Search

Introduction. Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies. The specific analysis in this paper probes primary health care leaders' assessments of progress towards more collaboration with other health and non-health agencies, and communities. Aim. This study aimed to investigate how ideas for more integration and joinedup care have found their way into the practice of primary health care in Aotearoa New Zealand. Methods. Applying a realist logic of inquiry, data from semi-structured interviews with primary health care leaders were analysed to identify key contextual characteristics and mechanisms. Explanations were developed of what influenced leaders to invest energy in joined-up and integrated care activities. Results. Our findings highlight three explanatory mechanisms and their associated contexts: a willingness to share power, build trusting relationships and manage task complexity. These underpin leaders' accounts of the success (or otherwise) of collaborative arrangements. Discussion. Such insights have import in the context of the current health reforms for stakeholders charged with developing local approaches to the planning and delivery of health services. [ABSTRACT FROM AUTHOR]

The background of this paper starts with the history and significance of the author's relationship to the Campaign, U=U; Undetectable equals Untransmissable as an Indigenous woman and well-known advocate living with HIV. The methods used in this paper explored an adaptation of a thriving indigenous Health Framework implemented in New Zealand for over 40 years. We anticipate the methods used in this paper along with the U=U Campaign will make the U=U relevant to other Indigenous Peoples. The common threads of the cultures are our creation stories and our rendition of the Health Circle or the Four Pillars. We interviewed and surveyed key community members, family, people living with HIV, and social workers that work in those communities over a period of 6 months; 36 people participated. We shared personal stories anecdotally of her experiences. The results were a health model comparison of U=U from a Maori worldview. Each aspect of the Four Pillars or cornerstones of the model is explained from a personal experience perspective, which is inclusive and reflects a process familiar to Indigenous Peoples and worldviews. We are using stories to relay that information from that particular worldview. In conclusion, after much deliberation, discussions with key people, and personal experiences, we can tie the concept of U=U to an intrinsic framework that other Indigenous Peoples and communities can easily interpret. [ABSTRACT FROM AUTHOR]

Purpose: Temporary labour mobility programmes (TLMPs) are initiated by high-income nations to fill their labour demands by offering temporary work opportunities to migrants from low-income nations. TLMPs also seek to contribute to economic development in workers' home countries. This paper aims to assess the accountability of New Zealand's Recognised Seasonal Employer (RSE) Scheme and Australia's Seasonal Worker Programme (SWP) in reaching their economic development objectives in one sending nation, Samoa. Design/methodology/approach: A qualitative study with RSE and SWP workers and key informants (collectively stakeholders) in Samoa was undertaken to assess the contributions of these schemes to economic development. An interdisciplinary research approach was taken using the Pacific methodology of talanoa. Talanoa was used to "operationalise engagement" and empower local stakeholder accounts. Findings: Talanoa supported the elicitation of accounts that contributed nuanced insights into the accountability of TLMPs. Specifically, stakeholder accounts revealed limitations in the ability of the RSE Scheme and SWP to meet their economic development objectives for Samoan communities and workers. Adjustments are necessary to meet Pacific nations' economic development objectives. Practical implications: This study responds to calls for on-the-ground accounts of stakeholders involved in TLMPs. It provides insights that may contribute to the development of more effective TLMPs, particularly regarding economic development in workers' home countries. Originality/value: Drawing on dialogic accounting literature, which calls for engagement with the marginalised, a talanoa approach has been engaged to assess TLMPs via on-the-ground participant accounts in a specific context. This paper introduces talanoa to the critical and social accounting literature, to move beyond a typical accounting qualitative interview process and encourage greater engagement and collaboration with Pacific scholars and partners. [ABSTRACT FROM AUTHOR]

Indigenous populations globally experience problem gambling at higher rates than mainstream communities, often leading to adverse outcomes in social, cultural, and health domains (The term 'indigenous' within this paper refers to all first nations people from the specified countries. When capitalised, this refers to Australian Indigenous people specifically.). Problem gambling in indigenous communities has been linked to relative poverty and social disadvantage. The sweeping impacts of problem gambling for indigenous communities are holistic in nature and are felt throughout many aspects of the community, including the local economy, education, employment, and cultural kinship obligations. The social links inherent in many gambling activities in addition to the motivations of players and complex socio-cultural milieu can make it very difficult to renounce the practice. This paper aims to evaluate the indigenous gambling literature to discern appropriate and effective principles to guide intervention development in the context of problem gambling pertaining to the Australian Indigenous population. A rapid review will be undertaken to gather, analyse, and interpret appropriate theoretical and empirical literature relating to gambling interventions for indigenous populations. Papers from Canada, Australia, New Zealand, and U.S.A (CANZUS) will be considered in the review and thematic analysis will be undertaken to ascertain a broad understanding of effective and appropriate problem gambling intervention principles applicable to these population groups. Despite the relative dearth of empirical evidence within this field, approaches to problem gambling intervention within indigenous populations must be culturally-centred and underpinned by a public health framework that considers the broad socio-politico-cultural context of the whole community. The importance of community-control, collaboration, community capacity building, workforce competence, a holistic approach, and gambling regulation cannot be overstated. The available literature focusses on an alternative approach to addressing problem gambling in indigenous communities, with much of the findings highlighting key indigenist principles within a context-based method of engagement and intervention, including addressing the social, political, and cultural determinants of problem gambling at a community-level. [ABSTRACT FROM AUTHOR]

The Muslim community is a vibrant part of New Zealand society. As this community grows, researchers will need to strengthen engagement and collaboration to tailor the delivery of services. Given the paucity of the literature, this conceptual paper drawing on a study on health and Ramadan presents an exemplar for doing research with Muslim communities. This paper proposes several key elements (i) the importance of relationships, (ii) engagement with imams (mosque leaders), (iii) cultural and religious safety, (iv) a gendered approach and (v) utilizing religious festivals. These findings will be of interest to policy makers, practitioners and scholars wishing to engage with this community. [ABSTRACT FROM AUTHOR]

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid‐1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care. [ABSTRACT FROM AUTHOR]

