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Item “The Fact [Is] That There Is No Easy Way”. A Qualitative Study of the Experiences of Aotearoa New Zealand Clinicians with Opioid Tapering for Chronic Non-Cancer Pain(Dove Medical Press Limited, 2025-11-18) Fu R; Bean D; Te Morenga L; Frei D; Devan H; Atkinson TObjective: Opioid tapering is a complex process for both clinicians and patients with chronic pain. This qualitative study explored the experiences of Aotearoa New Zealand clinicians in managing opioids for patients with chronic non-cancer pain. Methods: Purposive and snowball sampling were used to interview nineteen health professionals including general practitioners (n=5), pain medicine specialists (n=5), addiction medicine specialists (n=4), pain fellows (n=3), addiction medicine registrar (n=1) and a pain nurse practitioner (n=1). Data were collected using a face-to-face focus group and fourteen individual interviews conducted via Zoom. The data were analysed using a Reflexive Thematic Analysis approach. Independent parallel coding was done by members of our research team, and the final themes were iteratively developed by mutual consensus. Results: This qualitative study suggests that meaningful opioid tapering requires a patient-centred approach that considers the individual’s unique sociopsychobiomedical context. Clinicians emphasised the importance of building trust, addressing fears, and tailoring tapering regimens to patients’ needs and motivations. While opioid tapering is a complex process for all patients, participants acknowledged unique considerations for supporting people living in rural areas – Māori and Pasifika and their whānau (families and significant others) addressing social determinants of health. There were overwhelming accounts of clinician distress from all participants especially for rural general practitioners due to the lack of support, conflicting practices, limited resourcing, and time constraints. Conclusion: These findings call for a co-ordinated, multidisciplinary approach to opioid tapering that addresses systemic inequities and prioritises patient and clinician well-being.Item Service users’ experiences of tele-health abortion services in Aotearoa (New Zealand) : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Te Kunenga ki Pūrehuroa Manawatū, Aotearoa (New Zealand)(Massey University, 2025) Sutherland, Charmaine PatriciaThe Aotearoa (New Zealand) national abortion tele-health service, Decide, was launched in 2022, following legal abortion decriminalisation in 2020. The safety, effectiveness, and user satisfaction of tele-health abortion have been reported in a large body of global research. However, service user voices are often overlooked, and little is known about service delivery, especially the extent to which principles of person- and relational centred care are upheld. This study aims to address this oversight using a qualitative case study design focused on the Decide service. An online qualitative survey gathered data from 21 service users, which was analysed thematically alongside relevant textual data (seven national policy, guidance, and training documents on abortion care in Aotearoa, the Decide website content and researcher fieldnotes). A reflexive thematic analysis, guided by feminist standpoint, in conjunction with person- and relational-centred care frameworks, generated five themes: (1) the “Everything could be in done in my lunchbreak”; (2) Feeling seen, heard, and supported: Care is relational, supportive, and attentive to emotional wellbeing; (3) Care acknowledges interdependence and honours diverse support needs; (4) Care affirms autonomy and de-medicalises abortion decision-making; and (5) When person- and relational-centred care falls short: Structural strain and cultural stigma. The findings suggest that Decide services met the intended aims of being inclusive and emotionally responsive. However, pervasive stigma and structural inequalities undermine service delivery, resulting in fragmented care, erosion of trust in the service, emotional vulnerability, and suppressed autonomy. The findings highlight the importance of centring lived experience in service design and delivery, providing valuable insights for addressing service delivery issues and working toward reproductive justice.Item Enhancing Rangatahi Wellbeing in Secondary Education Through Implementation of the Meke Meter™(Springer Nature on behalf of the New Zealand Association for Research in Education, 2025-06-02) Armstrong D; Jagroop-Dearing A; Forrest RHAdolescent wellbeing is crucial, yet secondary schools face challenges in effectively addressing it. The Meke Meter™, an indigenous self-reflection tool, shows promise in promoting wellbeing, but its application in secondary schools remains unexplored. This study investigates the suitability and efficacy of the Meke Meter™ in capturing the self-evaluated wellbeing of rangatahi (adolescents) in Aotearoa New Zealand secondary schools. A qualitative multiple case study design was employed, involving two case studies: one in a mainstream co-educational school using the paper-based Meke Meter™, and another in an alternative education program using the online