Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.
The magnitude 6.2 Christchurch earthquake struck the city of Christchurch at 12:51pm on February 22, 2011. The earthquake caused 186 fatalities, a large number of injuries, and resulted in widespread damage to the built environment, including significant disruption to lifeline networks and health care facilities. Critical facilities, such as public and private hospitals, government, non-government and private emergency services, physicians’ offices, clinics and others were severely impacted by this seismic event. Despite these challenges many systems were able to adapt and cope. This thesis presents the physical and functional impact of the Christchurch earthquake on the regional public healthcare system by analysing how it adapted to respond to the emergency and continued to provide health services. Firstly, it assesses the seismic performance of the facilities, mechanical and medical equipment, building contents, internal services and back-up resources. Secondly, it investigates the reduction of functionality for clinical and non-clinical services, induced by the structural and non-structural damage. Thirdly it assesses the impact on single facilities and the redundancy of the health system as a whole following damage to the road, power, water, and wastewater networks. Finally, it assesses the healthcare network's ability to operate under reduced and surged conditions. The effectiveness of a variety of seismic vulnerability preparedness and reduction methods are critically reviewed by comparing the observed performances with the predicted outcomes of the seismic vulnerability and disaster preparedness models. Original methodology is proposed in the thesis which was generated by adapting and building on existing methods. The methodology can be used to predict the geographical distribution of functional loss, the residual capacity and the patient transfer travel time for hospital networks following earthquakes. The methodology is used to define the factors which contributed to the overall resilence of the Canterbury hospital network and the areas which decreased the resilence. The results show that the factors which contributed to the resilence, as well as the factors which caused damage and functionality loss were difficult to foresee and plan for. The non-structural damage to utilities and suspended ceilings was far more disruptive to the provision of healthcare than the minor structural damage to buildings. The physical damage to the healthcare network reduced the capacity, which has further strained a health care system already under pressure. Providing the already high rate of occupancy prior to the Christchurch earthquake the Canterbury healthcare network has still provided adequate healthcare to the community.
Christchurch has experienced a series of over 13,500 earthquakes between September 2010 and January 2012. Some children who have been exposed to earthquakes may experience post-traumatic stress disorder symptoms (PTSD) including difficulty concentrating, feeling anxious, restlessness and confusion. Other children may be resilient to the effects of disaster. Western models of resilience relate to a child’s social support and their capacity to cope. The Māori model of wellbeing relates to whanau (family), wairua (spiritual connections), tinana (the physical body) and hinengaro (the mind and emotions). Children’s concepts of helping, caring and learning may provide insight into resilience without introducing the topic of earthquakes into the conversation, which in itself may provoke an episode of stress. Many researchers have studied the effects of earthquakes on children. However, few studies have examined positive outcomes and resilience or listened to the children’s voices. The objective of this study was to listen to the voices of children who experienced the Canterbury earthquake period in order to gain a deeper understanding of the ideas associated resilience. Individual interviews were conducted with 17 five-year-old participants during their first term of primary school. After the interviews, the teacher shared demographic information and reports on the children’s stress and coping. Six children were identified as New Zealand European and eleven children identified as New Zealand Māori. Children had different views of helping, caring and learning. Themes of resilience from Western and Kaupapa Māori models were identified in transcripts of the children's voices and drawings. Māori children voiced more themes of resilience associated with the Western model, and in the Tapa Whā model, Māori children's transcripts were more likely to be inclusive of all four components of well-being. How five-year-old children, having experienced an earthquake disaster during their preschool years, talk or draw pictures about helping, caring and learning can provide insight into resilience, especially in situations where it is not advisable to re-traumatise children by discussing the disaster event. Future research should interview parents/caregivers and whānau to gain further insights. Considering information from both a Western and a Tapa Whā perspective can also provide new insights into resilience in young children. A limitation of this study is that qualitative studies are not always free from a researcher’s interpretation and are, therefore, subjective.
