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Drawing on the findings from a longitudinal study of vulnerable young people's transitions to adulthood, this paper explores the ideas of shame and recognition. The young people, aged between 12 and 17 years at the first interview, had experienced chronic exposure to adversity from an early age (abuse, violence, mental health issues, addictions, and expulsion from school). They were clients of statutory and non‐governmental services: child welfare, juvenile justice, remedial education, and mental health services. This paper draws on the qualitative phase of the study (n = 107); young people and a trusted other, nominated by the young person, participated in three annual qualitative interviews. Interviews focused on young people's experiences of services, key transitions, their relationships, and the strategies they used to locate support and resources. Experiences of shame, misrecognition, and seeking recognition emerged as dominant themes in the young people's accounts, and these are explored in this paper. The paper concludes with a discussion on responsive social work interventions that generate a deeper understanding of young people's experiences of shame and misrecognition. Central to this practice are critical and relational social work practices that actively support young people to achieve recognition. [ABSTRACT FROM AUTHOR]

There is widespread and growing support and requirement for researchers and larger organisations to collaborate with communities. This ensures that social, educational, or health programmes are relevant and acceptable and address the needs of groups that experience inequity. There is limited research about the processes and approaches that impact successful collaboration. The aim of this study was to identify the best‐practice processes used to develop and sustain collaborative partnerships between community members and formal organisations in Aotearoa New Zealand. Using a qualitative case study methodology and guidance from our community advisory group, we selected three effective collaborations with groups that experienced inequity in Aotearoa New Zealand. We examined these by reviewing their publicly available documents and conducting focus group discussions and interviews with key stakeholders. We coded and analysed transcriptions thematically to develop case study summaries of findings and then conducted cross‐case analysis to identify themes inherent in the data. Seven themes emerged from the data: (1) work together under Te Tiriti to ensure that collaborations are built on the articles of this founding document of Aotearoa New Zealand; (2) start before the beginning by forming strong relationships with diverse and representative community members; (3) walk the talk by using critically reflexive processes built on shared values and equal power relations; (4) use pencils not pens to implement ensuring an iterative project process; (5) recognise all contributions and especially the value of lived experience and local knowledge; (6) journey at a pace that allows all to participate; and (7) listen twice, talk once to give priority to hearing quieter voices. These seven practices can be utilised by other collaborative initiatives to increase genuine and power‐shared participation. These participatory processes can make sure that collaborative projects respect local knowledge, indigenous culture, and respond iteratively to community needs. [ABSTRACT FROM AUTHOR]

Social work aspires to empowerment ideals, including taking a 'non-expert' position of professional curiosity, and validating the perspectives of people in contact with services. Yet in child protection, social workers are involved in practice that refutes the views and opinions of people and are positioned by their role as an identifier of abuse and risk manager. Social workers and people who are subject to child protection services can be locked into meaning battles regarding the effect of parental behaviour and the representation of risks to children. These negotiations over meanings are especially difficult in the pre and perinatal period, where who controls the representation of the baby's voice or best interests is fundamental to decision outcomes. Using Fricker's concept of 'testimonial injustice' as an analytical lens, this article draws on studies in two different contexts: Aotearoa New Zealand and Scotland, to examine the implications of the intense mediation of meanings that affect child protection practice. We find that concepts relating to the importance of mothering, love for children, and extended family relationships were sources of mother's disagreements with professional views of risk, but that through qualified agreement or advocacy from community workers, a shared risk narrative could be constructed. [ABSTRACT FROM AUTHOR]

Introduction. Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim. We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods. Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-toface semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results. All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion. This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour. [ABSTRACT FROM AUTHOR]

Examining the concepts underpinning the reasoning processes of social worker's decision‐making provides important insights into how social work practice is undertaken. This paper examines one of the major discourses used by social workers in decision reasoning in a non‐governmental organization child protection context in Aotearoa/New Zealand: family maintenance. This study found that family maintenance as a concept was strongly privileged by social workers. This resulted in attempts to preserve families and created a hierarchy of preferred decision outcomes. A preference for family maintenance was supported by legal, moral, psychological and Māori cultural concepts. This pattern of constructs underpinned the ‘weighing up of harms’ when considering removal, and generally reflected a child welfare orientation. In addition to this, it was found that ‘family’ was broadly defined, and could include people who had a relationship with the children, or Māori definitions of extended family, in addition to legal ones. [ABSTRACT FROM AUTHOR]

Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease. [ABSTRACT FROM AUTHOR]

This article draws on the findings of the qualitative phase of a New Zealand longitudinal study on vulnerable young people’s transitions to adulthood. The young people were aged between 12 and 17 years at the time of the first interview. The paper focuses on one key finding, how youth enact agency through their relationships with significant others: families, social workers, teachers and care workers. These youth had experienced sustained exposure to harm including abuse, violence, addictions, disengagement from school and mental health issues. The qualitative interviews focused on young people’s experiences with services (child welfare, juvenile justice, mental health and education support services) their key transitions, and the strategies they used to locate support and resources. The thematic analysis of the interviews indicated that a search for agency was a central motif in young people’s experiences. This was reflected in three thematic clusters: making sense of the world, having a voice and acting on the world. [ABSTRACT FROM AUTHOR]

Background: Decreasing oral intake is common towards the end of life and a potential source of distress and concern for patients, relatives, whānau and clinicians. This paper provides insight to inform practice regarding clinicians' perceptions, practices, responses and communication with patients and their companions regarding declining oral intake towards the end of life. Methods: In this qualitative study ten specialist palliative care staff participated in semi-structured interviews. Qualitative thematic analysis was used to analyse the data. Findings: Three themes were identified: declining oral intake was a natural part of the dying process; responding empathetically; and clinicians described specific aims and ways regarding communication. Conclusion: Insight into clinicians' endeavours to manage declining oral intake and support the wellbeing of patients, families, and whānau can inform practice. However the perspectives of family, whānau and health professionals continue to show significant variation regarding the communication given and received around declining oral intake towards the end of life. [ABSTRACT FROM AUTHOR]

Background: The prevalence of CAM use is increasing. This integrative review investigated New Zealand healthcare professionals' practice of, attitudes toward, and knowledge about complementary and alternative medicine (CAM). Methods: Literature search was conducted in four databases from inception to April 2020. Studies were included if they reported results from primary data collection on practice of, attitudes toward, or knowledge about CAM amongst New Zealand healthcare professionals. Results: Eleven studies (two of 'high-quality', seven of 'moderate-quality', and two of 'low-quality') were identified with 2060 healthcare professionals including general practitioners (GPs), nurses, midwives, pharmacists, physiotherapists, and medical specialists. New Zealand healthcare professionals were generally positive regarding CAM use, but have concerns on the scientific evidence, regulation, safety, financial costs of CAM, and encourage an evidence-based CAM practice and stronger CAM regulation. Findings indicated that around 25% of GPs practise CAM, and 82.3% refer patients to CAM practitioners. When treating pregnant women, 48.4% of physiotherapists practise acupuncture, and 37.3% of midwives recommend CAM. GPs believe that acupuncture is the most helpful CAM modality, and most commonly practiced and referred patients to acupuncture. Up to 58% of GPs and Plunket nurses wanted to receive further education on CAM, and up to 66.7% GPs favour the idea CAM should be included in medical curriculums. Conclusions: Nine of the 11 included studies were of moderate to high quality, thus enhancing the reliability of the review findings. In order to better manage CAM in New Zealand New Zealand clinical settings, there is a need to invest in CAM research and education, and enhance CAM regulation. This review is a first step in developing an evidence base to offer insights for further development of effective CAM policies regarding safety, efficacy, regulation and integration in New Zealand. [ABSTRACT FROM AUTHOR]

