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Background: Written reflective practice (WRP) is a teaching tool used across speech–language therapy (SLT) clinical education programmes. The process aims to support the development of reflective skills required for the workplace (e.g., problem‐solving and self‐evaluation). Aims: This cross‐sectional and repeated‐measures study design investigated students' demonstration of breadth of WRP across the clinical education programme. Methods & Procedures: The participants were 77 undergraduate SLT students in their first, second or final professional year of the clinical programme. Participants wrote critical reflections following an interaction with a client/s as part of their clinical education experiences. Formative feedback was provided after each written reflection (WR). In total four WRs per participant were coded for breadth of WRP using a modification of Plack et al.'s coding schema from 2005. This was completed for each of the four time points across the academic year for each professional year. Outcomes & Results: There was a statistically significant association between time (i.e., professional year of the programme) and likelihood of demonstration of breadth of reflection for the lower level reflective element of 'attend' and higher level reflective element of 're‐evaluate'. A positive trend between time and likelihood of demonstration of breadth of reflection was seen for the lower level element of 'reflection‐for‐action'. Final‐professional‐year students exhibited significant enhancements in the higher level elements (e.g., 'premise') compared with first‐ and second‐professional‐year students. Conclusions & Implications: This group of SLT students exhibited significant change in breadth of WRP across the degree programme. This finding has positive implications for facilitating WRP with students and using the current coding framework in clinical programmes. What this paper adds: What is already known on this subject: WRP is one form of reflective practice (RP) used in SLT, allied health, medical and nursing clinical education programmes. Researchers have suggested that RP skills develop over time for students. Previously, studies examining WRP have focused on one off assessment of skill or over a timeframe of 6–10 weeks. Here, we examine SLT students' WRP skills across the degree programme. What this paper adds to existing knowledge: SLT students exhibited significant positive change in breadth of WRP across the degree programme as their clinical experience increased. Our results provide quantitative information in support of using RP as a learning tool throughout clinical education programmes for SLT. What are the potential or actual clinical implications of this work?: This study offers support for educators of SLT students; for example, how educators can assess WRP, and how educators can foster SLT student skill development with formative feedback and reflective questioning. This study also offers support for student SLT, for example, describing how WRP can be part of their individualized learning approach and provide a purposeful examination of self and clinical skill development. [ABSTRACT FROM AUTHOR]

In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as 'good' or 'excellent'; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice. [ABSTRACT FROM AUTHOR]

Background: Digital contact tracing (DCT) was a central component of the global response to containing COVID‐19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID‐19 are typically underrepresented. Methods: The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants. Results: Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID‐19 interventions. Conclusions: The findings highlight how addressing communication inequality can assist in the development of contact‐tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. Patient or Public Contribution: Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate whether childhood dental caries was associated with self‐reported general health in midlife. Methods: We used data on childhood oral health (caries experience) and adult self‐reported general health from two New Zealand longitudinal birth cohorts, the Dunedin Multidisciplinary Health and Development Study (n = 922 and n = 931 at ages 5 and 45 years, respectively), and the Christchurch Health and Development Study (n = 1048 and n = 904 at ages 5 and 40 years, respectively). We used generalized estimating equations to examine associations between age‐5 dental caries and self‐rated general health and the number of self‐reported physical health conditions at ages 45/40 (diagnosed by a doctor or health professional, n = 14 conditions among both cohorts). Covariates included known risk factors for poor health (SES, IQ, perinatal complications), and personality style, which is known to affect subjective health ratings. Results: Incidence rate ratios for 'Excellent' self‐rated health were lower among those who had high experience of dental caries as children than those who had not in both, the Dunedin (IRR, 0.76; 95% CI, 0.50, 1.14) and Christchurch studies (IRR, 0.69; 95% CI, 0.47, 1.00). Childhood dental caries was not associated with the number of self‐reported physical health conditions in midlife, in either cohort. Dunedin Study members who at age 5 were not caries‐free or whose parents rated their own or their child's oral health as poor were less likely to report 'Excellent' self‐rated general health at age 45 than those who were caries‐free and whose parents did not give a 'poor' rating (IRR, 0.69; 95% CI, 0.49, 0.97). Conclusions: Five‐year‐olds with greater caries experience were more likely to have poorer self‐rated general health by midlife. Beyond this longitudinal association, future research should examine whether childhood dental caries is associated with objective/biological markers of physical health and whether it may have utility as an early indicator for poor general health in adulthood. [ABSTRACT FROM AUTHOR]

