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Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

Many theories support the idea that children's literacy learning develops as they learn to make meaning through interactions with others. These assertions are premised on the understanding that childhood literacy serves various social purposes and that these literacies are learned through participating in social contexts. In this position paper, we seek to reframe current, widely accepted understandings and definitions of literacy. We draw upon mātauranga Māori (Māori knowledge/wisdom) concepts to illustrate Māori philosophical views about the nature of knowledge production. These concepts clearly delineate the link between knowledge, literacies, and power, a link often actively overlooked by western framing of literacy. We use a Māori whakataukī (proverbial saying) to re-conceptualise current understandings of literacy, positing varied literacies and literacy practices. Within this conceptual framework Māori children are re-positioned as maurea – treasures of the highest order, born of and with mana, an integral part of generations of whakapapa (genealogy), and an essential element in an intricate web linking all things (human and non-human). This paper proposes that children are inherently and inherited-ly literate; they are born literate—inheritors of multiple and cumulative genealogies of multimodal communication and knowledge sharing. [ABSTRACT FROM AUTHOR]

Historically there is a strong, amiable and mutually respectful relationship between Australian and New Zealand obstetricians and gynaecologists (O&Gs) and the British O&G establishment represented by the Royal College of Obstetricians and Gynaecologists (RCOG). The 'Royal' prefix pays homage to this relationship. With the evolution of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), there have been suggestions that the Royal prefix no longer accurately reflects the raison d'être and aspirations of RANZCOG. This paper will explore the arguments in favour and against dropping the Royal prefix from RANZCOG. [ABSTRACT FROM AUTHOR]

This case study looks at a denial-of-access event, where airborne asbestos material was found in a government-owned building leased by the New Zealand Parliamentary Counsel Office (PCO). The paper describes how despite the lack of advance notice, the PCO demonstrated its resilience to business disruption through its leadership and culture; its networks and relationships; and being change-ready. The paper also discusses how the incident provided an unexpected opportunity to build further resilience on return to the workplace. [ABSTRACT FROM AUTHOR]

Context. The aim of farm-systems research is to test concepts in a holistic context that enables results to be as applicable as possible to commercial farmers. A downside of such research has been that it can take several seasons to be confident in the consistency of the outcomes and interpretation of the results. Scientists are often reluctant to communicate outcomes until they have clear conclusions, which conflicts with farmers' desire to see rapid answers and engage with research. Aims. This paper reviews a 3-year farm-systems research project investigating flexible milking strategies for New Zealand dairy farmers. The aims of this paper are to (1) examine the impact of real-time science communication in achieving farm system change, and (2) develop a framework for science communication and engagement in adaptive farm-systems research. Methods. The project involved farmer interviews, a farmlet experiment, a component experiment, partner farms, modelling, and a farmer reference group. We use data from sources such as e-newsletter engagement, webinar participation, web-page engagement, presentation attendance, and farmer feedback to collect insights on the impact of the project. Key results. The analysis highlighted that farmers do not always seek complete information and will follow a project as it evolves, particularly when it is highly topical. We propose a framework for delivering adaptive farm systems research and communication. The framework includes the critical aspects for real-time farm-systems research: credible evidence, rapid results, inclusion of farmer voices, meaningful outcomes, flexible communication channels, iterative feedback loops, and adaptable research design. Conclusion. Farm-systems research can be designed to communicate results to farmers as a project develops, while simultaneously using the engagement with farmers to refine the direction of the research. Implications. This framework can guide scientists leading multi-year farm systems projects to design, implement, and communicate the project outcomes to improve farmer engagement and adoption. [ABSTRACT FROM AUTHOR]

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly. [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]

Stable, healthy families are the loto or heart of strong Pacific communities. This paper addresses the problem of a decline in the strength of Pacific families. It introduces and discusses the Tongan concept of O'ofaki , as the way in which shared, core relational commitments can bring Pasifika peoples together to support one another for health and community development. This process is based on a reciprocal sharing of social capital to promote cultural solidarity and social justice. We describe two studies by the lead author, through which the concept of O'ofaki emerged. The first study utilized an action research model while the second study focused on two Pasifika-centric research approaches: talanga , which is a Tongan word for interactive talking for a purpose, and the kakala (Tongan garland) research approach. The latter approach is incorporated within a general inductive methodology as well as luva— the dissemination of the results. Finally, the paper focuses on the components of O'ofaki and its application to Pasifika communities. [ABSTRACT FROM AUTHOR]

