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The authors present findings that emphasize a need for trauma-informed policy to mitigate vicarious trauma transmission for teachers who work in English language learning (ELL) classrooms. Qualitative data was collected from 10 stakeholders in Canada using an interpretive-phenomenological methodology. Findings assisted to better understand the impact of institutional policy, or lack thereof, on trauma-informed practices within English language teacher work. Themes that emerged were settlement factors, roles, and responsibilities (personal and professional), and organizational policies. A scan of publicly available information on trauma-informed policy suggested a gap for English language teachers. Current literature on vicarious trauma stresses that trauma-informed practice necessitates an individual and systemic approach to mitigating its effects. A basic scan of potential trauma-informed frameworks was discussed as potential institutional approaches to reduce the impact of vicarious trauma on teachers.

Suicide is one of the leading causes of death worldwide. Men are significantly more likely to commit suicide yet are an understudied population in suicide research. Hopelessness has repeatedly been shown to be one of the strongest predictors of suicide ideation, attempt, and completion. Meaning in life and social connectedness have been shown to be inverse associates of hopelessness. In a sample of n = 398 males living in Aotearoa, New Zealand between the ages of 18-30, this study examined the relationship between social connectedness, meaning in life, and hopelessness. Meaning in life and social connectedness were hypothesized to be negatively associated with hopelessness and that the relationship between social connectedness and hopelessness would vary across different levels of meaning in life. Results revealed that meaning in life and social connectedness were negatively associated with hopelessness. Meaning in life moderated the relationship between social connectedness and hopelessness such that the effect meaning in life exerted on hopelessness was strongest when social connectedness was low. Key Words: Suicide, Hopelessness, Meaning in life, Social connection, Yo ung males, INTRODUCTION Globally, each year over 700,000 individuals die by suicide (World Health Organisation, 2019). Despite a small reduction in the global suicide rate across the 21st century, suicide remains a [...]

Background: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of pregnant women and their unborn babies. Objective: To explore the impact of COVID-19 on intrapartum care in Ethiopia. Design: A concurrent mixed-methods design was employed. Methods: An interrupted time series analysis was implemented using a Poisson regression model to estimate monthly changes in the incidence rates of institutional childbirth, instrumental vaginal birth, caesarean section, stillbirth, institutional neonatal death, institutional maternal death and availability of essential medical supplies before and during COVID-19. The dataset included data from all women who gave birth in 15 public hospitals, and the total number of childbirths in the cohort study before COVID-19 (12 months of data from March 2019 to February 2020) was 24,478, while during COVID-19 (6 months of data from March to August 2020), the total number of childbirths in the cohort study was 11,966, forming a combined final dataset of 36,444. Simultaneously, a descriptive qualitative study using a purposive sampling technique was conducted through in-depth interviews until data saturation was reached, with data were collected from 14 February to 10 May 2022. Data from the interviews were imported into NVivo 12 Plus to perform an inductive thematic analysis. Quantitative and qualitative data were integrated using joint display methods to identify corroboration or contradiction between the different forms of evidence. Results: Our findings indicate that the incidence rates of caesarean sections and instrumental vaginal births significantly increased in the first 6 months of COVID-19. Three themes were identified: ‘ Barriers to providing intrapartum care during COVID-19 ’, ‘ Delays to provision of intrapartum care during COVID-19 ’ and ‘ Inadequate COVID-19 preventive measures ’. Conclusion: In combination, the three themes contributed to a considerable increase in neonatal and maternal deaths. Interventions such as fully equipped labour wards and obstetric triage systems are needed to restore disrupted maternal and perinatal care during the ongoing and future pandemics. In addition, stakeholders should inform the public that blood donations can help the community recover from recent shocks in emergency health and future pandemics. Further research should investigate the long-term impact of COVID-19 on maternity care and maternal and infant outcomes.

