230 results
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2. Policy Document Analysis: A Practical Educational Leadership Tool and a Qualitative Research Method
- Author
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Cardno, Carol
- Abstract
This paper presents policy document analysis as practical tool that can be put to valuable use by educational leaders and can also be adopted as a research method. Educational leaders are at the forefront of policy interpretation and consequently need knowledge and skills that enable them to analyse policy as part of their work in developing, implementing and reviewing organisational policy. They need to be able to look behind the policy to know what forces brought it into being; to tap into policy history to know how it was constructed; and most importantly, evaluate the way it is working to achieve its stated purposes. The analysis of policy documents is also an established and appealing qualitative research method, especially for students engaged in postgraduate research associated with educational leadership and policy studies because policy documents offer background insights into understanding educational problems in both research and practice. In this paper advantages and disadvantages associated with using documentary analysis as a qualitative research method are outlined and practical document analysis tools and approaches are presented.
- Published
- 2018
3. How Experienced SoTL Researchers Develop the Credibility of Their Work
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Billot, Jennie, Rowland, Susan, Carnell, Brent, Amundsen, Cheryl, and Evans, Tamela
- Abstract
Teaching and learning research in higher education, often referred to as the Scholarship of Teaching and Learning (SoTL), is still relatively novel in many academic contexts compared to the mainstay of disciplinary research. One indication of this is the challenges those who engage in SoTL report in terms of how this work is valued or considered credible amongst disciplinary colleagues and in the face of institutional policies and practices. This paper moves beyond the literature that describes these specific challenges to investigate how 23 experienced SoTL researchers from five different countries understood the notion of credibility in relationship to their SoTL research and how they went about developing credibility for their work. Semistructured interviews were facilitated and analyzed using inductive analysis. Findings indicate that notions of credibility encompassed putting SoTL research into action and building capacity and community around research findings, as well as gaining external validation through traditional indicators such as publishing. SoTL researchers reported a variety of strategies and approaches they were using, both formal and informal, to develop credibility for their work. The direct focus of this paper on "credibility" of SoTL work as perceived by experienced SoTL researchers, and how they go about developing credibility, is a distinct contribution to the discussions about the valuing of SoTL work.
- Published
- 2017
4. An Intervention in Literacy in Three Pacific Nations: Implications of a Context Specific Approach to Co-Design
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Jesson, Rebecca N. and Spratt, Rebecca
- Abstract
In this paper, we consider the implications of a commitment to acknowledging the role of context within a research practice partnership. We outline the approach to doing so within a design-based research intervention with 42 schools across three Pacific Island countries to improve literacy learning and language development. In doing so, the paper identifies context as a central concern for student and teacher learning, for schools as organisations and for intervention implementation. We draw on theories of context from each of these research bases to consider how aid interventions can best contribute to enhancing student learning outcomes across varied student populations in a way that is contextually appropriate, and builds sustainable local capability for ongoing improvement. In considering these concerns we argue for the potential of a design-based research approach, based on the Learning Schools Model (McNaughton, Lai, Jesson & Wilson, 2013) to incorporate "co-design" of the intervention. We exemplify how the process of jointly designing the content and implementation within preset phases of implementation is possible in ways that draw on the varied expertise of in-country and external partners. The focus on collective knowledge building, collective problem solving and sharing practice within trusting relationships is considered to foster capacity for sustained adaptation and improvement at local levels. We believe such an approach is relevant to the challenges faced by Pacific Island Ministries of Education and their aid donor partners in designing effective interventions for learning improvement.
- Published
- 2017
5. Pa'ina: Using the Metaphor of a Potluck to Reimagine a Third Space for Ethical Research in Indigenous Contexts
- Author
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Elisabeth Moore
- Abstract
This paper delves into the innovative use of the potluck, or "pa'ina," as a metaphor to reimagine a research approach aimed at fostering collective understanding between non-Indigenous knowledge seekers and Indigenous knowledge guardians in Indigenous contexts. By embracing the broader context of research, this metaphor strives to create a dialogical, relational, and ethical space for knowledge seekers to engage with knowledge guardians, promoting a reciprocal and respectful relationship. Central to this metaphor is the recognition of the insider/outsider binary and the need to transcend it. Indigenous knowledge is often guarded and restricted, granted access based on relationships and shared experiences. Understanding the complexity of these socio-spatial relationships is crucial for researchers to navigate respectfully. The metaphor also draws from the Oceanic concept of "va/va/wa," signifying the space between entities and the importance of maintaining harmony and balance within relationships. This relational space between the self and the other allows for transformative encounters and meaningful connections. To navigate this third space, researchers must undergo introspective reflexive exercises to understand their situationality and how it influences their research. Knowledge seekers must unsettle their histories, understand context, listen to the stories of others, create shared understanding, and launch new relationships that are centered on respect and reciprocity. Throughout the research process, the metaphor of "pa'ina" encourages researchers to be active participants, nurturing relationships with communities they seek knowledge from and reflecting upon their role within it. The "pa'ina" metaphor offers a transformative approach for Western academia to critically examine its historical impact on Indigenous communities and embrace a more respectful and inclusive research paradigm. By centering Indigenous voices and building meaningful relationships, this third space provides an opportunity for collaborative and sustainable research for the benefit of all stakeholders involved.
- Published
- 2023
6. Young People as Researchers in Schools: The Possibilities of Peer Research.
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Nairn, Karen and Smith, Anne
- Abstract
The focus of this paper is the politics and practicalities of using, training, and paying young people as peer researchers in their schools. It begins by presenting a five-point rationale for involving peer researchers in research about young people. The paper also discusses the ethics and politics of negotiating peer research in four New Zealand secondary schools, in particular the issue of payment for peer researchers. Two sections follow that focus on the relevance of research about students' rights to the nine peer researchers who worked on the project and their perceptions of the relevance of a peer research methodology. The paper includes an analysis of the quality of the data collected from the perspective of education researchers. The conclusion revisits the five-point rationale in light of what peer researchers had to say about their research experiences. (Contains 28 references.) (Author/SLD)
- Published
- 2003
7. Going Back and Researching in the Pacific Community
- Author
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Havea, Elisapesi Hepi, Wright, Farita Tepora, and Chand, Alvin
- Abstract
The move to focus on Pacific indigenous research methodologies and methods is a complex yet ongoing experience for researchers of Pacific heritage. The relational positionalities of Pacific researchers allow a move away from a dual or binary perspective of one's research responsibilities to a more fluid understanding of what it means to do research by, for, with Pacific communities. This paper highlights the diverse experiences of three Pacific researchers taking into consideration heritage connections, socio-cultural backgrounds and research contexts. We utilise talanoa as a method of engagement, reflexivity, and sharing of our experiences with Tongan, Samoan and Fijian communities. We argue that talanoa as a Pacific research method enables the diverse layers of experiences that take into particular consideration our connections to land, people and knowledges in the diaspora.
- Published
- 2020
8. Reframing Quality and Impact: The Place of Theory in Education Research
- Author
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Wright, Jan
- Abstract
In March 2004, Stephen Ball and others presented a symposium at the conference of the British Educational Research Association (BERA) on the necessity of theory in educational research. Like Ball, I have observed that theory, not just social theory, is a difficult space and one that divides researchers (those comfortable with theory and those less so), within educational research. It is an aspect of educational research training that rarely receives the attention essential for "quality" educational research. In the context of the contemporary research assessment exercises, it is worth reflecting on the relationship between research informed by social theory and expectations of quality and impact. In this paper I revisit the argument made by Ball and others for the necessity of theory, and discuss its role in framing research questions, informing analysis, and promoting reflexivity on the significance and relevance of research. I illustrate this process by discussing the ways theory can assist in the generation of research agendas and questions. I conclude the paper with an example of how a team of educational researchers from Australia, UK and New Zealand have made use of social theory to inform an Australian Research Council (ARC) funded project investigating the recontextualisation of health knowledge in schools. (Contains 1 endnote.)
- Published
- 2008
9. A Pasifika Research Methodology: Talaloto
- Author
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Naufahu, Mefi
- Abstract
A number of researchers have done extensive work on ontologies, epistemologies and pedagogies in relation to Pasifika research, but little on methodologies. Vaioleti describes talanoa as a phenomenological research approach which is ecological, oral and interactive. Halapua's article Talanoa Process: The Case of Fiji (2008) emphasises talanoa as a potential model for conflict resolution following Fiji's coup in the year 2000. Recently, talanoa as a research methodology has become widely used in the Pacific research arena. It has been defined by scholars as creating meaning out of nothing or simply to talk, gossip, share or chat about nothing. 'Talaloto' -a research methodology that I introduce and outline in this article is closely related in many ways to talanoa. While talanoa is the co-construction of knowledge/ideas by two or more people, talaloto is a person's testimony of constructed knowledge or lived experiences. There is a scarcity of information on this traditional practice yet like talanoa it is rooted in Tongan oral tradition. This paper foregrounds talaloto as a traditional cultural practice and it explains its use as a research methodology. It is hoped that more researchers will consider using this method in the future, recognising its place within Pasifika methodologies and its ability to generate rich and authentic data.
