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Accessible summary: What is known on the subject?: Medication does not always resolve a serious mood episode, and there is evidence that it needs to be combined with an evidence‐based psychotherapy to promote symptomatic and functional recovery.There is little known about what people with serious mood disorders want from mental health services to manage their mood. What the paper adds to existing knowledge?: Participants in this study wanted a framework other than the medical model for understanding and managing their mood.Their motivation to commence psychotherapy was based on a sense of having hit rock bottom and a need for understanding what was happening in order to better manage their mood. Introduction: There is little known about the motivations for people to participate in psychotherapy for depression. Aim: To explore why people, with a diagnosis of major depressive episode, chose to take part in a psychotherapy study and what they expected it to involve. Method: This was a qualitative study of participants' motivations and understandings of psychotherapy for depression. Data were collected using semi‐structured interviews and analysed using thematic analysis. Findings: Eight females and eight males with an age range from 21 years to 55 years were recruited. Three themes were identified that described why participants chose to participate in psychotherapy: medication was not enough, a turning point and making sense of experience. The participants chose to participate in psychotherapy after finding that medication was insufficient and this combined with a sense of crisis motivated them to engage in psychotherapy in order to learn to manage their mood differently. Discussion: The participants recognized that they wanted a framework other than a medical model with its reliance on medication, in order to make sense of their experiences and develop new self‐management strategies. Implications for Practice: Our study suggests that some people experiencing a serious mood disorder access psychotherapy after "hitting rock bottom" and finding insufficient help from medications. Mental health nurses need to be aware people do not always want a medical model approach to treatment of serious mood disorders and they need to provide the opportunity of engaging in a psychotherapeutic framework in order to better understand and manage their mood. [ABSTRACT FROM AUTHOR]

Objectives: HealthPathways, pioneered in Canterbury, New Zealand, in 2008, is a web-based tool designed to promote health care integration and patient management in primary care and to reduce fragmentation in the delivery of health services. This cross-sectional study evaluated the utilisation and perceptions of this tool among health professionals in Australia and New Zealand. Methods: A cross-sectional survey was administered online through Research Electronic Data Capture (REDCap) to general practitioners (GPs), practice nurses and managers, nurse practitioners, specialist and community nurses, hospital clinicians, nurses, managers, and allied health professionals between April and September 2018. The frequency of HealthPathways use in the previous month was modelled as an ordered response using an ordered logistic regression model after adjusting for the possible effects of sex, age, years in clinical practice, location and time spent in practice. Results: Health professionals perceived HealthPathways to be useful in primary care management and referral, as well as in the prereferral treatment of patients. GPs in New Zealand, New South Wales and Victoria were 73%, 47% and 27% more likely to have used HealthPathways ≥10 times in the previous month respectively. Conclusion: The results suggest that HealthPathways is having a positive effect on healthcare systems in New Zealand and Australia. However, differences in uptake suggests the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change. What is known about the topic?: Early evaluations suggest that HealthPathways is a useful tool for health professionals, although uptake and utilisation may be limited. However, there is no comparative evidence regarding uptake and implementation of the tool. What does the paper add?: This study is among the first to provide a comparative narrative of the literature assessing the implementation and uptake of HealthPathways across Australia and New Zealand. It is also among the first to compare the perceptions of allied health professionals in the use of HealthPathways across Australia and New Zealand. What are the implications for practitioners?: The results of this study suggest the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change. [ABSTRACT FROM AUTHOR]

Development and maintenance of professional competencies are essential for practitioners across all disciplines within the helping professions to ensure safe, accountable and ethical practice. This includes the practice of supervision which is considered as a set of competencies in its own right. For many supervisors, however, there is a struggle to find the opportunity for in-depth critical reflection and review of their supervision for the purpose of continuous professional development. This paper describes a learning community for supervision where, through a process of collaborative enquiry, four experienced supervisors, in Aotearoa New Zealand, from diverse professional and practice backgrounds critically reflected on audio-recordings of their supervision of practitioners. From this focus on direct practice, the group members created a model for critique and feedback which is centred on a 'thinking aloud' process. Key themes, which included supervisor authenticity and presence, encouraging reflection, participation and uncovering assumptions and the benefits of the thinking aloud process were identified and explored. Rarely is the practice of supervision scrutinised in a group setting for the purpose of learning and development. Placing supervision practice 'under the microscope' allows for creative opportunities and the promotion of different models of supervision development. [ABSTRACT FROM AUTHOR]

Worldwide, a growing burden of health and social issues now affect young people. Interagency collaboration and the "integration" of health and social care services are advocated to address the increasingly complex needs of at‐risk youth and to reduce barriers to accessing care. In New Zealand, Youth‐One‐Stop‐Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff. Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different "world views" and cultures of agencies which can run contrary to collaborative practice. Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co‐ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care. [ABSTRACT FROM AUTHOR]