Rising disaster losses, growth in global migration, migrant labour trends, and increasingly diverse populations have serious implications for disaster resilience around the world. These issues are of particular concern in New Zealand, which is highly exposed to disaster risk and has the highest proportion of migrant workers to national population in the OECD. Since there has been no research conducted into this issue in New Zealand to date, greater understanding of the social capital used by migrant workers in specific New Zealand contexts is needed to inform more targeted and inclusive disaster risk management approaches. A New Zealand case study is used to investigate the extent and types of social capital and levels of disaster risk awareness reported by members of three Filipino migrant workers organisations catering to dairy farm, construction and aged care workers in different urban and rural Canterbury districts. Findings from (3) semi-structured interviews and (3) focus groups include consistently high reliance on bonding capital and low levels of bridging capital across all three organisations and industry sectors, and in both urban and rural contexts. The transitory, precarious residential status conveyed by temporary work visas, and the difficulty of building bridging capital with host communities has contributed to this heavy reliance on bonding capital. Social media was essential to connect workers with family and friends in other countries, while Filipino migrant workers organisations provided members with valuable access to industry and district-specific networks of other Filipino migrant workers. Linking capital varied between the three organisations, with members of the organisation set up to advocate for dairy farm workers reporting the highest levels of linking capital. Factors influencing the capacity of workers organisations to develop linking capital appeared to include motivation (establishment objectives), length of time since establishment, support from government and industry groups, urban-rural context, income levels and gender. Although aware of publicity around earthquake and tsunami risk in the Canterbury region, participants were less aware of flood risk, and expressed fatalistic attitudes to disaster risk. Workers organisations offer a valuable potential interface between CDEM Group activities and migrant worker communities, since organisation leaders were interested in accessing government support to participate (with and on behalf of members) in disaster risk planning at district and regional level. With the potential to increase disaster resilience among these vulnerable, hard to reach communities, such participation could also help to build capacity across workers organisations (within Canterbury and across the country) to develop linking capital at national, as well as regional level. However, these links will also depend on greater government and industry commitment to providing more targeted and appropriate support for migrant workers, including consideration of the cultural qualifications of staff tasked with liaising with this community.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
People aged 65 years and older are the fastest growing age group in New Zealand. By the mid-2070s, there are predictions that this age group is likely to comprise approximately one third of the population. Older people are encouraged to stay in their own homes within their community for as long as possible with support to encourage the extension of ageing in place. Currently around 14% of those aged 75 years or older, make the move into retirement villages. This is expected to increase. Little is known by retirement villages about the wellbeing and health of those who decide to live independently in these facilities. Predicting the need for a continuum of care is challenging. This research measured the wellbeing and health of older adults. It was situated in a critical realist paradigm, overlaid with an empathetic axiology. A focused literature review considered the impact on wellbeing from the aspects of living place, age, gender, health status and the 2010/2011 Canterbury earthquakes. Longitudinal studies used the Enlightenment Scale and the interRAI Community Health Assessment (CHA) to measure the wellbeing and health of one group of residents (n=120) living independently in one retirement village in Canterbury, New Zealand. The research was extended to incorporate two cross-section studies when initial results for wellbeing were found to be higher than anticipated. These additional studies included participants living independently from other retirement villages (n=115) and those living independently within the community (n=354). A total of 589 participants, aged 65 – 97 years old, completed the Enlightenment Scale across the four studies. Across the living places, wellbeing continued to significantly improve with age. The Enlightenment Scale was a useful measure of wellbeing with older adults. Participants in the longitudinal studies largely maintained a relatively good health status, showing little change over the study period of 15 months. Predictions for the need for a move to supportive care were not able to be made using the CHA. The health status of participants did not influence their level of wellbeing. The key finding of note is that the wellbeing score of older adults increases by 1.27 points per year, using the Enlightenment Scale, irrespective of where they live.
