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This paper performs a critical qualitative inquiry exploring supervision pedagogies utilising duoethnography as both methodology and conceptual framing. We begin the inquiry by reflecting upon our social and cultural identities and our evolving supervisor/supervisee-colleague-friend relationship. Our critical dialogue then shifts to scrutinising our supervision experiences. Topics of relationships, ethics, power effects, cultural differences, students' anxieties and self-doubt, and institutional protocols emerged during our conversations. We analyse our narratives in light of literature on supervision pedagogy, duoethnography, and some theoretical notions drawn from critical multiculturalism and the work of Foucault and Bourdieu. In the current context of neoliberal incursions into university modalities, it is our intention that our dialogue might promote a refocusing on the need for critical socially-just supervision pedagogies, and we invite you to join us in this critical dialogic inquiry.

Compulsory teaching of Aotearoa New Zealand histories has potential to change how this country's young people think and feel about themselves. However, achieving the new curriculum's vision of a more thoughtful and responsible citizenry is unlikely to be straightforward. For Pakeha secondary school students, descendants of European settlers, the emphasis on te ao Maori could challenge a sense of centredness within the nation, and learning about colonial violence and injustice may be a source of emotional discomfort. For the new teaching framework to reach its transformative potential, these moments must be harnessed rather than allowed to block learning and engagement. This paper analyses three possible emotional responses of Pakeha students when monoculturalism is confronted and conflictual local histories are remembered: anxiety, guilt, and shame. While these emotions are usually framed as unnecessary or immobilising, I argue that they signal important starting points for Pakeha in responding to the complexity of colonialism and their complicity within it. Anxiety draws Pakeha attention to the constructed nature of the 'New Zealander' identity, and thus possibilities to de- and re-construct it, guilt pinpoints injustices that Pakeha must collectively address and monitor, and shame alerts Pakeha to their moral ideals. Yet, I also propose that if such feelings are to be harnessed constructively, they must be supplemented with a sense of mutual vulnerability and critical hope. Ultimately, this paper aims to show how discomforting emotions can either thwart or enrich learning and are therefore worth working with and through.

The purpose of this paper is to introduce the special issue on poverty, schooling and research and to tease out and discuss some of the concepts that this kind of writing and research work provokes. We frame the issue, briefly introduce each paper and then discuss "keywords" in four sections: living/knowledge, justice/connection, weakness/education, and affect/anxiety.

This paper presents a compilation of personal reflections from 66 contributors on the impact of, and responses to, COVID-19 in accounting education in 45 different countries around the world. It reveals a commonality of issues, and a variability in responses, many positive outcomes, including the creation of opportunities to realign learning and teaching strategies away from the comfort of traditional formats, but many more that are negative, primarily relating to the impact on faculty and student health and well-being, and the accompanying stress. It identifies issues that need to be addressed in the recovery and redesign stages of the management of this crisis, and it sets a new research agenda for studies in accounting education.

Folk devils have to date been significantly overlooked in previous studies of moral panics. While several studies have called attention to this problematic (Thornton and McRobbie 1995, De Young 2004, Lumsden 2009), no specific theoretical framework has been proposed for reading this dimension of a moral panic. This paper argues that a moral panic erupted over the gothic subculture following the horrific Columbine High School massacre of 20 April 1999. This paper subsequently offers a theoretical model for understanding how goths as folk devils reacted to their representation by the mainstream news media after this tragic event. Until the early 2000s very little scholarship had been produced on the gothic subculture. Instead researchers interested in the study of youth chose to focus on other subcultures, such as punk and club cultures. Although studies by Hodkinson (2002) and Brill (2008) have contributed comprehensive insights about goth to youth and subcultural studies, the subject of how goths have been the subject of moral panics has not been addressed in significant detail. This paper seeks to address this neglect, while also providing researchers interested in moral panics and youth culture a conceptual framework for better understanding folk devil reactions. (Contains 10 notes.)

The climate strikes of 2019 motivated millions worldwide onto the street and provided a platform for youth voices that demanded global climate action. This article explores the experiences of climate strike leaders in Aotearoa New Zealand questioning the motivational factors behind the youth action. In-depth interviews with 15 climate strike leaders identified emotions that influenced engagement and could motivate action. Climate strike leaders reported experiencing a series of turbulent emotional stages from apathy to action. Their experiences suggest that anxiety and anger are important stages in the emotional journey towards action. Using Boler's "Pedagogy of Discomfort," this paper examines these emotional stages that can disable or enable action. Considering youth perspectives increases our understanding of a suitable climate change educational framework that potentially supports both educators and students on this challenging journey.

Although a large body of literature recognises the impact of parent-teacher relationships on infant everyday experiences, less is known about the emotional experience and associated expectations of the adults themselves during earliest transitions. In the context of a multi-site international investigation across five countries -- Brazil, Finland, Scotland, New Zealand, and the United States -- the present paper examines teacher and parent interviews to reveal expectations prior to and after the transition to ECEC, highlighting the associated emotions that arise during this process. Irrespective of whether expectations are met, parents universally express insecurities and fears in relation to the transition. Parents are aware of the impact that the various aspects of the ECEC setting have on their child, and acknowledge difficulty in relinquishing control of the care of their child. Despite these concerns, parents consistently articulate their strong trust in the institution and the professional expertise of the staff. Correspondingly, teachers are keenly aware of the importance of their role in supporting families, and hold certain expectations for how the transition experience will play out accordingly. Regardless of country of context, the study shows that clear communication surrounding both centre and parental expectations establishes high levels of trust and ameliorates anxiety. Teacher-parent dialogues concerning routines, preferences, and anticipations are seen as pivotal in supporting a positive transition for all.

