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Across the globe universities are reckoning with issues of diversity, equity and inclusion. In Aotearoa (New Zealand), conversations have centered around decolonization and indigenization to assist with diversifying the workforce, reducing inequities and building inclusive cultures. This article presents case studies from three libraries and their steps toward indigenization. While each is traversing a unique path, and at different stages, they share common themes. Te Tiriti o Waitangi (The Treaty of Waitangi) forms the basis of the work and sets the tone for reciprocal partnerships between Maori (indigenous peoples of Aotearoa) communities and the respective libraries. Themes of recruitment and retention of Maori staff, the commitment of senior leaders to indigenization and allyship, and the active promotion of te reo Maori (Maori language) and tikanga Maori (Maori convention, practice, protocols) are explored. Key lessons learned throughout each library's indigenization journey form the basis of a challenge to other leaders in how they might take action toward indigenization within their own institutions.

Purpose: This article aims to explore the meanings of positionality and demonstrate how reflective memos can illustrate positionality in a constructivist grounded theory (CGT) study. Design/methodology/approach: Acknowledging the positionality of the researcher through a reflective approach is an essential element of CGT studies. The first author (IS) used reflective memoing in her CGT study on Indian immigrant children's asthma to practice reflexivity and make her positionality explicit. Through memos, IS acknowledges her knowledge, beliefs, practices, experience and pre-existing assumptions about the research topic. This article is a compilation of the reflective memos that IS wrote during the initial phase of her research and draws on her motivations as they relate to the topic under study in the context of current literature. Findings: The reflective accounts of a researcher's background and experience can act as a lens for understanding the research question and the choice of methodology. Practical implications: This article may be useful to novice qualitative researchers who are struggling to define and establish their own positionality. John Dewey's and David Schon's works on reflective thinking serve as valuable tools to practice reflexivity. Philosophically underpinned reflections in the form of memos, employed from the outset and throughout the study, can enhance the study rigour by making research decisions transparent. Originality/value: This article provides practical guidance on how to outline positionality at the outset of a CGT study.

Background: Administration of live vaccines following liver transplant (LT) has historically not been recommended due to concerns regarding risk of vaccine‐attenuated disease. However, there is evidence suggesting that in select transplant recipients live vaccinations can be administered safely. Studies in other regions have indicated that despite this evidence many clinicians remain hesitant to administer live vaccinations. Method: A REDCap survey was distributed to gastroenterologists, pediatricians, and infectious diseases physicians at pediatric centers across Australia and New Zealand via email between September and November 2023. The survey included a series of questions regarding live vaccine and varicella postexposure prophylaxis (PEP) practices in pediatric LT recipients and barriers to live vaccine administration in this cohort. Results: There was a total of 16 responses to the survey, from 10 different pediatric centers, including 10/11 pediatric gastroenterology centers and all four pediatric LT centers in the region. Only 31% (5/16) of respondents (from 3/10 different centers) offer live vaccines. The main barrier to live vaccine administration was clinician reluctance and the main reason for not offering live vaccines was insufficient safety data. Sixty‐nine percent (11/16) of respondents take vaccination status and/or serology into account when deciding whether to offer varicella PEP to this cohort. Respondents universally offer varicella zoster immunoglobulin as PEP, though 31% (5/16) also offer antiviral medication. Conclusions: Many clinicians in our region remain hesitant to provide live vaccines to pediatric LT recipients, with concerns regarding insufficient safety data. Updated local guidelines may help to address this. [ABSTRACT FROM AUTHOR]

Group A Streptococcus (GAS) primary peritonitis is a rare cause of pediatric acute abdomen (sudden onset of severe abdominal pain); only 26 pediatric cases have been reported in the English language literature since 1980. We discuss 20 additional cases of pediatric primary peritonitis caused by GAS among patients at Starship Children's Hospital, Auckland, New Zealand, during 2010-2022. We compare identified cases of GAS primary peritonitis to cases described in the existing pediatric literature. As rates of rates of invasive GAS increase globally, clinicians should be aware of this cause of unexplained pediatric acute abdomen. [ABSTRACT FROM AUTHOR]

