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Item Essays on corporate social responsibility : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Finance, School of Accountancy, Economics and Finance, Massey University(Massey University, 2025-09-18) Zhang, XiaochiThis thesis comprises three essays advancing the literature on workplace safety, an important component of corporate social responsibility. The first essay examines how generalist CEOs with transferable managerial skills enhance workplace safety. These executives improve safety by optimizing labor investments, reducing employee workloads, and ensuring higher information quality. The relation is more pronounced among firms facing financing constraints or intense market competition. The study also shows that workplace injuries and illnesses reduce innovation, productivity, and firm value. The second essay explores the impact of shareholder distraction on workplace safety. Distracted shareholders are linked to higher rates of work-related injuries, especially in firms with weak governance and high competition risks. Our findings suggest that reduced monitoring by distracted shareholders leads to lower safety investments, increased workloads, and greater earnings management, resulting in a poorer safety environment. The third essay investigates how the inclusion of general counsel in top management improves employee safety. Firms with general counsel in senior leadership are associated with lower injury and illness rates. The relation is more pronounced for firms with better information quality, more efficient labor investment, leadership by lawyer CEOs, weaker governance structures, and heightened agency problems. Overall, these essays provide new insights into how corporate leadership and governance influence workplace safety. The thesis offers contributions to the literature on workplace safety by addressing critical gaps in existing research. This work extends theoretical frameworks such as upper echelon theory by applying it to the domain of workplace safety. It also underscores the practical implications of aligning leadership capabilities and governance mechanisms to safeguard human capital, ultimately driving sustainable firm performance.Item Applying structured decision making for large-scale wildlife management programmes : Project Janszoon as a case study : a thesis presented in partial fulfilment for the degree of Doctor of Philosophy in Conservation Biology at Massey University, Palmerston North, New Zealand(Massey University, 2024-11-30) Kenup, CaioManaging threatened populations is challenging due to the delicate balance between urgency and uncertainty. While swift action is often needed to prevent further decline or extinction, significant uncertainty frequently surrounds the effectiveness of various management strategies and the future trajectory of populations. This uncertainty complicates the identification of the most effective course of action, especially when resources are limited. Structured decision making (SDM) is an approach that supports informed decision making in the face of uncertainty in conservation projects. The primary aim of this thesis is to develop a decision making framework for Project Janszoon’s bird translocations, guiding management and monitoring decisions to maximise establishment and persistence probabilities for the kākā (Nestor meridionalis) and pāteke (Anas chlorotis). This framework can serve as a blueprint for implementing SDM and adaptive management (AM), promoting their broader use in conservation initiatives within New Zealand and beyond. In Chapter 2, I discuss expert elicitation techniques for generating predictions from expert knowledge while accounting for epistemic uncertainty. Numerical improvements in handling elicited data are proposed, focusing on aggregating and transforming expert-provided values while maintaining their associated uncertainty. Preserving this uncertainty is critical to avoid generating overconfident predictions from expert judgment. In Chapter 3, I explore which uncertainties are worth reducing and to what degree. Value of information (VOI) analysis offers a way to understand how reducing uncertainty affects decision making and conservation outcomes. A key insight from this chapter is that while monitoring is valuable for reducing uncertainty, such reductions do not always improve conservation outcomes. Beyond a certain point, further reductions in uncertainty do not alter decision making. Practitioners must estimate the optimal level of monitoring for each conservation challenge. In Chapter 4, I outline a passive adaptive management framework to reduce uncertainty as management actions are implemented and monitored. The framework’s extendable nature makes it adaptable to other management problems. The tools and concepts presented here are valuable assets for effective decision making for managed populations under uncertainty.Item A novel decision support framework for building refurbishment towards zero carbon emissions(Elsevier Ltd, 2025-11-15) Bui TTP; Wilkinson S; Domingo N; MacGregor CThe refurbishment of existing buildings is vital to maximise carbon emissions reduction and alleviate the impacts of climate change. While various decision support frameworks for building refurbishment exist. There is a notable gap in the availability of comprehensive frameworks that combine diverse methods, tools, and systems to support decision-making aimed at reducing whole-of-life