Zealand University Research Articles

Patients’ experiences of the COVID-19 pandemic and the change to telephone consultations in cancer care

PurposeDuring the COVID-19 pandemic, teleconsultations have increasingly been used to reduce physical contact and thus risk of infection. This study investigated how patients with cancer experienced the COVID-19 pandemic and how they perceived the change from in-person consultations to telephone consultations in an oncology outpatient clinic. The aim was to provide insights that could optimize the future use of teleconsultations in cancer care.MethodsThis qualitative study included 15 patients with colorectal, breast, gynecological, lung, or prostate cancer treated at the outpatient clinic at the Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Denmark in June or July 2020. Data were collected through semi-structured individual interviews and analyzed by thematic analysis.ResultsPatients with cancer experienced social, psychological, and organizational consequences of the COVID-19 pandemic related to their cancer care. Not all patients were comfortable with telephone consultations. Six themes were identified: (1) double burden as a consequence of simultaneous cancer and the COVID-19 pandemic, (2) parameters for patient satisfaction with telephone consultations, (3) the importance of relatives attending consultations, (4) loss of information and nuances during telephone consultations, (5) the impact of physicians’ language and communicative skills during telephone consultations, and (6) patients’ suggestions for future telephone consultations.ConclusionBeyond the COVID-19 pandemic, it is important that hospitals offering teleconsultations involve patients’ preferences, consider for which patients and consultations the solution is suitable, which technology to use, how to prepare patients and relatives, and how to provide physicians with the necessary communicative skills.

An analysis of university academic integrity policies in New Zealand

ABSTRACT Policy analysis studies conducted in various countries have highlighted strengths and weaknesses in university academic integrity policy documents that outline expectations for student conduct while undertaking scholarly work. Missing from the literature is a review of such policies currently in place at the eight public universities in Aotearoa New Zealand. Using publicly accessible documents from each university, this study conducted a content analysis based on five core elements of exemplary academic integrity policies: access, approach, responsibility, detail, and support. Results revealed that the majority of universities had policies built on principles that aligned with both educative and punitive approaches to academic integrity. While most institutions presented detailed policies, the documents showed room for improvement with regard to access and support. The study offers suggestions for enhancing the academic integrity policies of Aotearoa New Zealand universities and calls for continued internal review and revision as one step towards an improved culture of academic integrity.

Prevalence of silent atrial fibrillation and cardiovascular disease in patients with obstructive sleep apnea

ObjectivePatients with silent and undiagnosed atrial fibrillation (AF) have increased risk of ischemic stroke. Patients with obstructive sleep apnea (OSA) have an increased risk of both AF and ischemic stroke. Our aim was to investigate the prevalence of silent AF and associated risk factors in patients investigated for OSA or with known OSA. MethodsThis prospective observational study was performed in two sites; one outpatient sleep-clinic at Zealand University Hospital and one private Ear-Nose- and Throat clinic. Patients were investigated with a type-3 portable sleep-monitoring device, while heart rhythm was home-monitored for 7 days with an event-triggered loop recorder. Patients were stratified in groups of mild, moderate and severe OSA based on Apnea-Hypopnea-Index (AHI). ResultsIn a cohort of 303 patients, 238 (78.5%) were diagnosed with moderate/or severe OSA and 65 (21.5%) with no/mild OSA who constituted the control group. In 238 patients with moderate and severe OSA, AF was detected in 21 patients (8.8%) vs. 1 patient (1.5%,[p=0.045]) with mild OSA. Candidates for anticoagulation therapy were referred for further cardiovascular treatment. The majority of patients had known hypertension (n = 200,66%) and dyslipidemia (n = 235,[77.6%]) In patients with moderate/or severe OSA (AHI≥15), hypertension was more dysregulated (p=0.005) and more patients suffered from unknown prediabetes (n = 36, 3.1% vs. 14.3%[p<0.001]). ConclusionUndiagnosed AF and undertreated cardiovascular modifiable risk factors are common in a cohort of patients with OSA. With this study we propose that long-period home-monitoring in these patients is useful for identifying candidates for preventive anticoagulation, cardiovascular treatment and possibly prevent future ischemic stroke.