version. Data collection involved questionnaires for students and teachers, analysed through inductive thematic analysis and appreciative inquiry. Both students and teachers found the Meke Meter™ appealing and valuable for self-reflection and goal-setting. The tool’s ease of use, visual design, and alignment with the curriculum were highlighted. It facilitated pastoral care, student voice, and co-construction of learning. However, challenges in data tracking and the need for clearer explanations and additional resources were identified. The Meke Meter™ shows promise in promoting rangatahi wellbeing in secondary schools. Future development should focus on a mobile app with goal-setting, gamification, and notification features. Comprehensive consultation with stakeholders is crucial to ensure cultural safety and effectiveness.Item Analysis of HER2-Low Breast Cancer in Aotearoa New Zealand: A Nationwide Retrospective Cohort Study(MDPI (Basel, Switzerland), 2024-09-20) Lasham A; Ramsaroop R; Wrigley A; Knowlton N; Radisky D; Lambertini MOBJECTIVES: To perform the first national analysis of demographic and clinicopathological features associated with the HER2 positive, HER2-low, and HER2-zero invasive breast cancers in New Zealand. The study will reveal the proportion of women who may benefit from new HER2-targeted antibody drug conjugate (ADC) therapies. METHODS: Utilising data from Te Rēhita Mate Ūtaetae (Breast Cancer Foundation NZ National Register), the study analysed data from women diagnosed with invasive breast cancer over a 21-year period. The HER2 status of tumours was classified into three categories-HER2-zero, HER2-low, HER2-positive. RESULTS: From 2009-2021, 94% of women underwent HER2 testing, with 14% diagnosed with HER2-positive breast cancer. For advanced-stage disease, 38% of those formerly classified as HER2-negative were reclassified as HER2-low. Including HER2-positive breast cancers, this indicates that 60% of women with advanced breast cancer may potentially benefit from the new HER2-directed ADCs (approximately 120 women per year). CONCLUSIONS: The findings suggest a significant proportion of women with invasive breast cancer in New Zealand could benefit from new HER2-targeted treatments. There is a need to standardise HER2 testing to enhance personalised treatment and improve outcomes.Item Towards a tika political science: Restoring balance, reflecting our context(Aboriginal and Torres Strait Islander Studies Unit, The University of Queensland, 2024-12-11) Azarmandi M; Beausoleil E; Bickerton SH; Choi S; Fadgen T; Greener B; Gregory T; Hayward J; Lovering I; Nissen S; Powles A; Sardelić J; Schick K; Skilling P; Tan LThis article is a rejoinder to Annie Te One and Maria Bargh’s article published in The Australian Journal of Indigenous Education in 2023, “Towards a Fairer and More Tika Political Science and Politics: Are Political Science Programs Equipping Students Adequately for Aotearoa Realities?” (vol. 52, no. 2).Item A new volcanic multi-hazard impact model for water supply systems: Application at Taranaki Mounga, Aotearoa New Zealand(Elsevier B.V., 2024-12-24) Porter H; Wilson TM; Weir A; Stewart C; Craig HM; Wild AJ; Paulik R; Fairclough R; Buzzella MWater supply systems provide an essential service for society and are highly vulnerable to damage and disruption during volcanic eruptions. Impacts sustained by water supply systems during volcanic eruptions have resulted in prolonged and repeated supply outages. Previous approaches to assessing volcanic impacts to water supply systems have been relatively simplistic, based on hazard intensity thresholds, and only considering direct damage. There is a need for water supply risk assessment approaches informed by vulnerability models that consider the pivotal role of system design and indirect impacts; such as supply and demand fluctuations, personnel shortages, and disruptions to interdependent infrastructure networks. We present a whole-of-system volcanic vulnerability model and impact assessment framework for water supply systems that can be used to estimate system-wide impacts during future volcanic eruptions. This model is developed in collaboration with volcanic risk researchers and water supply engineers in Aotearoa New Zealand and applied to a case study in the Taranaki region for a long-duration and multi-hazard eruption scenario from the active stratovolcano Taranaki Mounga. The model provides an assessment of the functionality of water supply systems affected directly and indirectly by the scenario eruption, interdependent critical infrastructure services, and associated emergency management actions (e.g., evacuations). This scenario, and its modelled impacts, allows practitioners to explore potential mitigation and emergency response options. This framework can be applied in other volcanic contexts to assess impacts on water supplies from future eruptions, highlight key systemic vulnerabilities, and provide a basis for the prioritisation and implementation of risk management strategies.Item Māori food culture and wellbeing on TikTok: a content and thematic analysis(Taylor and Francis Group, 2024-12-17) Renall N; Te Morenga LWe examined content posted on TikTok