Abstract In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015–16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns. Highlights • Older people position themselves as active co-managers in their support arrangements. • Framing problems as challenges not threats facilitates older people's resourcefulness. • People in old age adapt resiliently to health conditions as part of living and ageing. [ABSTRACT FROM AUTHOR]

Background and aims: The short‐lived regulated legal market for new psychoactive substances (NPS) in New Zealand marked a radical departure from the traditional prohibition‐based approach to drugs. This paper aimed to enhance understanding of this policy change using Punctuated Equilibrium Theory (PET). Methods: The analysis draws on 3 years of evaluative research, including interviews with key stakeholders, analysis of legislation and policy documents and academic and grey literature. Results: The reframing of the NPS issue from one of drug control to the need for stricter market regulation was achieved by the efforts of strategic policy entrepreneurs, including the legal high industry, drug law reform advocates, influential politicians and an independent legal advisory institution. This reframing was aided by the perceived saliency of the NPS problem and ineffectiveness of previous prohibition‐based responses. In the absence of any political opposition to the regulatory approach, the Psychoactive Substances Act rapidly progressed through the Parliament. However, once the interim legal market was established, portrayal of the issues shifted away from experts and lobbyists to critique from local communities, local government, animal rights activists and the media, who viewed the new regime as a source of social and health problems. The mobilization of criticism ('Schattschneider mobilization') drew on ideas of animal welfare and community safety. With a looming national election, the government responded by ending the interim market with the urgent passage of amendment legislation. Conclusions: Punctuated Equilibrium Theory (PET) helps explain how New Zealand's Psychoactive Substances Act (PSA) policy first emerged on the political agenda and how the initial positive tone of expert support for reform shifted to a tide of popular criticism during the interim regime. However, with its emphasis on explaining agenda‐setting, PET does not account for the legislative design shortcomings of the PSA. [ABSTRACT FROM AUTHOR]

The New Zealand early childhood Te Whāriki Curriculum’s vision statement draws attention to the responsibility teachers have to create environments in which children can develop holistically; including spiritually. This paper outlines the findings from a small qualitative research project that explored teachers’ perspectives on their understanding of spirituality and ‘wairua’ and the role they have in fostering these aspects in children’s development. Participants were in agreement that the concept of wairua and spiritualty are interwoven with both being about the spirit, soul, inner being, heart, the sum of who you are. Participants were in agreement that fostering this aspect of a child’s development was  part of a teacher’s responsibility. All respondents identified implications for their practice which included having environments that were inviting, stress free, engaging and filled with natural resources. The study highlighted that their initial teacher education programmes failed to cover these aspects in spirituality in any depth. [ABSTRACT FROM AUTHOR]

Introduction: New Zealand has implemented a series of seven annual increases in tobacco tax since 2010. All tax increases, except for the first in the series, were preannounced. It is unusual for governments to introduce small, persistent, and predictable increases in tobacco tax, and little is known about the impact of such a strategy. This paper evaluates the impact of the fifth and sixth annual increases.Methods: Smokers' behaviors were self-reported during the 3-month period before, and the 3-month period after, the two annual increases. Responses to the two increases were analyzed separately, and generalized estimating equations models were used to control for sociodemographic variables, recent quit attempts, and the research design.Results: Findings were consistent across years. The proportion of participants who made a smoking-related (54%-56% before and after each tax increase) or product-related change (fifth tax increase: 17%-19%; sixth tax increase: 21%-22%) did not significantly alter from before to after each tax increase. However, it should be noted that the proportion of participants making smoking-related changes was generally high, even prior to each increase. For example, before the 2015 tax increase, 1% reported quitting completely, 21% trying to quit, and 53% cutting down.Conclusions: In New Zealand, with its series of annual tobacco tax increases since 2010, there were no significant changes in smoking- or product-related behavior associated with the fifth and sixth increases. Nevertheless, overall cessation-related activity was high, with a majority of participants reporting either quitting and/or cutting down recently.Implications: Little is known about the impact of small, persistent, predictable tobacco tax increases on smoking behavior. This study evaluated the impact of the fifth (in 2014) and sixth (2015) tax increases in an annual series implemented in New Zealand. Although there were no detectable changes in smoking behaviors from before to after each tax increase, self-reported cessation-related activity was high overall (i.e., even prior to each increase). Given that there are multiple possible interpretations for these findings, more in-depth time-series analyses are needed to understand how such a tax strategy influences smoking behavior. [ABSTRACT FROM AUTHOR]

