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Objective This paper presents the first Naturalistic Decision Making model of prehospital resuscitation decision‐making, which has clear implications for education, practice and support. Methods: A mixed‐methods exploratory sequential research design consisting of interviews with ambulance personnel (study 1), focus groups with ambulance educators, managers and peer supporters (study 2), and an online survey of graduating paramedic students (study 3). This paper reports the model developed from integrated findings, across all three studies. All research was undertaken in New Zealand and underpinned by a critical realist worldview. Results: The Prehospital Resuscitation Decision Making model identifies key processes, challenges and facilitators before, during and after ambulance personnel attend a cardiac arrest event. It is the only descriptive model of resuscitation decision making which acknowledges the decision‐maker, non‐prognostic factors and the importance of adequate preparation and support. Conclusions: This research project is the first to comprehensively explore and model ambulance personnel perspectives on decisions to start, continue or stop resuscitation. The decision‐making process is complex and difficult to simply formularise. Education and supports must assist ambulance personnel in navigating this complexity. Where resuscitation is withheld or terminated, ambulance personnel need to feel confident that they can effectively provide after‐death care. [ABSTRACT FROM AUTHOR]

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]

Examining the concepts underpinning the reasoning processes of social worker's decision‐making provides important insights into how social work practice is undertaken. This paper examines one of the major discourses used by social workers in decision reasoning in a non‐governmental organization child protection context in Aotearoa/New Zealand: family maintenance. This study found that family maintenance as a concept was strongly privileged by social workers. This resulted in attempts to preserve families and created a hierarchy of preferred decision outcomes. A preference for family maintenance was supported by legal, moral, psychological and Māori cultural concepts. This pattern of constructs underpinned the ‘weighing up of harms’ when considering removal, and generally reflected a child welfare orientation. In addition to this, it was found that ‘family’ was broadly defined, and could include people who had a relationship with the children, or Māori definitions of extended family, in addition to legal ones. [ABSTRACT FROM AUTHOR]

Background Commercial surrogacy is prohibited in New Zealand by the Human Assisted Reproductive Technology Act 2004 ( HART Act). However, altruistic clinic-assisted surrogacy is permitted. Couples wishing to attempt altruistic surrogacy must apply for approval to a statutorily appointed ethics committee. One of seven principles that underpin the HART Act stipulates that the needs, values and beliefs of Maori ( NZ's indigenous population) should be considered and treated with respect. Aim This paper reviews the outcomes of surrogacy applications since the HART Act was established and the uptake of surrogacy by Maori. Methods The authors examined the demographic data provided to the ethics committee by way of surrogacy applications and the outcome data provided by fertility clinics. This paper reviews the outcomes for surrogacy applications: the number accepted/declined, the number of live births, those applications discontinued and uptake by Maori. Results Of 104 applications for surrogacy between 2005 and 2010, 4 (3.8%) were declined. By July 2011, of 100 approved, there have been 26 (26%) live births; 52 (52%) were discontinued, and 22 (22%) remain ongoing. Maori are much less likely to utilise surrogacy. Of the 104 original applications, 9 (8.6%) Maori women were willing to act as a surrogate, and 2 (1.9%) were intended mothers. 7 (6.7%) Maori were partners of a surrogate, with 2 (1.9%) intending mothers having Maori partners. Conclusions The process of surrogacy applications is comprehensive and robust, resulting in few being declined. Further research is required to discover why applications are discontinued and why, despite explicit attempts to meet the needs of Maori, few utilise surrogacy. [ABSTRACT FROM AUTHOR]

The significant health disparities experienced by people with mental illness indicate the need for mental health service improvement. This qualitative study explored family and whānau ( Māori family group) perspectives of smoke-free mental health services. Thematic analysis found that family and whānau identified a number of barriers to the implementation of successful smoke-free policy, including lack of coordination and consistency, and limited, if any, family and whānau inclusion. Family and whānau discussed smoking as a strategy for coping with anxiety and boredom; therefore, the need for other activities and strategies to replace smoking was identified as necessary in effective service delivery. The attitude that mental health service policy should be different from general health policy, due to the experience of mental distress, was also identified. In this paper, we argue that the development and implementation of quality mental health services would be strengthened by involving family and whānau in smoke-free initiatives. Furthermore, the provision of relevant information to family, whānau, and service users would help dispel myths and stigma associated with tobacco and mental health. [ABSTRACT FROM AUTHOR]

Over the past two decades, engaging families in decision-making has grown in popularity across child welfare systems internationally. The family group conference in particular has generated interest as a practice model that facilitates broader family engagement in care and protection. As the practice has flourished, research has been undertaken to strengthen the knowledge base and to support the introduction of family engagement strategies across jurisdictions. This paper examines the recent research relating to family engagement strategies in child welfare and explores the ways in which family involvement in decision-making can be incorporated into emerging protective practices. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper presents a critical review and analysis of issues in implementing electronic data and information sharing frameworks for organisations involved in response activities during disaster. An implementation focused approach is used to understand end-user needs and develop tools that meet their operational requirements. A case study of New Zealand roading organisations examines how information is currently shared both within and between organisations to support crisis decision-making, and the potential benefits and implications of enhanced data and information sharing frameworks. Preliminary results show that considerable performance gains in response activities during disasters can be achieved provided technology is designed to work with and enhance existing operating structures. [ABSTRACT FROM AUTHOR]

hardy d.j., o'brien a.p., gaskin c.j., o'brien a.j., morrison-ngatai e., skews g., ryan t. & mcnulty n. (2004) Journal of Advanced Nursing 46(1), 95–109 Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Numerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice. When researching literature on the Delphi technique, however, we discovered discrepancies in its application, and a lack of detail when reporting design, administration, and analysis methods. Such lack of specificity hinders the replicability and assessment of the clinical and cultural validity and reliability of Delphi studies. The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses ( n = 20) and consumers ( n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements ( n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarized responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4·5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements ( n = 86) reached the importance benchmark. When rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritizing experts judgements. [ABSTRACT FROM AUTHOR]