The paper is about practice, rather than research, and shows how a complex systems engineering project was done. The project was unique, involving a problem never before investigated, namely, to find the difference in occupational safety of a train driver between being alone in a locomotive cab and having an accompanying assistant. The project used a systems methodology discussed elsewhere. It required understanding the overall New Zealand Rail system and ensuring the objective was clear. A strategy was developed based on a set of system principles. Fault trees gave accident probabilities, from which relative values of Fatal Accident Frequency Rates were computed. As a practical simplification, detailed analysis was confined to a limited part of the overall rail system which could be taken as representative of the whole. Care was taken to treat input information as a whole rather than as separate unconnected items, emphasising information quality, which varied depending on type and source. Major points were the importance of (a) a clear and coherent strategy including careful system decomposition, (b) having a body of information of high and consistent quality, (c) fostering clarity and transparency in communication, and (d) having – and learning – good communication skills. This work is part of a Special Issue on Systems Perspectives: Clarity through Examples (see Dias 2023). [ABSTRACT FROM AUTHOR]

BACKGROUND: The International Ergonomics Association is a professional association for human factors and ergonomics (HFE) professionals. Australia and New Zealand are two of 52 Federated Societies within the IEA. OBJECTIVE: This paper describes an Ergonomics and the Future World (EFW) workshop held at the IEA Triennial Congress in 2018 (IEA2018), and reports the findings of the Australia / New Zealand (Southern Cross) Cluster (SCC). METHODS: Four questions were developed by the IEA EFW committee to evaluate the ergonomics state-of-play in various world regions. Southern Cross delegates (N = 17) participated in a 90-minute workshop discussion at IEA2018 (45% participation rate for SCC delegates). A summary was presented during the IEA2018 closing ceremony and as a written report for the IEA. RESULTS: Three themes emerged from the SCC discussions: (i) the impact of technology advances on HFE professional practice;(ii) communication with internal and external stakeholders; and (iii) HFE education. CONCLUSIONS: The workshop findings are similar to issues raised at local discussions in Australia and New Zealand over past decades and mirror comments and opinions published by authors in the HFE profession. They provide a benchmark for current SCC opinion and may provide direction for future discussion of these recurring issues. [ABSTRACT FROM AUTHOR]

This paper discusses changes taking place in the delivery of work-integrated learning (WIL) in a Faculty of Māori and Indigenous Development in Auckland, New Zealand. WIL in the faculty utilized a model adopted from a business school which did not recognize key aspects of the students' lives and expectations, in particular the strong connection that Māori students can have with their communities. Over time the nature of the WIL experience is moving to a model based on Māori values. Indigenous models must be relevant to and driven by a community's underlying values, as many students feel primary responsibility to their community, and second to the academy. This paper is part of an ongoing reflection on how WIL placements in Te Ara Poutama at Auckland University of Technology can fulfil wide-ranging expectations of students and their communities and help develop a coherent Indigenous framework for WIL. [ABSTRACT FROM AUTHOR]

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid‐1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care. [ABSTRACT FROM AUTHOR]

Background: Neuroscience patients can present with agitation due to a number of factors such as the presence of cerebral abnormalities, tumours, trauma, or medications. Agitation among neuroscience patients that escalates to violence and aggression appears to be increasing and highly challenging for neuroscience nursing practice across Australasia. Neuroscience wards or units endeavour to effectively manage patients who are affected by agitation and provide appropriate training for clinical and non-clinical staff. Following a workshop through Australasian Neuroscience Nurses' Association (ANNA), a group of neuroscience nurses, passionate about improving the care of neuroscience patients presenting with agitation and the safety of the staff; collaborated and researched the most effective prevention and management strategies that can be used to ensure that care delivery for these patients is therapeutic and effective. Purpose: The purpose of this paper is to share recommendations that can guide the prevention and management of agitation among neuroscience patients from the perspective of neuroscience nurses in Australasia. Discussion: These recommendations have been discussed from hospitals across Australasia including Perth, Brisbane, Sydney, Canberra, Melbourne, and Wellington in the hope that other cities can make changes in their own hospitals to inform neuroscience nurses and allied clinicians, improve guidelines and provide effective education for staff members that interact with neuroscience patients. [ABSTRACT FROM AUTHOR]