This article argues that teachers deserve more recognition for their roles as first responders in the immediate aftermath of a disaster and for the significant role they play in supporting students and their families through post-disaster recovery. The data are drawn from a larger study, 'Christchurch Schools Tell Their Earthquake Stories' funded by the United Nations Educational, Scientific and Cultural Organisation and the University of Auckland, in which schools were invited to record their earthquake stories for themselves and for historical archives. Data were gathered from five primary schools between 2012 and 2014. Methods concerned mainly semi-structured individual or group interviews and which were analysed thematically. The approach was sensitive, flexible and participatory with each school being able to choose its focus, participants and outcome. Participants from each school generally included the principal and a selection of teachers, students and parents. In this study, the data relating to the roles of teachers were separated out for closer analysis. The findings are presented as four themes: immediate response; returning to (new) normal; care and support; and long term effects.
This paper begins with a discussion of the history of negligent manslaughter in New Zealand and its development from the standard of ordinary negligence to the current test of a “major departure” from the expected standard of care, as set out under s 150A of the Crimes Act 1961. The paper then examines failings in s 150A’s current application, arguing that the “major departure” test has created injustices due to its strictly objective nature. Two examples of this are discussed in-depth, Bawa-Garba v R (UK) where a doctor was convicted of grossly negligent manslaughter for the death of her patient; and the decision not to prosecute the negligent engineers of the CTV building which collapsed in the Christchurch earthquake of 2011. The paper discusses three potential resolutions moving forward. It concludes that a more subjective interpretation of the wording of s 150A, which takes account of circumstances excusing or condemning a defendant’s conduct, would prevent future injustices and be a reasonably open interpretation on the wording of s 150A.
Decision making on the reinstatement of the Christchurch sewer system after the Canterbury (New Zealand) earthquake sequence in 2010–2011 relied strongly on damage data, in particular closed circuit television (CCTV). This paper documents that process and considers how data can influence decision making. Data are analyzed on 33,000 pipes and 13,000 repairs and renewals. The primary findings are that (1) there should be a threshold of damage per pipe set to make efficient use of CCTV; (2) for those who are estimating potential damage, care must be taken in direct use of repair data without an understanding of the actual damage modes; and (3) a strong correlation was found between the ratio of faults to repairs per pipe and the estimated peak ground velocity. Taken together, the results provide evidence of the extra benefit that damage data can provide over repair data for wastewater networks and may help guide others in the development of appropriate strategies for data collection and wastewater pipe decisions after disasters.
The Evaluating Maternity Units (EMU) study is a mixed method project involving a prospective cohort study, surveys (two postnatal questionnaires) and focus groups. It is an Australasian project funded by the Australian Health and Medical Research Council. Its primary aim was to compare the birth outcomes of two groups of well women – one group who planned to give birth at a primary maternity unit, and a second group who planned to give birth at a tertiary hospital. The secondary aim was to learn about women’s views and experiences regarding their birthplace decision-making, transfer, maternity care and experiences, and any other issues they raised. The New Zealand arm of the study was carried out in Christchurch, and was seriously affected by the earthquakes, halting recruitment at 702 participants. Comprehensive details were collected from both midwives and women regarding antenatal and early labour changes of birthplace plans and perinatal transfers from the primary units to the tertiary hospital. Women were asked about how they felt about plan changes and transfers in the first survey, and they were discussed in some focus groups. The transfer findings are still being analysed and will be presented. This study is set within the local maternity context, is recent, relevant and robust. It provides midwives with contemporary information about transfers from New Zealand primary maternity units and women’s views and experiences. It may help inform the conversations midwives have with each other, and with women and their families/whānau, regarding the choices of birthplace for well childbearing women.
