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This paper delves into the innovative use of the potluck, or "pa'ina," as a metaphor to reimagine a research approach aimed at fostering collective understanding between non-Indigenous knowledge seekers and Indigenous knowledge guardians in Indigenous contexts. By embracing the broader context of research, this metaphor strives to create a dialogical, relational, and ethical space for knowledge seekers to engage with knowledge guardians, promoting a reciprocal and respectful relationship. Central to this metaphor is the recognition of the insider/outsider binary and the need to transcend it. Indigenous knowledge is often guarded and restricted, granted access based on relationships and shared experiences. Understanding the complexity of these socio-spatial relationships is crucial for researchers to navigate respectfully. The metaphor also draws from the Oceanic concept of "va/va/wa," signifying the space between entities and the importance of maintaining harmony and balance within relationships. This relational space between the self and the other allows for transformative encounters and meaningful connections. To navigate this third space, researchers must undergo introspective reflexive exercises to understand their situationality and how it influences their research. Knowledge seekers must unsettle their histories, understand context, listen to the stories of others, create shared understanding, and launch new relationships that are centered on respect and reciprocity. Throughout the research process, the metaphor of "pa'ina" encourages researchers to be active participants, nurturing relationships with communities they seek knowledge from and reflecting upon their role within it. The "pa'ina" metaphor offers a transformative approach for Western academia to critically examine its historical impact on Indigenous communities and embrace a more respectful and inclusive research paradigm. By centering Indigenous voices and building meaningful relationships, this third space provides an opportunity for collaborative and sustainable research for the benefit of all stakeholders involved.

Significant efforts have now been made to identify the generic competencies required to succeed across different workplace contexts. The aims of this paper were to: (i) outline factors that contributed to the increased demand for generic competencies seen over the last three decades; and (ii) review the early generic competency frameworks developed in Australia, New Zealand, the US, Canada, the UK, and other European countries. It is concluded that whilst there were significant areas of commonality amongst the frameworks, regional differences were also apparent. The paper provides a historical context for more recent research into the generic competencies that should be emphasized within tertiary-level education and training curricula. (Contains 1 table.)

This paper summarises the findings from a literature review in mobile learning, developed as part of a 2-year six-institution project in New Zealand. Through the development of a key themes codebook, we address selected key themes with respect to their relevance to learner-generated learning through emerging technologies, with attention to mobile augmented reality and mobile virtual reality. We see that these two current mobile learning affordances, complemented though relevant approaches to research and practice in mobile learning such as design-based research and connected social learning, are critical to reconceptualise learning through mobile devices. We conclude that mobile learning still requires the theories, methodologies, and practices of its own as a field. We also see a need for mobile learning to be conceptualised around ever-changing learning affordances and educational settings, rather than focusing on static structures such as content-delivery approaches, while embedding it within the scholarship of technology enhanced learning.

This paper proposes a design based research (DBR) framework for designing mobile virtual reality learning environments. The application of the framework is illustrated by two design-based research projects that aim to develop more authentic educational experiences and learner-centred pedagogies in higher education. The projects highlight the first two phases of the DBR framework, involving the exploration of mobile virtual reality (VR) to enhance the learning environment, and the design of prototype solutions for the different contexts. The design of the projects is guided by a set of design principles identified from the literature.

Objective: Professional sport occupies a prominent cultural position in societies across the globe and commercial organisations make use of this to promote their products. The present scoping review explores existing academic literature on the relationship between professional sports clubs and food and drink marketing and considers how this relationship may impact upon the public's health.Design: The scoping review searched six databases. Experts were also consulted. Records written in languages other than English were excluded. We also excluded records relating to mega events (e.g. Olympics, Football World Cup) and alcohol marketing, because of the attention already given to these.Setting: Professional sports clubs.Results: We identified 18 166 titles, reviewed 163 abstracts and read twenty-six full texts. We included six papers in the review. Four were from Australia and New Zealand. The Australasian literature focused largely on the marketing of foods and beverages to children and the potential impact on consumption. Single papers from researchers in Turkey and the USA were identified. The Turkish paper analysed shirt sponsorship in football leagues internationally and showed food and beverage (including alcohol) companies were the most common sponsors. The US paper examined a mixed reaction to a football team named after an energy drink.Conclusions: Commercial relationships between professional sports clubs and Big Food corporations have largely eluded scrutiny in much of the world. The current review highlights the lack of public health research on these relationships. Research exploring the interdependent commercial practices of food and drink companies and professional sports clubs is urgently needed. [ABSTRACT FROM AUTHOR]

