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Globally, transgender people have been described as a highly marginalised population due to cisgenderism that delegitimises their gender identities and expressions. Despite robust evidence from many countries noting the association of discrimination and stigma for being transgender with heightened mental health risks, qualitative research that examines the nuances of mental health indicators using health equity frameworks has been scant both in Aotearoa/New Zealand and overseas. Using an inductive thematic approach, this paper analysed 222 open-text responses in the mental health section of the 2018 Counting Ourselves: Aotearoa New Zealand, Trans and Non-binary Health Survey. Our findings showed four overarching themes: gender-affirming healthcare, mental healthcare services and accessibility, gender minority stress, and self-affirmation and social support. Participants' narratives described pervasive gender minority stress experiences in gender-affirming and mental healthcare services, including unmet healthcare needs, lack of competency in healthcare delivery, and pathologisation of their genders. In social settings, our participants commonly reported discrimination and violence, although they also reported that self-affirmation strategies and social support offset the impacts of gender minority stress on their mental health. The current findings indicate the importance of exploring mental health outcomes for transgender people in relation to cisgenderism and resultant gender minority stress. [ABSTRACT FROM AUTHOR]

Heart failure is a chronic condition with various implications for individuals and families. Although the importance of implementing palliative care is recommended in best practice guidelines, implementation strategies are less clear. This study sought to; (1) determine Australian and New Zealand cardiovascular nurses and physicians' end of life care attitudes and specialist palliative care referral in heart failure and; (2) determine self-reported delivery of supportive care and attitudes towards service names. An electronic survey was emailed to members of four peak bodies and professional networks. Participants were also recruited through social media. Paper-based versions of the survey were completed by attendees of the 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, August 2018. There were 113 completed responses included in the analyses. Participants were nurses (n = 75), physicians (n = 32) and allied health professionals (n = 4). Most (67%) reported they were comfortable with providing end of life care; however, fewer respondents agreed they received support for their dying patients and one-third experienced a sense of failure when heart failure progressed. Most (84–100%) participants agreed they would refer a heart failure patient later in the illness trajectory. There was a more favourable attitude towards the service name 'supportive care' than to 'palliative care'. Comfort with end of life discussions is encouraging as it may lead to a greater likelihood of planning future care and identifying palliative care needs. Peer support and supervision may be useful for addressing feelings of failure. The use of needs-based assessment tools, adopting the service name 'supportive care' and further research focusing on primary palliative team-based approach is required to improve palliative care access. Cardiovascular nurses and physicians are comfortable providing end of life care, but referrals to palliative care in the later stages of heart failure persists. [ABSTRACT FROM AUTHOR]

Background: This paper presents the pilot testing of an online professional development (PD) course for New Zealand (NZ) speech-language therapists (SLTs) working with Māori with stroke-related communication disorders (predominantly aphasia). Taking a public health approach and focusing on the context of Māori as Indigenous peoples in a colonised society, the course lays the foundation for aphasia management for Māori. It consists of two modules. Module One addresses health inequities, social determinants of health, racism, the Treaty of Waitangi, cultural safety and power inherent in the role of the SLT. Module Two includes specific information about providing therapy for Māori stroke patients (particularly those with aphasia) and family members and working with Māori health colleagues. Aim: The primary aim was to ascertain the impact of the course on participants' clinical practice with Māori with aphasia. A secondary aim was to examine participants' assessment of the content and delivery of the course. Methods & Procedures: This was a qualitative longitudinal pilot study. Eleven SLTs completed the online course, immediately followed by a survey in which they gave feedback on the course and named three activities they would do to apply their learning in the following six months. Eight participants were available for interview six months later. Interviews aimed to ascertain what participants learned from the course, how they applied their learning and how the course could be improved. Interview data were analysed using a "general inductive approach", in conjunction with responses to the survey. Outcomes & Results: Interview findings were divided into two main themes – "putting it into practice" which revealed what participants learned and how they applied their learning and "keeping it at the forefront" which focused on maintaining that learning and practice, including reflection on the course content and delivery. All participants were positive about the course and all would recommend it to colleagues. Conclusions: The pilot testing revealed that participants made positive changes to their practice as a result of their learning. Challenges inherent in completing the course and applying learning and suggestions for improvement were also identified. Although the course content is NZ-specific, many of the ideas in the course are relevant to numerous multiethnic contexts across the world in which the speech-language therapy culture in service delivery could be impacted by issues such as power, racism, and inequity. [ABSTRACT FROM AUTHOR]

In this paper we explore whether power issues enhance and/or inhibit retention of foundation-learners in vocational education in Aotearoa New Zealand. After surveying reasons given for early departure in the retention literature, the paper offers Foucault's notion of governmentality as another possible factor in early departure. The paper explores three aspects of governmentality through the data: whether student resistance to the exercise of power creates conditions for early departure; whether the process of group formation, identity building and behaviour creates power dynamics within groups that inhibit or enhance retention; whether self-disciplining, using power on oneself to conform to others' expectations, norms or rules, influences learners' decisions about staying or leaving early. Our conclusions are tentative but we suggest that power issues do play a part in helping learners decide whether or not to complete their courses of study. [ABSTRACT FROM AUTHOR]

Background: This paper draws on a 2015 study in New Zealand that examined perceptions of registered nurses (RNs) and general practitioners (GPs) regarding the role of Nurse Practitioners (NPs) in long-term aged care facilities (LTACF). Aim: To explore the attitudes of RNs and GPs regarding the role of NPs in LTACFs. Design: A descriptive, mixed methods design with a survey and invitation to interview was used. RNs and GPs who provided hospital-level care were invited to participate. Findings: The findings showed RNs and GPs are open to considering the NP role in aged care. However, there remains a lack of understanding of what NPs do. Conclusions: This study suggests a shift in attitude towards accepting the NP role by RNs and GP working in LTACFs. [ABSTRACT FROM AUTHOR]

