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To investigate if a written guide or augmented reality (AR) guide improves free recall of diversified chiropractic adjusting technique and to capture participants' impressions of the study in a poststudy questionnaire. Thirty-eight chiropractic students were evaluated for diversified listing (a nomenclature denoting vertebral malposition and correction) recall, pre-AR and post-AR, or written guide review. The vertebral segments used were C7 and T6. Two randomized groups reviewed an original course written guide (n = 18) or a new AR guide (n = 20). A Wilcoxon-Mann-Whitney (C7) and t test (T6) compared group differences in reevaluation scores. A poststudy questionnaire was given to capture participants' impressions of the study. Both groups showed no significant differences in free recall scores after reviewing the guides for C7 or T6. The poststudy questionnaire suggested a number of strategies could be used to improve current teaching material such as more detail in the written guides and organizing content into smaller blocks. Use of an AR or written guide does not seem to change participants' free recall ability when used to review diversified technique listings. The poststudy questionnaire was useful to identify strategies to improve currently used teaching material. [ABSTRACT FROM AUTHOR]

This specially themed ""Getting of Wisdom," Learning in Later Life" Edition of the "Australian Journal of Adult Learning" ("AJAL") is not so much concerned with the issue of ageing itself, but more about quality of life regardless of age. It is about taking, but also giving back as best as possible at any age. This special issue is a result of the one week "The Getting of Wisdom Exchange", a collaboration between around 100 adult education practitioners and researchers from ten countries from Australia, New Zealand, Asia and Europe. In this issue, papers are presented from Sweden, Ireland, Aotearoa/New Zealand, Australia, Slovenia, Poland, Germany, Portugal and the United Kingdom. Papers cover different topics and open questions about various issues in older people's learning.

The move to focus on Pacific indigenous research methodologies and methods is a complex yet ongoing experience for researchers of Pacific heritage. The relational positionalities of Pacific researchers allow a move away from a dual or binary perspective of one's research responsibilities to a more fluid understanding of what it means to do research by, for, with Pacific communities. This paper highlights the diverse experiences of three Pacific researchers taking into consideration heritage connections, socio-cultural backgrounds and research contexts. We utilise talanoa as a method of engagement, reflexivity, and sharing of our experiences with Tongan, Samoan and Fijian communities. We argue that talanoa as a Pacific research method enables the diverse layers of experiences that take into particular consideration our connections to land, people and knowledges in the diaspora.

This paper is concerned with reporting the experience and findings of staff using a commercially-available text-matching tool (Turnitin) to detect plagiarism in a university setting in New Zealand. The use of actual instances of plagiarism revealed through Turnitin in a teaching department is a departure from the more usual self-reporting methodology used in many plagiarism research papers. The paper concludes by asking questions of the implications for institutions, teaching staff and students.

A number of researchers have done extensive work on ontologies, epistemologies and pedagogies in relation to Pasifika research, but little on methodologies. Vaioleti describes talanoa as a phenomenological research approach which is ecological, oral and interactive. Halapua's article Talanoa Process: The Case of Fiji (2008) emphasises talanoa as a potential model for conflict resolution following Fiji's coup in the year 2000. Recently, talanoa as a research methodology has become widely used in the Pacific research arena. It has been defined by scholars as creating meaning out of nothing or simply to talk, gossip, share or chat about nothing. 'Talaloto' -a research methodology that I introduce and outline in this article is closely related in many ways to talanoa. While talanoa is the co-construction of knowledge/ideas by two or more people, talaloto is a person's testimony of constructed knowledge or lived experiences. There is a scarcity of information on this traditional practice yet like talanoa it is rooted in Tongan oral tradition. This paper foregrounds talaloto as a traditional cultural practice and it explains its use as a research methodology. It is hoped that more researchers will consider using this method in the future, recognising its place within Pasifika methodologies and its ability to generate rich and authentic data.