carbon emissions. This paper brings together the development and validation processes of a novel early-stage decision support framework for building refurbishment towards zero carbon emissions in New Zealand (RefurbZC). The development of the framework was based on the critical analysis and interpretation of the literature review, preliminary study, and case study of university buildings in New Zealand, which integrate international best practices adopted to the local context and lessons learnt from real-life case studies. The framework was validated and refined using a focus group workshop with New Zealand building experts involved in the refurbishment process. The new RefurbZC provides a better detailed guideline to use in the early stages of the refurbishment process, focusing on maximising whole-of-life carbon reduction. It helps to understand the refurbishment decision-making process, identify areas for integrating carbon-reduction initiatives, determine key factors and actors in driving carbon-reduction solutions, and promote stakeholder collaboration and integration in carbon-reduction building refurbishment. The presented framework contributes extensively to theoretical and practical knowledge of building refurbishment towards zero carbon emissions and offers a basis and foundation for future work in this research area.Item A framework for enhanced decision making in construction organisations based on quality of pipeline information : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy, School of Built Environment, Massey University, New Zealand(Massey University, 2025-08-25) Moshood, Taofeeq DurojayeThe New Zealand government actively pursues the development of a sustainable construction sector that ensures high performance, productivity, innovation, and community well-being through diverse project initiatives spanning residential, non-residential, and infrastructure development. Despite these aspirations, construction projects in New Zealand are frequently delayed and not effectively completed, thus leading to underperformance. Two critical factors contributing to project delays and suboptimal outcomes are inadequate quality of information and ineffective strategic decision-making processes. Formulating effective strategic decisions is a fundamental challenge for construction organisations, significantly impacting their overall strategic goals and operational success. While information management and decision execution are widely recognised as crucial elements in organisational strategy, there remains a notable gap in understanding the intricate relationship between the quality of information and strategic decision-making, particularly within the context of construction business performance. This research addresses this critical knowledge gap by identifying the determinants for successful construction business performance. It investigates the mediating role of quality of information in the relationship between strategic decision-making and the performance of construction businesses in New Zealand. The study employs a comprehensive methodological approach combining systematic literature review, quantitative analysis, and stakeholder validation to develop a robust understanding of these complex relationships. The systematic literature review focused specifically on identifying critical determinants for successful construction business performance in New Zealand, utilising the ATLAS.ti 9 tool for analysis. This comprehensive review highlighted the fundamental role of the quality of information in strategic decision-making processes and its subsequent impact on organisational performance. This systematic analysis led to the development of a conceptual framework and associated hypotheses establishing the relationships between these factors and their impact on strategic decision-making, information quality, and construction business performance. A quantitative survey was conducted with 102 respondents, and the sample size was determined using G*Power analysis to ensure statistical validity. The study examined how strategic decision-making and information quality influence construction business performance in New Zealand. The research method that was employed integrated established theoretical models and employed Partial Least Squares Structural Equation Modelling (PLS-SEM) using SmartPLS4 software. This analytical approach allowed for robust testing of both direct relationships between variables and the mediating effect of information quality on the relationship between strategic management practices and business performance outcomes. The findings revealed a strong positive correlation between strategic decision-making management and construction business performance, with quality of information serving as a crucial mediating factor. A key research component involved validating the proposed strategic decision-making process framework for its sufficiency, clarity, coherence, relevance, and applicability in New Zealand construction organisations. This validation process included in-depth interviews with six industry experts representing various organisational approaches to strategic decision-making. Their responses revealed a spectrum of techniques ranging from highly structured to more informal methodologies, providing valuable insights into the practical application of strategic decision-making frameworks in different organisational contexts. The research outcomes significantly contribute to theoretical