Communication and literacy development of young children is shaped by the nature of social and cultural relationships in everyday situations. Few studies, however, have explored early story experiences encountered by infants and toddlers in naturalistic settings. We argue that personal stories about everyday lived experiences are a vital context for considering how toddlers develop communicative competencies as they participate in these stories within their families and communities. The paper presents selected findings from a qualitative study underpinned by a broad theoretical view of story embedded in a sociocultural, participatory framework. We contend that stories are collaborative, social endeavours in which intersubjectivity is accomplished collectively and multimodally. Evidence is offered of the communicative process enacted by 1-year-old Lexie, her parent, teacher and peers, as they shared meaning together in a personal story about eating lunch. Lexie and her family were participants in a wider study of the story experiences of 1-year-old toddlers, within and across their family home and early childhood settings, in a culturally diverse community of Aotearoa New Zealand. Drawing on multimodal ethnography and video data, findings illustrate how Lexie and her family, teacher and peers actively participated together in the weaving of a shared personal story using verbal, visual and kinaesthetic forms of communication. The study contributes to the field of early childhood literacy by providing unique insights into the potential of everyday personal stories as a valuable context for exploring ways children's communicative competencies are developed through relationships in family and community settings. [ABSTRACT FROM AUTHOR]

In many countries, an increasing proportion of deaths occur in residential aged care (RAC) (nursing homes) meaning that these have become both a place to live - a home- and a place to die. This paper reports on death practices and rituals in 49 RAC facilities in Aotearoa/New Zealand narrated in semi-structured interviews with staff. Themes coalesced around 'good death'. Dying alone was not seen as a good death and the demands of trying to prevent this caused tension for staff. Meeting family wishes, post death decision-making, after death practices and rituals, including communicating and remembrance of the death, were explored as part of good death. Overall, death rituals in RAC were limited. Balancing the needs of the living, the dying and the dead created tension. The rituals and practices facilities are currently enacting in death/post-death require attention, since more people will die in RAC with increasingly diverse needs. [ABSTRACT FROM AUTHOR]

Indigenous peoples throughout the world, despite being known to suffer from increased risk of stroke and traumatic brain injury (TBI), are marginalised in terms of access to rehabilitation services and have poorer health outcomes than non-indigenous peoples. Speech-language pathology services for indigenous people with aphasia have rarely been discussed in either clinical or research fora in this field, with few guidelines available for clinicians when working with indigenous clients, families, and communities. Exploiting the broad input gathered through the collective problem-solving of a focus group, the paper integrates the input of a group of practitioners and researchers at an international roundtable held in 2016 to generate a "declaration" of issues that need to be addressed regarding aphasia services for indigenous clients with aphasia. The paper aims to promote a transformative approach to service delivery that is driven by decolonizing attitudes and practices, and acknowledges historical, sociopolitical, linguistic, and family contexts as a framework for understanding indigenous clients with aphasia. [ABSTRACT FROM AUTHOR]

There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]

The Repeat Question Diary method involves research participants audio-recording many answers to a single question. This article investigates some of the features of the method that are relevant to the study of mobile practices. Particularly, the method encourages participant reflection and the paper argues that this can facilitate the study of mobile practices through enabling participants to notice and analyse previously taken-for-granted, pre-conscious, or corporeal aspects of their practices. The paper also explores the use of audio-recording in diary research and argues that audio-diaries can facilitate participant expression, particularly of emotions, and can avoid the stifling effects of self-editing in written diaries. [ABSTRACT FROM AUTHOR]

