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Background: Failure of communication can have potentially severe results in cardiothoracic surgery. Previous literature regarding patient safety highlighted communication as a common area for improvement. This study utilized a qualitative approach to analyze a national mortality audit data set to identify and describe communication issues that could potentially contribute to patient mortality following cardiothoracic surgery., Methods: We utilized a peer-reviewed audit of surgical deaths after cardiothoracic surgery in Australian hospitals from 2009 to 2015 via the Australian and New Zealand Audit of Surgical Mortality. Cases were identified with clinical management issues then individual analysis of cases highlighting communication issues was undertaken. A total of 91 reports from surgeons and assessors were analysed using a thematic analytic approach., Results: A total of 908 cases of potentially avoidable mortality were identified as being associated with clinical management issues, and communication issues were identified in 91 (10%) of these cases, which served as the basis for this analysis. The study found that failure to achieve shared decision making was the most common theme (n = 38, 41.8%), followed by failure to notify patient deterioration (n = 22, 24.1%), misreporting of patient condition (n = 10, 11.0%) and issues related to informed consent (n = 9, 10.0%). The most frequent communication issues occurred between surgeons and the intensive care unit., Conclusions: Poor communication was identified in patients who died after cardiothoracic surgery. Communication is an important modifiable factor in patient mortality. Efforts to address teamwork and communication have the potential to improve safety and quality of care for patients undergoing cardiothoracic surgery., (Copyright © 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Aotearoa New Zealand's pandemic communication approach amidst the COVID-19 (C19) has been applauded around the world. The New Zealand government's border controls and other measures in response to C19 impacted refugees at the margins and prevented people from accessing support services and healthcare. The sanctioned power to 'care' thus became a performative form of power for silencing through the dismissing of voices of refugees as being irrelevant. Experiences of refugees at the margins are constructed amid the erasure of community voices in dominant approaches to health. What was missing from the dominant discourses was the voice of the refugees, who had gone through painful experiences of displacement and resettlement. How did the refugee communities at the margins of Aotearoa New Zealand navigate through the prevailing structural impediments to health during the pandemic? In this study, we use a culture- centred analysis to centre the structural context of disenfranchisement during the COVID-19 lockdown. Drawing on in-depth interviews with refugee participants, we attend to how health is negotiated in the midst of the COVID-19 outbreak and lockdown response at the margins. Infectious diseases such asC19 lay bare the structural determinants that create health and well-being challenges among refugee communities in New Zealand. The narratives point out that the one-size-fits-all approach of the government left behind refugees at the margins during the C19 in the public health efforts. [ABSTRACT FROM AUTHOR]

Background: Smoking contributes to the 7 to 8 year gap between Maori and non-Maori life expectancy (2006 Census). To inform current discussions by policy-makers on tobacco control, we estimate life-expectancy in 2040 for Maori and non-Maori, never-smokers and current-smokers. If nobody smoked tobacco from 2020 onwards, then life expectancy in 2040 will be approximated by projected never-smoker life expectancy., Method: Life-tables by sex/ethnicity/smoking status for 1996-99 were estimated by merging official Statistics New Zealand life-tables, census data and linked census-mortality rate estimates. We specified six modelling scenarios, formed by combining two options for future per annum declines in mortality rates among never-smokers (1.5%/2.5% and 2.0%/3.5% for non-Maori/Maori; i.e. assuming a return to long-run trends of closing ethnic gaps as in pre-1980s decades), and three options for future per annum reductions in the mortality rate difference comparing current to never-smokers (0%, 1% and 2%)., Results: In 1996-1999, current smokers had an estimated 3.9 to 7.4 years less of life expectancy relative to never-smokers. This smoking difference in life expectancy was less among Maori than among non-Maori. If the 2006 census smoking prevalence remains unchanged into the future, we estimate the difference in 2040 between Maori and non-Maori life expectancy will range from 1.8 to 6.1 years across the six scenarios and two sexes (average 3.8). If nobody smokes tobacco from 2020 onwards, we estimate additional gains in life expectancy for Maori ranging from 2.5 to 7.9 years (average 4.7) and for non-Maori ranging from 1.2 to 5.4 years (average 2.9). Going smokefree as a nation by 2020, compared to no change from the 2006 Census population smoking prevalence, will close ethnic inequalities in life expectancy by 0.3 to 4.6 years (average 1.8 years; consistently greater for females)., Discussion: If smoking persists at current rates it will become an even greater constraint on life expectancy improvements for New Zealanders in the future. Continued increases in life expectancy, and closing of the Maori:non-Maori gaps in life expectancy, would be greatly assisted by the end of tobacco smoking in Aotearoa-New Zealand by 2020.