understanding and practical application in the construction industry. Establishing clear criteria for successful quality of information and identifying critical factors affecting project implementation success, this study offers valuable guidance for improving practices within the construction sector. The findings emphasise the crucial importance of prioritising both the quality of information and strategic decision-making to effectively lessen project delays and optimise overall performance in the construction sector. Furthermore, the research contributes to developing more effective strategic decision-making processes by highlighting the interconnected nature of the quality of information and strategic planning. The validated framework provides construction organisations with a practical tool for enhancing their strategic decision-making capabilities while considering the critical role of quality of information in achieving successful outcomes. This study's findings have significant implications for construction industry stakeholders, such as project managers, organisational leaders, and policymakers. The research demonstrates that improving the quality of information and strategic decision-making processes can enhance project outcomes and overall organisational performance. The validated framework offers a structured approach for organisations to assess and improve their current practices while considering their unique operational contexts and requirements.Item Healthcare assistant decision-making and information behaviour in long-term care settings : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, Palmerston North, New Zealand(Massey University, 2025-08-21) Burrow, MarlaHealthcare assistants (HCAs) are an unregulated workforce who provide most of the care to those living in Aged Residential Care (ARC) in Aotearoa New Zealand. Despite being the essential workforce for the aged care sector, there is a paucity of literature regarding how healthcare assistants make decisions in their everyday work. Increased demand for aged care and health workforce shortages have led to HCAs often working under pressure and required to make decisions about all manner of care. This study explores the direct care decision-making of HCAs. Critical ethnography underpinned by Elfreda Chatman’s small world theory informed data collection. Direct observations and semi-structured interviews provided data on participant characteristics, decision types, the decision-making environment and information landscape. Experimental vignettes explored decision-making in uncertainty by progressively manipulating three dimensions of knowing: knowledge of the environment of care, knowledge of the resident (familiarity), and knowledge as (HCA) experience. Small world and decision-making theories framed data analysis. Decisions were conceptualised as decision schemas associated with specific care actions. Routine, easy and more difficult decisions were identified. Decisions were influenced by the institutional schedule, availability of resources, and the rules of work. Resident attributes, HCA traits, and task prioritisation influenced how decisions were actioned. Frequent informal handovers between HCAs supported situational awareness of resident and communal care demands. Vignette data provided two compelling findings: the more uncertainty, the higher the frequency of advice sought from an experienced HCA, and HCAs took an active role in assimilating new residents into institutional care routines. Models are offered conceptualising the interplay of tensions, certainty, uncertainty and risk with the constructs, attributes and traits used to frame decisions. Professional implications are related to the provision of safe care to residents and the support of HCAs. Study findings clarified opportunities for the co-creation of strategies to address concerns and better advocate for residents. Nurse educators/managers and registered nurses can support HCAs by sharing information considered to be of relevance to the work and decisions they make. Study findings further highlighted the influence of institutional routines and the value HCAs placed on information held by experienced HCAs.Item Prioritising indicators of success in 'Build Back Better' post-disaster frameworks : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Construction at Massey University, Albany, New Zealand(Massey University, 2025-07-30) Hubbard, FrancisThis study explores the challenges and significance of indicator selection for key decision-makers in post-disaster response, recovery, and reconstruction efforts. When a community is overwhelmed in the aftermath of a disaster - various entities, including aid organisations, local authorities, and national agencies, are mobilised to provide emergency response and support in the subsequent response and recovery phases. These decision-makers rely on choosing appropriate indicators to evaluate the effectiveness of their interventions, track progress, and decide on appropriate actions and activities. Guided by the principle of "Build Back Better," which advocates for a comprehensive and holistic approach to resilience, practitioners need to comprehend the intricate relationships and dependencies among indicators to make informed decisions regarding their selection. This aspect has been identified as a significant weakness in the implementation process for all stakeholders. Employing a novel methodology, this thesis utilises the