Young people in statutory care and protection interact with social workers, who hold potential to provide a supportive adult role in their lives. Many however, run away at an early age and end up on the street trading sex for money or other favours. There is potential to improve outcomes for young people in care if the relationship between young people and their social workers is better addressed. This paper uses data from a qualitative study of 14 young people who traded sex and who had experienced interactions with social workers. A thematic analysis identified three themes: the rigidity of social work practice; contesting the family situation; and resisting the at-risk label. We argue that to have any impact on outcomes for young people in care, social workers need to prioritise relationship-building above the need to conform to organizational protocols and guidelines. Such guidelines assist the social worker in assessing whether family situations pose high risk for a young person, but the 'at-risk' label is contested by young people, which results in a lack of trust and a barrier to relationship building. [ABSTRACT FROM AUTHOR]

Background: Cognitive enhancement is the use of prescription stimulant medicines by healthy individuals for nonmedical use in academic settings. Commonly used cognitive enhancers (CEs) include methylphenidate, amphetamines, and modafinil. To understand the motivation to use CEs, it is important to look beyond prevalence and explore the extent to which attitudes, beliefs, and intentions predict the decision to use CEs. Objective: The study aimed to investigate what factors explain the decision to use CEs among tertiary students in New Zealand, using the Theory of Planned Behaviour (TPB). Methods: Students from the Schools of Pharmacy, Nursing, Medicine, Law, and Accounting at a university in New Zealand were invited to complete a paper-based questionnaire. The questionnaire elicited students' attitudes, subjective norms, and perceived control toward illicit use of CEs using TPB. An exploratory factor analysis was conducted. Results: Response rate was 88.6% (442/499). Students who perceived CE use to be socially and ethically acceptable were more likely to use CEs (odds ratio, OR: 1.56, 95% confidence interval, 95% CI: 1.153–2.105, p = 0.004). Students who were concerned about the health impact of CE use were less likely to use CEs (OR: 0.54, 95% CI: 0.492–0.826, p = 0.001). Students who believed that CE use was approved were more likely to use them (OR: 1.648, CI: 1.193–2.278, p = 0.002). Conclusion: This research supports the notion that the decision to use CEs is not just an autonomous choice that occurs in isolation. Attitudes on the ethical and social acceptability of CE use were more likely to drive the decision to use CEs. The study provides the impetus for an integrative discussion by health care professionals and academics on the impact of attitudes, social norms, and advocates on the decision to use CEs. [ABSTRACT FROM AUTHOR]

This paper provides a foundational framework to bring into conversation indigenous world views in reimagining universities. Highlighting a specific indigenous world view, the university is presented as a site for critical conversation and transformative praxis. We discuss the workplace experiences of indigenous staff in a university and infer from these how management practices related to indigenous staff could be enhanced. Building on our study of Māori academic and administrative staff in a New Zealand university, an indigenous typology and a Wero or challenge matrix is offered, which locates different positions and actions that universities adhere to or seek to emulate. The paper argues for universities to reimagine their policies and practices by drawing from the complex richness of indigenous world views. [ABSTRACT FROM AUTHOR]

Families play important roles in children's learning. Yet, teachers' values and beliefs may sway how families may participate in assessment of their child's learning within early childhood education. This paper reports on a qualitative case study in a New Zealand early childhood setting that explored teachers' views about involving families in assessment of infants’ and toddlers’ dispositional learning. Methods comprised interviews with five teachers, researcher field notes and documentation about children's learning. Findings suggested that teachers’ views about learning dispositions, teaching and assessment positioned families as consumers of, rather than participants in, assessment. Theoretical tensions arose between Gerber's Resources for Infant Educarers (RIE) approach that guided teachers' philosophy and practice andTe Whāriki, the mandated early childhood curriculum of New Zealand. The paper argues that weaving RIE with a national curriculum framework requires teacher engagement in critical thinking and discussion regarding actively involving families in assessment. [ABSTRACT FROM PUBLISHER]

In New Zealand in 2006, a professional photographer undertook a photo essay of residents and staff in an aged care residential setting. The photographer captured the 'lifeworld' of the institution through photographing the images of daily life. The resulting photo essay, which included some photographs of older people naked and in semi-dress, was published in New Zealand's principal nursing journal in May 2006. There ensued an unprecedented reaction that divided New Zealand's nursing world. In this paper, I explore possible meanings of the 'photo furore', through discourse analysis of the numerous letters to the nursing journal editors. These letters reveal reactions and opinions from both 'sides'- rejection and disapproval, acceptance and approval - as the situation developed into dichotomy. In this paper, the further aim is to address the issue of attitudes and reactions of the exposed ageing body from theoretical perspectives. Results reveal conflicting discourses and attitudes within nursing towards photographs of the ageing body and underlying this, how nurses believe older people should be thought about and cared for. These attitudes are wide-ranging and, on the one hand, include ageism and a desire to protect and supervise older people versus a greater tolerance and acceptance of older people as competent, autonomous beings. [ABSTRACT FROM AUTHOR]