The 22nd February 2011, Mw 6.3 Christchurch earthquake in New Zealand caused major damage to critical infrastructure, including the healthcare system. The Natural Hazard Platform of NZ funded a short-term project called “Hospital Functions and Services” to support the Canterbury District Health Board’s (CDHB) efforts in capturing standardized data that describe the effects of the earthquake on the Canterbury region’s main hospital system. The project utilised a survey tool originally developed by researchers at Johns Hopkins University (JHU) to assess the loss of function of hospitals in the Maule and Bío-Bío regions following the 27th February 2010, Mw 8.8 Maule earthquake in Chile. This paper describes the application of the JHU tool for surveying the impact of Christchurch earthquake on the CDHB Hospital System, including the system’s residual capacity to deliver emergency response and health care. A short summary of the impact of the Christchurch earthquake on other CDHB public and private hospitals is also provided. This study demonstrates that, as was observed in other earthquakes around the world, the effects of damage to non-structural building components, equipment, utility lifelines, and transportation were far more disruptive than the minor structural damage observed in buildings (FEMA 2007). Earthquake related complications with re-supply and other organizational aspects also impacted the emergency response and the healthcare facilities’ residual capacity to deliver services in the short and long terms.
The purpose of this research is to investigate men’s experiences of the 2016 7.8 magnitude Kaikōura earthquake and Tsunami. While, research into the impacts of the earthquake has been conducted, few studies have examined how gender shaped people’s experiences of this natural hazard event. Analysing disasters through a gender lens has significantly contributed to disaster scholarship in identifying the resilience and vulnerabilities of individuals and communities pre- and post-disaster (Fordham, 2012; Bradshaw, 2013). This research employs understandings of masculinities (Connell, 2005), to examine men’s strengths and challenges in responding, recovering, and coping following the earthquake. Qualitative inquiry was carried out in Northern Canterbury and Marlborough involving 18 face-to-face interviews with men who were impacted by the Kaikōura earthquake and its aftermath. Interview material is being analysed using thematic and narrative analysis. Some of the preliminary findings have shown that men took on voluntary roles in addition to their fulltime paid work resulting in long hours, poor sleep and little time spent with family. Some men assisted wives and children to high ground then drove into the tsunami zone to check on relatives or to help evacuate people. Although analysis of the findings is currently ongoing, preliminary findings have identified that the men who participated in the study have been negatively impacted by the 2016 Kaikōura earthquake. A theme identified amongst participants was an avoidance to seek support with the challenges they were experiencing due to the earthquake. The research findings align with key characteristics of masculinity, including demonstrating risky behaviours and neglecting self or professional care. This study suggests that these behaviours affect men’s overall resilience, and thus the resilience of the wider community.
Social and natural capital are fundamental to people’s wellbeing, often within the context of local community. Developing communities and linking people together provide benefits in terms of mental well-being, physical activity and other associated health outcomes. The research presented here was carried out in Christchurch - Ōtautahi, New Zealand, a city currently re-building, after a series of devastating earthquakes in 2010 and 2011. Poor mental health has been shown to be a significant post-earthquake problem, and social connection has been postulated as part of a solution. By curating a disparate set of community services, activities and facilities, organised into a Geographic Information Systems (GIS) database, we created i) an accessibility analysis of 11 health and well-being services, ii) a mobility scenario analysis focusing on 4 general well-being services and iii) a location-allocation model focusing on 3 primary health care and welfare location optimisation. Our results demonstrate that overall, the majority of neighbourhoods in Christchurch benefit from a high level of accessibility to almost all the services; but with an urban-rural gradient (the further away from the centre, the less services are available, as is expected). The noticeable exception to this trend, is that the more deprived eastern suburbs have poorer accessibility, suggesting social inequity in accessibility. The findings presented here show the potential of optimisation modelling and database curation for urban and community facility planning purposes.