Background: Although exclusive breastfeeding is recommended for the first six months of life, research suggests that breastfeeding initiation rates and duration among Indigenous communities differ from this recommendation. Qualitative studies point to a variety of factors influencing infant feeding decisions; however, there has been no collective review of this literature published to date. Therefore, the objective of this scoping review was to identify and summarize the qualitative literature regarding Indigenous infant feeding experiences within Canada, the United States, Australia, and Aotearoa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews and the Joanna Briggs Institute Guidelines, in October 2020, Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for relevant papers focusing on Indigenous infant feeding experiences. Screening and full-text review was completed by two independent reviewers. A grey literature search was also conducted using country-specific Google searches and targeted website searching. The protocol is registered with the Open Science Framework and published in BMJ Open. Results: Forty-six papers from the five databases and grey literature searches were included in the final review and extraction. There were 18 papers from Canada, 11 papers in the US, 9 studies in Australia and 8 studies conducted in Aotearoa. We identified the following themes describing infant feeding experiences through qualitative analysis: colonization, culture and traditionality, social perceptions, family, professional influences, environment, cultural safety, survivance, establishing breastfeeding, autonomy, infant feeding knowledge, and milk substitutes, with family and culture having the most influence on infant feeding experiences based on frequency of themes. Conclusions: This review highlights key influencers of Indigenous caregivers' infant feeding experiences, which are often situated within complex social and environmental contexts with the role of family and culture as essential in supporting caregivers. There is a need for long-term follow-up studies that partner with communities to support sustainable policy and program changes that support infant and maternal health. [ABSTRACT FROM AUTHOR]

Marginalised and ousted from the New Zealand education system, 70% of youths apprehended for offending and appearing in a New Zealand Youth Court or Rangatahi Court experiencing complex needs are not engaged in education, employment, or training (Oranga Tamariki, Oranga Tamariki. (2020). Quarterly report—September 2020). This article reports findings from a broader PhD study investigating the educational experiences of 10 rangatahi Māori (Māori youth) aged 15–17 years apprehended for serious youth offending and excluded from mainstream education. Drawing on mātauranga Māori (Māori knowledge) and kaupapa Māori, notions of indigenous resilience are used to unpack the rangatahi Māori participants' responses to negative educational experiences in the mainstream English medium secondary school education system. This article posits that resilience was evident when the rangatahi Māori exercised tino rangatiratanga (sovereignty) through boldness (a characteristic of Tū-mata-uenga the guardian of war), resistance and liminality to reject educational spaces where they perceived they were underserved, discriminated against, and marginalised. Changing the negative Māori student exclusion and disengagement statistics in mainstream education is critical. To address the exclusion statistics, classroom practitioners could be more responsive to rangatahi Māori experiencing complex needs by recognising their experiences and understanding their responses to those experiences. Understanding how resilience as resistance, liminality, and boldness is understood within te ao Māori (the Māori world) perspectives will enable a more culturally responsive approach to working with these rangatahi Māori in mainstream education. [ABSTRACT FROM AUTHOR]

The Kaiārahi, or Family Court Navigator, is a newly established role within the Ministry of Justice in New Zealand. The role of the Kaiārahi is to provide guidance and information about the resolution and support options available to parents, caregivers, and families who are considering applying to the Family Court. This research sought to understand how the introduction of the Kaiārahi role may be improving experiences of Family Court users. A qualitative methodology guided the research process and in 2022, four Kaiārahi engaged in semi-structured interviews. The findings suggested that the Kaiārahi role is contributing to an improved experience for people engaged in the Family Court in New Zealand. The level of impact is, however, affected by the strength of collaboration with community services such as social work organisations, and several implementation factors, including a lack of strategic direction, difficulty sourcing clientele, and variable support from the Ministry of Justice and the judiciary. Addressing these issues would further strengthen the effectiveness of the Kaiārahi role. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Purpose: Manufacturing companies continue to encounter a diverse set of obstacles while embracing sustainable development goals. Accordingly, the purpose of this study is to explore critical sustainable development-related barriers to flexible packaging manufacturing companies in the New Zealand context. Design/methodology/approach: Drawing on a qualitative multiple case studies approach, the authors collected data from the New Zealand flexible packaging industry. Semistructured interviews were conducted with the senior corporate managers in two large flexible packaging companies. Following the thematic analysis approach, the authors analyzed the information collected from the participants and synthesized our findings under the key dimensions of internal and external barriers to sustainable development. Findings: The findings revealed that internal barriers to sustainable flexible packaging are linked to economic, operational and technical issues. Conversely, external barriers include global crises and disruption, customer behavior and preferences and institutional and infrastructural-related aspects. Based on the analysis of empirical findings, the authors further identified the underlying reasons for sustainable flexible packaging barriers and recommended guidelines that could assist corporate managers and policymakers in addressing obstacles inhibiting the flexible packaging industry from adopting sustainable business practices. Originality/value: The authors argue that this study is one of the early studies to consider inhibiting factors to incorporate sustainable development into the New Zealand flexible packaging industry context. Building on a range of theoretical perspectives, the authors extend the current body of knowledge seeking to advance the sustainable development agenda in the New Zealand flexible packaging industry and offer recommended pathways fostering sustainable development in a distinctive manufacturing context. [ABSTRACT FROM AUTHOR]

