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Aims: The aim of this study is to measure staff compliance with the local umbilical cord lactate (UCL) sampling guideline and investigate the quality of paired UCG samples at a tertiary maternity unit. Methods: We performed a retrospective consecutive sampling of 100 babies delivered via emergency caesarean section and 50 babies with each of all other guideline‐based indications for UCL sampling born on and before 31 December 2021. Data were extracted from physical and electronic records. Compliance with guideline‐based indications for UCL at birth was measured. The proportion of valid UCG samples was calculated. Samples were considered invalid under the following cases: (i) inadvertently collecting from the same vessel, (ii) switching arterial and venous samples, (iii) collecting from only one vessel or (iv) committing errors during sample collection and handling. Results: Of the samples collected at birth from 321 babies, 280 (87%) had UCL. Small for gestational age and concerns about fetal well‐being in labour were indications associated with poorer compliance, 66% and 78%, respectively. About 99 (44%) babies of 226 babies with UCG performed had valid UCG samples. The most common reasons for invalid samples were collection and handling errors (22%) and inadvertent collection from the same vessel (15%). Conclusions: Generally, compliance with the guidelines is good. However, invalid UCG samples were more frequent than expected. [ABSTRACT FROM AUTHOR]

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care. [ABSTRACT FROM AUTHOR]

Purpose: This study examines how carbon tools, including carbon accounting and management tools, can be created, used, modified and linked with other traditional management controls to materialise and effectuate organisations' response strategies to multiple interacting logics in carbon management and the role of sustainability managers in these processes. Design/methodology/approach: This study utilises the construct of accounting toolmaking, which refers to practices of adopting, adjusting and reconfiguring accounting tools to unfold how carbon tools are used as means to materialise responses to multiple interacting carbon management logics. It embraces a field study approach, whereby 38 sustainability managers and staff from 30 organisations in New Zealand were interviewed. Findings: This study finds that carbon toolmaking is an important means to materialise and effectuate organisations' response strategies to multiple interacting carbon management logics. Four response strategies are identified: separation, selective coupling, combination and hybridisation. Adopting activity involves considering the additionality, detailing, localising and cascading of carbon measures and targets and their linkage to the broader carbon management programme. In adjusting carbon tools, organisations adapt the frequency and orientation of carbon reporting, intensity of carbon monitoring and breadth of carbon information sharing. Through focusing on either procedural sequencing, assimilating, equating or integrating, toolmaking reconfigures the relationship between carbon tools and traditional management control systems. Together, these three toolmaking activities can be configured differently to construct carbon tools that are fit for purpose for each response strategy. These activities also enact certain roles on sustainability managers in the process of representing, communicating and/or transferring carbon information knowledge, which also facilitate different response strategies. Practical implications: The study demonstrates the various carbon toolmaking practices that allow organisations to handle the multiple interacting logics in carbon management. The findings provide suggestions for organisations on how to adopt, adjust and reconfigure carbon tools to better embed the ecological logic in organisations' strategies and operations. Originality/value: The authors identify how carbon toolmaking materialises and effectuates organisations' responses to multiple interacting logics in carbon management. [ABSTRACT FROM AUTHOR]

In light of climate change, zero carbon refurbishment for existing buildings is imperative for maximising carbon emission reductions. Due to the increasing complexity of reducing carbon emissions for existing buildings, there is a need for a more collaborative and integrative approach. Extensive research has shown the importance, benefits, and challenges of collaboration and integration in implementing sustainable buildings. However, little attention has been paid to investigating collaboration and integration in refurbishment projects that focus on reducing life cycle carbon emissions. This paper explores the collaboration and integration in the decision-making process towards zero carbon refurbishment by examining three real-life case studies in New Zealand. The findings resulted from an interactive cross-case analysis using replication logic within and among cases. Empirically, the study emphasises the importance of (1) organisational commitment and compatibility of team members, (2) the timely involvement of key stakeholders, (3) the highest level of integration in the design process, and (4) a centralised and integrated information system. The paper also divulges the current practices and challenges faced in the integration process, where lessons learnt are identified for future refurbishment projects. A collaboration and integration framework towards successfully delivering building projects towards zero carbon is proposed. The research implications may assist the real-world uptake of the zero‑carbon refurbishment approach by promoting effective collaboration and integration. • An interactive analysis between theoretical propositions and cross-case synthesis • Divulging challenges and lessons learnt in the collaboration and integration process • Proposing a collaboration and integration framework towards zero carbon refurbishment • Promoting an effective collaboration to assist the real-world uptake of zero-carbon refurbishment [ABSTRACT FROM AUTHOR]