Aims: This paper explores two older Chinese immigrants' visual narratives on the value and impact of paintings beyond aesthetic merit, and the role art plays in their health, well-being and identity construction. Method: Focusing on two participants' accounts, this paper draws on data collected in a larger project that investigates ageing, housing and well-being through interviewing 32 older Chinese immigrants in New Zealand. Findings: The analysis illustrates that immigration to a new culture in old age often gives rise to experiences of biographical disruption and status-discrepancy, which may invoke isolation, anxiety and a sense of dislocation and loss. Findings reveal that art-making aids the participants in addressing biographical disruption and status-discrepancy and appreciating the richness of multiplicities of the self. Conclusions: Art contributed to positively influencing the well-being of both participants after they moved to a new culture later in their lives. [ABSTRACT FROM PUBLISHER]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [ABSTRACT FROM AUTHOR]

Despite numerous reviews, reports and commissions of inquiry, the investigation and prosecution of rape cases remains fraught. Victims are still ambivalent about reporting incidents of sexual violence, while those who do often struggle to be believed and have their cases progress through justice systems. This paper explores some of the reasons why promised reforms materialise so rarely into tangible benefits for the majority of rape complainants, and focuses on six areas: reporting, attrition, adversarial justice systems, victim support, specialisation and attitudes. These are canvassed with particular reference to examples from England and New Zealand demonstrating the barriers to substantive reform and the ways in which gender inequalities and patriarchal beliefs continue to impact upon both the prevalence of sexual violence as well as state responses to its occurrence. The paper contains a cautionary message regarding the potential dangers involved in accepting the rhetoric of reform while the underlying realities remain little changed. [ABSTRACT FROM PUBLISHER]

Purpose - Clients often report reluctance in attending publicly funded mental health services, particularly when those services are provided at segregated and stand-alone locations well known to the wider community. One way to address this stigma-driven reluctance to attend appointments is to deliver mental health services in combination with employment services, education and training, income support, housing, disability support, legal services, and other health services, as an essential suite of community services. This paper aims to research this possibility.Design/methodology/approach - The paper outlines the early planning and implementation phases of the Huntly Community Link project.Findings - The paper finds that ongoing joint governance and management, clear on-site leadership, and an evaluation strategy are needed to ensure joint service delivery goals are attained.Practical implications - Several important practical issues emerge. For instance, differences in organisational culture take time to change towards greater support for the new joint service delivery goals.Social implications - Early indicators suggest that the Huntly Community highly values the joint delivery of these essential services from a suitable purpose designed building.Originality/value - This is an innovative New Zealand program that promises to reduce attendance stigma by nesting the delivery of publicly-funded mental health services among a broad mix of other essential community services. [ABSTRACT FROM AUTHOR]

Abstract: This paper uses Arlie concept of emotion management and “surface” and “deep acting” to explore how sex workers separate and distance themselves from their public role. Experiences of stigmatisation prevail among sex workers and how stigma is resisted or managed has an impact on their health. In-depth interviews were carried out between August 2006 and April 2007 with 58 sex workers in five cities in New Zealand following decriminalisation of the sex industry. Most participants drew on ideas of professionalism in sustaining a psychological distance between their private and public lives. They utilised “deep acting”, transmuting private experiences for use in the work environment, to accredit themselves as professional in their business practices. They also constructed different meanings for sex between public and private relationships with the condom providing an important symbol in separating the two. A few (mostly female street-based) participants were less adept at “deep acting” and relied on drugs to maintain a separation of roles. This paper argues that in an occupation which is highly stigmatised and in which depersonalisation as an aspect of burn-out has been reported as a common occurrence, the ability to draw on strategies which require “deep acting” provides a healthy estrangement between self and role and can be seen as protective. The separation of self from work identity is not damaging as many radical feminists would claim, but an effective strategy to manage emotions. Hochschild, A. (1983). The managed heart: Commercialization of human feeling. Berkeley: University of California Press. [Copyright &y& Elsevier]