- Published
- 2018
10. From Curriculum to Competent Children: The Decade of Quality?
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Meade, Anne
- Abstract
Working out assessment philosophy and practices takes time, as the team members working on the "Competent Children" research project in New Zealand have found out during the first 18 months of the project. It is imperative that those with expertise in early childhood care and education insist on developmentally appropriate assessment practice and know why they are arguing for such practices. The "Competent Children" project's goal is to find out more about the influences of early childhood experiences on children's competencies as they enter school. The two strands of influences are family background and early childhood care and education. Attempts to align the project with the aims and goals of the National Curriculum have been made. Rather than focusing on only one or two competencies, the Competent Children project will study numerous competencies (including early literacy, logical reasoning, communication skills, and social problem-solving) and end up with numerous sets of results because no one instrument to measure holistic learning holistically has been developed. It is not possible to offer high quality early childhood care and education without assessment; but, though difficult, assessment guidelines need to be worked on by early childhood educators. (Contains 11 references.) (RS)
- Published
- 1993
11. Teacher Agency: A Systematic Review of International Literature
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Cong-Lem, Ngo
- Abstract
Teacher agency (TA) has been increasingly supported as an influential factor for teacher professional learning, school improvement and sustainable educational change. Previous studies, however, feature a variety of discrepancies in their conceptualisation and approaches to examining teacher agency. A systematic review is essential to map the field, refine our understanding of the concept and inform relevant stakeholders of useful insights for policy making and further research. After being screened against a number of inclusion criteria, 104 empirical studies were selected to be included in this review. Thematic analysis was adopted for the data analysis of these papers. Findings indicate an imbalance in geographical, theoretical, methodological and thematic distributions in previous studies. Six major themes were identified from the literature: (1) TA enactment, (2) the role of teacher cognition, (3) influential factors, (4) implementing professional development interventions, (5) TA outcomes and (6) TA change trajectory. TA can be extrapolated in terms of its source, enactment and outcomes. Teachers' capacities, implementation strategies, and contextual factors jointly determine the achievement of their professional agency. A conceptual framework for accounting teacher agency holistically is proposed and implications for relevant stakeholders are discussed.
- Published
- 2021
12. Re-Situation Challenges for International Students 'Becoming' Researchers
- Author
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Franken, Margaret
- Abstract
This paper presents data generated during a semester-long programme to support international students from countries in Melanesia and Asia embarking on masters research in education in a New Zealand university. All were scholarship recipients. The researcher-and facilitator-of the programme, was interested in documenting and understanding the nature of the students' experience as they planned and wrote research proposals. The process of developing a research proposal, as one of the early stages of "becoming" a researcher, highlighted a number of challenges for the six case study students. The challenges are viewed from a transition or "resituation" perspective (Eraut in "Stud Contin Educ" 26(2): 247-74, 2004, 2008) rather than an adjustment one. A resituation perspective assumes that students brought with them "personal expertise, practical wisdom and tacit knowledge" (Eraut 2008, p. 42) which needed to be reconciled with what was demanded of them by different aspects of the research planning process. The resituation challenges experienced by the students included situating a perceived problem or issue in the research literature; reconciling personal research goals with the limitations of one's own agency as a researcher; integrating new learning with research goals; and reconciling the new role or identity as a researcher with the previous role as colleague or community member. The paper presents a case for providing a context for postgraduate students in which explicit recognition of what they bring to the research task, and acknowledgement of the resituation challenges can take place.
- Published
- 2012
- Full Text
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13. Literacy Policy and English/Literacy Practice: Researching the Interaction between Different Knowledge Fields
- Author
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Moss, Gemma
- Abstract
This article considers the role of research in disentangling an increasingly complex relationship between literacy policy and practice as it is emerging in different local and national contexts. What are the tools and methodologies that have been used to track this relationship over time? Where should they best focus attention now? In answering these questions this paper will consider three different kinds of research perspectives and starting points for enquiry: 1. Policy evaluation. The use of a range of quantitative research tools to feed policy decision-making by tracking the impact on pupil performance of different kinds of pedagogic or policy change (Organisation for Economic Co-operation and Development [OECD], 2010). 2. Co-construction and policy translation. This has for some time been a central preoccupation in policy sociology, which has used small-scale and context specific research to test the limits to the control over complex social fields that policy exercises from afar (Ball, 1994). Agentic re-framings of policy at the local level stand as evidence for the potential to challenge, mitigate or re-order such impositions. 3. Ethnographies of policy time and space. Ethnographic research tools have long been used to document community literacy practices, and in training their lens on the classroom have sought to focus on the potential dissonance between community and schooled practices. It is rarer to find such research tools deployed to explore the broader policy landscape. In the light of debate within the field, part of the purpose of this article is to examine how ethnographic research tools might be refined to study how policy from afar reshapes literacy practices in the here and now. (Brandt and Clinton, 2002). (Contains 1 table.)
- Published
- 2012
14. Going Online to Learn Health Sciences Research Methods: The Student Experience
- Author
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Giddings, Lynne S., Campbell, Shirley, and Maclaren, Peter
- Abstract
Health professionals are attracted to the flexibility of the virtual classroom for their on-going education. Recent studies have documented the differences in pedagogy between Internet based learning online and the traditional classroom setting, but few have investigated student health professionals' transitional process while engaged in online learning. The purpose of this mixed methods evaluation study was to document students' experience of a six month online research methods paper (unit). Specifically it explores factors that influenced student transition to online pedagogy and successful completion of the paper. Descriptive qualitative and quantitative analyses were applied to 230 student evaluations and 1720 emails collected over a four year period. The findings supported those of previous studies; the main reasons students study online is the flexibility it offers (87%) and the ability to study without taking time off work (72%). The student experiences were captured in the overarching theme "from enduring to enjoying". A teacher who works within a collaborative team, engages students early with interactive skill acquisition learning activities, and is responsive to online students' unique needs, can successfully facilitate students through the virtual classroom transitional phases: from "virtual paralysis" to "engagement" to "getting into it" to "surprised enjoyment". Without strategies in place, however, teachers risk being overwhelmed by the onslaught of student emails, with the allotted teacher-student contact time slip sliding away. (Contains 1 table and 1 figure.)
- Published
- 2006
15. Using Hermeneutics as a Qualitative Research Approach in Professional Practice
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Paterson, Margo and Higgs, Joy
- Abstract
This paper is targeted primarily at doctoral students and others considering hermeneutics as a research strategy. Research using hermeneutics was carried out with occupational therapy educators and clinicians in Australia, New Zealand, Canada, and the UK. A total of 53 participants engaged in focus groups and individual interviews over a one-year. The paper explores hermeneutics as a credible, rigorous and creative strategy to address aspects of professional practice that similarly need to be flexible, adaptable to particular needs, and justifiable in the contexts of evidence-based as well as client-centred practice. The hermeneutic study produced A Model of Professional Practice Judgment Artistry (Paterson, 2003) which is briefly described and the connections. (Contains 2 tables, 2 figures, and 1 footnote.)
- Published
- 2005
16. Motherhood, Migration and Methodology: Giving Voice to the 'Other'
- Author
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De Souza, Ruth
- Abstract
This paper discusses the need for multi-cultural methodologies that develop knowledge about the maternity experience of migrant women and that are attuned to womens maternity-related requirements under multi-cultural conditions. Little is known about the transition to parenthood for mothers in a new country, particularly when the country is New Zealand. This paper will challenge the positivist hegemony of previously completed research on migrant women by reflecting on my own experience as a researcher grounded in a broadly-based, pluralistic set of critical epistemologies that allowed me to uncover the issues and contexts that impacted on the experience of migrant women. It concludes by proposing that, where research occurs with minority groups, multiple research strategies are incorporated in order to prevent the reproduction of deficiency discourses. (Contains 1 footnote.)