This paper is part of a phenomenological study that examined teachers' and students' experiences using Educational Online Technologies (EOTs) in Blended Tertiary Environments (BTEs). Its aim was to understand how EOT engagement was experienced, to inform insights on EOT interactions, challenges, functionality and benefits. Semi-structured interviews were conducted with 10 teachers and 10 students from New Zealand and Australia, and their EOT experiences explored, under a range of different interactions. A series of six papers, each based on a specific interaction type, detailed their experiences. This paper reports on teachers' EOT interactions with their students, in reference to three types of EOTs: Learning management systems, online video platforms, and online networking tools. Key aspects of the research approach adopted were detailed in the first of these six papers, and included the research questions, research significance, and research methodology. The strategies and rationales for participant selection, participant numbers, inclusion and exclusion criteria, data collection, and data analysis were also explained (Tuapawa, n.d.-a).

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Introduction. New Zealand health training institutions have an important role in supporting health workforce training programmes in the Pacific Region. Aim. To explore the experience of Pacific Island country-based doctors from the Cook Islands, Niue, and Samoa, studying in New Zealand’s University of Otago distance-taught Rural Postgraduate programme. Methods. Document analysis (16 documents) was undertaken. Eight semi-structured interviews were conducted with Pacific Island country-based students. Thematic analysis of the interviews was undertaken using the framework method. The two data sources were analysed separately, followed by a process to converge and corroborate findings. Results. For Pacific Island countries with no previous option for formal general practice training, access to a recognised academic programme represented a milestone. Immediate clinical relevance and applicability of a generalist medical curriculum with rural remote emphasis, delivered mainly at a distance, was identified as a major strength. Although technologies posed some issues, these were generally easily solved. The main challenges identified related to the provision of academic and other support. Traditional university support services and resources were campus focused and not always easily accessed by this group of students who cross educational pedagogies, health systems and national borders to study in a New Zealand programme. Study for individuals worked best when it was part of a recognised and supported Pacific in-country training pathway. Discussion. The University of Otago’s Rural Postgraduate programme is accessible, relevant and achievable for Pacific Island country-based doctors. The programme offers a partial solution for training in general practice for the Pacific region. Student experience could be improved by tailoring and strengthening support services and ensuring their effective delivery. [ABSTRACT FROM AUTHOR]

Introduction: It is now widely recognised that engaging consumers in research activities can enhance the quality, equity and relevance of the research. Much of the commentary about consumer engagement in research focuses on research processes and implementation, rather than dissemination in conference settings. This article offers reflections and learnings from consumers, researchers and conference organisers on the 12th Health Services Research Conference, a biennial conference hosted by the Health Services Research Association of Australia and New Zealand (HSRAANZ). Method: We were awarded funds via a competitive application process by Bellberry Limited, a national not‐for‐profit agency with a focus on improving research quality, to incorporate consumer engagement strategies in conference processes and evaluate their impact. Findings: Strategies included consumer scholarships, a buddy system, designated quiet space and consumer session co‐chairs; the reflections explored in this paper were collected in the funded, independent evaluation. Our insights suggest a need for more structured consumer involvement in conference planning and design, as well as the development of specific engagement strategies. Conclusion: To move toward active partnership in scientific conference settings, our experience reinforces the need to engage consumers as members in designing and conducting research and in presenting research and planning conference content and processes. Public Contribution: Consumer engagement in research dissemination at conferences is the focus of this viewpoint article. Consumers were involved in the conception of this article and have contributed to authorship at all stages of revisions and edits. [ABSTRACT FROM AUTHOR]

This paper draws upon a personal research journey and makes the case for recording this experience using a research journal to The context for this paper is based on a study of family life and leisure, which collected data using more traditional qualitative methods, namely focus groups and interviews with pre-birth and post birth couples and leisure managers in New Zealand. The research design for this study was based on phenomenology, where the experience of the subjects being studied was significant and involved developing an understanding of the lived experiences of pre-birth and post-birth couples, where the way they acted was dependent upon their understanding and meaning of their behavior (Waters, 1994) This paper draws on the researcher's own reflections recorded in a research journal, whilst undertaking this research study over a five year period. The paper discusses the meaning and importance of reflection as a way of evaluating the researcher's own research journey and highlights a number of issues with reference to the validity of such data. The paper concludes by revisiting the key benefits of reflection and affirms the belief that research journals are a useful tool, which enables the researcher to record personal thoughts and observations in a systematic manner. [ABSTRACT FROM AUTHOR]