We explored how academic departments, university teachers and students in one research-led university in New Zealand identified and addressed challenges in achieving three particular graduate attributes. These attributes (global perspective, environmental literacy and those aspect of ethics that involve personal social responsibility) are distinctive in that they may encompass values, attitudes and future behaviours, in addition to knowledge and skills. We documented formal processes in each participating department; interviewed university teachers to understand how they conceptualised these attributes and the processes of teaching them; explored student perspectives via individual and group interviews and written responses to verbal questions in groups; held project-based and departmental discussions to help us understand how the diversity of perspectives and processes extant in this institution were understood; and developed resources to explore and support future academic engagement with the issues that have arisen in this research. We discuss a potential mismatch between what this institution's strategic documentation aspires to and how departments and their teachers are managing these expectations, and we link this concern to the academic discourse on roles, responsibilities and capabilities of higher education. Our research has implications for all higher education institutions that express their aspirations or intentions for the values that their students will learn and we propose a research agenda to address our concerns.

The New Zealand fairy tern/tara iti (Sternula nereis davisae; NZFT) is New Zealand's most endangered bird, with approximately 40 individuals remaining. Due to previous poor breeding success, this species is on the brink of extinction. Nest failures occur because of adverse weather, predation, and potentially nest disturbance. We observed parental behaviour of 11 nesting pairs from November 2020 to January 2021 at three sites: Mangawhai, Waipu and Pakiri. Overall, avian predator disturbance was low at all nests, and most disturbance events were by interactions between conspecifics. Responses to conspecific disturbances were lowest for the three closely nesting pairs and highest for the three solitary nests. We measured the frequency of chick feeding and found feeding rates varied considerably between nests. Defensive response rates and feeding rates varied between nests but we found no relationship between the proportion of responses to disturbance and feeding rates. We found no relationship between feeding rate and tidal state. This could be due to our small sample size and the duration of our observation period (30 min). We urge future researchers to increase observation period time. With an understanding of feeding rates and disturbance, informed decisions can be made to support the conservation of NZFT. [ABSTRACT FROM AUTHOR]

Complementary and Alternative Medicines (CAMs) constitute products and practices not considered allopathic medicine. CAM use is high in children, but little is known about factors that may influence parents using CAM with their child. This study aimed to determine the variables associated with CAM use in children with a prospective study among children and their parents attending a tertiary care hospital in New Zealand (NZ). Outcomes included current CAM use, parental opinions on CAM, parental health literacy and child well-being. This study was completed by 130 parents (85% female), and the mean child age was 6.7 years. CAM use was reported for 59 (45%) children, the most common being oral supplements and body manipulation. Children were more likely to use CAM if their parent had higher health literacy (p = 0.001), and if they had previously attended the emergency department within 12 months (p = 0.03). There was no association between child well-being and CAM use. Parental opinion of using CAM only if a doctor recommended it was associated with CAM use for their child (p = 0.01). Only 40% of parents disclosed their child's CAM use to the medical team. This study highlights that parental health literacy influences the use of CAM for children in NZ, providing insight for translational research to improve CAM safety and disclosure rates in NZ. [ABSTRACT FROM AUTHOR]