The semi-formal benchmarking of TEL practice: Helping the TEL community get its act together

&#x0D; &#x0D; &#x0D; Over the last year, two major sector-wide events were held that have brought together technology enhanced learning (TEL) professionals from across the country to semi-formally benchmark their practices in the use of new and emerging technologies. These events have focused on major trends with technologies such as virtual and augmented reality and the use of the Office O365 suite of tools with a special focus on the use of the Teams application. This paper reports on the findings of these two national Summits hosted and facilitated by Griffith University. The motivating force for these free Summits was to provide an open forum for the sharing of practice across Australian and New Zealand universities. The data gained through the formal evaluations of these activities indicated that the collegial nature of these events has assisted in stimulating an openness and willingness to share examples of good practice seen across the sector. This form of semi-formal benchmarking is both appreciated and highly valued as TEL professionals seek to push in to new territories and provide opportunities for this community to further share their practices.&#x0D; &#x0D; &#x0D;

Analysing student interactions in a flipped engineering course

&#x0D; &#x0D; &#x0D; Flipped classrooms can support more open, flexible and collaborative student-centred learning. There is evidence that flipping learning can result in more effective learning processes and outcomes. However, not much is known about students’ learning process in terms of their interactions while working collaboratively in a flipped class context. This understanding is essential to inform lecturers’ timely and relevant facilitation of student learning. This paper reports on the findings from a study focused on the interactions, specifically types of talk, first- year undergraduate engineering students engaged in while collaboratively solving problem tasks in their practical lab sessions as part of a flipped class learning approach in a New Zealand university. Data were collected from a six-week video observation of student interactions. Herrington and Oliver’s (1999) analytical framework on higher order, lower order, procedural, and social talk was used to analyse the video data. Findings revealed that the highest proportion of student interactions were procedural in nature followed by higher order, lower order, and finally, social talk types. These indicate the potential of the flipped class approach in fostering higher order talk in support of learning. Implications for practice are offered.&#x0D; &#x0D; &#x0D;

Effect of structured rehabilitation versus non-structured rehabilitation following non-surgical management of displaced proximal humerus fractures: a protocol for a randomised clinical trial

IntroductionAn increasing number of patients with displaced proximal humerus fractures (PHF) are being offered non-surgical treatment, including short immobilisation and structured rehabilitation. There are no randomised controlled trials (RCTs) comparing...

“Life is based on reciprocity, so be generous”: ethical work in doctoral acknowledgements

PurposeThis paper aims to explore doctoral candidates’ ethical work in writing the acknowledgements section of their theses. With interest in the formation of academic identities/subjectivities, the authors explore acknowledgements writing as always potentially a form of parrhesia or risky truth-telling, through which the candidate places themselves in their relations to others rather than in their claims to knowledge (Luxon, 2008).Design/methodology/approachDoctoral candidates from all faculties in one Japanese and one Aotearoa New Zealand university participated in focus groups where they discussed the genre of thesis acknowledgements, drafted their own version and wrote a reflective commentary/backstory.FindingsViewing the backstories through the lens of parrhesia (with its entangled matters of frankness, truth, risk, criticism and duty) showed candidates engaged in complex ethical decision-making processes with, at best, “ambiguous ethical resources” (Luxon, 2008, p. 381) arising from their academic and personal lives. Candidates used these resources to try and position themselves as both properly academic and more than academic – as knowing selves and relational selves.Originality/valueThis study bares the ethical riskiness of writing doctoral acknowledgements, as doctoral candidates navigate the tensions between situating themselves “truthfully” in their relations with others while striking the necessary pose of intellectual independence (originality). In a context where there is evidence that examiners not only read acknowledgements to ascertain independence, student and/or supervisor quality and the “human being behind the thesis” (Kumar and Sanderson, 2020, p. 285) but also show bias in those readings, this study advises reader caution about drawing inferences from acknowledgements texts. They are not simply transparent. As examiners and other readers make sense, judgments even, of these tiny, often fascinating, glimpses into a candidate’s doctoral experience, they need to understand that a host of unpredictable tensions with myriad ambiguous effects are present on the page.