Hierarchical Decomposition Algorithm to analyse the priority of and the relationship between indicators proposed by the 2016 ‘Build Back Better Framework’, a synthesised framework reflecting a unified approach in disaster management. Empirical evidence from forty case studies examining key decision makers experiences of implementing disaster response efforts validates these findings. The study concludes with a rational process and workflow for determining indicator selection which considers the diverse nature of response and recovery in the pursuit to effectively build back better.Item A culture-centered exploration of India’s Community Health Workers’ meanings of the COVID-19 pandemic and the role of mobile technology in response strategies : a thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in Communication and Journalism at Massey University, Te Kunenga ki Pūrehuroa, Center for Culture-Centered Approach to Research and Evaluation (CARE)(Massey University, 2025-01-20) Pattanaik, SamikshaDuring the COVID-19 pandemic, Community Health Workers (CHWs), particularly in developing countries such as India, played a crucial role in controlling the virus's spread (Niyati & Nelson Mandela, 2020). India imposed the world’s largest lockdown (Ghosh, 2020; Mathur, 2020), swiftly deploying its CHWs known as ASHA workers for community-level COVID-19 prevention and mitigation (Niyati & Nelson Mandela, 2020). Reports indicated that ASHAs in some states were required to purchase and use smartphones for COVID-19 tasks (Brar Singh, 2020; Hindustan Times, 2020b). This top-down approach to pandemic communication and mHealth initiatives (M. J. Dutta, S. Kaur-Gill, et al., 2018; Kumar & Anderson, 2015) sidelined ASHAs' their voices in mainstream discourse, despite their essential role. Furthermore, while existing research in this area has identified the structural challenges faced by ASHAs—such as overwhelming workloads and inadequate compensation—these studies often treat these challenges in a reductionist manner (Lazarus, 2020; Nichols et al., 2022; Srivastava, 2021), often from the perspective of the researcher. This marginalisation of ASHAs' voices is particularly concerning in the context of public health emergencies, where they are thrust into frontline roles without adequate infrastructural and policy support. This thesis addresses this significant gap in research by foregrounding their voices and lived experiences as frontline workers during the COVID-19 pandemic. Drawing on the Culture Centered Approach (CCA), a meta-theoretical framework particularly suited for research in marginalised settings, this study uses semi-structured interviews to explore ASHAs’ narratives, shedding light on how they navigated the pandemic and engaged with mHealth initiatives. The study finds that ASHAs operate within intersecting layers of structural inequalities shaped by their socio-economic context and the neoliberal organisation of India’s healthcare system. This system reduces these marginalised female workers to ‘efficient’ subjects, using their labour to offload state responsibilities while offering minimal support and compensation. Through this analysis, the research advances the theoretical framework of the CCA by deepening the understanding of the layering of structures upon structures and their simultaneous interaction with culture. While existing CCA literature addresses the structure culture dynamic, this study uniquely highlights how these layered structures intersect, reinforce, and sometimes contradict each other, intensifying marginalisation. In the context of mHealth, the study uncovers the complex, multifaceted, and sometimes contradictory meanings of technology in marginalised spaces, ranging from the relevance of face-to-face communication and bottom-up uses of technology in rural healthcare, to issues surrounding data privacy, confidentiality, and digital burden in marginalised spaces. By placing these evolving and often contradictory meanings at the center of theorising, this research challenges techno-optimism and prompts a critical re-evaluation of the role of technology in healthcare delivery, with mHealth as a key example. Additionally, this study extends the concept of marginalised agency within the CCA by shifting away from binary understandings of resistance and submission, demonstrating how such agency is multidimensional and dynamic, shaped by an intricate web of cultural, social, religious, economic, and professional factors. This multilayered interaction forces ASHAs to continuously negotiate their positions, sometimes exercising their voices and demands, and at other times complying with top-down orders due to structural constraints, while drawing on cultural resources to navigate these structures. The thesis concludes with recommendations for a communicative framework that integrates ASHAs into decision-making processes, fostering resilience among CHWs and the communities they serve in future health crises.Item Construction of health among the Rohingya refugees in Bangladesh : a culture-centred approach : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, Manawatu, Palmerston North, New Zealand(Massey University, 2023-12-21) Rahman, Md MahbuburRohingyas, the majority of whom are Muslims (followers of the religion of Islam) are the ethnic minority group of the Rakhine state of Myanmar, where they have lived for centuries. However, Rohingyas lost their citizenship rights through a state sponsored