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

Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

This paper draws on a study that examined the experiences of four high-achieving Pasifika physiotherapy degree level students to identify factors contributing to their success. As peer students, they identified five approaches that assisted them to become high achievers within the tertiary environment. This paper refers specifically to these approaches as peer-based Pasifika pedagogies (PbPP) and broadly as culturally responsive practices. The aim of this paper is to examine how Pasifika pedagogies, such as PbPP provide culturally responsive practices that can address the 'culture of silence' while promoting the vā relationality, the cultural nuances and norms of their worldview as well as aligning it with modern pedagogies or tools to enhance success among Pasifika students in the New Zealand tertiary education context. [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]

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]

In March 2020, New Zealand went into a level 4 lockdown to contain the spread of Covid-19. Overnight, workplace operations shifted into the home, requiring employees to rapidly upskill and use online collaboration platforms to maintain ‘business-as-usual’. However, the home was not an empty space, rather it reflected specific cultural and gender activities and norms. A phenomenological research study conducted in 2020 examined the working from home experiences of 21 women from different cultural backgrounds employed by a South Auckland organisation. The research focused on two groupings of HRM themes; one the HR practices of productivity, performance, leadership, health and safety, and technology and equipment; the other, the impact of these practices on the domestic cultural norms and gender roles of the women employees. The paper identifies an unresolved tension between the organisation and the women and asserts the need for revised performance expectations in a working from home context. The paper argues that a potential resolution is available if the organisation adapts Trompenaars’s model of intercultural reconciliation. [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]

In 2020, the New Zealand (NZ) Parliament voted to decriminalise abortion. Although NZ's abortion law formally opposes sex selective abortions, there is considerable complexity in the gender politics of 'choice' and 'agency' in multi-ethnic societies, and interpretations of reproductive rights for ethnic minority women and for the girl child, respectively. This paper explores these complexities through the perspectives of reproductive and maternity care practitioners who are situated at the interface of legal systems, health service provision, and delivery of culturally sensitive care. Thirteen practitioners were interviewed as part of this study. The analysis highlights strains in framings of 'reproductive choice' (underpinned by western liberal notions of rights) and 'gender equality' (abortion rights that acknowledge the complexity of cultural son-preference) for ethnic minority women. These tensions are played out in three aspects of the post-reform landscape: (a) everyday practice and accountability; (b) consumerism and choice; (c) custodianship and gender rights. The findings point to the limitations in operationalising choices for ethnic women in health systems wherein trust deficit prevails, and cultural dynamics render complex responses to abortion. They also highlight reconfigurations of client-expert relationships that may have implications for practitioners' abilities to advocate for ethnic women's rights against cultural influences. [ABSTRACT FROM AUTHOR]

A core value of the Australian and New Zealand Association for Health Professional Educators (ANZAHPE) is to be a nurturing organisation. As part of being a nurturing organisation, ANZAHPE enshrines the value of mentorship. In this paper, we explore the roles of mentors and coaches. We look at how these roles might adapt over the next 50 years to assist novices to understand their workplace culture in order to enable them to function, survive and thrive within this context. We further propose that the respective roles of mentors and coaches will become increasingly distinct from each other to optimise the support that is available for new health professionals, educators and researchers as they enter the workforce and prepare for lifelong learning and scholarship. [ABSTRACT FROM AUTHOR]

This paper engages with the notion of universality by critically exploring the concepts of trauma and post-traumatic growth from a cultural perspective. Drawing on the indigenous Māori model of wellbeing "Te Whare Tapa Whā", the inter-relationships between family relationships, physical wellbeing, mental and emotional health, and spirituality are examined as a holistic model. Spirituality is a key component of this holistic approach and arguably an inseparable aspect of holistic wellness and can be defined as "a broad universal construct associated with individuals' ways of making meaning of their lives and the acknowledgment of the presence of a higher being". Within the cultural context of Aotearoa New Zealand, we make a case for the value of holistic interventions to support people who have experienced trauma that prioritise spirituality alongside other aspects of wellbeing. [ABSTRACT FROM AUTHOR]

