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Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could ‘death conversations’ early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand. Five exemplars are discussed, drawn from a sample of 21 semi-structured interviews with young older adults (54–65 years old) not receiving palliative care or diagnosed with a terminal illness. Together, these narratives indicate that further community consultation is required to determine culturally appropriate ways to initiate productive conversations around aging, death and dying and how to build patient/practitioner/family relationships which allow these conversations to happen safely. There is a need to acknowledge the important factor of culture related to age, generation, sex, faith and ethnicity when engaging in conversations about aging, death and dying. By doing so, health professionals will be best equipped to assist their patients to live well into death. [ABSTRACT FROM PUBLISHER]

This article enquires about why some countries have specialised their further education provision more than others, focusing on three types of specialisation: by subject, by geographical area and by age group. The article proposes an analytical framework to understand the drivers for further education provider specialisation, based on four variables: inputs to the further education system, regulatory framework, demand and supporting clusters. It then applies this framework to review the experience of Germany, New Zealand and the Netherlands in recent years. Drawing on this review, the last section of the paper provides some lessons for England and issues for further debate. It is concluded that the model proposed helps to explain the evolution of provider specialisation in the countries covered and that the UK's current specialisation profile suggests that greater efforts should be made to increase geographical specialisation, whereas action in stimulating further specialisation by subject and age group should be subject to caveats. [ABSTRACT FROM AUTHOR]

Intergenerational programmes recognise the relationships between the young and old as mutually important to both age groups and to society in general. While intergenerational programmes are a fairly new venture in New Zealand, the early childhood curriculum -Te Whariki, the woven mat, is a document which is based on the relationships between people and their environment. It is an ecological model where the context of a child's life is a critical factor in determining well-being, a sense of belonging, communication, a desire to explore, and contribution to society. These are the living strands of Te Whariki which are woven together to provide a sense of place from which children can grow strong and confident. These strands also apply to older people as they move through life's changes. This paper will explore the ways in which Te Whariki is an intergenerational curriculum that can be applied to any context and any age. [ABSTRACT FROM PUBLISHER]

This paper examines age-related differences in voice quality between 15 young and 15 old speakers, using electroglottographic (EGG) recordings of three elicitation types: sustained vowels, hVd word lists, and readings of the Rainbow Passage. For each elicitation type, fundamental frequency (F0), contact quotient (Qx), and their standard deviations are analysed. Results found, for all three elicitations, that Qx was significantly lower for older speakers. F0 was higher for the older speakers, but this was only significant for the hVd word lists. Sustained vowels were used to examine the effect of target pitch and loudness on F0 and Qx. Both Qx and F0 were raised with increased target loudness. The hVd word lists were used to examine the phonetic effects of different vowels. Lip rounded vowels had higher Qx than non-lip rounded vowels. Readings of the Rainbow Passage encompassed prosodic and phonetic variations in F0 and Qx, in addition to voice quality. F0 and Qx contours of the hVd word lists and the vowel/ei/taken from the Rainbow Passage were analysed using the discrete cosine transform. The hVd frame produced coarticulation effects on the Qx contour, but no such effects were evident for the vowel /ei/. The study concluded that using multiple elicitation types is beneficial in the study of the effect of age on the voice, and that analysing contour tracks for F0 and Qx will allow further examination of how prosodic and phonetic effects interact with age-related changes in voice quality. [ABSTRACT FROM PUBLISHER]

The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]

Many western countries have experienced increased rates of youth suicide over recent years. This has been an issue of particular concern in New Zealand, since it had the highest rate of youth suicide among OECD countries in the mid-1990s. However, while attention is drawn to the now declining youth suicide rate by politicians and policy-makers, what is obscured is a cohort effect. In this paper we will argue that a cohort effect is clearly visible; suicide rates among 15-24 year olds came to the fore in the mid-1980s, peaking 10 years later, and were displaced by that among 25-35 year olds by the late-1990s. Further, this century has been characterised by the rise of suicide rates among 35-44 year olds. This effect correlates with a dramatic downturn in the New Zealand economy in a five-year period bracketing 1970. We argue for an increased focus on social and economic factors underlying suicide. [ABSTRACT FROM AUTHOR]

Bronchiectasis is a chronic respiratory disease that impacts significantly on quality of life for those who have it. There is a paucity of literature exploring the perspectives of children and young people. The aim of this study was to examine the day-to-day life experience of a group of young people with bronchiectasis. A qualitative study using semi-structured interviews explored fifteen young people's perspectives of life with bronchiectasis. Key themes were identified using an inductive iterative approach through constant comparative analysis guided by Thorne's interpretive description. Life with bronchiectasis was conceptualized by participants as "Pretty Normal". This consisted of two co-existing life views which represented how young people balanced the ups and downs of adolescence while learning to accommodate the demands of living with bronchiectasis. Three key thematic elements "sore and tired", 'life interrupted and "looking after self", influenced and challenged these two views of life. Young people with bronchiectasis portray life as being the same as their peers. Despite this, they recognized that the symptoms, interruptions, and self-management responsibilities led them to find ways of coping and integrating their experience into a new and modified view of normal. [ABSTRACT FROM AUTHOR]