Psychosocial well-being is key to living well after stroke, but often significantly affected by stroke. Existing understandings consider well-being comes from positive mood, social relationships, self-identity and engagement in meaningful activities. However, these understandings are socioculturally located and not necessarily universally applicable. This qualitative metasynthesis examined how people experience well-being after a stroke in Aotearoa New Zealand. This metasynthesis was underpinned by He Awa Whiria (Braided Rivers), a model which prompts researchers to uniquely engage with Māori and non-Māori knowledges. A systematic search identified 18 articles exploring experiences of people with stroke in Aotearoa. Articles were analysed using reflexive thematic analysis. We constructed three themes which reflect experiences of well-being: connection within a constellation of relationships, being grounded in one's enduring and evolving identities, and being at-home in the present whilst (re)visioning the future. Well-being is multi-faceted. In Aotearoa, it is inherently collective while also deeply personal. Well-being is collectively achieved through connections with self, others, community and culture, and embedded within personal and collective temporal worlds. These rich understandings of well-being can open up different considerations of how well-being is supported by and within stroke services. Psychosocial well-being is critical for people living with stroke. Well-being should be a priority in rehabilitation, however people with stroke indicate they do no consistently receive psychosocial support. It is clear that well-being has strong cultural elements, and understanding what supports well-being in individuals, whānau (those within wider networks who the person with stroke considers important), and wider cultural groups is important. Supporting whānau is crucial as whānau are core to well-being both during and beyond rehabilitation, and their own well-being is impacted by stroke. [ABSTRACT FROM AUTHOR]

A significant shift in the dominant paradigm governing the relationship of humans with nature and society is crucial in order to change the current unsustainable practices. This article describes a pilot-study based on a Masters level sustainability course, which explored what specific content, activities and resources may contribute to promoting paradigm change and action competence among university students. Paradigm change and the development of action competence were assessed by analyzing students' weekly written reflections on their learning experiences and by comparing pre- and post-course questionnaires. At the end of the course students had enhanced their beliefs regarding socio-economic aspects of sustainability and gained an increase in awareness about local sustainability issues. Also some students showed a reframing of certain assumptions related to the dominant paradigm concerning beliefs about the environment and society at large and an increase in self-confidence about promoting change towards sustainability. The main course elements contributing to these results were the class discussions and a structured debate on green growth; an exercise that asked students to reflect on 'what does my happiness depend on?'; weekly feedbacks which stimulated reflection on what they had learnt; and guest speakers' accounts of their experiences of putting sustainability into practice.

Aims: The New Zealand National Intestinal Failure and Rehabilitation Service (NZ‐NIFRS) was established in October 2015 to gather longitudinal data on the aetiology, clinical course and outcomes of children with intestinal failure (IF). One main objective is to achieve health equity for patients with IF in NZ. Methods: Clinical outcomes (enteral autonomy, parenteral nutrition (PN) dependence, death or intestinal transplantation) for IF patients diagnosed from October 2015 to 2018 were analysed; comparisons were made by ethnicity and socio‐economic status (SES) using published 'prioritised‐ethnicity' health data and the NZ index of deprivation, respectively. The Cox proportional‐hazards model was used to assess time to enteral autonomy. Results: Of the 208 patients (55.77% male, 43.75% preterm), 170 (81.73%) achieved enteral autonomy and 14 (6.73%) remained PN dependent. Pacific and Māori children accounted for 12.98% and 27.88% of the patient cohort, respectively, compared to 9.46% and 25.65% of the NZ paediatric population. More significantly, IF patients with a high NZ socio‐economic deprivation score were overrepresented, with 35.92% in the highest deprivation quintile and 10.19% in the least deprived quintile, compared to 23.53% and 20.31%, respectively, of the NZ paediatric population. There were no significant differences in primary clinical outcomes for any patients based on ethnicity or SES. Conclusion: While disparities in ethnicity and social deprivation do exist in the incidence of IF in NZ children, clinical outcomes are similar for children regardless of ethnicity or SES. NZ‐NIFRS has achieved one of its core objectives: to achieve health equity for all patients with IF nationwide. [ABSTRACT FROM AUTHOR]