Indigenous Research Methodologies (IRMs) for considering cultural values of water are a missing component of water and wetlands management in Australia. On this dry, flat and ancient continent Traditional Knowledge has been passed on from generation to generation for millennia. The profound knowledge of surface and groundwater has been critical to ensuring the survival of Indigenous peoples in the driest inhabited continent, through finding, re-finding and protecting water. Indigenous Research Methodologies can provide a basis for the exploration of this knowledge in a way that that is culturally appropriate, and which generates a culturally safe space for Indigenous researchers and communities. The development of IRMs has been and continues to be limited in Australia in the water context, primarily due to the lack of Indigenous water practitioners, with non-Indigenous researchers dominating the sector. The intention of the paper is to shift and decolonise the research paradigm from studying Indigenous peoples through non-Indigenous research methodologies, to partnering in developing methods appropriate to Indigenous knowledge systems. Indigenous Research Methodologies are rooted in Indigenous epistemologies and ontologies and represent a radical departure from more positivist forms of research (Wilson, Can J Native Educ 25:2, 2001). This allows the Indigenous researcher to derive the terms, questions, and priorities of what is being researched, how the community is engaged, and how the research is delivered. This paper provides an overview of Indigenous engagement in water management in Australia and Aotearoa (New Zealand), with reference to case studies. These more general models are used as the basis for developing an IRM appropriate to the Kamilaroi people in the Gwydir Wetlands of northern NSW, Australia. [ABSTRACT FROM AUTHOR]

The importance of identifying and improving the distinctiveness of historical urban landscapes as a means of reinforcing place identity and supporting economic development has been widely acknowledged. However, research on the economic and social performance of heritage conservation areas is slow to develop, especially in New Zealand. In connection to the examination of Special Character Areas (SCAs) in Auckland, this paper seeks to quantify the value of the historical urban landscape and improve its management. A property value analysis is used to assess the impact of SCA designation on property values and an online questionnaire survey gathers information on homeowners' experiences of living in an SCA. The results indicate that designated SCA properties have higher average values than non-designated properties and homeowners are appreciative of a sense of community and having certainty about the look and feel of their neighbourhood in the future. However, the majority of people who had gone through the processes of building and planning applications found it to be a negative experience because of the high cost in terms of time and money. A historic urban landscape approach to the development of management plans and design guidelines is recommended to improve the implementation of the Special Character Areas in Auckland and beyond. [ABSTRACT FROM AUTHOR]

This paper discusses changes taking place in the delivery of work-integrated learning (WIL) in a Faculty of Māori and Indigenous Development in Auckland, New Zealand. WIL in the faculty utilized a model adopted from a business school which did not recognize key aspects of the students' lives and expectations, in particular the strong connection that Māori students can have with their communities. Over time the nature of the WIL experience is moving to a model based on Māori values. Indigenous models must be relevant to and driven by a community's underlying values, as many students feel primary responsibility to their community, and second to the academy. This paper is part of an ongoing reflection on how WIL placements in Te Ara Poutama at Auckland University of Technology can fulfil wide-ranging expectations of students and their communities and help develop a coherent Indigenous framework for WIL. [ABSTRACT FROM AUTHOR]

This paper explores the intersection between place, culture and identity as evidenced through photographic narratives of Pacific Island children, based in Samoa and a diasporic community in New Zealand. The study was undertaken with 71 children aged 6–14 in Samoa (35) and New Zealand (36). A Talanoa/fa'afaletui (conversation-based) Pacific research approach was used to analyse 1285 children's photos of 'things that matter to them'. Most photos showed multiple layers of meaning (e.g. sensory, love, pride, memory). Plants were most frequently featured in Samoan children's photos and family in New Zealand. Through the photos and conversations, children articulate dynamic and multi-layered connections to place, identity and belonging. For diasporic children, their Island of origin is central to their identity and articulated through cultural, family and community connections. An adapted place attachment model is proposed to help better understand children's place attachment, sense of belonging and their Pacific Island identity. [ABSTRACT FROM AUTHOR]

What happened to marriage patterns within the British Empire's colonies where more opportunity existed for breaks with past norms? This paper, drawn from research into a group of laborers known as Brogdens' Navvies who emigrated to New Zealand in 1872 and 1873, argues that working people conformed with social expectations around marriage until legal and economic constraints forced them into alternative forms of relationships. Additionally, communities were sometimes more flexible and accepting of arrangements than legal strictures and prescriptions might suggest. From 1898 onward, law changes that legalized marriage breakdown and allowed remarriage seem to have reduced the need for alternatives. [ABSTRACT FROM AUTHOR]

The coming decades are predicated to bring widespread shifts in local, regional, and global climatic patterns. Currently there is limited understanding of how ferns will respond to these changes and few studies have attempted to model shifts in fern distribution in response to climate change. In this paper, we present a series of these models using the country of New Zealand as our study system. Ferns are notably abundant in New Zealand and play important ecological roles in early succession, canopy biology, and understory dynamics. Here we describe how fern distributions have changed since the Last Glacial Maximum to the present and predict how they will change with anthropogenic climate change – assuming no measures are taken to reduce carbon emissions. To do this, we used MaxEnt species distribution modelling with publicly available data from gbif.org and worldclim.org to predict the past, present, and future distributions of 107 New Zealand fern species. The present study demonstrates that ferns in New Zealand have and will continue to expand their ranges and migrate southward and upslope. Despite the predicted general increased range size as a result of climate change, our models predict that the majority (52%) of many species' current suitable habitats may be climatically unsuitable in 50 years, including the ecologically important group: tree ferns. Additionally, fern communities are predicted to undergo drastic shifts in composition, which may be detrimental to overall ecosystem functioning in New Zealand. [ABSTRACT FROM AUTHOR]

Copyright of Knowledge Cultures is the property of Addleton Academic Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Given New Zealand's susceptibility to a range of natural hazards, reducing exposure is an important step towards strengthening community resilience and reducing potential social, environmental and economic consequences. Land-use planning has long been recognised as a contributor to achieving this goal. Focusing on earthquake hazards, this paper examines the evolution of risk reduction measures in local government land-use planning documents for 3 earthquake-prone regions of New Zealand in 2000 and again in 2016. While some progress has been made in planning for earthquake hazards, overall the planning documents in these regions remain inadequate. As such, resilience from a land-use planning perspective has not significantly improved. This is surprising in the context of major seismic events in New Zealand over the last decade that have caused considerable damage and loss of life. Future anticipated changes to the planning systems in the country provide opportunities for improvements to be included in documentation. [ABSTRACT FROM AUTHOR]

