Teenagers' perspectives on the Canterbury earthquakes : an insight into their needs and experiences : a thesis presented in partial fulfillment of the requirements of the degree of Doctor of Clinical Psychology, Massey University, Wellington, New Zealand

Natural disasters inflict physical, psychosocial, and economic impacts on individuals and their communities. Although a substantial number of disaster survivors are teenagers (13-19 years), this population group has not been widely investigated, especially regarding their views on their post-disaster needs and received supports. Such information would be important when planning post-disaster supports for current and future disaster-exposed teenagers. The aim of this research therefore, was to explore teenagers’ experiences and retrospective views of their needs, supports, and recovery following the Canterbury, New Zealand earthquakes. The first study surveyed 398 Christchurch secondary school students (aged 16-18 years [male = 169; female = 229]) who had experienced at least one of the major Canterbury earthquakes between September 2010 and June 2011. The survey’s purpose was to obtain an overview of teenagers’ experiences (including their needs and supports received), using both qualitative and quantitative data. Content analysis of this data revealed nine overall themes, including: physical basics, secondary stressors, social support, psychological impact, coping, school, support figures, gender, and recovery. Decile 2 school participants reported a need for physical basics significantly more than deciles 3, 9 and 10, and decile 10 reported a need for social support significantly more than decile 2. With gender, females reported a need for social support significantly more than males, and males reported a need for physical basics significantly more than females. Also, participants reported that their parents/caregivers understood their needs better than their siblings and friends, and their teachers were of greater help to them following the earthquakes compared to other students in their class. The second study extended the enquiry and involved six focus groups, each containing three to six students aged 16-18 years (male = 13; female = 18). Findings from the first study informed these focus group discussions, the aims of which were to gain deeper insights into disaster-exposed teenagers’ experiences, needs, and supports. The discussions were transcribed and analysed via thematic analysis. This analysis revealed seven major areas of importance, including participants’ advice for future planning and six others: individual, family, school, community, national and international. The latter six areas were incorporated into an ecological model combined with a timeline spanning from 2010 till 2013. The model demonstrated a number of notable points - for instance, immediately after the earthquakes many of the participants’ most important needs was to be in the presence of family, to know that family members were safe, and to receive comfort from them; however, three years later, participants’ concern had shifted to the rebuild of their city and their need for not only the pace to quicken, but also for youthfocused areas to be built (e.g., for recreational and leisure activities). The main recommendations from the research include: addressing acute post-disaster psychological responses early on and arranging preventative interventions; incorporating parental mental health support into youth-focused interventions; individually tailoring supports that address differences in gender, living conditions, and damage; encouraging youth to talk but not forcing them; having schools resume structured routines as soon as possible; providing psychoeducation to teachers, parents and guardians regarding typical disaster reactions and coping strategies for youth; and providing teenagers with accurate information. It is also recommended that communities provide or facilitate entertainment for youth post-disaster; that they organise youth-focused volunteer groups; involve youth in rebuild consultations; commence the rebuild of a disaster-struck city as soon as possible, and maintain gains in progress; distribute important information in multiple languages; and try to ensure that media coverage maintains a balance between both positive and negative content. Possible areas for future research include a deeper investigation into the experiences of disaster-exposed international students, the impact of the duration and permanency of relocation, and longitudinal studies into the recovery and adaptation of youth

Molecular mechanisms governing plant parasitic nematode signaling and host parasitism

Pathogen infection of crops causes large-scale annual yield losses for farmers worldwide and hinders global efforts to provide adequate amounts of nutrition for the ever-growing human population. Plant-parasitic nematodes (PPN) are among some of the most devastating pathogens due to their ability to parasitize an expansive variety of agriculturally important crops. In order to identify ways to attenuate PPN infection and limit yield losses it is vital that we increase our understanding of host-PPN interactions. Here we investigate the molecular mechanisms that are occurring both within PPN and at the interface between PPN and their host plants. Research into PPN-derived secretory proteins, termed effectors is currently the most well studied avenue of research to date. Discoveries made as part of this dissertation make a significant contribution to PPN effector research by identifying the first DNA-binding PPN effector and characterizing its functionality in the model PPN-host system Heterodera schachtii, the sugar beet cyst nematode, and Arabidopsis thaliana. The secretion of exosomes and small RNAs from a number of pathogens into their respective hosts, including animal parasitic nematodes, led us to investigate these potential mechanisms in PPN. Exploration into exosome secretion in two different PPN species yielded a small and inconsistent number of exosome-like vesicles. It became apparent that isolation of exosomes from obligate parasites such as PPN poses a number of technical challenges making it impossible to conclude that the release of exosomes is a bone-fide parasitic strategy utilized by PPN. High-throughput small RNA sequencing of H. glycines led to the detection of a set of PPN-derived miRNAs that have the potential to target host plant transcripts. Future verification of the functionality of PPN-derived miRNAs within host cells will represent a major breakthrough in our understanding of PPN infection. Finally, we investigated the role of spliced leader trans-splicing (SLTS) in Heterodera glycines, the soybean cyst nematode. The existence of spliced leaders (SL) within the nematode phylum was documented several decades ago but it is still unclear what role SLTS plays within the nematode and how vital this role is to nematode viability. A comprehensive genome and transcriptome-wide SL study was conducted in H. glycines, which identified a large set of hypervariable SLs that were collectively found on \u3e2,000 transcripts. The frequent appearance of H. glycines SLs on a large number of transcripts makes them an attractive target for future RNAi studies aimed at significantly affecting the viability of H. glycines. Collectively, the research presented in this dissertation furthers our understanding of currently explored parasitic mechanisms and offers plausible insights into promising new avenues of PPN research