Prevailing discourses condemn funerals as a costly distress purchase where funeral directors have greedily preyed upon funeral arrangers’ grief laden vulnerability. They explain funerals as distress purchases and so debt as the outcome of irrational decisions made while emotionally overwhelmed. These discourses ignore how people might use funeral purchases in dealing with the experience of death as they obscure rather than explain the emotionally infused decision-making that incurs funeral debt. This paper aims to shed light on this aspect of funeral purchases through a New Zealand-based empirical investigation of how intense feelings connect with decision-making associated with funeral cost and debt. The examination highlights that arranging a funeral, rather than being a hurried, ill-informed, choice-limited, emotionally overwhelming distress purchase, is a complex socio-emotional process that crystallises multiple affects into the culturally sanctioned emotion of responsibility, itself mobilised on class lines embedded in existing societal attitudes to debt and socio-economic structures. [ABSTRACT FROM PUBLISHER]

Effective preceptorship has consistently been identified as an essential support process for graduate nurses in their first year of practice. Quality preceptorship supports a new graduate to develop confidence and competence and is seen as a critical component of any new graduate programme. This paper provides an overview of nurse entry to practice (NETP) programmes within New Zealand, along with key findings from a commissioned evaluation study during 2007-2009 that focused on preceptorship support for new graduate nurses. Findings from the evaluation identified access to preceptors, the importance of the preceptor/new graduate relationship, preceptor preparation for their role and the overall culture of support as important. Nursing leadership is additionally identified as a critical component to support effective preceptorship in any new graduate nursing programme. [ABSTRACT FROM AUTHOR]

Spirituality is increasingly understood to be important in healthcare provision, as seen in policy, guidelines and practice across many Western healthcare systems. Definitions of spirituality remain controversial, despite their importance for consistency in research and practice. This paper reports on the definition findings of a nation-wide New Zealand (NZ) study (2006–2008) that examined understandings, experiences and ways to improve spiritual care, primarily focused in hospices. A mixed methods approach included 52 semi-structured interviews and a survey of 642 patients, family members and staff from 25 (78%) of NZ's hospices. A generic qualitative design and analysis was used to capture the experiences and understandings of participants' spirituality and spiritual care and a cross-sectional survey gave sample-based information about the study's questions. Across both studies the majority view held that spirituality is a useful, important, inclusive and broadly defined concept. NZ is a secular country, yet there is clear evidence that spirituality is important at the end of life. These findings add weight to the international trend for spirituality to be further investigated and attended to in healthcare. [ABSTRACT FROM AUTHOR]

This article examines the results of the world's largest ever survey of international relations (IR) scholars with an eye to establishing the particularities of the discipline in Australia and New Zealand. The survey covered the areas of teaching, research, the structure of the profession and scholars' views on foreign policy. From these results, this paper compares IR in New Zealand and Australia, and discusses the extent to which the discipline in these two countries is distinctive from its overseas counterparts, especially in the United States and the United Kingdom. The particular areas of focus include the degree to which the field in Australasia conforms to or differs from US or Commonwealth identities; epistemological and gender divides; the distinctive foci of what IR scholars in both countries teach and research; which publications are favoured and disfavoured; and the contrasting linkages between academia and the world of government and policy. We conclude with some suggestions about how the field in both countries might be improved. [ABSTRACT FROM AUTHOR]

International volunteering is increasingly recognised as a form of alternative tourism. However, the nature of the ‘alternative’ experience gained, and the ensuing narrative between host and volunteer, remains under-explored in published research, especially in volunteer tourism research within a cultural context in a developed nation. This paper examines the nexus between volunteer tourism and cultural tourism in the search for alternative and sustainable experiences through tourism. Qualitative research using in-depth interviews, diaries and participant observation was conducted to examine the pre-, during and post-trip experiences of 12 Australian visitors undertaking organised volunteer activities in an indigenous Maori community in the North Island of New Zealand during January 2005. Members of the indigenous Maori community were also interviewed to provide an important host perspective. Findings suggest that the nature of the interaction and cultural experiences gained were perceived as mutually beneficial and seemingly different from those gained from traditional cultural products. In particular, the volunteers experienced an alternative Maori cultural product and engaged in a different narrative with their Maori hosts through their volunteer work, one rich in authentic cultural content, genuine and reflective of modern Maori life in New Zealand society. [ABSTRACT FROM AUTHOR]

This paper uses panel data from New Zealand from the years 1995 and 1999 to examine the impact on those organizations, size fifty and over, that engaged in repeat downsizing during this period. It was found that, during the panel period, approximately 20 per cent of the 322 organizations in the survey had engaged in the permanent reduction of their workforce in both periods. When compared with organizations in the survey that had not engaged in downsizing in both periods, it was found that the repeat downsizers exhibited characteristics that were little different from those that had downsized only in the later period, who reported the greatest decline in performance. However, those who had downsized only in 1995 had, by 1999, largely recovered from the initial negative effects. The repeat downsizers appear to have created a long-term concession climate that is associated with negative workplace performance. [ABSTRACT FROM AUTHOR]

Culturally responsive treatments are often cited as essential for successfully addressing substance use-associated problems in indigenous and other ethnicgroups. However, there has been little investigation of the support for this assertion among alcohol and drug-user treatment workers, or how it might translate into clinical practice. The current paper reports on the results of a survey of the New Zealand alcohol and drug-user treatment field, which canvassed these issues. Eighty-six percent of respondents advocated adjustment of clinical practice when working with Māori. Two key strategies were referral to specialist Māori groups or individuals and/or contacting/meeting with whānau (family). Comparisons were made between respondents who referred clients on and those who provided intervention themselves. Implications of results, limitations and future research are discussed. [ABSTRACT FROM AUTHOR]

Diclofenac potassium 25mg (CataflamR, Novartis New Zealand Limited) was reclassified from prescription medicine to pharmacist-only sale in New Zealand in 1992. This paper discusses methodological issues in postmarketing surveillance of Cataflam. Consenting user-purchasers were recruited from 175 (16% of) pharmacies in New Zealand over 4 months. Purchasers were mailed a questionnaire for completion seven days after purchase. Those considered ''at risk'' of adverse events were resurveyed 30 days after purchase. The 1240 purchasers recruited returned 990 valid questionnaires (80% response). Of these, 56% (557) were mailed the second questionnaire (86% response). Two pharmacy based adjunct studies allowed some data validation. [ABSTRACT FROM PUBLISHER]