This paper examines the way in which Maori cultural frameworks have influenced mainstream social work practice. Using the example of indigenous practice developed by Maori social workers in Aotearoa New Zealand, the paper explores five sets of constructs that have provided a framework for thinking in mainstream social work practice. These constructs bring a richness to practice which encourages practitioners to critically reflect on the philosophies and practice knowledge that inform their work with clients. Of particular significance is building an understanding of the ways in which context shapes experience and the implications this has for practice. These emerging perspectives in mainstream practice have the potential to create practice that is more responsive to diverse populations and that recognises the central place of cultural frameworks in effective social work practice. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Citizenship is an important yet largely overlooked concept within psychiatric and mental health nursing practice, Many service users are subject to legally mandated restrictions that place conditions on their rights and responsibilities as citizens., What this paper adds to existing knowledge? Even though service users have legal status as citizens, they continue to experience many conditions on their rights and responsibilities., Concerns about services users' trustworthiness and doubts about their levels of insight impact on their status as full citizens., What are the implications for practice? Nurses' understandings of the conditions placed on the citizenship rights and responsibilities of service users will ensure inclusive and less restrictive care and treatment, Integration of the principles of therapeutic reciprocity and procedural justice within practice will help nurses balance both the rights of services users and legal restrictions on their liberty and autonomy, Abstract Introduction Service users have long been lobbying for equal participation as citizens, yet citizenship is an important and largely overlooked concept within nursing education and practice. Aims The study explored service users' understandings of their rights and responsibilities of citizenship and the conditions placed on these. Methods A total of 17 service users participated in semi-structured interviews. Isin's theory of the content of citizenship was used to analyze the data using a framework approach. Results Service users experience conditional citizenship that includes barriers to their participation and their rights and responsibilities that others in society enjoy. Discussion When the world of the service user is constructed through the language of the biomedical model, nurses may unwittingly reinforce psychiatric labels and thus perpetuate the stereotype that service users lack the competence to fully enact their rights and responsibilities. Implications for practice When providing care, nurses should incorporate the notion of therapeutic jurisprudence and the principles of reciprocity, procedural justice and the implementation of advanced directives to reduce conditions on service users' status as citizens. [ABSTRACT FROM AUTHOR]

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

In an era of unprecedented student mobility, increasingly diverse student populations in many national contexts, and globally interconnected environmental and social concerns, there is an urgent need to find new ways of thinking about teaching and learning. Static assumptions about so-called 'Western' versus 'non-Western' teaching and learning approaches or 'local' versus 'international' students are inadequate for responding to the complex histories, geographies and identities that meet and mingle in our higher education (HE) institutions. In this paper, I use María Lugones' 'world-travelling' as a framework for discussing international and New Zealand women students' reflections on teaching, learning and transition in New Zealand HE. I conclude with some suggestions as to what effective pedagogy might look like in internationalised HE if we think beyond culturalist them-and-us assumptions and recognise students' complexity. [ABSTRACT FROM AUTHOR]

In this paper, we examine how New Zealand children engage with public health agendas that seek to shape their understandings of health. We shed light on the ways children make sense of what they see, hear and come to know through public health ‘work’, and consider what effects this has for how they come to think of their ‘selves’ and relations with others. We pay attention to the way public health messages assemble, bolstered by dispositions, behaviours and ruminations expressed in schools, families and communities. Children’s talk exemplifies the sheer volume of public health missives saturating their worlds and the range of media used to reach into children’s lives. In many cases, children are ‘doing it for themselves’ in the sense that they are attempting to enact health imperatives about healthy eating, regular exercise and weight management. However, alongside the willingness of many to simply believe and enact health information, we draw attention to the capacity of some children to think through public health messages, negotiate and make sense of them in relation to their own lives. Despite the ubiquity and mantra-like quality of public health messages currently directed at children we contend they are variously interpreted and embedded in children’s lives. We regard the messiness and complexity of children’s engagement as affirmation that a critically informed variety of public health could provide opportunities for children to come to know health as more than simply eating the right foods and running a lot. [ABSTRACT FROM PUBLISHER]

Tobacco smoking is common among people with mental illnesses, and they carry a higher burden of smoking-related illnesses. Despite this, smoke-free policies and systems for supporting cessation have proved difficult to introduce in mental health and drug and alcohol services ( MHDAS). This paper examines the barriers to becoming smoke free within New Zealand services. Key informants, including staff, smoke-free coordinators, and cessation specialists were interviewed. Of the 142 invited informants 61 agreed (42%) to participate in a telephone interview, and 56 provided useable data. Organizations had a permissive or transitioning smoking culture, or were smoke free, defined by smoke-free environments, smoke-free-promoting attitudes and behaviours of management and staff, and cessation support. Most organizations were on a continuum between permissive and transitional cultures. Only eight services had a fully smoke-free culture. MHDAS face many challenges in the transition to a smoke-free culture. They are not helped by exemptions in smoke-free policies for mental health services, staff smoking, negative staff attitudes to becoming smoke free, poor knowledge of nicotine dependence, smoking-related harm and comorbidities, and poor knowledge and skills regarding cessation-support options. Health inequalities will continue across both service and socioeconomic divides without a concerted effort to address smoking. [ABSTRACT FROM AUTHOR]