There are two broad views of children's theory of mind. The mentalist view is that it emerges in infancy and is possibly innate. The minimalist view is that it emerges more gradually in childhood and is heavily dependent on learning. According to minimalism, children initially understand behaviors rather than mental states, and they are assisted in doing so by recognizing repeating patterns in behavior. The regularities in behavior allow them to predict future behaviors, succeed on theory-of-mind tasks, acquire mental state words, and eventually, understand the mental states underlying behavior. The present study provided the first clear evidence for the plausibility of this view by fitting head cameras to 54 infants aged 6 to 25 months, and recording their view of the world in their daily lives. At 6 and 12 months, infants viewed an average of 146.5 repeated behaviors per hour, a rate consistent with approximately 560,000 repetitions in their first year, and with repetitions correlating with children's acquisition of mental state words, even after controlling for their general vocabulary and a range of variables indexing social interaction. We also recorded infants' view of people searching or searching for and retrieving objects. These were 92 times less common and did not correlate with mental state vocabulary. Overall, the findings indicate that repeated behaviors provide a rich source of information for children that would readily allow them to recognize patterns in behavior and help them acquire mental state words, providing the first clear evidence for this claim of minimalism.

ABSTRACTQueer university students face multiple stressors which can contribute to mental health difficulties, including minority stressors unique to their queer identities. However, there is little literature exploring stressors faced by queer individuals in university settings. The aim of this study was to qualitatively explore the current challenges and strengths faced by queer university students in Aotearoa New Zealand, in order to contextualise their mental health experiences. Twenty-eight queer students participated across 12 focus groups or interviews. Two queer researchers thematically analysed the data. Three themes were interpreted from the data: ‘That’s not feminine enough’: the impact of societal ideologies on queer students; ‘There’s one rainbow person in the room’: Tokenism, social isolation, and then finding community; and ‘You know what it’s like to not be heard’: The transformation of challenges into strengths. The findings illustrate how queer university students make meaning of their challenges, and the strengths they develop to mitigate these. Educational institutions are highlighted as important sites of systemic change, to reduce minority stressors in students’ lives.

Background: The COVID-19 pandemic, drought and internal conflict have worsened Ethiopia’s already weak healthcare system. Antenatal and intrapartum care are especially prone to interruption under these circumstances. Objective: To explore women’s experiences receiving antenatal and intrapartum care during the pandemic. Design: A descriptive qualitative approach was utilised. Methods: We conducted in-depth interviews with 17 women and held 4 focus group discussions with women who gave birth at 4 public hospitals during the pandemic. A study was conducted at four public hospitals in the Sidama region of Ethiopia, during which data were collected from 14 February to 10 May 2022. Thematic analysis was performed to generate themes. Results: The peak of the COVID-19 pandemic in Ethiopia presented several barriers to access and uptake of antenatal and intrapartum care at public hospitals. Four themes and 10 subthemes emerged from the thematic analysis. The themes were ‘Barriers to maternity care uptake during COVID-19’, ‘Shortage of resources during COVID-19’, ‘Delays in maternity care uptake during COVID-19’ and ‘Mistreatment of women during maternity care during COVID-19’. The subthemes included ‘Fear of contracting COVID-19’, ‘People in the hospital neglecting COVID-19 prevention’, ‘Women losing their job during COVID-19’, ‘Shortage of beds in the labour ward’, ‘Shortage of medical supplies’, ‘Delays in seeking care’, ‘Delays in receiving care’, ‘Complications during childbirth’, ‘disrespectful’ and ‘suboptimal care’. Conclusion: The findings of this study underscore the impact of COVID-19 on antenatal and intrapartum care, leading to delays in seeking and receiving care due to reduced rapport, resource shortages, companion restrictions, disrespectful care and suboptimal care. These factors contribute to increased obstetric complications during COVID-19. It is imperative for policymakers to prioritise essential resources for antenatal and intrapartum care in the present and future pandemics. Moreover, healthcare providers should maintain respectful and optimal care even amid challenges.