• Develops and tests a conceptual framework of seasonal culture as rhythmic patterns. • Perceived seasonal patterns shift with climatic, environmental and social changes. • People maintain, recalibrate or detach from their seasonal patterns of activities. • Recalibrating seasonal cultures to shifting rhythms is sustainable adaptation. There is a growing literature on the cultural capacities influencing communities' adaptation to environmental and social change, including the temporal frameworks they draw on for timely action. This paper focuses on seasonal cultures, and how they enable communities on the Coromandel Peninsula to interpret and adapt practical timings to disrupted patterns of seasonal rhythms. The paper develops and applies a conceptual framework of seasonal cultures as perceived rhythmic patterns practiced by communities as cultural repertoires for action, emphasising the ways cultures evolve as patterns are contested and change. This concept steered critical, mixed-method ethnographic study with communities on the peninsula over two years. The research found that Coromandel communities' cultures make seasonal change visible as long-term shifts and asynchrony between rhythmic patterns, which they linked to climatic change, environmental degradation, colonisation and globalisation, and shifting relations between society and the environment. As seasonal patterns fail to hold, communities deploy a combination of strategies for re-configuring seasonal rhythms through their practices: (i) maintaining established, institutionalised schemas of activity while coping with seasonal variability; (ii) season-proofing activities from environmental rhythms; or (iii) re-learning and recalibrating cultures to mutable configurations of rhythms in a highly modified environment. [ABSTRACT FROM AUTHOR]

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Introduction. Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim. We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods. Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-toface semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results. All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion. This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour. [ABSTRACT FROM AUTHOR]

This literature review investigates tools used to assess self-regulation at school entry and to inform recommendations for use in Aotearoa New Zealand. We were particularly interested in identifying self-regulation screening tools that had been developed from Indigenous frameworks to enhance likelihood of culturally empowering assessment. APA PsycInfo and Clarivate Web of Science databases were searched for articles on self-regulation screening at school entry. Screening tools were included if they met the following criteria: available in English or te reo Māori (the two predominant written languages of Aotearoa New Zealand); appropriate for children aged 5–6 years; and focus on self-regulation or contain a component assessing self-regulation. 39 screening tools which met the criteria were identified. Overall, most tools were developed from a Euro-American perspective and many were deficit- and/or clinically-focused. Issues with translating screening tools to other cultures are discussed, specifically in the context of Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Background: The Aggressive Student Culture Scale (ASCS) is a survey designed to measure the extent to which New Zealand (NZ) students experience aggressive behaviours within the school environment. The aim of this study is to assess the psychometric properties of the ASCS in the multidisciplinary Growing Up in NZ longitudinal study. Methods: We used data from 4938 children from the Growing Up in NZ study to examine the psychometric properties of ASCS for 8-year-old children. Confirmatory factor analysis was conducted, and measurement invariance was tested across sex, ethnicity, and deprivation levels. Results: The ASCS tool comprises a single latent factor: aggressive student behaviour. The ASCS provides an adequate and satisfactory measure for student aggression experiences. Full measurement invariance was supported for child's sex, but only configural invariance was confirmed across ethnicity and area-level deprivation. Males reported higher levels of aggressive experiences than females. Conclusions: The one-factor model structure offers an excellent fit to our data with good internal consistency. Comparisons across sex are valid; however, direct comparisons across ethnicity and deprivation levels should be approached with caution. We recommend replication studies and encourage further research involving participants from different age groups to better understand the factor structure across diverse demographic variables. [ABSTRACT FROM AUTHOR]