This paper reports research that investigated how digital technologies were used to develop and maintain home–school connections and develop positive relationships when children transition to nursery schools and schools. School case studies, comprising four purposively selected schools with nursery provision in Northern Ireland and four primary schools in New Zealand, provided the context and evidence to enable a small-scale comparative study of how digital technologies enabled the development of relationships between homes and schools over time. In this paper, the findings were analysed using a conceptual model and framework derived from earlier studies in this field. However, given the contemporary social and technological context, it was found that the framework could be reviewed and elaborated, enabling the creation of a new conceptual framework that is offered here. Our findings reveal methods of employing digital technologies to positively support parental engagement when children transition to nurseries and schools. From the analysis of our findings using the framework developed, points to consider for future practice, policy, and research are highlighted, with an emphasis on understanding and integrating parents' aspirations into the transition process. Opportunities that use existing and emerging methods for home–school–community connections need to be made known to teachers and schools. While the digital technologies used must be capable of maintaining appropriate regular communication, additionally, supporting ways for involving parental voice in reviews of existing practices and exploring new opportunities should be shared with teachers and schools. Future research should explore how the use of digital technologies in developing wider and deeper engagement and participation of parents and carers with nurseries and schools might lead to a longer-term and positive engagement in later years beyond nursery schools and initial transition to school. [ABSTRACT FROM AUTHOR]

In New Zealand the last few years have seen a re-emergence of interest in processes that build on the theory of deliberative democracy. Commentary on this trend, which typically positions deliberative democracy as a novel development in New Zealand politics, ignores several decades of public agencies' democratic experimentation. In this article we describe three of the 15 identified processes displaying the critical elements of deliberative democracy: the Capital Power citizens' jury (1996); Toi te Taiao: the Bioethics Council's public deliberation on pre-birth testing (2007-08), and the citizens' advisory panel on the Newtown-Berhampore cycleway (2014). We analyse the reasons for their ostensible failure and identify lessons that current policymakers interested in deliberative democracy should draw from these historical cases. [ABSTRACT FROM AUTHOR]

Background: Early access to care for carpal tunnel syndrome (CTS) can avoid higher rates of surgery and permanent harm yet is often delayed, particularly for populations more likely to underutilise care. Objective: We sought to explore patient experiences and perspectives of health service access for CTS to inform an equity-focussed co-design of a health service for improving early care access. Methods: In this Normalisation Process Theory (NPT)-informed qualitative study we conducted semistructured in-depth interviews with 19 adults with experience of CTS. Recruitment prioritised New Zealand Māori, Pasifika, low-income, and rural populations. Data were analysed using deductive then inductive thematic analysis. Results: We identified five major themes: (1) the 'Significant Impact of CTS' of the sense-making and relational work to understand the condition, deciding when to get care, compelling clinicians to provide care, and garnering help from others; (2) 'Waiting and Paying for Care'– the enacting, relational, and appraising work to avoid long wait times unless paying privately, particularly where quality of care was low, employment relations poor, or injury compensation processes faltered; (3) circumstances of 'Occupation and CTS Onset' whereby the burden of proof to relate onset of CT symptoms to occupation created excessive relational and enacting work; (4) the 'Information Scarcity' of good information about CTS and the high relational and appraising work associated with using online resources; (5) 'Negotiating Telehealth Perspectives' where telehealth was valued if it meant earlier access for all despite the challenges it held for many. Conclusion: Quality, culturally and linguistically responsive information and communication from clinicians and health services will improve equitable early access to CTS care including realising the potential of telehealth modes of care. Policy changes that reduce individual burden of proof in injury compensation claims processes, enable time off work to attend health appointments, and increase public funding for surgical resources would improve early access to CTS care particularly for Māori and Pacific populations and those in small and rural workplaces. NPT is valuable for understanding where opportunities lie to reduce inequitable delays to accessing care including the impact of racism, particularly for populations more likely to underutilise care. [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]

