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Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

This review aimed to inform a deeper understanding of the varied experiences of ageing in place for older adults in Australia and New Zealand. Ageing in place involves older adults remaining in their own home or community as they age rather than moving into residential care. Our focus was on how ageing in place relates to older adults' mental health, life satisfaction, wellbeing, and overall ability to adapt well to ageing. This paper followed PRISMA‐ScR guidelines. Of the initial 210 papers identified, 20 met inclusion criteria and were retained. Four key themes related to experiences of ageing in place and the skills and strategies utilised to age in place were extracted from these studies. Themes encompassed older adults' individual characteristics and strategies, their connections to community, their home environment, and the appropriateness of support and services. We conclude that ageing in place should not be considered a "one size fits all" approach to ageing. Policymakers, researchers, and governments should acknowledge that older adults are a diverse group. Future ageing policy should strive to accommodate all older adults regardless of their circumstances or ageing preferences and researchers should include older adults from diverse populations and circumstances. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Background There is a keen interest to develop research systems and increase research output in the 14 Pacific Island Forum Countries ( PIFC) to support development of policies and practice based on locally relevant research evidence. Aims To assess the quantity and characteristics of reproductive health research output by each country (14 PIFC) from 2000 to 2011 using New Zealand's reproductive research outputs as the reference. Methods A systematic search of the literature using a broad definition of reproductive health. Results There were 174 papers published in the PIFC from 2000 to 2011 compared with 628 papers published in New Zealand ( NZ). Most (57%) of the PIFC papers were from Papua New Guinea ( PNG), although Samoa had the most papers by population (10/100 000). Five of the countries did not have a single publication. The majority of papers from both the PIFC and NZ were observational studies (72 vs 36%). Authors from Australia were responsible for 34% of PIFC publications followed by 25% from PNG. Sixty-three per cent of papers by PIFC sole and first authors were published in local journals, whereas 86% of non- PIFC authors published in international journals. Conclusion There is a need for reproductive research in PIFC. PNG had the most publications on the back of a well-funded dedicated research institute and a significant collaboration with Australian researchers. The large number of papers in PIFC countries without PIFC authors raises the question about the need to require non- PIFC researchers to enter into genuine research partnerships in order to build research capacity in the PIFC. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [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?: An important step towards improving mental health outcomes is the realignment of tertiary mental health education and research in a way which places strategic value on experience‐driven involvement in mental health and addiction‐related care.One of the most widely recognized ways of achieving this is by increasing representation of individuals with first‐hand experience of mental health and addiction distress (also known or referred to as Experts by Experience or EBE) within the tertiary sector. What this paper adds to existing knowledge?: Benefits of tertiary EBE representation such as improving student's preparedness for practice and the empowerment of mental health consumers are consistently reported throughout the literature. In striving towards these outcomes, it is crucial we remain mindful of relevant and often‐reported hurdles such as stigma and improper implementation.By using Aotearoa New Zealand as a case study, the need for approaches to increasing EBE representation which is conscious of diverse cultural contexts, perspectives and identities is highlighted. What are the implications for practice?: This review draws together a broad range of factors associated with improving clinical practice. These include the potential for EBE representation to improve outcomes for trainee clinicians, and the incorporation of consumer‐driven perspectives into evidence‐based practice.This review further highlights the need for EBE representation to be implemented in a way which is responsive to the cultural needs and nuances of mental health education and practice in Aotearoa New Zealand, and, similarly in other countries. Introduction: There is potential value in increasing representation of expert by experience (EBE) involvement in mental health education sectors. This approach to improving mental health outcomes is here explored in the context of Aotearoa New Zealand's tertiary education sector. Aim/Question: This review sought to identify potential outcomes, benefits and barriers associated with EBE representation in tertiary institutions, whilst critically analysing these strategies in the context of Aotearoa New Zealand's mental health education sector. Method: Data retrieved from electronic databases were subjected to critical appraisal and thematic analysis. The integrative review drew from a final data set of 113 articles. Results: An integrative review of our search results indicated that moving towards a tertiary mental health model in which lived experience plays a central role has the potential to benefit both teaching and research in the tertiary sector. Discussion: The interplay between contemporary perspectives on tertiary EBE representation and the cultural needs and nuances of Aotearoa New Zealand's tertiary sector highlights the need for critical and careful approaches to EBE representation. Implications for clinical practice: Findings surrounding tertiary EBE representation have direct implications for the training of mental health practitioners and the evaluation and development of clinical practice outcomes and procedures. [ABSTRACT FROM AUTHOR]

Introduction: Australian rural and remote areas are faced with the double burden of an ageing population paired with inequitable access to health resources due to the paradigm of major city centred health care. This complicates fall management within this space. Paramedics are a registered health profession, which provides mobile, equitable health care. However, this resource is not being effectively utilised in rural and remote areas where primary care access barriers may cause patient needs to go unmet. Objective: To describe the existing literature and describe the international scope of current paramedicine practice in the out‐of‐hospital management of falls amongst older adults in rural and remote settings. Design: Joanna Briggs Institute scoping review methodology was employed. CINAHL (EBSCO), MEDLINE (Ovid), EMBASE (Ovid), SCOPUS (Elsevier), Google Scholar and These Global were searched and Australian, New Zealand and the UK ambulance service guidelines were sought. Findings: Two records met inclusion criteria. Currently, rural and remote paramedic fall management involves preventative health promotion through patient education, population‐based screening and referrals. Discussion: The use of paramedics to screen at‐risk populations and refer is vital, as many rural adults had screened positive to fall risks and other unmet needs. There is poor recollection of physically printed education material and low acceptance of further in‐home assessments following paramedic departure. Conclusion: This scoping review has highlighted a significant knowledge gap on this topic. Further research is needed to effectively utilise paramedicine within areas where access to primary care is not possible to achieve downstream, risk reducing care in the home. [ABSTRACT FROM AUTHOR]

