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New public health approaches to palliative care highlight the role of communities in care, yet there is little evidence of studies on community-led initiatives in the palliative care context. Therefore, the aim of this study, which took place in Auckland, New Zealand, was to (1) explore Pacific family carers' views on what they need to feel supported as they care for older family members at the end of life and (2) to devise a resource that reflects their views that may be used to raise community awareness about these needs. This was achieved using a Participatory Action Research (PAR) framework in which a focus group was carried out and a work group formed to implement the focus group's recommendations that were informed by a thematic analysis of the focus group data. The analysis resulted in the foregrounding of four themes, with the focus of this paper being on the 4th theme, the centrality of spirituality for a group of Pacific caregivers. This emphasis was chosen due to it being an underexplored topic in the palliative care literature. Co-creating resources based on research with community members allows for the development of tailored approaches of significance to that community, in this instance, a music video. [ABSTRACT FROM AUTHOR]

Senior medical students at the University of Auckland, New Zealand spend most of their learning time in clinical attachments. Experiential apprentice-style training is traditionally recognised as an important aspect of obtaining competency. In March 2020 they were stood down from their general practice placements in the context of a national response to the COVID-19 pandemic. Acute conversion of their general practice education from experiential clinical exposure to online and offsite learning was required. This paper describes the steps taken and the underlying theoretical foundations for our expediently developed online course. Our online learning programme has three online components, reflecting the domains of educational environment theory: asynchronous discussion forums; a symposium facilitating social interactions and teacher presence, and a portfolio facilitating personal goal aspects. The latter is underpinned by a multi-theories model of adult learning, built upon the scaffolding framework that supports our entire medical curriculum. Within this theory, we propose a five-stage model of learning. Learning from this experience contributes to the body of knowledge around online education, particularly in meeting the needs of a clinical attachment traditionally grounded in experiential learning. It is hoped that the mechanisms described here might be useful to other educators facing similar challenges. [ABSTRACT FROM AUTHOR]

A literature search reveals minimal New Zealand and international research during the past 20 years with a specific focus on young bisexual women at school. This study addresses this paucity through acknowledgement of young bisexual women aged between 16 and 24 years and their experiences of being bisexual at secondary school in New Zealand. The study focuses on ways in which young bisexual women experience and negotiate teacher and student attitudes and practices in health classes that include sexuality education. A specific practice frames evidence from these experiences, this being societal misrecognition of the nature of bisexuality, or bisexual misrecognition. Bisexual theory and feminist qualitative methodology provide the study with a foundation for data gathering through focus groups, reflective journals and individual interviews with participants. Thematic analysis was applied to participants' responses, exposing their experiences at school of bi-misogyny and the ways in which their bisexuality is misrecognised and erased. Based on young bisexual women's narratives of their experiences in health education and sexuality education in New Zealand secondary schools, the study adds to the body of knowledge about this silenced minority. [ABSTRACT FROM AUTHOR]

Bronchiectasis is a chronic respiratory disease that impacts significantly on quality of life for those who have it. There is a paucity of literature exploring the perspectives of children and young people. The aim of this study was to examine the day-to-day life experience of a group of young people with bronchiectasis. A qualitative study using semi-structured interviews explored fifteen young people's perspectives of life with bronchiectasis. Key themes were identified using an inductive iterative approach through constant comparative analysis guided by Thorne's interpretive description. Life with bronchiectasis was conceptualized by participants as "Pretty Normal". This consisted of two co-existing life views which represented how young people balanced the ups and downs of adolescence while learning to accommodate the demands of living with bronchiectasis. Three key thematic elements "sore and tired", 'life interrupted and "looking after self", influenced and challenged these two views of life. Young people with bronchiectasis portray life as being the same as their peers. Despite this, they recognized that the symptoms, interruptions, and self-management responsibilities led them to find ways of coping and integrating their experience into a new and modified view of normal. [ABSTRACT FROM AUTHOR]