Background: The literature regarding nurses' experiences of caring for chronically critically ill (CCI) patients is scant, however, there are subtleties within the literature, identifying nurses are often challenged providing care to this patient group. This can lead to feeling frustrated, lack of control, and distress. Aims and objectives: As part of a larger study, this paper reports nurses' experiences of caring for patients during a prolonged critical illness in the intensive care unit (ICU). Design A longitudinal, qualitative, instrumental, multi‐case study consisting of six cases from four New Zealand ICUs was conducted. Theoretical underpinnings were informed by the Chronic Illness Trajectory Framework. The principles of consolidated criteria for reporting qualitative research were applied in reporting the methods and findings. Methods: Patients, family members, nurses, and other health care professionals constituted the participant groups in the larger body of work. Data were collected from observations, conversations, interviews, and document review. Data were analysed by identifying themes, developing vignettes, and trajectory mapping. Results: Nurses' experiences of caring for CCI patients in the ICU can be framed by a prolonged critical illness trajectory that is unpredictable, problematic, and prolonged. Nurses experienced distress in one of the phases in the trajectory because of uncertainty about a positive outcome for the patient related to multiple complications, with anxiety, delirium, and the suffering they witnessed. Nurses were frustrated and challenged to meet all the patient's needs because of the many tasks they needed to complete over the shift. Conclusion: Understanding the trajectory of a prolonged critical illness from the perspective of nurses, allows for challenges to be identified and is the first step in improving practice through the education of nurses. Relevance to clinical practice: Understanding the challenges posed by caring for CCI patients will assist in improving their interactions and prioritizing their care for nurses. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify and describe the international and New Zealand (NZ) evidence for models of integrated ambulatory care and describe key implementation issues and lessons learnt. Design/methodology/approach: A scoping review was conducted for published and grey literature on integrated care. Publications from 2000 to February 2019 that described integrated ambulatory care were included. Findings: A total of 34 articles were included. Internationally and in NZ, the most common models of integrated care found were: transfer, relocation and joint working. The international literature showed that transferring care from hospitals to community and other integrated models of care between the primary–specialist interface increased access and convenience for patients. However, there was insufficient evidence of clinical and economic outcomes. Very few NZ-based studies reported on effectiveness of models of care. Key implementation issues were: no viable and sustainable funding, lack of infrastructure, lack of confidence, trust and communication between providers, increased workload and time and knowledge and skills gap to perform new roles. The NZ literature highlighted the need for an appropriate location for services, committed leadership, development of a governance group representing different provider groups, strong communication mechanisms, new workforce skills and overall change management. Originality/value: The review provides an overview of key components of integrated care models in ambulatory settings and identifies some common elements across the models of care. The findings can inform the design and implementation of integrated ambulatory care in health systems. [ABSTRACT FROM AUTHOR]

This paper presents the responses of two "Spiritual Pastoral Therapists" (SPTs) at Porirua Hospital in Aotearoa New Zealand during COVID-19. The responses included the creation of local safe "bubbles," increased communication, maintaining chapel access, producing daily meditations for the employee newsletter, utilizing social media, writing letters, and using the labyrinth meditation walk. The authors record a variety of qualitative feedback from hospital staff affirming the contribution of SPT ministry in providing spiritual care services to nurture well-being among patients and hospital staff during the struggles caused by COVID-19. [ABSTRACT FROM AUTHOR]

Papers presented at the 2003 conference of HERDSA (Higher Education Research and Development Society of Australasia) proposed guidelines for change and innovation in higher education. This paper empirically studied these guidelines in the ICT environment of an institution. We explored change and innovation outputs by ICT staff at ITPs (Institutes of Technology and Polytechnics), aspects of the environment in which ICT staff work and the leadership of that environment. It appears that the particular environment does not emphasize change and innovation that one would typically expect of the ICT environments. Staff perceptions indicate that change and innovation are not highly emphasized and visibly lead by management. We advise on ways that leadership could create this environment. Empirically study of the organization for change and innovation by ICT staff will require further development of instruments that considers the observations made in this project. [ABSTRACT FROM AUTHOR]