Introduction. Manatū Hauora (Aotearoa New Zealand (NZ) Ministry of Health) recognises that respecting and listening to Pacific peoples' knowledge and skills in caring for their communities' wellbeing is a priority, and that novel approaches to care, particularly for chronic health conditions, are necessary. Allied health professionals have the potential to play important roles in primary care design and delivery. Pacific Trust Otago (PTO) provides a weekly seniors' group gathering that has evolved over the years and incorporates exercise, health information and cultural activities. Aim. This study aims to explore what Pacific seniors are learning about their health and wellbeing, and what factors contribute to sustained engagement with this weekly group activity. Methods. The research team conducted a qualitative study using the Kakala Research Framework and the pan-Pacific Talanoa Research Methodology to gather narratives in a relational and comfortable group space. Participants were recruited from the seniors group gathering. Group Talanoa were used to collect data, which were digitally voice-recorded, transcribed, translated, and de-identified. Ethical approval was granted by the University of Otago School of Physiotherapy Ethics Committee. Results. Pacific seniors valued how these gathering The seniors recognised how interconnected and intertwined culture, spirituality, and family were and how this contributed to their sense of individual and collective health and wellbeing. The study highlights the need to consider health beyond the individual to the collective, embracing indigenous perspectives, and authentically nurturing relationships with Pacific health providers. The study recommends primary care funders are supported to understand what is important to Pacific people and partner with Pacific health providers to deliver care in ways that align with indigenous models of care. Discussion. A weekly group gathering for Pacific seniors run by Allied Health professionals provides a welcoming, safe, and culturally meaningful environment where seniors can connect, share, and grow in health and wellbeing together. This study highlights the importance of adopting informed and inclusive approaches to promoting and addressing holistic health for Pacific people, especially in light of ongoing health reforms in Aotearoa NZ. [ABSTRACT FROM AUTHOR]

Homelessness has re-emerged as a significant issue in Aotearoa, New Zealand (Aotearoa/NZ) in recent decades, with Māori (Indigenous peoples of New Zealand) being impacted disproportionately due to ongoing processes of colonisation and impoverishment. Whether living on the streets of an urban centre, small city, or rural district, the lifeworlds of homeless people are frequently textured by social, material, and spatial exclusions, uncertainties, insecurities, and stigma. This article explores how the Open Arms Day Centre (OADC), a drop-in day centre for homeless people in Whangārei (a small city in Northland), functions as a dependable Pou Whirinaki (pillar of strength and support) in the everyday lives of Māori experiencing homelessness. Employing a Māori-centred, case-based approach, we explored the experiences of a small group of local service users, volunteers, and staff through interviews, photographic exercises, and regular casual conversations. This culturally informed mode of inquiry resulted in a deeper understanding of the OADC’s operation as what health geographers have also referred to as a space of care. Such spaces offer those frequenting them opportunities for respite, inclusion, belonging, and routine. They become Pou Whirinaki through enactments of Māori relational values and practices that foster a sense of ontological security, cultural continuity, and shared humanity. [ABSTRACT FROM AUTHOR]

Objective: Over 34% of New Zealand (NZ) adults are classed as obese, which reduces quality of life for many individuals. Those living in rural areas, high‐deprivation communities, and indigenous Māori populations are more likely to experience obesity and related co‐morbidities than other cohorts. General practice is positioned as most suitable to deliver effective weight management health care; however, little is understood about the rural general practitioner (GP) experience in NZ, despite having the majority of patients at high risk of developing obesity. The aim of this study was to investigate rural GP perspectives on barriers to delivering weight management. Design: Qualitative descriptive design guided by Braun and Clarke (2006) using semi‐structured interviews and analysed using deductive reflexive thematic approach. Setting: Rural Waikato general practice which has significant rural, Māori and high‐deprivation communities. Participants: Six rural Waikato GPs. Results: Three significant themes were identified: communication barriers, rural health care barriers, and social and cultural barriers. GPs reported not wanting to jeopardise the doctor‐patient relationship by discussing weight. GPs felt unsupported by the health system through lack of rurally appropriate obesity intervention options, funding and resources. The unique rural lifestyle and health needs were reportedly not understood at the wider health system level, making the role of a rural GP working in high‐deprivation communities more difficult. Additional barriers to delivering effective weight management included factors outside the clinical practice such as obesity stigma, an obesogenic environment and sociocultural factors shaping rural patients' lives. Conclusion: Rural GPs have a lack of weight management referral options that are considered effective for their patients, as the options available reportedly do not cater for their patients' unique rural health needs. GPs position addressing the individualised and complex weight management health issue as challenging. Navigating stigma, wider sociocultural issues, and limited intervention options were difficult and found to be questionable to achieve in a short 15‐min consult. There is a need for rural health support in the form of funding, staff (indigenous and non‐indigenous), and rurally feasible resources to improve health outcomes and reduce inequity. Effective primary care weight management strategies need to be appropriate for high‐deprivation rural communities, including tailored, affordable and reliable interventions that GPs can offer patients if future weight management efforts are to be successful in this space. [ABSTRACT FROM AUTHOR]