Background: Aphasia services are currently faced by increasing evidence for therapy of greater intensity and comprehensiveness. Intensive Comprehensive Aphasia Programs (ICAPs) combine these elements in an evidence-based, time-limited group program. The incorporation of new service delivery models in routine clinical practice is, however, likely to pose challenges for both the service provider and administering clinicians. This program of research aims to identify these challenges from the perspective of aphasia clinicians from six countries and will seek to trial potential solutions. Continual advancements in global communication technologies suggest that solutions will be easily shared and accessed across multiple countries. Aims: To identify the perceived and experienced barriers and facilitators to the implementation of 1) intensive aphasia services, 2) comprehensive aphasia services, and 3) ICAPs, from aphasia clinicians across six countries. Methods and procedures: A qualitative enquiry approach included data from six focus groups (n = 34 participants) in Australia, New Zealand, Canada, United States of America (USA), United Kingdom (UK), and Ireland. A thematic analysis of focus group data was informed by the Theoretical Domains Framework (TDF). Outcomes and results: Five prominent theoretical domains from the TDF influenced the implementation of all three aphasia service types across participating countries: environmental context and resources, beliefs about consequences, social/professional role and identity, skills, and knowledge. Four overarching themes assisted the identification and explanation of the key barriers and facilitators: 1. Collaboration, joint initiatives and partnerships, 2. Advocacy, the promotion of aphasia services and evidence-based practice, 3. Innovation, the ability to problem solve challenges, and 4. Culture, the influence of underlying values. Conclusions: The results of this study will inform the development of a theoretically informed intervention to improve health services' adherence to aphasia best practice recommendations. [ABSTRACT FROM AUTHOR]

The nature of sex/ualities, genders and schooling has changed considerably over the last 20 years, with global political, social and cultural shifts bringing the lives of queer youth to the fore. Trans youth are now more visible and various kinds of support groups in schools (such as diversity support groups, queer groups and gay-straight alliances) have emerged. This article reports on a critical ethnographic study conducted with queer youth in a co-educational secondary school in Auckland, Aotearoa/New Zealand. The focus of the research was on exploring how LGBTQ students actively negotiate their identities in school. A particular issue of interest was how gendered pronouns (s/he, him, her) are used (both in and outside of schools). We consider how the naming of pronouns both disrupts the articulation between sex, gender and sexuality and also reinforces stable gender identities and binaries. This opens up new possibilities for the trans students to identify but also works to reinforce hierarchies and power relations. We employ the theoretical tools of Foucault (power and resistance) and Butler (the heterosexual matrix, intelligible subjects and performativity) to conceptualise and interpret the power relations evident in trans students' experiences of using gender pronouns. [ABSTRACT FROM AUTHOR]

Problem: The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students.Intervention: In this article we explore the utility of Etienne Wenger's “communities of practice” (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform.Context: The Network operates across all medical schools in Australia and New Zealand.Outcome: Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students.Lessons Learned: By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity. [ABSTRACT FROM PUBLISHER]

Background: Benchmarking among medical schools is essential, but may result in unwanted effects. Aim: To apply a conceptual framework to selected benchmarking activities of medical schools. Methods: We present an analogy between the effects of assessment on student learning and the effects of benchmarking on medical school educational activities. A framework by which benchmarking can be evaluated was developed and applied to key current benchmarking activities in Australia and New Zealand. Results: The analogy generated a conceptual framework that tested five questions to be considered in relation to benchmarking: what is the purpose? what are the attributes of value? what are the best tools to assess the attributes of value? what happens to the results? and, what is the likely 'institutional impact' of the results? If the activities were compared against a blueprint of desirable medical graduate outcomes, notable omissions would emerge. Conclusion: Medical schools should benchmark their performance on a range of educational activities to ensure quality improvement and to assure stakeholders that standards are being met. Although benchmarking potentially has positive benefits, it could also result in perverse incentives with unforeseen and detrimental effects on learning if it is undertaken using only a few selected assessment tools. [ABSTRACT FROM AUTHOR]

This article critically analyses the discourse of consumer choice embedded in health communication interactions between maternity-care providers and migrant ethnic Chinese mothers in New Zealand. Findings indicate that Chinese mothers, as the customers of the New Zealand maternity and health care services, are encouraged to “fit in” with the Western discourse of choice. However, the mothers’ cultural predispositions for childbirth and communication have a significant impact on the ways in which they respond to and resist this discourse. Drawing on theoretical insights from postcolonialism and Third World feminism, this article contributes to the study of intercultural health communication by examining cultural dilemmas in the discourse of choice that is often taken for granted in Western health contexts. In doing so, it builds a platform for an inclusive maternity care and health environment in multicultural societies. [ABSTRACT FROM AUTHOR]

Colonization has resulted in Maori occupying a vulnerable position in New Zealand society. Comparatively poor health, along with complex social and economic problems, is a reflection of this fundamental insecurity. This article aims to put forward a historical and developmental perspective for understanding some of the current health disparities experienced by Maori, by exploring the concepts of historical trauma, loss of land, and alternative theories of development from post-development theory. [ABSTRACT FROM AUTHOR]