As the availability of new communication technologies increases, mental health professionals have incorporated these innovations into their practice and research. Up to now several studies have presented promising results in using the power and convenience of the Internet for clinical care. While multiple contributions focus on the potential and the advantages of therapies delivered through the Internet, mental health practitioners may take into account new technological opportunities to improve their practice. Mobile phone diffusion is expanding worldwide at breath-taking speed. In fewer than 20 years, mobile phones have gone from being rare and expensive pieces of equipment used primarily by the business elite, to a pervasive low-cost personal item. In many countries, mobile phones now outnumber land-line telephones, with most adults and many children now owning mobile phones. With high levels of mobile telephone penetration, a mobile culture has evolved, where the phone becomes a key social and cultural tool. The purpose of this paper is to explore the potentialities that mobile phones may offer in clinical care. The paper will investigate in which areas of clinical interventions mobile phones have already been successfully applied. Moreover, the paper will discuss these opportunities by presenting the results of two different studies based on the use of the mobile phone for anxiety management. (Contains 2 tables and 4 figures.)

This paper seeks to explore the relation between sexuality and pedagogy. This theoretical concern is examined with reference to two key pedagogical moments during a first-year undergraduate course about schooling and sexuality. Through critical reflection of these episodes it is argued that when sexuality is the intellectual focus of a course, the pedagogical scene becomes inescapably "sexual". While existing research analyses desire between teacher and student as a potential element of the pedagogical scene, this paper investigates how sexuality might manifest more generally and offer a pedagogical resource in educational encounters. The possibility of a sexual and embodied pedagogy that explicitly invites students to be sexual subjects in a space that traditionally prioritises mind over body is considered. How teacher and student subjects are invoked and to what ends this might be pedagogically productive are also investigated.

Christchurch-based science advisers Sabina Cleary and Carmen Kenton, from Kaha Education, talk about their experiences of supporting teachers during the COVID-19 lockdown. Insights from their experiences during a previous crisis guided them during COVID-19. They share their thoughts about useful learning to take forward as school life resumes. [This article was written with Rosemary Hipkins and Josie Roberts.]

Research into both student engagement and student emotions is increasing, with widespread agreement that both are critical determinants of student success in higher education. Less researched are the complex, reciprocal relationships between these important influences. Two theoretical frameworks inform this paper: Pekrun's taxonomy of academic emotions and Kahu's conceptual framework of student engagement. The prospective qualitative design aims to allow a rich understanding of the fluctuating and diverse emotions that students experience during the transition to university and to explore the relationships between academic emotions and student engagement. The study follows 19 mature-aged (aged 24 and over) distance students throughout their first semester at university, using video diaries to collect data on their emotional experiences and their engagement with their study. Pre and post-semester interviews were also conducted. Findings highlight that different emotions have different links to engagement: as important elements in emotional engagement, as inhibitors of engagement and as outcomes that reciprocally influence engagement. There are two key conclusions. First, student emotions are the point of intersection between the university factors such as course design and student variables such as motivation and background. Second, the flow of influence between emotions, engagement, and learning is reciprocal and complex and can spiral upwards towards ideal engagement or downwards towards disengagement and withdrawal.

Previous research has shown that children with high levels of early anxiety/withdrawal are at increased risk of later anxiety and depression. It has also been found that positive parent-child attachment reduces the risk of these disorders. The aim of this paper was to examine the extent to which positive parent-child attachment acted to mitigate the risk of later internalising disorders amongst children with high levels of early anxiety/withdrawal using data from a 30-years longitudinal study of a New Zealand birth cohort. The findings of this study showed that: (a) increasing rates of early anxiety/withdrawal were associated with an increased risk of later anxiety and depression; (b) positive parent-child attachment in adolescence was associated with a decline in the risk of later anxiety and depression; and (c) these associations persisted even after controlling for confounding factors. The implications of these findings for the role of parent-child attachment in mitigating the adverse effects of early anxiety/withdrawal are discussed. It is concluded that positive parent-child attachment in adolescence may act as a compensatory factor which buffers the adverse effects of childhood anxiety/withdrawal on risks of developing later anxiety and depression.

Is the doctoral "viva voce" a reasonable method of examination? This exploratory paper proposes that the doctoral "viva voce" (oral examination) is a slightly different hurdle for doctoral candidates for whom English is an additional language (EAL, also termed ESL) than for those whose first language is English. It investigates the experience of 11 EAL candidates at a New Zealand university to provide phenomenographical insight to the "viva voce" as an assessment process. Their additional anxiety about language highlights the problematic side of internationalisation: the need to maintain fairness, equity and impartiality in the face of diversity. What is somewhat glibly called "best practice" must accommodate the tension between institutional practice, desirably consistent and fair, and individual experience of that practice, experience that is unavoidably diverse. Unexpectedly, however, the EAL candidates critiqued the "viva voce" evaluation practice itself, endorsing it as a final confirmation of doctoral success in the English language.

How did early childhood education become "risky" for children and teachers? This paper takes a series of booklets written in the 1990s as a case study of the entry of official anxiety about sexual abuse in early childhood centres in New Zealand. I argue that these documents provided a basis for policy development which reflects risk anxiety rather than a proper, informed appraisal of any real dangers to children in early childhood education in New Zealand; in addition, the documents legitimate unprecedented ongoing (self-)regulation of teachers' practices, regulation about which critical questions cannot be asked without being understood as "denial" of abuse. It is concluded that the original documents, and the policies they engender, have had the negative and illegitimate effect of producing "risk of abuse" as a normal aspect of contemporary early childhood education. (Contains 5 notes.)

