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Objective: The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment. Background: Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region. Methods: Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs. Results: Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a "benefits realization" process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur. Conclusions: The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design. [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]

The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns' lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that extend beyond the household). This Kaupapa Māori (by Māori, for Māori) qualitative study aimed to explore the views of health practitioners identified as champions by whānau of preterm Māori infants. Ten health practitioners were interviewed and asked about their involvement with the whānau, their role in explanations and communication, and their thoughts on whānau coping. Interview data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: working together in partnership, a problem shared is a problem halved, and sacred space. Collaboration between health practitioners and with whānau was important to the champions and central to their goal of enabling whānau autonomy. This was built on a foundation of connectivity, relationships, and a full appreciation that childbirth is a sacred time that is potentially disrupted when an infant is born prematurely. The values- and relationship-based practices of these champions protected and uplifted whānau. They showed that health practitioners have important roles in both the elimination of inequities and the sustaining of Māori self-determination. This championship is an exemplar of what culturally safe care looks like in day-to-day practice with Māori and is a standard that other health practitioners should be held to. [ABSTRACT FROM AUTHOR]

Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support this work by familiarising themselves with te reo Māori (the Māori language) and respecting cultural care customs. However, achieving culturally safe end-of-life care necessitates fundamental structural change and shared decision-making. Conclusions: Our findings indicate that efforts to support equitable palliative care for Indigenous people should recognise, and support, the existing efforts of health practitioners from these communities. Colleagues from non-Indigenous populations can support this work in a range of ways. Cultural safety must be appropriately resourced and embedded within health systems if aspirations of equitable palliative and end-of-life care are to be realised. [ABSTRACT FROM AUTHOR]

Introduction: Across the world, mathematical expressions are represented very differently in braille. The aim of this study was (1) to gain an overall insight in mathematical braille notations and (2) to investigate how mathematical braille notations support braille readers in reading and comprehending mathematical expressions. Method: Twenty teachers from sixteen countries (thirteen European Union, EU, and three non-EU) were asked to transform 21 mathematical expressions and equations into the mathematical braille notation currently used by their braille readers. Three mathematical expressions were selected, and the transformed expressions in the different braille notations were qualitatively compared at braille and mathematical structure level. Results: The results illustrated that most mathematical braille notations use mathematical structures that either support braille readers in getting an overview of an expression—for example, by announcing the start and end of a fraction—or facilitate communication between braille readers and people who can see. Discussion: The method of comparing transformed expressions at structure level can be extended to other types of mathematical expressions and other mathematical braille notations. Agreement on the structure of different mathematical expressions can be a first step towards a universal mathematical braille notation. Implications for Practitioners: Mathematics teachers should be aware of and use the strengths of the mathematical braille notation and try to compensate for weaknesses of the notation in the support of braille readers. [ABSTRACT FROM AUTHOR]

Introduction: Evaluating how therapeutic horse riding improves health for children experiencing disability is made complex by a lack of clarity around mechanisms of treatment effect. This research develops an explanatory theory outlining how health outcomes may be optimised, by exploring what works for which riders, under what conditions and how. Method: Within a realist research framework, we undertook three phases of study using a mix of qualitative and quantitative data collection and analysis approaches. Findings were then integrated into an overall evaluative account. Results: Riders with a range of impairments (n = 32; aged 5 to 17 years), caregivers (n = 29) and therapeutic horse riding providers (n = 16) participated. Three key mechanisms of intervention effect are proposed: (1) therapeutic horse riding facilitates development of a rider's self-concept through opportunities for accessible, meaningful participation; (2) the context in which therapeutic horse riding is provided promotes a focus on riders' capacities and strengths and (3) therapeutic horse riding provides opportunities for a broad range of learning experiences. Conclusion: Therapeutic horse riding provides opportunities for meaningful occupational participation for children experiencing disability. Ensuring that the physical and ideological context in which therapeutic horse riding is provided focuses on a rider's capacities and strengths will enhance self-concept development and participation outcomes. [ABSTRACT FROM AUTHOR]

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

Although in vitro fertilization (IVF) has offered hope to those struggling with infertility, it has also had some unintended consequences, including the fate of embryos that may be “surplus” to requirement following IVF treatment. The number of embryos in storage across the world is high, creating a dilemma for patients who need to make disposal decisions, as well as presenting an administrative and practical dilemma for clinics. Research has suggested that patients’ views of the status of their embryo/s may affect their disposal decisions, and yet the nature of the links between views of the embryo and decisions to either donate or discard remain unclear. In this article, we engage in a discursive analysis of literature on disposal decisions. We discuss the range of ways in which embryos may be constructed, and demonstrate how these discourses make available or constrain particular action possibilities, and offer particular subject positions for patients. The analysis highlights the complexity of the relationship between embryo status and decision making, and may assist clinicians in supporting and guiding patients’ decisions. [ABSTRACT FROM AUTHOR]

In New Zealand, embryo donation (ED) is “open,” allowing offspring to access genetic information. Donors and recipients meet prior to donation. Drawing on interviews with 15 recipients, 22 donors, and nine counselors, this article discusses how ED may be constructed as a form of gifting. This discourse may evoke expectations that recipients will express gratitude for the gift, including through honoring contact agreements. Donation becomes a relational practice of obligations and counter-obligations. However, the gift discourse may not adequately capture the emotional sacrifice experienced by donors. Donors describe significant attachment to their embryos, ambiguity about relinquishment, and interest in offsprings’ welfare. Furthermore, embryos may be constructed as inalienable bodily gifts resulting in children with whom the donors share immutable social ties. A discourse of ED as mutual exchange, collaboration, and extended family building may be more useful to donors and recipients in managing ED. [ABSTRACT FROM AUTHOR]

The article presents information on the economic costs of health service provision for people with palliative care needs. Topics discussed include direct and indirect costs incurred by caregiving, increase of costs in palliative care, and influence of costs of caring on wider family and network. Also being discussed is the inadequate cost and care-support systems.