Pacific students are from a minority group in New Zealand who like minority groups in other countries find transition to university difficult and success elusive. Nowhere is that successful transition more important at the University of Otago than in Health Sciences First Year (HSFY) which is a competitive entry pathway to health professional courses. Retention for Pacific students is similar to other students but poor academic achievement remains. Tinto argues that students' pre-entry attributes are major contributors to success in first year of university study. The aim of this paper is to describe the development of an instrument which predicts the performance of prospective students in the first year at university. The purpose of the instrument is to inform the development of tailored interventions aligned with students' needs. The instrument also provides an early proxy for student engagement and a benchmark for evaluating ongoing interventions. [ABSTRACT FROM AUTHOR]

Background: Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people.Methods: Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020.Results: Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities.Conclusions: This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the nature of wellbeing as multidimensional and complex provides a policy window to generate a strengths-based policy orientation to promote wellbeing in education settings. The purpose of this exploratory paper is to map how wellbeing is interpreted across public education policy documents in Aotearoa New Zealand. Method: To explore the narrative that this group of documents weave, we draw on models of holistic wellbeing, ecological systems and appreciative inquiry. Policy documents were analysed using text mining software to track notions of wellbeing; their occurrence and co-occurrence with related concepts. Results: Key findings include the predominance of wellbeing, the interrelatedness of wellbeing with relationships, and the predominance of student wellbeing over the wellbeing of other stakeholders, highlighting that current education policy does not interpret wellbeing as relational, complex or contextual. Conclusion: We argue that interpreting such documents through a wellbeing lens demonstrates the complexity and disparity of the conceptualization and contextualization. We assert that it is critical to explore possibilities for deliberate and ecological wellbeing connections within educational policy and practice for the good of all stakeholders. [ABSTRACT FROM AUTHOR]

The aim of this paper is to outline the impact Coronavirus disease (COVID)-19 has had on health research in New Zealand. We used data from the University of Otago, Christchurch, a research intensive satellite campus of the University of Otago with a large number of research only grant funded staff to highlight challenges and opportunities. All non-COVID-19 related laboratory and clinical research was suspended under New Zealand COVID-19 alert level 4 and the majority under level 3. To date, researchers predict that 95% of research projects have been affected. During the periods of lockdown research salaries continued to be paid from grants resulting in a 'salary gap' to support research staff (both academic and technical). Most funders have indicated there will be no additional funding to support researchers affected by the delays. Early and mid-career researchers have been particularly affected and are currently unable to travel for post-doctoral training and networking. A more robust career structure with adequate funding, particularly for early and mid-career researchers is required to ensure that New Zealand has a stable research work force to address the next health crisis. [ABSTRACT FROM AUTHOR]

The appointment of the University of Waikato's first Assistant Vice-Chancellor Pacific in February 2019 was an important milestone, not only recognising years of work and dedication by numerous Pacific and Māori staff, but triggering a new strategic direction for 'Pacific at Waikato'. This paper explains that journey, one that is underpinned by Pacific cultural legacies, strengths, values and identity; built on talanoa-vā; informed by research, data analytics, student and community voice; combined with strategic thought and planning; and outworked in the pan-Pacific epithet, 'imua'. This is a story of resilience, determination, negotiating a pandemic, problem-solving and innovation in an environment that seeks a 'culture of belonging' and where Pacific learners are encouraged to be themselves in the pursuit of educational achievement. This paper will be of interest to education providers, stakeholders and policy makers. [ABSTRACT FROM AUTHOR]

