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Population nutrition and the food environments in Aotearoa NZ: Sharing research findings and feeding new insights
No full textWhen retrofit programmes meet everyday life: A socio-technical evaluation of retrofit practices in Aotearoa New Zealand
No full textAotearoa New Zealand's ageing housing stock presents significant retrofit potential, with many homes remaining cold and damp despite government-funded programmes. While these initiatives address technical deficiencies, they often prioritise shallow measures, lack performance-based targets, and seldom reflect household needs and everyday practices. Conventional post-occupancy evaluations remain largely technocentric, focusing on energy and thermal indicators, whereas practice-based studies, though insightful, rarely translate findings into actionable improvements. This study addresses both gaps by testing how socio-technical evaluations, informed by social practice theory and participatory design, can strengthen the alignment between household practices and retrofit programmes.
Drawing on professional and householder perspectives from nine case study homes, the research applies a convergent triangulation approach combining indoor environmental monitoring, in-home interviews, and a participatory focus group. Findings show that while retrofits delivered material upgrades, most homes continued to experience substandard indoor temperatures and high humidity. Divergences between perceived and monitored data reflected coping behaviours, affordability constraints, and emotional responses shaping engagement with programmes and household practices. The triangulated analysis revealed how technical, social, and institutional misalignments, such as limited follow-up and weak supervision, undermined retrofit outcomes, while participatory engagement helped co-develop strategies addressing critical household practices, rules, and meanings affecting performance.
By embedding participatory methods within a socio-technical evaluation, the study demonstrates how diagnostic evidence can be translated into context-sensitive, co-developed improvement strategies. It advances practice-based retrofit research by integrating relational, organisational, and technical dimensions, offering a transferable framework for policy and programme design. Future research should extend this approach across housing sectors and governance settings
Rethinking the design of marine protected areas in coastal habitats
No full textThe number and size of marine protected areas (MPAs), implemented globally to protect coastal habitats from human pressures, is growing annually. Commercial and recreational fishing are a commonly recognised stressor in coastal habitats, but the impact of sound pollution is largely overlooked in MPA design. Coastal habitats are taxonomically diverse, and this diversity is commonly represented in the soundscape, with many coastal species relying on effective communication for vital life functions, including breeding, prey selection, and predator avoidance. Sound pollution can mask communication and cause behavioural and physiological effects. More research is required to understand the role of sound in marine ecosystems, including which species actively produce sound. In the interim, the effects of sound pollution on those species which have been studied, and the relative ease with which sound pollution can be mitigated, strongly supports addressing this stressor in the design and management of existing and future MPAs
Laparoscopic Versus Open Approach for Emergency Repair of Groin Hernias: A Systematic Review and Meta-Analysis
No full textBackgroundAlthough open repair has historically been the preferred approach over laparoscopic repair for acutely strangulated and incarcerated groin hernias, the laparoscopic approach is gaining popularity. This systematic review and meta-analysis aims to investigate the safety and clinical outcomes of laparoscopic and open groin hernia repair in the emergency setting.MethodsPubMed, Embase, Scopus, Cochrane Library, and Web of Science were systematically searched for articles comparing clinical outcomes between laparoscopic and open emergency groin hernia repair in adult patients. The primary outcome was the length of hospital stay. Secondary outcomes included operative time, postoperative complications, recurrence, reoperation, postoperative mortality, and the rate of conversion from laparoscopic to open repair. Risk of bias was assessed.ResultsThirteen articles (4 prospective and 9 retrospective cohort studies) were included, with a total of 38,659 patients enrolled. Laparoscopic repair resulted in shorter length of hospital stay (MD -2.96 days [95% CI -4.91, -1.01] and p = 0.0074) and lower risk of wound infection (RR 0.29 [95% CI 0.20, 0.43] and p ConclusionEmergency laparoscopic repair of groin hernias results in shorter length of hospital stay and lower risks of postoperative morbidity and mortality, with no difference in operative time when compared to open repair. Although further large-scale prospective cohort studies and randomized controlled trials may be required to draw definitive conclusionsregarding the optimal surgical approach, laparoscopic repair of groin hernias appears to be a safe and feasible alternative to conventional open repair in the acute setting
The Impact of Thriving at Work and Occupational Supports: Early Career Nurse Intentions to Leave an Organisation and Profession
No full textAimTo examine the direct and indirect predictors of thriving at work and its impact on intention to leave the organisation or profession among early career nurses.DesignA repeated cross-sectional design.MethodsA sub-study of early career nurses as part of an Australian longitudinal follow up study, commenced in 2018, was conducted. The sub-study asked early career nurses between their second and sixth year after graduating to complete a structured online questionnaire assessing thriving at work and several predictor variables. Data were analysed using Pearson's correlation, multiple linear regression, and path analysis.ResultsAmong the 67 participants (response rate of 42.9%), thriving at work was positively correlated with occupational hardiness, social support from colleagues, and wellbeing, while negatively correlated with compassion fatigue. Thriving at work and perceived organisational support were the significant predictors of intention to leave the organisation, while perceived organisational support was the only significant predictor of intention to leave the profession.ConclusionThe importance of strong collegial relationships, compassion fatigue, and improving wellbeing to enhance thriving at work are highlighted. Fostering an environment where employees can thrive is crucial to reduce the intentions to leave an organisation. Relationships with the managers and quality of care provision also play a crucial role in reducing turnover and leave intentions. Perceived organisational support enhances employee wellbeing, thereby reducing turnover intentions. Future strategies should focus on comprehensive support systems to retain nurses in their organisation and the profession.Implications for the professionEnhancing thriving at work and perceived organisational support can reduce early career nurses' intention to leave their organisation. However, job stressors and interpersonal conflicts also influence professional leave decisions.Reporting methodThis study has adhered to the STROBE guidelines.Patient or public contributionNo Patient or Public Contribution
A Platform for Large Scale Statistical Modelling Using R
No full textWith the growing scale of big data, fitting novel statistical models
on larger-than-memory datasets becomes correspondingly challenging.