apartheid-like system in 1982 and since then they have been stateless. As a result of organised state-led persecutions and even genocide for decades, Rohingyas are now the largest stateless community of the world. It is estimated that around 3.5 million Rohingyas are now scattered throughout the world. Among them, only an estimated 600,000 Rohingyas are still living in Myanmar. However, the exact figure of Rohingyas in Myanmar is difficult to confirm. The largest group, more than 1.6 million Rohingyas, is in Bangladesh. The majority of the Rohingyas once living in Rakhine state of Myanmar fled to Bangladesh after the latest genocide perpetrated against them by the Myanmar authorities from August 2017 onwards. Most of the Rohingyas who fled from Myanmar are now living in 33 makeshift camps at Cox’s Bazar, Bangladesh. The Rohingyas have been living in the camps of Bangladesh for years without any citizenship rights or refugee status. In this thesis, the Rohingyas are deliberately designated as refugees as they fulfil all the conditions of refugees by various international laws. According to the 1951 Refugee Convention, "a refugee is defined as a person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country or to return there because there is a fear of persecution" [Article 1(a)(2), 1951 Refugee Convention]. Bangladesh is not a signatory to the 1951 Refugee Convention or its 1967 protocol and has avoided labelling the Rohingyas as “refugees.” Instead, Bangladeshi authorities refer to the Rohingyas as “Forcibly Displaced Myanmar Nationals” (FDMN) and do not afford them the right to work or freedom of movement. Rohingyas who fled persecution in Myanmar have reason to fear persecution if they return and so they have been staying in the camps for years. In the Bangladeshi camps, while the local authorities and international agencies barely manage to provide minimum basic needs, the Rohingya people suffer from a lack of provisions for long-term needs, such as adequate healthcare services and education. The current study explores various health issues concerning the Rohingya people living in 33 camps of Cox's Bazar, Bangladesh. To discover their health issues, the localised, lived experiences of Rohingyas have been studied to identify the current health policy approaches and interventions addressing their health needs. This research employs a Culture-Centred ethnographic data collection methodology, with 41 in-depth interviews including some Focused Group Discussions. Purposive and snowballing methods were used to identify and recruit the Rohingya participants. The researcher has applied the Culture-Centred Approach (CCA) to find out the Rohingya refugees’ health needs. The Culture-Centred Approach is a theory of health communication that works through centring culture along with structure and agency and believes the community should have a voice in defining their problems and finding solutions. This thesis argues that the construction of Rohingya healthcare services at the refugee camps of Bangladesh follow the top-down approach and the services are predetermined by the local authorities and international agencies. The Rohingyas are the passive users of all of their basic needs including the health needs. The voices of Rohingyas are not being heard and there is no attempt to hear them, even when critical decisions regarding their health and life are being made. From that point of view this thesis examines the lived experiences of Rohingyas living in the refugee camps of Cox’s Bazar, Bangladesh through dialogical exchanges between the researcher and the Rohingya refugees. The findings suggest a theory of “looking from below” through the lens of culture, structure and agency that enables a better understanding of Rohingya health issues in the ground-level micro-practices. The study demonstrates that, given proper opportunities to take part in the decision-making processes, the Rohingyas can improve their health utilising the existing health care facilities of the camps. This thesis also advocates the Rohingya refugees’ participation in any community engagement process so as to enable a better life for them in the refugee camps with the limited infrastructures and minimum opportunities. This study also argues for greater Rohingya involvement in medical care to provide facilities that may address the localised, culture-based health needs of the refugee community.Item Misfits of science and creatures of habitus : ecological expert witnesses across water resource management fields : a thesis submitted to Massey University in partial fulfilment of the requirements for the degree of Doctor of Philosophy(Massey University, 2024-11-01) Russell, MatthewThis thesis applies Bourdieusian field-theory to investigate the way scientific knowledge is converted into evidence to inform decision making across four key fields central to the development and enforcement of water resource management law in New Zealand: the New Zealand Environment Court, the Environmental Protection Authority, regional councils plan hearings, and ministerially appointed science and technology advisory groups. The New Zealand publicly funded science system now exhibits most of the characteristics of a “neoliberal science regime” (Lave, 2012), a regime constituted by an extensive and influential science "consultocracy" (Hodge and Bowman, 2006) a marketplace of expertise which encompasses the seven Crown Research Institutes, hybrid scientific research institutes