Background: The New Zealand (NZ) Ministry of Health ethnicity data protocols recommend that people of South Asian (SAsian) ethnicity, other than Indian, are combined with people of Japanese and Korean ethnicity at the most commonly used level of aggregation in health research (level two). This may not work well for perinatal studies, as it has long been observed that women of Indian ethnicity have higher rates of adverse pregnancy outcomes, such as perinatal death. It is possible that women of other SAsian ethnicities share this risk. Aims: This study was performed to identify appropriate groupings of women of SAsian ethnicity for perinatal research. Materials and Methods: National maternity and neonatal data, and singleton birth records between 2008 and 2017 were linked using the Statistics NZ Integrated Data Infrastructure. Socio‐demographic risk profiles and pregnancy outcomes were compared between 15 ethnic groups. Recommendations were made based on statistical analyses and cultural evaluation with members of the SAsian research community. Results: Similarities were observed between women of Indian, Fijian Indian, South African Indian, Sri Lankan, Bangladeshi and Pakistani ethnicities. A lower‐risk profile was seen among Japanese and Korean mothers. Risk profiles of women of combined Indian‐Māori, Indian‐Pacific and Indian‐New Zealand European ethnicity more closely represented their corresponding non‐Indian ethnicities. Conclusions: Based on these findings, we suggest a review of current NZ Ministry of Health ethnicity data protocols. We recommend that researchers understand the risk profiles of participants prior to aggregation of groups in research, to mitigate risks associated with masking differences. [ABSTRACT FROM AUTHOR]

Aim: We aimed to explore current approaches to assessing professionalism in dietetics education in Australia and New Zealand, and asked the questions what is working well and what needs to improve? Method: We employed a qualitative interpretive approach and conducted interviews with academic and practitioner (workplace‐based) educators (total sample n = 78) with a key stake in dietetics education across Australia and New Zealand. Data were analysed using team‐based, framework analysis. Results: Our findings suggest significant shifts in dietetics education in the area of professionalism assessment. Professionalism assessment is embedded in formal curricula of dietetics programs and is occurring in university and placement settings. In particular, advances have been demonstrated in those programs assessing professionalism as part of the programmatic assessment. Progress has been enabled by philosophical and curricula shifts; clearer articulation and shared understandings of professionalism standards; enhanced learner agency and reduced power distance; early identification and intervention of professionalism lapses; and increased confidence and capabilities of educators. Conclusions: These findings suggest there have been considerable advances in professionalism assessment in recent years with shifts in practice in approaching professionalism through a more interpretivist lens, holistically and more student‐centred. Professionalism assessment in dietetics education is a shared responsibility and requires further development and transformation to more fully embed and strengthen curricula approaches across programs. Further work should investigate strategies to build safer learning cultures and capacity for professionalism conversations and in strengthening approaches to remediation. [ABSTRACT FROM AUTHOR]

This study applied a fa'afaletui cultural lens to an exploratory qualitative study examining Samoan families' experiences and engagement with a person‐centred care model employed in specific mental health services in Aotearoa. Six semi‐structured talanoa group discussions with families who had been previously or currently engaged with mental health services. In addition, a local stakeholder group was recruited to guide stages of the fa'afaletui. A total of 13 individual participants from six families participated. Participants consisted of four mothers, two fathers, five sisters, one son, and one husband. Five themes were identified: (i) Fa'atuatua ile Atua; Spiritual faith in God; (ii) It is a hush hush topic; stigma of mental illness; (iii) We are in the dark with our communication and dealings with the services; (v) Practice what you preach; clinical service delivery misaligned with the model of care; and (vi) Alofa (love) and fa'aaloalo (respect); enablers of positive experience. The findings overall highlight spirituality and religion as core to a Samoan's faith to foster resilience and healing when facing adverse mental health events with their family members. In addition, the need to build up capacity for Pacific staffed specialist services and Pacific model to achieve equity and holistic care for Samoans and other Pacific populations at risk of adverse mental health outcomes are recommended. [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]