Faecal calprotectin (FC) is a marker of gut inflammation. The cause and relevance of raised FC in children outside the context of established inflammatory bowel disease (IBD) have had minimal attention. This study aimed to address this by carrying out a retrospective study on children with abnormal FC tests aged 4–17 years without established IBD in the South Island, New Zealand. Abnormal FC results were stratified: 51–249 μg/g, 250–499 μg/g, and 500+ μg/g, and participants were categorised into diagnostic groups. Data were collected on symptoms and diagnostic tests. Three-hundred and ten children had abnormal index FC results, with a mean age of 12.9 years, and a 55% proportion of females. The median FC was 125 μg/g; 71% had levels 51–249 μg/g and 21% had levels 500+ μg/g. Of those with FC 500+ μg/g, 89% either had infectious diarrhoea or were diagnosed with IBD at the time of, or subsequent to, the index FC. Alarm symptoms did not delineate between groups with FC 500+ μg/g. Abnormalities in platelet levels, abdominal ultrasound, and colonoscopy were more frequent for children diagnosed with IBD. Repeat FC test levels were significantly reduced except for those subsequently diagnosed with IBD. Abnormal FC levels for the majority were below the level indicative of mucosal inflammation. Repeat FC testing could play an important role in distinguishing between diagnoses. [ABSTRACT FROM AUTHOR]

Background and Aim: For children with inflammatory bowel disease (IBD), optimal levels of vitamin D are ascribed anti‐inflammatory and essential immune system roles that are associated with reduced disease activity, lower postoperative recurrence, and higher quality of life. International guidelines for vitamin D testing and supplementation provide inconsistent recommendations. The aim of this study was to survey Australasian pediatric gastroenterologists to ascertain current practices of vitamin D testing and supplementation for children with IBD. Methods: Members of the Australian Society of Pediatric Gastroenterology, Hepatology and Nutrition were invited to complete an online survey. Respondents were asked to provide information on frequency of vitamin D testing and supplementation, adherence, and benefits of vitamin D to children with IBD. Results: Thirty‐two (54%) pediatric gastroenterologists completed the survey: 27 (84%) from Australia and 5 (16%) from New Zealand. The majority (90%) tested vitamin D levels at diagnosis and follow up, although testing frequency varied (1–3 times/year) and only 8 (28%) tested seasonally. While 28 (88%) recommended supplementation based on serum levels, inconsistent cutoff values were used. Most respondents (n = 27) recommended Stoss (single dose) or vitamin D3 (daily for 8–12 weeks). The majority (84%) rated the overall benefit of optimal vitamin D levels at ≥6/10, although fewer (54%) rated the benefit to disease activity at ≥6/10. Conclusions: The results indicate that standardized guidelines for vitamin D testing and supplementation for clinicians caring for children with IBD throughout Australasia are required. Consensus statements may optimize the care of children with IBD in this diverse geographical region. [ABSTRACT FROM AUTHOR]

There is very little research about dementia in Aotearoa (New Zealand) New Zealand (NZ) Pacific communities, but information available suggests that Pacific people are presenting with dementia at a younger age and with more severe cognitive symptoms than do non-Pacific. The Samoan ethnic group is NZ's largest Pacific population. This study explores experiences and understanding of dementia from family sessions with 25 people from 10 Samoan families living with dementia. Thematic analysis of the interviews showed there was no Samoan concept for dementia as a disease of the brain that required special medical attention; instead, Samoan elders spoke of memory loss as part of ageing, signifying the end to one's purpose in life. A formal medical diagnosis saw family members honouring their obligations to care for their loved one at home, often at great cost. Culturally appropriate services, incorporating Samoan concepts of care and ageing, were rarely available. [ABSTRACT FROM AUTHOR]

