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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]

This article examines the inner workings of the supervision session through the descriptions provided by supervisees and supervisors of their sessions. The aims of this paper are: (1) to explore the supervision session from both sides of the interaction; (2) to propose an interactional map of the supervision session; and (3) to provide supervisors with a practical checklist for the interactional process of the session. Thirty-four participants were interviewed regarding their experience of a recent supervision session and their experiences of sessions generally. These experiences were thematically analysed. Results show that supervisees and supervisors proceed through particular stages and phases in their supervision sessions and there is a ritual to the session. The session process mirrored the social work interview and involved discussion and problem-solving. Variations to the process were made to accommodate individual and cultural differences. The implications of the results are: (1) an interactional map of the stages and phases of the supervision session; (2) practical guidance for supervisees and supervisors on navigating their way through sessions; and (3) a working framework through which supervisees and supervisors can evaluate their sessions. The article concludes with a practical checklist for supervisors to use within their sessions. [ABSTRACT FROM AUTHOR]

This paper presents a way of thinking about and doing child protection work using community development (CD) principles to guide practice. It suggests that a useful addition to CD can be found within the rights of the child provisions in Human Rights conventions. Using examples from the authors' three countries to illustrate the work that practitioners do in their work with children at risk, we argue that social work practice can be enhanced by the inclusion of these principles and practices which are essentially core generic social work practice. However, much of social work with the protection of children is bound by ‘risk’ perceptions which result in investigatory approaches being used as a first action, often to the exclusion of preventive approaches. This article demonstrates that in very different situations from different environments, CD in concert with the principles of the rights of the child can assist good outcomes with children at risk. A model is presented for unifying the worldview of human/children's rights with social work's core concern, the protection of children, using generic social work skills. [ABSTRACT FROM AUTHOR]

Dewey first described reflective thought as a way to solve issues of perplexity in his seminal work How We Think. Dewey’s work underpinned Strauss’ contribution to The Discovery of Grounded Theory. Grounded theory methods are characterised by memo writing. This paper will describe how memos, in the form of slides, were employed to demonstrate advanced skill acquisition in practice by an immigrant nurse and health visitor to a panel convened by the New Zealand Nursing Council. Globalisation and migration of the nursing workforce contributes to advancement of the nursing profession in some countries. New Zealand, whose critical mass of primary health care nursing leaders is small, with no specific postgraduate primary health care qualification, benefit from the transferable skills of migrant nurse and community practitioners. Finding easier ways to demonstrate advanced practice to New Zealand’s Nursing Council would maximise the potential contribution of immigrant nurses. [ABSTRACT FROM PUBLISHER]

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]

To examine the links between empathy and cognitions, 50 interview transcripts were analysed from a sample of male sex offenders who had abused children, recruited from four prisons in the North Island of New Zealand. Thematic analysis revealed an overarching framework where participants appeared to create “psychologically comfortable positions” that enabled them to offend. The main themes identified were: “complete denial”; “partial denial”; “justifications: beliefs and attitudes to support offending behaviour”; excuses: ignoring the perspectives of others”; and “taking responsibility for own actions”. These findings suggest that rather than viewing empathy as a trait-like process applied equally to all situations/people by each person in line with their empathic abilities, it would be better construed as a construct that is variously applied (i.e. it may be blocked by the presence of psychologically comfortable cognitions). This has implications for the way in which empathy is addressed in sex offender treatment programmes, as most work to improve empathic skills, which appears to conceptualise empathy as a trait-like skill or concept. The findings of this study would suggest that an increase in empathic skills will not necessarily have an impact on future offending, as cognitions in the form of denial, minimisation, excuse-making and justification are likely to prevent the application of empathic responses. [ABSTRACT FROM AUTHOR]

Background: Newly qualified doctors (interns) report that they learn a great deal in the first year of practice, but exactly what is learnt is not well understood. Aims: To document the reflections and perceptions of first year junior doctors in order to reveal and chronicle their informal and often tacit learning in the workplace within a practice methodology framework. Methods: New Zealand interns, from three sites, participated in group interviews modelled on a conversation and joint enquiry style. Results: We found that learning in the first year after graduation falls into three broad themes: (1) concrete tasks, (2) project management and (3) identity formation. Identity formation appeared the most challenging and included getting used to being seen by others as a doctor. Conclusion: All themes have implications for curriculum development and clinical supervision in both undergraduate programmes and during internship. The third theme (identify formation) is the most complex. We draw on a model from management literature, to describe intern education as a process of becoming: as an unfolding and as a transformation of the self over time. We argue that reconfiguring internship as a period of identity formation, and as a self-determined, active process of 'becoming a doctor' provides a wider perspective than enculturation or socialisation theories to understand this significant transition. [ABSTRACT FROM AUTHOR]