I te tau 1987, i whakaputaina e Max Abbott raua ko Mason Durie te pepa, 'A Whiter Shade of Pale' i tiro whanui ai i nga taunakitanga mo te mahi whakatuanui ahurea tahi (te arotuapori rato) i waenga i nga hotaka whakangungu kia huri te akonga hei kaimatai hinengaro rehita. E wha nga ngahurutau (2023) i muri mai, ka taruatia e matou te rangahau, a, i tonoa nga kaihautu hotaka (n = 15) kia whakahoki korero mai mo nga kaimahi o te hotaka; nga ranga tohutohu Maori; nga akonga o te hotaka; me nga kaupapa ako o te hotaka. I whakaaturia e nga tatari whakataurite te whakapiki ake o nga nama o nga kaiako Maori, nga kaupapa aronga Maori, me te whakapumautanga o nga hononga ki nga ranga tohutohu Maori. Heoi ano, ko te nuinga o nga kaihautu i whakapuaki mai i nga awangawanga mo te iti haere o nga akonga Maori e tono ana ki nga hotaka ngaio. Ko ta matou rangahau e miramira nei, ahakoa nga whakapikinga, na nga tauarai mauroa i whakaaweawe ai nga urupare whai tikanga ki Te Tiriti o Waitangi i nga wahi katoa o te akoranga. In 1987, Max Abbott and Mason Durie published the 'A Whiter Shade of Pale' paper that outlined evidence of monocultural (Eurocentric) dominance within training programmes to become a registered psychologist. Four decades (2023) later we replicated the study and invited programme directors (n = 15) to comment on programme staff; Maori advisory bodies; programme students; and programme content. Comparative analyses revealed improvements in the number of Maori teaching staff, Maori-focused content, and established links with Maori advisory bodies. However, most directors (77%) expressed concerns about the limited number of Maori students applying to the professional programmes. Our study highlights that despite improvements, ongoing barriers impact meaningful responses to Te Tiriti o Waitangi in all areas of the discipline. Keywords: Psychology; Indigenous; Maori; decolonising psychology, INTRODUCTION Psychology in Aotearoa New Zealand has a colonial history that reflects Western psychological concepts, ideals, models, theories, and practices (Groot et al., 2018; Love, 2002; Levy & Waitoki, 2016; [...]

Abstract Background Mistreatment of childbearing women continues despite global attention to respectful care. In Ethiopia, although there have been reports of mistreatment of women during maternity care, the influence of this mistreatment on the continuum of maternity care remains unclear. In this paper, we report the prevalence of mistreatment of women from various dimensions, factors related to mistreatment and also its association to the continuum of maternity care in health facilities. Methods We conducted an institution-based cross-sectional survey among women who gave birth within three months before the data collection period in Western Ethiopia. A total of 760 women participated in a survey conducted face-to-face at five health facilities during child immunization visits. Using a validated survey tool, we assessed mistreatment in four categories and employed a mixed-effects logistic regression model to identify its predictors and its association with the continuum of maternity care, presenting results as adjusted odds ratios (AORs) with their 95% confidence intervals (CIs). Results Over a third of women (37.4%) experienced interpersonal abuse, 29.9% received substandard care, 50.9% had poor interactions with healthcare providers, and 6.2% faced health system constraints. The odds of mistreatment were higher among women from the lowest economic status, gave birth vaginally and those who encountered complications during pregnancy or birth, while having a companion of choice during maternity care was associated to reduced odds of mistreatment by 42% (AOR = 0.58, 95% CI: [0.42–0.81]). Women who experienced physical abuse, verbal abuse, stigma, or discrimination during maternity care had a significantly reduced likelihood of completing the continuum of care, with their odds decreased by half compared to those who did not face such interpersonal abuse (AOR = 0.49, 95% CI: [0.29–0.83]). Conclusions Mistreatment of women was found to be a pervasive problem that extends beyond labour and birth, it negatively affects upon maternal continuum of care. Addressing this issue requires an effort to prevent mistreatment through attitude and value transformation trainings. Such interventions should align with a system level actions, including enforcing respectful care as a competency, enhancing health centre functionality, improving the referral system, and influencing communities to demand respectful care.

Abstract Authoritarianism is best conceptualised by three attitudinal clusters: Aggression, Submission, and Conventionalism. Once considered a fixed characteristic, recent observational research has demonstrated how the dimension of submission can fluctuate in response to COVID-19 threat as a means of maintaining collective security. However, this effect has not been investigated with other forms of threat, nor has it been supported experimentally. In the present study, we sought to test observational findings by priming 300 participants with either a COVID-19 threat, a domestic terrorism threat, or a non-threatening control. Levels of authoritarianism were tested before and after presentation of a prime and then the difference between the two measures could be compared between prime conditions. Results from a Bayesian multivariate regression analysis informed by observational findings suggested that participants who experienced the COVID-19 or terrorism primes reported higher levels of authoritarian submission after the prime compared to before the prime, relative to those who experienced the neutral control prime. In contrast, the aggression subfactor did not seem to elicit any change in response to threat, and the conventionalism subfactor showed a response only to the terrorism prime. We concluded that two different forms of societal threat could elicit changes in specific dimensions of authoritarianism over a very short time span. We caution against the common practice of treating authoritarianism as a unidimensional construct without careful consideration.