on the topic of kai Māori (traditional food and associated customs of the indigenous people of Aotearoa New Zealand) to inform strengths-based approaches to health promotion in Māori communities. We conducted a content analysis of 100 unique TikTok videos labelled with the hashtags #kai and #Maori and coded content characteristics and viewer engagement for each video. Twenty foods were determined to be key Māori identity foods from this analysis. We also undertook a reflexive thematic analysis of the content of all videos and user engagement from a sample of 40 videos. Three themes relating to the value of kai Māori were identified: Mauri ora (kai as an expression of pride in Māori identity), Ahikā kai (a means of keeping traditions alive) and Tūhononga (a means of connecting with Te Ao Māori). Māori used TikTok to celebrate Māori identity by sharing and discussing content about kai Māori that was informative and often humorous or self-deprecating. Health promotion in Māori communities should draw on the values of kai as more than food. Kai has an important role in strengthening wellbeing through facilitating cultural connections and linking healthy lifestyles with traditional practices like collecting seafood. Glossary of Māori words: Ahikā kai: keeping Māori traditions alive; Ahuriri: Napier, Aotearoa New Zealand; Aotearoa NZ: Aotearoa New Zealand; aroha: love; atua: deity, ancestor; ehe: e hē: an expression of no in Ngāi Tūhoe Iwi [tribe] dialect; hāngī: food cooked in an earth steam oven or gas steamer; he kai reka tenei: this food is yum or sweet; he tīno reka: very yummy; he reka: yum, sweet; huhu: huhu grub, Prionoplus reticularis; kai: food; kai Māori: traditional food and associated customs; kaimoana: food from the sea including fish and shellfish; kaitiaki: custodians, guardians; kānga wai/ kānga pirau: fermented ‘rotten’ corn; kamokamo: squash, vegetable marrow; kao: no; karakia: blessing, giving thanks; kare: an endearment; karengo /parengo: seaweed; kaupapa Māori: a Māori approach, Māori philosophy and principles guide practice; kia ora: hello, greetings, thank you; kina: sea urchin; koro:grandfather; kumara: sweet potato; kupu: word; kūtai: mussels; inanga: whitebait; mahinga kai: traditional food gathering place; mana whenua: Māori people who have customary authority and rights over identified land; manaakitanga: the act of showing support, caring for others; Māoritanga: Māori culture, way of life; mātua: parents; marae: a place of cultural significance to gather and meet; mauri: spirit, life essence; mauri ora: strong pride in having a unique Māori identity; meke: too much, good; mirimiri: to rub; moana: ocean; Ngāpuhi: northern iwi [tribe] of Aotearoa; noa: ordinary, unrestricted; ora: to be alive, healthy and well; Pākehā: New Zealanders of European descent; paraoa: fry bread; patu: traditional club used in warfare; paua: abalone; pikopiko: young fern shoots; pipi: shellfish, clam; puha: a sow thistle green; Rakiura: Stewart Island; rangatahi: Māori youth; rawe: excellent; reka: sweet; rēwana: fermented bread made with potato; Tā: Sir, Knight; tamariki Māori: Māori children; Tangaroa: the Māori atua (god) for the oceans; tapu: restricted, to be sacred, under atua protection; tautoko: show support; Te Ao Māori: the Māori world and its traditions; te taiao: the natural world; Te Whare Tapa Whā: a model of Māori health developed by Tā Professor Mason Durie; tēnā koe: greetings (speaking to an individual); tikanga: traditional customs or practices; tinana: body, physical self; tino reka: an expression of deliciousness; tino reka te kai: the kai is yum; tītī: mutton bird Puffinus griseus; toa: brave, accomplished, competent; toheroa: large clam;f toroi / whakamara: a fermented dish of cooked mussels and puha; tuatua: shellfish, clam; tūhononga: connecting with Te Ao Māori; tuna: eel; tūpuna / tīpuna: ancestors, grandparents; wahine: woman; Whaea: Mother, Aunty; whakaiti: look down on; whakapapa: lineage, genealogy, ancestry; a central concept in Māori culture of identity, relation and connection to people, place, and culture; whānau: family group, including extended family; whanaunga: relative, kin; whanaungatanga: relationship building; whenua: land, ground.Item Genotypic detection of barriers to rat dispersal: Rattus rattus behind a peninsula predator-proof fence.(Springer Nature, 2023-02-06) Yarita S; Morgan-Richards M; Trewick SAClear delimitation of management units is essential for effective management of invasive species. Analysis of population genetic structure of target species can improve identification and interpretation of natural and artificial barriers to dispersal. In Aotearoa New Zealand where the introduced ship rat (Rattus rattus) is a major threat to native biodiversity, effective suppression of pest numbers requires removal and limitation of reinvasion from outside the managed population. We contrasted population genetic structure in rat populations over a wide scale without known barriers, with structure over a fine scale with potential barriers to dispersal. MtDNA D-loop sequences and microsatellite genotypes resolved little genetic structure in southern North Island population samples of ship rat 100 km