Following the 2010/2011 Canterbury earthquakes a detailed campaign of door to door assessments was conducted in a variety of areas of Christchurch to establish the earthquake performance of residential dwellings having masonry veneer as an external cladding attached to a lightweight timber framing system. Specifically, care was taken to include regions of Christchurch which experienced different levels of earthquake shaking in order to allow comparison between the performance of different systems and different shaking intensities. At the time of the inspections the buildings in the Christchurch region had been repeatedly subjected to large earthquakes, presenting an opportunity for insight into the seismic performance of masonry veneer cladding. In total just under 1100 residential dwellings were inspected throughout the wider Christchurch area, of which 24% were constructed using the older nail-on veneer tie system (prior to 1996) and 76% were constructed using screw fixed ties to comply with the new 1996 standards revision (post-1996), with 30% of all inspected houses being of two storey construction. Of the inspected dwellings 27% had some evidence of liquefaction, ground settlement or lateral spreading. Data such as damage level, damage type, crack widths, level of repair required and other parameters were collected during the survey. A description of the data collection processes and a snapshot of the analysis results are presented within. http://15ibmac.com/home/
For 150,000 Christchurch school students, the 12.51 pm earthquake of 22 February 2011 shattered their normal lunch time activities and thrust their teachers into the role of emergency first responders. Whether helping students (children) escape immediate danger, or identifying and managing the best strategies for keeping children safe, including provision of extended caregiving when parents were unable to return to school to retrieve their children, teachers had to manage their own fears and trauma reactions in order to appear calm and prevent further distress for the children in their care. Only then did teachers return to their families. Eighteen months later, twenty teachers from across Christchurch, were interviewed. At 12.51pm, the teachers were essentially first responders. Using their usual methods for presenting a calm and professional image, the teachers’ emotion regulation (ER) strategies for managing their immediate fears were similar to those of professional first responders, with similar potential for subsequent burnout and negative emotional effects. Teachers’ higher emotional exhaustion and burnout 18 months later, were associated with school relocation. Lower burnout was associated with more emotional awareness, ER and perceived support. Consistent with international research, teachers’ use of cognitive reappraisal (re-thinking a situation) was an effective ER strategy, but this may not prevent teachers’ emotional resources from eventually becoming depleted. Teachers fulfill an important role in supporting children’s psychosocial adjustment following a natural disaster. However, as also acknowledged in international research, we need to also focus on supporting the teachers themselves.
The purpose of this research is to investigate men’s experiences of the 2016 7.8 magnitude Kaikōura earthquake and Tsunami. While, research into the impacts of the earthquake has been conducted, few studies have examined how gender shaped people’s experiences of this natural hazard event. Analysing disasters through a gender lens has significantly contributed to disaster scholarship in identifying the resilience and vulnerabilities of individuals and communities pre- and post-disaster (Fordham, 2012; Bradshaw, 2013). This research employs understandings of masculinities (Connell, 2005), to examine men’s strengths and challenges in responding, recovering, and coping following the earthquake. Qualitative inquiry was carried out in Northern Canterbury and Marlborough involving 18 face-to-face interviews with men who were impacted by the Kaikōura earthquake and its aftermath. Interview material is being analysed using thematic and narrative analysis. Some of the preliminary findings have shown that men took on voluntary roles in addition to their fulltime paid work resulting in long hours, poor sleep and little time spent with family. Some men assisted wives and children to high ground then drove into the tsunami zone to check on relatives or to help evacuate people. Although analysis of the findings is currently ongoing, preliminary findings have identified that the men who participated in the study have been negatively impacted by the 2016 Kaikōura earthquake. A theme identified amongst participants was an avoidance to seek support with the challenges they were experiencing due to the earthquake. The research findings align with key characteristics of masculinity, including demonstrating risky behaviours and neglecting self or professional care. This study suggests that these behaviours affect men’s overall resilience, and thus the resilience of the wider community.