Background: Complementary or alternative medicine (CAM) describes products/practices outside conventional medical care. CAM may be used to support or replace conventional/prescribed therapies. The aim of this study was to determine patterns of CAM use among children attending a tertiary care hospital in New Zealand (NZ) and measure parental opinion about CAM. Methods: Prospective survey-based study among children and their parents attending inpatient and outpatient clinical areas. Surveys collected demographic and health variables, current CAM use, and parental opinions on CAM. Results: Of the 236 children participating: 41% female, mean age 6.8 years (SD5), 76 (32%) with a chronic illness. CAM was used by 132 (56%) children, the most common being: oral supplements, body manipulation methods, or holistic practices. CAM use was associated with lower child health rating (p = 0.001), Māori ethnicity (p = 0.03), parent education level (p = 0.002), and family member CAM use (p < 0.001). Opinion survey results revealed CAM use was most strongly related to doctors recommending CAM, information on CAM, and CAM cost. There was a 31% CAM disclosure rate to the child's medical team. Conclusions: This study highlights cultural differences in CAM use not previously reported among children in NZ. Parental opinion regarding CAM influences use for their child and disclosure rates. [ABSTRACT FROM AUTHOR]

Indigenous voices and perspectives are necessary in advancing applied and global sport psychology. In Aotearoa New Zealand, Māori sport and exercise professionals are thriving despite existing systems that devalue, discriminate and exclude Māori from fulfilling their potential. This qualitative study investigated the perspectives of ten Māori sport and exercise experts including academics, allied health professionals, athletes, coaches and Māori healers in order to develop a critical understanding of their work related experiences and analyze the diverse forms of knowledge on which they draw. Participants-collaborators were interviewed using an insider research design to facilitate discussion about their current work. Results support a "space between" model and suggest that Māori sport and exercise work enables excellence in sport performance while also meeting holistic wellbeing needs of communities. Māori exercise professionals identified that their presence in their respective fields "speaks back" to racist practices and entrenched barriers that colonize Māori success. Further, applying holistic notions of wellbeing and ancestral knowledge to sport and exercise was seen as default and ordinary; shifting the illusion that sport and exercise operates in a culture-less, timeless and physical vacuum. From an applied and Indigenous perspective, these results emphasize that Indigenous sport leadership and practices are unequaled by Western methods and science alone. Māori exercise professionals demonstrate cultural innovation and intersectionality that not only revolutionizes sport, but brings with it essential community wellbeing. Lay summary: This article explores the experiences of ten Māori exercise professionals and analyses the diverse forms of knowledge they draw on in their work. The study provides insight into how Māori exercise professionals utilize their knowledge of social contexts and culture, in turn expanding the scope of sport and exercise psychology. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples of Canada, United States, Australia, and New Zealand experience disproportionately high rates of suicide as a result of the collective and shared trauma experienced with colonization and ongoing marginalization. Dominant, Western approaches to suicide prevention—typically involving individual-level efforts for behavioural change via mental health professional intervention—by themselves have largely failed at addressing suicide in Indigenous populations, possibly due to cultural misalignment with Indigenous paradigms. Consequently, many Indigenous communities, organizations and governments have been undertaking more cultural and community-based approaches to suicide prevention. To provide a foundation for future research and inform prevention efforts in this context, this critical scoping review summarizes how Indigenous approaches have been integrated in suicide prevention initiatives targeting Indigenous populations. Methods: A systematic search guided by a community-based participatory research (CBPR) approach was conducted in twelve electronic bibliographic databases for academic literature and six databases for grey literature to identify relevant articles. the reference lists of articles that were selected via the search strategy were hand-searched in order to include any further articles that may have been missed. Articles were screened and assessed for eligibility. From eligible articles, data including authors, year of publication, type of publication, objectives of the study, country, target population, type of suicide prevention strategy, description of suicide prevention strategy, and main outcomes of the study were extracted. A thematic analysis approach guided by Métis knowledge and practices was also applied to synthesize and summarize the findings. Results: Fifty-six academic articles and 16 articles from the grey literature were examined. Four overarching and intersecting thematic areas emerged out of analysis of the academic and grey literature: (1) engaging culture and strengthening connectedness; (2) integrating Indigenous knowledge; (3) Indigenous self-determination; and (4) employing decolonial approaches. Conclusions: Findings demonstrate how centering Indigenous knowledge and approaches within suicide prevention positively contribute to suicide-related outcomes. Initiatives built upon comprehensive community engagement processes and which incorporate Indigenous culture, knowledge, and decolonizing methods have been shown to have substantial impact on suicide-related outcomes at the individual- and community-level. Indigenous approaches to suicide prevention are diverse, drawing on local culture, knowledge, need and priorities. [ABSTRACT FROM AUTHOR]