Despite the existence of various large-scale surveys of human resource specialists, there has been little research focusing specifically on the top cohort of HR practitioners. In addition, the surveys offer little insight into the ambiguous, but important questions associated with the strategic management process in large, complex corporations. This article reports a study of the qualifications, work histories, role orientations and strategic contributions of the most senior HR specialists in the New Zealand business sector. These elite practitioners typically demonstrate a 'dual background' in specialist HR activities and line management, and strongly subscribe to Legge's notion of 'conformist innovation'. As in the United Kingdom, they tend to focus primarily on the management of managers and, to a lesser extent, the management of industrial relations. Their work is increasingly integrated with other spheres of the business such as quality management. Whether their contribution is regarded as 'strategic' depends on the model of strategic management that informs the question. This paper argues that the survey-based studies have inappropriately adopted 'outside-in' models of strategic management which privilege marketing notions and assume that 'formulation' is more strategic than 'implementation'. The work of these senior HR specialists is more fairly assessed under a conception of the strategic problem which balances external and internal concerns. Given the present realignment of strategy theory, the challenge facing these HR specialists is that of developing frameworks for corporate planning and performance analysis which attribute a more central role to the critical elements of HRM. [ABSTRACT FROM AUTHOR]

Dystonia is a neurological disorder characterised by involuntary muscle contractions. Pain is the primary non-motor symptom, and limited studies have investigated how dystonic pain is experienced. This study aimed to investigate how people with isolated dystonia describe their pain and compare across subgroups of dystonia. Anonymous online survey via social media asking participants to describe their pain in their own words, complete the McGill Pain Questionnaire (MPQ), and answer demographic questions. Thematic analysis identified common themes and frequencies were calculated for demographic and MPQ data. One-hundred and sixty-five respondents were included (mean age 51 years, 85% female). Thematic analysis identified four major themes "Physical sensations", "Temporal features", "Destruction", "Impact on life" with several sub-themes. The most chosen MPQ descriptor was "exhausting" followed by "tight," "sharp," "pulling," and "aching". The most common descriptors showed similar prevalence across subgroups of dystonia. As no objective tests for pain exist, pain sufferers must use language to describe their pain experience. People with isolated dystonia used sensory words combined with metaphorical language to detail temporal features of pain, as well as destructive internal battles or feelings of external forces acting upon them, and the significant toll pain has on everyday life. Pain is a common and debilitating non-motor symptom for people living with dystonia and should be discussed in a persons treatment plan. Pain sufferers use language to discuss their pain experience with others and report they don't feel well understood by others including health professionals. People with dystonic pain commonly described physical sensations, temporal features, destructive forces, and the impact on life caused by their pain. Findings suggest the experience of pain with dystonia is varied and better pain management options for people with dystonia are needed. [ABSTRACT FROM AUTHOR]

To explore speech-language pathologists' (SLP) practice in literacy prior to, and during, COVID-19 to understand the practicalities, feasibility and sustainability of telepractice literacy services. This exploratory study employed a cross-sectional survey comprising 46 questions covering participants' caseload profile and service delivery models, their assessment and intervention practices and telepractice delivery of literacy services. Participants were 44 SLPs working primarily in private practice and education with children and adolescents. Students with literacy difficulties comprised a significant proportion of SLPs' caseloads. Individual and group sessions were the most common format of delivery prior to COVID-19. In a telepractice model during COVID-19, SLPs saw fewer students overall. Most provided individual sessions only and reported cancellation of group sessions. SLPs described their practice in literacy as being aligned with evidence-based principles. A range of resources were used for literacy assessment and intervention. For most, their usual practice changed for telepractice. Many felt underprepared to use telepractice and experienced numerous challenges mostly relating to technology and family engagement. Literacy has become a core area of practice for SLPs; however, continued advocacy towards consultative and collaborative services is needed within onsite and telepractice models. Telepractice required SLPs to develop additional skills and modify usual practice. Despite experiencing challenges, many indicated they would continue with telepractice given its perceived benefits. [ABSTRACT FROM AUTHOR]

In 2020, the government of Aotearoa New Zealand imposed some of the most stringent funerary restrictions in the world as part of its efforts to eliminate COVID-19. This article explores how people experienced this situation, asking why restrictions that some described as precipitating 'the most difficult time of their lives' were described by others as a 'relief', 'blessing', or 'gift'. Much existing literature frames funerary restrictions as a distressing assault upon established ways of grieving to which mourners must try to adapt – and in Aotearoa, both the stringency of the restrictions and the means by which they had been imposed did lead to many people finding them challenging. However, for those with ambivalent pre-existing feelings regarding their funerary traditions – such as many in the Samoan diaspora – COVID-19 restrictions afforded both a reprieve from burdensome practices and a much-welcomed opportunity to reimagine their traditions. Funerary restrictions, though disruptive, are thereby shown to have generative potential. [ABSTRACT FROM AUTHOR]

What makes something a stressor within clinical students' education is unclear. Medical students moving from a predominantly protected classroom environment to a situated–work environment provided an ideal transition point to explore the criteria that might make a learning experience a stressor and whether these stressors hinder or challenge learning. Data on the stressors associated with learning experiences in clinical education were collected from New Zealand undergraduate medical students. Free text comments, in a survey-based questionnaire were supplemented by focus group data. Using inductive thematic analysis with grounded theory, themes were generated about the characteristics of stressors; referred to here as stressor criteria. These stressor criteria were then classified according to their impact on perceived learning. Under the broad headings of the nature of the learning task, external factors, internal factors, and social interaction; 12 stressor criteria groupings were defined. Some of these criteria were a positive challenge to learning (e.g. legitimacy of the task, novelty of the learning, social interactions) and others a hindrance. Not all stressors hinder learning. Instead, and depending on their nature, many result in perceived assistance to learning. Stressors hindering learning need to be recognised by the teacher, especially those that can be converted from a hindrance to an assistance. [ABSTRACT FROM AUTHOR]