- Published
- 2004
17. Walking a Tightrope: The Balancing Act of Learning Advising. Refereed Proceedings of the 2007 Annual International Conference of the Association of Tertiary Learning Advisors of Aotearoa New Zealand. Volume 3
- Author
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Manalo, Emmanuel, Bartlett-Trafford, Julie, and Crozier, Susan
- Abstract
This volume comprises the refereed proceedings of the 2007 ATLAANZ (Association of Tertiary Learning Advisors of Aotearoa/New Zealand) conference. The first three chapters set the scene well for the breadth and depth of issues addressed by the authors. In Chapter 1, Andy Begg refers to his own educational journey in discussing the inseparability of educational experiences and outcomes from day-to-day life. In Chapter 2, Owen Ormsby stresses the importance of integrating the cultural attributes of indigenous people within education to achieve meaningful forms of success. Justin Heke, in Chapter 3, addresses the question of how to incorporate Maori (the indigenous people of New Zealand) perspectives and experiences into the content of national curricula. Chapters 4 to 6 address issues about the broader sense of identity of tertiary learning advisors. Susan Carter and Julie Trafford report in Chapter 4 on learning advisors' views about themselves and their work. Susan Carter in Chapter 5 then discuss how tertiary learning advisors consider it best to define their identity, practice, and profession. Barbara Morris in Chapter 6 examines the critical question of how the instruction and support provided by learning centres produce tangible benefits for institutes of technology and their students. The next three chapters describe initiatives in response to the ever-changing needs of students. In Chapter 7, Jude Robinson and Liz Kerry discuss methods for overcoming some of the social problems that online delivery of student support presents. In Chapter 8, Nishani Singh examines the appropriateness and practical implications of developing reflective skills in a postgraduate preparatory programme delivered offshore. And in Chapter 9, Caroline Malthus discusses issues arising from workshops to promote the development of students' spoken "literacy". In Chapters 10 to 12, the core tertiary learning advisor work of providing one-to-one support for students is examined. Margaret Wilson, in Chapter 10, investigates her own practice when working one-to-one with students on their writing. In Chapter 11, Catherine Mitchell looks into the facilitative role of emotions in one-to-one consultations. Then Lois Wilkinson, Natilene Bowker, Judith Deane-Freeman, and Sam Rullan discuss in Chapter 12 useful lessons learnt from an online pre-reading service they provide to distance students. The final two chapters in this volume deal with research. In Chapter 13, Emmanuel Manalo examines the role of research in the work of tertiary learning advisors. Then, in Chapter 14, Barry White describes an approach to teaching research methodology and interdisciplinarity workshops for postgraduate students. (Individual papers contain references.) [This report was produced by the Association of Tertiary Learning Advisors of Aotearoa New Zealand (ATLAANZ).]
- Published
- 2008
18. An Instructional Design Course for Clinical Educators: First Iteration Design Research Reflections
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Blake, Adam and Doherty, Iain
- Abstract
This paper describes the theoretical foundations of an online course to teach clinical educators how to convert a traditional face-to-face course for either flexible or distance delivery. We describe the design research approach to the creation of the course and the pedagogical theory behind the course development. We also present the details of the research project that we will be running including the rationale for the research, the research hypothesis and the research methodology. In concluding we give a brief outline of our experience of teaching the course for the first time. (Contains 3 tables and 10 figures.)
- Published
- 2007
19. Reading Research in New Zealand.
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Nicholson, Tom
- Abstract
The nearly 40 research studies carried out in New Zealand during the last decade have resulted in some very important ideas. In the area of children and texts, research focused on how children learn from texts, and the resulting data suggest that children can and do teach themselves to read, learning from their mistakes. The complexity of the classroom environment and the effects of stressful situations were factors in research on teacher involvement in learning to read. The high proportion of non-European students with reading difficulties in New Zealand was the subject of research on language and cultural influences on learning to read. Research in the area of reading programs designed to intervene in the learning process varied from the effects of progress rewards in reading to massive book experiences to parent training. Field research on approaches to teaching reading has been very limited in New Zealand, but there has been considerable effort in survey testing. These data indicate that the reading achievement of New Zealand students ranks highly in comparison with that of other developed nations. There is a need, however, for a radical reassessment of evaluation procedures and objectives. Although some very good reading research has been done in New Zealand, there are gaps at the secondary and preschool levels and in the area of adult reading. (HTH)
- Published
- 1979
20. Cross-Cultural Environmental Modelling.
- Author
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Stea, David
- Abstract
This paper reports a series of studies of environmental cognition. Conducted among American preschoolers, Navajo and Puerto Rican school children, and American, Mexican and Maori adults, all of the studies employ techniques of environmental modelling that permit objects such as buildings, trees and vehicles. A pilot test of the environmental modelling technique conducted in Puerto Rico in 1968 demonstrated that increasingly with age, children grouped the models in ways resembling landscapes. Subsequent studies indicated (1) positive features of the technique in assessing environmental cognition and (2) considerable ability among very young children. Among the Navajo the models were found to be very effective in eliciting talk about Navajo residence patterns. Environmental modelling was used in 1972 to assess environmental cognition among adults in Santa Monica, CA, and, later, to assess the relation of sex roles and socioeconomic class to environmental knowledge among Mexican adults. In 1978, the modelling technique was used to solve a problem of environmental design when the Maori of Waahi, New Zealand, were awarded money to relocate and redesign important areas and structures in their community. Through the use of modelling techniques in planning seminars attended by community participants, planners and other environmental professionals, spatial attributes of Maori cultural organization became evident. (Author/RH)
- Published
- 1980
21. Educational Policy Research in New Zealand: Issues and Challenges.
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Wagemaker, H.
- Abstract
As exemplified by New Zealand, the nature of educational policy research is shaped by political and social factors that impinge upon the research environment. Following a description of the educational system and research funding methods, this paper analyzes three areas that affect policy research in New Zealand and addresses relevant social science research literature on public policy formation. In regard to the first area, responses from the central government indicate that the minister and his/her political party are able to alter the direction of policy research. The second area concerns the process of agenda setting within the department of education, which is determined by varying perceptions of priorities. Institutional arrangements can create a narrow concept of reform, which has been characteristic of New Zealand's centralized educational system. Policy researchers have neglected to recognize that inherent ethnocentrism in the knowledge legitimation process causes a disjunction among diverse cultural groups. Applied research in Maori culture should derive its focus and concepts from indigeneous interpretations of reality rather than from European academic assumptions. Finally, the operating environment and in particular the influence of labor organizations representing teachers affect research in various ways. The challenge for policy research is to maintain integrity of purpose through an understanding of influential factors. Appended are 26 references. (CJH)
- Published
- 1986
22. Pathways Home: Te Hoe Nuku Roa (The Long Journey).
- Author
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Durie, Arohia
- Abstract
New Zealand's 1989 Education Act has resulted in a range of educational reforms. These reforms have offered the Maori opportunities to bring about positive educational developments for their people. Devolution of educational responsibility from a regional to a local level provided some of the space quickly utilized by the Maori. The requirement that university charters address the educational aspirations of all the community resulted in Massey University developing a charter referring to the rights and obligations in the 1840 Treaty of Waitangi. Subsequently, Maori participation in Massey University courses has increased. Changes on the research front have made it possible to engage in work that is valued equally by the researchers and the Maori participants who provide the necessary data. The research project Te Hoe Nuku Roa has developed an integrated framework that allows those factors impacting Maori to be given weighted representation. One factor is Maori cultural identity. Data from surveys of 102 households in the Manawatu-Whanganui region of the North Island were used to construct four cultural identity profiles, to be used to determine the role of cultural identity in successful educational outcomes. The project advances the interests of Maori in an appropriate way while furthering the frontiers of knowledge. This is a new experience for Maori, as they have long been the subjects of research that lies somewhere between intellectual invasion and theft of cultural property. (TD)
- Published
- 1999
23. Collaborative Storytelling: Meeting Indigenous Peoples' Desires for Self-Determination in Research.
- Author
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Bishop, Russell
- Abstract
Maori and other indigenous peoples are concerned about the power and control that non-indigenous people hold over research. Research issues such as initiation, benefits, representation, legitimation, and accountability have usually been determined by the researcher's interests and agenda. One means of addressing indigenous peoples' desire for self-determination in educational research is to develop collaborative storytelling as a research approach. Such an approach, when conducted within indigenous ways of knowing, facilitates ongoing collaborative analysis and construction of meaning about participants' lived experiences. Collaborative stories are selected, recollected, and reflected on by research participants (including the researcher), then merged to create a collaborative text--a mutually constructed story created out of the lived experiences of all participants. Five collaborative research projects conducted by the bicultural research group of the University of Otago (New Zealand) are described. These projects involved: (1) representing Otago Maori parents' aspirations for their children's education to national policy makers; (2) addressing systemic change through "spiral discourse" within a College of Education; (3) developing a reading tutoring procedure and offering it to Maori groups as a traditional "koha"--a gift that may be accepted or refused; (4) family history and genealogy; and (5) evaluating characteristics of Maori programs in mainstream schools that indicate success. These examples demonstrate how the researchers became located within new"story-lines" that used metaphor and imagery from the research participants' domain. (Contains 39 references.) (Author/SV)
- Published
- 1999
24. New Zealand postgraduate medical training by distance for Pacific Island country-based general practitioners: a qualitative study.