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A growing body of research in psycholinguistics, corpus linguistics, and sociolinguistics shows that we have a strong tendency to repeat linguistic material that we have recently produced, seen, or heard. The present paper investigates whether priming effects manifest in continuous phonetic variation the way it has been reported in phonological, morphological, and syntactic variation. We analyzed nearly 60,000 tokens of vowels involved in the New Zealand English short front vowel shift (SFVS), a change in progress in which trap / dress move in the opposite direction to kit, from a topic-controlled corpus of monologues (166 speakers), to test for effects that are characteristic of priming phenomena: repetition, decay, and lexical boost. Our analysis found evidence for all three effects. Tokens that were relatively high and front tended to be followed by tokens that were also high and front; the repetition effect weakened with greater time between the prime and target; and the repetition effect was stronger if the prime and target belonged to (different tokens of) the same word. Contrary to our expectations, however, the cross-vowel effects suggest that the repetition effect responded not to the direction of vowel changes within the SFVS, but rather the peripherality of the tokens. We also found an interaction between priming behavior and gender, with stronger repetition effects among men than women. While these findings both indicate that priming manifests in continuous phonetic variation and provide further evidence that priming is among the factors providing structure to intraspeaker variation, they also challenge unitary accounts of priming phenomena. [ABSTRACT FROM AUTHOR]

Worldwide, a growing burden of health and social issues now affect young people. Interagency collaboration and the "integration" of health and social care services are advocated to address the increasingly complex needs of at‐risk youth and to reduce barriers to accessing care. In New Zealand, Youth‐One‐Stop‐Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff. Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different "world views" and cultures of agencies which can run contrary to collaborative practice. Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co‐ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care. [ABSTRACT FROM AUTHOR]

It is well documented that Health care assistants (HCAs) provide the most hands‐on care to residents in aged care facilities, and play a critical role in the provision of care to dementia residents. Over the last 25 years, a philosophy of person‐centred care has become the preferred approach to care and this has meant that HCAs are encouraged to get to know the resident very well. This paper reports the experiences of HCAs in caring for people at end‐of‐life, identifies the skills required for their work and examines the education provided against these skills. Semi‐structured interviews were conducted in 49 facilities (n = 34) across New Zealand and data analysed thematically, with the aim of critically examining the adequacy of education for health care assistants which meets their needs within a person‐centred environment. The results confirm that the skills include traditional tasks of care (showering, feeding, toileting, and dressing) but the increasingly important communication and de‐escalation skills, both verbal and non‐verbal, have become central to their care skills. Education provided has not sufficiently shifted focus to include these more complex skills. Provision of educations that acknowledges the increased complexities of their role needs to be provided. As well, facilities need to be challenged to reconsider the HCA's position in the facility care tem. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to compare different employee perceptions of the success of one change: a move to new offices and an open-plan design. Design/methodology/approach: In sum, 25 interviews were carried out in a New Zealand law firm that six months earlier had moved to new premises. Findings: Contrary to academic and practitioner reports that open-plan offices are disliked, participants appreciated the new office space. A well-planned and highly participative program of change management led to positive perceptions of aesthetic design, open communication, collegiality, egalitarianism and inclusiveness. Research limitations/implications: Given the small sample used in one organization, the study highlights the need for more research into the processes and outcomes of office space changes. Originality/value: The roles of communication and culture, in particular, collegiality and egalitarianism, were salient factors in a complex web of causes and consequences in this context of change. [ABSTRACT FROM AUTHOR]

Work-integrated learning (WIL) has attracted considerable attention as an instrument for enhancing professional practice and developing work-readiness in graduates. It is widely considered as a point of difference in developing graduate employability by enhancing skill outcomes through an authentic learning experience. This paper focuses on student insights of the added value of WIL and their development of personal and professional graduate attributes. Thematic content analysis was undertaken of students' reflections (n=271) of their perceived learning outcomes and overall experiences from their sport management and coaching WIL experiences at Massey University, New Zealand. The findings show that enjoyment, achievement and reinforcing career decisions added value to the student's experiences. Gratitude for the support and mentoring of workplace and academic supervisors was also evident. Development of personal attributes involving self-management, enterprise, and effective communication were important learning outcomes. Professional development of a community of practice and leadership responsibilities were also highlighted. [ABSTRACT FROM AUTHOR]