Introduction. Body image dissatisfaction and its associated challenges have been related to poorer health outcomes among adolescents worldwide, including disordered eating behaviour, depression, and anxiety. However, current prevalence estimates of these issues in Aotearoa New Zealand or, relatedly, the estimates of positive attitudes and behaviours, such as intuitive eating and body appreciation are dated. Aim. The primary aim of this paper was to provide updated estimates for a variety of constructs related to eating behaviours and body image, sourced from a diverse range of early adolescent participants. Methods. For this report, a brief online survey was advertised to adolescents throughout Aotearoa New Zealand (n = 893) via school and community noticeboards. Results. Approximately one-in-three male participants and one-intwo female participants reported body image dissatisfaction. One in four participants reported clinically significant symptoms of depression and anxiety. Discussion. Given such issues, there is clearly still much progress to be made in advancing positive health among early adolescents. Identifying potentially protective constructs such as intuitive eating and body appreciation may offer guidance into the best targets for prevention and early intervention. [ABSTRACT FROM AUTHOR]

Crisis intervention services for people experiencing psychological distress and suicidal ideation are frequently described by the people accessing them as failing to meet their needs. This paper reports a prominent finding from a realist evaluation of Taranaki Retreat—a charitable, non‐clinical organisation in New Zealand, which offers free respite for people experiencing acute distress. Using qualitative methods, the study aimed to move beyond vague notions regarding the helpfulness of respite, to a deeper understanding of the contextual factors and mechanisms which generate outcomes for such an intervention. Participant observation, focus groups with staff, semi‐structured interviews with service users, and analysis of service users' case notes were conducted over a six‐month period in 2018. The most prominent finding from the study related to 'genuine care'—care which is interpreted by the recipient as being motivated by a genuine desire to help. We present this finding as to the central mechanism in a wider programme theory developed through the realist evaluation study. We also present five key features of the care participants were offered at Taranaki Retreat which contributed to their common interpretation regarding the motivations behind this care. Upon considering the centrality of this mechanism we conclude that, in designing crisis interventions, greater consideration should be given to how the intervention can demonstrate genuine care. Having highlighted the ways in which the structure of charitable organisations appears conducive for interpretations of genuine care, we further conclude that the provision of comprehensive crisis intervention by charitable organisations should be further explored and supported. [ABSTRACT FROM AUTHOR]

Compulsory teaching of Aotearoa New Zealand histories has potential to change how this country's young people think and feel about themselves. However, achieving the new curriculum's vision of a more thoughtful and responsible citizenry is unlikely to be straightforward. For Pākehā secondary school students, descendants of European settlers, the emphasis on te ao Māori could challenge a sense of centredness within the nation, and learning about colonial violence and injustice may be a source of emotional discomfort. For the new teaching framework to reach its transformative potential, these moments must be harnessed rather than allowed to block learning and engagement. This paper analyses three possible emotional responses of Pākehā students when monoculturalism is confronted and conflictual local histories are remembered: anxiety, guilt, and shame. While these emotions are usually framed as unnecessary or immobilising, I argue that they signal important starting points for Pākehā in responding to the complexity of colonialism and their complicity within it. Anxiety draws Pākehā attention to the constructed nature of the 'New Zealander' identity, and thus possibilities to de- and re-construct it, guilt pinpoints injustices that Pākehā must collectively address and monitor, and shame alerts Pākehā to their moral ideals. Yet, I also propose that if such feelings are to be harnessed constructively, they must be supplemented with a sense of mutual vulnerability and critical hope. Ultimately, this paper aims to show how discomforting emotions can either thwart or enrich learning and are therefore worth working with and through. [ABSTRACT FROM AUTHOR]

Chronic pain is common in older people. However, little is known about how pain is experienced in residents of retirement villages ('villages'), and how pain intensity and associations are experienced in relation to characteristics of residents and village living. We thus aimed to examine pain levels, prevalence and associated factors in village residents. The current paper is a cross‐sectional analysis of baseline data from the 'Older People in Retirement Villages' study in Auckland, New Zealand. Between July 2016 and August 2018, 578 village residents were interviewed face‐to‐face by gerontology nurse specialists, using interRAI Community Health Assessment (CHA) and customised survey. We used a validated pain scale and multivariable logistic regression analyses adjusted for pre‐specified confounders. Residents' median age was 82 years; 420 (73%) were female; 270 (47%) exhibited/reported daily pain, and in 11% this was severe. After controlling for confounders, daily pain was positively associated with self‐reported arthritis (OR = 3.88, 95% CI = 2.57–5.87), poor/fair self‐reported health (OR = 3.19, 95% CI = 1.29–7.93), having no health clinic on‐site (OR = 1.76, 95% CI = 1.10–2.83), and minimal fatigue (diminished energy but completes normal day‐to‐day activities) (OR = 1.77, 95% CI = 1.11–2.81). Similar associations were observed for levels of pain. We conclude that levels of pain and prevalence of daily pain are high in village residents. Self‐reported arthritis, self‐reported poor/fair health, no health clinic on‐site and minimal fatigue are all independently associated with a higher risk of daily pain and with levels of pain. This study suggests potential opportunities for villages to better provide on‐site support to decrease prevalence and severity of pain for their residents, and thus potentially increase wellbeing and quality‐of‐life, though as we cannot prove causality, more research is needed. [ABSTRACT FROM AUTHOR]

