Goffman framework, we observe how the two compose their messages to resist the West's stigma and perceptions of Islam and plea to being "normal." Specifically, attention is placed on how normality is constructed through the presentation of Muslim's place of worship, mosques, and their communities. A qualitative textual analysis revealed different interpretations of how these places of worship and their communities identify "normalness" in an attempt to de-stigmatize the negative construction of Islam in the West. Therefore, we consider how these interpretations produce normality amongst a perceived stigma of Islam in the West in the aftermath of a terrorist attack. [ABSTRACT FROM AUTHOR]

Background: The management of prediabetes in the community setting is a global priority. We evaluated the feasibility of a 6-month multilevel practice nurse-led prediabetes dietary intervention which involved goal setting. The aim of this paper is to explore the weight loss goals and strategies reported by participants to achieve their weight loss goals as recorded by practice nurses, and report on factors that influenced dietary behaviours. Methods: This study used a convergent mixed-methods design. A six-month pragmatic non-randomised pilot study with a qualitative process evaluation was conducted in two neighbouring provincial cities in New Zealand. A structured dietary intervention delivered by practice nurses was implemented in four practices in 2014–2016. Content analysis of the text and descriptive statistics were used to analyse the data. Results: One hundred and fifty seven people with prediabetes were enrolled (85 intervention, 72 control). The intervention group lost a mean 1.3 kg more than the control group (p <.0.001). The majority of the intervention group indicated either a high level of readiness (n = 42, 53%) or some readiness (n = 31, 39%) to make food changes. The majority of weight loss goals aligned with clinical guidelines (between 5 and 10% of body weight). While just over half (n = 47, 55%) demonstrated weight loss at the end of the six month period, the majority of participants did not achieve their predetermined weight loss goal (n = 78, 83%). Gender, ethnicity and budget were not related to weight loss at six months. Readiness to change and reported challenges to making dietary changes were related to weight loss at six months. Negative factors or set-backs included sporadic adherence to diet due to other health problems, change in context or environment and coping with ill health, most notably stress and low mood. Conclusions: The data relating to weight loss and dietary goals provided insight into the challenges that people faced in making dietary changes for weight loss across a six month period. Simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the person, in a socially supportive environment, may increase the success of goal achievement. Trial registration: ANZCTR ACTRN1261500080656. Registered 3 August 2015 (Retrospectively registered). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366560&isReview=true [ABSTRACT FROM AUTHOR]

Research has analyzed media framing of cause and solution responsibility attribution in diabetes discourse. Studies have not similarly engaged with how media frame diabetes ‘effects’, an integral framing component because it comprises the ‘problem definition’ of diabetes. Moreover, the combination of causal attribution and effects provides a ‘moral evaluation’ on who carries the burden of the disease. This paper asks ‘how does the New Zealand print media frame diabetes definition and responsibility attribution?’ We identify key frames used to discursively construct Gestational, Type 1 and Type 2 diabetes discourse. Content and thematic analysis reveal that media predominantly discuss diabetes without type-specification and with a high reference to obesity and behavioral choices as causal factors. Diabetes is defined as an individual’s medical concern, which when mismanaged results in amputation, blindness, kidney disease and coronary disease. We consider the implications of media coverage on public response to diabetes as a societal concern. [ABSTRACT FROM PUBLISHER]

Purpose A case study is reported of a relationship-based early intervention (EI) service for children with complex needs in New Zealand. The purpose of this paper is to explore parent and professional views and perceptions about the key characteristics of a relationship-based EI service.Design/methodology/approach This qualitative study involved interviews and observations with 39 participants (10 children, 11 parents and 18 professionals).Findings Parents appreciated the knowledgeable, well-trained professionals who invested time in getting to know (and love) children and families and family practices, worked together in harmony and valued the contribution that parents made to their child’s progress and achievement. Professionals described the key characteristics of the service in terms of the range of therapies offered by the service, the focus on a strengths-based and family-focussed approach, play-based assessments, acceptance and value of family practices (including responsiveness to Maori and bi-culturalism), appropriate and respectful places to meet and greet families and work with children, and recruitment and retention of humble professionals who identified with the ethos of the model. Observable social processes and structures within the delivery of the model include respectful professional interactions and relationships with children and families, integrated professional working, effective and timely communication between professionals and families, pedagogy of listening, waiting and personalisation, engaged families and actively participating children.Originality/value This case study emphasises the significance of professional love and relational pedagogy to EI services and the value of this to improving parent-child relationships and children’s long-term outcomes. [ABSTRACT FROM AUTHOR]

