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In 2021 Professor Papaarangi Reidi, at The University of Melbourne, shared the ancient proverb "I nga ra o mua", translated to mean "before we know where we are going, we must know where we have come from". This proverb sets the tone for discussing the Arts in the New Zealand curriculum, as during radical upheaval and social change as being experienced in the pandemic, we are forced to examine activities to reflect and discover anew the road ahead (Lindley, et al., 2021; Wood, et al., 2021). This is a critical inflection point for redefining the future of New Zealand Arts Education, as it coincides with the current New Zealand Curriculum (Ministry of Education [MoE], 2007) refresh (MoE, 2021). This research informed paper advocates for matauranga Maori and te ao Maori in the Arts curriculum to ensure distinctive, bold transformational learning opportunities are experienced by learners within the education system. This article suggests the values of interconnectedness, intergenerational purpose and improvisation can dismantle disciplinary boundaries and offer a critical frame to reconsider a forward-focused Arts curriculum.

There is a conflict between the claims of Maori sovereignty and the imposition of State legislation on Maori children. This conflict of interest has been given very little consideration in the public sphere. This research-informed article speculates that despite legislation ensuring that education attendance is fixed as a legal obligation for all Primary and Secondary aged children, there is urgency to address if conceivably this is a deeply flawed assumption as it contradicts notions of tribal sovereignty. Cautiously, this article does not romanticise past positioning of Maori peoples, nor makes claims to indigenous righteousness, rather moves to suggest that State-led education belongs part of positive outcomes for Maori, however there must be negotiation to the terms and expectations for education attendance. This paper is a catalyst for future orientated discussion aiming to broaden what education can move to become in Aotearoa, New Zealand.

Background: The experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents of children with developmental disabilities (DDs) in health and early learning systems are largely understudied. Inclusive, affirming services are critical to timely identification and intervention for DDs. This literature review aimed to establish whether LGBTQ parents experience structural bias and discrimination when accessing care for their children in health and early learning systems. Methods: PubMed, ERIC, and Scopus were searched for empirical research from 1990 to 2020 on: LGBTQ; parents, children, families; bias, disparities, discrimination; and health and early learning services. Themes were analyzed by conceptual model bias levels, participant type, and setting. Results: The search yielded 1,872 unduplicated records (three through hand search). Twenty-nine articles representing 26 studies in health and early learning in eight countries met the inclusion criteria. Biases common across sectors included challenges surrounding LGBTQ status disclosures; lack of acknowledgment of non-biological parents; and heterosexist forms. Knowledge gaps and negative attitudes about LGBTQ families were found among some professionals and students. Conclusion: Some LGBTQ parents experienced bias and discrimination while accessing care for their children in health and early learning systems. Policies and programs to implement and monitor LGBTQ-inclusive health education and evaluate practice changes are recommended to improve professionals' knowledge, attitudes, and behavior. Multilevel workforce development (e.g., accreditation standards, organizational audits, and training) is needed to create and sustain LGBTQ-affirming health and education environments. Honoring LGBTQ family diversity and reducing health and early learning inequities are critical for improving children's health and education outcomes.

Academics in Physical Education Teacher Education (PETE), similar to their counterparts in other disciplines, receive little formal preparation when they take on academic leadership positions. Yet such career changes require different skill sets and expose academics to complex challenges of leadership. We (three academics) initiated this study to explore the implications of academic leadership positions for our PETE identities. We wished to unpack the consequences of taking on these leadership roles, or our 'desire to become more' and 'to better understand' (Ovens, A., & Fletcher, T. (2014). Doing self-study: The art of turning inquiry on yourself. In A. Ovens & T. Fletcher (Eds.), "Self-study in physical education teacher education: Exploring the interplay of practice and scholarship" (Vol. 13, pp. 3-14). London: Springer, p. 7). This research used a collective self-study methodology and drew on Skype meetings, reflections, critical friend prompts and emails. We present our findings as coming to view identity changes as tensions: bridging between roles; competing identities; identity as stable or malleable; and educator or fiscal manager. Gee's four identity perspectives including natural, institutional, discursive and affinity are used to unpack these tensions. While challenges associated with our role change persist, collective S-STEP was critical to understanding ourselves, the tensions experienced, and navigating the gaps between PETE and academic leadership.