This paper presents data generated during a semester-long programme to support international students from countries in Melanesia and Asia embarking on masters research in education in a New Zealand university. All were scholarship recipients. The researcher-and facilitator-of the programme, was interested in documenting and understanding the nature of the students' experience as they planned and wrote research proposals. The process of developing a research proposal, as one of the early stages of 'becoming' a researcher, highlighted a number of challenges for the six case study students. The challenges are viewed from a transition or 'resituation' perspective (Eraut in Stud Contin Educ 26(2): 247-74, , ) rather than an adjustment one. A resituation perspective assumes that students brought with them 'personal expertise, practical wisdom and tacit knowledge' (Eraut , p. 42) which needed to be reconciled with what was demanded of them by different aspects of the research planning process. The resituation challenges experienced by the students included situating a perceived problem or issue in the research literature; reconciling personal research goals with the limitations of one's own agency as a researcher; integrating new learning with research goals; and reconciling the new role or identity as a researcher with the previous role as colleague or community member. The paper presents a case for providing a context for postgraduate students in which explicit recognition of what they bring to the research task, and acknowledgment of the resituation challenges can take place. [ABSTRACT FROM AUTHOR]

The article examines several papers relating to public policy schools and programs around the world. According to the author, the paper focused on six emerging programs that had representatives present, including four that usefully supplemented the conference paper's survey of broad trends in Canada, Europe, Australia and New Zealand. In addition, the programs examined have complex relationship with the demand side of policy education. Furthermore, a table showing a descriptive overview of some of the programs discussed is offered.

To be more prepared for future hazard events, learnings from past events must be identified, shared, and applied. This task does not belong solely to either practice or academia but requires a collaborative approach. In line with this goal, this special issue presents a combination of empirical research papers, research updates, and practice updates which contribute to knowledge of the impacts and outcomes of the M7.8 14th November 2016 Kaikōura earthquake in Aotearoa New Zealand, focusing particularly on lessons for the capital city of Wellington. The main focuses are how the event affected the thoughts and behaviours of Wellington residents; how organizations can improve their operation during disruptive events; and using collaborative, multi-sector approaches to identify how resilience can be understood and demonstrated. The title "Pathways to Earthquake Resilience" reflects the nature of the papers included in this special issue, bringing focus to the ways in which various sectors and disciplines can contribute to increasing resilience to earthquakes by implementing the lessons learned from past events. [ABSTRACT FROM AUTHOR]

Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.Methods: We conducted a systematic review of qualitative studies reporting lone parents' accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.Conclusion: WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs. METHODS: The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis. RESULTS: There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective. DISCUSSION: The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people's needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs. [ABSTRACT FROM AUTHOR]

ABSTRACT Kench, P.S.; Ryan, E.J.; Owen, S.; Bell, R.; Lawrence, J.; Glavovic, B.; Blackett, P.; Becker, J.; Schneider, P.; Allis, M.; Dickson, M., and Rennie, H.G. 2018. Co-creating resilience solutions to coastal hazards through an interdisciplinary research project in New Zealand, In: Shim, J.-S.; Chun, I., and Lim, H.S. (eds.), Proceedings from the International Coastal Symposium (ICS) 2018 (Busan, Republic of Korea). Journal of Coastal Research, Special Issue No. 85, pp. 1496–1500. Coconut Creek (Florida), ISSN 0749-0208. Coastal communities ‘living at the edge’ face intensification and acceleration of coastal hazard risk in the face of climate change. Communities will need to be adaptive in reducing these risks now and over long timeframes. Developing coastal hazard adaptation pathways requires co-production of interdisciplinary knowledge between scientists, policy makers and communities. However, there remains little guidance and limited dialogue about the research practices and frameworks that underpin co-created research. In a first for New Zealand, a co-created research programme is underway titled ‘Living at the Edge’ that aims to improve the resilience of coastal communities to coastal hazards. This paper provides novel insights into the complexities underpinning the formative stages of co-created research, drawing on practical experience from the Living at the Edge project. We explore the enablers and shapers that led to co-created shifts in the research project objectives and framework. Notions of integration, trust, and flexibility are three fundamental aspects that influenced the early stages of co-creation. The importance of bridging interactions with actors early on in co-created projects is exemplified. [ABSTRACT FROM AUTHOR]