Molecular-based approaches for harmful algal bloom species, which can be difficult to identify by light microscopy, are important tools for detecting and predicting the blooms. In this study, 84 samples from Aotearoa/New Zealand coastal waters that contained Azadinium-like cells were analysed using an Amphidomataceae real-time PCR assay. Nineteen samples were positive, and 24 Azadinium-like clonal isolates were established from these samples. Subsequently, only five isolates from one sampling point were positive using the real-time PCR assay. Four of the five isolates were genetically identified as Amphidoma languida and one as Azadinium dalianense. The field samples were analysed retrospectively using the species-specific real-time PCR assays; Am. languida was detected from the temperate areas, while Az. poporum and Az. spinosum were detected at one site. Two representative strains of each species were analysed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), including Am. languida, which is known as toxic in the previous studies, but neither produced the currently monitored azaspiracids (AZAs). These two newly recorded species for New Zealand are important findings. The results highlight the need for more information on the spatio-temporal variations of potentially toxic Amphidomataceae species and the risk of AZAs in New Zealand coastal waters. [ABSTRACT FROM AUTHOR]

This article examines the drivers and process of change in carbon controls within a New Zealand electricity utility, using a meta‐triangulation approach that employs three theoretical perspectives (transactional cost economics, the resource‐based view and new institutional sociology). Results suggest three main objectives motivate carbon controls: cost control, competitiveness and legitimacy. Multiple environmental demands and expectations were met by focusing controls on a particular stakeholder group or objective. Further, the research identifies the conditions under which carbon controls are integrated and institutionalised within an organisational management control system. The theoretical interplay provides insight into inter‐relationships between institutional environments, organisational resources and carbon transactional characteristics. [ABSTRACT FROM AUTHOR]

Background: Starfield described the importance of system-level components of primary care (first contact, continuous, comprehensive, coordinated), on countries' health systems. It is postulated that, at the individual level, interpersonal interactions and relationship-centred care are central to primary care. Aim: To explore the impact of COVID-19 on disruption to the doctor--patient relationship and subsequent development of new models of care. Design & setting: A series of 11 cross-sectional surveys of New Zealand (NZ) urban and rural primary care doctors, nurses, and managers, from May 2020 to February 2021, to understand and monitor responses to the pandemic. Method: Using inductive content analysis, cumulated qualitative data from doctors were examined through the lenses of the doctor--patient relationship, its disruption, and resulting changes in models of care. Results: There were 1519 responses to the surveys, representing 482 unique participants. The majority (86%) of responses were from doctors. The following four key themes emerged: moving to transactional consultations; task-shifting with team changes; creating a production line; and diminished communication and coordination across services. Conclusion: The advent of the pandemic led to severe and ongoing strain on practices requiring rapid change to the model of care. Team members took on new roles for triaging, testing, and separating patients with respiratory and non-respiratory symptoms. There was a rapid move to telehealth, with policies developed on where face-to-face consultations were necessary. Practice strain was exacerbated by disruption to coordination with secondary and other referral services. As new models of general practice develop, further disruptions to development of doctor--patient relationships must be avoided. This work extends Starfield's system-level paradigm to the individual level, with the core value of primary care the doctor--patient relationship. Successful sustainable models are likely to be where relationships are treated as of central importance. [ABSTRACT FROM AUTHOR]