- Author
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Blattner, Katharina, Faatoese, Allamanda, Smith, Mark, Maoate, Kiki, Miller, Rory, and Richards, Rosalina
- Subjects
RESEARCH methodology ,INTERVIEWING ,CURRICULUM ,EXPERIENCE ,QUALITATIVE research ,LABOR supply ,STUDENTS ,GRADUATE education ,RESEARCH funding ,THEMATIC analysis ,DATA analysis software ,ALTERNATIVE education ,MEDICAL education - Abstract
Introduction. New Zealand health training institutions have an important role in supporting health workforce training programmes in the Pacific Region. Aim. To explore the experience of Pacific Island country-based doctors from the Cook Islands, Niue, and Samoa, studying in New Zealand’s University of Otago distance-taught Rural Postgraduate programme. Methods. Document analysis (16 documents) was undertaken. Eight semi-structured interviews were conducted with Pacific Island country-based students. Thematic analysis of the interviews was undertaken using the framework method. The two data sources were analysed separately, followed by a process to converge and corroborate findings. Results. For Pacific Island countries with no previous option for formal general practice training, access to a recognised academic programme represented a milestone. Immediate clinical relevance and applicability of a generalist medical curriculum with rural remote emphasis, delivered mainly at a distance, was identified as a major strength. Although technologies posed some issues, these were generally easily solved. The main challenges identified related to the provision of academic and other support. Traditional university support services and resources were campus focused and not always easily accessed by this group of students who cross educational pedagogies, health systems and national borders to study in a New Zealand programme. Study for individuals worked best when it was part of a recognised and supported Pacific in-country training pathway. Discussion. The University of Otago’s Rural Postgraduate programme is accessible, relevant and achievable for Pacific Island country-based doctors. The programme offers a partial solution for training in general practice for the Pacific region. Student experience could be improved by tailoring and strengthening support services and ensuring their effective delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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25. Implementing new forms of collaboration and participation in primary health care: leveraging past learnings to inform future initiatives.
- Author
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Middleton, Lesley, O'Loughlin, Claire, Tenbensel, Tim, Silwal, Pushkar, Churchward, Marianna, Russell, Lynne, and Cumming, Jacqueline
- Subjects
INTERPROFESSIONAL relations ,PRIMARY health care ,HEALTH policy ,INTERVIEWING ,SOCIAL services ,CONTINUUM of care ,COMMUNITIES ,DESCRIPTIVE statistics ,HEALTH care reform ,PATIENT-centered care ,THEMATIC analysis ,ATTITUDES of medical personnel ,RESEARCH methodology ,TRUST ,INTERPERSONAL relations ,INTEGRATED health care delivery ,PATIENT participation - Abstract
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]
- Published
- 2024
- Full Text
- View/download PDF
26. Exploring the relationship between Big Food corporations and professional sports clubs: a scoping review.
- Author
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Ireland, Robin, Chambers, Stephanie, and Bunn, Christopher
- Subjects
ATHLETIC clubs ,PROFESSIONAL sports ,PROFESSIONAL corporations ,JUNK food ,SPECIAL events ,PUBLIC health research ,SPORTS drinks ,COMPARATIVE studies ,CORPORATIONS ,FOOD habits ,FOOD industry ,HEALTH promotion ,MARKETING ,RESEARCH methodology ,MEDICAL cooperation ,PUBLIC health ,RESEARCH ,RESEARCH funding ,SPORTS ,SYSTEMATIC reviews ,LITERATURE reviews ,EVALUATION research - Abstract
Objective: Professional sport occupies a prominent cultural position in societies across the globe and commercial organisations make use of this to promote their products. The present scoping review explores existing academic literature on the relationship between professional sports clubs and food and drink marketing and considers how this relationship may impact upon the public's health.Design: The scoping review searched six databases. Experts were also consulted. Records written in languages other than English were excluded. We also excluded records relating to mega events (e.g. Olympics, Football World Cup) and alcohol marketing, because of the attention already given to these.Setting: Professional sports clubs.Results: We identified 18 166 titles, reviewed 163 abstracts and read twenty-six full texts. We included six papers in the review. Four were from Australia and New Zealand. The Australasian literature focused largely on the marketing of foods and beverages to children and the potential impact on consumption. Single papers from researchers in Turkey and the USA were identified. The Turkish paper analysed shirt sponsorship in football leagues internationally and showed food and beverage (including alcohol) companies were the most common sponsors. The US paper examined a mixed reaction to a football team named after an energy drink.Conclusions: Commercial relationships between professional sports clubs and Big Food corporations have largely eluded scrutiny in much of the world. The current review highlights the lack of public health research on these relationships. Research exploring the interdependent commercial practices of food and drink companies and professional sports clubs is urgently needed. [ABSTRACT FROM AUTHOR]- Published
- 2019
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27. New insights on rural doctors' clinical courage in the context of the unfolding COVID-19 pandemic.
- Author
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Campbell, David, Williams, Susan, Konkin, Jill, White, Isabella, Couper, Ian, Stewart, Ruth, and Walters, Lucie
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OCCUPATIONAL roles ,RURAL health services ,WORK ,RESEARCH methodology ,LEADERSHIP ,MEDICAL personnel ,INTERVIEWING ,PHYSICIANS' attitudes ,COURAGE ,QUALITATIVE research ,EXPERIENTIAL learning ,RESEARCH funding ,RURAL health ,PHYSICIANS ,DATA analysis software ,THEMATIC analysis ,COVID-19 pandemic ,PSYCHOLOGY of physicians - Abstract
Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd 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.)
- Published
- 2023
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28. An Interview with Linda Tuhiwai Te Rina Smith, March 27, 2002.
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Smith, Linda Tuhiwai Te Rina, Battiste, Marie, Bell, Lynne, and Findlay, L. M.
- Abstract
Linda Tuhiwai Te Rina Smith--Maori researcher, educator, and activist--discusses key moments in the journey toward decolonization of Maori education, the impact of her book about decolonizing research methodologies, the concept of postcolonialism, challenges to the sustainability of social and educational change, disrupting the power relation between teacher and learner, making room for Indigenous pedagogies, and collaboration between Indigenous and non-Indigenous researchers. (SV)
- Published
- 2002
29. The Transformative Potential of Kaupapa Māori Research and Indigenous Methodologies: Positioning Māori Patient Experiences of Mental Health Services.
- Author
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Haitana, Tracy, Pitama, Suzanne, Cormack, Donna, Clarke, Mauterangimarie, and Lacey, Cameron
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MENTAL health services ,MAORI (New Zealand people) ,PATIENT positioning ,RESEARCH methodology ,PEOPLE with mental illness - Abstract
This article presents a description of a specific Indigenous research methodology, Kaupapa Māori Research (KMR), followed by a discussion of the potential contribution that KMR and other Indigenous frameworks make toward understanding and addressing widespread mental health inequities affecting the world's Indigenous peoples. The contribution of existing qualitative KMR to the fields of health and mental health in New Zealand is discussed, and innovative approaches employed within these studies will be outlined. This paper describes the utility of KMR methodology which informed the development of qualitative interviews and the adaptation of an analytic framework used to explore the impact of systems on the experiences of Māori (the Indigenous peoples of New Zealand) with bipolar disorder (BD). This paper adds to others published in this journal that describe the value, inherent innovation, and transformative potential of KMR methodologies to inform future qualitative research with Indigenous peoples and to enact systemic change. Transformation is achieved by privileging the voices of Māori describing their experiences of mental health systems; presenting their expert critique to those responsible for the design and delivery of mental health services; and ensuring equal weight is given to exploring the clinical, structural and organizational changes required to achieve health equity. It is proposed that this approach to research praxis is required to ensure that studies do not perpetuate institutional racism, which requires close adherence to Indigenous research priorities and partnership with Indigenous peoples in all steps of the research process. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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30. Between reproductive rights and sex selection in New Zealand's abortion reforms: practitioner dilemma in institutionalising 'choice' and 'agency'.
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Simon-Kumar, Rachel, Sharma, Vartika, and Singh, Nikki
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MATERNAL health services ,CULTURE ,PARENT attitudes ,BIRTHPLACES ,SEX preselection ,PRACTICAL politics ,RESEARCH methodology ,ABORTION ,MEDICAL personnel ,INTERVIEWING ,HEALTH care reform ,RESPONSIBILITY ,PSYCHOSOCIAL factors ,AUTONOMY (Psychology) ,RESEARCH funding ,REPRODUCTIVE rights ,DECISION making in clinical medicine ,GENDER inequality ,TRUST - Abstract
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]
- Published
- 2023
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31. The characteristics of behaviour change interventions used among Pacific people: a systematic search and narrative synthesis.
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Matenga-Ikihele, Amio, McCool, Judith, Dobson, Rosie, Fa'alau, Fuafiva, and Whittaker, Robyn
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HEALTH behavior ,PARTICIPANT observation ,COLLECTIVISM (Social psychology) ,SOCIAL cognitive theory ,EUROCENTRISM ,RESEARCH ,SOCIAL support ,RESEARCH methodology ,SYSTEMATIC reviews ,BEHAVIOR therapy ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,RESEARCH funding - Abstract
Background: Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people.Methods: Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020.Results: Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities.Conclusions: This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities. [ABSTRACT FROM AUTHOR]- Published
- 2021
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32. Integrating dietitians into primary health care: benefits for patients, dietitians and the general practice team.