Background: Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA. Methods: In total, 13 electronic databases and 14 websites for the period from January 2015 to May 2021 were searched. Information on the characteristics and methodological quality of included studies was extracted using standardised assessment tools. Results: Thirteen published evaluations were identified; 10 for Australian Aboriginal and Torres Strait Islander peoples. The main positive outcomes reported were improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. The methodological quality of evaluations and the reporting of methodological criteria were moderate. Conclusions: Cultural competency education programs can improve knowledge, attitudes and confidence of healthcare workers to improve the health of First Nations peoples. Providing culturally safe health care should be routine practice, particularly in places where there are concentrations of First Nations peoples, yet there is relatively little research in this area. There remains limited evidence of the effectiveness of cultural education programs alone on community or patient outcomes. Cultural competency is often promoted as a strategy to address health inequities, although evidence linking cultural competency to patient outcomes is scarce. We conducted a narrative review of the recent literature on cultural education programs and found 13 published evaluations, mainly reporting improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. Although cultural education has a positive short-term impact, none of the studies included measured improved patient health outcomes. [ABSTRACT FROM AUTHOR]

hoare k.j., mills j. & francis k. (2011) The role of government policy in supporting nurse-led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review. Journal of Advanced Nursing 68(5), 963-980. Abstract Aim. This article is a report on a review that examined the role of Government policy in primary care and its association with nurse-led care in the United Kingdom, New Zealand and Australia between 1998 and 2009. Background. The United Kingdom, New Zealand and Australia share a similar model of first point access to the healthcare system via general practitioners. General practice is synonymous with the term primary care. Data sources. Medline, CINAHL, EMBASE, Scopus, PsychInfo, Google, Department of Health, England (United Kingdom), Ministry of Health, New Zealand, Department of Health and Ageing, Australia. Searches of electronic databases from 1998 to December 2009 and hand searches of identified leads and key journals. Historical papers accessed to describe the genesis of practice nursing and historical Government policy documents prior to 1998, were examined. Review methods. A modified realist review was used to synthesize research and policy documents relating to government policies pertaining to nurse-led care. In addition, a systematic review was used to identify literature that described practice nurse-led care. Results. Nurse-led primary care services are well described in the United Kingdom with a total of 45 studies meeting the inclusion criteria for the second review. There are no published studies from New Zealand, and only two from Australia describing nurse-led primary care. Conclusion. New Zealand and Australia lag behind the United Kingdom in practice nurse development. Implementation of clinical governance was fundamental to the development of nurse-led care in the UK. [ABSTRACT FROM AUTHOR]

Football codes (rugby union, soccer, American football) train and play matches on natural and artificial turfs. A review of injuries on different turfs was needed to inform practitioners and sporting bodies on turf-related injury mechanisms and risk factors. Therefore, the aim of this review was to compare the incidence, nature and mechanisms of injuries sustained on newer generation artificial turfs and natural turfs. Electronic databases were searched using the keywords 'artificial turf', 'natural turf', 'grass' and 'inj*'. Delimitation of 120 articles sourced to those addressing injuries in football codes and those using third and fourth generation artificial turfs or natural turfs resulted in 11 experimental papers. These 11 papers provided 20 cohorts that could be assessed using magnitude-based inferences for injury incidence rate ratio calculations pertaining to differences between surfaces. Analysis showed that 16 of the 20 cohorts showed trivial effects for overall incidence rate ratios between surfaces. There was increased risk of ankle injury playing on artificial turf in eight cohorts, with incidence rate ratios from 0.7 to 5.2. Evidence concerning risk of knee injuries on the two surfaces was inconsistent, with incidence rate ratios from 0.4 to 2.8. Two cohorts showed beneficial inferences over the 90% likelihood value for effects of artificial surface on muscle injuries for soccer players; however, there were also two harmful, four unclear and five trivial inferences across the three football codes. Inferences relating to injury severity were inconsistent, with the exception that artificial turf was very likely to have harmful effects for minor injuries in rugby union training and severe injuries in young female soccer players. No clear differences between surfaces were evident in relation to training versus match injuries. Potential mechanisms for differing injury patterns on artificial turf compared with natural turf include increased peak torque and rotational stiffness properties of shoe-surface interfaces, decreased impact attenuation properties of surfaces, differing foot loading patterns and detrimental physiological responses. Changing between surfaces may be a precursor for injury in soccer. In conclusion, studies have provided strong evidence for comparable rates of injury between new generation artificial turfs and natural turfs. An exception is the likely increased risk of ankle injury on third and fourth generation artificial turfs. Therefore, ankle injury prevention strategies must be a priority for athletes who play on artificial turf regularly. Clarification of effects of artificial surfaces on muscle and knee injuries are required given inconsistencies in incidence rate ratios depending on the football code, athlete, gender or match versus training. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the current state of knowledge about the use of the sit‐to‐stand intervention with older people and to identify implications for further research. Background: Many older people experience mobility challenges which can negatively affect their well‐being. Physical activities are vital to improving or maintaining mobility. Although there is evidence that mobility challenged older people benefit from the sit‐to‐stand intervention, there is a need to systematically examine the state of knowledge about this intervention. Design: Scoping review using Arksey and O'Malley's methodological framework. Methods: A systematic search of three databases was completed. Abstracts were evaluated for relevance using predetermined inclusion criteria. Studies that met the inclusion criteria had data extracted and were appraised for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. Results: Of 3,041 papers, six studies met the inclusion criteria. Publications provided a range of sit‐to‐stand interventions with durations varying from four weeks to six months. The frequency of each intervention fluctuated from three to seven times/week with a duration of 15–45 min. Different professionals prompted the activity. Three themes were identified the following: (a) sit‐to‐stand activity as an intervention; (b) generalisability of findings; and (c) sustainability. Conclusions: Most of the studies reviewed indicated improvements in performance of the sit‐to‐stand activity and in motor function. However, issues with studies rigour do not allow us to make generalisations. Further research is needed to confirm the effectiveness of the intervention. Implications for practice: Healthcare providers are expected to offer evidence‐based patient care. This review details current knowledge about the sit‐to‐stand intervention with older people. [ABSTRACT FROM AUTHOR]

Background Physical inactivity rates have remained high worldwide since 2001. Public policies are an essential upstream lever to target individual physical activity (PA) behaviour. However, implementers have different strategies and face implementation challenges that are poorly understood. The present study analyzes the implementation processes of public policies to promote PA in terms of: (i) the policies covered and their legal quality, (ii) the actors and stakeholders involved in the implementation process and (iii) the used implementation strategies (vertical, horizontal or a mix). Methods A scoping review was systematically conducted (registered Open Science Framework: osf.io/7w84q/), searching 10 databases and grey literature until March 2022. Of the 7741 titles and abstracts identified initially, 10 studies were included. Results The current evidence includes high-income countries (USA, n  = 7; UK, New Zealand and Oman, n  = 1 each). Policy areas covered are education (school sector) and PA promotion in general (national PA plans or city-wide approaches). The legal classification ranges from laws (school sector) to coordination and budgeting to non-legally binding recommendations. The jurisdictions covered were federal (n  = 4), state (n  = 1), county (n  = 1), school district (n  = 1) and city (n  = 3). Implementation strategies for city-wide approaches are characterized by a coordinated approach with vertical and horizontal integration; federal PA policies by a mix of implementation strategies; and the school sector by a strict horizontal top-down integration without the involvement of other actors. Conclusion Implementation strategies differ by policy field. Therefore, continuous evaluation of the implementation process is necessary to align policy implementation with policy goals to promote individual PA behaviour. [ABSTRACT FROM AUTHOR]