There is widespread and growing support and requirement for researchers and larger organisations to collaborate with communities. This ensures that social, educational, or health programmes are relevant and acceptable and address the needs of groups that experience inequity. There is limited research about the processes and approaches that impact successful collaboration. The aim of this study was to identify the best‐practice processes used to develop and sustain collaborative partnerships between community members and formal organisations in Aotearoa New Zealand. Using a qualitative case study methodology and guidance from our community advisory group, we selected three effective collaborations with groups that experienced inequity in Aotearoa New Zealand. We examined these by reviewing their publicly available documents and conducting focus group discussions and interviews with key stakeholders. We coded and analysed transcriptions thematically to develop case study summaries of findings and then conducted cross‐case analysis to identify themes inherent in the data. Seven themes emerged from the data: (1) work together under Te Tiriti to ensure that collaborations are built on the articles of this founding document of Aotearoa New Zealand; (2) start before the beginning by forming strong relationships with diverse and representative community members; (3) walk the talk by using critically reflexive processes built on shared values and equal power relations; (4) use pencils not pens to implement ensuring an iterative project process; (5) recognise all contributions and especially the value of lived experience and local knowledge; (6) journey at a pace that allows all to participate; and (7) listen twice, talk once to give priority to hearing quieter voices. These seven practices can be utilised by other collaborative initiatives to increase genuine and power‐shared participation. These participatory processes can make sure that collaborative projects respect local knowledge, indigenous culture, and respond iteratively to community needs. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) experiences rely heavily on the development of relationships between the university, industry and often community organizations. As participation in WIL is increasing, the issue of sustainability becomes paramount, requiring processes and practices for effective collaborations and partnerships. This paper reports on an action research project to develop a framework to represent the critical success factors for sustainable WIL relationships. Drawing on reflections from WIL practitioners on what they considered were the critical success factors and a review of literature, a framework was developed, prioritizing three key themes: communication, commitment and compatibility. Within these themes, nine key factors were identified and then evaluated by academic and industry stakeholders in New Zealand, Canada and Australia. Trust, expectations, reciprocity, coordination, vision, learning, resources, reputation, and recognition were confirmed as important factors for sustainable WIL relationships. The framework provides good practice guidelines for all WIL stakeholders. [ABSTRACT FROM AUTHOR]

The words recovery, landscape and experience come together in this paper's examples of how experiences are articulated in the landscapes of Christchurch, New Zealand, after the 2010 and 2011 earthquakes. This paper describes the city in its early stages of recovery when community and urban design processes helped create a sense of place as art and creativity brought life to Christchurch. Examples are projects that rethink the city landscapes and transform them into experiencescapes. Street art, events and festivals act as pathways to experiences for the locals in their daily life and for visitors as well. [ABSTRACT FROM AUTHOR]

Introduction: The usual output following health consultations from paediatric services is a clinical letter to the referring professional or primary care provider, with a copy sent to the patient's caregiver. There is little research on how patients and caregivers perceive the letter content. We aimed to: first understand child, young people and caregiver experiences of and preferences for receiving a health feedback letter about the child/young person's health measures within a healthy lifestyle programme; and second to provide a set of recommendations for designing letters to children, young people and their families within a healthy lifestyle programme. Methods: This qualitative study, informed by Kaupapa Māori principles, included focus groups of children aged 5–11 years and young people aged 12–18 years who were participants in a healthy lifestyle programme in Taranaki, Aotearoa New Zealand and of their respective caregivers (total n = 47). Discussions were audio‐recorded, transcribed and analysed using thematic analysis. Findings: Key themes were identified: letters sometimes acted as 'discourses of disempowerment'—some participants experienced a lack of safety, depersonalisation with medical jargon and 'feeling like a number'. Participants described the need for acknowledgement and affirmation in written communication—health feedback should include validation, choice regarding content, respectful tone and a strengths‐based approach to health messages. Interpretation: Letters to referrers, copied to families, can be perceived as disempowering, and participant and caregiver perspectives of content should be considered. This study challenges conventional practice in communicating health feedback with broader implications for written communication in healthcare. We propose separate letters aimed at the child/young person and their caregiver that offer choice in the information they receive. The administrative burden of multiple letters can be mitigated by advances in digital health. Patient Contribution: This study originated in response to feedback from service users that current health feedback was not meeting their needs or expectations. Patient perspectives, especially from children, are rarely considered in the generation of clinic letters from health professionals. Participants were child participants in the community‐based clinical service and their caregivers, and care was taken to represent the demographic backgrounds of service users. Collection and interpretation of Māori data were led by researchers who were local community members to ensure prioritisation and preservation of participant voice. Where possible, results are illustrated in the text by direct quotes from participants, whose identities are protected with a pseudonym. [ABSTRACT FROM AUTHOR]