Gaining insight from future mothers: A survey of attitudes and perspectives of childbirth

ObjectiveTo determine whether participant characteristics and/or birth preferences of future mothers are associated with a fear of birth. DesignA cross-sectional survey was used to determine if fear of birth could be profiled in specific participant characteristics and birth choices. SettingUrban New Zealand university. ParticipantsA convenience sample of women (final n = 339) who were < 40 years old, attending university, not pregnant nor had been pregnant but wished for at least one child in the future. FindingsMultivariable analysis identified a subset of four variables that were independently associated with the instrument Childbirth Fear Prior to Pregnancy (CFPP) measuring fear of birth (mean CFPP=38.0, SE=10.1). Preferences of birth by caesarean section (n=32, mean CFPP=44.3, SE=1.8, p < 0.0001), use of epidural analgesia (n=255, mean CFPP=45.0, SE=1.1, p < 0.0001), participants born outside of New Zealand (n=123, mean CFPP=42.9, SE=1.4, p < 0.0001), and participants who scored > 20 (‘severe’) for depression on DASS-21 scale (n=11, mean CFPP=44.8, SE=1.7, p < 0.0001) were all positively associated with CFPP. Post-hoc analyses revealed that mean CFPP was higher for those that perceived birth technologies as easier, safer, necessary, and required. ConclusionsWomen born outside of New Zealand and/or suffering ‘severe’ depression were more likely to have a fear of birth. Fear of birth was associated with the participants choices towards medicalised childbirth. Familiarising women with the provision of maternity care in New Zealand and identifying mental health status early could reduce fear of birth and possibly support the vaginal birth intentions of future parents.

Investigating the effect of a social norms message on meat-based food purchases in a New Zealand university food outlet

Investigating the effect of a social norms message on meat-based food purchases in a New Zealand university food outlet

Beyond technology use: a people-centred approach to reconceptualising the adoption of learning technologies

Research into the adoption of learning technologies has identified predictive factors of individual adoption. However, this research largely assumes technology adoption-as-use, which, I argue, is technology-centric and disregards the role of teachers and their teaching practice. Following a people-centred approach, I sought to focus on teachers’ experiences during technology adoption and in doing so contribute to the notion of adoption-as-process. I undertook interpretive phenomenology research, conducting semi-structured interviews with a group of seven academic teachers in a New Zealand university where a new learning management system (LMS) was implemented following an institutional-wide LMS review. I analysed the interview data using a reflexive thematic analysis method. The findings indicate that technology adoption is more than technology use; it is laden with emotional experiences, learning experiences, experiences of inability to perform and experiences of incongruence in the teaching space. To facilitate appropriate individual adoption, the study calls for future research to focus on adoption-as-process and institutional practice to address emotional responses, enable learning in safe and authentic environments, scaffold performance, and align existing policies and practices with new technologies.

Surgical experience is predictive for bladder tumour resection quality

Objectives To assess the resection quality of transurethral bladder tumour resection (TURBT) and the association to surgeon experience depending on the presence of detrusor muscle. Methods A retrospective study on 640 TURBT procedures performed at Zealand University Hospital, Denmark, from 1 January 2015 − 31 December 2016. Data included patient characteristics, procedure type, surgeon category, supervisor presence, surgical report data, pathological data, complications data and recurrence data. Analysis was performed using simple and multiple logistic regression on the association between surgeon experience and the presence of detrusor muscle in resected tissue from TURBT. Results Supervised junior residents had significant lower detrusor muscle presence (73%) compared with consultants (83%) (OR = 0.4, 95% CI = 0.21–0.83). Limitations were the retrospective design and the diversity of included TURBT. Conclusions It was found that surgical experience predicts detrusor muscle presence and supervised junior residents performing TURBT on patients resulted in less detrusor muscle than consultants.