In light of climate change, the construction industry plays a crucial part in alleviating carbon emissions and other environmental impacts. The focus on improving the public procurement process poses an important opportunity for the successful implementation of carbon reduction strategies in construction projects. There is a growing body of literature mapping green and sustainable procurement practices in construction. However, previous studies have not treated the implementation of procurement in a particular area, such as carbon reduction, in much detail. This study aims to investigate the implementation of construction procurement incorporating carbon reduction strategies, with a specific focus on the public sector in New Zealand. The research was conducted through 13 semi-structured interviews with construction procurement experts in New Zealand. The results shed light on the current implementation of carbon reduction strategies in construction procurement and its challenges, such as a lack of knowledge and ambiguous procurement guidelines and documents. It also emphasises the importance of (1) well-developed carbon reduction evaluation criteria, (2) specifying a budget for carbon-related initiatives, and (3) the prerequisite of a high level of innovation in the procurement document. The study adds to the rapidly expanding field of carbon reduction construction procurement by providing a deeper insight into the way carbon reduction strategies are effectively implemented in the procurement process. [ABSTRACT FROM AUTHOR]

Harmful algal blooms (HABs) have wide-ranging environmental impacts, including on aquatic species of social and commercial importance. In New Zealand (NZ), strategic growth of the aquaculture industry could be adversely affected by the occurrence of HABs. This review examines HAB species which are known to bloom both globally and in NZ and their effects on commercially important shellfish and fish species. Blooms of Karenia spp. have frequently been associated with mortalities of both fish and shellfish in NZ and the sub-lethal effects of other genera, notably Alexandrium spp., on shellfish (which includes paralysis, a lack of byssus production, and reduced growth) are also of concern. Climate change and anthropogenic impacts may alter HAB population structure and dynamics, as well as the physiological responses of fish and shellfish, potentially further compromising aquatic species. Those HAB species which have been detected in NZ and have the potential to bloom and harm marine life in the future are also discussed. The use of environmental DNA (eDNA) and relevant bioassays are practical tools which enable early detection of novel, problem HAB species and rapid toxin/HAB screening, and new data from HAB monitoring of aquaculture production sites using eDNA are presented. As aquaculture grows to supply a sizable proportion of the world's protein, the effects of HABs in reducing productivity is of increasing significance. Research into the multiple stressor effects of climate change and HABs on cultured species and using local, recent, HAB strains is needed to accurately assess effects and inform stock management strategies. [ABSTRACT FROM AUTHOR]