Background: Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children’s mental health. Objective: The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. Methods: A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. Results: A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Conclusions: Kākano is an app co-designed with parents to help manage their children’s mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
When the devastating 6.3 magnitude earthquake hit Christchurch, Aotearoa New Zealand, at 12.51pm on 22nd February 2011, the psychological and physical landscape was irrevocably changed. In the days and weeks following the disaster communities were isolated due to failed infrastructure, continuing aftershocks and the extensive search and rescue effort which focussed resources on the central business district. In such moments the resilience of a community is truly tested. This research discusses the role of grassroots community groups in facilitating community resilience during the Christchurch 2010/11 earthquakes and the role of place in doing so. I argue that place specific strategies for urban resilience need to be enacted from a grassroots level while being supported by broader policies and agencies. Using a case study of Project Lyttelton – a group aspiring towards a resilient sustainable future who were caught at the epicentre of the February earthquake – I demonstrate the role of a community group in creating resilience through self-organised place specific action during a disaster. The group provided emotional care, basic facilities and rebuilding assistance to the residents of Lyttelton, proving to be an invaluable asset. These actions are closely linked to the characteristics of social support and social learning that have been identified as important to socio-ecological resilience. In addition this research will seek to understand and explore the nuances of place and identity and its role in shaping resilience to such dis-placing events. Drawing on community narratives of the displacement of place identity, the potential for a progressive sense of place as instigated by local groups will be investigated as an avenue for adaptation by communities at risk of disaster and place destabilisation.
Interagency Emergency Response Teams (IERTs) play acrucial role in times of disasters. Therefore it is crucial to understand more thoroughly the communication roles and responsibilities of interagency team members and to examine how individual members communicate within a complex, evolving, and unstable environment. It is also important to understand how different organisational identities and their spatial geographies contribute to the interactional dynamics. Earthquakes hit the Canterbury region on September, 2010 and then on February 2011 a more devastating shallow earthquake struck resulting in severe damage to the Aged Residential Care (ARC) sector. Over 600 ARC beds were lost and 500 elderly and disabled people were displaced. Canterbury District Health Board (CDHB) set up an interagency emergency response team to address the issues of vulnerable people with significant health and disability needs who were unable to access their normal supports due to the effects of the earthquake. The purpose of this qualitative interpretive study is to focus on the case study of the response and evacuation of vulnerable people by interagencies responding to the event. Staff within these agencies were interviewed with a focus on the critical incidents that either stabilised or negatively influenced the outcome of the response. The findings included the complexity of navigating multiple agencies communication channels; understanding the different hierarchies and communication methods within each agency; data communication challenges when infrastructures were severely damaged; the importance of having the right skills, personal attributes and understanding of the organisations in the response; and the significance of having a liaison in situ representing and communicating through to agencies geographically dispersed from Canterbury. It is hoped that this research will assist in determining a future framework for interagency communication best practice and policy.
<b>Aotearoa has undoubtedly some of the most beautiful landscapes in the world, a privilege for its inhabitants. However, as our cities have developed post-colonisation, the connection between the natural environment and its occupants has diminished. Designers play a vital role within an ever evolving world to progress the built environment in a way that reflects and restores vital values that have been deprioritised. Future practice should prioritise diversity, care for the land, enhancement of community space, and sustainable practices.</b>
This research sets out to demonstrate that new design methodologies can encourage kaitiakitanga, whilst meeting the needs of urban public space. Initially through critical analysis and literature based research, a study of Ōtautahi Christchurch, the South Island’s largest city, was undertaken. The principles of a ‘15 minute city’ were also explored and applied to the city, establishing issues within the built environment that drove the overall research direction.
Through the tools of critical reflection and a research through design methodology, a design toolkit was constructed. This toolkit sets out to provide designers with a simple streamlined method of developing urban interventions that are sustainable and beneficial for human well-being. The toolkit incorporates an abstraction of the ‘15 minute city’ ideology and introduces the concepts of evolving green transportation routes within cities. Ōtautahi Christchurch, a city with a significant history of earthquake-caused damage, was chosen as the primary site for the application of this research’s proposed toolkit. The city becomes a canvas for an urban rebuild that explores and aims to set a precedent for a progressive 21st-century city.
A key finding as the toolkit research developed was the idea of a ‘temporary’ phase or intervention, being added to traditional design methodologies prior to permanent building. The research explains how this temporary phase could more actively engage diverse user groups and create active conversations between communities and designers.