Background: Little is known about experiences and barriers for trans and non‐binary (TGNB) people eligible for cervical screening in Aotearoa New Zealand. Aims: To identify uptake, barriers and reasons for delaying cervical cancer screening among TGNB people in Aotearoa. Materials and Methods: The 2018 Counting Ourselves data on TGNB people assigned female at birth aged 20–69 years who had ever had sex, were analysed to report on experiences of those who were eligible for cervical screening (n = 318). Participants answered questions about whether they had taken part in cervical screening and reasons behind any delays in receiving the test. Results: Trans men were more likely than non‐binary participants to report that they did not require cervical screening or were unsure if they needed it. For those who had delayed cervical screening, 30% did so due to feeling worried about how they would be treated as a trans or non‐binary person and 35% due to another reason. Other reasons for delay related to general and gender‐related discomfort, previous traumatic experiences, anxiety or fear of the test and pain. Material barriers to access included cost and lack of information. Conclusions: The current cervical screening program in Aotearoa does not consider the needs of TGNB people, leading to delayed and reduced uptake of cervical screening. Health providers require education on the reasons TGNB people delay or avoid cervical screening in order to provide appropriate information and affirmative healthcare environments. The human papillomavirus self‐swab may address some of the existing barriers. [ABSTRACT FROM AUTHOR]

Objectives: To compare periodontitis prevalence estimates obtained using the new classification system with those generated using other case definitions from the literature, examine the strength of the association between tobacco smoking and periodontitis (and that between periodontitis and its impact on oral‐health‐related quality of life; OHRQoL) using those definitions. Methods: We conducted a secondary analysis of data from the 2009 New Zealand Oral Health Survey, a cross‐sectional dental examination survey of a representative sample of people aged 18 or over. We identified cases using 10 different periodontitis case definitions and then compared weighted prevalence estimates across those. The associations between smoking and periodontitis, and between periodontitis and short‐form Oral Health Impact Profile (OHIP‐14) scores, were then compared across the various case definitions. Results: There was considerable variation in periodontitis prevalence estimates (range 3% to 59%). All definitions (but one) showed a higher prevalence of periodontitis in smokers than in non‐smokers. The new classification stage III definition showed the strongest association, with an adjusted prevalence ratio of 1.99 (95%CI: 1.35, 2.91). All case definitions (but one) had a higher mean OHIP‐14 score among people with periodontitis. Conclusions: Periodontitis prevalence estimates are greatly influenced by case definition choice. The new classification system may be more accurate than any other used to date, but questions remain about its utility for periodontal epidemiology. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prevalence of halitosis in young adults. Methods: Young adults (n = 372; mean age = 21.0 ± 2.6 years old, range = 18–30 years) in Dunedin, New Zealand, were recruited into the cross sectional study after providing informed consent. The prevalence of halitosis was determined using both objective measurements (parts per billion [ppb] volatile sulphur compounds [VSCs] in the exhaled air) and subjective measurements (self‐reported halitosis questionnaire, tongue coating index, and organoleptic assessment). Results: Volatile sulphur compounds measurements indicated that the prevalence of halitosis (values ≥140 ppb) was 31.2%; 25.6% of participants self‐reported halitosis. The organoleptic assessment revealed that 14.3% of the participants had a score of ≥2. A positive correlation was found between the VSC measurements and organoleptic assessment (p < 0.05). No significant relationship was found between self‐reported halitosis and either organoleptic assessment or VSC measurements. Self‐reported dry mouth, smoking, oral hygiene index, DMFT index, and tongue coating score were significantly associated with the organoleptic assessment (p < 0.05). The self‐reported dry mouth, mouth breathing and tongue coating score were significantly associated with the VSC scores (p < 0.05). Conclusion: Halitosis, as represented by VSC, was found in 31.2% of the participants. VSC scores and organoleptic assessment were positively correlated. There was no significant relationship between self‐reported halitosis and either organoleptic assessment or VSC measurements. [ABSTRACT FROM AUTHOR]

