The dominant discourse of gender focuses on the binary of woman/man, despite the known additional risks for diverse sexualities and gender minorities in disasters. Given the small but growing body of literature concerning gender minorities in disasters, this paper sets out to explore the place of sex and gender minorities in disasters and to examine whether a binary definition needs to be extended. A five-stage rapid review was undertaken following Arksey and O’Malley’s method. Peer-reviewed journal articles in English language were sought that included disaster and gender terms in the title, abstract, and/or body of the article published between January 2015 and March 2019. The search included MEDLINE and Scopus databases. Relevant information from the studies were charted in Microsoft Excel, and results were summarized using a descriptive analytical method. In total, 729 records were identified; 248 that did not meet the inclusion criteria were excluded and 166 duplicates were removed. A total of 315 records were sourced and their full text was reviewed. Of those, only 12 journal articles included content relative to more than two genders. We also recognized that sex and gender terms were used interchangeably with no clear differentiation between the two. We recommend that disaster scholars and practitioners adopt correct terminology and expand their definition of gender beyond the binary; utilize work on gender fluidity and diversity; and apply this to disaster research, policy, and practice.

This research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand. Qualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui) is a culturally appropriate methodology. Thematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust. The responses from all groups endorsed the need for community based risk management including information dissemination. Engaging with communities will be essential to facilitate preparedness and build community resilience to future pandemic events. This research provides an illustration of the complexities of how people understand and respond to health messages related to the H1N1 pandemic. The importance of the differences identified in the analysis is not the differences per se but highlight problems with a "one size fits all" pandemic warning strategy.

Background: This article presents findings from a prospective, longitudinal cohort educational study investigating empathy communication in clinical consultations. It reports on changes in students’ self-report empathy during medical undergraduate training, investigates how well peers can assess student competence in motivational interviewing/brief interventions (MI/BI) skills and explores the relationship between students’ self-report empathy and peer- or tutor-assessments of competence. Methods: 72 medical students completed the Jefferson Scale of Physician Empathy at three time points: at the beginning of their fifth year medical training (Time 1), after a specific MI/BI training session during their fifth year medical training (Time 2) and 1 year later during a revision session in year 6. Competence in BI/MI consultation was assessed using the validated tool Behaviour Change Counselling Index. Results: A significant decline in medical students’ empathy scores was observed from year 5 to year 6, consistent with international findings. Peer assessments and tutor ratings of competence in MI/BI skills performance were moderately correlated, but peer assessments were negatively correlated with medical students’ self-rated empathy. Senior medical students who self-rated as more empathic received lower competence evaluations of MI/BI skills from their peers. Interventions to further investigate teaching and learning of empathy are discussed.

INTRODUCTION: Internationally, a number of studies have investigated general practitioner (GP) opinion of weight management interventions. To date there have been no similar studies carried out in New Zealand. This study aimed to explore GP opinion of weight management interventions in one region of New Zealand. Understanding GP opinion is important, as rates of obesity are increasing and GPs are front-line health care service providers. The data collected could be used to guide health service development in New Zealand, and to inform training and support of GPs in obesity management. METHODS: A qualitative study using inductive thematic analysis of a series of 12 semi-structured interviews with GPs in the Wellington region of New Zealand. FINDINGS: Five key themes were identified: 1) GP perceptions of what the GP can do; 2) the roots of the obesity problem; 3) why the GP doesn’t succeed; 4) current primary care interventions; and 5) bariatric surgery. CONCLUSION: The GPs interviewed felt responsible for treatment of obesity in their patients. They expressed a sense of disempowerment regarding their ability to carry this out, identifying multiple barriers. These included: a society where overweight is seen as normal; complex situations in which weight management is rooted in personal issues; stigma associated with overweight and its management; lack of efficacious interventions; and low resource availability. Bariatric surgery was viewed cautiously in general, though some examples of positive results were reported, as well as a desire for increased access to this treatment option. KEYWORDS: Body weight change; general practice; obesity; primary health care; therapy

The transition from student to health practitioner at entry-to-practice is complex, requiring critical acquisition of collaborative practice skills. In rural communities where health need is multidimensional, there is potential for multiple intentional collaborative learning objectives to be met concurrently. A five-week, rurally-located, clinically-based interprofessional programme was introduced as a transition-to-practice rotation for final-year, pre-registration health professional students in the professions of dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy. The programme integrated learning objectives in four related domains: interprofessional practice; hauora Māori (Māori health); rural health; long-term condition management. This study investigated student learning experiences over the first two complete years of the programme, comparing responses from participating students with those from a cohort of non-participating peers. Using a pre and post quasi-experimental design, respondents from two successive student year cohorts completed questionnaires at the start and end of their final year. Additional survey data were collected from participating students at the end of each rotation. 131 students participated in the programme during 2013–2014. Participating student respondents (55/131;42 %) reported being significantly better prepared than a cohort of 56 non-participating colleagues in many aspects of their understanding of and knowledge about each of four key learning domains. 94 % (123/131) of programme participants completed end-of-rotation questionnaires. Positive from the outset (mean 5-point Likert scale scores between 3 and 5; 5 = most positive), student satisfaction further increased across all domains in the second year (mean 5-point Likert scale scores between 4 and 5). At entry-to-practice level, multiple learning objectives, including indigenous health learning, can be met simultaneously in the clinical context within an integrated, rotational programme. Rural settings are highly suitable for delivering such programmes if well supported.

INTRODUCTION: Obesity is overtaking tobacco smoking in New Zealand as the leading potentially modifiable risk to health. International obesity guidelines recommend that health professionals opportunistically encourage weight management with their patients. However, research shows consistently low rates of weight management discussion, suggesting that health professionals may not be realising their full potential to address obesity. AIM: To identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations. METHODS: A secondary analysis was conducted of 36 video-recorded consultations in general practices, selected for relevance from a database of 205 consultations. Content and interactional analysis was conducted in the context of the entire consultation. RESULTS: The topic of weight was initiated more often by GPs than patients and was raised mostly once or twice in a consultation and occasionally as many as six times. GPs employed opportunistic strategies twice as often as they used structured strategies. DISCUSSION: This study of naturally occurring consultations confirmed GPs do engage in opportunistic discussions about weight. However, such discussions are challenging and interactionally delicate. Highlighting the clinical relevance of weight appears to be effective. The high frequency of patient contact with GPs provides opportunity to reach and work with people at risk of chronic conditions associated with excess weight. Further research is required to identify suitable training and brief intervention tools for use in routine consultations that may be beneficial for both GPs and patients.