Background: Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness. Methods: The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study. Results: For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation. Conclusion: Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities. [ABSTRACT FROM AUTHOR]

Introduction. The value of family health history as a means to understanding health risk has been long known. Its value in a precision medicine context is also now becoming apparent. General practitioners (GPs) are considered to play a key role in the collection, and investigation, of family health history, but it remains widely reported as being both poorly and infrequently undertaken. Little is known about this practice in Aotearoa New Zealand (NZ). Aim. This study aimed to explore current practices in relation to the ascertainment of family health history, with a view towards precision medicine. Methods. Semi-structured interviews were conducted with 10 GPs recruited from one urban area of NZ. The interviews were subjected to a thematic analysis. Results. Family health history information was used to varying degrees in four areas - risk ascertainment, patient engagement with a diagnosis, social context and building relationships. Patient cultural considerations were rarely mentioned. Reliability of information provided by patients, resource constraints, context driven consults and electronic health record limitations are potential indicators of current limits of family health history. Discussion. Our findings present a baseline of current practice and echo larger studies from overseas. As precision medicine is not yet routine, a unique opportunity exists for consideration to be given to establishing specific roles within the NZ health system to enable equitable practice of, and subsequent health gains from, the use of family/whānau health history information as part of precision medicine. [ABSTRACT FROM AUTHOR]

Purpose: While communication changes associated with Parkinson's disease (PD) have been documented, research on the impact of these changes on family members is just beginning to emerge. With this new focus on family, questions arise as to how well speech-language pathology services address their needs communicating with their loved one with PD. The purpose of this study was to explore the experiences of family members of people with PD (PwPD) and their recommendations for speech-language pathology services that incorporated their needs. Method: Seventeen spouses/partners of PwPD participated in focus groups that were recorded, transcribed, and analyzed using thematic analyses. Results: Three themes emerged, all focusing around the central tenet that the experiences of family members, and hence their need for speech-language pathology support, transitioned through the stages of PD progression. Theme 1 summarized increasing burdens on family to manage communication as PD progressed beyond a brief period of independent strategy use by PwPD. Theme 2 highlighted multifactorial contributors to communication burdens on families, with cognitive impairments being the most underrecognized. Theme 3 illustrated how families wanted more intervention options from speech-language pathologists (SLPs) that included them, but with a tailored approach for PD stages and personal preferences. Conclusions: When SLPs provide families with either generic communication strategies or strategies that do not fit the individualized needs of PwPD and their families, we may inadvertently be increasing the burden on families. There is a need for systematic, evidence-based, family-centered interventions that include, but go beyond, current speech-focused interventions to meet the shared communication needs of PwPD and their families. [ABSTRACT FROM AUTHOR]

The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

As Latin American academics living in Aotearoa, we have been asked whether we are Indigenous or not. We would answer this question negatively - as common sense - in our home countries. However, in our diasporic location, and interpellated by the Māori concept of whakapapa (genealogy, ancestral ties), what the question revealed is that the fiction of mestizaje had prevented us from thinking about our ancestral connections. This article engages with the affordances of te ao Māori (the Māori world) - for us as Latin American mestizas - to reweave the threads of our whakapapa that have been severed through colonisation and subsequent colonialities, and to reconfigure our relations with Indigenous and Afrodescendant worlds in Abya Yala and Aotearoa. We question the fiction of mestizaje making visible its commitments with the erasure - through forgetfulness - of Black and Indigenous peoples and worlds, and the whitening of Abya Yala. Inspired by te ao Māori (the Māori world), we come together committed to the (re)weaving of memory to articulate a mestizaje of remembering while reconfiguring the sense of (our) 'belonging' to Indigeneity. [ABSTRACT FROM AUTHOR]