Aim: To synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti‐racist praxis to inform nursing in Aotearoa New Zealand. Design: An integrative literature review was undertaken, integrating Indigenous Kaupapa Māori methodologies to ensure a cultural and philosophical lens. Methods: Peer‐reviewed literature published, between January 2011 and July 2023 were sourced. Of 1296 articles, 16 met the inclusion criteria and 4 were identified via citation chaining. In total, 20 articles were included. The Johns Hopkins Research Evidence Tool was applied, findings extracted, and thematic analysis completed utilising Indigenous Kaupapa Māori principles. Data Sources: Databases, including CINAHL, Scopus, PubMed and Aus/NZ Reference Centre, were searched in July 2023. Results: Two key themes were identified: (1) colonial active resistance to change; and (2) transformational, visionary, and proactive nursing. Conclusion: Nurses are well‐positioned to confront the structures that maintain racism in health and education systems but are often actors in maintaining status quo. Anti‐racist praxis can be a mechanism for nurses to reimagine, redefine and transform nursing care, leadership, and nursing education to begin to eradicate racism. Reporting Method: This integrative review adhered to the 2020 Preferred Reporting for Systematic Reviews and Meta‐Analyses (PRISMA) method. Patient or Public Contribution: No patient or public contribution. Implications for the Profession: Racism remains prevalent in nursing and the healthcare system. It is necessary to implement anti‐racist praxis and policies that resist, deconstruct, and dismantle power and racism while validating Indigenous values, beliefs and practices. This is vital to deliver equitable health care. Impact: This integrative review presents lived realities and knowledge of Indigenous and racially minoritised nurses and scholars, alongside nursing allies to inform anti‐racist praxis. This evidence signifies that it is time to walk the walk to challenge the colonising systems and processes that hold racism in place. [ABSTRACT FROM AUTHOR]

Background: New Zealand is one of the last high‐income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this. Aim: To explore nursing practices that optimise rheumatic fever prevention. Design: An integrative review. Methods: Four electronic databases (CINAHL, SCOPUS, Medline via, and Ovid) were searched for peer‐reviewed empirical articles published from 2013 to 2023. Grey literature (guidelines/reports) was also sourced. Critical appraisal was applied using the Mixed‐Methods Appraisal Tools and the Joanna Briggs Critical Appraisal checklist. Qualitative Research in Psychology, 3(2), 77–101, thematic analysis method was used to generate themes. Results: Seven research articles and three national reports were included. Four themes—in‐depth nursing knowledge and improving prophylaxis adherence, cultural competency, and therapeutic nurse–patient relationships—were found. Conclusion: While nursing knowledge and ways to improve injection adherence are essential, being culturally receptive and developing therapeutic relationships are equally important. Without strong and trusting relationships, it is difficult to deliver care required for prevention success. Implications to care: When working with vulnerable populations it is important to be culturally receptive in all interactions with patients and their families. Impact: New Zealand has high rates of rheumatic fever, especially among vulnerable populations such as Pacific Islanders and Māori. Nurses are often frontline primary care providers who, when skilled with the right tools, can help reduce the prevalence of this disease. Reporting method: The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis flow chart. Patient or public contribution: No Patient or Public Contribution was required for this research. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. Background: Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide‐ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. Evaluation: A scoping review, guided by Arksey and O′Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. Key issues: Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. Conclusions: Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. Implications for nursing management: Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero‐tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to investigate the transition experiences of students with previous nursing qualifications (nondegree qualifications) entering a nursing degree program. Background Nurses with professional nursing qualifications (nondegree) are an important pool of professionals to draw on to help address nursing shortages through providing alternative pathways to becoming registered nurses. However, research suggests this cohort need higher levels of support and intervention to be successful. Design An integrative review was conducted, guided by Whittemore and Knafl's framework. A comprehensive search was conducted and 14 studies were included in the review. Methods A five-stage approach was used to conduct the review: problem identification, literature search, data evaluation, data analysis and presentation of results. Constant comparative analysis was used to identify commonalities, differences and themes in the relevant literature. Results Themes emerged that suggested students struggled with academic and institutional challenges, becoming learners, managing conflicting demands of outside life, developing a student identity and experienced threat to their sense of professional identity. Additionally, the cohort did not view themselves as 'the same' as traditional students. Holland's framework provides a useful framework from which to conceptualise these students' experiences. Conclusion There are challenges for this cohort of students as they transition into degree level study. Supportive activities that extend and further develop students' personality orientations may be a useful starting point in addressing some of the challenges and providing a more positive transition to university. Relevance to clinical practice The demand for health care is growing and there remains a shortfall of registered nurses. Nurses with professional qualifications (nondegree) are an important pool of professionals from which to increase registered nurse numbers and address workforce sustainability issues. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

Rural medical education is known as one of the most effective strategies in improving rural recruitment and retention. The aim was to identify modes of delivery to improve access to rural postgraduate medical education. Arksey and O'Malley's methodological framework was used for conducting scoping reviews. CINAHL, Google Scholar, ERIC, PsycINFO, Medline and PubMed were searched to identify peer‐reviewed English‐language literature published between 2000 and 2019 focusing on postgraduate rural and regional medical education. A total of 102 articles were identified, with 51 included in the final analysis after applying inclusion and exclusion criteria. Outcome measures included: article type; research methodology; date of publication; country of origin; and study population. Through iterative reading, common themes were identified. A typology of 6 content themes emerged as follows: rural curriculum; procedural skills; rurally based learning; service delivery; workforce; and distance learning. The majority of articles focused on rural curriculum, and rurally based learning, with half originating from Australia or New Zealand. Although results strongly emphasised context and curriculum in rural environments, lack of specific and pragmatic approaches was noted. Surprisingly, few articles focused on rural distance learning utilising information and communication technology. Pathways to improve rural education access include recognition of the unique rural context in curriculums; development of rural educational faculty; and creation of opportunities for rural specialist training. Emphasis should be given for education provided through rural centres rather than urban facilities. Use of information technology could be increased, for example in remote trainee supervision programs. [ABSTRACT FROM AUTHOR]

Introduction. The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middleincome countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim. This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods. The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results. Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion. This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems. [ABSTRACT FROM AUTHOR]