Shortly after the COVID‐19 pandemic reached Aotearoa New Zealand, stringent lockdown measures lasting 7 weeks were introduced to manage community spread of the virus. This paper reports the findings of a qualitative study examining how lockdown measures impacted upon the lives of nurses, midwives and personal care assistants caring for community‐based patients during this time. The study involved nationwide surveys and in‐depth interviews with 15 registered nurses employed in community settings, two community midwives and five personal care assistants. During the lockdown, nurses, midwives and personal care assistants working in the community showed considerable courage in answering their 'call to duty' by taking on heightened care responsibilities and going 'the extra mile' to help others. They faced significant risks to personal and professional relationships when they were required to take on additional and complex responsibilities for community‐based patients. Despite the hypervigilant monitoring of their personal protective equipment (PPE), the need to safeguard family and community members generated considerable stress and anxiety. Many also faced personal isolation and loneliness as a result of lockdown restrictions. Moreover, the negative impacts of experiences during lockdown often continued to be felt once restrictions had been lifted, inflecting life during periods in which community transmission of COVID‐19 was not occurring. This article makes five core service delivery and policy recommendations for supporting community‐based nurses, midwives and personal care assistants in respiratory disease pandemics: acknowledging the crucial role played by community‐based carers and the associated stress and anxiety they endured by championing respect and compassion; demystifying the 'heroism' or 'self‐sacrifice' projected onto care workers; the timely provision of adequate protective equipment; improving remuneration, with adequate provision for time off; and regular counselling, peer support groups and education on work‐life balance delivered by support workers in recognition of stressors arising from these complex and isolated working conditions. [ABSTRACT FROM AUTHOR]

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This paper will explore the clinical application of tracking sequences in family therapy with a particular focus on Bowen family systems theory. It considers how sequences can be used to track the emotional process occurring in relationship interactions, and the similarities and differences of a Bowen theory‐informed approach compared with dialectical behaviour therapy and both classic and contemporary family therapy models. Case examples are utilised from the author's clinical practice to raise ideas about the therapist joining the client as a co‐researcher in this exercise and facilitating a process that helps assist the client develop their own self‐awareness and problem‐solving resources in the context of their relationships. [ABSTRACT FROM AUTHOR]

The neoliberal direction of social policy under New Zealand’s fifth National government (2008–) is demonstrated in its 2012White Paper for Vulnerable Children. This document advocates increased monitoring and policing of welfare populations and the downgrading of child protection policy to a technical administrative system for managing ‘risky’ families. TheWhite Paper’srelease came soon after the coroner’s report into the deaths of the ‘Kahui twins’, which were treated by the media as a shocking case of child abuse, and exemplified the media’s use of a fantasy of a ‘savage’ Maori welfare underclass in reporting cases of child abuse. Drawing on Isin’s analysis of ‘governing through neurosis’, this article explores how these media and policy discourses reinforce normative patterns of neoliberal citizen subjectivity by offering compelling pathways out of anxiety that re-route citizens’ anxiety over child abuse in support of neoliberal modes of citizen subjectivity. [ABSTRACT FROM AUTHOR]

Purpose |!|#8211; The purpose of this paper is to look at the role of community participation in reducing anxiety and trauma in communities during two New Zealand earthquakes: the 1987 Edgecumbe and 2003 Te Anau events and explore the effectiveness of various approaches in providing information, reducing stress, and facilitating a recovery process. Design/methodology/approach |!|#8211; The principle methods of data collection were semi-structured interviews were undertaken between October 2006 and March 2007 with key agencies and individuals involved in the response and comprehensive analysis of papers, reports and articles in newspapers. The research was undertaken prior to the 4 September 2010 and 2011 earthquakes in Canterbury, New Zealand, and therefore community recovery from these events are not discussed in this paper. Findings |!|#8211; Effective survival and recovery from disasters depends not just on people|!|#39;s abilities to cope with the physical impacts of the event, but also on how the societal environment complements and supports the complex and protracted processes of community recovery. Central to recovery is how society organises, mobilises and coordinates the diverse range of organizational and professional resources that can be called upon to assist recovery. Originality/value |!|#8211; The paper offers insight into the effectiveness and benefit of incorporating of community participation in reducing anxiety and trauma in communities during earthquakes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the perceived quality of life, unmet needs and psychological distress in patients with head and neck cancer in a rural setting in New Zealand. Method: Patients presenting with head and neck cancer in Northland, New Zealand, were asked to complete questionnaires on quality of life, unmet needs, and anxiety or depression together with a free-text option. Results: About one quarter of respondents (27 per cent) scored high in the anxiety and depression scale, with corresponding diminished quality of life scores and increased needs. Over half of respondents (54 per cent) found it challenging to travel for treatment. Financial difficulties were encountered more frequently with indigenous patients. Rurality alone does not lead to significant differences in quality of life or needs. Conclusion: After treatment for head and neck cancer, it is important to monitor and manage patients' psychological distress and ease of access to health services to improve quality of life. [ABSTRACT FROM AUTHOR]

Brad McGann's Possum has been described as a film about the primal relationship between individuals and their environment. This article draws upon Clark's work on feral ecologies in the colonial peripheries to suggest that it can also be understood as a historically specific allegory about nineteenth-century imperialism and settlement in New Zealand. [ABSTRACT FROM AUTHOR]