As psychosocial factors have been recognised as significant predictors of the recovery trajectory from chronic back pain, the 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed based on themes obtained from patient interviews, but previous psychometric analyses with a general population sample revealed uncertainty around the factor structure of the instrument. To provide more detailed information about the psychometric properties of the Back-PAQ when used with participants from the general population and also to test the internal validity of the tool for use with General Practitioners (GPs). After applying partial-credit Rasch analysis with a sample of participants from the general population (n = 600), a replication analysis was conducted with a sample of GPs (n = 184). This approach permitted examination of sample-specific personal factors for differential item functioning. Subtests were used to differentiate between local dependency due to underlying dimensionality from local dependency due to method effects. A unidimensional fit to the Rasch model was achieved after 14 misfitting items had been deleted. The final 20-item solution also fit with a sample of 184 GPs. In both cases, the Back-PAQ-20 demonstrated good reliability (PSI ≥ 0.80), with no evidence of differential item functioning by personal factors. The ordinal-to-interval conversion algorithms presented here further enhance the precision of the scale and permit analysis of Back-PAQ-20 scores using parametric statistics. The present study provided evidence for valid and reliable assessment of the back pain recovery beliefs of both users as well as providers of health services. Psychosocial factors have been recognised as significant predictors of the recovery trajectory from chronic back pain. The 34-item Back Pain Attitudes Questionnaire (Back-PAQ) was developed based on themes obtained from patient interviews, but previous psychometric analyses with a general population sample revealed uncertainty around the factor structure of the instrument. The 20-item version of the Back Pain Attitudes Questionnaire (Back-PAQ) is shown here to have strong psychometric properties for administration with users and providers of health services. [ABSTRACT FROM AUTHOR]

There is an increase in medical students with long term conditions applying for accommodations in assessment. Medical school responses to such applications appear inconsistent, possibly reflecting insufficient guidance for policy. We aimed to inform an approach by developing guidance. Within a New Zealand and Australian context, we used a four-stage action research methodology: discussion with medical educators and survey of all 21 medical schools, including responding to 22 hypothetical scenarios; developing an approach; applying the approach to the hypothetical scenarios; and seeking feedback from stakeholders on the proposed approach. Current practice varied among the 13 responding medical schools. Medical schools were consistent in their responses for 10 hypothetical scenarios but inconsistent in 12. An approach based on a matrix of authenticity to practice, including regulatory and employment factors, and feasibility to educational institutions was developed. This was applied to the hypothetical scenarios and highlighted how consistency could be better achieved, and where further discussion between regulators and employers might be needed. This approach and the matrix based on authenticity and feasibility provides guidance to consider assessment accommodation applications. It highlights the need for discussions among regulators, employers, educational institutions and the disability sector. [ABSTRACT FROM AUTHOR]

Policy makers in New Zealand advocate investments in training and Research and Development (R&D) as effective policy options to increase the country's level of productivity. However, uncertainty remains about the strategic prioritisation of these policy options. The article examines the impact of public investment in training and R&D on productivity, technological advancement and innovation. Based on an international survey of empirical findings, the article rejects calls for substantial government funded training programmes and highlights the limitations of public investment in business R&D. Instead, the article wishes to advance knowledge by developing a two-stage wage strategy in support of a process of ‘creative destruction’, first through initial wage growth, subsequently through wage restraint and, ultimately, in pursuit of a sustainable platform for investment in technological advancement, skills, innovation and economic growth. It concludes with an assessment of political pressures and respective reasons why this strategy, although capable of meeting multiple policy objectives, is unlikely to be favoured by policy makers and political interest groups. [ABSTRACT FROM AUTHOR]

To enhance understanding of access to rehabilitation services in Australian and New Zealand acute care facilities for older adults living with dementia and/or living in residential aged care facilities (RACFs) following a hip fracture. Information on hip fracture rehabilitation was obtained from an online survey of 40 health professionals who were members of the Australian and New Zealand Hip Fracture Registry Network. This information was supplemented with key informant interviews with five geriatricians and five rehabilitation physicians. Availability of hip fracture rehabilitation services differed by region and country. Around one in 10 respondents indicated that their facility had specific rehabilitation protocols for people living in RACFs or who were living with dementia. Barriers to providing hip fracture rehabilitation were commonly related to availability of resources. Rehabilitation pathways were determined according to individual patient characteristics and perceived potential benefit. Decision making was mainly informed by the patient's pre-fracture morbidity and residence. Three key themes and nine sub-themes emerged from the interviews. The development of consistent decision criteria and pathways for access to hip fracture rehabilitation could provide a standard approach to access to rehabilitation, particularly for patients with cognitive impairment and/or who reside in RACFs. Need to establish evidence-based criteria for patients who will benefit from hip fracture rehabilitation. Consistent decision criteria for access to hip fracture rehabilitation will assist in guiding a standard approach to providing rehabilitation, particularly for patients with cognitive impairment and/or who reside in RACFs. There is a need to ensure the availability of physiotherapy services in RACFs to assist with rehabilitation provision. Rehabilitation provided to patients with cognitive impairment and/or who are living in RACFs should be tailored to their physical and mental ability. [ABSTRACT FROM AUTHOR]

A range of barriers that impede collaborations between consumer researchers and other researchers have been identified, despite clear acknowledgement of the benefits of this approach in the literature. Recent research has questioned whether the costs of collaborative research outweigh the benefits. The overarching aim of the current study is to better understand non-consumer researchers' attitudes to, and issues concerning, engagement with consumer researchers. Non-consumer researchers from mental health disciplines were invited to participate in the cross-sectional Consumers as Researchers in Mental Health survey, and to respond to open-ended questions about their experiences of collaborative research with consumer researchers. The findings demonstrate a range of benefits associated with collaborations with consumer researchers – including increased relevance and credibility of research, and greater translation of research findings into changes in health policy, service, research and education. Collaborations were found to be varied and not limited by research design, decision-making styles, or research topic. Understanding these benefits within the context of identified barriers can make an important contribution to the proliferation of mental health consumer researcher roles. [ABSTRACT FROM AUTHOR]

We analyse the effect of different incentive structures on response rates for an online survey of New Zealand landowners who have previously not responded to an earlier wave of the survey. We find response rates are lowest for direct cash payment, lower even than for a control group with no incentive, which may be due to direct payment extinguishing any warm glow people receive from the charitable act of completing a survey. Lottery and charitable donation incentives do not increase response rates relative to a control group with no incentive. [ABSTRACT FROM AUTHOR]

