title: The ‘problem’ of Asian women’s sexuality: public discourses in Aotearoa/New Zealand

authors: Simon-Kumar, Rachel

subjects: Asian

abstract: Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicised as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them.

text: The ‘problem’ of Asian women’s sexuality: public discourses in Aotearoa/New Zealand Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicised as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them.

year: 2009

title: Exploring discharge delay from an acute surgical unit

authors: Voogt, Jolene Elouise

subjects: Discharge

abstract: Background: Within the hospital system, efficient patient flow is essential. Discharge delay, the period of continued hospital stay after a patient is deemed medically fit to leave hospital, is one of the most significant barriers to optimal patient flow. Discharge delay retains non-acute patients in the acute environment unnecessarily, while preventing acutely presenting patients from accessing services in a timely manner. It results in overcrowded emergency departments with delayed admissions, slowed theatre schedules, and bed blocking in critical care, as well as negatively impacting on patient experience. In the context of a public health system under pressure, reducing discharge delay is critical to improving overall function of the system. This study aims to explore the features in the context of an acute surgical unit that cause discharge delay, the impacts of discharge delay, and the ways discharge delay could be minimised.
Methods: A two phased, mixed methods design was employed in this research. Phase one obtained qualitative data through semi-structured interview with staff members occupying different roles within the health care team within Te Whatu Ora – Waikato. Themes derived from phase one informed the development of an audit form utilised in phase two, which collected quantitative data through its completion by registered nurses working in the acute surgical unit during the two-week audit time period. This audit recorded discharge related times and delaying factors that occurred for all the patients discharged from the ward during the audit period.
Findings: Interviews were undertaken with nine participants (Hospital management n=2, Acute Surgical Unit management n=2, Registered Nurse n=1, Surgical Fellow n=1, Surgical Registrar n=1, Surgical House officer n=1, and multi-disciplinary team member n=1). Thematic analysis of the transcriptions revealed three core themes: (i) It takes a village to discharge a patient; (ii) Preparation, clearance, home; and (iii) Challenges and solutions to discharge delay. The survey was completed by 44 Registered Nurses and on analysis revealed a mean patient delay of 225 minutes, or 3.75 hours. For the audited patients, the most frequently occurring factor was ‘waiting for paperwork’ (55%) followed by ‘waiting for transport’ (40%).
Conclusions: This study found that to reduce discharge delay a coordinated, system-wide approach with discharge focused optimisation across the entire patient journey, and particular focus on reducing the amount of delay caused by discharge paperwork, is required. Introducing a ‘discharge-focused clinician’, would effectively reduce discharge delay by ensuring the prioritisation of discharges, allowing discharge paperwork to be completed promptly. In addition to the introduction of a discharge-focused clinician, the systems and policies surrounding discharge paperwork could also be improved. Additionally, improving the utilisation of transit lounge by routinely sending all appropriate patients to transit lounge to wait for their transport, will also reduce discharge delay.

text: Exploring discharge delay from an acute surgical unit Background: Within the hospital system, efficient patient flow is essential. Discharge delay, the period of continued hospital stay after a patient is deemed medically fit to leave hospital, is one of the most significant barriers to optimal patient flow. Discharge delay retains non-acute patients in the acute environment unnecessarily, while preventing acutely presenting patients from accessing services in a timely manner. It results in overcrowded emergency departments with delayed admissions, slowed theatre schedules, and bed blocking in critical care, as well as negatively impacting on patient experience. In the context of a public health system under pressure, reducing discharge delay is critical to improving overall function of the system. This study aims to explore the features in the context of an acute surgical unit that cause discharge delay, the impacts of discharge delay, and the ways discharge delay could be minimised.
Methods: A two phased, mixed methods design was employed in this research. Phase one obtained qualitative data through semi-structured interview with staff members occupying different roles within the health care team within Te Whatu Ora – Waikato. Themes derived from phase one informed the development of an audit form utilised in phase two, which collected quantitative data through its completion by registered nurses working in the acute surgical unit during the two-week audit time period. This audit recorded discharge related times and delaying factors that occurred for all the patients discharged from the ward during the audit period.
Findings: Interviews were undertaken with nine participants (Hospital management n=2, Acute Surgical Unit management n=2, Registered Nurse n=1, Surgical Fellow n=1, Surgical Registrar n=1, Surgical House officer n=1, and multi-disciplinary team member n=1). Thematic analysis of the transcriptions revealed three core themes: (i) It takes a village to discharge a patient; (ii) Preparation, clearance, home; and (iii) Challenges and solutions to discharge delay. The survey was completed by 44 Registered Nurses and on analysis revealed a mean patient delay of 225 minutes, or 3.75 hours. For the audited patients, the most frequently occurring factor was ‘waiting for paperwork’ (55%) followed by ‘waiting for transport’ (40%).
Conclusions: This study found that to reduce discharge delay a coordinated, system-wide approach with discharge focused optimisation across the entire patient journey, and particular focus on reducing the amount of delay caused by discharge paperwork, is required. Introducing a ‘discharge-focused clinician’, would effectively reduce discharge delay by ensuring the prioritisation of discharges, allowing discharge paperwork to be completed promptly. In addition to the introduction of a discharge-focused clinician, the systems and policies surrounding discharge paperwork could also be improved. Additionally, improving the utilisation of transit lounge by routinely sending all appropriate patients to transit lounge to wait for their transport, will also reduce discharge delay.