Background: To better prepare practitioners for the complex world of clinical decision-making, teaching evidence-based practice needs to move beyond its focus on skills and knowledge to give students an experience and understanding of applying evidence in practice. Aim: To explore whether incorporating an online values-based tool enhanced learning in a post graduate epidemiology course. Methods: Having completed a critical appraisal of an epidemiological study, students were asked to then respond to a case scenario, using the analytical frameworks of the Values-Exchange, a software tool that highlights ethical domains in decision-making. The student experience of the Values-Exchange was evaluated using focus groups. Sessions were audiotaped and transcribed. In total, 613 responses were analysed by two independent coders to identify emergent themes. Results: Three main themes emerged: (1) the Values-Exchange exposed students to new concepts and ideas relating to healthcare decision-making; (2) the diversity of other student values broadened their perspectives and (3) the experience brought reality to what it means to apply evidence in practice. Conclusion: Adding an online values-based tool to clinical epidemiology teaching was highly valued by students and enabled new understandings of empirical evidence and its application in practice. [ABSTRACT FROM AUTHOR]

Academic dishonesty is an insidious problem that besets most tertiary institutions, where considerable resources are expended to prevent and manage students' dishonest actions within academia. Using a mixed retrospective and prospective design this research investigated Gottfredson and Hirschi's self-control theory as a possible explanation for academic dishonesty in 264 university students. The relationship between academic dishonesty and general criminality was also examined. A significant but small to moderate relationship between academic dishonesty and general criminality was present, including correlations with general dishonesty, violent crime and drug offending subcategories. These findings suggested that a general criminological theory may be of use in explaining academic dishonesty, but the overall ability of self-control variables to explain academic dishonesty was not strong. Controlled logistic regressions indicated that a significant positive association with academic dishonesty was only present for one of 6 self-control subscales (self-centeredness), and even this association was only present in the prospective study component. A strong relationship between past and future academic dishonesty was present. Implications of the study for institutions are discussed. [ABSTRACT FROM AUTHOR]

Ray Blanchard presented a theory of male-to-female (MtF) transsexualism based on a typology, classifying MtF transsexuals as autogynephilic or homosexual. This theory has produced much debate, and many transsexuals have disagreed with it. In this research, comments about Blanchard's theory were collected through an anonymous questionnaire from a convenience sample of 170 mostly White/European Internet-using MtF transsexuals. Positive responses to the theory were given by 15.9% of participants, 31.9% gave neutral responses, and 52.2% gave negative responses. The most common theme of the responses was that the theory was too narrow and restrictive. Other common themes were that the theory was simply wrong, did not apply to the participant's experience, was not acceptable, was not important, only applied to cross-dressers, and suggested underlying motives of the researcher. Some participants reported that they had experienced autogynephilia, and some reported changes of their sexual orientation. Given the anonymity of the participants, transsexual participants were unlikely to consciously distort their responses. Although there were sampling limitations, this study lends insight into the proportion of MtF transsexuals who are supportive of/opposed to Blanchard's typology and the reasons why some are opposed to it. The findings are of interest as transsexuals' reactions to the theory can be and have been used to theorize about the nature of autogynephilia. [ABSTRACT FROM PUBLISHER]

In this article we aim to explore those points at which migrant identity and landscape intersect. We also consider implications for holistic models of counselling with migrant groups. The New Zealand migration literature was the starting point to consider how and why the experience of migration has been studied. We asked how collective biography might work as a way to research questions about our relationship with this new land and its indigenous people. Following feminist and post-structural influences, we shared a sequence of memories of geographical transitions in a structured sequence. We used poetic representation and photographs, in addition to prose, to express what was often experience beyond words. Subsequently we have reflected on how memory work in collective biography and indigenous, holistic models of wellness might add to ways of working therapeutically with migrants. [ABSTRACT FROM AUTHOR]