Climate change is a critical sustainability challenge for alpine tourism and the ski industry. Climate change adaptation is characterised as identifying and taking advantage of new business opportunities plus reducing physical risks. For adaptation strategies to be sustainable they should consider the environment, economy and society. While several adaptive ski industry strategies have been identified, not all can fulfil these criteria; some adaptive strategies could be perceived as unsustainable, or maladaptive. This paper provides a qualitative, perceptual study of ski industry stakeholders in Queenstown, New Zealand, addressing perceptions of climate change adaptation by the core industry, wider industry actors, local community and tourists. It answers two research questions: What are perceived as the main climate change adaptation strategies for Queenstown's ski industry? How do ski industry stakeholders perceive current adaptation strategies in terms of sustainability? It finds snowmaking central to addressing both current weather variability and medium/long-term future climate change. Ski-field operators use snowmaking to ensure the industry's economic sustainability, to extend seasons even beyond traditional norms, but with little consideration for environmental or social sustainability. It finds some local people questioning snowmaking on ethical and environmental grounds, and skier acceptance of snowmaking connected to activity preference. [ABSTRACT FROM AUTHOR]

For older people gardens may be paradoxical sites. Whilst gardening is associated in multiple ways with wellbeing and health, gardens may also become a source of frustration and worry as ageing bodies limit gardening activities. Yet determination remains. However, little of the well-established body of work on gardens and old age includes people in advanced age. In this paper, we draw on interviews with Māori and non-Māori 85-90-year olds in Aotearoa, New Zealand, focusing on how they talk about their wellbeing in relation to past, present, and future experiences of home gardening. Our research shows home gardens and gardening figure prominently and positively in the narratives of people in advanced age. Most of our participants described themselves as active gardeners; most also lived with multimorbidity, sometimes severe and complex. Applying positioning theory, we examine how our participants connect gardens and gardening to identity; connectedness; and adaptation and renegotiation of health and wellbeing in ageing bodies. Home gardens are 'more than therapeutic'; while they are protective of health and wellbeing, they are also enabling places for the expression and performance of agency in advanced age. These understandings have practical implications for supporting wellbeing amongst those in advanced age. • Gardening links to health & well-being, but may also cause frustration & worry. • We explore home gardening of people in advanced age including older indigenous people. • Most participants identified as active gardeners; most lived with multimorbidities. • They related gardening to identity, connectedness, & expressing agency in very old age. • Home gardens protect health & are enabling places; they are therapeutic and more. [ABSTRACT FROM AUTHOR]

Disabled young people have lower levels of participation in community life than nondisabled peers across a number of domains, including sporting activities, with profound implications for health, wellbeing and life course opportunities. Playing sport is a defining feature of identity for many young people in Aotearoa/New Zealand. Participation in sporting activities provides opportunities to develop competencies, to have fun and to compete, while also providing a sense of inclusion and peer group belonging. However, despite policies promoting inclusion of disabled young people in school and club sport, ableist attitudes and practices still function to exclude individuals who do not fit able-bodied norms. Drawing on recent 'assemblage thinking' in health and cultural geography, this paper explores the material, social and affective dimensions of 'enabling' and 'disabling' sporting assemblages, drawing on interviews with 35 disabled young people (12–25 years), parents and key informants. Many reported instances of demoralising exclusion in mainstream sporting activities. Some turned to adaptive sporting codes, designed for inclusion. In our exploration of participants' embodied experiences of enabling and disabling assemblages we employ assemblage theory to examine how social, affective and material forces and processes converge to either enable or constrain participation in local sporting activities. We close with a brief assessment of the implications of our analysis for ongoing efforts to promote inclusion for disabled youth in physical activity. • Disabled young people have lower sports participation levels than non-disabled peers. • Ableist attitudes and practices frequently exclude those who do not fit able-bodied norms. • Ableist attitudes produce social, cultural and physical barriers to participation. • Disability-specific sports can enable experiences of pleasure, freedom and inclusion. • Assemblage thinking has helped identify forces that enable/constrain participation. [ABSTRACT FROM AUTHOR]