Background: Health assessment tools developed using mainstream or Western concepts have been widely used in clinical practice worldwide. However, even culturally adapted or culturally based tools may not be relevant in other social contexts if they are grounded in Western beliefs and perspectives. The application of mainstream assessment tools, when used in Indigenous populations, can lead to the inappropriate application of normative data and inaccurate or biased diagnosis of conditions as Indigenous concepts of health differ from Western biomedical concepts of health. Thus, considering the need for culturally meaningful, sensitive, safe, and unbiased health assessment approaches and instruments over recent years, tools have been developed or adapted by and with Indigenous populations in Australia, Aotearoa/New Zealand, Canada, and the United States. However, there is no existing systematic or scoping review to identify the methods and approaches used in adapting or developing health assessment tools for use with the Indigenous population in Australia, Aotearoa/New Zealand, Canada, and the United States. Methods: In response to these gaps, we are working with a First Nations Community Advisory Group in Northern Ontario, Canada, to undertake a scoping review following the 2020 JBI methodology for scoping reviews. A systematic search will be conducted in PubMed, APA PsychINFO, CINAHL, MEDLINE, Web of Science, Bibliography of Native North Americans, Australian Indigenous Health info data set, and Indigenous Health Portal. Two reviewers will independently screen all abstracts and full-text articles for inclusion using criteria co-developed with an advisory group. We will chart the extracted information and summarize and synthesize the data. The summarized findings will be presented to a Community Advisory Group, including First Nations community partners, an Elder, and community members, and their feedback will be incorporated into the discussion section of the scoping review. Discussion: This scoping review involves iterative consultation with the Indigenous and non-Indigenous scholars, First Nations Community Advisory Group, and community partners throughout the research process. This review aims to summarize the evidence on standard ethical approaches and practices used in Indigenous research while adapting or developing health assessment tools. It will inform the larger study focused on developing an Indigenous Functional Assessment tool. Further, it will seek whether the Indigenous ways of knowing and equitable participation of Indigenous people and communities are incorporated in the Indigenous research process. Systematic review registration: Open Science Framework https://osf.io/yznwk. [ABSTRACT FROM AUTHOR]

Background: A disability is defined as a combination of impairments, activity limitations, and participation restrictions, with approximately 15% of the global population affected by some form of disability. While dental caries remains the primary unmet oral health need for children globally, children with disabilities exhibit a significantly higher risk than their counterparts. Understanding the specific challenges faced by this group is crucial to improving overall dental care outcomes. This narrative review explores dental caries prevalences and experiences in children with congenital disabilities and the barriers affecting their access to dental care both in New Zealand (NZ) and internationally. Methods: A narrative review was conducted to investigate the oral health implications in children with common congenital disabilities. Utilising key terms from relevant sources, a comprehensive search strategy was developed and applied to three databases: MEDLINE, CINAHL Complete, and Dentistry & Oral Science Source, all accessed through EBSCO. An initial pool of 913 sources was identified. A process of titles and abstracts screening followed by full-text screening refined the number to 117 for the review. Then, selected sources were analysed narratively to synthesise the findings. Findings: Alarmingly, children with congenital disabilities, including those with intellectual disability and physical impairments, exhibit a significantly higher prevalence of dental caries than their peers without disability. New Zealand-specific data is sparse, with a single study highlighting caregivers' concerns about dental services for their children with disability. These parents emphasised the lack of clarity in dental service protocols and the absence of regular dental check-ups in their children's annual screening programmes. Recommendation: There is an urgent need for New Zealand-centric research to understand the experiences faced by children living with disabilities and their families. Future research should focus on understanding the challenges faced by both dental service users and providers, informing policy and practice and improvements in the region. [ABSTRACT FROM AUTHOR]

Summary Background Presentations to emergency departments (EDs) and patient acuity continue to increase. Whilst strategies to deliver safe patient care in the ED are evolving, emergency nurses need to be well educated through specialist qualifications to enable delivery of advanced patient care. This paper presents a comparative analysis of available international practice and competency standards for nurses graduating from emergency nursing courses in Australia, Canada, New Zealand, the United Kingdom, and the United States. Methods CINAHL, Scopus, Ovid MEDLINE, and Embase were searched for papers, published in English, using the terms: ‘emergency’, ‘accident and emergency’, ‘nursing’, ‘competency’, ‘practice standards’, ‘scope of practice’, ‘regulation’, and ‘specialist standards’. Secondary sources from relevant reference lists and professional websites were also searched. Results The standards from the five countries were common across five domains: clinical expertise, communication, teamwork, resources and environment, and legal. None of the standards were specific to the emergency nursing graduate, and there was variability in the level of expertise required for which the standards apply. Conclusions The available practice standards demonstrated some commonality. Consideration of the utility of a universal framework for informing the development of emergency nursing practice standards and emergency nursing curriculum for nurses wishing to specialise is needed. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

Objective: Despite low patient numbers, rural emergency departments have a similar diversity of case presentations as urban tertiary hospitals, with the need to manage high‐acuity cases with limited resources. There are no consistent descriptions of the resources available to rural emergency departments internationally, limiting the capacity to compare clinical protocols and standards of care across similarly resourced units. This review aimed to describe the range of human, physical and specialist resources described in rural emergency departments in developed countries and propose a typology for use internationally. Design and setting: A systematic literature search was performed for journal articles between 2000 and 2019 describing the staffing, access to radiology and laboratory investigations, and hospital inpatient specialists. Results: Considerable diversity in defining rurality and in resource access was found within and between Australia, New Zealand, Canada and USA. Discussion: A typology was developed to account for (a) emergency department staff on‐floor, (b) emergency department staff on‐call, (c) physical resources and (d) access to a specialist surgical service. This provides a valuable tool for relevant stakeholders to effectively communicate rural emergency department resources within a country and internationally. Conclusion: The proposed five‐tiered typology draws together international literature regarding rural emergency department services. Although further research is required to test this tool, the formation of this common language allows a base for effective communication between governments, training providers and policy‐makers who are seeking to improve health systems and health outcomes. [ABSTRACT FROM AUTHOR]