and significant aspects of the university sector. This regime has structurally entrenched a series of contradictions across New Zealand’s publicly funded science system which have a decisive influence on 1.) scientific habitus across institutional settings, 2.) the production of ‘public good' environmental expert knowledge claims, and 3.) the way that ecological expertise is converted into evidence to inform decisions on RMA law and policy. While the autonomy of New Zealand’s publicly funded science system has been greatly diminished, the New Zealand Environment Court has developed a set of procedures and rules that are designed to reconstruct the idealised or ‘pure’ autonomous scientific community inside the juridical field. Some of these procedures and rules, most significantly those that relate to the still developing practice of expert-conferencing, have been replicated within regional authority plan hearings and science and technology advisory groups. These procedures function relatively effectively inside the Environment Court. Within quasi-juridical fields like the EPA, councils and STAGs however, politics and power have a significant influence in the process of converting scientific knowledge into evidence to inform actions and judgements, as well as the evidentiary burden that is placed on ecological and biophysical evidence versus other forms of expertise. The neoliberal regime favours agents with the greatest economic capital to engage experts, primarily industry and local and regional authorities. Aside from a small number of highly active ‘misfit' individuals, university-based experts are not major players in the Environment Court, which points towards the powerful authority assigned to expert-knowledge claims produced outside academia. Within this context, mātauranga Māori increasingly represents a corrective to the technocratic, ecological modernisation project embodied in the New Zealand RMA. Ecological misfits see mātauranga Māori as the most powerful articulation of 'public good' environmental values in Aotearoa today. However, the most vocal champions of mātauranga Māori tend to argue around the contradictions produced by the neoliberal science regime, rather than challenging them directly, arguably blunting its transformative potential.Item Respiratory Support of Adults in the Emergency Department : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, [Auckland], New Zealand(Massey University, 2024-11) O'Donnell, Jane FrancesIntroduction: Adult emergency department (ED) patients frequently require respiratory support (RS), yet limited research on RS, particularly nasal high-flow (NHF) therapy, is available in this setting. This doctoral research aimed to analyse the nature of ED-based RS and its impact on adult patient outcomes, focusing on NHF therapy. Grounded in an evidence-based practice (EBP) framework, this research proposes to bridge a theory-practice gap and inform NHF clinical decision-making in the ED. Methodology: This thesis was informed by a positivist philosophical paradigm and methodology underpinned by an EBP theoretical framework. The research approach was quantitative, the research strategy was non-experimental, the design was multi-method, and the time horizon was cross-sectional, using two methods. The two methods were a systematic review (SR) with meta-analysis (MA) and a point prevalence study (PPS). Each method was conducted in parallel and as per the multi-method design, and the results were integrated to form the thesis findings and answer the research questions. Results: In the first method, the SR provided five MAs involving 18 ED RCTs reporting on 1874 participants. A 45% reduction in escalation relative risk (RR) was seen for NHF vs conventional oxygen therapy (COT) (RR 0.55; 95% CI, 0.33 to 0.92; p = 0.02), with no difference in mortality or adverse event risk. For NHF vs non-invasive ventilation (NIV), NHF increased escalation risk by 81% (RR 1.81; 95% CI, 1.19 to 2.75; p < 0.01). Mortality risk was not different for NHF vs NIV. In the second method, the PPS characterised 76 patients receiving RS from a total of 898 ED-presenting patients. The PPS was underpowered and unable to support its planned inferential analyses. The mean age of the participants was 67.38 years (SD ± 17.4); 52% (n = 40) were male, 48.6% (n = 37) had greater than three comorbidities, and 44% (n = 34) had primary respiratory diagnoses. By ethnicity, the Indigenous New Zealand Māori were overrepresented in the data (n = 18, 23%). Of those receiving RS, the minority (n = 12, 15.7%) received NHF; however, all these required subsequent hospitalisation. The absolute prevalence of the requirement for escalation of RS was n = 22 (28.9%). The hospitalisation rate was 22% higher, and the hospital length of stay was 42% longer for those requiring RS escalation in the ED. Māori demonstrated a 5.8% higher risk of requiring escalation of care on an absolute scale (n = 6, 33.3%) vs (n = 16, 27.5%), and a 22% increased risk on a relative scale (RR 1.22; 95% CI 0.56 to 2.67; p = 0.60) than non-Māori. Conclusions: When the results from the two methods were integrated, the main finding was that nearly a third of those receiving RS required escalation of their RS, with those receiving NHF requiring less escalation than those receiving all other forms of RS combined. These findings align with the meta-analysis of studies for the comparison of NHF compared to COT but not the comparison of NHF compared to NIV.