This study explores patterns of alcohol drinking within a representative New Zealand sample (2887 participants (1464 female, 1423 male)). Alcohol use and drinking patterns across the population are described. Multivariable logistic regressions document associations between alcohol use and drinking patterns and the likelihood of experiencing different health outcomes. Alcohol use, early drinking initiation, frequent drinking, and heavy episodic drinking (HED) are prevalent in New Zealand and vary in relation to gender, age, and socioeconomic characteristics. Those who reported alcohol-related problems were more likely to report poor mental health (AOR: 2.21; 95% CI: 1.42–3.46) and disability (AOR: 1.79, 95% CI: 1.06–3.00), and less likely to experience positive mental health (AOR: 0.28, 95% CI: 0.18–0.42). Those who reported HED were also less likely to experience good general health (AOR: 0.61, 95% CI: 0.47–0.81) and positive mental health (AOR: 0.67, 95% CI: 0.53–0.84). Younger age cohorts were more likely to engage in early drinking, and those who initiated regular drinking before age 18 were more likely to report HED and alcohol-related problems. Findings indicate that problem drinking and HED are not only associated with poor physical health, but also reduce the likelihood of individuals experiencing positive mental health. This provides information to enable public health practitioners to target alcohol prevention strategies at the entire population of drinkers. [ABSTRACT FROM AUTHOR]

Introduction. Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim. We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods. Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-toface semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results. All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion. This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour. [ABSTRACT FROM AUTHOR]

This paper follows from the findings of the 2006 review of research on women, gender and migration published in International Migration Review. We begin by discussing three international trends in contemporary migration flows: diversification, bifurcation and feminisation; and examine their significance for New Zealand. We then review the research on gender and economic integration of migrants in developed countries in relation to three aspects: the characteristics of migrants; the strategies migrants use during settlement; and the contexts of reception in receiving communities. We identify insights and omissions in this scholarship relevant to New Zealand policy-oriented migration research. We argue that the gendered nature of migration cannot be ignored, and that while human capital approaches to economic integration are important, they are insufficient for understanding complex migrant outcomes. Rather, comprehensive, integrated and local research is required to understand migrant experience and outcomes and to assess the effectiveness of immigration policy settings. [ABSTRACT FROM AUTHOR]

In 1997, Professor Kevin Ronan published a paper in the first ever edition of the Australasian Journal of Disaster and Trauma Studies, titled "The Effects of a "Benign" Disaster: Symptoms of Post-traumatic Stress in Children Following a Series of Volcanic Eruptions". Over the next 23 years, Kevin and his many colleagues pursued aspects of children and disasters to both improve practice and advance scholarship in this area. In March 2020 we were saddened by the untimely passing of Kevin. As a tribute to Professor Ronan this special issue of the Australasian Journal of Disaster and Trauma Studies brings together accounts of current research and practice initiatives inspired by, building upon, and directly influenced by Professor Ronan's work. [ABSTRACT FROM AUTHOR]

Research and development can be classified into three categories: technology adoption, technology extension, and knowledge and technology creation. In general, technology adoption is embedded in operational forensic science laboratory practice but the latter two categories require partnerships with industry and/or academia both to conduct the research and implement the outcomes. In a 2012 survey, Australian and New Zealand forensic science laboratories identified a number of 'roadblocks' to undertaking research and operationalizing research outcomes. These included insufficient time and funding, a lack of in-house research experience and the absence of a tangible research culture. Allied to this is that, increasingly, forensic science research is conducted in a 'commercial in confidence' environment and the outcomes are not readily or cost-effectively available to be integrated into operational forensic science laboratories. The paper is predominantly reflective of the current situation in Australia and New Zealand., (© 2015 The Author(s) Published by the Royal Society. All rights reserved.)