In Aotearoa, many of us often situate ourselves on one side of a binary of colonial dynamics, despite how we have whakapapa (genealogies) that interweave these locations of belonging. This article will reflect on what it can mean to be Māori and Pākehā (NZ European of mainly British descent) and attempt to come to terms with historical and ongoing tensions between many of our collective ancestors that are still ongoing in Aotearoa (New Zealand). This includes the author's mixed cultural whakapapa (ancestry). Influences in this article include mātauranga Māori (Māori knowledge) and Western philosophy and art-related perspectives. Pūrākau (stories of origin) of Māui the Trickster in relation to notions of productive idiocy and testing informed by Avital Ronell's reading of Friedrich Nietzsche's Gay Science with an influence by Michel Foucault will be explored in relation to art and live art practices of artists who slide through the woven relationships of being Māori and Pākehā. Projects of Rebecca Ann Hobbs and Martin Awa Clarke Langdon, James Tapsell-Kururangi and Mark Harvey are reflected on, considering this theme. Each of these works will be contextualised in response to political tensions pertaining to normative cultural ideals and notions of acceptability in the worlds of Māori and Pākehā. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines what facilitates the swift reconfiguration of freight movements across transport modes in the wake of a major disaster. Design/methodology/approach: A qualitative research approach focussing on the New Zealand (NZ) domestic freight transport operations in the wake of the 2016 Kaikōura earthquake is used with data collected through 19 interviews with 27 informants. The interviews are thematically analysed by using the framework method. Findings: The paper provides rich and detailed descriptions of the ability of a freight transport system to recover from a disaster through rapid modal shifts. This paper identifies nine factors enabling modular transport operations and highlights the critical role of physical, digital, operational and inter-organisational interconnectivity in the aftermath of a disaster. Originality/value: Although the management of freight disruptions has become a prevalent topic not only in industry and policy-making circles, but also in the academic literature, qualitative research focussing on the ability of commercial freight systems to adapt and recover from a disaster through rapid modal shifts is limited. This qualitative study sheds light on the mechanisms underlying the continuity of freight operations in the wake of a disaster and provides a comprehensive understanding of modular transport operations and the ability of freight systems to keep goods moving. [ABSTRACT FROM AUTHOR]

This article argues that the cultural assimilation of Māori family forms, originating in colonial private family laws, continues under the Care of Children Act 2004 (COCA). It finds that the opportunity to draft a law that was respectful of tikanga Māori and te Tiriti o Waitangi was lost when legislators ignored all the critiques of the operating principles and processes of the Pākehā legal system, provided by Māori during the 1980s and 1990s. The article argues that cultural assimilation continues through court decisions, since COCA principles require priority to be given to parents, with a corresponding marginalisation of whānau, hapū and iwi. The article concludes that incremental reform would be unlikely to achieve legislation that is fit for a bicultural Aotearoa New Zealand. It advocates for a transformational Māori-led family law reform process, guided by te Tiriti o Waitangi/the Treaty of Waitangi and by tikanga Māori. [ABSTRACT FROM AUTHOR]

Introduction: The global nursing workforce is predominantly female, with a large proportion working in the 45–55 age group. Menopause is a transition for all women, and; therefore needs recognition as it can impact work performance and consequently staff turnover. Background: Women will go through the menopause, but not all women are affected. The menopause transition presents a range of signs and symptoms both physical and psychological which can impact the quality of life and individuals' work/life balance. The nursing workforce is predominantly women that will work through the menopause transition. Objectives: The study explored perspectives on digital health interventions as strategies to support menopausal women and to understand the requirements for designing health interventions for support in the workplace. Design: A qualitative explorative design. Settings: Nurses working in a range of clinical settings in England, Finland, Denmark, New Zealand, Australia and USA. Methods: Nurses (n = 48) participated in focus groups from six different countries from February 2020–June 2022 during the pandemic from a range of acute, primary care and education settings. Nurses were invited to participate to share their experiences. Thematic analysis was used. Results: All participants were able to describe the physical symptoms of menopause, with some cultural and possible hemisphere differences; more noticeable was the psychological burden of menopause and fatigue that is not always recognized. Four themes were identified: Managing symptoms in the workplace; Recognition in the workplace; Menopause interventions; and Expectation versus the invisible reality. These themes revealed information that can be translated for implementation into digital health interventions. Conclusions: Managers of nursing female staff in the menopausal age range need greater awareness, and menopause education should involve everyone. Finally, our results demonstrate design attributes suitable for inclusion in digital health strategies that are aligned with likely alleviation of some of the discomforts of menopause. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