Police Ten 7 is a reality crime show that follows the police of Aotearoa New Zealand in responding to antisocial and criminal activity. In the current study, we coded 24 episodes of Police Ten 7, screened between 2011 and 2021. For each episode, each offence depicted was coded into one of five categories (i.e., aggressive, driving, drug and alcohol, property, or other) and the ethnicity of the suspect was also coded. We had two hypotheses. First, that Maori and Pasifika will be more likely to be depicted as committing violent crimes than Pakeha suspects. Second, that the proportion of aggressive offences Maori and Pasifika are depicted committing on Police Ten 7 will be higher than that drawn from the National Annual Apprehension statistics. Both hypotheses were supported. Keywords: Media, Prejudice, Stereotype, INTRODUCTION Police Ten 7 is a reality crime show that follows the day-to-day activities of police officers in Aotearoa New Zealand. In 2021, Auckland City Councillor Efeso Collins asked Television [...]

Introduction Achieving the Sustainable Development Goals to reduce maternal and neonatal mortality rates will require the expansion and strengthening of quality maternal health services. Midwife-led birth centres (MLBCs) are an alternative to hospital-based care for low-risk pregnancies where the lead professional at the time of birth is a trained midwife. These have been used in many countries to improve birth outcomes.Methods The cost analysis used primary data collection from four MLBCs in Bangladesh, Pakistan and Uganda (n=12 MLBC sites). Modelled cost-effectiveness analysis was conducted to compare the incremental cost-effectiveness ratio (ICER), measured as incremental cost per disability-adjusted life-year (DALY) averted, of MLBCs to standard care in each country. Results were presented in 2022 US dollars.Results Cost per birth in MLBCs varied greatly within and between countries, from US$21 per birth at site 3, Bangladesh to US$2374 at site 2, Uganda. Midwife salary and facility operation costs were the primary drivers of costs in most MLBCs. Six of the 12 MLBCs produced better health outcomes at a lower cost (dominated) compared with standard care; and three produced better health outcomes at a higher cost compared with standard care, with ICERs ranging from US$571/DALY averted to US$55 942/DALY averted.Conclusion MLBCs appear to be able to produce better health outcomes at lower cost or be highly cost-effective compared with standard care. Costs do vary across sites and settings, and so further exploration of costs and cost-effectiveness as a part of implementation and establishment activities should be a priority.

Qualitative research about women and birthing people's experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, 'WOmen's Experiences of Monitoring Baby (The WOMB Study)', aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants' perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience.

BackgroundCoronavirus disease 2019 (COVID-19) continues to pose a global public health threat. The pandemic overstretched already weak health systems in low- and low-middle-income countries, including Ethiopia. There is a paucity of studies on the impact of COVID-19 on antenatal care access, uptake, and provision in Ethiopia. This study examines the impact of COVID-19 on antenatal care provision in the Sidama region, Ethiopia.MethodsA concurrent mixed-methods study was conducted between 14 February and 10 May 2022 at 15 public hospitals in the Sidama region. An interrupted times series design was applied for a quantitative study, which included data from all pregnant women who attended antenatal care before COVID-19 (12 months, March 2019 to February 2020) and during COVID-19 (six months, March to August 2020) at 15 public hospitals in the region. The total numbers in the antenatal care 1 cohort (at least one antenatal care contact) and antenatal care 4 cohort (at least four antenatal care contacts) were 15,150 and 5,850, respectively, forming a combined final dataset of 21,000 women. Routinely collected monthly data were derived from the hospitals' health management information system and imported into Stata version 17 for analysis. The mean monthly incidence rate ratio of antenatal care uptake was calculated using a Poisson regression model with a 95% confidence interval. Simultaneously, an exploratory study design was conducted for qualitative using in-depth interviews to explore maternity care providers' perceptions of the impact of COVID-19 on antenatal care access, uptake, and provision. Qualitative data were thematically analysed. The quantitative and qualitative findings were then integrated using the joint display technique.ResultsOur findings indicate a significant monthly decrease of 0.7% in antenatal care 1 and 1.8% in antenatal care 4 during the first six months of the pandemic. A lack of medical supplies, fear of contracting COVID-19, inadequate personal protective equipment, discrimination against those attending the hospital, and the absence of antenatal care guidelines for care provision, COVID-19 vaccine hesitancy and long waiting times for ANC led to disrupted access, uptake, and provision of antenatal care during COVID-19.Conclusion and recommendationsOur findings demonstrate that the COVID-19 pandemic affected antenatal care access, uptake, and provision in the study area from March to August 2020. To mitigate disrupted antenatal care access, uptake and provision, antenatal care clinics should be equipped with medical supplies. It is crucial to maintain rapport between the community and maternity care providers and provide training for maternity care providers regarding the adapted/adopted guidelines during COVID-19 at the hospital grassroots level for use in the current and future pandemics. Pregnant women should have timely access to maternity care providers in order to maintain at least a minimum standard of care in current and future pandemics.