Introduction. Delayed diagnosis of gut disease is a continuing problem, variously attributed to a range of patient, doctor, and health system factors. Gut disease often begins with indeterminate gut behaviours that are hard to classify. Aim. This study aimed to investigate delayed diagnosis from the point of view of the patient, or prospective patient. How gut and gut disease was understood, what might prompt them to seek care, and their experiences of seeking care. Methods. Using a qualitative design, we interviewed 44 people in New Zealand. Thirty-three had a diagnosis of gut disease, and 11 did not, though some of the patients in this latter group had symptoms. Results. Some participants had a smooth trajectory from first noticing gut symptoms to diagnosis. However, a subgroup of 22 participants experienced long periods of troublesome gut behaviours without a diagnosis. For this subgroup of 22 participants, we found people struggled to work out what was normal, thus influencing when they sought health care. Once they sought health care, experiences of that care could be frustrating, and achieving a diagnosis protracted. Some who remained undiagnosed felt abandoned, though had developed strategies to self-manage. Discussion. Indeterminate gut behaviours remain complex to deal with and it can difficult for both patients and doctors to assess when a symptom or group of symptoms need further investigation, watchful waiting or the use of other supportive strategies. Effectively communicating with healthcare staff can be a significant problem and there is currently a gap in support for patients in this regard. [ABSTRACT FROM AUTHOR]

This paper provides an examination of how small populations of deaf and hard-of-hearing (DHH) students attending New Zealand postsecondary institutions faced and dealt with various challenges in participating in classes, obtaining adequate access to services, and becoming socially integrated into campus life. Sixty-four students completed a survey and 8 were interviewed, providing information about their support needs, learning, and social participation experiences and challenges within the postsecondary context. Findings indicated that access to accommodations that facilitated communication and inclusion were critically important to their learning and participation experiences but were not always available in the institutions they attended. Reflecting recent policy and legislative changes, greater awareness and greater funding support are needed within New Zealand postsecondary institutions of DHH students’ academic and social needs. This process should be at the forefront of moves toward inclusive education at the postsecondary level, if DHH students are to be equal participants. [ABSTRACT FROM PUBLISHER]

Purpose: To understand adolescents' and their parents' perspectives on 'being active', this study explored the experience of participation in physical activity (PA), the role of long-term participation in PA, and the importance of remaining active for life. Methods: Eight ambulant adolescents with CP (aged 11–16 years, seven male) participated in a high-level mobility programme twice per week for 12 weeks. Guided using interpretive description, adolescents and 12 of their parents were interviewed before, after and nine months following the programme. Thirty-eight interviews were coded, analysed, and interpreted, informed by audit information, reflective journaling, and team discussions. Results: Adolescents and their parents highly value being active now and into adulthood. Sustainable participation in PA requires adolescents and families to navigate complex environments (interpersonal, organisational, community, and policy). Core themes were: 'Just Doing it', 'Getting the Mix Right' (right people, right place, right time), 'Balancing the Continua' and 'Navigating the Systems'. The continua involved balancing intra-personal attributes: 'I will try anything' through to 'I will do it if I want to' and 'It's OK to be different' through to 'It sucks being disabled'. Conclusions: The journey to sustainable participation was complex and dynamic. Experiences of successful journeys are needed to help adolescents with CP "stay on track" to sustainable participation. [ABSTRACT FROM AUTHOR]

The article focuses on the portrayal of rural health inequities in Aotearoa New Zealand and the problematic framing of rural populations and health systems. Topics include the impact of rural health disparities on mortality and education, the influence of media and research in shaping rural deficit narratives, and the concept of "metro-normativity" and its role in marginalizing rural communities through urban-centric assumptions.