QuakeCoRE is one of 10 Centres of Research Excellence funded by the New Zealand Tertiary Education Commission. With a focus on earthquake resilience of communities and societies, it has played a major role in addressing needs identified following the Christchurch Earthquake and other major events over the last decade. QuakeCoRE comprises a number of Flagship Programmes, including Flagship 4, which is entitled "Next-generation infrastructure: Low-damage and repairable solutions." This paper aims to support turning research into practice by identifying the key areas of Flagship 4 that are likely to have an impact on the industry. Five key areas of impact were identified, based on a review of the published research, engagement with Flagship 4 leadership and the authors' experience in the industry. For each area identified, summaries of the major research outcomes are provided, along with views as to how these can support the engineering practice. [ABSTRACT FROM AUTHOR]

Background: Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA. Methods: In total, 13 electronic databases and 14 websites for the period from January 2015 to May 2021 were searched. Information on the characteristics and methodological quality of included studies was extracted using standardised assessment tools. Results: Thirteen published evaluations were identified; 10 for Australian Aboriginal and Torres Strait Islander peoples. The main positive outcomes reported were improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. The methodological quality of evaluations and the reporting of methodological criteria were moderate. Conclusions: Cultural competency education programs can improve knowledge, attitudes and confidence of healthcare workers to improve the health of First Nations peoples. Providing culturally safe health care should be routine practice, particularly in places where there are concentrations of First Nations peoples, yet there is relatively little research in this area. There remains limited evidence of the effectiveness of cultural education programs alone on community or patient outcomes. Cultural competency is often promoted as a strategy to address health inequities, although evidence linking cultural competency to patient outcomes is scarce. We conducted a narrative review of the recent literature on cultural education programs and found 13 published evaluations, mainly reporting improvements in health professionals' attitudes and knowledge, and improved confidence in working with First Nations patients. Although cultural education has a positive short-term impact, none of the studies included measured improved patient health outcomes. [ABSTRACT FROM AUTHOR]

The article shows, on the example of Croatian newspapers in Australia and New Zealand, the possibilities of researching the publications of Croatian emigrants. The goal of the Croatian Emigrant Press project implemented at the Faculty of Humanities and Social Sciences, University of Zagreb, is explained. The method of creating bibliographies within the project (with views in ISBD and MARC 21 formats) is also explained, as is the research methodology, which includes searching library catalogues, community engagement (crowdsourcing) and searching archival materials. The role of archives as heritage institutions that are indispensable in the research of publications is especially explained. Examples are given of New Zealand and Australian newspapers for which the only surviving sources are archival ones. One New Zealand newspaper (Glas istine, The Voice of Truth) has not been preserved in any of its copies, but documents preserved in the New Zealand archives prove that they were published. A similar example is of an Australian newspaper (Svijetlo, The Light) for which a document was found which makes it clear that the person who wrote the document had the publication in his hands. Images of documents related to the research of Croatian newspapers are also presented in the paper. One of these documents is related to the implementation of censorship in Australia in the 1930s and indicates that it were the Croatian newspapers Iskra (The Sparkle) and Oganj (The Flame) that influenced the amendments to regulations in order to control press as effectively as possible. The importance of private archives and community archives within Croatian associations is pointed out, and new possibilities for researching Croatian publications in archives in countries where emigrated Croats live are also emphasized. [ABSTRACT FROM AUTHOR]

Background: Digital contact tracing (DCT) was a central component of the global response to containing COVID‐19. Research has raised concerns that DCT could exacerbate inequities, yet the experiences of diverse communities at greater risk from COVID‐19 are typically underrepresented. Methods: The present study aimed to understand the perceived barriers to the adoption of the app amongst Māori, Pasifika, and disabled people. Focus groups and interviews were undertaken with Māori, Pasifika, and disability sector stakeholders and community participants. Results: Participants (n = 34) generally expressed willingness to utilise DCT and support its adoption within the communities. Simultaneously, participants revealed how the app could marginalise community members who struggled with the usability and those distrusting of the government's COVID‐19 interventions. Conclusions: The findings highlight how addressing communication inequality can assist in the development of contact‐tracing responses that are both effective and equitable. The study provides insights about the role of information and communication technologies as health resources. Patient or Public Contribution: Consulting with members of the target communities was central throughout the present study, including recommendations for potential participants, participation in interviews and sharing early findings for feedback. This study reports on focus groups and interviews with individuals from Māori and disability sectors. [ABSTRACT FROM AUTHOR]

In October 2015, the European Union's Scientific Committee on Consumer Safety issued a Preliminary Opinion on Hydroxyapatite (nano). Past industrial experience with this material and participation in ISO/TC-229, Nanotechnologies, led me to submit comments on the Committee's interpretations of physico-chemical properties, especially solubility, that in retrospect were also probing of the Committee's collective understanding of nanomaterials. The Committee's responses are examined against a background of other Opinions issued in the same time period. The expert's role and responsibility, whether as an individual or a group member or in representing a scientific discipline, are examined through the concept of epistemic community taken from the public policy literature. A central theme is the Committee's framing of chemical narratives such that its administrative procedures are projected onto the nanomaterial safety literature that is itself undergoing considerable investigation and revision. Inherent to this analysis is the singular role of toxicologists in the regulatory process. A related exchange by Australian and New Zealand colleagues is examined for its parallels to the SCCS actions, and there is a cursory discussion of later SCCS Opinions regarding Hydroxyapatite (nano). [ABSTRACT FROM AUTHOR]