Abstract Background Despite recognition of the adverse impacts of the mistreatment of women during pregnancy, labour and birth, there remains limited evidence on interventions that could reduce mistreatment and build a culture of respectful maternity care (RMC) in health facilities. The sustainability of effective individual interventions and their adaptability to various global contexts remain uncertain. In this systematic review, we aimed to synthesise the best available evidence that has been shown to be effective in reducing the mistreatment of women and/or enhancing RMC during women’s maternity care in health facilities. Methods We searched the online databases PubMed, CINAHL, EBSCO Nursing/Academic Edition, Embase, African Journals Online (AJOL), Scopus, Web of Science, and grey literature using predetermined search strategies. We included cluster randomized controlled trials (RCTs) and pre-and-post observational studies and appraised them using JBI critical appraisal checklists. The findings were synthesised narratively without conducting a meta-analysis. The certainty of evidence was assessed using GRADE criteria. Results From the 1493 identified records, 11 studies from six sub-Sahara African countries and one study from India were included: three cluster RCTs and nine pre- and post-studies. We identified diverse interventions implemented via various approaches including individual health care providers, health systems, and policy amendments. Moderate certainty evidence from two cluster RCTs and four pre- and post-studies suggests that multi-component interventions can reduce the odds of mistreatment that women may experience in health facilities, with odds of reduction ranging from 18 per cent to 66 per cent. Similarly, women’s perceptions of maternity care as respectful increased in moderate certainty evidence from two cluster RCTs and five pre- and post-studies with reported increases ranging from 5 per cent to 50 per cent. Conclusions Multi-component interventions that address attitudes and behaviors of health care providers, motivate staff, engage the local community, and alleviate health facility and system constraints have been found to effectively reduce mistreatment of women and/or increase respectful maternity care. Such interventions which go beyond a single focus like staff training appear to be more likely to bring about change. Therefore, future interventions should consider diverse approaches that incorporate these components to improve maternal care.

Objective To determine the socio-demographic profile of all students enrolled to study medicine in Aotearoa New Zealand (NZ).Design and setting Observational, cross-sectional study. Data were sought from the Universities of Auckland and Otago, the two NZ tertiary education institutions providing medical education, for the period 2016–2020 inclusive. These data are a subset of the larger project ‘Mirror on Society’ examining all regulated health professional enrolled students in NZ. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. NZ denominator population data (18–29 years) were sourced from the 2018 census.Participants 2858 students were enrolled to study medicine between 2016 and 2020 inclusive.Results There were more women (59.1%) enrolled to study medicine than men (40.9%) and the majority (96.5%) were in the 18–29 years age range. Māori students (rate ratio 0.92; 95% CI 0.84 to 1.0) and Pacific students (rate ratio 0.85; 95% CI 0.73 to 0.98) had lower overall rates of enrolment. For all ethnic groups, irrespective of rural or urban origin, enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation. Enrolments were lower for students from rural areas compared with those from urban areas (rate ratio 0.53; 95% CI 0.46–0.61). Overall NZ’s medical students do not reflect the diverse communities they will serve, with under-representation of Māori and Pacific students and students who come from low socioeconomic and rural backgrounds.Conclusions To meaningfully address these issues, we suggest the following policy changes: universities commit and act to Indigenise institutional ways of knowing and being; selection policies are reviewed to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine (specifically, the impact of low socioeconomic status should be factored into selection decisions); and the government fund more New Zealanders to study medicine.