Background: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning.Methods: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines.Results: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females).Conclusion: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning. [ABSTRACT FROM AUTHOR]

Background: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitlist and triage" model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction.Methods/design: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12 weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial.Discussion: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12615001016527 . Approved 15/9/2015. [ABSTRACT FROM AUTHOR]

Seeking ethics committee approval for research can be challenging even for relatively simple studies occurring in single settings. Complicating factors such as multicentre studies and/or contentious research issues can challenge review processes, and conducting such studies internationally adds a further layer of complexity. This paper draws on the experiences of the LINNAEUS Collaboration, an international group of primary care researchers, in obtaining ethics approval to conduct an international study investigating medical error in general practice in six countries. It describes the ethics review processes applied to exactly the same research protocol for a study run in Australia, Canada, England, the Netherlands, New Zealand, and the US. Wide variation in ethics review responses to the research proposal occurred, from no approval being deemed necessary to the study plan narrowly avoiding rejection. The authors' experiences demonstrated that ethics committees operate in their own historical and cultural context, which can lead to radically different subjective interpretations of commonly-held ethical principles, and raised further issues such as 'what is research?'. This first LINNAEUS study started when patient safety was a particularly sensitive subject. Although it is now a respectable area of inquiry, patient safety is still a topic that can excite emotions and prejudices. The LINNAEUS Collaboration now extends to more countries and continues to pursue an international research agenda, so reflection on the influences of history, social context, and structure of each country's ethical review processes is timely.

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]

This paper explores the deployment of second responders from the Wellington region to Christchurch during the civil emergencies of 2010 to 2011. Both primary and secondary data were analysed using a realist thematic approach. It was revealed that there were a group of people, known as second responders - employees of local authority and governmental organisations, who 'fell through the cracks' of the emergency management framework. This paper argues that the definition, identification and training of second responders have to be prioritised as a part of emergency management activities. This exploratory study provides the basis for further research into the role of second responders and the challenges confronting both them and those responsible for their deployment. [ABSTRACT FROM AUTHOR]

This paper summarizes an initial exploratory study undertaken to consider the ministry of New Zealand chaplaincy personnel working within the mental health care context. This qualitative research (a first among New Zealand mental health care chaplains) was not concerned with specific health care institutions per se, but solely about the perspectives of chaplains concerning their professional contribution and issues they experienced when trying to provide pastoral care to patients, families, and clinical staff involved in mental health care. Data from a single focus group indicated that chaplains were fulfilling various WHO-ICD-10AM pastoral interventions as a part of a multidisciplinary and holistic approach to mental health care; however, given a number of frustrations identified by participants, which either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of chaplaincy and thus maximize the benefits of pastoral care to patients, families, and clinical staff. Some implications of this exploratory study relating to mental health care chaplaincy, ecclesiastical organizations, health care institutions, and government responsibilities and the need for further research are noted. [ABSTRACT FROM AUTHOR]

In 2003 the Royal New Zealand Foundation of the Blind commissioned independent research to gain a greater understanding of the costs of blindness faced by its 11,300 blind, deaf-blind and vision-impaired members. The most common cost incurred by survey respondents was that of taxi use, which is used in this paper as an example of the difference between an incurred cost and a true cost of blindness. This difference is initially discussed in a qualitative framework, and then quantified. The survey data showed that many blind and vision-impaired individuals face restrictions on their use of such services as taxis due to their limited financial resources when mitigating the effects of their vision loss. This paper demonstrates why the constraints on expenditure need to be identified in order to provide better estimates of the true costs of blindness. These findings have relevance for the planning of any future investigations into the costs of disability or other similar social research. [ABSTRACT FROM AUTHOR]