Background Diabetes mellitus (DM) is associated with a greater risk of mortality in kidney transplant patients, primarily driven by a greater risk of cardiovascular disease (CVD)-related mortality. However, the associations between diabetes status at time of first allograft loss and mortality on dialysis remain unknown. Methods All patients with failed first kidney allografts transplanted in Australia and New Zealand between 2000 and 2020 were included. The associations between diabetes status at first allograft loss, all-cause and cause-specific mortality were examined using competing risk analyses, separating patients with diabetes into those with pre-transplant DM or post-transplant diabetes mellitus (PTDM). Results Of 3782 patients with a median (IQR) follow-up duration of 2.7 (1.1–5.4) years, 539 (14%) and 390 (10%) patients had pre-transplant DM or developed PTDM, respectively. In the follow-up period, 1336 (35%) patients died, with 424 (32%), 264 (20%) and 199 (15%) deaths attributed to CVD, dialysis withdrawal and infection, respectively. Compared to patients without DM, the adjusted subdistribution HRs (95% CI) for pre-transplant DM and PTDM for all-cause mortality on dialysis were 1.47 (1.17–1.84) and 1.47 (1.23–1.76), respectively; for CVD-related mortality were 0.81 (0.51–1.29) and 1.02 (0.70–1.47), respectively; for infection-related mortality were 1.84 (1.02–3.35) and 2.70 (1.73–4.20), respectively; and for dialysis withdrawal-related mortality were 1.71 (1.05–2.77) and 1.51 (1.02–2.22), respectively. Conclusions Patients with diabetes at the time of kidney allograft loss have a significant survival disadvantage, with the excess mortality risk attributed to infection and dialysis withdrawal. [ABSTRACT FROM AUTHOR]

Malnutrition and frailty affect up to one-third of community-dwelling older adults in Australia and New Zealand (ANZ), burdening individuals, health systems and the economy. As these conditions are often under-recognised and untreated in the community, there is an urgent need for healthcare professionals (HCPs) from all disciplines to be able to identify and manage malnutrition and frailty in this setting. This paper describes the systematic and iterative process by which a practical guide for identifying and managing malnutrition and frailty in the community, tailored to the ANZ context, was developed. The development of the guide was underpinned by the Knowledge-to-Action Framework and included the following research activities: (1) a comprehensive literature review; (2) a survey of ANZ dietitians' current practices and perceptions around malnutrition and frailty; (3) interviews with ANZ dietitians; and (4) a multidisciplinary expert panel. This resulted in the development of a guide tailored to the ANZ context that provides recommendations around how to identify and manage malnutrition and frailty in the community. It is now freely available online and can be used by all HCPs across several settings. The approach used to develop this guide might be applicable to other conditions or settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment. Malnutrition and frailty are common in Australian and New Zealand communities, burdening individuals, health systems and the economy. This paper describes the process by which an evidence-informed guide for identifying and managing these conditions in the community was developed. The guide is now freely available online and can be used by all healthcare professionals across several settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment. [ABSTRACT FROM AUTHOR]

Background: Inflammatory Bowel Disease (IBD) is one of the most serious chronic diseases affecting the global population. Clinical team members involved in the care of individuals with IBD should have sufficient knowledge about IBD. Aims: The study aim was to assess IBD knowledge among four health care professional groups in New Zealand: nurses, medical students, dietitians, and pharmacists. Methods: All four groups completed surveys on demographics, work experience, and contact with patients with IBD. All completed a validated IBD knowledge assessment questionnaire (IBD-KID2), and percentage scores with standard deviation (SD) for each group calculated and compared. Results: Participants included 200 nurses, 196 medical students, 45 dietitians, and 28 pharmacists. Mean IBD-KID2 percentage scores were nurses 69.7% (SD 14.7), medical students 77.6% (SD 14.5), dietitians 87.4% (SD 8.3), and pharmacists 83.4% (SD 10.1). Nurses scored lower than other HCP (P < 0.001). Independent variables were associated (P < 0.05) with higher scores for nurses having first degree relative with IBD, access to IBD guidelines, worked with children with IBD; medical students in their clinical years of study; and dietitians with IBD-specific education. Specific items scored poorly: growth, food triggers, heritability of IBD, and nutrient absorption. Conclusions: Knowledge gaps exist among HCP that may be addressed with targeted education. Improvements in the knowledge of those caring for people with IBD may optimize patient outcomes. [ABSTRACT FROM AUTHOR]

This collaborative paper reflects on academic life in Aotearoa-New Zealand. Drawing on our different personal histories, we examine the dominant influence of neoliberal ideas in shaping tertiary education reform, explore the importance of identity and worldview in structuring academic experience, and discuss the role of philosophy of education in the contemporary university.