year: 2022

title: Mai uta ki tai: Cyclone-driven suspended sediment effects on early benthic juvenile kōura (Jasus edwardsii), Te Ākau o Tokomaru, Aotearoa

authors: Karaha-Paki, Vijuan

abstract: Kōura (Jasus edwardsii) are ecologically, culturally, and economically significant taonga species central to mahinga kai systems throughout Aotearoa New Zealand. In Te Tairāwhiti, particularly Te Ākau o Tokomaru, Cyclone Gabrielle (February 2023) resulted in unprecedented sediment loads being delivered to coastal waters, smothering inshore rocky reefs that serve as critical nursery habitats for settling puerulus and juvenile kōura. This research investigated how repeated suspended sediment exposure affects the body condition, survival, and physiological condition of early benthic juvenile kōura, integrating Western scientific methods with mātauranga Māori perspectives to support kaitiakitanga and ecosystem recovery. 

A 52-day pulse-based laboratory experiment exposed 81 early benthic juvenile kōura to three treatment levels: Control (0 mg/L), Tobserved (1,000 mg/L), and Tmaximised (5,000 mg/L) suspended sediment concentrations, alternating between exposure phases and recovery periods to simulate natural post-storm sedimentation dynamics. Sediment was sourced from the Mangahauini River mouth to reflect local conditions. Kōura were initially housed communally (Days 1-19), and then separated into individual tāruke following observed cannibalism. Across the experiment, body weight to carapace length (BW:CL) ratios, survival, blood refractive index, gill condition, and moult stage were assessed. 

All treatment groups began with statistically equivalent body condition (p = 0.135), but cumulative effects emerged over time. During communal housing, mortality was highest in the Tobserved treatment (51.9%) compared with Control and Tmaximised treatments (both 18.5%). After separation, Tmaximised individuals showed the greatest losses (45.5%), mostly during the recovery rather than exposure phases. Overall mortality reached 45.7%, with sediment-exposed treatments experiencing 55% (Tmaximised) to 59% (Tobserved) losses compared with 22.2% in the Controls (p = 0.001). 

By Day 52, sediment exposure significantly reduced body condition (p = 0.016), with the Controls maintaining higher BW:CL ratios than Tmaximised (p = 0.013). Gill assessments indicated universal and severe damage in sediment-exposed kōura (100%) but none in the Controls (0%). Quantitative image analysis confirmed strong sediment concentration- dependent effects across all damage metrics – particle lodgement, filament integrity, surface discolouration, and composite scores (all p < 0.001) – with structural deformities in 66.7% of Tobserved and 100% of Tmaximised individuals. Blood refractive index showed no treatment differences, and 84.1% of kōura remained in intermoult stage at Day 52, with no significant difference in moult stage distribution between treatments (p = 0.328). However, moult frequency during the individual phase was lower in sediment-exposed groups compared to the Controls (Control: n = 11, Tobserved: n = 4, Tmaximised: n = 5). 