Background Complementary medicines are a popular healthcare choice among patients/consumers, and most pharmacies sell these products. Pharmacists are well-placed to advise on complementary medicines, but their training and practices for these products are not optimal. Pharmacists' professional practices for complementary medicines ought to be influenced by professional codes of ethics and standards. Objective To examine community pharmacists' perspectives on complementary medicines in New Zealand, including motivations and justifications for selling these products, and professional and ethical issues complementary medicines raise for pharmacists. Setting Community pharmacists in New Zealand. Method Qualitative, semi-structured interviews with 27 New Zealand practising community pharmacists identified through purposive and convenience sampling. Main outcome measure Participants' views, experiences, and professional practices for complementary medicines. Results Participants struggled to clearly describe products they considered complementary medicines. Perspectives towards these products ranged from strongly supportive to somewhat sceptical; none was strongly opposed. Participants had several motivations for selling complementary medicines, particularly consumer demand and profits. Participants acknowledged ethical issues concerning complementary medicines, including lack of evidence of efficacy and pharmacists' limited training/knowledge. Few referred explicitly to complementary-medicines-related statements in the Pharmacy Council of New Zealand's Code of Ethics, or indicated these guided their practice. Conclusion Participants sold complementary medicines despite having limited knowledge on these products and concerns about efficacy; participants justified this as they believe they are providing an holistic option for patients, and/or ensuring complementary medicines do no harm. Participants were mindful of ethical/professional issues regarding complementary medicines, but were not necessarily aware of, or guided by, explicit statements in the Pharmacy Council of New Zealand's Code of Ethics. [ABSTRACT FROM AUTHOR]

Background: Falls in hospitals remain a major challenge to patient safety. All hospitalised adults are at risk of falling during their inpatient stay, though this risk is not always realised by patients and clinicians. This study will evaluate the outcomes of a hospital clinician education program that teaches clinicians how to screen for falls risk and assign mitigation strategies using clinical reasoning, rather than relying on a standardised falls risk assessment tool (FRAT). The education program aims to increase clinician knowledge, motivation and confidence in screening falls risk and selecting individual falls prevention interventions. Perceptions of the education intervention will also be examined.Methods: Participants will be a sample of convenience of nurses and allied health professionals from five Australian hospitals. For each hospital there will be two cohorts. Cohort 1 will be clinical leaders who shall receive a three-hour education program on the latest evidence in hospital falls risk assessment and how to implement a new falls screening and management tool. They will also be taught practical skills to enable them to deliver an effective one-hour in-service training session to Cohort 2. Cohort 2 will be recruited from the workforce as a whole and include nurses and other health professionals involved in routine hospital falls screening and prevention. The investigation will be framed on Keller's Model of Motivational Design and Kirkpatrick's evaluation framework. It will involve a mixed methods pre and post-test questionnaire design inclusive of semi-structured telephone interviews, to triangulate the data from multiple approaches.Discussion: This study will quantify the outcomes of a high-quality clinician education program to increase knowledge of evidence-based practice for falls prevention. It is predicted that positive behavioural changes will occur in health professionals, leading to organisational change and improved patient outcomes. Furthermore, the findings from the study will inform the future refinement of educational delivery to health professionals across hospital sites.Trial Registration: The study has also been approved by the Australian New Zealand Clinical Trials Registry: Preventing Hospital Falls: Optimal Screening UTN U1111-1225-8450. Universal Trial Number (UTN): U1111-1228-0041 (obtained 5/2/19). Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000200189 (obtained 12/2/19). [ABSTRACT FROM AUTHOR]

Just as ageing is part of life, so is death. Death does not end people's desire to connect with deceased family members and, arguably, the connection between the dead and the living plays an important role in people's lives and relationships. This article explores the matter of ancestor worship, as a form of filial piety, and highlights the importance of considering an "expanded" connection between past and current generations, beyond death. Data were collected from two qualitative studies with Korean residents from Australia, New Zealand and Korea, and analysed using an altered mode of thematic analysis in a Korean and English bilingual context. The findings from the studies show that connectedness with ancestors is an important part of the participants' physical and mental worlds. The discussion in this article includes the meaning of ancestral engagement, ancestral veneration, and mutual connections between ascendants and descendants. The term "memorial piety" is used to define what people practise in relation to remembering and commemorating ancestors or other late loved ones – not necessarily worshipping them in contemporary times. This article addresses a need to broaden the scope and quality of social work for both people who have died and their surviving families, and highlights the potential role of social workers in promoting a meaningful relatedness between past and living generations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate dietetic practice in the management of gestational diabetes in New Zealand, compare this with evidence ‐ based guidelines and determine the need for New Zealand ‐ specific evidence ‐ based nutrition practice guidelines for gestational diabetes. Methods: A 64 ‐ item cross ‐ sectional online survey of New Zealand ‐ registered dietitians providing care to women with gestational diabetes was undertaken. Participants were recruited through Dietitians New Zealand, District Health Boards and private practices across New Zealand. The survey examined dietetic service provision, management recommendations, guideline use, service evaluation, compliance with national and international guidelines and the perceived need for New Zealand ‐ specific evidence ‐ based guidelines for the nutritional management of gestational diabetes. Results: Thirty ‐ three (62%) eligible dietitians participated in the survey. There was significant variation in dietetic services and management recommendations. Nine (28%) dietitians felt the service within which they worked did not offer adequate dietetic services for women with gestational diabetes. Compliance with national and international evidence ‐ based guidelines ranged from 28 to 100% depending on the recommendation. Twenty ‐ five (76%) respondents felt there was a need for New Zealand ‐ specific evidence ‐ based nutrition practice guidelines for gestational diabetes. Conclusions: These results highlight differences in dietetic services and practice in New Zealand and variations in compliance with local and international evidence ‐ based guidelines. The development of New Zealand ‐ specific evidence ‐ based nutrition practice guidelines for gestational diabetes is supported. [ABSTRACT FROM AUTHOR]