Due to recent legal cases highlighting a lack of cross-ethnicity validity research using correctional risk assessment tools, we evaluated psychometric properties of Dynamic Risk Assessment for Offender Re-entry (DRAOR) scores across Māori (n = 1,812) and New Zealand (NZ) European samples (n = 1,211) in Aotearoa NZ. Using routine administrative data, our analyses suggested scoring properties were invariant across ethnicity for 15 of 19 items. Discrimination properties were also equivalent, but we observed a higher recidivism base rate among Māori participants, consistent with official statistics. Consequently, calibration analyses using a fixed follow-up (N = 372) demonstrated higher predicted recidivism rates for Māori participants at each DRAOR score. This suggests that Māori participants with similar levels of DRAOR-assessed need factors as NZ European participants experienced relatively greater continued justice contact. DRAOR users should prioritize delivering quality case management to clients, recognizing that both case-specific and systemic factors may underlie differential base rates. [ABSTRACT FROM AUTHOR]

Communicating recidivism risk is individualized to each assessment. Labels (e.g., high, low) have no standardized meaning. In 2017, the Council of State Governments Justice Center (CSGJC) proposed a framework for standardized communication, but balancing the framework's underlying principles of effective risk communication (and merging static and dynamic information) adds complexity. In this study, we incorporated dynamic risk scores that case managers rated among a routine sample of adults on parole in New Zealand (N = 440) with static risk scores into the Five-Level Risk and Needs System. Compared with static risk only, merging tools (a) enhanced concordance with the recidivism rates proposed by CSGJC for average and lower-risk individuals, (b) diminished concordance for higher-risk individuals, yet (c) improved conceptual alignment with the criminogenic needs domain of the system. This example highlights the importance of attending to the underlying principles of effective risk communication that motivated the development of the system. [ABSTRACT FROM AUTHOR]

Background: Almost 20 000 people undergo an emergency laparotomy each year in New Zealand and Australia. Common indications include small and large bowel obstruction, and intestinal perforation. Considered a high‐risk procedure, emergency laparotomy is associated with significantly high morbidity and mortality. The aim of this review was to identify and compare 30‐day, 90‐day and 1‐year mortality rates following emergency laparotomy in New Zealand and Australia. Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Electronic searches were performed in Medline, Embase, PubMed and Scopus in April 2020. Results: Thirty‐three papers met the inclusion criteria. Studies ranged in size from 58 to 75 280 patients. Weighted mean 30‐day mortality was 8.40% (8.39–8.41). Mortality rates increased with longer postoperative follow up with 90‐day weighted mortality rate of 14.14% (14.13–14.15) and the weighted mortality rate at 1 year of 24.60% (24.56–24.66). There was significant variability in mortality rates between countries. Conclusion: There is a wide variability of 30‐day, 90‐day and 1‐year mortality rates internationally. Lowering postoperative mortality rates following emergency laparotomy through quality improvement initiatives could result in up to 120 lives in New Zealand and over 250 lives in Australia being saved each year. The continued work of the Australian and New Zealand Emergency Laparotomy Audit – Quality Improvement is crucial to improving emergency laparotomy mortality rates further in New Zealand and Australia. [ABSTRACT FROM AUTHOR]

The New Zealand Intensive Medicines Monitoring Programme (IMMP) undertakes prospective observational cohort studies on selected new drugs in the early postmarketing period using prescription-event monitoring (PEM) methodology with the purpose of identifying signals of previously unrecognised ADRs and establishing risk profiles for each drug. Events are reviewed by a physician and a relationship is established between each event and the drug. The events are then sorted into reactions and incidents. The latter are used to assist signal detection and control for bias. Rates for reports, reactions and incidents are used to assess the adequacy of reporting, signal detection and identification of confounders. Most signals are identified by clinical evaluation of the reports at a stage when statistical analyses are unlikely to have the power to detect them with confidence. The incident group is used for signal detection and controlling for bias. A low reporting rate indicates that certain types of event are unlikely to be reported. A systematic review of the original case reports at the site of collection provides the best opportunity for early signal detection. More resources need to be invested in the training and support of clinical evaluators. Categorising events into reactions and incidents gives added value to the data. Rates of reporting should be quoted with the results of cohort studies to facilitate assessment of their power to detect new signals. [ABSTRACT FROM AUTHOR]