These findings show that suspended sediment exposure poses population-level threats to kōura recruitment through irreversible gill damage and delayed mortality. Elevated cannibalism during communal holding, particularly observed in the Tobserved treatment, likely resulted from temporal clustering of moult events rather than sediment-induced behaviour. For Te Ākau o Tokomaru and the wider CRA 3 fishery, this highlights the need for integrated catchment-to- coast management addressing land-derived sediment inputs and protecting coastal nursery habitats. From a Te Ao Māori perspective, sedimentation represents a disruption to whakapapa relationships with Tangaroa and a weakening of mauri in coastal ecosystems. Restoring these connections requires co-governance frameworks that embed mātauranga Māori, empower kaitiaki-led monitoring and rāhui, and address the cumulative impacts of land-use intensification and repeated cyclone events on ecosystem resilience in Te Tairāwhiti.

text: Mai uta ki tai: Cyclone-driven suspended sediment effects on early benthic juvenile kōura (Jasus edwardsii), Te Ākau o Tokomaru, Aotearoa Kōura (Jasus edwardsii) are ecologically, culturally, and economically significant taonga species central to mahinga kai systems throughout Aotearoa New Zealand. In Te Tairāwhiti, particularly Te Ākau o Tokomaru, Cyclone Gabrielle (February 2023) resulted in unprecedented sediment loads being delivered to coastal waters, smothering inshore rocky reefs that serve as critical nursery habitats for settling puerulus and juvenile kōura. This research investigated how repeated suspended sediment exposure affects the body condition, survival, and physiological condition of early benthic juvenile kōura, integrating Western scientific methods with mātauranga Māori perspectives to support kaitiakitanga and ecosystem recovery. 

A 52-day pulse-based laboratory experiment exposed 81 early benthic juvenile kōura to three treatment levels: Control (0 mg/L), Tobserved (1,000 mg/L), and Tmaximised (5,000 mg/L) suspended sediment concentrations, alternating between exposure phases and recovery periods to simulate natural post-storm sedimentation dynamics. Sediment was sourced from the Mangahauini River mouth to reflect local conditions. Kōura were initially housed communally (Days 1-19), and then separated into individual tāruke following observed cannibalism. Across the experiment, body weight to carapace length (BW:CL) ratios, survival, blood refractive index, gill condition, and moult stage were assessed. 

All treatment groups began with statistically equivalent body condition (p = 0.135), but cumulative effects emerged over time. During communal housing, mortality was highest in the Tobserved treatment (51.9%) compared with Control and Tmaximised treatments (both 18.5%). After separation, Tmaximised individuals showed the greatest losses (45.5%), mostly during the recovery rather than exposure phases. Overall mortality reached 45.7%, with sediment-exposed treatments experiencing 55% (Tmaximised) to 59% (Tobserved) losses compared with 22.2% in the Controls (p = 0.001). 

By Day 52, sediment exposure significantly reduced body condition (p = 0.016), with the Controls maintaining higher BW:CL ratios than Tmaximised (p = 0.013). Gill assessments indicated universal and severe damage in sediment-exposed kōura (100%) but none in the Controls (0%). Quantitative image analysis confirmed strong sediment concentration- dependent effects across all damage metrics – particle lodgement, filament integrity, surface discolouration, and composite scores (all p < 0.001) – with structural deformities in 66.7% of Tobserved and 100% of Tmaximised individuals. Blood refractive index showed no treatment differences, and 84.1% of kōura remained in intermoult stage at Day 52, with no significant difference in moult stage distribution between treatments (p = 0.328). However, moult frequency during the individual phase was lower in sediment-exposed groups compared to the Controls (Control: n = 11, Tobserved: n = 4, Tmaximised: n = 5). 

These findings show that suspended sediment exposure poses population-level threats to kōura recruitment through irreversible gill damage and delayed mortality. Elevated cannibalism during communal holding, particularly observed in the Tobserved treatment, likely resulted from temporal clustering of moult events rather than sediment-induced behaviour. For Te Ākau o Tokomaru and the wider CRA 3 fishery, this highlights the need for integrated catchment-to- coast management addressing land-derived sediment inputs and protecting coastal nursery habitats. From a Te Ao Māori perspective, sedimentation represents a disruption to whakapapa relationships with Tangaroa and a weakening of mauri in coastal ecosystems. Restoring these connections requires co-governance frameworks that embed mātauranga Māori, empower kaitiaki-led monitoring and rāhui, and address the cumulative impacts of land-use intensification and repeated cyclone events on ecosystem resilience in Te Tairāwhiti.

year: 2025