Background: Lisdexamfetamine dimesylate (LDX) has demonstrated safety and efficacy for treatment of Binge Eating Disorder (BED). However, to date, trials have not included participants with co-occurring psychiatric disorders. This study explores how LDX affects eating disorder psychopathology, symptoms of common psychiatric comorbidities of BED (ADHD, depression, anxiety), and psychological quality of life, in people with moderate to severe BED. Methods: These are secondary analyses of an open-label LDX trial conducted in 41 adults (18–40 years) over eight-weeks. Participants received LDX titrated to 50 or 70 mg. Clinical assessments and self-report questionnaires were conducted at baseline and 8-week follow-up. Results: Eating disorder psychopathology and psychological quality of life improved after 8-weeks of LDX. No significant group-level changes in depression, anxiety or ADHD severity scores were observed. However, the majority within the small subsets with elevated depression and ADHD symptoms experienced reduced depressive and inattentive symptom severity, respectively. Conclusions: We provide proof-of-concept evidence that LDX may provide broader psychological benefits to individuals with BED, beyond reducing their BE frequency. Effects of LDX on anxiety should be monitored closely by clinicians. Early indications suggest that LDX may be effectively used in people with BED, with and without co-occurring psychiatric conditions, however tolerability may be lower in highly complex cases. Trial registration: Australian and New Zealand Clinical Trials Registry (anzctr.org.au) #ACTRN12618000623291. Plain English summary: Lisdexamfetamine dimesylate (LDX) has been shown to reduce binge eating frequency among those with Binge Eating Disorder (BED). However, little is known about how LDX affects symptoms of common co-occurring conditions (ADHD, depression, anxiety) and mental health more broadly. In this study, 41 people with BED received an 8-week course of LDX and their symptoms were monitored before and after treatment. Overall, people experienced a robust improvement in eating disorder psychopathology and psychological quality of life. For those with higher levels of depression and ADHD, LDX had the additional benefit of improving depressive symptoms and inattentive symptom severity, respectively. The effect of LDX on anxiety symptoms appears to be more complex, with an equal proportion of people experiencing a decrease or an increase in anxiety over the course of treatment. Those who experienced reductions in anxiety during treatment tended to have greater concurrent reductions in binge eating frequency. This study provides preliminary evidence that for people with BED, LDX may be effective at improving co-occurring symptoms of eating disorder psychopathology and psychological well-being, and potentially ADHD and depression symptoms when present at an elevated level. More research is needed among a larger sample to verify these findings. [ABSTRACT FROM AUTHOR]

Background: Symptoms of anxiety and depression are common in patients with terminal illness and multiple challenges exist with timely and effective care in this population. Several centres have reported that one dose of the serotonergic psychedelic psilocybin, combined with therapeutic support, improves these symptoms for up to 6 months in this patient group. Drawing upon related therapeutic mechanisms, 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy may have the potential to achieve similar, positive mental health outcomes in this group. Preliminary evidence also supports the tolerability of MDMA-assisted therapy for anxiety and depression in advanced-stage cancer. Methods: Up to 32 participants with advanced-stage cancer and associated depression and anxiety will be randomised in a 1:1 ratio into one of two blinded parallel treatment arms. The intervention group will receive 120 mg (+ 60 mg optional supplemental dose) MDMA-assisted therapy. The psychoactive control group will receive 20 mg oral (+ 10 mg optional supplemental dose) methylphenidate-assisted therapy. For each medication-assisted therapy session, participants will undergo two 90-min therapeutic support sessions in the week preceding, and one 90-min support session the day after the experimental session. A battery of measures (mood, anxiety, quality of life, mystical experience, spiritual wellbeing, attitudes towards death, personality traits, holistic health and wellbeing, connectedness, demoralisation, expectations, qualitative data and safety measures) will be assessed at baseline and through to the end of the protocol. Participants will be followed up until either 12 months post-randomisation or death, whichever occurs first. Discussion: This study will examine the effect of MDMA-assisted therapy on symptoms of anxiety and depression in advanced-stage cancer. Potential therapeutic implications include establishing the safety and effectiveness of a novel treatment that may relieve mental suffering in patients with life-threatening illness. Trial registration: Trial registered on Australian New Zealand Clinical Trials Registry. Registration number: ACTRN12619001334190p. Date registered: 30/09/2019. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378153&showOriginal=true&isReview=true [ABSTRACT FROM AUTHOR]

Introduction: Concurrent diagnosis of gestational diabetes mellitus and mental disorders is associated with adverse outcomes for mother and child, but there is limited information about prevalence or which women are at risk. Material and methods: This study was a prospective cohort study of women with gestational diabetes from 10 hospitals in New Zealand who reported anxiety (6‐item Spielberger State–Trait Anxiety Inventory), depression (Edinburgh Postnatal Depression Scale) and health‐related quality of life (36‐Item Short‐Form General Health Survey) at time of gestational diabetes diagnosis (baseline), 36 weeks' gestation, and 6 months postpartum. Potential predictors were assessed using multivariable logistic regression. Results: Among 414 respondents, 17% reported anxiety, 16% vulnerability to depression and 27% poor mental health‐related quality of life at time of gestational diabetes diagnosis. At 36 weeks' gestation, prevalence decreased for vulnerability to depression (8%) and poor mental health‐related quality of life (20%). Younger maternal age, Pacific ethnicity, previous history of gestational diabetes, and older gestational age at time of gestational diabetes diagnosis were associated with poorer mental health outcomes. At 6 months postpartum the prevalence of mental disorders did not differ from in late pregnancy and they were associated with later gestational age at time of gestational diabetes diagnosis and elevated 2‐hour postprandial glucose concentrations. Conclusions: Perinatal mental disorders are common at time of diagnosis among women with gestational diabetes in New Zealand and had decreased by late pregnancy and at 6 months after birth. These disorders are more common among women with specific risk factors who may therefore benefit from additional support. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care.Design/methodology/approach: Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers).Findings: In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98).Originality/value: Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture may be another avenue to improve prescribing in residential aged care. [ABSTRACT FROM AUTHOR]