A core element of almost all educational improvement efforts is an intention to improve teacher practice in order to enhance student- and system-level outcomes. To this end, a range of strategies are deployed to facilitate teacher professional learning and development, with great investments of time, financial, and human resources. However, the environments in which teachers learn and their impact on teachers' implementation of new learning remain underexamined. By considering how the psychosocial learning environments present in schools affect the teacher development process, there is scope to enhance the impacts of professional development. This study explored how aspects of school climate and culture (that is, the learning environments that teachers experience) affect teachers' classroom implementation of their professional learning. Qualitative data were gathered from 36 teachers in New Zealand through focus groups and analysed via reflexive thematic analysis following a latent inductive approach. Five areas of school climate and culture were identified that, according to the teachers, affected their implementation of new professional learning. These areas were: leadership engagement/actions; the change environment; relationships; beliefs and attitudes related to TPLD; and all being on the same page. Understanding the roles these five areas play provides insights into how school leaders and policymakers can seek to shape the learning environments that surround teachers' daily classroom practice in order to facilitate learning and improvement for all. [ABSTRACT FROM AUTHOR]

The Generalized Workplace Harassment Questionnaire (GWHQ) has not been validated among medical students whilst they are on clinical placements. Therefore, this study aims to validate its use when applied to this cohort. A sample of 205 medical students in their clinical training phase completed the GWHQ. To examine the validity of the proposed factor structure of the validated 25-item GWHQ, which was reduced to from the original 29-item set, a confirmatory factor analysis was conducted. Model fit was appraised by evaluating the comparative fit index (CFI), the root mean square error of approximation (RMSEA), and the standardized root mean squared residual (SRMR). Spearman's rho correlation coefficients were applied to correlations between factors. With the exclusion of Item 19, the resulting fit was improved. In the revised model for a 24-item GWHQ, CFI = 0.995, RMSEA = 0.047, and SRMR = 0.115. Overall, the fit met the criteria for two fit indices and was thus deemed to be acceptable. Factor loadings ranged from 0.49 to 0.96. The Spearman's rho correlation coefficient between Verbal and Covert Hostility was high, although all correlations with Physical Hostility were weak. In conclusion, the amended 24-item version of the GWHQ is a valid instrument for appraising instances of harassment or hostility within clinical placements attended by medical students in New Zealand. [ABSTRACT FROM AUTHOR]

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Management of domestic and wild animals is an integral part of conservation and is often based on how an animal is categorised. For example, feral cats are often killed, while valued companion cats and native wildcats are protected.Drawing on qualitative research and using the concept of boundary‐work, this paper examines the complex categorisation and management of cats within conservation in Britain and Aotearoa, New Zealand (NZ). We examine how, both in theory and in practice, valued companion and wildcats are distinguished from unprotected feral cats, and in‐between categories of stray and hybrid cats.We demonstrate that stakeholders draw boundaries between cat categories differently. These differences in boundary‐drawing reflect the inherent blurriness of category boundaries, practical challenges and, importantly, differences in values, in particular whether priority is placed on the life of the cat or the cat's potential victim, particularly native or game birds. This can mean that laws outlining protections for specific categories of animals have limited effect if, in practice, those encountering cats draw boundaries differently.This paper also reports on important differences between the two case studies. In NZ, even cat advocates support the humane killing of unambiguously feral cats while this is less true in Britain. Furthermore, due to the nature of the contexts, conservationists in NZ are more inclined to assume that ambiguous cats are feral whereas conservationists in Britain are more inclined to assume that they are wildcats.This paper demonstrates that values not only shape people's perceptions and treatment of animals but also how they draw boundaries between them. This finding may have important implications for understanding other controversies in conservation and animal management. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Organised football, in all its variant forms, has been perceived almost exclusively as a male domain until the late 1960s/early 1970s. The story told in this article is set in 1921 when groups of women in Auckland, Wellington and Christchurch formally decided to play soccer, rugby union and rugby league. Michel Foucault's genealogical framework is employed to analyse media texts from five leading New Zealand newspapers from 1 June to 30 October 1921, as well as football texts from the minute books of the Auckland Football Association (AFA), 1920–1922. While nobody knows what influenced several hundred women to form clubs, train and play these games during this particular historical moment, a discursive analysis reveals that ‘The Girl Footballer’ emerged as a particular historical construct. The tactical deployment of key discourses positioned her as irresponsible, selfish and unfeminine and, after a blaze of publicity, she vanished without a trace. As an unrevealed period in the history of women's sport in New Zealand, this genealogical examination offers a fascinating insight into the feelings, attitudes and actions towards women who wished to participate in team sports. [ABSTRACT FROM PUBLISHER]