The refined toolkit sets outs proposed timeline phases, methods of site analysis and development of design drivers. Alongside this, a modular architectural system establishes a design proposal for the temporary phase of an individual site within an evolving green route. This outcome provides further opportunity for realistic testing, which would actively involve communities and aims to shift our priorities within urban development. The introduction of the ‘temporary’ phase is beneficial in mitigating psychological implications on people and limiting physical impacts on the landscape.
The final design stage of the thesis applied the toolkit process to three sites in Ōtautahi Christchurch. Through a holistic lens, the toolkit framework set out methods to collate information that provides guidance for development on the sites. While some layers are initiated simply by recognising site characteristics, others are informed through software such as GIS.
Connected by a proposed green transport route, the three initial sites are developed with temporary interventions that utilise the modular design set out previously in the research. Contextualising the interventions on real world sites tested the flexibility of the system and allowed for critical reflection on the applicability of the toolkit to Aotearoa.
The research concludes by identifying future research opportunities and speculates on possible applications of its findings within the real world. Temporary Permanence highlights the significant role that we, as designers, have in shifting urban priorities to create more holistic, sustainable, and inclusive cities for people and the planet.
The supply of water following disasters has always been of significant concern to communities. Failure of water systems not only causes difficulties for residents and critical users but may also affect other hard and soft infrastructure and services. The dependency of communities and other infrastructure on the availability of safe and reliable water places even more emphasis on the resilience of water supply systems. This thesis makes two major contributions. First, it proposes a framework for measuring the multifaceted resilience of water systems, focusing on the significance of the characteristics of different communities for the resilience of water supply systems. The proposed framework, known as the CARE framework, consists of eight principal activities: (1) developing a conceptual framework; (2) selecting appropriate indicators; (3) refining the indicators based on data availability; (4) correlation analysis; (5) scaling the indicators; (6) weighting the variables; (7) measuring the indicators; and (8) aggregating the indicators. This framework allows researchers to develop appropriate indicators in each dimension of resilience (i.e., technical, organisational, social, and economic), and enables decision makers to more easily participate in the process and follow the procedure for composite indicator development. Second, it identifies the significant technical, social, organisational and economic factors, and the relevant indicators for measuring these factors. The factors and indicators were gathered through a comprehensive literature review. They were then verified and ranked through a series of interviews with water supply and resilience specialists, social scientists and economists. Vulnerability, redundancy and criticality were identified as the most significant technical factors affecting water supply system robustness, and consequently resilience. These factors were tested for a scenario earthquake of Mw 7.6 in Pukerua Bay in New Zealand. Four social factors and seven indicators were identified in this study. The social factors are individual demands and capacities, individual involvement in the community, violence level in the community, and trust. The indicators are the Giving Index, homicide rate, assault rate, inverse trust in army, inverse trust in police, mean years of school, and perception of crime. These indicators were tested in Chile and New Zealand, which experienced earthquakes in 2010 and 2011 respectively. The social factors were also tested in Vanuatu following TC Pam, which hit the country in March 2015. Interestingly, the organisational dimension contributed the largest number of factors and indicators for measuring water supply resilience to disasters. The study identified six organisational factors and 17 indicators that can affect water supply resilience to disasters. The factors are: disaster precaution; predisaster planning; data availability, data accessibility and information sharing; staff, parts, and equipment availability; pre-disaster maintenance; and governance. The identified factors and their indicators were tested for the case of Christchurch, New Zealand, to understand how organisational capacity affected water supply resilience following the earthquake in February 2011. Governance and availability of critical staff following the earthquake were the strongest organisational factors for the Christchurch City Council, while the lack of early warning systems and emergency response planning were identified as areas that needed to be addressed. Economic capacity and quick access to finance were found to be the main economic factors influencing the resilience of water systems. Quick access to finance is most important in the early stages following a disaster for response and restoration, but its importance declines over time. In contrast, the economic capacity of the disaster struck area and the water sector play a vital role in the subsequent reconstruction phase rather than in the response and restoration period. Indicators for these factors were tested for the case of the February 2011 earthquake in Christchurch, New Zealand. Finally, a new approach to measuring water supply resilience is proposed. This approach measures the resilience of the water supply system based on actual water demand following an earthquake. The demand-based method calculates resilience based on the difference between water demand and system capacity by measuring actual water shortage (i.e., the difference between water availability and demand) following an earthquake.