Background: Despite a number of clinicians having been trained in Parent–Child Interaction Therapy (PCIT) in Aotearoa/New Zealand, few are regularly delivering the treatment, with barriers to use including a lack of suitable equipment and lack of professional support. This pragmatic, parallel-arm, randomised, controlled pilot trial includes PCIT-trained clinicians who are not delivering, or only rarely utilising, this effective treatment. The study aims to assess the feasibility, acceptability and cultural responsivity of study methods and intervention components and to collect variance data on the proposed future primary outcome variable, in preparation for a future, larger trial. Methods: The trial will compare a novel 're-implementation' intervention with a refresher training and problem-solving control. Intervention components have been systematically developed to address barriers and facilitators to clinician use of PCIT using implementation theory, and a draft logic model with hypothesised mechanisms of action, derived from a series of preliminary studies. The intervention includes complimentary access to necessary equipment for PCIT implementation (audio-visual equipment, a 'pop-up' time-out space, toys), a mobile senior PCIT co-worker and an optional weekly PCIT consultation group, for a 6-month period. Outcomes will include the feasibility of recruitment and trial procedures; acceptability of the intervention package and data collection methods to clinicians; and clinician adoption of PCIT. Discussion: Relatively little research attention has been directed at interventions to resurrect stalled implementation efforts. Results from this pragmatic pilot RCT will refine and shape knowledge relating to what it might take to embed the ongoing delivery of PCIT in community settings, providing more children and families with access to this effective treatment. Trial registration: ANZCTR, ACTRN12622001022752, registered on July 21, 2022. [ABSTRACT FROM AUTHOR]

Aim: To assess whether febrile neonates from the community received their first dose of intravenous antibiotics within 1 h from time of arrival, as per the regional paediatric sepsis pathway, at a tertiary combined adult/child emergency department in New Zealand. Method: Retrospective data were collected from January 2018 to December 2019 with 28 patients included. Results: Mean time to first antibiotic dose for all neonates and those with serious bacterial infection was 3 h 20 min and 2 h 53 min respectively. No case used the paediatric sepsis pathway. A pathogen was identified in 19/28 (67%) neonates and 16/28 (57%) had clinical signs of shock. Conclusion: This study adds to Australasian data on community neonatal sepsis. Antibiotic administration was delayed for neonates with serious bacterial infection, clinical signs of shock and raised lactate. The reasons for delay are examined, with a number of potential areas for improvement identified. [ABSTRACT FROM AUTHOR]

Determining the relative influence of biotic and abiotic processes in structuring communities at local to large spatial scales is best understood using a biogeographic comparative‐experimental approach. Using this approach, previous work suggests that intertidal community dynamics (top‐down and bottom‐up effects) vary unimodally along an upwelling‐based productivity gradient, termed the Intermittent Upwelling Hypothesis (IUH). Evidence consistent with the IUH comes from the sessile invertebrate/predator (SIP) subweb in certain rocky intertidal communities, but whether this pattern extends to macrophyte/herbivore (MH) subwebs is unknown. Here we ask: Are MH subwebs also structured as predicted by the IUH? What is the relative importance of herbivory and predation in structuring these communities? Under what conditions do ecological subsidies like nutrients or propagule production drive community dynamics? And are omnivorous interactions important? We hypothesize that MH subwebs are driven by a new construct, the Grazing‐Weakening Hypothesis (GWH), which states that MH interactions weaken monotonically with increasing nutrients, with strong (weak) herbivory and low (high) macrophyte productivity at low (high) nutrients. We explored local‐to‐large spatial scale dynamics of both subwebs using a biogeographic comparative‐experimental factorial field experiment testing joint and separate effects of herbivores and predators between two continents. Experiments at 10 sites ranging from persistent upwelling to persistent downwelling regimes ran for 26–29 months in Oregon and California, and New Zealand (NZ) South Island. For the MH subweb, results were consistent with the GWH: herbivory declined and macrophytes increased with increasing nutrients. As expected, results for the SIP subweb were consistent with the IUH: predator effect size was unimodally related to upwelling. Overall, herbivory explained more variation in community structure than did predation, especially in NZ. Omnivory was weak, sessile invertebrates outcompeted macrophytes, and ocean‐driven subsidies provided the basic template driving ecosystem dynamics. We propose a unified meta‐ecosystem dynamics model combining MH and SIP results: with increased upwelling, sessile invertebrates and underlying dynamics vary unimodally (as in the IUH), while herbivory decreases and macrophytes generally increase. While this model was based on research in temperate ecosystems varying in upwelling regime, its wider applicability remains to be tested. [ABSTRACT FROM AUTHOR]

Background: Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. Aim: To explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. Design: A Kaupapa Māori qualitative study. Setting/participants: Interviews were conducted with 103 participants from four areas of the North Island of Aotearoa New Zealand. Participants comprised bereaved whānau (family) of Māori with a life limiting illness and Māori health practitioners. Results: Māori health practitioners undertake cultural and connecting work to promote culturally safe palliative and end-of-life care for Māori patients and their whānau. This work is time-consuming and emotionally and culturally demanding and, for most, unpaid and unrecognised. Non-Māori staff can support this work by familiarising themselves with te reo Māori (the Māori language) and respecting cultural care customs. However, achieving culturally safe end-of-life care necessitates fundamental structural change and shared decision-making. Conclusions: Our findings indicate that efforts to support equitable palliative care for Indigenous people should recognise, and support, the existing efforts of health practitioners from these communities. Colleagues from non-Indigenous populations can support this work in a range of ways. Cultural safety must be appropriately resourced and embedded within health systems if aspirations of equitable palliative and end-of-life care are to be realised. [ABSTRACT FROM AUTHOR]

Technology and digital platforms have become essential for people and communities to interact because of COVID-19. Despite its benefits, digital exclusion disproportionately affects Pacific communities living in New Zealand. This article provides insights into how Niue mamatua (older adults) used their gifted mobile phones and mobile data as part of a COVID-19 digital inclusion initiative. It begins with an overview of the digital inclusion needs of older adults, followed by a description of the digital vā (relational space) and negotiating a new way of maintaining connection in an online world. The tutala (a Niue method of conversation anchored on respect) with 12 mamatua highlighted the benefits, support factors, and challenges of how they were able to use their mobile phone. Importantly, mobile phones provided the necessary access and connectivity to interact in a digitally connected world, namely the digital vā, when in-person connections were disrupted because of COVID-19. [ABSTRACT FROM AUTHOR]

More than a decade ago, the first exploratory study into the experiences of Self-Represented Litigants in Aotearoa (New Zealand) recommended the need for more cultural perspectives in this area of research. This article makes a timely contribution to building this knowledge base while identifying some of the gaps, attitudes, intersectional experiences and challenges faced by Pacific communities within their respective cross-cultural contexts in response to Aotearoa's justice system. As a starting point, we explore the existing framework of self-represented litigation in Aotearoa as well as some of the key limitations to highlight how responsive it is to cultural and systemic issues of bias. This article further explicates key principles from a customary approach used in Samoa to demonstrate how it may help facilitate meaningful engagement across diasporic Pan-Pacific communities to further enhance cross-cultural litigation in the civil justice system of Aotearoa—a largely under-theorised area. [ABSTRACT FROM AUTHOR]