Introduction: New Zealand's Alcohol Licencing Trusts (ALTs) are community-owned entities that sell alcohol in their districts and return profits back to the local community. Aim: To investigate support for applying the ALT model to regulate legal cannabis. Method: An online survey asked people living in two ALT districts to rate their support for applying the ALT model to legal cannabis; 2,379 people completed the survey. Logistic regression models were fitted to identify predictors of support for applying the ALT model to cannabis. Results: Thirty-nine per cent supported the ALT model for legal cannabis. Reasons for support included: the trust's donations to the community (53%), potential to restrict cannabis sales (43%), controlling the cannabis industry (43%), and better than the current prohibition (42%). Support for the existing ALT (OR = 8.86), recent history of cannabis use (OR = 1.42), younger age (OR = 1.02) and not being in employment (OR = 1.46) predicted support for the model for cannabis. Cannabis users were more likely to support the trust model on pragmatic grounds ('better than prohibition') while non-users valued the model's capacity to responsibly regulate sales and the cannabis industry. Discussion: The ALT model can offer a middle-ground approach that attracts support from cannabis users and non-users, albeit on different grounds. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the current practices of New Zealand speech–language pathologists (SLPs) working with multilingual children, to compare these with best practice guidelines and make recommendations for training and service development. Method: An online survey was sent to SLPs working with children in New Zealand, asking questions about their training, languages spoken and management of multilingual children. Result: Responses from 146 SLPs were analysed. While 28% reported over 25% of children on their caseloads were multilingual, most SLPs felt under-trained to work with these clients. In accordance with best practice guidelines, SLPs supported retention of home languages for their multilingual children. Half of the children seen were assessed and treated in all languages, despite the majority of SLPs being monolingual English speakers. However contrary to best practice recommendations, parents were used as interpreters more frequently than professional interpreters. The SLPs reported a lack of resources for assessment and treatment of multilingual children. Informal assessments were frequently used, but dynamic assessment and peer-child comparisons were under-utilised. Conclusion: There were marked differences between SLPs' current practice with multilingual children and best practice guidelines. Increased training opportunities along with resource development in languages commonly spoken in New Zealand are required. [ABSTRACT FROM AUTHOR]

As health-related mobile apps have proliferated in recent years in USA and Australia, counsellor opinions were solicited to aid development of therapeutic apps. After being informed of the therapeutic potential of time and location-based reminders, 33 drug and alcohol counsellors from New Zealand and Australia answered an anonymous online survey. Counsellors were willing to use timed and location based reminders to assist clients with their sobriety, but were concerned about running costs. Less experienced counsellors may be less willing to use mobile technology therapeutically. Counsellors could be willing to use location services on mobile phones therapeutically, but training may be required to address concerns about privacy and the ability to engage with clients about their spatial and temporal vulnerabilities. [ABSTRACT FROM AUTHOR]

Introduction: The Professionalism of Medical Students (PoMS) study aimed to develop a comprehensive understanding of Australian and New Zealand (Aus/NZ) medical students' opinions and experience with professionalism dilemmas. Methods: A confidential, online survey for medical students was developed and distributed to all Aus/NZ medical schools. Students submitted de-identified demographic information, gave opinions on the acceptability of a range of student behaviours for professionally challenging situations, and whether they had encountered similar situations. Results: 3171 medical students participated from all 21 Aus/NZ medical schools (16% of the total student population). Medical students reported encountering many of the professionally challenging situations and had varying opinions on what was acceptable behaviour for the scenarios. In general, students' opinions were not influenced by the seniority, gender or the type of health professional involved in the scenario. Participant demographic factors appeared to have significant effects on professional opinions – particularly male gender and being a student in the latter stages of the course. Discussion: Medical students' professional opinions are a complex area. The PoMS data provides a reference point for students, their educators and other health professionals in identifying current student professional behaviour norms, determining the effects of demographic factors on their decision making, and where important gaps exist in medical students' approaches to professionalism. [ABSTRACT FROM AUTHOR]

Background: Past research has shown farmer anxiety and stress have significantly affected many farmers and their families due not only to the impact on feelings of happiness and success, but also on output efficiency, accident rates, and health. The past approach to ameliorating anxiety has been through utilizing coping mechanisms such as sharing with significant others, venting, planning, self-blame, and positive thinking. A problem has also been farmers' reluctance to voice difficulties and seek help. Method: An alternative, more basic approach to anxiety amelioration is possible. This involves isolating the human characteristics that lead to anxiety, and subsequently modifying these to reduce anxiety and its associated impacts. Accordingly, the extensive literature on anxiety and stress was reviewed to facilitate developing an hypothesis outlining the important components explaining farmer anxiety. To assess the parameters of farmer anxiety, a random survey of New Zealand farmers was used to obtain their ratings on their anxiety. Regression models were used to quantify the relationships. Results: Specific farmer personal characteristics were shown to be highly related to anxiety. These included a farmer's personality, objective set, belief in their ability to control outcomes, as well as education and age. Conclusion: This analysis provides the information required to direct counseling efforts to modify the anxiety creating personal variables and, consequently, reduce anxiety and its impact on a longer term basis. [ABSTRACT FROM AUTHOR]

The quality of parent-child interactions and family relationships has a powerful influence on children's development and well-being. The International Parenting Survey (IPS) is a brief, web-based survey developed to provide a cross-national, community-level, population snapshot of the experiences of parents related to raising children. The IPS was developed as a planning tool to assist policy makers and community agencies plan, implement, and evaluate parenting programs and as a tracking tool to evaluate parenting support programs in different countries. We report the preliminary psychometric properties of the IPS on various domains of measurement in an international sample of over 9,000 parents. Moderate to high reliabilities were obtained for all domains of measurement. High internal consistency reliabilities (α = .88-.97) were obtained for the domains of children's behavior and emotional maladjustment, for parental self-efficacy, parental distress and parental beliefs. Moderate levels of reliabilities (α = .52-.83) were obtained for domains of parental consistency, coercive parenting, positive encouragements, and parent-child relationships. Overall, the measure appears to have satisfactory reliability justifying further psychometric validation studies in population level studies of parenting. Examples of uses of the IPS are described and directions for future research and policy explored. [ABSTRACT FROM AUTHOR]