Background: Helicobacter pylori is a gram‐negative gut bacterium most often acquired during childhood. International guidelines state that children with suspected H. pylori infection should be referred to a gastroenterologist for investigation via gastroscopy and biopsy. Eradication therapy should be prescribed for children with peptic ulcer disease or following a treatment risk/benefit discussion for those with an incidental gastroscopy finding. Guidelines state that for children a "test‐and‐treat" approach is not warranted, contrasting recommendations for adults. The aim of this study was to profile pediatric H. pylori infections in the South Island of New Zealand (NZ) to determine diagnostic and management strategies, and adherence to international guidelines. Materials and Methods: Retrospective data for positive H. pylori tests between 2010 and 2021 were retrieved from hospitals and regional testing laboratories throughout the South Island (NZ) for children ≤18 years. Outcome data were retrieved from tertiary care hospital records; sociodemographic, testing methods, eradication therapy, and symptoms. Results: Two‐hundred and forty children were identified: 105 (44%) male, mean age 13.2 years (SD 4.3). Participants of Pasifika, Asian, and Middle Eastern/Latin American/African heritage were overrepresented compared to the NZ census data. Overall, 138 (58%) children were diagnosed via stool antigen tests, 78 (32%) serum, and only 24 (10%) adhered to international guidelines in being confirmed via gastroscopy. Only 59 (25%) had a record of eradication therapy, and 39/59 (66%) were retested to determine eradication success, with 32 (82%) negative tests and seven (18%) remaining positive. Of the 181 (75%) that had eradication status unknown, 66 (28%) had a retest result available with 48 (73%) testing negative and 18 (27%) positive, suggesting a substantial proportion had received eradication therapy without adhering to international guidelines. Conclusions: International guidelines were not adhered to for most children in the study cohort. Implications of this include cost, unnecessary venipuncture, and unjustified antibiotic exposure. [ABSTRACT FROM AUTHOR]

Background and Aim: Children and adolescents account for approximately 14% of inflammatory bowel disease (IBD) diagnoses. At an appropriate age and level of development adolescents with IBD have their care transferred from the pediatric to adult clinical team during a process termed "transition". The study aim was to survey pediatric gastroenterologists throughout Australasia to identify commonality in the transition process to contribute to standardized guideline development. Methods: A descriptive survey captured key variables: transition clinic format, process and infrastructure, transition assessments, and guidelines. The survey was distributed electronically to 59 Pediatric Gastroenterologists throughout Australasia in January 2023. Results: Seventeen (29%) clinicians completed the survey: Australia 13 (76%). New Zealand 4 (24%). Thirteen (76%) respondents had access to a dedicated IBD transition clinic. Adolescents attended transition clinics 1–7 times, and the main processes transferred were: prescription provision, biologic appointments, and adult team contacts. Transition was first discussed age 13–15 years (53%), or 16–18 years (47%), with the main discussion topics including: continuing adherence (88%), smoking (59%), alcohol use (59%), recreational drug use (59%). Transition readiness assessments were done infrequently (24%). The minority (24%) used formal guidelines to inform the transition process, but 15 (88%) considered the development of a standardized Australasian guideline as beneficial/extremely beneficial. Conclusions: This survey highlighted that transition care for adolescents with IBD is variable across Australasia. Australasian guideline development may optimize the transition process for adolescents with IBD and improve their longitudinal outcomes. [ABSTRACT FROM AUTHOR]

The global tourism industry has been hard hit by the COVID-19 pandemic, with the World Tourism Organization predicting the possible loss of 1.1 billion international visitors and 1.2 trillion in export revenues. Media coverage has also highlighted the job losses across tourism organizations worldwide. Until recently, tourism was New Zealand's biggest export earner, employing 8% of the country's total workforce. However, a negative perception of tourism as both a subject of study and as a career presents challenges for the New Zealand tourism industry, which even before the pandemic was struggling to attract workers. Previous research has found that the often-vocational nature of tourism education contributes to tourism's reputation as a less credible academic subject. This research, conducted prior to the COVID-19 pandemic, identifies the perceptions New Zealand secondary school tourism students have about a tourism career and the study of tourism and the implications for education, industry and government. [ABSTRACT FROM AUTHOR]