To determine knowledge, attitudes, and behavior toward concussion in cyclists and to identify predictors of concussion knowledge. Cycling organizations sent members a web link to online information about the study and a questionnaire. Anyone aged >16 years, living in New Zealand and engaged in a cycling activity was invited to participate. The 36-item questionnaire included sociodemographics, knowledge about concussion, helmet use, and personal concussion history. Data were collected between 15/05/19 and 30/06/19. A multiple linear regression model identified factors associated with levels of concussion knowledge. The questionnaire was completed by 672 participants aged between 16 and 82 years (x̄ = 48.6 years). Knowledge of concussion was high. However, knowledge that helmets are not able to prevent concussion was low and time to return to sport after injury was variable. Knowledge did not always translate to seeking of medical attention or replacement of helmet behavior. Younger age and having sustained at least one prior concussion were associated with higher levels of concussion knowledge F(df = 3) = 8.81, p <.001. Knowledge and attitudes toward concussion were positive. However, knowledge gaps and discrepancies between attitudes and behavior were identified. Consistent, clear messages are needed around return to sport timeframes. [ABSTRACT FROM AUTHOR]

Background: Past research has shown farmer anxiety and stress have significantly affected many farmers and their families due not only to the impact on feelings of happiness and success, but also on output efficiency, accident rates, and health. The past approach to ameliorating anxiety has been through utilizing coping mechanisms such as sharing with significant others, venting, planning, self-blame, and positive thinking. A problem has also been farmers' reluctance to voice difficulties and seek help. Method: An alternative, more basic approach to anxiety amelioration is possible. This involves isolating the human characteristics that lead to anxiety, and subsequently modifying these to reduce anxiety and its associated impacts. Accordingly, the extensive literature on anxiety and stress was reviewed to facilitate developing an hypothesis outlining the important components explaining farmer anxiety. To assess the parameters of farmer anxiety, a random survey of New Zealand farmers was used to obtain their ratings on their anxiety. Regression models were used to quantify the relationships. Results: Specific farmer personal characteristics were shown to be highly related to anxiety. These included a farmer's personality, objective set, belief in their ability to control outcomes, as well as education and age. Conclusion: This analysis provides the information required to direct counseling efforts to modify the anxiety creating personal variables and, consequently, reduce anxiety and its impact on a longer term basis. [ABSTRACT FROM AUTHOR]

Purpose: Communication disorders associated with Parkinson’s disease (PD) often lead to restricted participation in life roles, yet there is a limited understanding of influencing factors and few quantitative measurement tools available. This study aimed to identify variables associated with communicative participation in PD and to examine the relationship between the Communicative Participation Item Bank (CPIB) and existing health-related quality-of-life (HRQoL) measures. Method: Self-report data from 378 participants with PD from the US and New Zealand were analysed. Data included responses to the CPIB, PD Questionnaire-8, sub-scales of the Global Health instrument from the Patient Reported Outcomes Measurement Information System (PROMIS) and additional self-report instruments. Result: Greater perceived speech disorder, lower levels of speech usage, fatigue, cognitive and emotional problems and swallowing difficulties were associated with lower levels of communicative participation. Participants’ age significantly influenced findings, interacting with country of residence, sex and speech usage. Scores on the CPIB were moderately correlated with HRQoL measures. Conclusion: Communicative participation in PD is complex and influenced by both demographic and disease-based variables, necessitating a broader view of the communicative experiences of those with PD. Measurement of communicative participation as a separate construct to existing HRQoL measures is recommended. [ABSTRACT FROM PUBLISHER]

Background: Concerned groups are pressuring government bodies to implement warning labels. However, research informed label development is limited and current labels are generic, despite tobacco research revealing targeted messages are more effective. Expectancy research provides a platform to inform message development, however reliance on researcher-driven survey-dependent expectancies has limited findings. This study aims to extend expectancy theory and inform warning label development by identifying negative expectancies that are participant derived and salient to drinkers from specific segments. Method: A New Zealand sample involving 1168 drinkers (651 men) completed an online survey measuring their demographics, their drinking and self-reported negative alcohol expectancies. Thematic analysis resulted in 13 salient expectancies, and differences between segments were examined. Results: Chi-square analyses revealed: heavy drinkers and young adults were characterised by concerns for self (e.g. liver damage); lighter drinkers and older adults by expectancies that could harm others (e.g. violence); females reported greater concern than males with the majority of expectancies. Conclusion: Results extend alcohol expectancy theory by revealing negative expectancies that are salient to drinkers from specific segments. This study delivers the initial steps for systematically informing alcohol warning label development, by identifying expectancies that are likely to be integrated by drinkers. [ABSTRACT FROM AUTHOR]