Immersive simulations with extreme teams

Extreme teams (ETs) work in challenging, high pressured contexts, where poor performance can have severe consequences. These teams must coordinate their skill sets, align their goals, and develop shared awareness, all under stressful conditions. How best to research these teams poses unique challenges as researchers seek to provide applied recommendations while conducting rigorous research to test how teamwork models work in practice. In this article, we identify immersive simulations as one solution to this, outlining their advantages over existing methodologies and suggesting how researchers can best make use of recent advances in technology and analytical techniques when designing simulation studies. We conclude that immersive simulations are key to ensuring ecological validity and empirically reliable research with ETs

Overcoming the challenges and complexities of researching a vulnerable population within a palliative care context

While previous studies have investigated sleep issues in chronic illness and the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I), this has not been examined within palliative care. High rates of sleep difficulties have been found in patients receiving palliative care. We aimed to explore the practical feasibility of implementing CBT-I among palliative patients using techniques such as stimulus control therapy, progressive muscle relaxation and guided imagery/thought blocking. However, issues such as the intervention protocols being relatively labor intensive and time consuming for participants that were receiving palliative care, involving completion of daily diaries and quantitative outcome measures, led to high non-completion rates among participants. Consequently, a shift in methodology was required and a qualitative approach was adopted to explore participants’ experiences of sleep disturbance within palliative care. The aim was to gain an in-depth understanding of the specific issues and challenges within palliative care that impacted on sleep. Focus groups were conducted with patients, informal carers and hospice staff who all described how they experienced sleep difficulties. This provided a broader understanding of insomnia from multiple perspectives within palliative care. Furthermore, it helped inform how we will go about designing future studies in CBT-I in palliative care; having illuminated the appropriate adaptions required to current protocols. This case study will discuss the complexities and ethical issues we faced at each stage of the research process and how adopting both quantitative and qualitative approaches helped provide useful insights that will inform future research

Moving towards social inclusion: engaging rural voices in priority setting for health

Background Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable in this regard, but there are limited examples of their practical application, and gaps in understanding their outcomes, especially with rural populations. Objective To address this gap, we implemented a modified priority setting tool (Choosing All Together—CHAT) that enables individuals and groups to make trade-offs to demonstrate the type of health services packages that may be acceptable to a rural population. The paper presents the findings from the individual choices as compared to the group choices, as well as the differences among the individual choices using this tool. Methods Participants worked in groups and as individuals to allocate stickers representing the available budget to different health topics and interventions using the CHAT tool. The allocations were recorded at each stage of the study. We calculated the median and interquartile range across study participants for the topic totals. To examine differences in individual choices, we performed Wilcoxon rank sum tests. Results The results show that individual interests were mostly aligned with societal ones, and there were no statistically significant differences between the individual and group choices. However, there were some statistically significant differences between individual priorities based on demographic characteristics like age. Discussion The study demonstrates that giving individuals greater control and agency in designing health services packages can increase their participation in the priority setting process, align individual and community priorities, and potentially enhance the legitimacy and acceptability of priority setting. Methods that enable group level deliberation and individual level priority setting may be necessary to reconcile plurality. The paper also highlights the importance of capturing the details of public engagement processes and transparently reporting on these details to ensure valuable outcomes. Public Contribution The facilitator of the CHAT groups was a member from the community and underwent training from the research team. The fieldworkers were also from the community and were trained and paid to capture the data. The participants were all members of the rural community- the study represents their priorities

Training school teachers in Malawi about substance misuse and trauma: the need for a sustainable strategy

Purpose The World Health Organisation found depression to be the fourth leading cause of disability in Malawi (Bowie, 2006) with the prevalence of mental health need in children and young people in Malawi estimated between 10 and 30% (Kutcher et al., 2019). One option to address this was to provide schoolteachers with skills and knowledge related to mental health so they can better support children. There is generally a lack of evidence of the utility or feasibility of school-based mental health literacy programmes in low to medium income countries (LMIC). This paper aims to report on a project to train schoolteachers in Malawi on aspects of mental health. Design/methodology/approach The aim of this project was to determine the acceptability and feasibility of delivering a training initiative in Malawi to teachers to better enable them to recognise and cope with school children who had been exposed to trauma and substance misuse. Findings Feedback was generated through the use of a specifically designed pre and post measure, focus groups, interviews and observations of the teaching delivery. Practical implications Teachers found the training built on their existing knowledge and they requested further opportunities for training and consultation about how to manage difficult presentations. It was evident that teachers did not know how to access mental health care or support for children whose needs could not be met by schoolteachers alone. Originality/value For a sustainable improvement for children’s mental health care in this context, further training becomes valuable when located as part of a network of joined up health and educational services