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Beckingsale, Louise, Fairbairn, Kirsty, and Morris, Caroline
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DIETITIANS ,HEALTH care teams ,INTERVIEWING ,RESEARCH methodology ,MEDICAL care ,SENSORY perception ,PRIMARY health care ,RESEARCH funding ,STATISTICAL sampling ,QUALITATIVE research ,OCCUPATIONAL roles ,THEMATIC analysis - Abstract
INTRODUCTION: Dietetic service delivery in primary health care is an emerging area of dietetic practice in New Zealand. AIM: This paper aims to describe the dietetic services being delivered in this setting and dietitians' perceptions of the factors that have an effect on their ability to deliver an optimal service. METHODS: Individual, qualitative, semi-structured, face-to-face interviews were conducted with 12 primary healthcare dietitians from a range of age, ethnicity and professional backgrounds. Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS: Participants were delivering a range of services including: providing nutrition care directly to patients, helping to upskill other primary health care professionals in nutrition, and delivering health promotion initiatives to their local community. Three key factors were identified that participants perceived as having an effect on their ability to deliver effective dietetic services in primary health care: being part of a multidisciplinary general practice team, having flexible service delivery contracts appropriate for the setting and that supported integration, and having an adequate level of dietetic experience. DISCUSSION: Dietitians working in primary health care recognise the importance of being well integrated into a multidisciplinary general practice team. This enables them to deliver more collaborative and coordinated nutrition care alongside their colleagues, to benefit patient care. Establishing flexible dietetic service delivery contracts, which support integration and take into account funding and workforce capacity requirements, may help ensure that the unique skill set of a dietitian is utilised to best effect. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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33. The shaping of sustainability assurance through the competition between accounting and non-accounting providers.
- Author
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Farooq, Muhammad Bilal and de Villiers, Charl
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SUSTAINABILITY ,SUSTAINABLE development reporting ,CONCEPTUAL models ,RESEARCH methodology ,STANDARDS - Abstract
Purpose: The purpose of this paper is to examine the competition between accounting sustainability assurance providers (ASAPs) and non-accounting sustainability assurance providers (NASAPs), and how this competition influences the institutionalization of the evolving field of sustainability assurance. Design/methodology/approach: An interpretivist research methodology, guided by an institutional work perspective, is used to analyze interviews with 15 SAPs and 35 sustainability reporting managers (SRMs) in Australia and New Zealand. Findings: ASAPs prefer to use International Standard on Assurance Engagements 3000 (ISAE3000), because it is well recognized in the profession, adheres to ASAPs' regulatory requirements, and mirrors their financial audit methodologies. This preference influences ASAPs' institutional work as they compete against NASAPs and how they institutionalize sustainability assurance. ASAPs' institutional works include presenting sustainability assurance as similar to a financial audit, arguing in support of a single provider for financial audits and sustainability assurance, and undermining NASAPs and their preferred sustainability assurance standard, AA1000 Assurance Standard (AA1000AS), by appealing to senior management. In comparison, NASAPs promote AA1000AS as a specialist standard among SRMs, emphasizing the standard's sustainability enhancing qualities and its flexibility, while discrediting ASAPs and ISAE3000 as out of touch with sustainability objectives. Research limitations/implications: A new conceptual model is constructed that can be used in institutional work research. Practical implications: The accounting profession is encouraged to consider more flexible, innovative methods in new assurance markets. This involves using new assurance standards as well as developing specialist standards for new forms of assurance. Regulation over sustainability assurance could be helpful, but regulators should be careful not to stifle competition in this evolving field. Originality/value: This paper examines how competition between ASAPs and NASAPs influences the institutionalization of sustainability assurance. The paper offers a new model for the analysis of institutional work, which could be used by researchers, new insights into the emerging field of sustainability assurance, as well as a figure and discussion that clarifies the broader implications of the findings. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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34. Control of Recreational Cannabis in a New Zealand University Sample: Perceptions of Informal and Formal Controls.
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Robertson, Kirsten J and Tustin, Karen
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SUBSTANCE abuse prevention ,DRUGS of abuse laws ,UNIVERSITIES & colleges ,CANNABIS (Genus) ,COLLEGE students ,RESEARCH methodology ,STUDENT attitudes ,AFFINITY groups ,CROSS-sectional method ,DESCRIPTIVE statistics - Abstract
An increasing number of countries have, or are moving towards, reforming cannabis policies. New Zealand is also moving in this direction and the government will hold a referendum on the legalization of recreational cannabis in September 2020. To inform imminent public and political discussions it is important to understand how current cannabis use is controlled. Research suggests that cannabis law has been ineffective in NZ. Internationally, informal controls, rather than the law, have been found to shape cannabis use by creating a threshold for normalization, but the attitudes shaping this threshold are unknown. This study aimed to examine drug acceptability attitudes, specifically students' attitudes towards the illegal use of cannabis and their attitudes towards peers who abstain, sometimes use, or are heavy users of cannabis, to identify the factors that control cannabis use. Using a mixed methods approach, university students recruited their peers (N = 535) to complete a pen and paper survey investigating perceptions towards 3 cannabis user prototypes (abstainers, moderate users, heavy users), concern for legality of cannabis use, and the integration of cannabis into the student culture (perceptions of peers' use, ease of acquisition, and availability). Perceptions of peers' lifetime and regular use were 82% and 38.5%, respectively. Participants rated cannabis as easy to acquire and likely to be available at a typical student social occasion. The majority stated that the law does not deter use (92.7%); participants perceived the law to be soft and that they are unlikely to get caught. Participants' descriptions of the 3 cannabis user prototypes revealed a threshold for normalization. For instance, abstaining was perceived to be associated with positive attributes (such as being studious), linked to being less sociable, and linked to being less likely to be judged. Moderate use of cannabis was perceived to be normal and sociable. Heavy use was perceived to be associated with having negative attributes, such as being addicted, unhealthy, and an underachiever, and negative drug labels. Our findings revealed that cannabis use is not controlled by the law, but by informal thresholds of control. Moderate cannabis use is accepted whereas heavy cannabis use is not. We extended research by identifying the attitudes shaping these thresholds, in particular that negative outcomes associated with heavy use deters the normalization of this behavior. We argue that policy must be informed by, and build on, these informal controls. The negative perceptions associated with heavy use also raise concerns regarding the well-being of heavy users, and coupled with the ineffectiveness of cannabis law, lend support towards a health model for regulating cannabis. Furthermore, insights into the negative perceptions associated with heavy use could inform health interventions on the types of concerns that will resonate with users. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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35. Exploring the role of goal setting in weight loss for adults recently diagnosed with pre-diabetes.
- Author
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Whitehead, Lisa, Glass, Courtney C., Abel, Sally L., Sharp, Kiri, and Coppell, Kirsten J.
- Subjects
BODY weight ,CONTENT analysis ,DIABETES ,DIET therapy ,FOOD habits ,GOAL (Psychology) ,RESEARCH methodology ,MEDICAL office nursing ,HEALTH outcome assessment ,PREDIABETIC state ,RESEARCH funding ,WEIGHT loss ,QUALITATIVE research ,PILOT projects ,DESCRIPTIVE statistics ,ADULTS - Abstract
Background: The management of prediabetes in the community setting is a global priority. We evaluated the feasibility of a 6-month multilevel practice nurse-led prediabetes dietary intervention which involved goal setting. The aim of this paper is to explore the weight loss goals and strategies reported by participants to achieve their weight loss goals as recorded by practice nurses, and report on factors that influenced dietary behaviours. Methods: This study used a convergent mixed-methods design. A six-month pragmatic non-randomised pilot study with a qualitative process evaluation was conducted in two neighbouring provincial cities in New Zealand. A structured dietary intervention delivered by practice nurses was implemented in four practices in 2014–2016. Content analysis of the text and descriptive statistics were used to analyse the data. Results: One hundred and fifty seven people with prediabetes were enrolled (85 intervention, 72 control). The intervention group lost a mean 1.3 kg more than the control group (p <.0.001). The majority of the intervention group indicated either a high level of readiness (n = 42, 53%) or some readiness (n = 31, 39%) to make food changes. The majority of weight loss goals aligned with clinical guidelines (between 5 and 10% of body weight). While just over half (n = 47, 55%) demonstrated weight loss at the end of the six month period, the majority of participants did not achieve their predetermined weight loss goal (n = 78, 83%). Gender, ethnicity and budget were not related to weight loss at six months. Readiness to change and reported challenges to making dietary changes were related to weight loss at six months. Negative factors or set-backs included sporadic adherence to diet due to other health problems, change in context or environment and coping with ill health, most notably stress and low mood. Conclusions: The data relating to weight loss and dietary goals provided insight into the challenges that people faced in making dietary changes for weight loss across a six month period. Simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the person, in a socially supportive environment, may increase the success of goal achievement. Trial registration: ANZCTR ACTRN1261500080656. Registered 3 August 2015 (Retrospectively registered). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366560&isReview=true [ABSTRACT FROM AUTHOR]
- Published
- 2020
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36. Lone parents, health, wellbeing and welfare to work: a systematic review of qualitative studies.