Introduction. Quality of health care contributes to poor physical health outcomes for people with mental health and substance use conditions (MHSUC). AIM. This study investigated experiences of people with MHSUC who sought help for a physical health condition in primary healthcare services, examining quality of care attributes. Methods. An online survey of adults currently or recently accessing services for MHSUC was fielded in 2022. Respondents were recruited nationally through mental health, addiction and lived experience networks and social media. The attributes of service quality assessed were relationships (respect and being listened to), discrimination due to MHSUC, and diagnostic overshadowing (MHSUC diagnosis distracted from physical health care). Results. Respondents who had used primary care services were included (n = 335). The majority of respondents reported both being treated with respect (81%) and being listened to (79%) always or most of the time. A minority of respondents reported diagnostic overshadowing (20%) or discrimination due to MHSUC (10%). People with four or more diagnoses or a diagnosis of bipolar disorder or schizophrenia had significantly worse experiences across all quality measures. Those with a diagnosis of substance use disorders had worse experiences for diagnostic overshadowing. Māori had worse experiences for respect and diagnostic overshadowing. Conclusions. Although many respondents reported good experiences in primary care, this was not the case for everyone. Quality of care was affected by type and number of diagnoses and the person's ethnicity. Interventions to reduce stigma and diagnostic overshadowing for people with MHSUC are needed in primary care services in New Zealand. [ABSTRACT FROM AUTHOR]

This article reports on an evaluated workshop using a speed networking method to promote inter-professional work-integrated learning (WIL) in a tertiary classroom setting. The article includes specific reference to speechlanguage therapy, nursing and social work, three of the seven disciplines that engaged with the exercise. Social constructivist learning theory is discussed with reference to development of work readiness for interprofessional teamwork among final year speech-language therapy students. The practical considerations used in facilitating the workshop are explained, with findings derived from a thematic analysis of the evaluation feedback provided. The key outcomes from the learning exercise identified an increased understanding of diverse professional identities amongst students whilst challenging pre-existing disciplinary stereotypes. Finally, the pedagogical implications of facilitating this WIL initiative are discussed. [ABSTRACT FROM AUTHOR]

Introduction. Restrictions imposed to eliminate the spread of the coronavirus disease 2019 (COVID-19) virus had significant implications on peoples’ experiences of caring for family/whānau at the end of life, and on their own bereavement process. Aim. This qualitative research explored the impact of COVID-19 lockdown restrictions on experiences of loss, grief and bereavement in Aotearoa New Zealand. Methods. This qualitative narrative research used semi-structured interviews with 10 participants who experienced the loss of a loved one during Levels 3 or 4 lockdown in Aotearoa New Zealand (23 March–13 May 2020). Interviews were coded using NVivo software and inductive thematic analysis was used to evaluate the data. Results. Results were grouped into three themes: death experience; mourning in isolation; and availability of support. These themes provide insight into the challenges and difficulties participants faced when they experienced the death of a loved one during a COVID-19 lockdown, and the impact of these restrictions on their experiences of grief and bereavement. Discussion. The findings from this research suggest there is an increased risk of prolonged grief among those bereaved during lockdown. Primary care professionals need to be aware of this increased risk in order to identify need and provide access to bereavement support. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Interprofessional education is internationally recognised as a key element in preparing a collaborative practice-ready health workforce, for improving health care outcomes and patient-centred practice. The Tairāwhiti interprofessional education (TIPE) programme was introduced in 2012 in a rural area with a high Māori population. Students from seven health professions: dentistry, dietetics, medicine, nursing, occupational therapy, pharmacy and physiotherapy participated in clinical rotations as well as working in Māori communities with Māori health providers. AIM: The primary aim was to retrospectively investigate clinical workplace providers' perspectives on their participation in the TIPE project over its first 3 years. METHODS: Face-to-face, semi-structured interviews were completed with 16 clinical workplace providers involved in TIPE. A qualitative approach using template analysis methodology and a priori themes was used to identify predominant themes from the providers' perspectives. RESULTS: All 16 providers reported positive experiences during their involvement in TIPE and wished to continue with this educational model. Benefits described included greater interprofessional collaboration at the workplace; improved engagement between students and providers; enhanced patient-centred care, particularly with Māori and whānau; and positive outcomes from community projects undertaken by the students. Although providers acknowledged additional costs on time, pressure on staff and extra workloads, all confirmed that the benefits from the project far outweighed the costs. CONCLUSION: From the providers' perspectives, the TIPE project met its objectives. Furthermore, providers noted several students had re-located back to Tairāwhiti to work as health professionals, which suggests that investment in TIPE adds long-term value to the community. [ABSTRACT FROM AUTHOR]