A variety of techniques exist in an attempt to solve this problem in a
general case, with generally subpar results in practice among statisticians.
In the absence of a sound interface and conceptual structure for designing
statistical algorithms for large scale data, the large-scale statistical modelling
field has lacked the accessibility and results that it otherwise may
have possessed. This thesis outlines the development and use of a platform
created specifically for the development of statistical models for big
datasets. Requirements for such a platform are constructed and justified,
including a formally specified interface. The delivered platform satisfies
such requirements, and serves as a functioning example of what form a
large scale statistical modelling platform backed by sound conceptual
requirements may take
Reexamining the relationship between syntactic complexity and human judgment of EFL writing quality: the role of genre and rating levels
No full textSyntactic complexity constitutes a salient indicator of second language (L2) learners’ developmental progress and writing proficiency; however, empirical findings remain inconclusive, largely due to insufficient consideration of contextual variables such as genre and rating levels. The present study sought to elucidate the moderating effects of genre and rating levels on the predictive relationship between syntactic complexity and human evaluations of students’ English as a foreign language (EFL) writing quality. A convenience sample of 411 Chinese-speaking college English as a foreign language (EFL) learners was recruited from two colleges in Western China. They were asked to write an argumentative and a narrative essay, and syntactic complexity of their written productions were analyzed by the Tool for the Automatic Analysis of Syntactic Sophistication and Complexity. The results of ANOVA and Welch’s Test demonstrated statistically significant differences in syntactic complexity between argumentation and narration and also across three rating levels. Multiple group analysis showed syntactic complexity indices demonstrated different predictive influences on human ratings of EFL students’ argumentative and narrative essays across different rating levels and genres. The results of these analyses also revealed that genre and rating levels could moderate the above-mentioned predictive effects. These findings highlight the need to consider genre and proficiency levels in validating rating scales and rater training, and they underscore the potential role of syntactic complexity as an indicator in L2 writing assessment
Topical hydrogen peroxide versus fusidic acid for non-severe impetigo in Auckland, Aotearoa New Zealand (the TIARA trial): a single-blind, randomised controlled trial
No full textBackground:
Impetigo is a common skin disease affecting mostly children worldwide. Topical antibiotics are frequently prescribed for non-severe impetigo, but their use has been associated with antimicrobial resistance. We aimed to compare topical antibiotic fusidic acid with topical antiseptic hydrogen peroxide and with simple wound hygiene in management of impetigo lesions in school-aged children in a low socioeconomic, urban setting.
Methods:
This community-based, single-blind, non-inferiority, randomised controlled trial enrolled children aged 5–13 years. Children with non-severe impetigo were recruited from school health clinics across 51 school sites in Auckland, Aotearoa New Zealand. Children were excluded if they required systemic antibiotics, were immunocompromised, had known allergy to study medication, or current or recent use of antimicrobials. Children were block randomised (1:1:1) to receive topical fusidic acid, topical hydrogen peroxide, or wound hygiene. Each management strategy was used for any impetigo lesions identified at the time of study entry twice daily for 5 days. Investigators were masked to allocation; however, children and nurses were not due to the appearance differences between treatments. Digital images of impetigo lesions were taken on days 0 and 7 and graded by reviewers, masked to treatment allocation. The primary outcome was treatment success defined by improvement on digital image assessed by masked review at day 7 for the analysis population with a 10% non-inferiority margin. This trial is registered with Australian New Zealand Clinical Trials Registry (12616000356460) and is complete.