- Author
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Campbell, Mhairi, Thomson, Hilary, Fenton, Candida, and Gibson, Marcia
- Subjects
SINGLE parents ,QUALITATIVE research ,POVERTY rate ,HIGH-income countries ,COMPARATIVE studies ,EMPLOYMENT ,HEALTH status indicators ,RESEARCH methodology ,MEDICAL cooperation ,POVERTY ,PUBLIC welfare ,RESEARCH ,RESEARCH funding ,SYSTEMATIC reviews ,EVALUATION research - Abstract
Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.Methods: We conducted a systematic review of qualitative studies reporting lone parents' accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.Conclusion: WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW. [ABSTRACT FROM AUTHOR]- Published
- 2016
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37. The complexity of food for people with multiple long-term health conditions.
- Author
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Francis, Helen, Carryer, Jenny, and Wilkinson, Jill
- Subjects
CHRONIC diseases ,FOOD ,INTERVIEWING ,RESEARCH methodology ,NUTRITION ,QUALITY of life ,RESEARCH ,HEALTH self-care ,QUALITATIVE research ,THEMATIC analysis - Abstract
INTRODUCTION: The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs. METHODS: The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis. RESULTS: There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective. DISCUSSION: The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people's needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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38. He Aroka Urutā. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Māori and Pasifika communities: a qualitative study.
- Author
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Blattner, Katharina, Clay, Lynne, Keenan, Rawiri, Taafaki, Jane, Crengle, Sue, Nixon, Garry, Fortune, Kiri, and Stokes, Tim
- Subjects
HEALTH services accessibility ,MEDICAL personnel ,RURAL health ,QUALITATIVE research ,RESEARCH funding ,FOCUS groups ,MEDICAL care of indigenous peoples ,VACCINATION ,PACIFIC Islanders ,INTERVIEWING ,PRIMARY health care ,COVID-19 vaccines ,POPULATION geography ,JUDGMENT sampling ,ATTITUDE (Psychology) ,VACCINATION coverage ,THEMATIC analysis ,ATTITUDES of medical personnel ,RURAL conditions ,METROPOLITAN areas ,RESEARCH methodology ,HEALTH of indigenous peoples ,COVID-19 pandemic ,EMERGENCY management - Abstract
Introduction. From a coronavirus disease (COVID-19) pandemic perspective, Aotearoa New Zealand (NZ) rural residents formed an at-risk population, and disparities between rural and urban COVID-19 vaccination coverage have been found. Aim. To gain insight into factors contributing to the urban-rural COVID-19 vaccination disparity by exploring NZ rural health providers' experiences of the vaccine rollout and pandemic response in rural Māori and Pasifika communities. Methods. Rural health providers at four sites participated in individual or focus group semi-structured interviews exploring their views of the COVID-19 vaccine rollout. Thematic analysis was undertaken using a framework-guided rapid analysis method. Results. Twenty interviews with 42 participants were conducted. Five themes were identified: Pre COVID-19 rural situation, fragile yet resilient; Centrally imposed structures, policies and solutions - urban-centric and Pakehā focused; Multiple logistical challenges - poor/no consideration of rural context in planning stages resulting in wasted resource and time; Taking ownership - rural providers found geographically tailored, culturally anchored and locally driven solutions; Future directions - sustained investment in rural health services, including funding long-term integrated (rather than 'by activity') health services, would ensure success in future vaccine rollouts and other health initiatives for rural communities. Discussion. In providing rural health provider perspectives from rural areas serving Māori and Pasifika communities during the NZ COVID-19 vaccine rollout, the importance of the rural context is highlighted. Findings provide a platform on which to build further research regarding models of rural health care to ensure services are designed for rural NZ contexts and capable of meeting the needs of diverse rural communities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
39. Advanced practice physiotherapists in primary health care: stakeholders' views of a new scope of practice.
- Author
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Stotter, Gill, McKinlay, Eileen, and Darlow, Ben
- Subjects
PHYSICAL therapy ,PHYSICAL therapists' attitudes ,HUMAN services programs ,QUALITATIVE research ,RESEARCH funding ,PRIMARY health care ,MEDICAL care ,MUSCULOSKELETAL system diseases ,INTERVIEWING ,STATISTICAL sampling ,DESCRIPTIVE statistics ,SOUND recordings ,THEMATIC analysis ,RESEARCH methodology ,STAKEHOLDER analysis ,MEDICAL practice ,HEALTH care teams - Abstract
Introduction. Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice. Aim. This study aimed to explore health professionals' perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care. Methods. Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken. Results. Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice. Discussion. Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants' personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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40. Private practice model of physiotherapy: professional challenges identified through an exploratory qualitative study.
- Author
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Darlow, Ben, Stotter, Gill, and McKinlay, Eileen
- Subjects
PHYSICAL therapy ,PROFESSIONALISM ,CORRUPTION ,ORGANIZATIONAL behavior ,CORPORATE culture ,AUDIT trails ,PHYSICAL therapists' attitudes ,QUALITATIVE research ,INTERPROFESSIONAL relations ,INCOME ,MEDICAL quality control ,DATA analysis ,RESEARCH funding ,PRIMARY health care ,MUSCULOSKELETAL system diseases ,INTERVIEWING ,CULTURE ,PATIENT care ,JUDGMENT sampling ,HELP-seeking behavior ,PROFESSIONAL peer review ,MENTORING ,EMAIL ,RESEARCH methodology ,TRUST ,RESEARCH ,COMMUNICATION ,ECONOMIC competition ,SOCIAL support ,DATA analysis software ,MEDICAL practice ,PSYCHOSOCIAL factors ,PHYSICAL therapists ,MEDICAL referrals - Abstract
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]
- Published
- 2024
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- View/download PDF
41. The costs, barriers and enablers of providing PGY2 placements in general practice in Aotearoa New Zealand: a mixed-methods study.
- Author
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Atmore, Carol, Sullivan, Trudy, Millar, Jessica, Paulose, Aisha, Shute, Andy, Brown, Dot, and Stokes, Tim
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SCHOOL environment ,FAMILY medicine ,MEDICAL education ,RESEARCH funding ,QUALITATIVE research ,INTERNSHIP programs ,COST analysis ,PRIMARY health care ,DESCRIPTIVE statistics ,MEDICAL students ,RESEARCH methodology ,DATA analysis software - Abstract
Introduction. Few mandatory community-based attachments for postgraduate year two doctors (PGY2s) in Aotearoa New Zealand are hosted in general practices, due to space, time and remuneration barriers. Aim. This study aimed to explore the costs, barriers and enablers to general practices of hosting PGY2s. Methods. A cost analysis for four general practices beginning to host PGY2s was undertaken, including time spent supervising and supporting PGY2s, revenue impact including subsidies and cost of providing clinical space. Interviews with these practices and seven experienced PGY2 host practices were conducted and analysed thematically. Results. The estimated mean cost of hosting PGY2s excluding room cost was NZ$4907 per 13-week placement (range $890-$9183), increasing to $13 727 per placement (range $5750-$24 715) when room rental was included. Four themes were identified: working within a small business model; a new learning environment for PGY2s; providing positive experiences for the PGY2s; the relationship between practices and district hospitals that employed the PGY2s, including job sizing. Discussion. Tension exists between the small business model of general practice and providing positive experiences for PGY2s in a new learning environment. Guidance and support structures for PGY2 hosting should be developed nationally, and communication and cooperation between practices and employing hospitals needs improvement. Out-of-hours work should be included in community-based attachments so PGY2s' remuneration is consistent. General practice teams are willing to be part of creating a sustainable workforce. However, the time taken to host and costs of providing training in primary care are barriers. There is urgent need to increase funding to general practices for hosting PGY2s. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
42. Electronic transmission of prescriptions in primary care: transformation, timing and teamwork.
- Author
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Campbell, Chloë, Morris, Caroline, and McBain, Lynn
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TEAMS in the workplace ,ELECTRONIC data interchange ,ATTITUDES of medical personnel ,WORK ,DRUGSTORES ,RESEARCH methodology ,PHYSICIANS' attitudes ,INTERVIEWING ,PHARMACISTS ,PRIMARY health care ,WORKFLOW ,EXPERIENTIAL learning ,INTERPROFESSIONAL relations ,COMMUNICATION ,DESCRIPTIVE statistics ,MEDICAL prescriptions ,JUDGMENT sampling ,PATIENT-professional relations ,THEMATIC analysis - Abstract
INTRODUCTION: During the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy. AIM: The purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy. METHODS: Semi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants' perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach. RESULTS: Four themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs). DISCUSSION: Both general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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43. Outcomes of a pilot study in chiropractic practices in Western Australia.