Purpose: The authors unpack the critical role of rhetoric in developing and justifying the New Zealand (NZ) government's coronavirus disease 2019 (COVID-19) lockdown strategy. Design/methodology/approach: Using Green's (2004) theory of rhetorical diffusion, the authors analysed government documents and media releases before, during and after the lockdown to reconstruct the government's rationale. Findings: The blending of kairos (sense of urgency and "right" time to act), ethos (emphasis on "saving lives"), pathos (fear of disruption and death) and selective use of health-based logos (shrinking infection rates), prompted fast initial adoption of the lockdown. However, support for the rhetoric wavered post-lockdown as absence of robust logos became apparent to the public. Research limitations/implications: The authors implicate the role of rhetoric in decision-makers' ability to successfully elicit support for a new practice under urgency and the right moment to act using emotionalisation and moralisation. The assessment of the NZ government's response strategy provides insights decision-makers could glean in developing policies to tame the virus. Practical implications: This study's analysis demonstrates the unsustainability of rhetoric in the absence of reliable information. Originality/value: The authors demonstrate the consequences of limited (intermittent) evidence and disregard for accounting/accountability data in public policy decisions under a rhetorical strategy. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate whether educating junior doctors and hospital pharmacists about analgesic prescribing improved discharge prescribing of opioids for opioid‐naïve patients after surgical admissions. Design: Cluster randomised controlled trial, undertaken during the first half of 2019. Setting: The Alfred Hospital, a major Melbourne teaching hospital with 13 surgical units. Participants: Opioid‐naïve patients discharged from surgical units after a stay of at least 24 hours. Intervention: Surgical units were randomised to the intervention or control arms. Interns, residents, and clinical pharmacists assigned to intervention arm units attended education sessions, presented by the hospital analgesic stewardship pharmacist, about appropriate analgesic prescribing for patients in hospital surgical units. Main outcome measures: The patients prescribed slow release opioids on discharge from hospital during the baseline (1 February – 30 April 2018) and post‐intervention periods (17 February – 30 April 2019). Results: During the baseline period, 1369 intervention unit and 1014 control unit admissions were included in our analysis; during the evaluation period, 973 intervention unit and 706 control unit episodes were included. After adjusting for age, length of stay, pain score, acute pain service involvement, and use of immediate release opioids prior to admission, patients in the intervention group were prescribed slow release opioids at discharge less frequently than patients in the control group (adjusted odds ratio [aOR], 0.52; 95% CI, 0.35–0.77) and were more frequently discharged without any prescribed opioids following the intervention (aOR, 1.69; 95% CI, 1.24–2.30). Providing de‐escalation plans was more frequent for intervention than control group patients prescribed slow release opioids on discharge post‐intervention (OR, 2.36; 95% CI, 1.25–4.45). Conclusions: Specific education for clinicians and pharmacists about appropriate analgesic prescribing for surgical patients is effective in reducing prescribing of opioids at discharge. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12618000876291 (prospective). [ABSTRACT FROM AUTHOR]

Our study examines the drivers of tight budgetary control in carbon management in the context of climate change regulation. Using the setting of New Zealand Emissions Trading Scheme (ETS), our study explores how firms manage their carbon performance using carbon‐focused budgetary control. Based on a survey data from New Zealand firms, including both those with and those without an ETS compliance obligations, our results suggest that economic and regulatory environmental pressures, the level of proactiveness of emissions management strategy, the level of integration of carbon issues in strategic and operational processes and the perceived importance of carbon issues are the significant drivers of tight carbon‐focused budgetary control. [ABSTRACT FROM AUTHOR]

By understanding strategies as promises, this study investigates how management controls are implicated in organisations' strategising practice under continuous changes of external forces. Based on a historical case study of a New Zealand electricity firm, the study shows how multiple management controls facilitate a strategising practice that focuses on repromising new futures for the firm by enabling senior managers, board members and operational staff to memorise, forget and forgive promises made. The study suggests that organisations seeking to move from one promised future to another use management controls to help develop, solidify and bridge promises. [ABSTRACT FROM AUTHOR]

Using a broad institutional theory lens, this paper examines the climate change strategies and carbon accounting practices adopted by two New Zealand electricity firms in response to changes in government climate change policies over time (2002–12). The two firms pursue different strategic responses to climate change‐related institutional and economic pressures in order to maintain both legitimacy and a competitive advantage. Five different strategic responses are identified: avoidance, operational conformance, strategic conformance, strategic differentiation, negotiation and manipulation. Firm‐level characteristics are also important drivers of inter‐firm variations in the strategic responses. Further, carbon accounting makes the greatest contribution to carbon reduction when integrated as part of strategic processes that support strategic conformance and strategic differentiation. Carbon monitoring systems, internal carbon information use and carbon disclosure were the main forms of carbon accounting used to realise the different strategies employed. Using an institutional lens, this study examines the strategic responses to climate change and carbon accounting practices of two New Zealand electricity generators over time. The strategic responses adopted balance the need for legitimacy and competitiveness. Carbon accounting drives significant carbon reduction when it supports a strategic conformance or differentiation strategy. [ABSTRACT FROM AUTHOR]