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

This paper presents findings from a study exploring the nurses' experience of caring for adults with intellectual disability and mental health issues in inpatient settings. Semi structured interviews were undertaken with 13 nurses from various regions of New Zealand. Methods suggested by an Appreciative Inquiry methodology were used to explore the nurses' positive experiences of their role. Interviews were transcribed and analysed using open coding and Leximancer (an online data mining tool) analysis to identify dominant themes in the discourse. Analysis revealed themes around 'Contextualising behaviour', 'Communication', 'Confidence to care' and 'Time'. Participants reflected upon their experiences offering personal interpretations in identifying the aspects of nursing that mattered and that worked. What is shown is that nurses were able to describe a range of creative and adaptive ways of nursing in responding to numerous complex factors they faced in their roles. This suggests a strong foundation on which to advance nursing care in this field. [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]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate the development of institutional repositories in New Zealand, exploring factors affecting the adoption and success of institutional repositories from the perspective of the library managers who established them, and from the perspective of the academic community. Design/methodology/approach – Data from a series of interviews with library managers are compared with the findings from a randomised national survey of academics. Findings – The responses of the library managers suggest that they are positive about the value of their institutional repository, and the progress made towards recruiting content for it. Data from the survey of academics indicate that academics have been slow to embrace the concept of institutional repositories, and show little interest in using repositories for increasing the accessibility of their own work, or to access the work of others. The number of deposits remains low, mirroring patterns throughout the world, and subject or disciplinary repositories appear to have greater value to the academic community. Practical implications – The future long-term sustainability of institutional repositories depends on gaining a stronger commitment from the academic community, or developing different goals, against which their success might be measured. Originality/value – The study is the first random survey of academic staff across all disciplines, and an entire country, and the findings have a very high level of generalisability. [ABSTRACT FROM AUTHOR]

INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy. AIM: The purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy. METHODS: Semi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants' perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach. RESULTS: Four themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs). DISCUSSION: Both general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper was to determine the value and impact of the Leadership Development – Coaching and Mentoring Programme at Counties Manukau Health and understand how the skills gained are applied.Design/methodology/approach Mixed-methods approach including surveys of programme participants and senior staff and semi-structured interviews with programme participants.Findings The survey response rate was 24.4 per cent for programme participants and 30 per cent for senior staff. Eight programme participants participated in semi-structured interviews. Of the 70 programme participants, 69 utilised their learning from the programme; 45 of 70 changed their approach to managing staff; and 40 of 68 programme participants reported that meeting with peers for triad group coaching was the most challenging aspect of the programme. Key themes identified through interviews included: working with others; not owning others’ problems; professional support and development; coaching and mentoring; future participants.Practical implications The majority of participants changed their leadership behaviours as a result of the programme, which has resulted in improved communication, a more supportive culture and distributed leadership. These changes contribute to better patient care.Originality value There is a paucity of evidence in the literature about the impact of coaching and mentoring programme on leadership development and how the skills gained in such programmes are applied in practice in a healthcare context. This evaluation helps to address that gap. [ABSTRACT FROM AUTHOR]

Background: The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. Objective: To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. Design: Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. Results: The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. Conclusion: Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them. [ABSTRACT FROM AUTHOR]

Background: Digital contact tracing (DCT) was a central component of the global response to containing COVID‐19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID‐19 are typically underrepresented. Methods: The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants. Results: Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID‐19 interventions. Conclusions: The findings highlight how addressing communication inequality can assist in the development of contact‐tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. Patient or Public Contribution: Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors. [ABSTRACT FROM AUTHOR]