Objective: To identify and describe the attributes of relational care from an Indigenous Māori healthcare consumer perspective. Data Sources: CINAHL Plus, Ovid MEDLINE, ProQuest Nursing & Allied Health, Scopus, New Zealand Index, the Ministry of Health Library, New Zealand Research and Google Scholar were searched between 23 and 30 May 2022. Methods: This scoping review used the Joanna Briggs Institute methodology for scoping reviews, thematic analysis and the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework for the synthesis of the findings. Results: A total of 1449 records were identified, and 10 sources were selected for final review. We identified five relational attributes that were most important to Māori: (1) the expressive behaviours and characteristics of healthcare professionals (HCPs), (2) communication to facilitate the healthcare partnership, (3) appreciating differing worldviews, (4) the context in which healthcare is delivered and (5) whanaungatanga (meaningful relationships). Conclusion: The relational attributes identified are inextricably linked. Connecting with HCPs and developing a therapeutic relationship is fundamental to improving consumer experience and engagement with mainstream healthcare services. Whanaungatanga is fundamental to meaningful engagements with HCPs. Future research should explore how relational care is practiced in acute care settings when clinician–consumer interactions are time‐limited, examine how the health system influences the capacity for relational care and how Indigenous and Western paradigms can co‐exist in healthcare. Implications: This scoping review can inform future projects addressing health equity for Indigenous communities by creating environments that prioritise culturally safe relational care and value Indigenous knowledge systems. Reporting Method: We used the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) Checklist. No Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The nursing profession has experienced significant change over the last 100 years. Consequently, the work-force of the 21st century is a diverse entity that is edging toward the specialization of nurses in a specific clinical setting. In such an environment, a common knowledge base is demanded of nurses - a factor that has affected the development of second level, or enrolled nurses (ENs). The forces at play raise questions about nursing roles and scopes of practice. The establishment of education pathways that promote career development has been the stimulus for conversations about the effectiveness of the transition of EN to registered nurse (RN). This paper presents a review of the literature that identifies and explores common emerging themes (making the move from EN; adapting to Bachelor of Nursing; transitioning to RN) associated with this transition through the process of undertaking baccalaureate studies in nursing. [ABSTRACT FROM AUTHOR]

Targeted injury prevention strategies, based on biomechanical analyses, have the potential to help reduce the incidence and severity of gymnastics injuries. This review outlines the potential benefits of biomechanics research to contribute to injury prevention strategies for women's artistic gymnastics by identification of mechanisms of injury and quantification of the effects of injury risk factors. One hundred and twenty-three articles were retained for review after searching electronic databases using key words, including ‘gymnastic’, ‘biomech*’, and ‘inj*’, and delimiting by language and relevance to the paper aim. Impact load can be measured biomechanically by the use of instrumented equipment (e.g. beatboard), instrumentation on the gymnast (accelerometers), or by landings on force plates. We need further information on injury mechanisms and risk factors in gymnastics and practical methods of monitoring training loads. We have not yet shown, beyond a theoretical approach, how biomechanical analysis of gymnastics can help reduce injury risk through injury prevention interventions. Given the high magnitude of impact load, both acute and accumulative, coaches should monitor impact loads per training session, taking into consideration training quality and quantity such as the control of rotation and the height from which the landings are executed. [ABSTRACT FROM PUBLISHER]

Acromioclavicular joint (ACJ) separation injuries are common injuries among sporting populations. ACJ separations are graded according to severity from grade I being a mild sprain to grade VI, which is severe dislocation with displacement. There is consensus in the literature that grade I-III ACJ separations are managed conservatively and grades IV-VI are managed surgically. Despite conservative care being recommended for lesser grades of injury, there is very little evidence in the literature as to what constitutes conservative care. Therefore, the purpose of this paper was, first, to review the relevant anatomy and kinematics of the ACJ and, second, to review the literature relating to current evidence of conservative management of ACJ injury. Using this data, a best practice guideline for conservative rehabilitation in grade I-III ACJ separations was developed. For the conservative management, a literature search was undertaken using the following databases in the Auckland University of Technology's electronic library resources; MEDLINE, CINAHL, SPORTDiscus~" and the Cochrane Library. The following keywords or phrases were used: 'acromioclavicular joint separa- tions', 'injury', 'dislocations', 'rehabilitation', 'conservative care', 'physio- therapy' and 'exercise'. A total of 24 articles was identified. There were no randomized con- trolled trials (RCTs) that investigated conservative treatment for grade I-III ACJ sprains. Therefore, a narrative review was formulated covering the anatomy and biomechanics of the ACJ, injury mechanisms and relevant literature reviewed covering rehabilitation principles. Conservative manage- ment of grade I-III ACJ separations is still the main recommendation following this review. A best practice guideline for managing grade I-III ACJ separations is presented to help guide clinicians until well constructed RCTs are carried out to improve the conservative management of ACJ injuries. [ABSTRACT FROM AUTHOR]

The quality of nursing documentation is an important issue for nurses both nationally and internationally. Nursing documentation should, but often does not show the rational and critical thinking behind clinical decisions and interventions, while providing written evidence of the progress of the patient. A number of frameworks are currently available to assist with nursing documentation including narrative charting, problem orientated approaches, clinical pathways, and focus notes. However many nurses still experience barriers to maintaining accurate and legally prudent documentation. A review of nursing documentation of patient care and progress towards achieving outcome goals in our organisation identified a lack of clear and easy to follow information about the patient's progress. In order to address with this issue a project group was established to look at different frameworks for nursing documentation. The aim of the project was to identify and implement a documentation framework that would encourage critical thinking and provide evidence of the rationale for nursing actions utilising a problem based approach in order to provide accurate evidence of patient progress. This paper provides a synopsis of available literature related to the frameworks mentioned above, highlights barriers to safe, timely and accurate documentation for nurses, and concludes with an explanation of the framework chosen as a result of this review. [ABSTRACT FROM AUTHOR]

Although the adverse health consequences of zinc deficiency are becoming increasingly well known internationally, few studies have investigated zinc status in Australia and New Zealand. The aim of this review was to identify which population groups, if any, in Australia and New Zealand are likely to be at risk of zinc deficiency. A literature review was conducted to identify papers on zinc status in Australasia using electronic databases (MEDLINE, BIOSIS Previews, CINAHL, EMBASE, Web of Knowledge, ProQuest and Cochrane Library). Government databases and reference lists from peer-reviewed journal articles were also accessed. Thirty-one Australasian studies that measured dietary zinc intake and/or serum zinc were identified. Many were based on a small number of self-selected subjects, and did not use the recommended procedures for evaluating the prevalence of inadequate zinc intakes and low serum zinc concentrations. Existing data suggest that at-risk groups in Australasia are toddlers, adolescents (especially those of Pacific and Aboriginal ethnicities), institutionalised elderly and possibly people with diabetes. Data on the zinc status of selected population groups in Australasia are limited. Randomised controlled zinc supplementation trials that include the recommended indicators and other clinical outcomes are needed to confirm the existence of zinc-related health outcomes among the at-risk groups identified. [ABSTRACT FROM AUTHOR]

The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organizations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this article was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context. A systematic search of key databases and gray literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies and uses a narrative synthesis approach to reporting. There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3–66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 full-time equivalent (FTE) included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4. Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is a minimal amount of trend data available; therefore, it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available. CRD42021232196 [ABSTRACT FROM AUTHOR]