During the nineteenth-century gold rush era, Chinese gold miners arrived spontaneously in California and, later, were invited in to work the Otago goldfields in New Zealand. This article considers how the initial arrival of Chinese in those areas was represented in two major newspapers of the time, the Daily Alta California and the Otago Witness. Both newspapers initially favored Chinese immigration, due to the economic benefits that accrued and the generally tolerant outlook of the newspapers' editors. The structure of the papers' coverage differed, however, reflecting the differing historical circumstances of California and Otago. Both papers gave little space to reporting Chinese in their own voices. The newspapers editors played the crucial role in shaping each newspaper's coverage over time. The editor of the Witness remained at the helm of his newspaper throughout the survey period and his newspaper consequently did not waver in its support of the Chinese. The editor of the Alta, by contrast, died toward the end of the survey period and his newspaper subsequently descended into racist, anti-Chinese rhetoric. [ABSTRACT FROM AUTHOR]

Sexual violence prevention has shifted from centering around a message of ‘no means no’ toward a message of ‘get consent.’ This paper explores how young adults conceptualise consent in relation to how they talked about expressing a willingness to participate in sex. The analysis here argues that understandings of consent are disconnected from how young people understand communication about sex. Consent is viewed as a formal minimum requirement for ‘ok’ sex. At the same time, young people were more sophisticated when discussing how they understand and communicate a willingness to have sex. Implications for sexual violence prevention education and research on sexual consent are discussed. [ABSTRACT FROM PUBLISHER]

Introduction. In 2009, the Royal New Zealand College of General Practitioners commissioned the development of a framework to facilitate quality-improvement activity in primary care settings. This paper outlines the development of the framework, which integrates concepts of quality with the reality of practice-based clinical care, and discusses its value for primary care quality improvement. Method. Framework development involved: (1) literature review of theoretical approaches to healthcare quality; (2) field work utilising a mixed methods approach to obtain empirical data; and (3) model design. Results. Primary care practitioners are juggling competing priorities. Models and tools that promote quality-related activity at practice level need to take into account, and incorporate by design, day-to-day clinical and practice functions. Conclusions. The quality framework identifies the components of primary care practice and locates this model within the concepts and activities necessary for quality improvement. It may be used by primary care organisations and practices to facilitate focussed quality-improvement activity and self-directed process review. The framework was developed for, and within a New Zealand primary care setting, and is applicable internationally and within other healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major health issue for individuals and for health services. There is a considerable literature on the management of diabetes and also on communication in primary care consultations. However, few studies combine these two topics and specifically in relation to nurse communication. This paper describes the nature of nurse-patient communication in diabetes management. Methods: Thirty-five primary health care consultations involving 18 patients and 10 nurses were video-recorded as part of a larger multi-site study tracking health care interactions between health professionals and patients who were newly diagnosed with Type 2 diabetes. Patients and nurses were interviewed separately at the end of the 6-month study period and asked to describe their experience of managing diabetes. The analysis used ethnography and interaction analysis. In addition to analysis of the recorded consultations and interviews, the number of consultations for each patient and total time spent with nurses and other health professionals were quantified and compared. Results: This study showed that initial consultations with nurses often incorporated completion of extensive checklists, physical examination, referral to other health professionals and distribution of written material, and were typically longer than consultations with other health professionals. The consultations were driven more by the nurses' clinical agenda than by what the patient already knew or wanted to know. Interactional analysis showed that protocols and checklists both help and hinder the communication process. This contradictory outcome was also evident at a health systems level: although organisational targets may have been met, the patient did not always feel that their priorities were attended to. Both nurses and patients reported a sense of being overwhelmed arising from the sheer volume of information exchanged along with a mismatch in expectations. Conclusions: Conscientious nursing work was evident but at times misdirected in terms of optimal use of time. The misalignment of patient expectations and clinical protocols highlights a common dilemma in clinical practice and raises questions about the best ways to balance the needs of individuals with the needs of a health system. Video- recording can be a powerful tool for reflection and peer review. [ABSTRACT FROM AUTHOR]

gilmour j.a., huntington a., broadbent r., strong a. & hawkins m. (2012) Nurses' use of online health information in medical wards. Journal of Advanced Nursing 68(6), 1349-1358. Abstract Aim. This paper is a report of a study of nurses' access, use and evaluation of online health information in medical wards. Background. Online health information is commonly used by patients with chronic illness to support their education needs. Nurses have a critical role in assisting patients to access and use this information. Method. This descriptive cross-sectional survey of a random sample of 540 nurses employed in medical wards was carried out in 2009. The response rate was 58·7% (293). The analytical approach included descriptive statistics and non-parametric tests of correlation and differences between groups. A content analysis was performed on the qualitative data. Results. Most respondents (78·6%) were satisfied with work Internet access and 58·2% believed that the use of online information improved care delivery. Nearly half the group was aware of patient misconceptions about their illness due to incorrect interpretations of online information, but only 24·4% checked if patients used online information. There was a significant association between assessing patients use and awareness of patient misconceptions. Conclusion. The findings of this study highlight that while online resources add to education opportunities, the ongoing nursing assessment required to determine online information needs is not always incorporated into nursing practice. Patient misunderstandings of online material were also identified; developing patient competency in evaluating open access health information should now be recognized as an integral aspect of illness management education. [ABSTRACT FROM AUTHOR]