Aims: Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. Design: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach. Methods: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audiorecorded and then inductively coded and developed into themes. Results: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized. Conclusions: The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services. Implications for the profession and/or patient care: Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging. Impact (Addressing): • What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. • What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. • Where and on whom will the research have an impact? This research impacts Indigenous peoples' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development. Reporting method: We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2—CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3—COREQ Checklist). [ABSTRACT FROM AUTHOR]

Maternal mental health plays a vital role in the overall wellbeing of mothers, children, families, whānau (core support network) and communities. However, many mothers face mental health challenges during the transition to parenthood. In this study, we used an online story-sharing platform to collect the experiences of mothers who have faced unmet needs while using the Well Child Tamariki Ora (WCTO) service in Aotearoa New Zealand. From the 420 submitted stories, 125 stories related to mental health need while using the WCTO service. Using thematic analysis, we identified three main themes that highlighted the experiences of mothers with the service. This includes (1) making it seem that I'm coping: Mothers' fear of being judged; (2) i wish I had connected with my WCTO nurse: Fostering meaningful relationships to facilitate personal information sharing; and (3) beyond the baby: Mothers desire for recognition and support during WCTO visits. These findings point to several missed opportunities for WCTO providers to inquire about mental health and offer support needed by mothers. To address this, a relational approach to care would prioritise families and whānau as the focus of care rather than just monitoring the development of babies. [ABSTRACT FROM AUTHOR]

Introduction. In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim. This study aims to explore the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods. Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results. In total, 11 participants aged 19-65 years completed the interviews (female n = 9 and male n = 20); the comprised Māori (n = 5), NZ European (n = 5) and Asian (n = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion. Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau. [ABSTRACT FROM AUTHOR]

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

Summary Background Presentations to emergency departments (EDs) and patient acuity continue to increase. Whilst strategies to deliver safe patient care in the ED are evolving, emergency nurses need to be well educated through specialist qualifications to enable delivery of advanced patient care. This paper presents a comparative analysis of available international practice and competency standards for nurses graduating from emergency nursing courses in Australia, Canada, New Zealand, the United Kingdom, and the United States. Methods CINAHL, Scopus, Ovid MEDLINE, and Embase were searched for papers, published in English, using the terms: ‘emergency’, ‘accident and emergency’, ‘nursing’, ‘competency’, ‘practice standards’, ‘scope of practice’, ‘regulation’, and ‘specialist standards’. Secondary sources from relevant reference lists and professional websites were also searched. Results The standards from the five countries were common across five domains: clinical expertise, communication, teamwork, resources and environment, and legal. None of the standards were specific to the emergency nursing graduate, and there was variability in the level of expertise required for which the standards apply. Conclusions The available practice standards demonstrated some commonality. Consideration of the utility of a universal framework for informing the development of emergency nursing practice standards and emergency nursing curriculum for nurses wishing to specialise is needed. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field. Aims: To examine how speech and language therapists perceive their role in the delivery of palliative care to clients, to discover current international speech and language therapist practices and to explore the similarities and differences in speech and language therapists’ practice in palliative care internationally. This will inform professional clinical guidelines and practice in this area.Design:Anonymous, non-experimental, cross-sectional survey design.Participants:Speech and language therapists working with adult and paediatric palliative care populations in Republic of Ireland, United Kingdom, United States, Canada, Australia and New Zealand where the speech and language therapist profession is well established. Method: Purposive and snowball sampling were used to recruit participants internationally using gatekeepers. An online survey was disseminated using Survey Monkey (http://www.surveymonkey.com). Results: A total of 322 speech and language therapists responded to the survey. Speech and language therapist practices in palliative care were similar across continents. Current speech and language therapist practices along with barriers and facilitators to practice were identified. The need for a speech and language therapist professional position paper on this topic was emphasised by respondents. Conclusion: Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care. [ABSTRACT FROM AUTHOR]

This article draws on the findings of the qualitative phase of a New Zealand longitudinal study on vulnerable young people’s transitions to adulthood. The young people were aged between 12 and 17 years at the time of the first interview. The paper focuses on one key finding, how youth enact agency through their relationships with significant others: families, social workers, teachers and care workers. These youth had experienced sustained exposure to harm including abuse, violence, addictions, disengagement from school and mental health issues. The qualitative interviews focused on young people’s experiences with services (child welfare, juvenile justice, mental health and education support services) their key transitions, and the strategies they used to locate support and resources. The thematic analysis of the interviews indicated that a search for agency was a central motif in young people’s experiences. This was reflected in three thematic clusters: making sense of the world, having a voice and acting on the world. [ABSTRACT FROM AUTHOR]