This paper explores the views of healthcare staff regarding the provision of culturally appropriate palliative care for Māori, Pacific Island and Chinese elders living in Auckland, New Zealand. The ageing population is culturally and ethnically diverse and, along with other developed countries experiencing high levels of migration, the challenge is balancing the rise in numbers of older people from different ethnic and cultural groups with end-of-life care, which reflects personal values and beliefs. Two joint interviews and ten focus groups were conducted with eighty staff across a range of primary, secondary and speciality care settings in 2010. The findings demonstrated that participants viewed the involvement of family as fundamental to the provision of palliative care for Māori, Pacific Island and Chinese elders. For Māori and Pacific Islanders, healthcare staff indicated the importance of enabling family members to provide 'hands-on' care. The role of family in decision-making was fundamental to the delivery of and satisfaction with care for older Chinese family members. Care staff highlighted the need to be cognisant of individual preferences both within and across cultures as a fundamental aspect of palliative care provision. The role of family in 'hands-on' palliative care and decision-making requires care staff to relinquish their role as 'expert provider'. Counter to the prioritisation of autonomy in Western health-care, collective decision-making was favoured by Chinese elders. Providing families with the requisite knowledge and skills to give care to older family members was important. Whilst assumptions are sometimes made about preferences for end-of-life care based on cultural values alone, these data suggest that care preferences need to be ascertained by working with family members on an individual basis and in a manner that respects their involvement in palliative care provision. [ABSTRACT FROM AUTHOR]

ABSTRACT:This paper estimates the incidence (all ages) of spinal cord neurological impairment (SCI; traumatic and non traumatic) in New Zealand and describes pre-SCI characteristics and early post-SCI outcomes for participants (16-64 years) in this longitudinal study. Demographic and clinical data on all people admitted to New Zealand's two spinal units (mid-2007 to mid-2009 )were included for the estimate of incidence. Participants in this longitudinal study were asked at first interview about pre-SCI socio-demographic, health and behavioural characteristics, and about post-SCI symptoms, general health status (EQ-5D) and disability (WHODAS 12-item). Age-adjusted incidence rates (95% CI) for European,Maori, Pacific and 'Other' ethnicities were 29 (24-34), 46 (30-64), 70 (40-100) and 16 (9-22) per million, respectively. Interviews with 118 (73%) participants (16-64 years), occurred 6.5 months post-SCI. Most reported bother with symptoms, and problems with health status and disability. Compared with Europeans, the incidence of SCI is high among Maori and particularly high among Pacific people. Six months after SCI, proximate to discharge from the spinal units, considerable symptomatic, general health and disability burden was borne by people with SCI. [ABSTRACT FROM AUTHOR]

roy d.e. & giddings l.s. (2012) The experiences of women (65-74 years) living with a long-term condition in the shadow of ageing. Journal of Advanced Nursing 68(1), 181-190. Abstract Aims. This paper reports on a study that explored experiences of women (65-74 years) as they grow older while living with a long-term condition. The phenomenon of focus was 'ageing with a long-term condition', rather than the experience of developing a long-term condition after reaching older adulthood. Background. People with long-term conditions are living into older age. There is limited literature on the nexus of ageing with a long-term condition. It is known that ageing shapes and is shaped by women's experiences of living with a long-term condition. Methods. In this interpretive descriptive study, nine women participated in a series of three focus groups held in 2007 and 2008. Transcripts were analysed thematically and participants given the opportunity to respond to the analysis. Findings. 'In the shadow of ageing' was the overarching theme. The women reported that although their long-term condition remained the referent point in their daily lives, for others including health professionals, the focus was on their appearance and the effects of older age. To overcome the back-grounding of their long-term condition, the women used 'strategies already-in-place'; it became 'just another thing to deal with'. Ageing, however, remained 'a privilege'. Conclusion. If health professionals focus on age and its concomitant effects, rather than a woman's long-term condition, they are at risk of delivering inappropriate care. They need to be prepared to advocate for the special needs of older women who live with a long-term condition and remain cognizant of the women's resourcefulness and expertise developed over time. [ABSTRACT FROM AUTHOR]

Nursing and midwifery are demanding professions. Efforts to understand the health consequences and workforce needs of these professions are urgently needed. Using a novel electronic approach, the Nurses and Midwives e-cohort Study (NMeS) aims to investigate longitudinally Australian and New Zealand nurses' and midwives' work/life balance and health. This paper describes NMeS participation; provides key baseline demographic, workforce and health indicators; compares these baseline descriptions with external norms; and assesses the feasibility of the electronic approach. From 1 April 2006 to 31 March 2008, nurses in Australia and New Zealand, and midwives in Australia were invited to participate. Potential participants were directed to a purpose-built NMeS Internet site, where study information was provided and consent sought. Once obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited. Overall, 7633 (2.3%) eligible nurses and midwives participated (6308 from Australia and 1325 from New Zealand) from a total pool of 334 400. Age, gender, occupational and health profiles were similar between countries and to national figures. However, some differences were noted; for instance, Queensland participants were over-represented, while Victorian and South Australian participants were under-represented, and 28.2% of Australians were in high strain positions compared with 18.8% of New Zealanders. Using an internationally novel web-based approach, a large cohort, which appears generally similar to population norms, has been established. Provided participant retention is adequate, the NMeS will provide insight into understanding the drivers of nurses' and midwives' workforce retention and work-related factors associated with their health. [ABSTRACT FROM AUTHOR]