This paper addresses the benefits of participatory youth research for young people who do not have the opportunity to speak out in their own immediate familial and cultural environments. Different cultural methodological processes are described with the intent of illustrating the limitations of blanket participatory designs for young people of indigenous, cross-cultural and trans-national identities. The paper includes a detailed discussion of three individual research projects developed by the author. Two involved young women of Samoan descent in New Zealand and one involved the participation of young people of diverse backgrounds in New York. These studies accentuate the potential for participatory research methods to empower young people not only within the immediate research context but also across cultures and geographical locations. [ABSTRACT FROM AUTHOR]

Background: Researchers have previously expressed concern about some national indicators of injury incidence and have argued that indicators should be validated before their introduction. Aims: To develop a tool to assess the validity of indicators of injury incidence and to carry out initial testing of the tool to explore consistency on application. Methods: Previously proposed criteria were shared for comment with members of the International Collaborative Effort on Injury Statistics (ICE) Injury Indicators Group over a period of six months. Immediately after, at a meeting of Injury ICE in Washington, DC in April 2001, revised criteria were agreed over two days of meetings. The criteria were applied, by three raters, to six non-Fatal indicators that underpin the national road safely targets for Canada, New Zealand, and the United Kingdom. Consistency of ratings were judged. Consensus outcome: The development process resulted in a validation tool that comprised criteria relating to: (1) case definition, (2) a focus on serious injury, (3) unbiased case ascertainment, (4) source data for the indicator being representative of the target population, (5) availability of data to generate the indicator, and (6) the existence of a full written specification for the indicator. On application of these criteria to the six road safety indicators, some problems of agreement between raters were identified. Conclusion: This paper has presented an early step in the development of a tool for validating injury indicators, as well as some directions that can be taken in its further development. [ABSTRACT FROM AUTHOR]

In 2000, under the rubric of `Nation-Building: Life-long Learning in a Knowledge Society', New Zealand's Labour Government launched an inquiry into the future of tertiary education in the small South Pacific nation. This review was conducted by the Tertiary Education Advisory Commission (TEAC) - a Commission established by the Government independently of New Zealand's Ministry of Education. The TEAC produced four major reports, which recommended, inter alia, the establishment of a Tertiary Education Commission (TEC) to manage the tertiary system. The Government subsequently implemented this recommendation and in mid-2002, produced its first five-year strategy paper.

Aim: The study aimed to explore the perceptions of intensive care unit staff deployed to other clinical areas. It also aimed to identify challenges that the staff face during their redeployment. Design: A mixed method study. Method: 40 participants (nurses and healthcare assistants) completed an anonymous online questionnaire, and five participants (nurses) participated in one-to-one semi-structured interviews. Participants were recruited through purposive sampling from the selected ICU/HDU. Results: Content analysis of the data revealed three major themes: "Negative feelings of redeployment", "Positive feelings of redeployment" and "Visible and Structured leadership interventions". Results indicate that ICU nursing management needs to make some additional efforts and implement the study recommendations to improve the overall perception and experience of ICU/HDU staff redeployment. Public Contribution: This research will create insight into the redeployment of intensive care unit staff to other clinical areas. Furthermore, it will add value to patient safety and improve institutional healthcare policies. [ABSTRACT FROM AUTHOR]

Introduction. Antimicrobial resistance is an infectious disease threat to public health globally, and antimicrobial stewardship among healthcare professionals is one key way to address this potential problem. Registered nurse designated prescribers are the newest group of health professionals to gain prescribing authority in Aotearoa New Zealand, yet little is known about their understanding of their antimicrobial stewardship role. Aim. The aim of this study was to explore registered nurse designated prescribers’ understanding of their antimicrobial stewardship role through their prescribing practices and approaches to clinical reasoning. Methods. This exploratory descriptive qualitative study used individual semi-structured interviews with six registered nurse designated prescribers. Thematic analysis was used to analyse the interviews. Results. Four themes were identified: antibiotic prescribing practices and antimicrobial resistance; clinical indicators for prescribing antibiotics, with the sub-themes of history taking, presence of infection and bacterial versus viral infection; patient education; and safety and monitoring. These themes provide insight into registered nurse designated prescribers’ understanding of their antimicrobial stewardship role and prescribing of antibiotics. Discussion. This research found that the registered nurse designated prescribers had an awareness of the importance of their antimicrobial stewardship role in relation to antibiotic prescribing and reducing antimicrobial resistance. Education about antimicrobial resistance and antimicrobial stewardship for this professional group can be effective, but further research is needed to understand their ongoing educational needs. [ABSTRACT FROM AUTHOR]