Māori primary producers have focused their export attention to China, with many seeking to turn supply chains into value chains. Little attention is paid to the role of culture in value chain literature yet much has been made of the cultural similarities between Māori and Chinese in a business context. In this article, the concept of culturally aligned value chains is developed and explored, specifically examining how business cultures can help with chain governance and relationships, audit and authentication cultures can help with chain tracing, verification, and provenance, and food cultures can help with consumer-orientation of the chain. While the analysis is focused on Māori and Chinese cultures, the findings have a wider applicability for Indigenous and East Asian cultures, and more generally, the concept of culturally aligned value chains is viewed as an important insight for the value chain concept. [ABSTRACT FROM AUTHOR]

In 2020, the government of Aotearoa New Zealand imposed some of the most stringent funerary restrictions in the world as part of its efforts to eliminate COVID-19. This article explores how people experienced this situation, asking why restrictions that some described as precipitating 'the most difficult time of their lives' were described by others as a 'relief', 'blessing', or 'gift'. Much existing literature frames funerary restrictions as a distressing assault upon established ways of grieving to which mourners must try to adapt – and in Aotearoa, both the stringency of the restrictions and the means by which they had been imposed did lead to many people finding them challenging. However, for those with ambivalent pre-existing feelings regarding their funerary traditions – such as many in the Samoan diaspora – COVID-19 restrictions afforded both a reprieve from burdensome practices and a much-welcomed opportunity to reimagine their traditions. Funerary restrictions, though disruptive, are thereby shown to have generative potential. [ABSTRACT FROM AUTHOR]

Objectives There is evidence that loneliness is detrimental to the subjective well-being of older adults. However, little is known on this topic for the cohort of those in advanced age (80 years or older), which today is the fastest-growing age group in the New Zealand population. We examined the relationships between loneliness and selected subjective well-being outcomes over 5 years. Methods We used a regional, bicultural sample of those in advanced age from 2010 to 2015 (Life and Living in Advanced Age: a Cohort Study in New Zealand). The first wave enrolled 937 people (92% of whom were living in the community): 421 Māori (Indigenous New Zealanders aged 80–90 years) and 516 non-Māori aged 85 years. We applied standard regression techniques to baseline data and mixed-effects models to longitudinal data, while adjusting for sociodemographic factors. Results For both Māori and non-Māori, strong negative associations between loneliness and subjective well-being were found at baseline. In longitudinal analyses, we found that loneliness was negatively associated with life satisfaction as well as with mental health-related quality of life. Discussion Our findings of adverse impacts on subjective well-being corroborate other evidence, highlighting loneliness as a prime candidate for intervention—appropriate to cultural context—to improve well-being for adults in advanced age. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in palliative care within Indigenous communities, and within Aotearoa New Zealand, of the significant role that Māori (Indigenous people) families play in caring for older relatives. This study explored the centrality of culture in how Māori extended families (whānau) in Aotearoa New Zealand interpret and enact family-based care roles within the Māori world (Te Ao Māori). Methods: Applying Māori-centered and community-based participatory research principles, we examined 17 interviews with older Māori who shared experiences of palliative care for a partner or family member. The thematic analysis used a cultural-discursive framework incorporating Māori principles of wellbeing and values expressed within the care relationship. Results: The findings centered on three whānau roles in palliative care: whānau as (1) Holders and protectors of Māori knowledge; (2) Weavers of spiritual connection; and (3) Navigators in different worlds. Conclusion: The study problematizes the notion of a single 'primary caregiver', privileges whānau as an inter-woven relational, dynamic care network, and encourages health professionals to recognize the cultural embeddedness of dominant approaches to palliative care. [ABSTRACT FROM AUTHOR]