Introduction: It is well established that rural workforce outcomes are more likely among medical graduates who spend time training in non‐urban areas; however, fewer studies have assessed whether graduates are more likely to return to the specific area where they undertook rural training. Objective: This study aimed to determine whether graduates who had undertaken a regional–rural immersion program in Northland, NZ, were more likely to have returned to work in Northland as of mid‐2021, relative to peers who did not participate. Design: This prospective cohort study used longitudinal tracking survey responses, medical school administrative data and workforce outcome information. A multinomial model, accounting for other covariates, was built to determine the association between graduates practising in Northland (population ⟨ 100 000), which encompasses both rural (population ⟨ 25 000) and regional (25 000 ⟩ population ⟨ 100 000) areas, and having participated in a Northland‐based immersion program during medical school. The study population was University of Auckland domestic medical students graduating between 2009 and 2018, inclusive. Immersion program participants who responded to longitudinal career tracking surveys were included in the study sample. Findings The final sample size was 1320 students (80% of population of interest). Graduates who undertook the Northland immersion program (n = 169) were more likely than non‐participants (n = 1151) to be working in Northland as of 2020–2021 (relative risk: 3.2). Discussion and Conclusion: Regional–rural immersion programs might preferentially build workforces in that specific region; however, further research is required to understand whether these findings are generalizable, and the main reasons for this effect. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Background: Blended teaching combines traditional in‐person components (simulation‐based training and clinical‐based placement) with online resources. Due to the COVID‐19 pandemic, we modified our Women's Health Interprofessional Learning through Simulation (WHIPLS) program – to develop core obstetric and gynaecological skills – into a blended teaching program. There is limited literature reporting the observations of blended teaching on learning. Aims: To qualitatively evaluate the blended teaching program and explore how it contributes to learning. Materials and Methods: This study was performed at Monash University in Melbourne, Australia. A total of 98 medical students and 39 midwifery students participated. Data were collected by written survey and analysed by authors using a thematic analysis framework. Results: Students reported that in‐person teaching remains a vital aspect of their curriculum, contributing an averaged 63.2% toward an individual's learning, compared with online. Five substantial themes demonstrate how students learnt and maximised education opportunities using a blended teaching program: 'low‐pressure simulation environments', 'peer‐assisted learning', 'haptic learning', 'scaffolded learning' and 'the impact of online discourse'. Discussion: In‐person teaching remains a cornerstone of obstetric and gynaecological clinical skills education, of which interprofessional simulation and clinical‐based placement are key components. Teaching via online discourse alone, is not sufficient to completely replace and provide comparable learning outcomes, but certainly plays an important role to prime students' learning and to maximise in‐person opportunities and resources. Our study reveals key pedagogies of a blended (online and in‐person) learning program, providing further evidence to support its ongoing utility as a feasible and warranted approach to learning. [ABSTRACT FROM AUTHOR]

This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate‐to‐vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free‐text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate‐to‐vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate‐to‐vigorous physical activity. Work‐related physical activities were higher for those working in the inpatient area than in community settings. Transport‐related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity. [ABSTRACT FROM AUTHOR]