Introduction. Counties Manukau Health Otolaryngology programme for general practitioners with special interest (GPwSI) was developed to provide a group of GPs with tools to manage low complexity, secondary otolaryngology (ORL) problems in their local communities. After clinical triaging, the medical records were retrieved to assess patient outcomes from community (GPwSI) review. This programme provides an example of how the aims of the Health NZ reforms may work in practice, by bridging primary and secondary services. Aim. To assess whether the GPwSI programme provides patients with suitable specialty care in the community, compared to a specialised, hospital outpatient otolaryngology clinic (OPC). Methods. This is a retrospective study of patients with an assigned priority of three (non-urgent) referred to Middlemore Hospital for a first specialist assessment (FSA) during 2018-19. Results. Of the 6231 patients referred, one-fifth (22%) were directed to the GPwSI service, and the remainder (78%) were arranged to be seen in the OPC. GPwSI patients were more likely to be seen for their FSA earlier than OPC patients (RR 1.55, 95% CI 1.46-1.64, P < 0.05). Most patients (99%) referred for surgery by GPwSIs and about one-quarter (23%) of GPwSI patients (315/1345; 23%) were assigned to GPwSI follow up, of which almost all (95%) were managed within the GPwSI programme. Discussion. Patients being seen through the GPwSI programme are suitably managed in the community, more efficiently than if they were to be seen in an outpatient specialist clinic. [ABSTRACT FROM AUTHOR]

Introduction. There is considerable variation in the structure and resources of New Zealand (NZ) rural hospitals; however, these have not been recently quantified and their effects on healthcare outcomes are poorly understood. Importantly, there is no standardised description of each rural hospital's catchment boundary and the characteristics of the population living within this area. Aim. To define and describe a catchment population for each of New Zealand's rural hospitals. Methods. An exploratory approach to developing catchments was employed. Geographic Information Systems were used to develop drive-time-based geographic catchments, and administrative health data (National Minimum Data Set and Primary Health Organisation Data Set) informed service utilisation-based catchments. Catchments were defined at both the Statistical Area 2 (SA2) and domicile levels, and linked to census-based population data, the Geographic Classification for Health, and the area-level New Zealand Index of Socioeconomic Deprivation (NZDep2018). Results. Our results highlight considerable heterogeneity in the size (max: 57 564, min: 5226) and characteristics of populations served by rural hospitals. Substantial differences in the age structure, ethnic composition, socio-economic profile, 'remoteness' and projected future populations, are noted. Discussion. In providing a standardised description of each rural hospital's catchment boundary and its population characteristics, the considerable heterogeneity of the communities served by rural hospitals, both in size, rurality and socio-demographic characteristics, is highlighted. The findings provide a platform on which to build further research regarding NZ's rural hospitals and inform the delivery of highquality, cost-effective and equitable health care for people living in rural NZ. [ABSTRACT FROM AUTHOR]

Insufficient water for irrigation is a common problem in the Canterbury Region of New Zealand. Farmers have the option of applying for resource consent or joining a community irrigation scheme to take water. Water supply becomes more problematic during drought seasons as farmers must adhere to water restrictions imposed by the water authority. To deal with this problem, we developed an agent-based irrigation management system that can be used by farmers to calculate the ideal crop water needs on individual farms, which is particularly useful during periods of water scarcity. During water scarcity, most farms will have shortages of water. However, it is possible that there are farmers who will have excess water that could be distributed to those who need it. By doing this, farmers with excess water can make more profit and those who do not have enough water can purchase water to reduce their losses. In this work, we explore how auction-based negotiation in a multi-agent setting can be used to maximise water sharing within a community during periods of water scarcity. We evaluate various auction mechanisms that can be used to distribute excess water. In addition, we investigate the effect of various different agents' behaviours on water distribution and community profit. [ABSTRACT FROM AUTHOR]

Introduction: Community pharmacies are high-performance workplaces; if the environment is not conducive to safe practice, mistakes can occur. There has been increasing demand for pharmacists during the COVID-19 pandemic as they have become integral to the response. Suboptimal practices in the work environment and with pharmacists and their teams can impact the safe delivery of services. New Zealand pharmacists' perceptions of the current work environment and beliefs around whether suboptimal practice have increased within the last five years and the effect of the COVID-19 pandemic on their practices are unknown. Aim/Objectives: To assess what New Zealand pharmacists associate with suboptimal practice in their workplace and investigate the effect of the COVID-19 pandemic on pharmacists and their workplaces. Methods: We employed an anonymous online questionnaire derived from a human factors framework utilised in the aviation industry to explore the potential environment, team and organisational factors as the determinants of suboptimal work practices. The software, hardware, environment and liveware (S.H.E.L.L) model was adapted to create questions classifying the risk factors to potentially identify aspects of work systems that are vulnerable and may provide risks to optimal practice. Additional perceptions around the effect of COVID-19 on their workplace and roles as pharmacists were explored. Participants were community pharmacists working in New Zealand contacted via a mailing list of the responsible authority for the profession. Findings: We received responses from 260 participants. Most participants indicated that suboptimal practice had increased in the last 5 years (79.8%). The majority of participants indicated that COVID-19 had impacted their workplaces (96%) and their roles as pharmacists (92.1%). Participants perceived that suboptimal practice was associated with a lack of leadership and appropriate management; poor access to resourcing, such as adequate staff and narrow time constraints for work tasks; a lack of procedures; competition; and stress. A lack of experience, professionalism and poor communication between staff, patients and external agencies were also issues. COVID-19 has affected pharmacists personally and their work environments. Further study in this area is required. Conclusions: We have identified that pharmacists across all sectors of New Zealand agreed that suboptimal practices had increased in the last 5 years. A human factors S.H.E.L.L framework can be used to classify themes to understand the increases in suboptimal practice and the role of COVID-19 on pharmacist practice. Many of these themes build on the growing body of the international literature around the effect of the pandemic on pharmacist practice. Areas for which there are less historical data to compare longitudinally include pharmacist wellbeing and the impact of COVID-19. [ABSTRACT FROM AUTHOR]