Objectives: To explore Chinese late-life immigrants' perceptions of loneliness and social isolation. Methods: A qualitative descriptive methodology underpinned this study. In-depth individual interviews were conducted in Mandarin with purposively recruited participants. The twenty-three participants in the study had all emigrated from China, were 65–80 years old on arrival and had lived in New Zealand for between 2.5 and 16 years. An inductive thematic analytic process was undertaken. The COREQ checklist was followed to ensure study rigour. Results: Three themes, ‘high value placed on meeting family obligations’, ‘feeling a deep sense of imbalanced intergenerational reciprocity’ and ‘moving away from filial expectations’, were identified. Confucianist values of ‘women's domestic duty of caring for grandchildren’, ‘filial piety’, and ‘saving face’ to be accepted and respected by others negatively attributed to participants' understandings and experiences of loneliness. To plan for increasing frailty and to avoid family conflict while ameliorating potential loneliness, some participants reluctantly discarded prior customary filial piety expectations in favour of formal aged care options. Conclusions: Participants' profound sense of loneliness was seen to be attributed to their deeply rooted cultural values and backgrounds from having lived for a significant period of time in China. Loneliness occurred as a result of the resettlement process in later life. These experiences highlight the importance of using cultural framing that takes into account beliefs and adaptations to host societies anticipated during the process of late-life immigration. [ABSTRACT FROM AUTHOR]

A growing body of research indicates both positive and negative effects of grandparent childcare; effects that are largely dependent upon the context and intensity of the care are required. Here, we suggest that context to be inclusive of cultural background. Drawing on the indigenous methodological framework, talanoa, the views of 13 Pacific Island grandparents in relation to themes of grandparent childminding are explored, as well its proximity to perceptions of elder abuse. A cultural analysis reveals that traditions specific to the Pacific way of life may lead to increased risk of prolonged childcare. The participants in this study felt that prolonged childminding deprived them of time which could be used to benefit them and their community in the long run. It was viewed as a form of disrespect, as older people are revered and held in high regard in decision making activities from the Pacific worldview. The participants embraced their roles as the knowledge holders of cultural treasures; responsible for teaching children and grandchildren their genealogy and language, and for upholding the protocols of their cultural heritage. However, they felt their contributions were not reciprocated nor valued, but instead exploited. [ABSTRACT FROM AUTHOR]

Introduction. The impact of contextual factors on primary health-care quality improvement is significant. In-depth research is required to identify the key contextual factors that influence quality improvement initiatives to develop high-performing primary health-care systems. Aim. This research seeks to answer two questions; what are the contextual factors influencing primary care improvement initiatives?; and how do contextual factors, the quality improvement initiative and the implementation process influence one another and the overall improvement outcomes? Methods. A multi-case study methodology was used to explore the complexities of the phenomena in situ. Three sites where successful quality improvement had occurred were selected by purposeful theoretical sampling to provide a sample of rural, urban and Kaupapa Māori general practice settings typical of the New Zealand environment. Semi-structured interviews were conducted with team members and triangulated with secondary data provided by the organisations. Results. The quality improvement topic and the approach taken were intrinsically linked to context. Sites reported success in achieving the desired outcomes benefitting the patients, practice and staff. Teams did not use formal improvement methods, instead relying on established relationships and elements of change management methods. The culture in all three cases was a large component of why and how these initiatives were successful. Discussion. Intrinsic motivation was generated by community connections and networks. This combined with a learning climate generated by distributed leadership and teamwork enabled success. Iterative reflection and sensemaking processes were able to deliver quality improvement success in primary care without the use of formal improvement methods. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to explore whether there is diversity of occupational culture among IT workers. Prior work conceptualizes IT occupational culture (ITOC) as based around six distinctive values (ASPIRE) but has not explored whether there is variation in ITOC. Design/methodology/approach: Survey data from 496 New Zealand IT workers was used to create factors representing IT occupational values based on the ASPIRE tool. Hierarchical cluster analysis and discriminant analysis were applied to identify distinctive segments of ITOC. Findings: Four ITOC segments were identified: fun-lovers, innovators, independents and institutionalists. These differed in the relative emphasis ascribed to the ITOC values with each segment being distinguished by 1–2 dominant values. Segment membership varied according to level of responsibility and birth country. Institutionalists and innovators had higher concern about organizational and IT issues than fun-lovers and independents. Job satisfaction was lowest among innovators and highest along institutionalists. Research limitations/implications: This study challenges the concept of a unified ITOC, suggesting that ITOC is pluralistic. It also theorizes about interactions between ITOC, individual motivation and values and national culture. Practical implications: Management needs to be cognizant of the fact that IT occupational culture is not homogeneous and different IT occupational segments require unique management approaches, and that their own values may not match those of others in IT work. By understanding ITOC segments, managers can tailor support, assign tasks appropriately and design teams to optimize synergies and avoid conflict. Originality/value: This study reveals the existence of ITOC segments and theorizes about the relationship of these to innovation-orientation, job satisfaction, individual motivation, work styles and national culture. The combination of cluster and discriminant analysis is a valuable replicable inductive method that is underrepresented in Information Systems (IS) research. [ABSTRACT FROM AUTHOR]