This paper reports a review of 55 cases of polycystic ovary syndrome by general practice registrars in the Waikato region of New Zealand. In addition to demographic data, presenting symptoms, diagnostic tests, associated conditions and treatment post-diagnosis are discussed. The majority of cases (76%) were first diagnosed by the general practitioner. The review suggests there may be a need for better recording of key diagnostic criteria and that ultrasound is being widely used as a diagnostic test despite local guide lines discouraging its use if other appropriate diagnostic criteria are met. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Falls and injury have the most devastating consequences for very old people. Depression may be a significant cause and consequence of falls. AIM: To examine the association between falls and depression in octogenarians. METHODS: LiLACS NZ (Life and Living in Advanced Age: A Cohort Study in New Zealand), cohort study data of Māori (aged 80-90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the incidence and prevalence of falls and depression. Falls by self-report were accumulated over 3 years. Geriatric depression score (GDS) was ascertained at baseline. RESULTS: Over 3 years, fewer Māori (47%) than non-Māori (57%) fell; 19% of non-Māori and 20% of Māori scored 5+ (depressed) on the GDS. For non-Māori and Māori, people with depression were more likely to fall than Māori not diagnosed with depression (OR 2.72, CI 1.65-4.48 for non-Māori and OR 2.01, CI 1.25-3.25 for Māori). This remained significant, adjusted for age and sex. Depression was a significant predictor of hospitalisations from falls for Māori (OR 5.59, CI 2.4-12.72, adjusted for age and sex) and non-Māori (OR 4.21, 2.3-7.44, adjusted for sex). CONCLUSION: Depression and falls are common and co-exist in octogenarians. GPs thinking about falls should also think about depression and vice versa. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Recognition of the need to reduce harm and optimise patient outcomes from the use of medicines is contributing to an evolution of pharmacy practice in primary health care internationally. This evolution is changing community pharmacy and leading to new models of care that enable pharmacist contribution beyond traditional realms. There is little information about the extent of these changes in New Zealand. AIM: The aim of this study was to investigate emerging roles of pharmacists in primary health care. METHODS: A 10-question electronic survey was used to collect quantitative data about location, employment and roles of pharmacists practising in primary health care. RESULTS: There were 467 survey responses. Although most pharmacists are employed by (78%, n = 357/458) and located in (84%, n = 393/467) community pharmacies, small numbers are dispersed widely across the primary health care sector. Of the 7% (n = 31/467) working in general practices, most are employed by Primary Health Organisations or District Health Boards. Limited cognitive pharmacy service provision is evident in the sector overall, but is much greater for pharmacists spending time located within general practices. DISCUSSION: The large proportion of pharmacists practising in community pharmacies emphasises the importance of the Community Pharmacy Services Agreement in facilitating increased cognitive pharmacy service provision to optimise patient outcomes. The small numbers of pharmacists located elsewhere in the primary health care sector suggest there is scope to improve collaboration and integration in these areas. Flexible funding models that promote innovation and support sustainable practice change are key. [ABSTRACT FROM AUTHOR]