Fine grained sediment deposition in urban environments during natural hazard events can impact critical infrastructure and properties (urban terrain) leading to reduced social and economic function and potentially adverse public health effects. Therefore, clean-up of the sediments is required to minimise impacts and restore social and economic functionality as soon as possible. The strategies employed to manage and coordinate the clean-up significantly influence the speed, cost and quality of the clean-up operation. Additionally, the physical properties of the fine grained sediment affects the clean-up, transport, storage and future usage of the sediment. The goals of the research are to assess the resources, time and cost required for fine grained sediment clean-up in an urban environment following a disaster and to determine how the geotechnical properties of sediment will affect urban clean-up strategies. The thesis focuses on the impact of fine grained sediment (<1 mm) deposition from three liquefaction events during the Canterbury earthquake sequence (2010-2011) on residential suburbs and transport networks in Christchurch. It also presents how geotechnical properties of the material may affect clean-up strategies and methods by presenting geotechnical analysis of tephra material from the North Island of New Zealand. Finally, lessons for disaster response planning and decision making for clean-up of sediment in urban environments are presented. A series of semi-structured interviews of key stakeholders supported by relevant academic literature and media reports were used to record the clean-up operation coordination and management and to make a preliminary qualification of the Christchurch liquefaction ejecta clean-up (costs breakdown, time, volume, resources, coordination, planning and priorities). Further analysis of the costs and resources involved for better accuracy was required and so the analysis of Christchurch City Council road management database (RAMM) was done. In order to make a transition from general fine sediment clean-up to specific types of fine disaster sediment clean-up, adequate information about the material properties is required as they will define how the material will be handled, transported and stored. Laboratory analysis of young volcanic tephra from the New Zealand’s North Island was performed to identify their geotechnical properties (density, granulometry, plasticity, composition and angle of repose). The major findings of this research were that emergency planning and the use of the coordinated incident management system (CIMS) system during the emergency were important to facilitate rapid clean-up tasking, management of resources and ultimately recovery from widespread and voluminous liquefaction ejecta deposition in eastern Christchurch. A total estimated cost of approximately $NZ 40 million was calculated for the Christchurch City clean-up following the 2010-2011 Canterbury earthquake sequence with a partial cost of $NZ 12 million for the Southern part of the city, where up to 33% (418 km) of the road network was impacted by liquefaction ejecta and required clearing of the material following the 22 February 2011 earthquake. Over 500,000 tonnes of ejecta has been stockpiled at Burwood landfill for all three liquefaction inducing earthquake events. The average cost per kilometre for the event clean-up was $NZ 5,500/km (4 September 2010), $NZ 11,650/km (22 February 2011) and $NZ 11,185/km (13 June 2011). The duration of clean-up time of residential properties and the road network was approximately two to three months for each of the three liquefaction ejecta events; despite events volumes and spatial distribution of ejecta. Interviews and quantitative analysis of RAMM data revealed that the experience and knowledge gained from the Darfield earthquake (4 September 2010) clean-up increased the efficiency of the following Christchurch earthquake induced liquefaction ejecta clean-up events. Density, particle size, particle shape, clay content and moisture content, are the important geotechnical properties that need to be considered when planning for a clean-up method that incorporates collection, transport and disposal or storage. The geotechnical properties for the tephra samples were analysed to increase preparedness and reaction response of potentially affected North Island cities from possible product from the active volcanoes in their region. The geotechnical results from this study show that volcanic tephra could be used in road or construction material but the properties would have to be further investigated for a New Zealand context. Using fresh volcanic material in road, building or flood control construction requires good understanding of the material properties and precaution during design and construction to extra care, but if well planned, it can be economically beneficial.