Implementing community services can be a very complex process where people end up “not seeing the wood for the trees” and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management-control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there. [ABSTRACT FROM AUTHOR]

The work proposes a mathematical model of the process of COVID-19 epidemic as it evolved in New Zealand. The model uses a system of differential equations which emanate from natural assumptions on some probability measure and evolution of this measure on evolving family of simplexes. The authors tried to create the model which, at one hand, is simple and easy to follow. and, at the other hand, reflects the observed epidemic process correctly. The practical aim was to come to justifiable estimations of important parameters like the rate of infection as function of time, thus quantifying effectiveness of the Government measures. Another parameters estimated were the probability distribution of detection times and recovery times. [ABSTRACT FROM AUTHOR]

This paper examines evolutions of domestic foodwork and associated status among diasporic Iranian women in contemporary Aotearoa/New Zealand. Drawing on feminist food studies, as well as on Bourdieu's notion of cultural and symbolic capitals, we examine the two-fold, oppression-empowerment aspects of domestic foodwork, specifically its transformation from a socio-cultural obligation in the origin home to a means of agentic liberation and social empowerment in diaspora. Furthermore, we explore how this transformation is strategically negotiated by some women to successfully generate positions of enhanced respect, status, and private influence both within the domestic sphere and the wider diasporic Iranian community in Aotearoa/New Zealand. [ABSTRACT FROM AUTHOR]

The disparity in young people's access to extracurricular activities, known as the activity gap, remains largely unexplored in Aotearoa New Zealand. In this qualitative study we aimed to identify barriers to accessing activities and potential solutions. We interviewed 12 key informants between December 2021 to February 2022 with experience in providing extracurricular activities or relevant academic or policy-making expertise. Participants identified many positive impacts from extracurricular participation including improved wellbeing, social connection, and skill development. All agreed there is inequitable access to extracurricular activities in Aotearoa New Zealand with children from low socioeconomic backgrounds most affected. Participants explained how poverty created interconnected financial, transportation and infrastructure barriers. Community-embedded extracurricular programmes with low or no fees were considered an effective measure for increasing access. We recommend existing and novel community-led programmes are supported to expand their services, including support for disadvantaged communities to access funding opportunities. We also recommend examples of good practice within schools are disseminated to seed ideas. Further government investment in infrastructure and policy is required to alleviate poverty and facilitate participation. We recognise ongoing awareness, advocacy, and action at both community and policy levels will be required to ultimately close the activity gap in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Background: Discrepancies have been reported between what is being researched, and what patients/families deem important to be investigated. Our aim was to understand research priorities for those who live with cancer in Aotearoa/New Zealand, with emphasis on Māori. Methods: Adult outpatients with cancer and their whānau/family completed a survey (demographics, selecting keywords, free-text comments) at Christchurch hospital. Quantitative and qualitative data were evaluated using standard statistical and thematic analyses, respectively. Results: We recruited 205 participants, including both tūroro/patients (n = 129) and their whānau/family/carer (n = 76). Partnership with Māori health workers enabled greater recruitment of Māori participants (19%), compared to the proportion of Māori in Canterbury (9%). Cancer research was seen as a priority by 96% of participants. Priorities were similar between Māori and non-Māori participants, with the keywords 'Cancer screening', 'Quality of Life' and 'Development of new drugs' chosen most often. Free-text analysis identified three themes; 'Genetics and Prevention', 'Early Detection and Treatment', and 'Service Delivery', with some differences by ethnicity. Conclusions: Cancer research is a high priority for those living with cancer. In addition, participants want researchers to listen to their immediate and practical needs. These findings may inform future cancer research in Aotearoa. Māori terms and translation: Aotearoa (New Zealand) he aha ō whakaaro (what are your thoughts) hui (gathering) mate pukupuku (cancer) mokopuna (descendent) Ōtautahi (Christchurch) rongoā (traditional healing) tāne (male) te reo (Māori language) Te Whatu Ora (weaving of wellness, Health New Zealand) tikanga (methods, customary practices) tūroro (patients) (alternative terms used: whānau affected by cancer or tangata whaiora (person seeking health)) wahine (female) Waitaha (Canterbury) whakapapa (genealogy) whānau ((extended) family, based on whakapapa, here also carer) [ABSTRACT FROM AUTHOR]