This paper reports key findings from a content analysis of gender and ethnic depictions in a sample of 2,120 New Zealand prime-time television advertisements screened in 2006. The study explored the following questions: With what product categories are male and female White, Māori/Pasifika and Asian characters most commonly associated? What are the most common occupational roles of male and female White, Māori/Pasifika and Asian characters? The results reveal highly stereotypical depictions of women and men within each ethnic category. White men dominated advertisements for foodstuffs, telecommunications and financial/corporate/legal services and were over-represented as professionals/white collar workers, while White women were over-represented in advertisements for household products, personal products, and medical products and featured predominantly as homemakers. Māori/Pasifika men were over-represented as athletes and service and sales workers. Non-White women featured prominently within multi-ethnic groups in advertisements for personal grooming products and most frequently featured as glamour models, while non-White men were over-represented as blue collar workers. Largely absent were Māori/Pasifika women and Asians of both genders, potentially exacerbating the multiple axes of subordination encountered by these groups in the New Zealand context. [ABSTRACT FROM AUTHOR]

The challenges of providing sensitive and structured care for children in foster care go well beyond normative experiences of parenting. The present paper describes a mixed-methods study of foster carers' perceived need for support and training, referenced to estimates of their burden of care. Semi-structured interviews were conducted with 17 foster carers in the Canterbury region of New Zealand. Carers' perceived need for support and training were identified through qualitative analysis of interviews using domain analysis method. Carers' burden of care was estimated from the Parenting Stress Index and from a measure of carers' encounters with children's emotional, behavioural and relationship difficulties that was designed for the present study (the Caregiver Behavioural Encounters Index). Foster carers reported substantive, unmet needs for support and training. Foster carers also reported high parenting stress and encounters with a wide range of children's mental health difficulties, including both uncommon and severe difficulties, which together represent an exceptional burden of care. Carers' highest priority need was for training and support on managing and responding to children's mental health difficulties, while their greatest existing support came from Caregiver Liaison Social Workers and other carers. The findings suggest a number of critical implications for practice. [ABSTRACT FROM AUTHOR]

A body of scholarship has begun to chart the influence of 'chat' modes of news delivery on discourse quality as part of what is termed the internal fragmentation of news: the shift from monological to dialogical modes of news delivery (Ben-Porath, 2007). This article investigates the democratic costs and benefits of political discourse contained in these 'political talk' news formats. It focuses on four New Zealand programmes and is structured in terms of market (commercial) and non-market (public service) performance. Discourse quality is measured quantitatively by content analysis; the results identify some important democratic trade-offs that market and non-market modes of political talk make. This paper adds to international scholarship by contributing empirical data to research investigating the democratic values of public service and commercial news content; it also enables critical engagement with the issue of the internal fragmentation of news formats by providing a more nuanced account of political talk than previous criticisms. [ABSTRACT FROM AUTHOR]

This paper focuses on awareness of and attitudes towards issues arising from New Zealand's first tobacco litigation trial. It is based on a national telephone survey and a content analysis of related print and radio media relating to the trial. Interviewees showed a moderate level of awareness about the trial and verdict. Only a minority supported the plaintiff (Janice Pou) in her claim for damages against the tobacco companies. The majority of support was in favour of the tobacco companies (68%). The reasons cited for this support included: the information about the effects of smoking was widely known at the time Pou became addicted, she did not try hard enough to quit, and the tobacco companies reasonably informed the public about the effects of smoking their products. In contrast, the majority of media coverage about the trial and verdict was in favour of Janice Pou, or neutral. Thus, contrary to expectation and the support of the media, the New Zealanders' surveyed were reluctant to support litigation as a means of addressing the costs to the country caused by smoking-related illness. Tobacco industry denormalisation strategies could help to shift public support in favour of litigation and corporate accountability. [ABSTRACT FROM AUTHOR]

This paper reports on a study which investigated the language-related experiences of Afrikaans-speaking South African immigrants living in New Zealand. In-depth narrative interviews with 14 parents of children aged 18 and under were conducted in various geographical locations across New Zealand. The focus was on their perceptions of their children's changing language practices. The primary aim of the study is not so much to account for the children's linguistic changes, as it is to present their parents' awareness of those changes and their emotional responses to what they observe. The data were the stories generated during the interviews. A content analysis of these shows that the parents in this study are deeply aware of the linguistic changes taking place in their children. They are also aware of what is going on linguistically within their own families and homes. Children, as members of these domains, are shifting to English and most, especially the younger ones, are experiencing Afrikaans loss (attrition), notwithstanding the strategies employed by parents to decelerate the process. Parents' emotional responses to this situation are often conflicting, but they generally feel that any gains outweigh the losses. [ABSTRACT FROM AUTHOR]