Long-term (decadal) records of microplankton provide insights into how lower trophic levels of coastal ecosystems respond to nutrient enrichment, over and above shorter-term variability. We used a 15-year seasonal census in the Firth of Thames, a deep, nutrient-enriched estuary in northeastern Aotearoa/New Zealand, to determine microplankton responses to enrichment. Kendall trend analyses showed that dissolved inorganic nitrogen (DIN) and dissolved organic nitrogen were enriched by 99% and 34%, respectively, over 15 years, while phosphorus changed little. Larger phytoplankton (> 2 µm) increased by 46%, including 57% increases by diatoms (mainly large centrics with 93% increase) and nanoflagellates (151% increase). Dinoflagellates decreased by 46%, such that the community shifted from dinoflagellate to diatom/nanoflagellate dominance. Within phytoplankton ≤ 2 µm, picoprokaryotes increased by 369%, while picoeukaryotes changed little. Among microheterotrophs (< 200 µm), bacteria increased by 89%, and small oligotrichs increased by 53%. Trend analyses and multivariate general additive modelling showed that microplankton biomass responded primarily to increased DIN over the 15-year period and secondarily to stratification variation at shorter time scales. The changed biomasses and community composition are explained as responses to increased N:P and food-web interactions. Deleterious changes included increased toxic Pseudo-nitzschia abundance and potentially reduced nutritional quality of the phytoplankton community for grazers. The increased N and larger diatoms indicated potential for increased deposition to sediments, possibly explaining previous observations of lowered denitrification in the Firth during the time series period. The results indicated a continuation of enrichment the Firth has received over decades, with implications for expression of ecosystem stressors of acidification and hypoxia. [ABSTRACT FROM AUTHOR]

Forty million people around the world and more than one million in the United States live with HIV. Despite the gains in the prevention and treatment of HIV due to medical advances and community advocacy, HIV/AIDS continues to claim lives and disproportionately affect marginalized communities. Stigma against people with HIV remains powerful. While individuals with HIV have gained some visibility in the media, the scarcity of politicians with HIV is striking. This article analyzes a possible reason: voter bias. We examine voters' reactions to political candidates with HIV using original nationally representative survey experiments from the United States, the United Kingdom and New Zealand. Voters penalize candidates with HIV by 10–12 percentage points in the three countries. Prejudice, electability concerns, and the moral judgment that candidates are responsible for their HIV+ status explain bias. The lack of descriptive representation remains an obstacle to improved policy outcomes for this marginalized community. [ABSTRACT FROM AUTHOR]

Background Many public health experts have claimed that elimination strategies of pandemic response allow 'normal social life' to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement. Methods Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand. Results A majority of participants reported that life after elimination was 'more or less the same' as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social. Conclusions Elimination strategies can successfully allow 'normal social life' to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies. [ABSTRACT FROM AUTHOR]

New forests can bring many benefits; however, public concern over wildfires can create a dilemma for restoration ecologists, managers, and policy makers advocating for forestation. In southern montane New Zealand, destocking following pastoral tenure review and forestation incentives have resulted in an increase in woody vegetation, raising concerns over fire risk. We used abundance‐weighted community flammability metrics to investigate changes in the flammability of montane grassland within Mahu Whenua Ecosanctuary following destocking, and the relative flammability of woody communities likely to establish naturally in this area. While woody species cover increased following destocking, a decrease in highly combustible graminoids and shrubs, and increased abundance of non‐flammable herbaceous species meant community flammability metrics reduced or showed no change. Woody communities that could potentially develop in the area varied substantially in structure and composition. Open, species‐rich, shrublands showed lower flammability metrics for both understorey and canopy than mixed dense shrubland/forests or species‐poor beech (Nothofagaceae) forests. For active forestation projects where fire is undesirable, a low‐flammability herbaceous understorey can reduce fire risk. Where desirable forest species are highly combustible but fire‐intolerant, e.g. New Zealand beech, fire risk could be reduced by maintaining buffer zones of low‐flammability vegetation or applying planting strategies such as nucleation that accelerate the development of closed canopy forest patches more likely to have moisture‐retentive ground layers. However, in historically burnt landscapes, additional information will be needed to define the wider pool of low‐flammability species appropriate for forestation programs. [ABSTRACT FROM AUTHOR]

Background: Translocation is a common tool in wildlife management and its implementation has resulted in many conservation successes. During translocations, any associated infectious agents are moved with their wildlife hosts. Accordingly, translocations can present a risk of infectious disease emergence, although they also provide an opportunity to restore natural infectious communities ('infectome') and mitigate the long-term risks of reduced natural resistance. Methods: We used metatranscriptomic sequencing to characterise the cloacal infectome of 41 toutouwai (North Island robin, Petroica longipes) that were translocated to establish a new population within the North Island of New Zealand. We also screened for pathogenic bacteria, fungi and parasites. Results: Although we did not detect any known avian diseases, which is a positive outcome for the translocated toutouwai population, we identified a number of novel viruses of interest, including a novel avian hepatovirus, as well as a divergent calici-like virus and four hepe-like viruses of which the host species is unknown. We also revealed a novel spirochete bacterium and a coccidian eukaryotic parasite. Conclusions: The presumably non-pathogenic viruses and microbial species identified here support the idea that most microorganisms likely do not cause disease in their hosts, and that translocations could serve to help restore and maintain native infectious communities. We advise greater surveillance of infectious communities of both native and non-native wildlife before and after translocations to better understand the impact, positive or negative, that such movements may have on both host and infectome ecology. [ABSTRACT FROM AUTHOR]