This article reports on findings from a mixed-methods New Zealand study of young people’s experience of service use. It focuses on young people’s experiences with mental health services. The youth (aged 13 to 17) were multiple users of statutory and nongovernmental services: mental health, child welfare, juvenile justice, and remedial education. The research explored their life experiences including exposure to harmful events and environments (such as abuse and neglect, violence, and substance abuse) and of particular interest was how services contributed to better outcomes for this vulnerable group of young people. This article explores the components of mental health services that contribute to effective practice. It underlines the key role for services in supporting young people to seek out resources that have the potential to enhance their health and wellbeing. [ABSTRACT FROM AUTHOR]

Background The present study describes the development of evidence-based practice guidelines for the nutritional management of adult patients with head and neck cancer using a wiki platform to enable wide international stakeholder consultation and maintain currency. Methods A dietitian steering committee and a multidisciplinary steering committee were established for consultation. Traditional methods of evidence-based guideline development were utilised to perform the literature review, assess the evidence and produce a draft document. This was transferred to a wiki platform for stakeholder consultation and international endorsement processes in Australia, New Zealand and the UK. Data were collected on website traffic utilising Google Analytics. Results In addition to broad stakeholder consultation through the steering committees, an additional twenty comments were received via the wiki by twelve individuals covering six different professions from three different countries, compared to four comments by e-mail. The guidelines were subsequently endorsed by the dietetic associations of Australia, New Zealand and the UK. During a 4-month period monitoring the use of the guidelines, there were 2303 page views to the landing page from 33 countries. The average number of pages accessed per visit was five and the duration of time spent on the website was approximately 6 min. Conclusions Using a wiki platform for guideline development and dissemination is a successful method for producing high-quality resources that can undergo wide international stakeholder review and include open public consultation. This can replace conventional methods whereby guidelines can quickly become outdated. [ABSTRACT FROM AUTHOR]

In the context of discussions about the potential of collaborative research, a practice-based project was implemented in Auckland, New Zealand during 2006 and 2007, aimed to help develop a culture of enquiry among practitioners in social service. One design variable in this project was the World Café, a conversational process that helps groups to engage in constructive dialogue around critical questions, to build personal relationships, and to foster collaborative learning. In relation to other collaborative approaches, the World Café is powerful in terms of the use of cross-pollination of ideas through evolving rounds of information exchange and the use of a café-style social context that allows the sharing of information in an equitable and non-threatening manner. This article reports on the design and implementation of a World Café approach, located in the philosophy of appreciative inquiry, through ‘Café Hear and Now’. The authors reflect on the perceived value of this initiative and invite dialogue on the implementation of the World Café in social work research. [ABSTRACT FROM PUBLISHER]

Over the last decade, global workforce shortages have seen governments seek to recruit social work practitioners offshore; as a consequence, increasingly, mobile practitioners are navigating the opportunities and challenges posed by working and living in countries other than where they obtained their professional qualifications. This article reports a small exploratory study describing the experiences of ten social workers who qualified in New Zealand but who were practising in England, Scotland or Ireland during 2010–11. While differences in community, work and professional cultures pose challenges, the opportunity such travel provides for reflection on cultural and professional differences is found to be at the heart of participants' overall positive experiences. [ABSTRACT FROM PUBLISHER]