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Amorin-Woods, Lyndon G., Parkin-Smith, Gregory F., Nedkoff, Lee, and Fisher, Colleen
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CHIROPRACTIC ,CHIROPRACTIC education ,CONFIDENCE intervals ,HEALTH promotion ,INFORMED consent (Medical law) ,RESEARCH methodology ,MEDICAL practice ,MENTAL health ,POSTURE ,QUALITY of life ,QUESTIONNAIRES ,SOCIAL norms ,STATISTICS ,PHYSICIAN practice patterns ,LOGISTIC regression analysis ,PILOT projects ,QUANTITATIVE research ,CLINICAL trial registries ,HUMAN research subjects ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background: This paper reports the quantitative outcomes of a mixed-methods pilot study of the characteristics and demographics of chiropractic practices and patients in Western Australia. Methods: This was a mixed-methods data transformation model (qualitative to quantitative) pilot study. A non-random sample of chiropractic practices across Western Australia was recruited and data collected anonymously from consecutive new patients using an online platform. Data covered practice and patient demographics and characteristics, alongside quality of life measures. A descriptive quantitative analysis characterised the sample, and the patient population was stratified by main reason for presentation to compare characteristics according to the presence of secondary complaints. Odds ratios were calculated to estimate the odds of a secondary complaint for various combinations of main complaints, from univariate logistic regression models. Results: Of the 539 registered practitioners in WA in July 2014, 33 agreed to participate, from 20 different practices. Ten participating practices provided data on 325 adult new patients. The recruited practices (metropolitan n = 8, regional n = 2) had a positive response rate of 79.7% (n = 301 metropolitan and = 24 regional patients), mean age 36.3 years (range 18-74) (53.2 % female). Spinal problems were reported as the main reason for consultation by 67 % and as secondary reasons by 77.2 % of patients. People presented primarily for health maintenance or a general health check in 11.4 %, and as a secondary reason 14.8 %. There were 30 % of people below societal norms for the SF-12 Physical Component Score (mean 47.19, 95 % CI; 46.27-48.19) and 86 % for the Mental Component Score (mean 36.64, 95 % CI; 35.93-37.65), Pain Impact Questionnaire mean scores were 54.60 (95 % CI; 53.32-55.88). Conclusions: Patients presented to chiropractors in Western Australia with a fairly wide range of conditions, but primarily spinal and musculoskeletal-related problems. A significant proportion of patients had associated, or found to be at risk of, depression. Consequently, there are responsibilities and opportunities for chiropractors with respect to providing care services that include health promotion and well-being education related to musculoskeletal/spinal and mental health. This pilot study supports the feasibility of a future confirmatory study where the potential role of chiropractors in spinal/musculoskeletal health management may be explored. Trial registration: ACTRN12616000434493: Australian New Zealand Clinical Trials Registry (ANZCTR), Registered 5 April 2016, First participant enrolled 01 July 2014 Retrospectively Registered. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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44. A scoping review of female drowning: an underexplored issue in five high-income countries.
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Roberts, Kym, Thom, Ogilvie, Devine, Susan, Leggat, Peter A., Peden, Amy E., and Franklin, Richard C.
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DROWNING ,FEMALES ,SWIMMING ,ACCIDENTS ,PUBLIC health ,RESEARCH ,DEVELOPED countries ,RESEARCH methodology ,SYSTEMATIC reviews ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,LITERATURE reviews - Abstract
Background: Drowning is a significant public health issue, with females accounting for one third of global drowning deaths. The rate of female drowning has not decreased within high-income countries and presentations to hospital have increased. This scoping review aimed to explore adult female unintentional drowning, including risk factors, clinical treatment and outcomes of females hospitalised for drowning.Methods: A systematic search of the literature following the PRISMA-ScR framework was undertaken. The databases OVID MEDLINE, Embase, CINAHL, OVID Emcare, Web of Science, Informit and Scopus were accessed. Study locations of focus were Australia, Canada, New Zealand, the United Kingdom, and the United States. Studies from January 2003 to April 2019 were included. The quality of evidence of included studies was assessed using GRADE guidelines.Results: The final search results included 14 studies from Australia (n = 4), Canada (n = 1), New Zealand (n = 1), United States (n = 6), United Kingdom (n = 1), and one study reporting data from both Australia and United States. Nine studies reported risk factors for female drowning including age, with the proportion of female drowning incidence increasing with age. Although females are now engaging in risk-taking behaviours associated with drowning that are similar to males, such as consuming alcohol and swimming in unsafe locations, their exposure to risky situations and ways they assess risk, differ. Females are more likely to drown from accidental entry into water, such as in a vehicle during a flood or fall into water. This review found no evidence on the clinical treatment provided to females in hospital after a drowning incident, and only a small number of studies reported the clinical outcomes of females, with inconsistent results (some studies reported better and some no difference in clinical outcomes among females).Conclusion: Adult females are a group vulnerable to drowning, that have lacked attention. There was no single study found which focused solely on female drowning. There is a need for further research to explore female risk factors, the clinical treatment and outcomes of females hospitalised for drowning. This will not only save the lives of females, but also contribute to an overall reduction in drowning. [ABSTRACT FROM AUTHOR]- Published
- 2021
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45. Improving management of sexually transmitted infections in primary care: feasibility and acceptability of a new patient management tool for clinicians.
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Rose, Sally B., Garrett, Susan M., and Pullon, Susan R. H.
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EXPERIMENTAL design ,PATIENT aftercare ,GONORRHEA ,STUDENT health services ,FOCUS groups ,RESEARCH methodology ,RESEARCH methodology evaluation ,INTERNET ,HUMAN sexuality ,PHYSICIANS' attitudes ,SEXUALLY transmitted diseases ,PRIMARY health care ,DOCUMENTATION ,QUALITY assurance ,INFORMATION resources ,SEX customs ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,RESEARCH funding ,CHLAMYDIA trachomatis ,THEMATIC analysis ,DISEASE management ,CHLAMYDIA infections - Abstract
INTRODUCTION: Routinely following an evidence-based clinical pathway of care for bacterial sexually transmitted infections (STIs) such as chlamydia or gonorrhoea is important to help reduce the spread of infections, prevent reinfections and avoid associated health complications. AIM: To develop an easy-to-use tool for routine use by primary care clinicians to ensure best practice management of patients tested for and diagnosed with chlamydia or gonorrhoea. METHODS: The tool (a MedTech Advanced Form) was developed in consultation with seven primary care clinicians and included different tabs for use during the STI care pathway (testing, treatment, advice, partner notification and follow up) with clickable links to relevant online resources. The tool was trialled over 3 months by 19 clinicians in three Wellington primary care clinics - two youth health and a student health service. Outcome measures were frequency of use, completeness of fields related to best practice care and clinician acceptance of the tool (from focus group feedback). RESULTS: The tool was used for approximately one in four patients who were tested during the trial period, with 'forgetting' reported as the mostcommonreason for non-use. Clinician views about the tool were favourable, with most indicating they would like to continue use and would recommend it to colleagues. Documentation of best practice care was excellent; fields to record reasons for testing, discussion of sexual history, provision of treatment and advice given were used for most patients for whom the form was completed. CONCLUSIONS: Inclusion of this STI management tool in the electronic patient records system appeared to improve primary care clinicians' delivery and documentation of best practice sexual health care at a practice level. Wider use of a modified version of this tool could facilitate more comprehensive best practice management of bacterial STIs. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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46. Young peoples' perspectives about care in a youth-friendly general practice.
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McKinlay, Eileen, Morgan, Sonya, Garrett, Sue, Dunlop, Abby, and Pullon, Sue
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HEALTH services accessibility ,FAMILY medicine ,PHYSICIAN-patient relations ,RESEARCH methodology ,INTERVIEWING ,PATIENTS' attitudes ,QUALITATIVE research ,TEENAGERS' conduct of life ,DESCRIPTIVE statistics ,RESEARCH funding ,DATA analysis software ,THEMATIC analysis - Abstract
INTRODUCTION: Youth health outcomes are poor in New Zealand and have a life-long impact on individuals, wha-nau (family) and society. Little is known about how young people view their experiences of general practice care despite it being the most common place to access health care. AIM: This study sought to explore young peoples' experiences of care in a selected, youth-friendly general practice. METHODS: In-depth individual interviews with six young people. RESULTS: Four themes were identified from young peoples' narratives in relation to their experiences of general practice care: going to the doctor is not easy for a young person; the attributes of staff make all the difference; specific youth-friendly consultation practices help young people; and a youth-friendly physical environment can help young people access services and feel safe. DISCUSSION: Even though the study general practice had explicitly instituted youth-friendly initiatives, including offering no-charge consultations and specialist staffmembers, young people still described considerable barriers to attendance. Many barriers are practice-based and could bemodified by staff training, provision of further youth care staff roles and consideration of environmental changes. Other barriers such as waiving prescription costs need government funding. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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47. Patient perceptions of barriers to attending annual diabetes review and foot assessment in general practice: a qualitative study.