Background: While there is increasing evidence on the benefits of PROMs in cancer care, the extent of routine collection and use of PROMs in clinical cancer practice across Australia and New Zealand (ANZ) is unknown. This study examined the prevalence and characteristics of PROMs use in routine clinical cancer care in ANZ. Methods: An online survey was designed and disseminated via professional societies and organisations using a snowball sampling approach to clinical and health administration professionals managing cancer care in ANZ. A poster advertising the study was also circulated on professional social media networks via LinkedIn and Twitter inviting health professionals from ANZ to participate if they were using or intending to use PROMs in clinical cancer practice. Responders opted into the survey via the survey link. Results: From 132 survey views, 91(response rate, 69%) respondents from 56 clinical practices across ANZ agreed to participate in the survey, and of these 55 (n = 55/91, 60%) respondents reported collecting PROMs within their clinical practice. The majority of the respondents were from the State of New South Wales in Australia (n = 21/55, 38%), hospital (n = 35/55, 64%), and a public setting (n = 46/55, 83%). PROMs were collected in all cancer types (n = 21/36, 58%), in all stages of the disease (n = 31/36, 86%), in an adult population (n = 33/36, 92%), applied in English (n = 33/36, 92%), and used to facilitate communication with other reasons (27/36, 75%). A geospatial map analysis provided insights into the variation in PROMs uptake between the two countries and in certain jurisdictions within Australia. This study also highlights the limited resources for PROMs implementation, and a lack of systematic priority driven approach. Conclusion: PROM use across Australia and New Zealand seems variable and occurring predominantly in larger metropolitan centres with limited standardisation of approach and implementation. A greater focus on equitable adoption of PROMs in diverse cancer care settings is urgently needed. [ABSTRACT FROM AUTHOR]

In 2023, a Diploma of Rural Generalist Anaesthesia (DipRGA) was implemented across Australia. Developed collaboratively by the Australian and New Zealand College of Anaesthetists (ANZCA), the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP), the 12-month qualification is completed during or following ACRRM or RACGP Rural Generalist Fellowship training. Focused on the needs of rural and remote communities for elective and emergency surgery, maternity care, resuscitative care for medical illness or injury, and stabilisation for retrieval, the DipRGA supports rural generalist anaesthetists working within collaborative teams in geographically isolated settings. The goal is a graduate who can anaesthetise American Society of Anesthesiologists physical status class 1, 2 and stable 3 patients for elective surgery, provide obstetric anaesthesia and analgesia, anaesthetise paediatric patients and undertake advanced crisis care within their scope of practice. Crucially, they also recognise both limitations of their skills and local resources available when considering whether to provide care, defer, refer or transfer patients. DipRGA curriculum design commenced by adapting the ANZCA specialist training curriculum with consideration of the training approach of both the ACRRM and the RACGP, particularly the rural and remote context. Curriculum content is addressed in seven entrustable professional activities supported by workplace-based assessments and multisource feedback. Trainees are supervised by rural generalist anaesthetists and specialist anaesthetists, and complete flexible learning activities to accommodate geographical dispersion. Standardised summative assessments include an early test of knowledge and an examination, adapted from the ACRRM structured assessment using multiple patient scenarios. [ABSTRACT FROM AUTHOR]