Findings:
Between June 2, 2017, and March 18, 2020, 505 children were enrolled and randomly assigned to treatment, of whom 400 were included in the analysis population: fusidic acid (n=157), hydrogen peroxide (n=169), or wound hygiene alone (n=74; an interim safety analysis led to early termination of recruitment in the wound hygiene group). The mean age was 8·4 years (SD 2·1), 175 (44%) of 400 were female and 225 (56%) were male, and ethnicities included children of Māori (117 [29%]), Pacific (256 [64%]), and Aotearoa New Zealand European or other (20 [5%]). Fusidic acid was successful in 132 (84%) of 157 children, hydrogen peroxide successful in 134 (79%) of 169, and wound hygiene successful in 48 (65%) of 74. Overall, hydrogen peroxide did not show non-inferiority compared with fusidic acid; that is, hydrogen peroxide was not as effective (absolute difference –4·8% [90% CI –11·8 to 2·3]). Wound hygiene alone did not show non-inferiority (absolute difference –19·2% [90% CI –29·2 to –9·2). One adverse event of mild erythema was reported with hydrogen peroxide; no systemic adverse events were reported.
Interpretation:
Topical hydrogen peroxide was not non-inferior to topical fusidic acid for treatment of non-severe impetigo. However, as these infections are mild and the difference in cure rate is small, when balanced with the potential benefits of lessening antimicrobial resistance, topical hydrogen peroxide use in non-severe impetigo management remains reasonable. Children and families should be provided with appropriate advice regarding review for non-resolving or deteriorating lesions.
Funding:
Cure Kids New Zealand, Auckland District Health Board Charitable Trust (A+ Trust), Tupu Research Grant, Ko Awatea, The New Zealand Wound Care Society, the Joan Mary Reynolds Charitable Trust, the Starship Foundation, and the Health Research Council of New Zealand
Interconnected pathways link faecal microbiota plasma lipids and brain activity to childhood malnutrition related cognition
No full textMalnutrition affects over 30 million children annually and has profound immediate and enduring repercussions. Survivors often suffer lasting neurocognitive consequences that impact academic performance and socioeconomic outcomes. Mechanistic understanding of the emergence of these consequences is poorly understood. Using multi-system SHAP interpreted random forest models and network analysis, we show that Moderate Acute Malnutrition (MAM) associates with enrichment of faecal Rothia mucilaginosa, Streptococcus salivarius and depletion of Bacteroides fragilis in a cohort of one-year-old children in Dhaka, Bangladesh. These microbiome changes form interconnected pathways that involve reduced plasma odd-chain fatty acid levels, decreased gamma and beta electroencephalogram power in temporal and frontal brain regions, and reduced vocalization. These findings support the hypothesis that prolonged colonization by oral commensal species delay gut microbiome and brain development. While causal links require empirical validation, this study provides insights to improve interventions targeting MAM-associated neurodevelopmental deficits
Advancing Equity and Leadership for Māori Registered Nurses in Aotearoa New Zealand: Elements for Success
No full textAim: Māori (Indigenous peoples of Aotearoa New Zealand (Aotearoa NZ)) nurses play a crucial role in the delivery of healthcare services in Aotearoa NZ, yet their representation in leadership remains disproportionately low. This PhD explores Māori nurse workforce sustainability and leadership capacity. This study aims to provide actionable insights to promote equitable workplace environments and leadership opportunities for Māori registered nurses (RNs). Māori nurse leadership is essential for addressing health disparities and promoting a more inclusive and effective healthcare system in Aotearoa NZ.
Methods: This research is by Māori, for Māori, with Māori, employing a Kaupapa Māori (Māori way) methodological approach with constructivist narrative inquiry. Semi-structured interviews and focus groups were conducted with Māori RNs and tauira (Māori student nurses) to explore their experiences and insights regarding nursing education, workforce sustainability, and Māori in leadership roles. Researcher conduct was guided in tikanga Māori (Māori customs) by a Māori Advisory Komiti (committee).
Findings: This study identified four key areas that impact Māori nurse workforce sustainability and leadership capacity. The findings highlight the significance of acknowledging self-worth, overcoming inequity, growing our workforce, and embodying leadership. Māori nurses possess unique leadership qualities which allow them to effectively advocate for the well-being of the Māori community while navigating mainstream services. This demands a strong identity, cultivated resilience, upholding kawa whakaruruhau (cultural safety for Māori), accessibility to replenishing wairua (spiritual essence), and cultural recognition within the health sector. The ‘Ngā Kaiārahi - Māori nurses leading the way to better health outcomes’ framework was co-created to facilitate Māori nurses in their journey to reclaim Māori health.
Conclusion: Aligning the Māori nurse workforce with the population and fostering Māori nurse leadership is vital for driving transformative change within the health sector. This research highlights the necessity of implementing strategies to enhance Māori nurse workforce sustainability and leadership capacity. The ‘Ngā Kaiārahi’ framework reflects participant perspectives and offers recommendations for attaining nurse workforce equity and supporting Māori nurse leaders in their commitment to improving Māori health in Aotearoa NZ. This framework has potential to be adapted and implemented by Indigenous nations globally in the pursuit of health equity