INTRODUCTION: As of February 2017, almost 300,000 New Zealanders were using E-portals, offered in over 455 general practices. Patient portals are intended to give patients convenient and secure electronic access to their health information and increase their ability to manage their own health care. Early patient experience of E-portal use in New Zealand has not yet been studied. AIM: This exploratory qualitative study provides insight into E-portal use in rural primary care. METHODS: Thirty-three patients from three rural general practice sites were interviewed between December 2015 and June 2016. Eleven patients were not using a portal. Data were analysed using ethnograph and comparative analysis between two researchers. RESULTS: Four major themes emerged from the data: (i) technology acceptance, (ii) activation to full engagement with E-portals, (iii) benefits and concerns, and (iv) the impact of rural contextual understandings for these 33 patients. DISCUSSION: Portal use in New Zealand is in its infancy, but signs suggest that New Zealanders are ready and enthusiastic adopters of such technology. Engagement levels are variable and it is too soon to fully explore the impact of E-portals on the general practice culture, provider relationships and the degree to which portals increase personal self-efficacy in relation to health care. [ABSTRACT FROM AUTHOR]

This paper explores the schooling effects of discontinuities in the rules of interaction the child experiences in family and classroom. Two fundamental forms of rules are identified: exchange rules of interaction (which define allowed and expected behavior based on relative position, age, sex and/or status differences), and communal rules of interaction (which define desired and appropriate behavior based on interpersonal affinities and attitudes). Data gathered on 196 children in eight elementary school classrooms in suburban New Zealand suggest that families tend to cluster into three general types, similar to those identified by earlier researchers: Cohesive (strong in both types of rules), Coercive (strong in exchange but relatively weak in communal rules), and Laissez-faire (relatively weak in both). When classrooms are similarly classified, analyses of variance yield significant interactive effects between family and classroom interaction rules on children's academic grades. These findings suggest (a) that the greater the discontinuity in interaction rules between home and school, the more the child's academic grades decline, and (b) that children from any type of home can be relatively advantaged in some classrooms and relatively disadvantaged in others, implications for further research and theory development are discussed. [ABSTRACT FROM AUTHOR]

Background: Primary care in Aotearoa New Zealand is largely delivered by general practices, heavily subsidised by government. Te Tiriti o Waitangi (1840) guarantees equal health outcomes for Māori and non-Māori, but differences are stark and longstanding. Seven models of primary care have evolved. We hypothesised that patient health outcomes would differ between models of care; and that Māori, Pacific peoples and those living in material deprivation would have poorer outcomes from primary care. Methods: We conducted a cross-sectional study of patient-level data from national datasets and practices, at 30 September 2018, using multilevel mixed effects regression analyses (patients clustered within practices). Primary outcomes, considered to be measures of unmet need for primary care, were polypharmacy (≥ 65 years), HbA1c testing in adults with diabetes, childhood immunisations (6 months), ambulatory sensitive hospitalisations (0–14, 45–64 years) and emergency department attendances. Explanatory variables adjusted for patient and practice characteristics. Equity, by model of care, ethnicity and deprivation, was assumed if they showed no significant association with patient outcomes. Patient characteristics included: age, ethnicity, deprivation, multi-morbidity, first specialist assessments and practice continuity. Practice characteristics included: size, funding and doctor continuity. Clinical input (consultations and time with nurses and doctors) was considered a measure of practice response. Results: The study included 924 general practices with 4,491,964 enrolled patients. Traditional practices enrolled 73% of the population, but, on average, the proportion of Māori, Pacific and people living with material deprivation was low in any one Traditional practice. Patients with high health needs disproportionately enrolled in Māori, Pacific and Trust/NGO practices. There were multiple associations between models of care and patient health outcomes in fully adjusted regressions. No one model of care out-performed others across all outcomes. Patients with higher health need received more clinical input but this was insufficient to achieve equity in all outcomes. Being a Māori or Pacific patient, or living in material deprivation, across models of care, remained associated with poorer outcomes. Conclusions: Model-level associations with poor patient outcomes suggest inequity in measures that might be used to target investment in primary care. [ABSTRACT FROM AUTHOR]

Background: A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Māori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. Aims: To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. Methods: We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30–65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. Results: Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. Conclusion: RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. Trial registration: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245–0645. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM: To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS: Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS: Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION: Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts. [ABSTRACT FROM AUTHOR]