Background: Hospitalisation of a child is a unique opportunity for health staff to offer smoking cessation support; that is screening for carer smoking status, discussing cessation and providing interventions to carers who smoke. This has the potential to reduce the child's exposure to second-hand smoke, and in turn tobacco related illnesses in children. However, these interventions are not always offered in paediatric wards. The aim of this study was to explore the provision and prioritisation of smoking cessation support to patient carers in a paediatric ward with a high proportion of Aboriginal patients and carers in a regional area of Australia's Northern Territory. Methods: This is a qualitative descriptive study of data collected through semi-structured interviews with 19 health staff. The interviews were audio recorded and transcribed verbatim. Thematic analysis was performed on the transcripts. Results: We found low prioritisation of addressing carer smoking due to, a lack of systems and procedures to screen for smoking and provide quitting advice and unclear systems for providing more detailed cessation support to carers. Staff were demotivated by the lack of clear referral pathways. There were gaps in skills and knowledge, and health staff expressed a need for training opportunities in smoking cessation. Conclusion: Health staff perceived they would provide more cessation support if there was a systematic approach with evidence-based resources for smoking cessation. These resources would include guidelines and clinical record systems with screening tools, clear action plans and referral pathways to guide clinical practice. Health staff requested support to identify existing training opportunities on smoking cessation. [ABSTRACT FROM AUTHOR]

Background: Research and clinical outcomes that matter to people with lived experience can significantly differ from those outcomes studied by researchers. To inform a future Cochrane review of suicide and self‐harm prevention interventions, we aimed to work with young people with relevant lived experience to agree on priority outcomes. Design: Four participatory codesign workshops were completed across two sites (New Zealand, United Kingdom) with 28 young people in total. We iteratively adapted the methods over the course of the study. Results: 'Improved coping' and 'safer/more accepting environment to disclose' were the final top‐rated outcomes. 'Reduction of self‐harm' was considered a low priority as it could be misleading, stigmatizing and was considered a secondary consequence of other improvements. In contrast to typical research outcomes, young people emphasized the diversity of experience, the dynamic nature of improvement and holistic and asset‐based framing. Methodologically, dialogue using design materials (personas) to thematically explore outcomes was effective in overcoming the initial challenge of disparate quantitative ratings. Discussion: The results will directly inform the development of a Cochrane review, enabling identification of whether and how outcomes of most importance to young people are measured in trials. Rather than producing discrete measurable outcomes that could be easily added to the systematic review, the young people challenged the academic conceptualization of outcomes, with implications for future evidence synthesis and intervention research, and for future codesign. Patient or Public Contribution: Young people with lived experience were codesigners of the outcomes, and their feedback informed iterative changes to the study methods. [ABSTRACT FROM AUTHOR]

On the 22nd of February 2011, a 6.3 magnitude earthquake struck Christchurch, New Zealand. The events of February 2011, the preceding and the thousands of aftershocks have had a devastating effect on those living in the region including the junior doctor workforce. The purpose of this study was to document and describe new graduate doctors personal and professional experience of the Christchurch earthquakes. As phenomenological research, this paper seeks to describe the lived experience of the junior doctor workforce who experienced the event. This article focuses on the analysis of qualitative data generated as part of a larger mixed method study designed to capture the experience of this defined cohort of front line junior staff. A phenomenological approach was used to analyse qualitative data from survey and in-depth interviews to allow the experiences of participants to be described. Qualitative data from the survey and thematic analysis of the narratives suggest that few were emotionally prepared for the events of February. Seven themes were identified and from these we have prepared a composite narrative to demonstrate themes in the language of those interviewed. The individual experience of the earthquakes had a significant impact on individuals, their emotional well-being, living circumstances, work, and learning and for some, their career direction. This study provides an insight into the experiences and reminds us of the personal impact of disaster on a workforce. We hope it can contribute to and maybe generate interest within the health research community, in further exploring these kinds of experiences. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers' breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support. Methods: We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward. Results: Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support. Conclusions: The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers. [ABSTRACT FROM AUTHOR]