Mothers are consistently reported as a victim of violence or abuse from a child at higher rates than fathers. Despite this, the safety implications and impact this violence has on mothers continue to be obscured within research and policy frameworks, due to a generic focus being placed on "parents" as victims. This review employed a mixed-methods integrative review methodology to examine Australian and New Zealand research relating to young persons' violence towards their mother. Six themes were extracted, which included mothers being the common target of violence from a child; mothers experiencing both partner and child domestic violence victimisation; mothers experiencing blame, maternal guilt and loyalty; access to formal support; mothers being responsible for arranging treatment for their abusive child; and mothers contacting the police as a last resort. The findings highlight a need for further research examining the pathways to violence utilising multiagency, longitudinal data for both a mother and her child. IMPLICATIONS Clearly labelling a young person's violence towards their mother may help break down the shame, guilt and fear mothers report and their reluctance to seek help. Early intervention programs, one of which has a clear joint mother-and-child focus and others which have separate mother and child foci, are needed. Multidisciplinary research that incorporates information and experiences of mothers and children across multiple longitudinal data sources is needed to examine trajectories towards violence and impacts for both mothers and their children. [ABSTRACT FROM AUTHOR]

Introduction. Rheumatic fever is a preventable illness caused by untreated Group A Streptococcus (GAS) infection. Despite reductions in most high-income countries, rheumatic fever rates remain a concern in Aotearoa New Zealand. Pacific and Māori people are inequitably affected, with risk of initial hospitalisation due to rheumatic fever 12- and 24-fold more likely, respectively, compared to non-Māori and non-Pacific people. Aim. This scoping review aims to explore the range of interventions and initiatives in New Zealand seeking to prevent GAS and rheumatic fever, with a particular focus on Pacific and Māori. Methods. Databases Scopus, Medline, EMBASE and CINAHL, along with grey literature sources, were searched to broadly identify interventions in New Zealand. Data were screened for eligibility and the final articles were charted into a stocktake table. Results. Fifty-eight studies were included, reporting 57 interventions. These targeted school-based throat swabbing, awareness and education, housing, secondary prophylaxis, improving primary care guidelines and diagnosis of sore throats and skin infections. Some interventions reported short-term outcomes of improvements in awareness, a reduction in rheumatic fever risk and fewer hospitalisations. Evaluation outcomes were, however, lacking for many initiatives. Pacific and Māori people primarily served only in an advisory or delivery capacity, rather than as partners in co-design or leadership from the beginning. Discussion. Although positive outcomes were reported for some interventions identified in this review, rheumatic fever rates have not shown any long-term reduction over time. Co-designing interventions with affected communities could ensure that strategies are better targeted and do not contribute to further stigma. [ABSTRACT FROM AUTHOR]

Introduction. Gout in Aotearoa New Zealand (NZ) remains an equity issue. The prevalence in Pacific and Māori people is one of the highest internationally. Although Pacific and Māori experience earlier onset and higher burden of gout, which can severely impact their quality of life, their management of it is often sub-optimal. Aim. To conduct a scoping review of the NZ literature for interventions to improve the uptake/management of allopurinol for gout and their evaluation. Methods. Databases Medline, Scopus, Embase, and CINAHL Plus and the grey literature were searched systematically to identify all NZ intervention studies aiming to improve allopurinol uptake for gout treatment. Interventions included: if they were delivered in NZ, aimed to improve allopurinol uptake, and were provided in English. A narrative approach was used to extract and synthesise data. Results. Eighteen peer-reviewed and grey literature publications met the search criteria. Interventions clustered into three domains: multifaceted or multipractitioner; gout app; and online booklets or fact sheets. Serum urate levels improved in multi-faceted or multi-practitioner interventions only, whereas the gout app only improved patients' awareness and understanding of gout and medications. Online fact sheets and booklets need more active utilisation from health professionals to improve gout health literacy. Discussion. Most gout interventions in NZ use multifaceted or multi-practitioner approaches. Although most interventions successfully controlled serum urate levels and improved equitable access for gout patients to urate-lowering therapy, these interventions did not sustain retention, completion, and engagement for certain population groups, particularly Pacific and Māori, who experience a higher burden of gout. [ABSTRACT FROM AUTHOR]

For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. [ABSTRACT FROM AUTHOR]

The researchers aim in this synthesis is to interpret the cultural constructions of menopause in Indigenous women and apply these interpretations to the context of Māori women in Aotearoa/New Zealand. There is a lack of research about Indigenous women's interpretations of health, and how culture mediates understandings and experiences of menopause. There is even less research regarding Māori women's understandings and experiences of menopause, as the discourse is dominated by Western ideology. Using meta ethnography methodology, the researchers selected eight studies, that provided the foundations to enable the interpretation of the cultural constructions of menopause in Indigenous women. The findings were then translated into four metaphors- natural, cultural protection, freedom and idiomatic and then were subsequently translated to Māori concepts mana wahine, Mātauranga Māori, tikanga and pepeha. We suggest that broader mainstream understandings of the cultural constructions of menopause for Indigenous women are necessary to provide equitable health outcomes for Māori and other Indigenous women. The researchers further developed a model that can be used to represent the foundations of Māori women's conscious understandings and experience of menopause. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and preventive health care to reduce the burden of non-communicable disease. AIM: To review the recent evidence of effectiveness of dietetic intervention in primary health care on health and wider economic outcomes. Health benefits and cost benefits of employing dietitians to perform nutrition intervention in the primary health care setting are evaluated in the areas of obesity in conjunction with diabetes and cardiovascular disease, and malnutrition in older adults. METHODS: An electronic literature search of four scientific databases, websites of major dietetic associations and high-impact nutrition and dietetic journals was conducted. Randomised controlled trials and non-randomised studies conducted from 2000 to 2014 were included. RESULTS: Dietetic intervention demonstrates statistically and clinically significant impacts on health outcomes in the areas of obesity, cardiovascular disease, diabetes, and malnutrition in older adults, when compared to usual care. Dietitians working in primary health care can also have significant economic benefits, potentially saving the health care system NZ$5.50-$99 for every NZ$1 spent on dietetic intervention. DISCUSSION: New Zealand must look to new models of health care provision that are not only patient-centred but are also cost-effective. This review demonstrates that dietitians in primary health care can improve patients'health and quality of life. Increasing the number of dietitians working in primary health care has the potential to make quality nutrition care accessible and affordable for more New Zealanders. [ABSTRACT FROM AUTHOR]