Background There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before these DRPs can lead to patient harm. Objective To identify the types and quantities of DRPs that community pharmacies detect within a single district health board (DHB) in New Zealand. Setting One DHB in New Zealand that contains 50 community pharmacies, which receive discharge prescriptions from two local hospitals. Method All community pharmacies in the DHB area (n = 50) were invited to participate in the 2 week study which involved documenting the number of hospital discharge prescriptions received, and then the number and type of DRPs identified and what interventions were required. Main outcome measure The number and type of DRPs identified as a proportion of all discharge prescriptions received during the 2 week study period. Results Initially a total of 38 pharmacies agreed to participate in this study, however only 32 pharmacies provided data for the entire 2 week period. Over a 2 week period a total of 1,374 hospital discharge prescriptions were presented to these pharmacies. From these prescriptions 344 (25 %) required further action to be taken by the pharmacist. These 344 prescriptions consisted of a total of 396 individual DRPs. Actions classified as 'Supply and/or Funding' accounted for 43 % (171), which represented the largest class of all actions required from hospital discharge prescriptions. This class consisted of 'Special Authority' problems, medications not being available, non-subsidised items on the prescription and other supply/funding problems. 'Errors' accounted for 38 % (151) which included errors of omission (20 %) and errors of commission (18 %). Conclusion This study found a significant number of DRPs identified by community pharmacists on hospital discharge prescriptions. These included missing and incorrect information which required clarification with prescribers. Interventions need to be put in place to reduce the number of errors and improve clarity of hospital discharge prescriptions. Better information sharing and understanding of medications available in primary care will reduce the potential for DRPs. [ABSTRACT FROM AUTHOR]

Background: Successful observation of behaviour depends upon knowing both which behaviours to look for and focusing on the appropriate areas of the body to observe them. Behaviour based scoring systems have become increasingly widely used to assess animal pain and distress. Although studies are available demonstrating which behaviours need to be observed, there has been little attempt to assess how effectively observers apply such information when viewing an animal's behaviour. Methodology/Principal Findings: This study used historical video recordings of New Zealand white rabbits (Oryctolagus cuniculi) considered to be experiencing varying degrees of post-operative pain to assess the pattern of observation and the ability to assess pain exhibited by both experienced and inexperienced human participants (n = 151). Eye tracking equipment was used to identify how quickly, how frequently, for how long different areas of the rabbit's body were attended to by the participants. Simple visual analgoue scoring was used to assess the pain experienced in each sequence. The results demonstrate that irrespective of their experience or gender, observers focus first, more frequently and for longer on the face, compared to the abdomen, ears, back and hindquarters of the rabbit and that participants were poor at identifying rabbits in pain. Observing the back and hindquarters was correlated with 'correct' assessments and observing the face was correlated with 'incorrect' assessments. Conclusions: In conclusion, irrespective of experience and gender, observers focused on the face when using behaviour to assess pain and were unable to effectively identify rabbits in pain. Focusing on the face is unlikely to be effective when using behavioural indicators of pain since they involve other body areas. Alternatively, if animals exhibit pain-related facial expressions, then it could improve our ability to assess pain. In addition, these results have potential implications for the use of behaviour to assess how rabbits and potentially other species feel. [ABSTRACT FROM AUTHOR]

To demonstrate how the Intensive Medicines Monitoring Programme (IMMP) can be used to monitor adverse events associated with an intrauterine device, using the levonorgestrel-releasing intrauterine device (Mirena) as an example. A long-term prospective observational cohort study using Prescription Event Monitoring (PEM) is currently being undertaken in women using Mirena in New Zealand. This report describes the method used and reports the early results for those women who used the device between March 1998 and March 2001. Adverse events were recorded by inserting doctors and general practitioners on registration forms and systematic follow-up questionnaires. Between March 1998 and March 2001, the IMMP received 3519 registration forms for insertions in 3452 women. ‘Difficult insertion’ was the most frequently reported event (3.6% of all insertions). Approximately, 2% of the Mirena insertions were carried out under GA and there were three uterine perforations (0.9 per 1000 insertions) in the total cohort. To date, follow-up questionnaires have been processed for 495 patients. The response rate for these was 83%. As adapted in the IMMP, PEM is an effective tool for the early post-marketing surveillance of an intrauterine device in real life clinical practice. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Examines notifications of eye pain and blurred vision associated with nifedipine treatment in the Intensive Medicines Monitoring Programme in New Zealand. Assessment of treatment types; Possibility of glaucoma as an adverse reaction; Evidence of a method evaluating early signs of adverse drug reactions.