This paper reports on a study that examined children’s perceptions of the prevalence, incidence and impact of violence experienced or witnessed by them, and factors that mitigated and reduced its impact. A national survey was undertaken of New Zealand children aged 9 to 13 years, with a representative sample of 2,077 children from 28 randomly selected schools of various sizes, geographic areas and socio-economic neighbourhoods. A questionnaire was developed for children to report the nature and extent of physical, sexual and emotional violence (including bullying) experienced at home, school and in the community. To assess the impact of this violence, as well as children’s perceptions of school, their coping experiences and the extent to which they used violence in their own interpersonal relationships, analyses of data examined frequencies, bivariate correlations, t-tests and multiple regressions. Results showed a high prevalence of physical, emotional and sexual violence. The study also examined the ethical considerations and philosophy underpinning research that involves children. Guided by Article 12 of the United Nations Convention on the Rights of the Child, the findings support the controversial ethical decision to adopt a passive consent procedure and demonstrated children’s competence to express the ways in which violence has affected them. [ABSTRACT FROM AUTHOR]

The experience of Māori stroke survivors and their caregivers is the focus of this paper. A series of qualitative face-to-face interviews was conducted, firstly with Māori who had experienced stroke, and who were part of the 2002/03 Auckland Regional Community Stroke (ARCOS) study; and secondly with their primary caregivers. Experiences of Māori stroke survivors and caregivers are presented under the following themes: experience and knowledge of stroke, experience in hospital and the importance of cultural identity in motivating rehabilitation, the financial impact of stroke on Māori whānau, the stigma and social isolation associated with stroke and health services, and the associated policy issues that emerge from these interviews for Māori. [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: Family-based treatment (FBT) is the current treatment of choice for adolescent AN based on positive outcomes that include weight restoration in around two-thirds of adolescents. Nevertheless around a quarter drop-out from treatment, particularly in the earlier phases, and a notable proportion of treated adolescents are reported to experience ongoing psychological distress during and post-treatment. This study explores the under-researched experiences of these adolescents. Method: Fourteen participants from Australia, New Zealand and the United Kingdom were interviewed about their experiences of FBT. An inductive thematic analysis of interview transcript data generated key themes related to their experiences, identity negotiations and the discursive materials these used to construct these. Results: The participants identified working as a family unit as key to their recovery, highlighting the importance of family therapy interventions for adolescent AN. However, they perceived an almost exclusive focus on weight restoration in the first phase of FBT was associated with experiences that included a relative neglect of their psychological distress and a loss of voice. Key within these experiences were processes whereby the adolescent engaged in identity negotiation and (re)claiming of their voice and implicit in their family standing with them in the treatment was that their life was worth saving. What was noted as most helpful was when therapists advocated and took into consideration their unique needs and preferences and tailored treatment interventions to these. Conclusions: There is a need to develop and research treatments that address, from the outset of treatment, the adolescents' psychological distress (including as experienced in the context of their weight restoration). This should be with priority accorded to the adolescent's voice and identity negotiations, as they and their families take steps to address the physical crisis of AN and in doing so, support more holistic and durable recovery. Plain English summary: Family-Based Treatment (FBT) is a well-established, intensive approach to the treatment of adolescent anorexia nervosa (AN). The first phase of treatment focuses on eating and weight restoration, where parents are given responsibility for the adolescent's home-based refeeding. This is followed by handing over of this responsibility to the adolescent with the final-phase a focusing on adolescent-specific psychological issues. While the majority of adolescents gain weight with this treatment, a substantive proportion experience ongoing psychological distress and around a quarter of families drop out in the first phase. Little is known about these adolescents' experiences. In this project, we interviewed 14 individuals who, with their family, had either dropped out of FBT and/or experienced ongoing psychological distress post-treatment. The participants noted that their parents' stance in supporting them was life-saving and contributed to a sense that their life was worth saving. However, they also noted a relative absence of focus on their psychological distress, particularly in the early stages of treatment. Most helpful for participants was when therapists took into consideration and tailored treatments to them. Future treatments need to consider ways to support an adolescent's psychological distress more comprehensively, prioritise their voice and support them in finding an identity outside of the AN identity. [ABSTRACT FROM AUTHOR]