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Ju, William, Al-Busaidi, Ibrahim S., Lunt, Helen, and Hudson, Ben
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HEALTH services accessibility ,RESEARCH funding ,QUALITATIVE research ,FAMILY medicine ,PRIMARY health care ,INTERVIEWING ,DESCRIPTIVE statistics ,THEMATIC analysis ,TYPE 2 diabetes ,RESEARCH methodology ,MEDICAL needs assessment ,DATA analysis software ,PATIENTS' attitudes ,COVID-19 pandemic - Abstract
Introduction. Regular diabetic foot checks, at least annually, are important for early identification of risk factors and prevention of ulceration and amputation. To ensure this, most general practices in Aotearoa New Zealand (NZ) offer free annual diabetes reviews (ADRs) which include a comprehensive foot evaluation. However, attendance rates at these ADRs are low. Aim. To explore patients' perspectives on the barriers to attending ADRs and foot checks. Methods. Semi-structured interviews with people with type 2 diabetes who were overdue their ADR (n = 13; 7 women, 6 Māori) from two urban practices were conducted. Interviews were audio recorded and transcribed verbatim and then analysed using an inductive thematic analysis approach. Results. We identified three key themes demonstrating barriers to attendance: healthcareassociated factors (suboptimal clinician-patient relationship, not having a consistent general practitioner (GP)); patient-related factors (co-morbid health conditions, issues surrounding identity, and logistical issues); and systemic factors (COVID-19 pandemic, travel distance to the practice, unawareness of available foot care services). Participants' feedback focused on patient-centred approaches for improvements to service delivery, for example using online educational materials, and utilising culturally appropriate models of health including Te Whare Tapa Whā and Whānau Ora approach. Discussion. We identified several barriers to attendance, some of which are potentially modifiable. Addressing modifiable barriers and incorporating suggestions made by participants may improve access to the ADR and reduce non-attendance. Further participatory action research could explore these insights in ways that facilitate tino rangatiratanga (self-determination) and palpable action. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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48. 'I think we just do it once and leave it...' The collection and utility of family health history in general practice in Aotearoa New Zealand: a qualitative study.
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Jefferies, R., Wilcox, P., Paringatai, K., Stubbe, M., Grainger, R., Dowell, A., and Filoche, S. K.
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CHRONIC disease risk factors ,CHRONIC disease diagnosis ,FAMILY health ,RISK assessment ,PATIENTS' families ,FAMILY medicine ,OCCUPATIONAL roles ,QUALITATIVE research ,MEDICAL personnel ,INTERVIEWING ,HEALTH ,PRIMARY health care ,FAMILY history (Medicine) ,PHYSICIANS' attitudes ,CULTURAL values ,INFORMATION resources ,THEMATIC analysis ,CHRONIC diseases ,RESEARCH methodology ,PHYSICIAN-patient relations ,INDIVIDUALIZED medicine ,PHYSICIANS ,PATIENT participation ,SELF-disclosure ,ACCESS to information - Abstract
Introduction. The value of family health history as a means to understanding health risk has been long known. Its value in a precision medicine context is also now becoming apparent. General practitioners (GPs) are considered to play a key role in the collection, and investigation, of family health history, but it remains widely reported as being both poorly and infrequently undertaken. Little is known about this practice in Aotearoa New Zealand (NZ). Aim. This study aimed to explore current practices in relation to the ascertainment of family health history, with a view towards precision medicine. Methods. Semi-structured interviews were conducted with 10 GPs recruited from one urban area of NZ. The interviews were subjected to a thematic analysis. Results. Family health history information was used to varying degrees in four areas - risk ascertainment, patient engagement with a diagnosis, social context and building relationships. Patient cultural considerations were rarely mentioned. Reliability of information provided by patients, resource constraints, context driven consults and electronic health record limitations are potential indicators of current limits of family health history. Discussion. Our findings present a baseline of current practice and echo larger studies from overseas. As precision medicine is not yet routine, a unique opportunity exists for consideration to be given to establishing specific roles within the NZ health system to enable equitable practice of, and subsequent health gains from, the use of family/whānau health history information as part of precision medicine. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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49. Attitudes regarding a warranty and the expected longevity of dental treatment amongst New Zealand dentists, dental students, and patients: a mixed methods survey.
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Liu, Belinda, Roessler, David, and Morse, Zac
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PSYCHOLOGY of dentists ,DENTAL crowns ,DENTAL resins ,DENTAL students ,ATTITUDES of medical personnel ,RESEARCH methodology ,CROSS-sectional method ,DENTAL care ,MANN Whitney U Test ,SURVEYS ,PEARSON correlation (Statistics) ,COMPARATIVE studies ,PSYCHOSOCIAL factors ,QUESTIONNAIRES ,CHI-squared test ,LONGEVITY ,STATISTICAL sampling ,LOGISTIC regression analysis ,THEMATIC analysis ,COMPLICATIONS of prosthesis - Abstract
Objectives: To investigate and compare estimates of the longevity of dental treatment, expectations for free remedial treatment, and attitudes about formal dental warranties among dentists, students, and patients. Materials and methods: This is a mixed-method cross-sectional questionnaire survey with convenience sampling from dentists, dental students, and patients in New Zealand. A questionnaire was distributed to New Zealand dentists (n = 28) and final-year dental students (n = 27). A separate questionnaire was provided to patients in a university dental clinic (n = 43). Mann-Whitney U, Chi-square and Pearson Correlation, and Binary logistic regression tests were used to test for differences between groups and correlations amongst variables. Qualitative data were analysed thematically. Results: Dentists believed that their posterior composite resin restorations would last longer (p = 0.014), would remediate failed crowns for longer (p = 0.002) and would provide longer crown warranties (p = 0.003) compared to students. Patients had higher expectations for restoration longevity and free remediation for failed treatment. Students were generally more willing to provide warranties. Crowns were perceived to be the most warrantable, while endodontic treatment was the least warrantable. Recall attendance, mechanical failure, and adequate oral hygiene were commonly proposed as warranty conditions for restorations and crowns. There was little consensus about complete dentures and endodontic treatment. Conclusions: There are significant disparities between the expectations of patients and clinicians regarding treatment longevity and free remediation times. Clinicians, in general, are willing to provide free remediation within a specified time frame, except for endodontic treatment, but are hesitant to provide formal dental warranties. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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50. Improving access for community health and sub-acute outpatient services: protocol for a stepped wedge cluster randomised controlled trial.
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Harding, Katherine E., Watts, Jennifer J., Karimi, Leila, O'Reilly, Mary, Kent, Bridie, Kotis, Michelle, Leggat, Sandra G., Kearney, Jackie, and Taylor, Nicholas F.
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COMMUNITY health services ,OUTPATIENT medical care ,MEDICAL triage ,PUBLIC health ,QUALITY of life ,PATIENT satisfaction ,RANDOMIZED controlled trials ,COMMUNITY health services administration ,COMPARATIVE studies ,COST effectiveness ,HEALTH services accessibility ,LONGITUDINAL method ,MANAGEMENT ,RESEARCH methodology ,MEDICAL appointments ,MEDICAL cooperation ,MEDICAL referrals ,QUALITY assurance ,QUESTIONNAIRES ,RESEARCH ,EVALUATION research - Abstract
Background: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitlist and triage" model known as STAT (Specific Timely Appointments for Triage) may be successful in reducing waiting times without adversely affecting other aspects of patient care. This trial aims to test whether the model is cost effective in reducing waiting time across multiple services, and to measure the impact on service provision, health-related quality of life and patient satisfaction.Methods/design: A stepped wedge cluster randomised controlled trial has been designed to evaluate the impact of the STAT model in 8 community health and outpatient services. The primary outcome will be waiting time from referral to first appointment. Secondary outcomes will be nature and quantity of service received (collected from all patients attending the service during the study period and health-related quality of life (AQOL-8D), patient satisfaction, health care utilisation and cost data (collected from a subgroup of patients at initial assessment and after 12 weeks). Data will be analysed with a multiple multi-level random-effects regression model that allows for cluster effects. An economic evaluation will be undertaken alongside the clinical trial.Discussion: This paper outlines the study protocol for a fully powered prospective stepped wedge cluster randomised controlled trial (SWCRCT) to establish whether the STAT model of access and triage can reduce waiting times applied across multiple settings, without increasing health service costs or adversely impacting on other aspects of patient care. If successful, it will provide evidence for the effectiveness of a practical model of access that can substantially reduce waiting time for outpatient and community services with subsequent benefits for both efficiency of health systems and patient care.Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12615001016527 . Approved 15/9/2015. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
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