The objective of this research was to explore social connectedness and associations with self‐perceived health amongst older adults in New Zealand at a population level. The data for this analysis were derived from the 2016 Health and Lifestyle Survey, a nationally representative survey administered via face‐to‐face interviews. The findings from this analysis of 1,374 respondents, all of whom were over the age of 55 years, highlight that being female, belonging to older age groups (above 70 years), being employed full‐time or part‐time, connecting online with known people, considering cultural connections to be important and not feeling isolated from others are significantly and positively associated with positive self‐perceived health. The findings underscore the resilience potential of older adults and importance of social connectedness for positive health and well‐being. In addition, the findings reveal target areas that would benefit by intervention and support by health professionals and policy makers. [ABSTRACT FROM AUTHOR]

Previous literature has applied system-focused structures to understand the success of First Nations Peoples' nutrition and exercise group programmes. Existing system-focused measures have included biomedical outcomes, access and service utilization. By broadening the focus of programme success beyond the system, we can evaluate programmes from a First Nations Peoples' lifeworld perspective. Critical hermeneutics and yarning using a lens of Habermas' Theory of Communicative Action to the literature has the potential to transform understandings of "success" in First Nations Peoples' nutrition and exercise group programmes. In this literature interpretation, we explored the critical success factors from a lifeworld perspective, giving scope to go beyond a system perspective to include a cultural, social or personal perspective. Our yarning led us to understand that there is a communicative relationship between explicit system structures and implicit lifeworld concepts that are critical success factors for First Nations nutrition and exercise group programmes. We have developed a set of reflective questions to guide others in considering a lifeworld perspective. Our findings represent a shift away from success measured by the dominant power structure to respect the lifeworld culture, knowledges and values of First Nations Peoples towards shared understanding and mutual decision-making. [ABSTRACT FROM AUTHOR]

Major losses of early juvenile seed mussels or spat are a typical feature of the aquaculture production cycle for many mussel species. These losses are caused by a variety of factors including predation, mortality, and the innate migratory behaviour of spat. In this study, we examined the potential to reduce spat losses by using a floating upwelling system (FLUPSY) for raising the spat of New Zealand's Greenshell™ mussel (Perna canaliculus) to a larger size before transfer to a coastal mussel farm. The losses of spat experimentally cultured within a FLUPSY over 85 days were much lower compared to spat that were seeded directly into coastal waters (78% vs. 99.8%). At the end of the 85‐day nursery culture period, spat in the FLUPSY were 7% larger despite being cultured at higher densities. The losses for two size classes of spat that were raised in the FLUPSY remained relatively high (83% and 95% for spat seeded out at 6.6‐ and 15.5‐mm shell length (SL) respectively) after two months of being experimentally seeded onto a coastal mussel farm. However, these losses are lower than have been reported previously for this species during this stage of production. The results from this study suggest that the addition of a FLUPSY nursery stage to the Greenshell™ mussel production could greatly reduce spat losses and improve production efficiency. [ABSTRACT FROM AUTHOR]