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In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015–16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns. • Older people position themselves as active co-managers in their support arrangements. • Framing problems as challenges not threats facilitates older people's resourcefulness. • People in old age adapt resiliently to health conditions as part of living and ageing. [ABSTRACT FROM AUTHOR]

Abstract: This paper uses Arlie concept of emotion management and “surface” and “deep acting” to explore how sex workers separate and distance themselves from their public role. Experiences of stigmatisation prevail among sex workers and how stigma is resisted or managed has an impact on their health. In-depth interviews were carried out between August 2006 and April 2007 with 58 sex workers in five cities in New Zealand following decriminalisation of the sex industry. Most participants drew on ideas of professionalism in sustaining a psychological distance between their private and public lives. They utilised “deep acting”, transmuting private experiences for use in the work environment, to accredit themselves as professional in their business practices. They also constructed different meanings for sex between public and private relationships with the condom providing an important symbol in separating the two. A few (mostly female street-based) participants were less adept at “deep acting” and relied on drugs to maintain a separation of roles. This paper argues that in an occupation which is highly stigmatised and in which depersonalisation as an aspect of burn-out has been reported as a common occurrence, the ability to draw on strategies which require “deep acting” provides a healthy estrangement between self and role and can be seen as protective. The separation of self from work identity is not damaging as many radical feminists would claim, but an effective strategy to manage emotions. Hochschild, A. (1983). The managed heart: Commercialization of human feeling. Berkeley: University of California Press. [Copyright &y& Elsevier]

General practitioners provide treatment for the majority of people diagnosed as having a mental disorder in New Zealand, but much research suggests that they fail to diagnose many common mental disorders. This paper explores the issue of GP recognition of mental health problems through four discussion groups with GPs from the lower half of the North Island of New Zealand. GPs were asked to consider what they thought their role was in relation to mental health, what facilitated discussion of mental health issues in consultations and what could influence patients to disclose mental health problems. The analysis of the data collected drew on thematic and discourse analysis. Four key domains that had an impact on the consultation were identified, which were categorised as practice pressures, socio-cultural factors, the medico-legal framework and the consultation process. GPs employ a number of strategies to respond to the systemic and social issues influencing the consultation. This research suggests that GPs do recognise mental health problems in patients, but that a number of important factors result in the consultations not being labeled as mental health ones. The paper concludes by offering a framework for the mental health consultation that illustrates the systemic issues that GPs consider when making decisions about mental health consultations. [ABSTRACT FROM AUTHOR]

This paper draws together work on therapeutic assemblages, geographic assemblages, and therapeutic landscapes to develop the concept of "multi-sited therapeutic assemblages." Assemblage theory has been productively used in health research since it achieved prominence in the social sciences two decades ago. One facet that, however, remains as yet under-developed in the literature on "therapeutic assemblages" (as well as their close kin, "health assemblages," "ill-health assemblages," "care assemblages," etc.) is that of the multi-sited therapeutic assemblage. This paper demonstrates the significance of the multi-locality of therapeutic assemblages by mapping the mental health support activities of young New Zealanders. Grounded theory analysis of interviews with 150 New Zealand youth (which took place from 2015 to 2020) about their online and offline engagements in mental health support highlights the importance of the emplacement of therapeutic practices whilst also foregrounding their multi-sitedness. It enables opportunities to examine how therapeutically-meaningful places can be constituted both as independent sites and simultaneously re-made through their fluid, dynamic and temporal relations with one another. Through this analytic perspective, care and other elements of the therapeutic come to be understood as neither anchored to a single site nor constituted through the inter-relation of home and clinic, but defined via a shifting, dynamic, and multi-directional assemblage of multiple places, people, and resources. This has noteworthy implications for how we envisage relationships between a wide variety of therapeutic digital and real-life sites, as well as for examining scholarly and practical understandings of the emplacement of care. • Develops the conceptual framework of multi-sited therapeutic assemblages. • Highlights the multi-spatial dimension of online/offline therapeutic activity. • Expands scholarly approaches to therapeutic landscapes beyond singular sites. • Examines youths' multi-sited, multi-directional engagement in mental health support. • Finds multi-directional support can coincide with de-centring of professional care. [ABSTRACT FROM AUTHOR]