Inforatio technique to promote wound healing of diabetic foot ulcers: study protocol for a parallel-group, evaluator-blinded, randomised clinical trial

IntroductionDiabetic foot ulcers (DFUs) are associated with extensive consequences for the affected patients and treatment of these hard-to-heal ulcers is known for being challenging. New treatment methods to supplement the...

Academic Vocabulary Acquisition Difficulties for Saudi Postgraduate Students in New Zealand Universities

Education outcomes for L2 students in academic preparation programs, undergraduate studies, and graduate work are directly influenced by the learning and use of academic vocabulary. Among 15 Saudi graduate students studying in New Zealand, this study investigated at their perspectives with academic vocabulary learning. Students in Saudi Arabia who are enrolled at New Zealand universities were asked about their difficulties in learning academic vocabulary. According to this study, a new perspective on academic vocabulary can be gained by studying students&amp;#39; assessments of their problems in learning academic vocabulary. Four research questions are the focus of the study: 1) When it comes to mastering academic vocabulary, what are the most common challenges faced by postgraduate students? 2) What methods do these Saudi postgraduate students employ in order to increase their knowledge of academic language? 3) Do students who perceive the most difficulty in learning a new language likely to have had the least effective ways for learning vocabulary. 4) Saudi graduate students confront what kinds of problems in learning academic vocabulary? Academic vocabulary is typically a problem for graduate students in a number of areas. These challenges were addressed utilizing a qualitative approach, that comprised an exploratory study, personal face-to-face questions, and a group discussion. A wide range of academic circumstances were found to be problematic for all 15 participants, regardless of language proficiency. It was difficult to find time to read for writing when there was so much emphasis on paraphrasing. (Hirvela, 2016) Aside from that, participants had no prior experience with academic vocabulary learning and only a limited number of strategies at their disposal to assist them. In contrast, the results of this study do not support the concept that merely being revealed to academic language can increase the chances of incidental vocabulary development; somewhat more, they recommend that deliberate vocabulary knowledge is needed, so such learning should be based on sound academic skills, including the use of vocabulary study materials; and unsuitable vocabulary acquisition strategies could indeed risk causing unhappiness and loss of vocabulary knowledge.&amp;nbsp;&#x0D; &amp;nbsp;

Being and becoming an international student: the inter-relation between language socialization and identities

Abstract This article draws on Lefebvre’s production of space to understand the cultural negotiations and underlying meanings of being and becoming an international student. Rich and multiple data sources including video/audio recordings of classroom interactions, field notes, interviews, diaries, and institutional documents from a Vietnamese student’s participation in English for Academic Purposes (EAP) and mainstream courses in a New Zealand university (NZU) were drawn upon. The findings of this study show that the student’s engagement in both the new social space and academic environment of NZU is mediated through negotiations and reflections of her Vietnamese-ness and constant comparison of the host culture with that of Vietnam and how her experience of navigating the social space of New Zealand influences her perceptions of Vietnamese-ness. International students’ socialization is mediated through engagement with materialities of space, mastering the norms of their social space, participating in activities, and reflecting on their own life and learning trajectories.

Indigenous Inclusion and Indigenising the University

‘Indigenous inclusion’ has been the most common approach to Māori engagement in university education in Aotearoa-New Zealand. Increasingly, another orientation, based on different premises, which might be called ‘indigenisation’, is becoming evident. We argue that indigenisation offers more hopeful possibilities for New Zealand universities as they/we continue to think about their/our obligations under Te Tiriti o Waitangi.

Glass ceilings in New Zealand universities: Inequities in Māori and Pacific promotions and earnings

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The ‘dark side’ of data–driven marketing: a system’s thinking analysis

ABSTRACT Data-driven marketing has become a prominent strategic marketing approach, but it is prone to complex challenges, often referred as its dark side. The literature on data-driven marketing is dominated by its positive aspects, but there is an emerging literature stream focussing on its challenges. This study aims at contributing to this literature stream by providing an empirical study involving a holistic analysis of the undesirable effects of data-driven marketing using a systems thinking approach. The challenges faced by a New Zealand university in its international marketing using data-driven marketing is used as a case. Using 23 interviews, a systems model was developed, capturing the underlying structure behind these challenges. Eight interacting feedback loops were identified in the model, responsible for these complex challenges. A focus group was used to formulate three strategic interventions to address the complex challenges facing this organisation involved in data-driven marketing.