Many nurses are burned out, exhausted and have a high intent to leave their jobs. These factors, when experienced over a period of time, are consistent with the development of mental illness. This study takes a collective autoethnographical approach to mental illness in the nursing workplace by focusing on the stories of nurses who have experienced mental illness in clinical practice. It highlights three ways in which nursing and mental illness are connected; the nurse who is vulnerable to mental illness prior to entering the profession, the nurse who develops mental illness that is independent of her work but is nevertheless impacted by it, and the nurse who develops mental illness as a result of her work and/or role. This paper explores the hyphenated lives and bullying these nurses experience, and recommends strategies that the profession, employing organisations, and individuals can adopt to reduce nurses' progression from stress to distress and mental illness. [ABSTRACT FROM AUTHOR]

The goal of this paper is to examine the incentives to vote insincerely, other than those created by rounding, faced by voters in systems of proportional representation (PR). We rigorously investigate two models of voter behaviour. The first model assumes that the voter is primarily interested in the distribution of seats in the post-election parliament (seat maximizer) while the second considers a voter who is concerned with the distribution of power in it (power maximizer). We show that under pure PR, seat maximizers do not have any incentives to manipulate, which justifies the Bowler and Lanoue (1992) claim, and that such incentives for seat maximizers appears with the introduction of a threshold. We show that, even in the absence of a threshold, there will always exist circumstances where a power maximizer would have an incentive to vote insincerely. We demonstrate that her incentives to make an insincere vote depends on her attitude toward uncertainty. The introduction of a threshold creates new and stronger opportunities for strategic voters regardless of their attitude toward uncertainty. Finally we discuss the overshooting/undershooting phenomenon, when either too many or too few like-minded voters attempt to manipulate. We use the two models to explain voters' behaviour at the 2005 New Zealand general election and demonstrate that rounding creates not only incentives but also disincentives for strategic voting. [ABSTRACT FROM AUTHOR]

Discrepancies between hospice service usage and cancer rates in Māori, the indigenous peoples of Aotearoa New Zealand, raise several questions. There have been numerous studies into these discrepancies highlighting issues regarding the appropriateness of care in hospice services in Aotearoa for Māori. This paper explores these issues, accentuating some gaps in the literature—such as intergenerational trauma—as well as ways that Pākehā psychotherapists (New Zealander psychotherapists of European descent) can biculturally engage with Māori. The author encourages psychotherapists to become allies by embracing a Māori‐centred approach to psychotherapy that brings both groups together as partners, while working through numerous post‐colonial issues. [ABSTRACT FROM AUTHOR]

Background: The New Zealand (NZ) government is to lift the ban on the sale of nicotine for use in electronic cigarettes (e-cigarettes). Methods: Using a naturalistic approach, we sought to understand how the current law was experienced by e-cigarette users (vapers). Twenty-nine vapers were interviewed by telephone, between May and September 2016, using a semi-structured interview schedule. Open-ended questions covered: initiating vaping, the experience of stopping smoking, technical problems encountered, reasons for vaping, acceptability of vaping, addiction to vaping and advice given to smokers about vaping. The audio recordings were transcribed and then independently coded using a general inductive thematic analysis. Results: This paper presents the main theme which was that vapers employed a range of reactionary strategies to the ban on the sale of nicotine e-liquid in NZ. These included lobbying government, spreading the word, establishing vaper support groups, helping people stop smoking by switching to vaping and advocating for e-cigarettes to be incorporated into smoking cessation practice. Conclusions: Vapers' experience and observations form a popular or lay epidemiology––one that identified that e-cigarettes were helping people stop smoking and could thus deliver public health benefits. Public health researchers and workers, and government fears about vaping, and proposals to strengthen restrictions contributed to the growth of the vaper community who reacted by forming self-help groups and providing alternative cessation support to smokers. For a significant switch from smoking to vaping to occur, the health sector needs to have a change of attitude towards vaping that is positive, and the public needs evidence-based information on vaping. A first step could be for the health sector to collaborate with the vaping community to reorient current tobacco control and cessation practice to encourage smokers to switch to less harmful smoke-free alternatives to smoking. [ABSTRACT FROM AUTHOR]