Examines the association of cough with captropil and enalapril in New Zealand. Specialization of the intensive medicines monitoring program for postmarketing surveillance system; Analysis of cough as an adverse reaction to the drugs; Lack of evidence on the pathogenesis of drug reaction.

A letter to the editor is presented which discusses Y-score as a tool for the Short Messaging Applied Coma Calculation (SMACC) assessment of the Fixated On A Mobile (FOAM) patient.

Aims Because of the importance of treating dyslipidaemia in the prevention of ischaemic heart disease and because patient selection criteria and outcomes in clinical trials do not necessarily reflect what happens in normal clinical practice, we compared outcomes from bezafibrate, gemfibrozil and simvastatin therapy under conditions of normal use. Methods A random sample of 200 patients was selected from the New Zealand Intensive Medicines Monitoring Programme’s (IMMP) patient cohorts for each drug. Questionnaires sent to prescribers requested information on indications, risk factors for ischaemic heart disease, lipid profiles with changes during treatment and reasons for stopping therapy. Results 80% of prescribers replied and 83% of these contained useful information. The three groups were similar for age, sex and geographical region, but significantly more patients on bezafibrate had diabetes and/or hypertension than those on gemfibrozil or simvastatin. After treatment and taking the initial measure into account, the changes in serum lipid values were consistent with those generally observed, but with gemfibrozil being significantly less effective than expected. More patients (15.8%) stopped gemfibrozil because of an inadequate response compared with bezafibrate (5.4%) and simvastatin (1.6%). Gemfibrozil treatment was also withdrawn significantly more frequently due to a possible adverse reaction compared with the other two drugs. Conclusions In normal clinical practice in New Zealand gemfibrozil appears less effective and more frequently causes adverse effects leading to withdrawal of treatment than either bezafibrate or simvastatin. [ABSTRACT FROM AUTHOR]

Insertion of Multiload Cu375 was studied in 16,159 women in a 10-year prospective observational cohort study in New Zealand. Of 17,468 insertions, about 9% were performed in nulliparous women.Problems fitting Multiload Cu375 (e.g., failed or difficult insertion) were experienced during approximately 2% of all insertions. The incidence of these was significantly higher in nulliparous women compared to parous women. Adverse reactions to insertion (e.g., pain, bleeding) occurred in 1.2% of all insertions, with nulliparous women experiencing significantly more adverse reactions than parous women.The insertions were performed by 1,700 different doctors in New Zealand with general practitioners performing 92% of these. Doctors who reported inserting over 100 devices in the study period experienced significantly less insertion problems than doctors who reported inserting less than 10 devices.This study suggests that insertion of Multiload Cu375 in a mixed community setting is associated with few inserting problems and adverse reactions to insertion. Risk factors identified for inserting problems included nulliparity and experience of the doctor inserting the intrauterine device. [Copyright &y& Elsevier]

Abstract: The Burkholderia cepacia complex (Bcc) is a group of significant opportunistic respiratory pathogens which affect people with cystic fibrosis. In this study, we sought to ascertain the epidemiology and geographic species distribution of 116 Bcc isolates collected from people with CF in Australia and New Zealand. We performed a combination of recA-based PCR, amplified rDNA restriction analysis (ARDRA), pulsed-field gel electrophoresis and repetitive extragenic palindromic PCR on each isolate. Each Burkholderia cenocepacia isolate was also screened by PCR for the presence of the B. cepacia epidemic strain marker. One hundred and fourteen isolates were assigned to a species using recA-based PCR and ARDRA. B. cenocepacia, B. multivorans and B. cepacia accounted for 45.7%, 29.3% and 11.2% of the isolates, respectively. Strain analysis of B. cenocepacia revealed that 85.3% of the isolates were unrelated. One related B. cenocepacia strain was identified amongst 15 people. Whilst full details of person-to-person contact was not available, all patients attended CF centres in Queensland (Qld) and New South Wales (NSW). Although person-to-person transmission of B. cenocepacia strains has occurred in Australia, the majority of CF-related Bcc infections in Australia and New Zealand are most likely acquired from the environment. [Copyright &y& Elsevier]