Postoperative Pain Management and Patient Evaluations After Five Different Surgical Procedures. A Prospective Cohort Study

BackgroundSufficient pain management is a necessity and can play an important role in patients’ contentment. AimsTo investigate the instituted postoperative pain treatment, patients’ levels of pain, opioid consumption, and patient contentment, supplemented with a questionnaire based on the International Pain Outcome (IPO). MethodsThis prospective observational cohort study was conducted at Zealand University Hospital Køge, Denmark (ZUHK) from March 8, 2017, to January 7, 2019, aiming for a consecutive inclusion of 200 patients, 40 from five major surgical procedures. The study was approved by the Danish Data Protection Agency (REG-121-2016) and registered at ClinicalTrials.gov (NCT03080272). The Research Ethics Committee of the Zealand Region was consulted, but approval was not needed according to Danish law (J.nr. 16-000014). ResultsWe included 189 patients in total. We found a significant number of patients that did not achieve “no worse than mild pain” (Numeric Rating Scale ≤3) across surgical procedures. The provided pain treatment was heterogenic and inconsistent even among individuals who underwent similar surgical procedures. Although patients did not achieve “no worse than mild pain” (Numeric Rating Scale ≤3), the majority stated that they were content with their pain treatment. ConclusionsThe analgesic treatment varied between procedures and patients and a significant number of patients did not achieve “no worse than mild pain” (Numeric Rating Scale ≤3). A significant association between patient contentment and experience of severe pain, pain relief, and involvement in own pain treatment, was found.

Dual-Mode Teaching in the Language Classroom: Reconciling the Pandemic, Equity, and the Future of Quality Language Teaching Pedagogy

The COVID-19 pandemic sent New Zealand universities into crisis, and as a key crisis response measure, classes were mostly moved online. While navigating national public health settings, educators simultaneously had to innovate quickly: to keep our courses in operation, students learning, and quality pedagogy present. The author has been navigating a faculty-wide ‘dual-mode’ teaching policy at their home institution, to teach the Māori language. Dual-mode refers to teaching both in-person and online. Although dual-mode teaching has brought a significant amount of learning flexibility and innovation to the classroom, it also has disadvantages. This article attempts to document some of the positive and negative characteristics noted over two years of dual-mode teaching, from the position of intermediate Māori language classes. It concludes that although this kind of teaching is flexible and equitable, it is not of high quality, and contributes to poor proficiency outcomes for students. Teaching in this way could, however, be of a much higher quality, with support, resourcing and time. As we look to keep these more accessible teaching methods in the future, those additional aspects will be critical in designing classes that are not only equitable, dynamic, and in line with contemporary technological learning styles, but also of a standard that maintains quality language proficiency-building within our learners.

Seen but unheard: navigating turbulent waters as Māori and Pacific postgraduate students in STEM

ABSTRACT The experiences of Māori and Pacific postgraduate students in STEM (Science, Technology, Engineering and Mathematics) offer insights into how universities, particularly science faculties, currently underserve Māori and Pacific people. This article shares the experiences of 43 current or past postgraduate students at New Zealand universities. Collectively, our stories offer insight into how representation, the white imprint, space invaders/stranger making, and institutional habits, specifically operate to exclude and devalue Māori and Pacific postgraduates in STEM. We provide new understandings of the white imprint (rewarding and incentivising white behaviour), where Māori and Pacific postgraduates were prevented from being their authentic selves. Importantly, this research documents how Māori and Pacific postgraduates experience excess labour because of institutional habits. This research also provides insight into how the science funding system results in superficial and unethical inclusion of Māori and Pacific postgraduates. Our stories provide persuasive evidence that the under-representation of Māori and Pacific in STEM will not be addressed by simply bolstering university enrolments. Instead, our stories highlight the urgent requirement for universities to change the STEM learning environment which continues to be violent and culturally unsafe for Māori and Pacific postgraduates.