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Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

In 2014, New Zealand enacted the Fisheries (Foreign Charter Vessels and Other Matters) Amendment Act in response to ongoing labour abuses on board South Korean vessels in New Zealand's foreign charter vessel sector. Importantly, the legislation expresses the universality of the International Labour Organization's Decent Work Agenda: all member countries must pursue policies based on the strategic objectives of equality, dignity, safe working conditions and that workers are protected from exploitation. The Act was in response to the identification of widespread labour abuses in this sector. In June 2011, the extent of the abuses came to light when 32 Indonesian crewmen of the Oyang 75 walked off their vessel. In this paper, we explore how a range of stakeholders worked organically to bring about change. We do this qualitatively by combining semi-structured interview (with over 160 Indonesian migrant crewmen between 2011 and 2017), observation and document analysis. We analyse our data through the lens of participatory action research which provides a framework to document the processes of who was involved, the cycles of change, what was achieved in each cycle, and importantly the platform for change. Specifically, we look at how stakeholders – the crew themselves, their advocates, academics, non-governmental organisations, journalists, activists, among others – all played a part in achieving legislated protections. [ABSTRACT FROM AUTHOR]

The fathers’ rights movement is a worldwide phenomenon that takes a particular form in our geopolitical region. Responding initially to an apparent judicial preference for mothers to have custody of children, the movement grew alongside, and in resistance to, the women’s movement. In this paper, we analyse how texts of fathers’ rights discourse strategically appropriate egalitarianism in the context of gendered struggles over rights within the nuclear family. Texts from four fathers’ rights websites are engaged to locate, construct and critique the discursive power of the movement in Aotearoa/New Zealand. We discuss examples of strategies that appropriate egalitarianism, engage quantifying logic, and demonise women and argue how the fathers’ rights sites exemplify resistance to the impact of the women’s movement on Family Court and criminal justice interventions into violence against women at home. [ABSTRACT FROM PUBLISHER]

How intimate partner violence (IPV) is conceptualized affects what we see when we look at situations involving IPV and what we think the solutions to the problem of IPV are—either in individual cases or in the development of broader legal and policy responses. In this article, it is suggested that while conceptualizing IPV as coercive control is an improvement over previous understandings, it does not go far enough. Coercive control must be located within a broader conceptualization of IPV as a form of social and systemic entrapment if it is not to operate in a harmful manner for victim-survivors. [ABSTRACT FROM AUTHOR]

Objectives: Aotearoa New Zealand has demonstrable maternal and perinatal health inequity. We examined the relationships between adverse outcomes in a total population sample of births and a range of social determinant variables representing barriers to equity. Methods: Using the Statistics New Zealand Integrated Data Infrastructure suite of linked administrative data sets, adverse maternal and perinatal outcomes (mortality and severe morbidity) were linked to socio-economic and health variables for 97% of births in New Zealand between 2003 and 2018 (~970,000 births). Variables included housing, economic, health, crime and family circumstances. Logistic regression examined the relationships between adverse outcomes and social determinants, adjusting for demographics (socio-economic deprivation, education, parity, age, rural/urban residence and ethnicity). Results: Māori (adjusted odds ratio=1.21, 95% confidence interval=1.18–1.23) and Asian women (adjusted odds ratio 1.39, 95% confidence interval=1.36–1.43) had poorer maternal or perinatal outcomes compared to New Zealand European/European women. High use of emergency department (adjusted odds ratio=2.68, 95% confidence interval=2.53–2.84), disability (adjusted odds ratio=1.98, 95% confidence interval=1.83–2.14) and lack of engagement with maternity care (adjusted odds ratio=1.89, 95% confidence interval=1.84–1.95) had the strongest relationship with poor outcomes. Conclusion: Maternal health inequity was strongly associated with a range of socio-economic and health determinants. While some of these factors can be targeted for interventions, the study highlights larger structural and systemic issues that affect maternal and perinatal health. [ABSTRACT FROM AUTHOR]

Waka ama is unique as a sport because, as well as the physical benefits for paddlers, it also creates opportunities for participants to experience and connect with the natural environment. This research draws on interviews with waka ama paddlers in Aotearoa New Zealand to illustrate how the well-being of the environment connects to the spiritual, cultural, and physical health of people. Results highlight the multifaceted benefits of participating in waka ama. As well as the physical benefits for paddlers, waka ama also has a strong tikanga, which encourages language revitalization with the use of te reo Māori through karakia, waiata, and the general terms used associated with waka. It also creates opportunities for participants to experience and connect with the natural environment and improve their health. The knowledge gained from participants provide evidence of effective ways to improve health and well-being within communities with a particular focus on waiora, the spiritual connection between hauora and the environment. [ABSTRACT FROM AUTHOR]

Background: Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. Aim: The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. Design: A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. Setting/participants: Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were 'extremely' or 'very' satisfied with a public hospital admission their older relative experienced in their last 3 months of life. Results: Participants' accounts of good care aligned with Dewar and Nolan's relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. Conclusion: We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff. [ABSTRACT FROM AUTHOR]

Background: The acute hospital plays a significant role in caring for people with a life-limiting illness. Most research to date has focused exclusively upon the negative aspects of hospitalisation. Currently, there is little known about the benefits of hospital admissions for patients with palliative care needs. Aim: The aim of this study was to explore the benefits of hospital admissions, from the perspectives of patients with palliative care needs. Design: A qualitative study design was adopted. Longitudinal, semi-structured, face-to-face interviews were used to elicit the views of patients admitted to hospital in one large urban acute hospital in New Zealand. Setting/participants: The study sample comprised 14 patients admitted to Auckland City Hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need. Results: Through a process of thematic analysis, four themes were identified from the data: being cared for and feeling safe, receiving care to manage at home, relief for family and ‘feeling better and/or getting better’. The benefits of being in hospital were reported to extend beyond treatments received. Most participants reported their preference was to come to hospital even if they had been able to access the care they received in hospital at home. Conclusion: This research contributes to a greater understanding of the benefits associated with hospitalisation for patients with palliative care needs. The findings suggest that such benefits extend beyond the treatment patients receive and challenge current assumptions regarding the role of the acute hospital in palliative care. [ABSTRACT FROM AUTHOR]