The refurbishment of existing buildings offers the greatest opportunity to maximise carbon reduction within the built environment. Although the conceptual framework of the refurbishment process incorporating various methods, tools, and systems to support decision making in reducing whole-of-life carbon emissions exists in the literature, empirical research reporting on how and why the decisions are made in current industry practice is lacking. This paper aims to address this knowledge gap by investigating the decision-making process of building refurbishment considering whole-of-life carbon reduction using three real-life case studies that incorporate decarbonisation decisions. The important findings emerged from an interactive analysis between theoretical propositions and cross-case synthesis. The study sheds a new insight into (1) the effective adoption of building rating systems, (2) the required whole-of-life carbon reduction targets, (3) the importance of establishing a dedicated financial budget for carbon-reduction refurbishment solutions, (4) the need for adaptable refurbishment designs and long-term strategies, (5) holistic design reports, (6) the promotion of early contractor involvement (ECI) approach, (7) government funding and incentives, and (8) the availability of supply chains and data. The originality of the paper is providing a new understanding of the decision-making practices and challenges faced in the refurbishment process, in which lessons learnt for improving the implementation of building refurbishment towards zero carbon are recommended. The research expands theoretical knowledge and practical experience in whole-of-life carbon analysis and performance estimation for building refurbishment. The insights gained from this study offer practitioners and researchers a streamlined interdisciplinary guide to better deliver refurbishment projects towards zero carbon. • An interactive analysis between theoretical propositions and cross-case synthesis. • Revealing the decision-making process towards zero carbon refurbishment. • Expanding knowledge in whole-of-life carbon reduction for building refurbishment. • Providing an interdisciplinary guide to better deliver zero carbon refurbishment. [ABSTRACT FROM AUTHOR]

Rationale, aim and objective: In Australia and New Zealand, there are no established standards for the final presentations of prepared intravenous medications in Intensive Care Units (ICUs). Variability has the potential to contribute to deficiencies in safety, efficiency and cost effectiveness. This study aimed to examine the variability in the preparation of intravenous medications in ICUs. Methods: An electronic survey was distributed to critical care pharmacists in Australia and New Zealand via an established email group. The preparation of vasopressors, inotropes, sedation, analgesia, heparin, insulin and neuromuscular blockers were examined. Respondents were asked about initial presentation, final concentration prepared, who prepared and current safety practices used. Questions also addressed opinions and attitudes to safety practices and responsibility for leading change. Results: Forty responses to the survey were received, representing 17% of ICUs in Australia and New Zealand. Significant variation in final concentration was observed for all infusions except insulin and esmolol. The final volumes varied significantly for all drugs. The majority of infusions were prepared by nursing staff with only a small number of pre‐prepared presentations currently in use. Labelling was usually hand‐written with some colour‐coding. Most respondents identified safety and efficiency but not cost effectiveness as likely to be improved by the use of pre‐prepared infusions. Most respondents felt ‘government’ or peak clinical bodies should lead practice standardization. Conclusion: Significant variation exists in the preparation of intravenous medications across ICUs in Australia and New Zealand. Nationally or regionally coordinated rationalization and standardization could improve safety and efficiency and potentially reduce the barrier of cost. [ABSTRACT FROM AUTHOR]

Since the mid-1980s, professional accounting bodies, employers of accounting graduates and academics alike have lamented the failure of universities to equip accounting graduates with the competencies required for the modern business environment. Changes to accounting education have been made but the gap between the competencies which employers expect—and perceive—accounting graduates to possess has not previously been examined holistically. Based on a review of the literature, a framework of accounting education's expectation-performance gap (comprising an expectation gap, a constraints gap and a performance gap) is proposed. The paper also reports an exploratory study designed to test the proposed framework. Following a document study of the accounting programme of a New Zealand university, interviews were conducted with students, academics, graduate trainees and employers associated with the programme. The research provides support for the proposed framework and resulted in identifying ways in which the gap may be narrowed. [ABSTRACT FROM AUTHOR]