The aim of this paper is to report nurses' and midwives' health, vitality and well-being in relation to adherence to current health behaviour recommendations. Healthy lifestyle factors constitute a core set of parameters required if an individual wants to live a healthy life, age successfully and avoid morbidity and a premature mortality. The investigation is an observation study of Australian and New Zealand nurses and midwives. Data were generated from the e-Cohort survey and the healthy lifestyle (HL;N = 338) group categorised as those adhering to physical activity and dietary guidelines, not smoking, consuming moderate alcohol and getting between 7 and 9 hours of sleep in a 24-hour period. All others were categorised as non-healthy lifestyle (NHL;N = 338) irrelevant of the number of factors present. It was found that HL group reported less work place activity but more leisure-time activity and had a lower BMI than NHL. In addition, the HL group was most likely to report improved sleep quality and least likely to report workplace and emotional barriers in day-to-day life. In contrast, those in the NHL group were less likely to report their health as excellent and were more likely to report a history of anxiety, depression and limitations in daily activities. It was concluded that collectively, the professions need to take action and members need to change lifestyle choices around physical activity, diet, smoking, alcohol and sleep. This study has important implications for workforce planners and administrators concerned about the well-being of individual members of the professions and the nursing and midwifery workforce. [ABSTRACT FROM PUBLISHER]

• Computer assisted self interviewing (CASI) offers a relevant alternative to paper-and-pen administration, particularly in the context of transcultural psychiatry. • Symptom scores obtained with CASI are equivalent to those obtained with pen-and-paper administration. • CASI retains the construct validity of the paper-and-pen administration. Multimedia-based administration of questionnaires, presenting items both in writing and spoken word, offers numerous potential benefits in transcultural psychiatry, such as improved comprehension of each question, ease of administration, prevention of missing or arbitrary responses, and obviating subsequent data entry. The concept has become known as "Computer-Assisted Self Interviewing" (CASI), and while preliminary results are promising, previous studies have not directly compared CASI to paper-and-pen administration in a large and representative sample of refugees. The aim of this study was to evaluate the procedural validity of multilingual CASI in comparison to paper-based-administration. The Hopkins Symptom Checklist-25 anxiety and depression subscales were administered in both modalities with a total of N = 281 participants from sites in Australia, New Zealand, and Denmark. We evaluated potential deviations in both the raw item and scale scores in each modality, while psychometric properties of each subscale were compared for an Arabic-speaking subsample (n = 125). Results showed no significant differences between raw item- or scale score across the two modalities, nor between the level of construct validity. In conclusion, this study supports a wider adaptation of multilingual CASI in the context of transcultural psychiatry, both for purposes of screening and treatment evaluation. [ABSTRACT FROM AUTHOR]

BACKGROUND AND CONTEXT: New Zealand's primary mental health initiatives (PMHIs) have successfully filled a health service gap and shown good outcomes for many presenting with mild to moderate anxiety/depression in primary health care settings. Maori have higher rates of mental health disorders and complexity of social and mental health needs not matched by access to PMHIs. ASSESSMENT OF PROBLEM: The Wairua Tangata Programme (WTP), a Hawkes Bay PMHI, aimed to provide an integrated, flexible, holistic, tikanga Maori-based therapeutic service targeting underserved Maori, Pacific and Quintile 5 populations. External evaluation of the programme provided formative and outcome feedback. RESULTS: The WTP reported high engagement of Maori (particularly women), low non-attendance rates, good improvements in mental health assessment exit scores, strong stakeholder support and service user gratitude. GPs reported willingness to explore mental health issues in this high needs population. Challenges included engaging Pacific peoples and males and recruiting from scarce Maori, Pacific and male therapist workforces. STRATEGIES FOR IMPROVEMENT: Effectively meeting the target population's complex social and therapeutic needs required considerable programme flexibility, referral back into the programme and assistance with transitioning to other therapeutic or social support services. Referral criteria required adaptation to accommodate some sectors, especially youth. A group programme was developed specifically for males. LESSONS: A holistic PMHI programme delivered with considerable flexibility and a skilled, culturally fluent team working closely with primary care providers can successfully engage and benefit underserved Maori communities with complex social and mental health needs. Successful targeted programmes are integral to reducing mental health disparities. [ABSTRACT FROM AUTHOR]

This paper reports on the cost-effectiveness of pedometer-based versus time-based Green Prescriptions in improving physical activity and health-related quality of life (EQ-5D) in a randomised controlled trial of 330 low-active, community-based adults aged 65 years and over. Costs, measured in $NZ (NZ$1=A$0.83, December 2008), comprised public and private health care costs plus exercise-related personal expenditure. Based on intention-to-treat data at 12-month follow up, the pedometer group showed a greater increase in weekly leisure walking (50.6 versus 28.1min for the time-based group, adjusted means, P=0.03). There were no significant between-group differences in costs. The incremental cost-effectiveness ratios, for the pedometer-based versus time-based Green Prescription, per 30min of weekly leisure walking and per quality-adjusted life year were, (i) when including only community care costs, $115 and $3105, (ii) when including only exercise and community care costs, $130 and $3500, and (iii) for all costs, -$185 and -$4999, respectively. The cost-effectiveness acceptability curves showed that the pedometer-based compared with the time-based Green Prescription was statistically cost-effective, for the above cost categories, at the following quality-adjusted life year thresholds: (i) $30000; (ii) $30500; and (iii) $16500. The additional program cost of converting one sedentary adult to an active state over a 12-month period was $667. The outcomes suggest the pedometer-based Green Prescription may be cost-effective in increasing physical activity and health-related quality of life over 12 months in previously low-active older adults. [ABSTRACT FROM AUTHOR]