apart. In contrast, samples from major islands differed significantly for both mtDNA and nuclear markers. We also compared ship rats collected within a small peninsula reserve bounded by sea, suburbs and, more recently, a predator fence with rats in the surrounding forest. Here, mtDNA did not differ but genotypes from 14 nuclear loci were sufficient to distinguish the fenced population. This suggests that natural (sea) and artificial barriers (town, fence) are effectively limiting gene flow among ship rat populations over the short distance (~ 500 m) between the peninsula reserve and surrounding forest. The effectiveness of the fence alone is not clear given it is a recent feature and no historical samples exist; resampling population genetic diversity over time will improve understanding. Nonetheless, the current genetic isolation of the fenced rat population suggests that rat eradication is a sensible management option given that reinvasion appears to be limited and could probably be managed with a biosecurity programme.Item The potential of gender (and intersectional) equality indices: the case of Aotearoa New Zealand’s public service(Edward Elgar Publishing Limited in association with the International Labour Office, 2024-06-07) Parker J; Donnelly N; Sayers J; Loga P; Paea S; Rönnmar M; Hayter SThe COVID-19 pandemic has impacted in a multi-faceted and gendered manner on the labour market in most countries. In Aotearoa New Zealand, high-level gender indices (GIs) have broadly captured this impact, helping to inform sectoral policy reform. However, these indices seldom capture more qualitative, nuanced and connected aspects of (in)equity despite increasing labour market and workplace diversification, and more scholarly attention on how these inequities are created, perpetuated or nuanced. The need for finer-grain analysis of women’s diversity encouraged a transdisciplinary study of working women in several public service agencies in New Zealand. Experts, employees and managers in the sector participated in in-depth interviews to help generate institution-specific gender indices which can be used alongside ‘conventional’ quantitative measures to closely assess workplace (in)equities. This study thus extends the conceptual parameters of GIs applied at national levels; provides a framework of equity considerations and (emergent) indicators for inclusion in organizational-level equity policy development; and briefly assesses meso-level equity indices with respect to the gender-responsive/accommodating/transformative or ‘gender-inclusive’ framework used throughout this volume.Item Balancing risk in sexual violence restorative justice : professional views on risk assessment for restorative justice processes addressing sexual violence : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology at Massey University, Wellington, New Zealand(Massey University, 2024) Bremer, Charlotte (Charlie) GraceSexual violence is an ongoing international human rights issue, often resulting in significant negative impacts, and not always well addressed within conventional criminal justice systems. Restorative justice following sexual violence (SVRJ) is a victim-centred justice process showing significant benefits for victim-survivors (including meeting justice needs and supporting recovery), perpetrators of harm (including insight, community reintegration, and reduced reoffending), and wider communities (encouraging accountability and addressing harmful beliefs). However, there is a risk of causing further harm through SVRJ, meaning professionals in this space have an obligation to manage risk as best as possible. Risk of further harm is one reason why SVRJ is not particularly common around the world, and why opinions are often divided regarding the appropriateness of its use. Currently, there are no standardised guidelines for assessing risk within SVRJ. Instead, professionals may rely on their judgement alone, which is the least reliable and valid method of risk assessment. The current research seeks to address this by investigating professional perspectives about the factors important within SVRJ risk assessment, and subsequently developing SVRJ risk assessment guideline recommendations, which could enable a structured and more reliable approach to SVRJ risk assessment. Professionals (n=16) experienced in the areas of SVRJ and RJ risk assessment were interviewed about their experiences of SVRJ risk assessment, particularly what they considered within their assessments and risk-related decisions. Interview data were analysed using reflexive thematic analysis, with four themes identified: perceived participant preparedness, safe support systems, culturally competent assessment, and participant alignment. These findings formed the basis for developed SVRJ risk assessment guideline recommendations. Wider implications of the findings for SVRJ risk assessment, policy and practice are discussed. It is hoped that this research provides important insight into SVRJ professional practice and risk assessment and contributes to the safe use of SVRJ both in Aotearoa New Zealand and internationally, allowing more people to access the benefits of SVRJ in safe and considered ways.