Background: Suboptimal endometrial receptivity is a key factor behind in vitro fertilisation (IVF) implantation failure. Direct clinical tests of the endometrium of natural killer (NK) cells and endometrial receptivity analysis (ERA) are controversial. Aims: To examine the current practice of endometrial receptivity tests (NK cells and ERA) and immunological treatments (corticosteroids, anticoagulants, antiplatelets, intravenous immunoglobulin, Intralipid, other) among fertility specialists in Australia and New Zealand. Methods: A prospective 23‐item web‐based survey was distributed by email via the Fertility Society of Australia and New Zealand, between August and October 2020. Data were collected and analysed using Qualtrics. Results: Of 238 fertility specialists, 90 completed the survey (response rate 37.8%). ERA (48/90, 53.3%) was most commonly ordered, followed by uterine NK (uNK) (36/90, 40.0%) and peripheral blood NK (pNK) (12/90, 13.3%). For all tests, the most common indication was recurrent implantation failure (RIF) (41/48, 22/36, 6/12; 85.4%, 61.1%, and 50.0%, respectively for ERA, uNK and pNK). Of those that did not offer these tests, the main reason cited was insufficient evidence (30/42, 47/54, 68/78; 71.4%, 87.0%, and 87.0%). A third of specialists offered empirical immunological treatment for RIF (30/90, 33.3%): anticoagulants (28/30, 93.3%), antiplatelets (27/30, 90.0%), and corticosteroids (25/30; 83.3%). The majority of specialists (56/90, 62.2%) stated they had refused a patient request for endometrial testing or treatment. Conclusions: Tests for presumed endometrial receptivity pathology are often used in Australia and New Zealand. Immunological treatments for RIF are commonly employed empirically, without strong evidence of their effectiveness or safety. Further studies should focus on education and clinical adherence to evidence‐based guidelines. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to identify to what extent the sentinel lymph node (SLN) technique is utilised by gynaecological oncologists in Australia and New Zealand, identifying the techniques used, any barriers to uptake, and management of isolated tumour cells (ITCs) and micrometastases. Materials and methods: We conducted an online survey of all practising gynaecological oncologists in Australia and New Zealand. They were asked whether they utilised SLN biopsy and in what circumstances, how they managed non‐mapping and how their multidisciplinary team managed small volume disease. Those who did not were asked to identify their concerns with the procedure, reasons for non‐uptake and their alternate technique. Results: We surveyed 63 gynaecological oncologists of whom 59 were practising, and 48 (81%) responded. Six members (11%) do not utilise SLN biopsy, and 42 (89%) do. Areas where clinicians differ in practice are those areas that are most controversial and include the use of SLN biopsy in complex atypical hyperplasia, the management of ITCs and micrometastases and procedures on unilateral or bilateral non‐mapping. Those who do not utilise the technique cite concerns about the false‐negative rate, equipment and training issues. Conclusions: The utilisation of SLN biopsy in endometrial cancer is well established in Australia and New Zealand, with similar practices and concerns to those of other international groups. [ABSTRACT FROM AUTHOR]

We present the results of a study examining adolescent help‐seeking intentions (HSIs), stress, subjective school achievement and life satisfaction. Using a cross‐sectional design with a sample of New Zealand adolescents (n = 1601), we tested whether HSIs could mediate or moderate relations between stress and subjective achievement, and between stress and life satisfaction. We inspected these dynamics alongside different help sources (informal and formal) and domains where stress might be experienced (school and personal). Using mediation testing, findings suggest that informal HSIs have at least some influence on the relations between stress and well‐being indicators, whereas formal HSIs did not. Conditional indirect effects for the mediation models (moderated mediation) revealed that gender and age did not moderate the relations between stress and informal HSIs, or between stress and well‐being indicators with one exception: gender moderated the relation between personal stress and informal HSIs. In most models, tests of moderation lent support for a protective‐reactive model in which HSIs reduce the adverse effects of stress on well‐being indicators. Discussion focuses on modelling and promoting help‐seeking activities across diverse support sources, and doing so earlier in life so that adolescents can benefit from well‐honed coping strategies. [ABSTRACT FROM AUTHOR]