Introduction. The allied health workforce is a crucial, if at times poorly visible, component of modern healthcare systems. The services provided by allied health professionals may be particularly important for underserved populations, including rural and remote communities. Aim. To determine what is currently known through research about the allied health workforce in rural Aotearoa New Zealand. Method. A scoping review of diverse sources of literature from Aotearoa New Zealand was obtained from seven databases (July 2011-July 2021). Results. Eighty-nine articles were identified, of which 10 met the inclusion criteria; nine empirical studies and one narrative review. The included research fell into two main categories: geographic workforce distribution (n = 8), and the role of the rural allied health workforce (n = 2). Discussion. The paucity of research that meets the criteria for inclusion makes it difficult to draw conclusions about the allied health workforce in rural Aotearoa New Zealand. There is a focus in both the international rural allied health literature and the Aotearoa New Zealand rural medical and nursing literature on: measuring geographic workforce distribution; and rural-specific training. This suggests that these issues are important to the rural workforce. Similar research is needed in Aotearoa New Zealand to inform policy and ensure the rural allied health workforce reaches its full potential in improving health outcomes for rural New Zealanders. [ABSTRACT FROM AUTHOR]

Research on the value of interprofessional education (IPE), collaboration and practice in the health sector at both a pre- and post-registration level has increased in recent years. A scoping review of Australian and New Zealand studies was conducted on the value of IPE to interprofessional practice in allied health professionals from 2013 to 2019. A scoping review framework was used to identify 109 studies. Twenty-one articles met the eligibility criteria. The studies were grouped into undergraduate students in academic and WIL settings, allied health professionals and clinical educators. Results suggest that IPE is necessary for the maintenance of interprofessional practice and that it is strongly connected to the development of successful communication within the interprofessional environment. Authentic IPE experience and socialization opportunities appear to be major facilitators of interprofessional practice but no consensus regarding the ideal length of time or timing of IPE was found. The studies also provided an insight into facilitators and barriers to successful implementation of IPE and interprofessional practice in rural environments. As IPE has been shown to contribute to improved interprofessional practice and patient outcomes, future research should explore how to create IPE opportunities for implementation within rural communities where adequate resourcing is most challenged. [ABSTRACT FROM AUTHOR]

Background: Severe maternal morbidity or maternal near miss (MNM) events can have significant consequences for individuals, their families and society and the study of these events may inform practices to reduce future adverse pregnancy outcomes. Aims: To review the scope of MNM studies undertaken in Australia, New Zealand, South‐East Asia and the South Pacific region. Materials and Methods: A systematic search of four online databases (MEDLINE, EMBASE, SCOPUS and CINAHL) and the World Health Organization Library was conducted to identify all relevant studies published between 1 January 2011 and 31 December 2020. The studies were reviewed and included if they assessed MNM using a composite outcome or a predefined set of indicators. Results: The literature search yielded 143 articles of which 49 are included in this review. There were substantial differences in the monitoring approach to MNM in the Australasian region. Overall rates of MNM in the region ranged from two to 100/1000 births and the most common aetiologies identified were direct obstetric causes such as postpartum haemorrhage, pre‐eclampsia and sepsis. Multidisciplinary review indicated a substantial number of MNM cases were preventable or amenable to improved management, mostly from a provider perspective. Conclusions: Assessment of MNM is an important part of the evaluation of maternity care provision. Reaching a consensus on indicators and how best to collect information will allow a more discerning assessment of MNM including longer‐term health outcomes, aspects of preventability and financial implications for health services. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region. Design: A quantitative review of the nursing violence literature was summarized. Data sources: A literature search was conducted using the CINAHL, Medline and PsycInfo data bases. Studies included had to report empirical results using a nursing sample, and include data on bullying, sexual harassment, and/or violence exposure rates. A total of 136 articles provided data on 151,347 nurses from 160 samples. Procedure: Articles were identified through a database search and by consulting reference lists of review articles that were located. Relevant data were coded by the three authors. Categories depended on the availability of at least five studies. Exposure rates were coded as percentages of nurses in the sample who reported a given type of violence. Five types of violence were physical, nonphysical, bullying, sexual harassment, and combined (type of violence was not indicated). Setting, timeframe, country, and source of violence were coded. Results: Overall violence exposure rates were 36.4% for physical violence, 66.9% for nonphysical violence, 39.7% for bullying, and 25% for sexual harassment, with 32.7% of nurses reporting having been physically injured in an assault. Rates of exposure varied by world region (Anglo, Asia, Europe and Middle East), with the highest rates for physical violence and sexual harassment in the Anglo region, and the highest rates of nonphysical violence and bullying in the Middle East. Regions also varied in the source of violence, with patients accounting for most of it in Anglo and European regions, whereas patents' families/friends were the most common source in the Middle East. Conclusions: About a third of nurses worldwide indicated exposure to physical violence and bullying, about a third reported injury, about a quarter experienced sexual harassment, and about two-thirds indicated nonphysical violence. Physical violence was most prevalent in emergency departments, geriatric, and psychiatric facilities. Physical violence and sexual harassment were most prevalent in Anglo countries, and nonphysical violence and bullying were most prevalent in the Middle East. Patients accounted for most physical violence in the Anglo region and Europe, and patient family and friends accounted for the most in the Middle East. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly's hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples' experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas. [ABSTRACT FROM AUTHOR]

The Australian government has announced major reforms with the move to a primary maternity care model. The direction of the reforms remains contentious; with the Australian Medical Association warning that the introduction of non-medically led services will compromise current high standards in maternity services and threaten the safety of mothers and babies. The purpose of this paper is to conduct a critical review of the literature to determine whether there is convincing evidence to support the safety of non-medically led models of primary maternity care. Twenty-two non-randomised international studies were included representing midwifery-led care, birth centre care and home birth. Comparative outcome measurements included: perinatal mortality; perinatal morbidity; rates of medical intervention in labour; and antenatal and intrapartum referral and transfer rates. Findings support those of the three Cochrane reviews, that there is sufficient international evidence to support the conclusion of no difference in outcomes associated with low risk women in midwifery-led, birth centre and home birth models compared with standard hospital or obstetric care. These findings are limited to services involving qualified midwives working within rigorous exclusion, assessment and referral guidelines, limiting the number of urgent intrapartum transfers that come with increased risk of perinatal mortality. What is known about the topic? Systematic reviews of maternal and perinatal outcomes associated with midwifery-led care when compared to conventional intrapartum hospital care concluded that these non-medically led models of care are associated with several benefits for low risk women and their babies with no identified adverse effects. What does this paper add? The finding of no difference in outcomes associated with midwifery-led, birth centre and home birth compared with standard hospital or obstetric care is limited to international studies involving women in the care of qualified midwives working within rigorous guidelines for practice involving inter-professionally agreed exclusion, assessment and referral criteria. What are the implications for practitioners? Midwives caring for women in non-medically led models are urged to be vigilant to the need for early detection and prompt action in the event of unforseen complications to avoid an over emphasis on normality. This decreases the likelihood of urgent intrapartum transfers that come with an increased risk of perinatal mortality. [ABSTRACT FROM AUTHOR]