Aim: This case study of one woman's (Jane's) experience of dialogical journal writing presents a way of finding a 'compassionate image' for self-therapy. Various theoretical analyses are indicated with Mindfulness-based conceptualisations at the forefront. Methodology: Based on three recorded interviews, the narrative inquiry took place over a year. Methodologically, this paper is also one contribution to an ongoing debate about different research approaches in therapeutic writing research. Participants: This study took place in Aotearoa New Zealand, where both Jane and I are migrants. Discussion: This account draws on a report of self-directed writing for well-being, seen as an alternative to counselling or medication for depression and anxiety. It focuses on how a particular style of writing evolved and how the motivation to write continues. [ABSTRACT FROM AUTHOR]

Energy poverty in Aotearoa New Zealand is well-documented, and tertiary students have been identified as an at-risk group. However, there has been very little research on tertiary students' experiences of energy poverty in New Zealand. This paper used a nationwide online survey to investigate the extent and impact of energy poverty among tertiary students. Furthermore, it aimed to identify disparities between different demographic groups, understand the effects of COVID-19 and evaluate the effectiveness of the support policies available to students. Responses from 522 students were analysed; 85% were under 30 years old, 72% were female, 14% identified as Māori, and 14% reported having long-term disabilities or health concerns. The findings of this study are concerning. Tertiary students in New Zealand are largely living in dwelling conditions that do not meet recommended health standards and exacerbate energy poverty. Energy poverty has adverse effects on their physical and mental health; however, available support is limited or inaccessible. Most significantly, the impact of energy poverty is disproportionally affecting students with long-term disabilities or health concerns as well as students identifying as Māori. Moreover, the impact of COVID-19 further strained students experiencing energy poverty and again, disproportionally affected more vulnerable students. [ABSTRACT FROM AUTHOR]

Partially as a response to community concerns related to sexual abuse, men's interactions with other people's children have become highly regulated. This paper documents media deliberations regarding the maintenance of barriers to men's interactions with children. Attention is given to news coverage of an incidence where a man was asked to shift seats on an aircraft due to an airline policy prohibiting men from sitting next to unaccompanied children. Media framing of controversy surrounding this incidence occurred across television, radio and newspaper reports and letters to the editor and talkback radio calls. Coverage reveals tensions between negative constructions of pedophiles and positive constructions of family men. The analysis highlights dilemmas within popular knowledge regarding children's safety and discrimination against men. Implications of media framing of such issues are explored through the experiences of 12 men participating in ongoing research into bloke culture in New Zealand. Seven of these men raised the airline case to invoke tensions they face when interacting with children. Of particular note are the ways in which men use media items as shared reference points for making sense of their own situations. The research strategy of analysing media items identified by research participants enables us to demonstrate the legacy of media and community deliberations in the accounts and relational practices of men. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

How did early childhood education become "risky" for children and teachers? This paper takes a series of booklets written in the 1990s as a case study of the entry of official anxiety about sexual abuse in early childhood centres in New Zealand. I argue that these documents provided a basis for policy development which reflects risk anxiety rather than a proper, informed appraisal of any real dangers to children in early childhood education in New Zealand; in addition, the documents legitimate unprecedented ongoing (self-)regulation of teachers' practices, regulation about which critical questions cannot be asked without being understood as "denial" of abuse. It is concluded that the original documents, and the policies they engender, have had the negative and illegitimate effect of producing "risk of abuse" as a normal aspect of contemporary early childhood education. [ABSTRACT FROM AUTHOR]

Foucault's view of the body as a detailed text from which can be read a system of power is used to consider some aspects of contemporary teacher work. In particular, this paper considers the impact on primary school teachers of social anxiety about touching children. One effect has been an intensification of self-surveillance by teachers, and increased experience of child-touch and child-proximity as 'uncomfortable'. Paradoxically, teachers' need for visibility so they can be seen as innocent has the effect of constituting teachers as always and already guilty—as potential sexual abusers. This guilt is now enacted in the everyday common sense actions of 'safe' teachers. The argument is developed with reference to teacher union policy texts and interview data from teachers in a range of New Zealand primary schools. [ABSTRACT FROM AUTHOR]

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

Existing research highlights adaptive applications of spiritual intelligence, specifically its relationship to positive well-being and quality of life. Limited studies have examined its applicability within secular Western contexts. Two-hundred and fourteen New Zealand university students completed a questionnaire measuring their spiritual intelligence, resilience, and several aspects of wellbeing. Results revealed that spiritual intelligence was significantly associated with increased resilience and reduced feelings of depression and stress, but not anxiety. However, the relationship between spiritual intelligence scores and combined depression, anxiety, and stress scores was fully mediated by resilience scores, suggesting that spiritual intelligence per se may not directly affect wellbeing. [ABSTRACT FROM AUTHOR]