Using the push and pull framework, this study examines the relationship between tourist activities in New Zealand and behaviours such as tourist spending, travel style (group vs. independent travel) and length of stay. Data from the International Visitor Survey were analysed for a 19-year period (1997-2015). The findings, based on 62,288 respondents, identified 9 typologies of international visitors over this period. For example, type one visitors are primarily pulled by the nature-based activities offered in New Zealand while type two is pulled by adventure activities. Some of the typologies have activities that overlap reflecting the needs of international visitors. Significant relationships were found between the nine typologies, tourist spending, travel style and length of stay. Implications for destination marketing purposes are highlighted. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate the prevalence of self-reported sleep complaints in New Zealand adults and determine the independent association of sleep complaints with adverse health outcomes. Design: We used 2002/03 New Zealand Health Survey data (n = 12,500 adults, ≥15 years). The prevalence of self-reported sleep complaints was estimated by ethnicity. The relationship between sleep complaints and mental health, physical health and health risk behaviors were investigated using multivariable logistic regression models. Results: The prevalence of each sleep complaint measure was highest for the indigenous Māori population (23.6% reported ‘any’ sleep complaint; 10.3% reported multiple sleep complaints). Reporting ‘any’ sleep complaint was associated with higher odds of poorer mental health, diagnosed high blood pressure, diagnosed diabetes, diagnosed heart disease, poor/fair self-rated health, obesity, current smoking, and hazardous drinking. Conclusion: The higher prevalence of sleep complaints among Māori and the consistent association with poor health suggests a potential role for suboptimal sleep in ethnic health inequities. [ABSTRACT FROM AUTHOR]

Background: The effect of natural disasters internationally is linked to intensity and duration and the impact of these events for tertiary level professional students is not clearly understood. Following a 7.1 magnitude earthquake in New Zealand in 2010 (with aftershocks lasting 27 months) a number of tertiary nursing students experienced significant disruption to their studies. Aim: To compare the psychological health, resilience and the impact on learning for three cohorts of students engaged in tertiary nursing education during this time. Method: A cross-sectional survey design and convenience sampling was used for three cohorts of learners. An online survey was completed (n = 290) and included: Depression Anxiety and Stress Scale; PTSD Checklist; Work and Social Adjustment Scale; Connor-Davidson Resilience Scale. Results: Statistically significant differences were found across the psychometric scales with regard to relationship status. Whilst an increase in self-reported physical and mental health issues prior to and following the earthquakes were noted, mitigating factors were also identified. Conclusions: In order to support psychological health amongst nursing students, tertiary education systems need to plan for sustainable learning. The importance of facilitating future orientation within organisations is necessary to develop resilience amongst staff and students, which, in turn, will enable on-going education during significant disaster events. [ABSTRACT FROM AUTHOR]

Objectives:We previously found large variations in general practitioner (GP) hypertension treatment probability in oldest-old (>80 years) between countries. We wanted to explore whether differences in country-specific cardiovascular disease (CVD) burden and life expectancy could explain the differences. Design:This is a survey study using case-vignettes of oldest-old patients with different comorbidities and blood pressure levels. An ecological multilevel model analysis was performed. Setting:GP respondents from European General Practice Research Network (EGPRN) countries, Brazil and New Zeeland. Subjects:This study included 2543 GPs from 29 countries. Main outcome measures:GP treatment probability to start or not start antihypertensive treatment based on responses to case-vignettes; either low (<50% started treatment) or high (≥50% started treatment). CVD burden is defined as ratio of disability-adjusted life years (DALYs) lost due to ischemic heart disease and/or stroke and total DALYs lost per country; life expectancy at age 60 and prevalence of oldest-old per country. Results:Of 1947 GPs (76%) responding to all vignettes, 787 (40%) scored high treatment probability and 1160 (60%) scored low. GPs in high CVD burden countries had higher odds of treatment probability (OR 3.70; 95% confidence interval (CI) 3.00–4.57); in countries with low life expectancy at 60, CVD was associated with high treatment probability (OR 2.18, 95% CI 1.12–4.25); but not in countries with high life expectancy (OR 1.06, 95% CI 0.56–1.98). Conclusions:GPs’ choice to treat/not treat hypertension in oldest-old was explained by differences in country-specific health characteristics. GPs in countries with high CVD burden and low life expectancy at age 60 were most likely to treat hypertension in oldest-old.Key Points • General practitioners (GPs) are in a clinical dilemma when deciding whether (or not) to treat hypertension in the oldest-old (>80 years of age). • In this study including 1947 GPs from 29 countries, we found that a high country-specific cardiovascular disease (CVD) burden (i.e. myocardial infarction and/or stroke) was associated with a higher GP treatment probability in patients aged >80 years. • However, the association was modified by country-specific life expectancy at age 60. While there was a positive association for GPs in countries with a low life expectancy at age 60, there was no association in countries with a high life expectancy at age 60. • These findings help explaining some of the large variation seen in the decision as to whether or not to treat hypertension in the oldest-old. [ABSTRACT FROM PUBLISHER]

Background: Satisfaction with life is a complex interplay of older people's perspectives on life achievements. Satisfaction with life, alongside health and functional ability contribute to successful ageing. Aim: To explore the impact of increasing age on older people's perceptions of their health, functional ability and life satisfaction. Methods: A cross-sectional survey of non-institutionalised older people (65+) was conducted (n = 542). The Short Form-12 Health Survey measured perceived physical and mental health, the Groningen Activity Restriction Scale measured functional ability and the Satisfaction With Life Scale measured life satisfaction. Results: Significant group differences were found; while participants' perceptions of health and function decreased with age, perceptions of life satisfaction increased. Unexpectedly, the youngest groups reported low levels of life satisfaction while the oldest reported very high levels. Conclusions: Further study should consider factors that might influence the perception of health, functional ability and particularly life satisfaction across older age groups. [ABSTRACT FROM AUTHOR]