We examined the association between habitat parameters and gastropod communities across a number of freshwater ecosystems, whose biodiversity has been affected by increased mining activities over decades. Reservoirs inhabited by the New Zealand mud snail (Potamopyrgus antipodarum (Gray, 1843)) exhibited different abiotic conditions than waterbodies that were not, such as higher salinity indicators (max. conductivity 13400 μS/cm, TDS 7700 mg/l and chlorides 7200 mg/l), and degraded water quality. In such water bodies P. antipodarum density was high (max. 23686/m2). Further, invaded waters were inhabited by less diverse gastropod communities than reservoirs without P. antipodarum. The invader has established reproducing populations and were the dominant species (D 87.53%), or formed mono-specific assemblages, in the reservoirs. Our results indicate that P. antipodarum occurred in habitats whose conditions are unfavorable or less preferred by other species, such as those with high conductivity, and high concentrations of chlorides and calcium. Since this snail is known to inhabit water bodies with degraded water quality, we assumed that along with the progressing development of industries worldwide, this species will continue to spread to industrial areas and will inhabit increasing numbers of anthropogenically affected water environments. Our study contributes to the global understanding of the mechanisms involved in successful establishment in waters by P. antipodarum, and is especially novel in addressing its occurrence in anthropogenically created ecosystems. Our results showed that human impact is the cause of the trend in P. antipodarum populations, and compared habitats from the perspective of both abiotic parameters and community structure. Human activities can have a significant impact on water quality that can result in the permanent establishment of P. antipodarum populations, especially when the environment is not favorable for the native species. [ABSTRACT FROM AUTHOR]

This study investigated how university students in Pacific Island contexts coped with the shift to remote learning caused by the COVID-19 pandemic. The researchers aimed to investigate the social capital of a group of Pasifika university students in Fiji, New Zealand and Solomon Islands universities during COVID-19 and how they coped with the rapid shift to remote learning. Social capital refers to building relationships and networks to deal with collective issues in the present and future. The researchers used tokstori to collect data from Solomon Islands students and talanoa in New Zealand. Sixteen Solomon Islanders participated in tokstoris and ongoing Pasifika students' talanoa and faikava (kava consumption) to share concerns and challenges to their academic studies and lives. Deductive in nature, the analysis found that communication with fellow students, often via digital media, and interaction with supportive staff helped their success. Furthermore, getting in touch with the family and following COVID-19 protective practices helped students adjust positively. Being able to 'tap' the social resources within these spaces helped build perseverance, resilience and strong social capital. The research findings show the importance of individuals, student communities and institutions consciously strengthening social networks among students during a crisis such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Macroinvertebrate communities in running waters are commonly used as bioindicators of fine sediment pollution, but few studies evaluate impacts across multiple years. We used a 5-year dataset from 46 rivers in Southland, New Zealand to investigate the consistency of the relationship between deposited fine sediment and stream macroinvertebrates across three categories of agricultural land-use intensity (low, medium, and high). We also compared the performance of four widely used invertebrate stream health metrics and their recently developed sediment-specific counterparts. Linear and non-linear regressions were fitted and effect sizes were interpreted to identify biologically meaningful relationships (r2 ≥ 0.1). Sites within medium-intensity catchments showed the greatest number of such relationships (29 of 40 cases), compared to low- (8) or high-intensity catchments (23). Invertebrate metrics responded more frequently, and mostly negatively, to increasing sediment in medium- and high-intensity catchments. Overall, sediment-specific metrics performed better than their widely used counterparts. Our findings show that land-use intensity influences the multi-year dynamics of deposited fine sediment and the corresponding stream invertebrate responses. These temporal dynamics can be substantial and should be considered in future stream biomonitoring efforts. [ABSTRACT FROM AUTHOR]

As the American Psychological Association Taskforce on Indigenous Psychology acknowledges, fidelity to the inalienable right to self‐determination is the ethical foundation of Indigenous psychology. The task of decolonizing psychology is not only about divesting from Eurocentric paradigms that have controlled and limited Indigenous wellbeing, but producing new paradigms founded on Indigenous knowledges. The Indigenous paradigm of social and emotional wellbeing is both a new therapeutic practice and theory of wellbeing. As the exploration of the domains of SEWB has shown, findings from the National Empowerment Project indicate that strengthening a connection to culture is identified as of highest importance to the flourishing of Indigenous individuals, families, and communities. Wellbeing in Abya Yala (the Americas) is conceived as Sumak Kawsay or Buen Vivir and Māori constructs of wellbeing as Hauora. These transnational wellbeing conceptualizations can be situated within a larger global health movement, which is centered on strengthening Indigenous cultures of wellbeing, and sustainable planet–people relationships. Indigenous community psychologies are not anthropocentric and are centered on the sacredness of nature, the cultivation of spirituality, and accountability to maintain harmonious ecosystem relationships. Indigenous community psychologies from Australia, Aotearoa New Zealand, and Mexico are brought in plurilogue envisioning international solidarity networks that engage communities, activists, and committed student generations. Highlights: Indigenous community psychologies constitute global movements forging transnational solidaritiesIndigenous psychologies are not anthropocentric and promote holistic wellbeing.Embodied examples of Indigenous community psychologies trace hopeful pathways toward decoloniality.Transnational collaborations among Indigenous psychologists create innovative pedagogies.The inalienable right to self‐determination is the ethical foundation of Indigenous psychologies. [ABSTRACT FROM AUTHOR]

Relationships with place provide critical context for characterizing biocultural diversity. Yet, genetic and genomic studies are rarely informed by Indigenous or local knowledge, processes, and practices, including the movement of culturally significant species. Here, we show how place‐based knowledge can better reveal the biocultural complexities of genetic or genomic data derived from culturally significant species. As a case study, we focus on culturally significant southern freshwater kōura (crayfish) in Aotearoa me Te Waipounamu (New Zealand, herein Aotearoa NZ). Our results, based on genotyping‐by‐sequencing markers, reveal strong population genetic structure along with signatures of population admixture in 19 genetically depauperate populations across the east coast of Te Waipounamu. Environment association and differentiation analyses for local adaptation also indicate a role for hydroclimatic variables—including temperature, precipitation, and water flow regimes—in shaping local adaptation in kōura. Through trusted partnerships between community and researchers, weaving genomic markers with place‐based knowledge has both provided invaluable context for the interpretation of data and created opportunities to reconnect people and place. We envisage such trusted partnerships guiding future genomic research for culturally significant species in Aotearoa NZ and beyond. [ABSTRACT FROM AUTHOR]