Background: Sleep is necessary for healthy development and mental wellbeing. Despite this, many children do not get the recommended duration of sleep each night, and many experience sleep problems. Although treatable, existing interventions for sleep disturbance are time-consuming, burdensome for families, and focus on providing behavioural strategies to parents rather than upskilling children directly. To address this gap, we modified Sleep Ninja®, an evidence-based cognitive behavioural therapy for insomnia (CBT-I) smartphone app for adolescent sleep disturbance, to be appropriate for 10 to 12 year olds. Here, we describe the protocol for a randomised controlled trial to evaluate the effect of Sleep Ninja on insomnia and other outcomes, including depression, anxiety, sleep quality, and daytime sleepiness, and explore effects on the emergence of Major Depressive Disorder (MDD), compared to an active control group. Methods: We aim to recruit 214 children aged 10 to 12 years old experiencing disturbed sleep. Participants will be screened for inclusion, complete the baseline assessment, and then be randomly allocated to receive Sleep Ninja, or digital psychoeducation flyers (active control) for 6-weeks. The primary outcome, insomnia symptoms, along with depression, anxiety, sleep quality, and daytime sleepiness will be assessed at 6-weeks (primary endpoint), 3-months, and 9-months post-baseline (secondary and tertiary endpoints, respectively). A mixed model repeated measures analytic approach will be used to conduct intention-to-treat analyses to determine whether reductions in insomnia and secondary outcomes are greater for those receiving Sleep Ninja relative to the control condition at the primary and secondary endpoints. The difference in relative risk for MDD onset will be explored at 9-months and compared between conditions. Discussion: This is the first clinical trial examining the effects of a CBT-I smartphone app in children experiencing sleep disturbance. Results will provide empirical evidence about the effects of Sleep Ninja on insomnia and other mental health outcomes. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12623000587606). Universal Trial Number: U1111-1294-4167. [ABSTRACT FROM AUTHOR]

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]

The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organizations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this article was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context. A systematic search of key databases and gray literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies and uses a narrative synthesis approach to reporting. There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3–66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 full-time equivalent (FTE) included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4. Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is a minimal amount of trend data available; therefore, it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available. CRD42021232196 [ABSTRACT FROM AUTHOR]

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

Background: Little is known about experiences and barriers for trans and non‐binary (TGNB) people eligible for cervical screening in Aotearoa New Zealand. Aims: To identify uptake, barriers and reasons for delaying cervical cancer screening among TGNB people in Aotearoa. Materials and Methods: The 2018 Counting Ourselves data on TGNB people assigned female at birth aged 20–69 years who had ever had sex, were analysed to report on experiences of those who were eligible for cervical screening (n = 318). Participants answered questions about whether they had taken part in cervical screening and reasons behind any delays in receiving the test. Results: Trans men were more likely than non‐binary participants to report that they did not require cervical screening or were unsure if they needed it. For those who had delayed cervical screening, 30% did so due to feeling worried about how they would be treated as a trans or non‐binary person and 35% due to another reason. Other reasons for delay related to general and gender‐related discomfort, previous traumatic experiences, anxiety or fear of the test and pain. Material barriers to access included cost and lack of information. Conclusions: The current cervical screening program in Aotearoa does not consider the needs of TGNB people, leading to delayed and reduced uptake of cervical screening. Health providers require education on the reasons TGNB people delay or avoid cervical screening in order to provide appropriate information and affirmative healthcare environments. The human papillomavirus self‐swab may address some of the existing barriers. [ABSTRACT FROM AUTHOR]

To date there has been little explicit theorization concerning the role of risk in global migration studies. Drawing upon Beck's concept of the 'risk society,' this paper presents an investigation of the interplay between societal risk and micro-level migration decision-making. Thick historical contextualization and interview data are used to examine the process of decision-making of South Koreans' migration to New Zealand. Four risk factors were found to contribute to their 'exit' decisions: South Korea's highly competitive, work-oriented society brought about by compressed modernity; North Korea's threat of war and the South's consequent political and military culture; the home nation's obsession with education and academic performance; and the difficulties of reconciling traditional collectivist values with upward mobility. It is argued that while elements of risk may be universal, they need to be understood within specific cultural contexts and in relation to how they influence peoples' lived experiences. [ABSTRACT FROM AUTHOR]

Background: More than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications.Objective: To evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery.Method: A two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes.Study Outcomes: The primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events.Conclusion: This study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients.Trial Registration: Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910. [ABSTRACT FROM AUTHOR]

Background Many public health experts have claimed that elimination strategies of pandemic response allow 'normal social life' to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement. Methods Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand. Results A majority of participants reported that life after elimination was 'more or less the same' as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social. Conclusions Elimination strategies can successfully allow 'normal social life' to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies. [ABSTRACT FROM AUTHOR]

Highlights: What We Already Know? The COVID-19 pandemic has caused substantial disruption to daily life. The pandemic increased anxiety and depression in the general population of New Zealand in its first 3 months. What This Article Adds? This study found that depression and anxiety reduced over the first year of the pandemic in New Zealanders. However, even in a country with low transmission, anxiety and depression remained elevated compared to pre-pandemic norms. Younger age, being a pet owner, negative life events, and having mental health disorder increased the risk of anxiety and depression. This longitudinal study investigated changes in and risk factors for anxiety and depression during the COVID-19 pandemic in a New Zealand cohort. Online surveys were distributed to 681 participants at three time-points: May 2020 (Time 1), August–September 2020 (Time 2), and March–April 2021 (Time 3). Participants completed measures of anxiety and depression, alongside measures of possible risk/protective factors. A total of 261 participants completed all three surveys and were included in analyses. Depression and anxiety reduced over time; however, levels were still significantly higher than pre-pandemic norms. Being younger, having a prior mental health disorder, experiencing negative life events due to COVID-19, and being a pet owner were risk factors for poorer depression and anxiety, whereas having higher positive mood was protective. This study demonstrates persisting negative effects of the pandemic on anxiety and depression in a context of low transmission and highlights the importance of providing psychological help to those most at risk. [ABSTRACT FROM AUTHOR]