Universities in New Zealand are increasingly focused on an employability and global citizenship agenda, leading to a proliferation of work-integrated learning (WIL) courses across diverse curriculum areas. WIL exposes students to authentic learning opportunities in a workplace. It is however an activity with inherent risks which may have significant consequences for students, universities and host organizations. This study drew on qualitative interpretive methodology to examine risks related to WIL at eight universities from the perspective of eighteen academic and professional staff. The findings indicate that significant risks for students undertaking WIL relate to the readiness and suitability of the student, the learning environment and student safety. A framework that outlines the responsibilities and conduct of students during WIL is presented. While it is acknowledged that all stakeholders are important in the WIL enterprise, it is the student experience that should be prioritized. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) is an activity with inherent risks, different from those that occur with on-campus learning experiences. Risks associated with WIL may have serious financial, reputational and legal consequences for universities, WIL staff, students and host organizations. Using a mixed methods approach, this study examined how risk was defined and perceived by those involved in WIL, across eight New Zealand universities. Differences in understanding were examined and compared across disciplines and university roles. WIL staff perceived health and safety; conduct of students; student characteristics; conduct of the host organization (including exploitation and physical safety of students) as high risk. These factors were all linked to reputational risk for the university. WIL staff (both new and more experienced) need to have a clear understanding of the risks, so they can design risk management practices to help mitigate these risks for universities, students, host organizations, as well as themselves. [ABSTRACT FROM AUTHOR]

Traditionally work-integrated learning (WIL) programs document tripartite outcomes for students, workplace organisations and universities. This qualitative research study considers a fourth stakeholder, the client. It examines clients' (n=40) perceptions of the benefits of being part of an on-campus Exercise Prescription Clinic (EPC), and students' (n=22) perceptions of their learning outcomes from participation in a New Zealand university's WIL program within a Bachelor of Sport and Exercise. The clinic provides opportunities for clients to undertake physical activity, training and rehabilitation programs in a social, supervised and safe environment, and is accessible to anyone who wants to improve their fitness for sport or health. The findings reinforce the importance of developing WIL experiences that enrich both benefits for the clients and enhance the learning outcomes for students. Designing authentic industry WIL clinical experiences for future health professionals should also enable students the opportunity to engage with a range of clients. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times. [ABSTRACT FROM AUTHOR]

Background: The number of people dying in advanced old age is increasing rapidly and building the evidence base regarding end - of - life care for older people has been identified as an international policy priority. The unique opportunity to link longitudinal studies of ageing with studies exploring the end of life circumstances of older people remains under-exploited internationally. Very little is known about the specific circumstances, cultural needs and care preferences of indigenous older people, including Māori, at end - of - life and the needs of their whānau/ extended family carers. Methods: We will use rigorous qualitative methods to conduct post-bereavement interviews with bereaved whānau and family of 50-60 people who died >80 years; approximately half of participants will be Maori. The older decedents were participants in the first longitudinal study of older people involving a specific indigenous cohort internationally: Te Puāwaitanga O Ngā Tapuwae Kia Ora Tonu, Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ). Prior to death, they completed a questionnaire regarding their end-of-life preferences and nominated a family or whānau member to participate in this separate study exploring end-of-life circumstances of those in advanced age. Discussion: Recommendations to improve care will be formulated in collaboration with participants and their local hapū (sub-tribe). Ultimately this study has the potential to inform better outcomes for the growing numbers of people dying in advanced old age both in New Zealand and internationally, as well as their whānau and family caregivers. It also highlights the ability to generate an in-depth understanding of end-of-life circumstances by appending studies of palliative and end-of-life care onto existing longitudinal studies. [ABSTRACT FROM AUTHOR]

The interplay between religion, morality, and community-making is a core theme across human experience, yet scholars have only recently begun to quantify these links. Drawing on a sample of 1512 self-identified religious – mainly Christian (86.0%) – New Zealanders, we used structural equation modeling to test hypothesized associations between Religious Orientations (Quest, Intrinsic, Extrinsic Personal, Extrinsic Social) and Moral Foundations (Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, Sanctity/Degradation). Our results show, for the first time in a comprehensive model, how different ways of valuing communities are associated with different ways of valuing religion. [ABSTRACT FROM AUTHOR]