This paper incorporates peer researchers from refugee backgrounds to deconstruct their experiences of conducting interviews and focus groups with refugee communities in a post-disaster environment in the Canterbury region of New Zealand. The associated dynamics illustrate the contextual intricacies of recruitment, building relationships, the politics of interpreting and engaging with people’s lived experiences in respectful and safe ways. The peer researchers’ experiences highlight several methodological and ethical complexities to critically examine the role of ‘insiders’ and ‘outsiders’ as a continuum when working in post-disaster contexts with culturally and linguistically diverse populations. [ABSTRACT FROM PUBLISHER]

Background: Diabetes is a major health issue for individuals and for health services. There is a considerable literature on the management of diabetes and also on communication in primary care consultations. However, few studies combine these two topics and specifically in relation to nurse communication. This paper describes the nature of nurse-patient communication in diabetes management. Methods: Thirty-five primary health care consultations involving 18 patients and 10 nurses were video-recorded as part of a larger multi-site study tracking health care interactions between health professionals and patients who were newly diagnosed with Type 2 diabetes. Patients and nurses were interviewed separately at the end of the 6-month study period and asked to describe their experience of managing diabetes. The analysis used ethnography and interaction analysis. In addition to analysis of the recorded consultations and interviews, the number of consultations for each patient and total time spent with nurses and other health professionals were quantified and compared. Results: This study showed that initial consultations with nurses often incorporated completion of extensive checklists, physical examination, referral to other health professionals and distribution of written material, and were typically longer than consultations with other health professionals. The consultations were driven more by the nurses' clinical agenda than by what the patient already knew or wanted to know. Interactional analysis showed that protocols and checklists both help and hinder the communication process. This contradictory outcome was also evident at a health systems level: although organisational targets may have been met, the patient did not always feel that their priorities were attended to. Both nurses and patients reported a sense of being overwhelmed arising from the sheer volume of information exchanged along with a mismatch in expectations. Conclusions: Conscientious nursing work was evident but at times misdirected in terms of optimal use of time. The misalignment of patient expectations and clinical protocols highlights a common dilemma in clinical practice and raises questions about the best ways to balance the needs of individuals with the needs of a health system. Video- recording can be a powerful tool for reflection and peer review. [ABSTRACT FROM AUTHOR]

With the increasing burden of chronic kidney disease (CKD) in New Zealand (NZ) the number of people requiring pre-dialysis care is increasing. Pre-dialysis nurses play a central role in the delivery of this care. This paper describes and discusses what pre-dialysis nurses perceive to be key influences on effective pre-dialysis nursing care in NZ. It is based on findings from a wider qualitative study that interviewed the majority of NZ pre-dialysis nurses. Following inductive data analysis four main influences were identified. They were: having time from referral to commencement of renal replacement therapy (RRT) to provide adequate education and support; having good access to cultural and other supports and an understanding of differing cultural views of health; the importance of good inter-professional relationships; and support from nursing management and doctors to advance professionally. With the knowledge of the projected increase in patients with CKD, we argue that it is important to ensure the positive aspects of these influences are enhanced in order to ensure effective pre-dialysis nursing care, nurse satisfaction and professional advancement. [ABSTRACT FROM AUTHOR]

The Education Review Office (ERO) conducted an external evaluation in over two hundred New Zealand schools to find out more about the engagement between schools and the parents and whānau (families and extended families) of their students. This paper provides some historical background and key findings from the relevant literature before expanding on the six key factors which the evaluation found were critical to enhancing and strengthening this engagement: leadership, relationships, school culture, partnerships, community networks, and communication. The paper concludes with recommendations for ways in which all parties can strengthen this vital relationship. [ABSTRACT FROM AUTHOR]