Objective Clinical psychology trainees with problems of professional competence ( PPC) continue to be a challenge for courses. Despite the rapid development of competency-based training models, the impact of this shift to the identification and management of professional competency problems is unclear. This project aims to describe how clinical psychology trainees with PPC are identified and managed within the Australian and New Zealand context. Method An online survey was distributed through Australian and New Zealand universities offering clinical psychology training programmes. Questions addressed approaches to monitoring progress on placements, identification and management of trainees determined to be underperforming on placements, and the perceived usefulness of a range of strategies such as the use of standardised-rating tools. Results Thirty one responses were received, representing 40 clinical psychology training courses in 22 institutions across Australia and New Zealand. In all cases, at least one trainee with a PPC had been detected in the previous 5 years, most commonly attributed to psychological, behavioural, and developmental issues. Respondents reported the use of a range of preventive and remedial strategies, including the use of psychometrically validated competency evaluation rating forms to assist in the grading of placements. Conclusion Trainees with PPC occur on a fairly regular basis in clinical psychology training courses in Australian and New Zealand. While some processes involved in the identification and management of these students have been refined and systematised, some opportunities to facilitate early identification and remediation may yet need further enhancement. [ABSTRACT FROM AUTHOR]

Objectives: (1) To examine whether the willingness of people to socialize with adolescents with brain injury is influenced by gender, visibility of injury and/or knowing how to interact with people with brain injury; and (2) To consider two models: the responsibility model (attributions about the cause of a condition) and the danger appraisal model (perceptions of dangerousness due to anger/aggression) for their effect on willingness to socialize and to understand how these perceptions lead to avoidant behaviour. Method and procedures: Participants were recruited either by personal approach or via Facebook advertising and completed a survey after reading a brief vignette and seeing a photo of an adolescent male or female, with or without a head scar. Vignettes for some participants were varied to represent perceptions of responsibility and dangerousness Main outcomes and results: ANOVAs and structural equation modelling revealed that participants were more willing to socialize with the adolescents with a scar than with no scar. Knowledge about how to interact with survivors impacted willingness to socialize, but familiarity did not. The full danger appraisal model was supported, but only some aspects of the responsibility model were supported. Conclusion: The results provide useful information for rehabilitation health professionals working with survivors of brain injury. The implications of these findings are discussed with regards to assisting adolescents’ re-entry into society post-injury. [ABSTRACT FROM PUBLISHER]

Background: Palliative care (PC) medical and nursing professionals are potentially the most death literate group in the community yet little is known about their personal uptake of advance care planning (ACP) or written advance care directives (ACDs). Aim: To describe Australian and New Zealand PC medical and nursing professionals’ participation in personal ACP activities. Method: Between 12 May 2014 and 6 June 2014 an anonymous cross sectional online survey about personal ACP activities was distributed to Australian and New Zealand PC medical and nursing professionals. Results: The survey link was emailed to 946 medical and nursing PC health professionals with 329 (35%) recipients commencing the survey. Ninety-one percent of participating Australian and New Zealand PC medical and nursing health professionals have engaged in some form of ACP; 21% have a written ACD. Over 80% of those without a current ACD have engaged in an ACP conversation with family or significant others. Thirty percent of doctors did not feel an ACD was relevant for them, 29% considered them a low priority, 27% relied on conversations and 14% felt ACDs were poorly designed or ineffective. These proportions were 15%, 44%, 36%, and 2%, respectively for nurses. Conclusion: This study supports the notion that familiarity with ACP increases overall participation however, it does not support the popular view that familiarity with ACDs ensures uptake. The favoured mode of ACP amongst this group of health professionals was a conversation outlining values and preferences with family or significant others. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to investigate attitudes of New Zealanders towards death and dying. We administered an online version of Collett-Lester Fear of Death Scale and Concerns About Dying Instrument subscales to a representative sample of the New Zealand population. In total, 1001 people responded to the survey. Women reported more anxiousness concerning their own death (p = .001) and dying at a young age (p > .001). Women also showed more agreement towards spiritual aspects of dying (p > .001). Single female respondents worry more about dying (p = .02) especially when young (p = .003). Single participants (p > .001) aged 18 and 29 (p > .001) reported higher anxiety for Items relating to the death of others especially concerning never being able to communicate with the person again. Our findings show that marital status and gender strongly predict higher levels of death anxiety among New Zealanders. This is probably due to the cultural identity of those sampled. [ABSTRACT FROM AUTHOR]

This article reports on findings from a mixed-methods New Zealand study of young people’s experience of service use. It focuses on young people’s experiences with mental health services. The youth (aged 13 to 17) were multiple users of statutory and nongovernmental services: mental health, child welfare, juvenile justice, and remedial education. The research explored their life experiences including exposure to harmful events and environments (such as abuse and neglect, violence, and substance abuse) and of particular interest was how services contributed to better outcomes for this vulnerable group of young people. This article explores the components of mental health services that contribute to effective practice. It underlines the key role for services in supporting young people to seek out resources that have the potential to enhance their health and wellbeing. [ABSTRACT FROM AUTHOR]

Introduction Palliative care delivery has become integral to the role of healthcare staff in residential aged care (RAC) internationally. Challenges within this work environment (e.g. workload, staffing levels, resources) may impact on healthcare staffs' willingness to undertake formal palliative care education. The study described herein explored factors (socioenvironmental and psychological) that influence staff willingness to engage in palliative care education. Methods The predictors of palliative care education uptake for healthcare staff (n = 431) from 52 New Zealand RAC facilities in one large urban District Health Board were assessed. Logistic regression was used to explore willingness to engage in education. Results Higher scores for burnout predicted a decreased likelihood of engaging in palliative care education (odds ratio (OR) 0.41, P = 0.01). The identified predictor of willingness to engage in education was previous palliative care experience (OR 1.59, P = 0.027). Discussion These results can inform the design and delivery of future palliative care education programmes within RAC. [ABSTRACT FROM AUTHOR]

Quad-bike incidents are a major cause of occupational injury and fatality on farms warranting health and safety attention. As part of a larger study, we carried out a face-to-face survey with 216 farmers in New Zealand. We quantitatively identified farmers’ propensity for risk-taking, unrealistic optimism, and fatalism as risk factors in quad-bike loss-of-control events (LCEs). The purpose of the analysis presented in this article was to use these same farmers’ recollections of LCEs to explore the a priori constructs in more detail using qualitative methods. Participants reporting one or more LCEs described their first LCE and any experienced in the previous 12 months. Participants provided open-text responses about what occurred at each LCE, their reflections, and general thoughts on LCE risk factors. Directed qualitative content analysis (QCA) was used to “unpack” risk-taking, unrealistic optimism, and fatalism whilst also delineating any additional concepts that farmers associate with LCEs. Risk-taking elements were more evident than unrealistic optimism or fatalism and more suggestive of farmers finding themselves in risky situations rather than engaging in risk-seeking behavior per se. Additional inductively derived categories of fatigue/stress, multitasking, inexperience, and quad-bike faults highlight the complex nature of LCEs and the importance of risk assessment covering these concepts as well as risky situations. [ABSTRACT FROM AUTHOR]