The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions. [ABSTRACT FROM AUTHOR]

Annual age cohort groupings promote relative age effects (RAEs), which often, inadvertently, create participation and attainment biases between relatively older and younger players within the same age cohort. In a globally evolving sport, women's rugby team selection practices may potentially bypass qualified players as a result of maturational differences.Purpose:Our study examined the prevalence of RAEs in women's rugby union.Method:Player data (age range = 4–21+ years) were gathered from the 2006 and 2010 Rugby World Cups (n = 498) and from Canadian (n = 1,497) and New Zealand (NZ; n = 13,899) developmental rugby leagues.Results:Although no evidence of an RAE was found in the World Cup samples, chi-square analyses identified some typical and atypical patterns of RAEs at the developmental levels (w≥  .3). Younger developmental groups displayed a typical RAE patterning with a greater representation of older players (Canadian 13-year-olds,w = .58; NZ 4-year-olds,w = .35), whereas older developmental groups displayed an atypical RAE patterning with a greater representation of younger players (Canadian 19-year-olds,w = .58; NZ 17-year-olds,w = .32). Further, a traditional RAE emerged in the Canadian 11- to 15-year-old age group, χ2(3) = 10.92,p <  .05,w = .30.Conclusion:The lack of homogeneity of traditional RAEs across the sample questions the existence of a single, clear RAE in women's rugby. Some evidence of participation inequalities at the developmental levels suggests that further RAE research in more varied sociocultural contexts may be necessary. [ABSTRACT FROM PUBLISHER]

Objectives: To investigate whether individuals with a history of traumatic brain injury (TBI) experience a greater number of adverse life events (ALE) compared to controls, to identify significant predictors of experiencing ALE and whether the severity of childhood TBI negatively influences adult life outcomes. Design: A total of 167 individuals, injured prior to age 18, 5 or more years post-injury and 18 or more years of age, were recruited in the Canterbury region of New Zealand, with 124 having sustained childhood TBI (62 mild, 62 moderate/severe) and 43 orthopaedic injury controls. Participants were asked about ALE they had experienced and other adult life outcomes. Results: Individuals with a history of TBI experienced more ALE compared to controls. The number of ALE experienced by an individual was associated with more visits to the doctor, lower education level and lower satisfaction with material standard of living. Conclusions: Childhood TBI is associated with an increased number of ALE and adult negative life outcomes. Understanding factors that contribute to negative outcomes following childhood TBI will provide an avenue for rehabilitation and support to reduce any problems in adulthood. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the spoken expository discourse skills of children and adolescents elicited in generation and retelling conditions. There were three groups of participants: young school-age children (M = 7.0 years; n = 64); intermediate-school-age children (M = 11.3 years; n = 18) and high-school-age students (M = 17.6 years; n = 18). Participants were asked to generate expository discourse using the favourite game or sport (FGS) task and to retell an expository passage about the game of curling. All samples were transcribed and analysed on measures of verbal productivity (number of utterances), syntactic complexity (mean length of utterance in T-units [MLU] and clausal density) and verbal fluency (percent maze words). Results indicated that although all age groups produced longer samples in the generation condition, MLU was significantly longer in the retelling condition. The results suggest that the expository retelling task may be a clinically useful addition to a language assessment battery for children and adolescents. [ABSTRACT FROM AUTHOR]

The article presents estimates of New Zealand Maori vital rates from the mid-nineteenth century to World War I. Recently, some South Pacific populations appear to have undergone rapid declines in mortality after decades of very high death rates. The available evidence suggests that mortality levels increased after contact with Europeans reaching peaks in the nineteenth century, particularly during epidemics, then declined gradually until the period of accelerated decrease after World War II. Probably the birth rate was, under normal circumstances, reasonably high. To obtain estimated vital rates for the population as a whole one must use enumeration data as a base. There are many methods available to carry out such an analysis, but the minimum requirement is the availability of at least one and preferably two censuses with a published breakdown by quinquennial age groups. Moreover, the populations under analysis should, in principle, be closed and stable. For a "closed" population it is not necessary to assume that the structure is quasi-stable if one uses for estimates the survivorship of cohorts between censuses as a basis. However, there is the problem of intercensal differences in the quality of enumeration for the same cohort.