In Australia, undertaking cultural safety education often evokes strong emotional responses by health students. Despite the potential for emotion to drive transformative learning in this space, measures of emotion are uncommon. To review existing tools that intend to measure emotional components of learning in relation to cultural safety education. Articles published in English from January 2005 to January 2020; reported studies from Australia, New Zealand, Canada and United States of America; and measured an emotional construct/s after an education intervention offered to university students enrolled in a health programme were included. Studies were assessed for quality according to the Critical Appraisals Skills Programme criteria. Eight articles were reviewed; five conducted in the United States of America, and three in Australia. Intervention type, measures, methodological rigour and outcomes varied. Studies predominately measured empathy, guilt and/or fear. Although students' emotional responses were measured, processes for students to reflect upon these reactions were not incorporated in the classroom. The review has implications for future research and curricula through developments in measuring and acting upon emotion in cultural safety education for nursing students in Australia. [ABSTRACT FROM AUTHOR]

Indigenous peoples are more likely than non-Indigenous peoples to experience family violence (FV), with wide-reaching impacts on individuals, families, and communities. Despite this, service providers indicate that Indigenous peoples are less likely to seek support than non-Indigenous peoples. Little is known about the reasons for this, particularly from the perspective of Indigenous people themselves. In this scoping review, we explore the views Indigenous peoples have on help seeking for FV. Online databases, Google Scholar, and reference lists were searched for relevant studies. Inclusion and exclusion criteria were applied so that only original studies where the Indigenous voice was specifically sought were chosen. Fifteen studies met our inclusion criteria including qualitative and mixed-methods research. Studies were conducted in the Americas, New Zealand, Australia, and India. Overall, findings suggest that Indigenous peoples are reluctant to engage in help-seeking behaviors for FV. Data were inductively organized into three main themes reflecting this reluctance: tendency to avoid help seeking (acknowledging the barriers of shame, tight-knit communities, and inappropriate service responses causing mistrust and fear), turning to informal support networks, and help is sought when crisis point is reached. We conclude that to overcome barriers for Indigenous peoples seeking help for FV, improving service providers response to FV through training and more research about what works is required; these activities need to be informed by both male and female Indigenous voices. [ABSTRACT FROM AUTHOR]

The number of people waiting for a transplant far outweighs the number of organ donors in Australia. The Northern Territory (NT) of Australia has the highest incidence of end-stage kidney disease (ESKD) in Australia. A large proportion of those with ESKD are First Nations Australians that require renal dialysis and who are more likely to require and benefit from a renal transplant. In 2018, 53% (21/40) of potential organ donors referred to DonateLife NT identified as First Nations Australian; one of these went on to become an organ donor. DonateLife NT coordinates all organ donation activities across the NT and is responsible for increasing community awareness, promoting the importance of organ donation, and discussing willingness to be an organ donor with families. During these activities with First Nations Australians, a variety of views that influence thoughts and decision making about organ donation have become very apparent. To explore this further, a literature review was undertaken to determine the views on organ donation among First Nations People and consider how this compared to the anecdotal experience of DonateLife NT. Findings from the literature review are consistent with the experience of DonateLife NT. To optimise dialogue about organ donation with First Nations People, it must be conducted in a respectful and culturally appropriate way. This serves to empower through enhancing knowledge and understanding and enables the ability to make informed decisions. Further qualitative research is recommended to increase understanding of the views of First Nations Australians about organ donation and ultimately ensure that donation discussions are appropriately informed, culturally secure, and form part of quality end of life care in hospital settings. [ABSTRACT FROM AUTHOR]

Caloric restriction occurs when athletes attempt to reduce body fat or make weight. There is evidence that protein needs increase when athletes restrict calories or have low body fat. Purpose: The aims of this review were to evaluate the effects of dietary protein on body composition in energy-restricted resistance-trained athletes and to provide protein recommendations for these athletes. Methods: Database searches were performed from earliest record to July 2013 using the terms protein, and intake, or diet, and weight, or train, or restrict, or energy, or strength, and athlete. Studies (N = 6) needed to use adult (≥ 18 yrs), energy-restricted, resistance-trained (> 6 months) humans of lower body fat (males ≤ 23% and females ≤ 35%) performing resistance training. Protein intake, fat free mass (FFM) and body fat had to be reported. Results: Body fat percentage decreased (0.5-6.6%) in all study groups (N = 13) and FFM decreased (0.3-2.7kg) in nine of 13. Six groups gained, did not lose, or lost nonsignificant amounts of FFM. Five out of these six groups were among the highest in body fat, lowest in caloric restriction, or underwent novel resistance training stimuli. However, the one group that was not high in body fat that underwent substantial caloric restriction, without novel training stimuli, consumed the highest protein intake out of all the groups in this review (2.5-2.6g/kg). Conclusions: Protein needs for energy-restricted resistance-trained athletes are likely 2.3-3.1g/kg of FFM scaled upwards with severity of caloric restriction and leanness. [ABSTRACT FROM AUTHOR]

Background: In New Zealand, health equity is a pressing concern and reaching disadvantaged populations has become the goal to close the inequity gap. Building and strengthening health systems is one way to secure better outcomes. However, the discourse to date has predominately focussed on inequities in health outcomes for Māori. This study has interest in the African ethnic minority community in New Zealand. It undertakes a narrative review of the New Zealand health system which aims to identify literature around the attainment of health equity of African minority by: (i) providing a critical overview of the healthcare delivery system using World Health Organization's six inter-related building blocks of health system strengthening; (ii) developing a summary and discussions of the research results and; (iii) identifying priorities and recommendations for future research. Method: A narrative review of 27 articles published between January 2010 and June 2019 were selected from CINAHL, PubMed, Scopus, Google Scholar. Grey literature also informed the review. Articles excluded studies: (i) non-related to New Zealand; (ii) with no focus on equity on ethnic minority in the delivering of healthcare; (iii) had no full text available. Findings: Literature on Africans health outcomes were scarce regarding the six building blocks. However, findings show inequities in accessibility of health services, a non-ethnic inclusive health workforce, a leadership and governance which lack political will on migrant health and resultantly an under-performing health information system which influences resource allocation. Recommendation and conclusion: An improvement and well-functioning health information system is pivotal to capture the unmet needs of the African population. There is a need for research and political will to invest in African minority health and diverse workforce that understands the background of the African population; and action to address structural and institutional racism and white privilege to address root causes of inadequate access and care processes for ethnic minorities. [ABSTRACT FROM AUTHOR]