In New Zealand – like in the US and UK – independently produced podcasts fall outside of local media regulations. New Zealand's media laws and regulatory bodies remain broadcast and legacy media-focussed, so podcast content that has not been previously broadcast is not regulated or otherwise overseen. In the absence of regulation, this study explores the ways nine independent podcast producers from New Zealand self-govern their content, as well as their motivations for doing so. It is an investigation of the ways 'amateur' content producers approach media ethics, and more broadly podcast production in practice. Not guided or bound by formal publishing or editorial responsibilities, and mostly with no formal media training, study participants demonstrate adherence to journalistic principles. They consider ethical and editorial quandaries as they arise during the production process, factoring in the needs and disposition of their audience. This process is informed by their worldview, as well as their perspectives and experiences as media consumers. Though these podcasters champion the ethos of independent podcasting, the content of their shows is not free from third party influence. These podcasters are also parents, partners, employees, and colleagues; life roles that inform the content of their show. Though they push back against podcasting being legislated, these podcasters see value in creating an informal set of guidelines or a voluntary code of practice for podcasting in New Zealand. This project contributes to ongoing explorations of independent podcasting and podcasting practice, focussing on what defines, motivates, and informs self-driven practitioners. [ABSTRACT FROM AUTHOR]

Weeds are known as 'plants out of place', but how do we come to understand what belongs in place and what does not? Organisms that thrive beyond boundaries of control threaten life that is 'in place', or nature. As a threat to life and nature, weeds are transformed into objects of hate and elimination. Exploring the collective hate of weeds helps to untangle the affective dimensions of colonisation. Using the story of the blackberry in Dunedin, both through its settler history and contemporary relationship with urban foragers, this paper describes how weeds have become powerful affective objects. [ABSTRACT FROM AUTHOR]

Background: In November 2021, assisted dying (AD) became lawful in Aotearoa New Zealand. A terminally ill person may now request, and receive, pharmacological assistance (self-administered or provided by a medical practitioner/nurse practitioner) to end their life, subject to specific legal criteria and processes. Exploring the experiences of health providers in the initial stage of the implementation of the End of Life Choice Act 2019 is vital to inform the ongoing development of safe and effective AD practice, policy and law. Aim: To explore the early experiences of health care providers (HCPs) who do and do not provide AD services seven months after legalisation of AD to provide the first empirical account of how the AD service is operating in New Zealand's distinctive healthcare environment and cultural context. Design: Qualitative exploratory design using semi-structured individual and focus group interviewing with a range of HCPs. Results: Twenty-six HCPs participated in the study. Through a process of thematic analysis four key themes were identified: (1) Difference in organisational response to AD; (2) challenges in applying the law; (3) experiences at the coal face; and (4) functionality of the AD system. Conclusion: A range of barriers and enablers to successful implementation of AD were described. Adoption of open and transparent organisational policies, ongoing education of the workforce, and measures to reduce stigma associated with AD are necessary to facilitate high quality AD service provision. Future research into the factors that influence responses to, and experience of AD; the impact of institutional objection; and the extent to which HCP perspectives evolve over time would be beneficial. In addition, further research into the integration of AD within Māori health organisations is required. [ABSTRACT FROM AUTHOR]

Delivery of interprofessional education (IPE) initiatives for pre-licensure students is increasingly the norm in health and social care training programmes. This collaborative form of education relies on teachers from various disciplines joining together to facilitate IPE. When IPE programmes first start, goodwill often prevails and facilitators are keen to take part. But as time goes on, retaining the IPE facilitator workforce is challenging. Research was undertaken to explore the experience of IPE facilitators who were part of a New Zealand university-based ten year old IPE programme. The research used a qualitative survey approach. Responses were received from 29% of all those invited to participate. Closed questions were collated and free-text survey responses analyzed using Template Analysis. Three themes and one integrative theme were identified. Themes include facilitators who are recognized, facilitators who are confident, and facilitators who are inspired. Themes were mediated by macro, meso and micro level forces. The cross-cutting integrative theme showed IPE facilitators experienced individual tipping points, with the potential to influence their continued involvement. These tipping points need to be recognized and addressed by those in senior level positions (macro-governance and meso-management), to ensure IPE facilitators continue and IPE programmes remain sustainable. [ABSTRACT FROM AUTHOR]