The eastern Australian flatback mangrove goby Mugilogobius platynotus (Günther 1861) is recorded for the first time from Aotearoa, New Zealand. Three voucher specimens (two males and one female) were collected using fish traps submerged in tidal drains of a saltmarsh wetland edged by mangroves adjacent to Ngunguru River, Northland. Key characters for identification: the colour of freshly thawed specimens, meristic counts, and morphometric measurements are presented and compared with the same characters described by Larson (2001) for all Mugilogobius. We discuss this major range extension from its natural Australian distribution, concluding it is an adventive species, probably carried across the Tasman Sea into New Zealand waters by shipping, not ocean currents. Our analysis of goby species recorded from northern New Zealand mainland waters concludes seven (86%) are probably adventive and introduced from Australia. We recommend a further survey of mangrove and saltmarsh estuary habitats to discover if this new goby has established a breeding population and is expanding its current limited distribution within northern New Zealand. [ABSTRACT FROM AUTHOR]

Provincial academies represent an important bridge between amateur and professional level rugby union in New Zealand. Athletes are provided with professional-level coaching; however, limited direct nutrition support is available. Congested training schedules and the requirement to work or study due to a lack of financial support may present a challenge towards athletes meeting nutrition requirements. The aim of the study was to facilitate improvement in nutrient intake, body composition and subjective well-being in provincial academy athletes via the implementation of a nutrition-support protocol based around behaviour change techniques. Significant increases in total energy (pre: 2492 ± 762 kcal; post: 2614 ± 625 kcal), relative energy (pre: 24.4 ± 7.5 kcal·kg; 25.5 ± 6.0 kcal·kg), total protein (pre: 131.1 ± 41.8 g; 153.8 ± 37.1 g) and relative protein (pre: 1.3 ± 0.4 g·kg; post: 1.5 ± 0.3 g·kg) were observed. Furthermore, changes in subjective sleep quality, stress, mood and upper body soreness were observed following the intervention. No changes were observed in body composition, carbohydrate or fat intake. Significant variability in nutrition and body composition changes highlights the importance of applying an individualised approach to nutrition support provision in developmental athletes. Practitioners working within these environments should be aware of the challenges and influences contributing to athletes' nutrition choices and habits. [ABSTRACT FROM AUTHOR]

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

Aim: This study aimed to explore dietitians' perceptions of their current practice for identifying and managing malnutrition/frailty in the community, to fill an evidence gap. Methods: This mixed‐methods study involved an online survey distributed to dietitians practising in Australia and New Zealand, and semi‐structured interviews with a subset of survey participants. The 34‐item survey and interviews explored dietitians' practices for identifying/managing malnutrition and frailty, focusing on the community setting. Survey data were analysed descriptively and some simple association tests were conducted using statistical software. Interview data were analysed thematically. Results: Of the 186 survey respondents, 18 also participated in an interview. Screening and assessment for malnutrition varied in the community and occurred rarely for frailty. Dietitians reported practising person‐centred care by involving clients/carers/family in setting goals and selecting nutrition interventions. Key barriers to providing nutrition care to community‐dwelling adults included a lack of awareness/understanding of nutrition by clients and other health professionals (leading to them not participating in or valuing nutrition care), lack of time and resources in the community, and client access to foods/supplements. Enablers included engaging family members/carers and coordinating with other health professionals in nutrition care planning. Conclusion: Reported practices for identifying malnutrition and frailty vary in the community, suggesting guidance may be needed for health professionals in this setting. Dietitians reported using person‐centred care with malnourished and frail clients but encountered barriers in community settings. Engaging family members/carers and multidisciplinary colleagues may help overcome some of these barriers. [ABSTRACT FROM AUTHOR]

Group A Streptococcus (GAS) primary peritonitis is a rare cause of pediatric acute abdomen (sudden onset of severe abdominal pain); only 26 pediatric cases have been reported in the English language literature since 1980. We discuss 20 additional cases of pediatric primary peritonitis caused by GAS among patients at Starship Children's Hospital, Auckland, New Zealand, during 2010-2022. We compare identified cases of GAS primary peritonitis to cases described in the existing pediatric literature. As rates of rates of invasive GAS increase globally, clinicians should be aware of this cause of unexplained pediatric acute abdomen. [ABSTRACT FROM AUTHOR]