In the light of climate change, the drive for zero carbon buildings is known as one response to reduce greenhouse gas emissions. Within New Zealand, research on climate change mitigation and environmental impacts of buildings has received renewed attention. However, there has been no detailed investigation of zero carbon building practices. This paper undertakes an exploratory study through the use of semi-structured interviews with government representatives and construction industry experts to examine how the New Zealand construction industry plans and implements zero carbon buildings. The results show that New Zealand's construction industry is in the early stage of transiting to a net-zero carbon built environment. Key actions to date are focused on devising a way for the industry to develop and deliver zero carbon building projects. Central and local governments play a leading role in driving zero carbon initiatives. Leading construction firms intend to maximise the carbon reduction in building projects by developing a roadmap to achieve the carbon target by 2050 and rethinking the way of designing and constructing buildings. The research results provide an insight into the initial practices and policy implications for the uptake of zero carbon buildings in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Background: There is a known positive relationship between time in therapy and therapy outcomes. Effective rehabilitation should therefore include larger doses of therapy. However, individuals participating in inpatient rehabilitation have low levels of activity throughout the day. This level of inactivity may limit rehabilitation potential. New technologies which deliver personalised exercise programs and track time spent on exercises may lead to greater activity levels and therefore improve functional outcomes in rehabilitation. This pilot randomised control trial aimed to investigate whether an app-based supplemental exercise program in orthopaedic rehabilitation will be feasible and acceptable to participants, increase activity levels and improve functional outcomes. Methods: Participants were randomised to receive supplemental exercise via an app (PTPal™) on a tablet device additional to usual care or usual care alone. Primary outcome measures were participant satisfaction with app-based supplemental exercise, total repetitions of each activity and time in supplemental exercise programs. Secondary measures were 10-m walk test (10MWT), 6-min walk test (6MWT), Timed Up and Go (TUG), Functional Independence Measure and length of stay assessed by a blinded assessor. Results: Twenty individuals admitted into an inpatient private general rehabilitation unit for orthopaedic rehabilitation over a 4-week duration were included in this study. High acceptance of the app-based supplemental exercise program was demonstrated. Those using the app completed an additional 549 exercise repetitions during their admission (694 supplemental app-based repetitions vs 146 supplemental paper-based repetitions in the control group, mean difference [MD] 549, 95% CI 95 to 1002, p = 0.02) and an additional 157 min in supplemental exercise throughout their admission (195.3 min vs 38.7 min, MD 157 min, 95% CI 0.9–312.3 min, p = 0.05). There was insufficient power to demonstrate statistical significance in functional outcomes, but a trend towards improved functional outcomes was observed in the intervention group. Conclusion: An app-based exercise program increases activity levels, is feasible and is a safe intervention with the potential to improve functional outcomes. This pilot study should be followed with a larger study powered to demonstrate functional effects with more participants having greater impairment. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR); trial number ACTRN12617000817347. This study was retrospectively registered (registration date 05/06/2017). [ABSTRACT FROM AUTHOR]

This paper begins by exploring a smart city approach in post-earthquake Christchurch, New Zealand, by telling the city's story so far. We take the position of critical scholars who are engaged in a live smart cities project that involves the measurement of air quality by using sensor tools. As the project is still ongoing, the final results of the work are yet to be seen, but, nonetheless worth documenting. This article is composed as an early analysis of the air quality sensing project as a framework for the larger smart city story of Christchurch. It provides an overview of the experiences and lessons learned about the implementation of new technologies in a post-disaster environment. We examine how the narrative of the smart city is constructed, with focus on the terminology used by citizens, academicians, government and corporations. We then argue that top-down technocratic solutions to urban problems alone do not suffice to improve life in the city; rather, they can result in misaligned expectations or outcomes for stakeholders at the government and citizen level. We conclude by suggesting that citizen-led initiatives may be a way to promote more nuanced and inclusive ways of addressing local urban problems in a smart cities context. [ABSTRACT FROM AUTHOR]