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The purpose of this study was to identify the relative contribution of individual and contextual predictors to students’ attitudes toward the acceptability of cheating and plagiarism. A group of 324 students from a tertiary institution in New Zealand completed an online survey. The findings indicate that gender, justice sensitivity, and understanding of university policies regarding academic dishonesty were the key predictors of the students’ attitudes toward the acceptability of cheating and plagiarism, both as agents of dishonest conduct and as witnesses of misconduct among their peers. The implications of these findings for the development of policies and initiatives in tertiary institutions are discussed. [ABSTRACT FROM AUTHOR]

While coexisting mental health problems (CEP) are recognised as the norm among people seeking addiction treatment, little is known about the capability of the addiction workforce to address CEP with clients during their treatment. The aim of this study was to investigate the mental health assessment and treatment practices of addiction-treatment workers in New Zealand. Phone interviews were conducted with a representative national sample of New Zealand addiction-treatment workers (n= 232), and of these, 86 workers had recently completed a comprehensive assessment. Only 27 of this latter group reported inquiring about all five commonly experienced coexisting mental health disorders. This result differed significantly from workers’ perceived optimal assessment practice. One hundred and forty-nine from the total sample of 232 workers reported routinely addressing CEP with clients all or most of the time. The majority of workers endorsed a need for further education relating to mental health practice. Taken overall, the findings from this study contribute to the CEP literature and call for urgent education of the addiction-treatment workforce to increase its capability to respond to people with CEP. [ABSTRACT FROM AUTHOR]

Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13–18 presenting to an adolescent outpatient mental health service. At the time of the interview, 37.6% were smokers according to the study definition, with 25.8% scoring high or very high on the Fagerstrom Test for Nicotine Dependence. Smoking was more likely if patients had conduct disorder or cannabis/alcohol dependence or abuse, but no difference was detected between smokers and nonsmokers in relation to attention-deficit/hyperactivity disorder, depression, or anxiety disorders. Only 15.1% of patients were given a chart diagnosis of nicotine dependence. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate how noise-induced hearing loss (NIHL) or noise injury (NI) affects individuals and others of dairy farm communities in New Zealand. Using “grab” or opportunistic sampling at DairyNZ discussion groups and a recreational function, a survey questionnaire was completed by 74 participants from two dairy farming communities in New Zealand. Self-reported hearing difficulties were highlighted by 48% (42) of the 74 participants. The effects of NI on individuals and others included communication difficulties leading to the development of coping strategies, social isolation; decreased employment opportunities, loss of productivity, and increased effort and adjustments by family and work colleagues. Frustration, anxiety, stress, resentment, depression, and fatigue are also negative consequences that may contribute to a loss of quality of life and contribute to further health costs. Increased lateness, absenteeism, sickness and other behavioral aspects were not expressed as normal issues in the workplace, as the majority of the individuals are/were self-employed or working in a family business. This study shows that each year in New Zealand NI results in significant negative social, psychological, and economic consequences for those individuals affected, along with their families, friends, and work colleagues. [ABSTRACT FROM PUBLISHER]

The current status of interprofessional education (IPE) in Australian and New Zealand universities is largely unexamined despite its generally acknowledged benefit. Data are also limited about the use of IPE in teaching medication safety to nursing, pharmacy and medical students. For this reason a web-based cross-sectional survey was used to gather information from Australian and New Zealand universities offering nursing, pharmacy or medical programs. Responses were received from 31 of the 43 (72%) target universities. Eighty percent of the participants indicated that they currently offer IPE experiences, but only 24% of these experiences met the accepted definition of IPE. Of the participants who offer IPE as defined by Center for the Advancement of Interprofessional Education, only 50% use it to teach medication safety. Timetabling restrictions and lack of appropriate teaching and learning resources were identified as the main barriers to implementation of IPE. All participants reported that staff development, multi-media and e-learning resources would be beneficial to IPE initiatives and the teaching of medication safety. Innovative approaches will be needed to overcome the barriers and facilitate the uptake of quality IPE more broadly. Web-based and e-learning options promise a possible way forward, particularly in the teaching of medication safety to nursing, pharmacy and medical students. [ABSTRACT FROM AUTHOR]

Two New Zealand surveys were examined to assess the robustness and reliability of the Problem Gambling Severity Index (PGSI). The PGSI cohered to a single factor in both data sets and had high internal reliability. These features held when separately considering men, women, Māori, Pacific and Asian people. Positive associations were evident between the PGSI and gambling behaviour, accessing gambling intervention services, arguing about gambling, the burden of debt due to gambling, and the co-morbidity of smoking. A meta-analysis of the two surveys establishes a prevalence of .53%. When considering 36 overseas studies this figure is adjusted to .50%. These estimates are around 20% higher than that established by the largest NZ study and 25% lower than the latest study. The use of meta-analysis is recommended to obtain a timely and accurate estimate of the prevalence of problem gambling, especially when repeating a large sample survey is prohibitively expensive. [ABSTRACT FROM PUBLISHER]

In New Zealand, schools implement a variety of strategies in an attempt to address health factors that influence students' learning. The purpose of this study was to determine the extent to which schools were able not only to identify health issues influencing learning but also to use a health promoting schools approach to address these issues. A questionnaire was posted to a randomly selected sample of 1000 New Zealand primary and secondary schools. Questions were asked about the school's strategic responses to the health issues that were identified as barriers to learning as well as respondents' knowledge of health promoting schools. The health issues that respondents most frequently perceived as affecting learning were related to food choices, lack of food, and physical activity and fitness. The piecemeal approach to addressing the issues suggests schools do not have a clear understanding of the concept of health promoting schools and that there is a need for professional development and a comprehensive national strategy. [ABSTRACT FROM AUTHOR]