This article discusses teaching online under emergency conditions early in the Covid-19 pandemic and reviews the literature on these experiences from various teaching contexts, including ESOL. It finds commonalities in the student experience regarding appreciation of keeping courses going, discrepancies in people's skills and infrastructure that affect their ability to participate, and feelings of isolation or lack of community. It uses example research from 2020, conducted at a university in New Zealand with students on an ESP programme, and relates the findings of that programme to international research, finding similarities. It concludes with recommendations to reduce problems in the future. [ABSTRACT FROM AUTHOR]

Within this text, we discuss themes that cover the relationship between our personal visual art collaborations and how they relate to the heavy music scene and culture within Aotearoa. We provide background context to the origins of Prickly Jim, and display examples of the type of work we create. We explore the culture of the 'moshpit' in relation to our own personal experiences and the wider correspondence it has with our creative output. The pit becomes a perfect metaphor to describe the dichotomy between the aesthetics of metal and metal's true heart. On the outside, the pit is choreographed violence, intimidating to the uninitiated. On the inside, there is a profound sense of community and belonging. Yes, we punch and shove each other, but it is in a way that could only be described as endearing. [ABSTRACT FROM AUTHOR]

Western worldviews dominate the information systems (IS) literature, accepted and taken for granted as the natural way of doing things. While diversity in terms of gender and ethnicity has been studied in the IS field, there is scant research on the experiences of Indigenous information technology (IT) professionals. This study uses narrative inquiry to provide temporal, contextualised accounts of IT professional experiences from the Indigenous (Māori) community in Aotearoa, New Zealand. These accounts demonstrate how participants actively draw from their culture to enact their professional activities. We identify three cultural elements that differentiate the practices of Māori IT professionals from Western approaches that dominate the IS literature: whakapapa (genealogical connections), tikanga (customary traditions) and tino rangatiratanga (collective cultural determination). Further, we theorise how Indigenous IT professionals capitalise on the re‐presentational power of digital artefacts as a vehicle for cultural re‐affirmation to project their Indigenous identity in contemporary society. Our findings are useful for attempts to enhance Indigenous representation in the IT workforce and for designing systems and artefacts that are relevant to and inclusive for Indigenous communities. [ABSTRACT FROM AUTHOR]

Place-based community networks provide a resource that can be drawn on to protect and promote the wellbeing of residents. We investigate the role of social networking sites (SNSs) in community formation in a new master-planned, mixed tenure, affordable housing estate in Auckland, Aotearoa/New Zealand. Waimahia Inlet was developed by a consortium of Māori organizations and community housing providers. Community formation was an explicit developer goal with public spaces to encourage face-to-face interaction designed into the development and social infrastructure nurtured on site. New residents were invited to join a closed Facebook group, created and moderated by a residents' association set up by the developer. In-depth interviews with 38 residents between 2017/18 revealed synergies between residents' use of online and offline interactional spaces for producing and performing an engaged and supportive community. Neighbourhood networks contributed to strengthened attachment to place and sense of security by residents. [ABSTRACT FROM AUTHOR]

This article provides an account of the role that agential realism might play in sex research, intersexuality and education, as well as the possibilities this opens up for research, institutions, policy, intersex communities and understandings of intersexuality. The account begins by addressing key issues in the field of sex research, intersexuality and education, then demonstrates how these may be read through an agential realist lens. This approach provides a more accountable means of thinking through matters of sexual difference and opens up more nuanced enquiry. Subsequently, the article speculates on what kinds of explorations of sex might emerge with future research and pedagogy, followed by an example of the ways in which this reading of sex has flow-on effects in relation to gender and sexuality, which are often taught alongside sexual difference. From consultations with members of the New Zealand intersex community, the article closes by discussing pertinent issues the community faces, which might be addressed in sex education. [ABSTRACT FROM AUTHOR]

Aim: No measure has formally been developed to assess the published ICD‐11 model of Personality Disorder (PD) severity. We therefore set out to develop and evaluate the 14‐item Personality Disorder Severity ICD‐11 (PDS‐ICD‐11) scale. Method: A representative U.S. community sample (N = 428; 50.9% women) and a New Zealand mental health sample (N = 87; 61.5% women) completed the PDS‐ICD‐11 scale along with a series of established PD and impairment measures. Results: Item response theory supported the unidimensionality of PDS‐ICD‐11 (median item loading of 0.68) and indicated that a PDS‐ICD‐11 score of 17.5 may serve as a benchmark for pronounced dysfunction. Correlation and regression analyses supported both criterion validity and incremental validity in predicting impairment and PD symptoms. The PDS‐ICD‐11 was particularly associated with measures of Level of Personality Functioning Scale (LPFS), Global PD severity, and Borderline PD symptom score. A comparison between clinical individuals diagnosed with an ICD‐11 PD vs. no PD supported diagnostic validity. Conclusion: This initial construction study suggests that the PDS‐ICD‐11 constitutes a promising instrument that provides a quick impression of the severity of personality dysfunction according to the official ICD‐11 PD guidelines. Clearly, more research is needed to corroborate its validity and utility. The PDS‐ICD‐11 scale is provided as online supporting information. [ABSTRACT FROM AUTHOR]

The study presents a blockchain-based incentive mechanism intended to encourage those in underserved communities to engage with healthcare services. The smart healthcare system, which is the result of the amalgamation of advanced technologies, has emerged recently and is increasingly seen as essential to meet the needs of modern society. An important part of the healthcare system is the prescription management system, but studies show that prescription affordability and accessibility play a part in creating unequal access for underserved communities. This is a form of unequal access that results in those living in underserved communities to become disengaged from accessing healthcare services. In New Zealand, the prescription management system plays a crucial role and this study seeks to address the issue by presenting the BlockPres framework, which uses a novel incentive mechanism to encourage patients to participate and engage with services in order to be rewarded. The blockchain attribute of immutability in BlockPres enhances equality and participation by providing sophisticated authorisation and authentication capabilities for healthcare providers and patients. BlockPres empowers the patient by assigning ownership or control of some patient information to the patient. A simulation is carried out using the Ethereum blockchain and the evaluation of successful transaction completion and superficial performance assessment demonstrates that the blockchain would be sufficient to cope with the needs of a prescription management system. Furthermore, for the simulation, a BlockPres Smart Contract is developed using solidity and implemented in Remix. The Ropsten network is used as the simulation environment and the initial results show that the proposed incentive mechanism mitigates unequal access. [ABSTRACT FROM AUTHOR]