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.
This paper presents a qualitative study with multiple refugee background communities living in Christchurch, New Zealand about their perspectives and responses to the Canterbury earthquakes of 2010-2011 (32 semi-structured interviews and 11 focus group discussions comprising 112 participants). Whilst the Canterbury earthquakes created significant challenges for the entire region, several refugee background communities found multiple ways to effectively respond to such adversity. Central to this response were their experiences of belonging which were comprised of both ‘civic’ and ‘ethno’ conceptualisations. This discussion includes an analysis on the intersectionality of identity to highlight the gendered, contextual and chronological influences that impact people’s perspectives of and responses to a disaster. As the study was conducted over 18 months, the paper discusses how social capital resources and experiences of belonging can help inform urban disaster risk reduction (DRR) with refugee groups. http://3icudr.org/program
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
This thesis investigates life-safety risk in earthquakes. The first component of the thesis utilises a dataset of earthquake injuries and deaths from recent earthquakes in New Zealand to identify cause, context, and risk factors of injury and death in the 2011 MW6.3 Christchurch earthquake and 2016 MW7.8 Kaikōura earthquake. Results show that nearly all deaths occurred from being hit by structural elements from buildings, while most injuries were caused by falls, strains and being hit by contents or non-structural elements. Statistical analysis of injured cases compared to an uninjured control group found that age, gender, building damage, shaking intensity, and behaviour during shaking were the most significant risk factors for injury during these earthquakes. The second part of the thesis uses the empirical findings from the first section to develop two tools for managing life-safety risk in earthquakes. The first tool is a casualty estimation model for health system and emergency response planning. An existing casualty model used in New Zealand was validated against observed data from the 2011 Christchurch earthquake and found to underestimate moderate and severe injuries by an order of magnitude. The model was then updated to include human behaviour such as protective actions, falls and strain type injuries that are dependent on shaking intensity, as well as injuries and deaths outside buildings. These improvements resulted in a closer fit to observed casualties for the 2011 Christchurch earthquake. The second tool that was developed is a framework to set seismic loading standards for design based on fatality risk targets. The proposed framework extends the risk-targeted hazard method, by moving beyond collapse risk targets, to fatality risk targets for individuals in buildings and societal risk in cities. The framework also includes treatment of epistemic uncertainty in seismic hazard to allow this uncertainty to be used in risk-based decision making. The framework is demonstrated by showing how the current New Zealand loading standards could be revised to achieve uniform life-safety risk across the country and how the introduction of a new loading factor can reduce risk aggregation in cities. Not on Alma, moved and emailed. 1/02/2023 ce
This thesis describes the management process of innovation through construction infrastructure projects. This research focuses on the innovation management process at the project level from four views. These are categorised into the separate yet related areas of: “innovation definition”, “Project time”, “project team motivation” and “Project temporary organisation”. A practical knowledge is developed for each of these research areas that enables project practitioners to make the best decision for the right type of innovation at the right phase of projects, through a capable project organisation. The research developed a holistic view on both innovation and the construction infrastructure project as two complex phenomena. An infrastructure project is a long-term capital investment, highly risky and an uncertain. Infrastructure projects can play a key role in innovation and performance improvement throughout the construction industry. The delivery of an infrastructure project is affected in most cases by critical issues of budget constraint, programme delays and safety Where the business climate is characterized by uncertainty, risk and a high level of technological change, construction infrastructure projects are unable to cope with the requirement to develop innovation. Innovation in infrastructure projects, as one of the key performance indicators (KPI) has been identified as a critical capability for performance improvement through the industry. However, in spite of the importance of infrastructure projects in improving innovation, there are a few research efforts that have developed a comprehensive view on the project context and its drivers and inhibitors for innovation in the construction industry. Two main reasons are given as the inhibitors through the process of comprehensive research on innovation management in construction. The first reason is the absence of an understanding of innovation itself. The second is a bias towards research at a firm and individual level, so a comprehensive assessment of project-related factors and their effects on innovation in infrastructure projects has not been undertaken. This study overcomes these issues by adopting as a case study approach of a successful infrastructure project. This research examines more than 500 construction innovations generated by a unique infrastructure alliance. SCIRT (Stronger Christchurch Infrastructure Rebuild Team) is a temporary alliancing organisation that was created to rebuild and recover the damaged infrastructure after the Christchurch 2011 earthquake. Researchers were given full access to the innovation project information and innovation systems under a contract with SCIRT Learning Legacy, provided the research with material which is critical for understanding innovations in large, complex alliancing infrastructure organisation. In this research, an innovation classification model was first constructed. Clear definitions have been developed for six types of construction innovation with a variety of level of novelties and benefits. The innovation classification model was applied on the SCIRT innovation database and the resultant trends and behaviours of different types of innovation are presented. The trends and behaviours through different types of SCIRT innovations developed a unique opportunity to research the projectrelated factors and their effect on the behaviour of different classified types of innovation throughout the project’s lifecycle. The result was the identification of specific characteristics of an infrastructure project that affect the innovation management process at the project level. These were categorised in four separate chapters. The first study presents the relationship between six classified types of innovation, the level of novelty and the benefit they come up with, by applying the innovation classification model on SCIRT innovation database. The second study focused on the innovation potential and limitations in different project lifecycle phases by using a logic relationship between the six classified types of innovation and the three classified phases of the SCIRT project. The third study result develops a holistic view of different elements of the SCIRT motivation system and results in a relationship between the maturity level of definition developed for innovation as one of the KPIs and a desire though the SCIRT innovation incentive system to motivate more important innovations throughout the project. The fourth study is about the role of the project’s temporary organisation that finally results in a multiple-view innovation model being developed for project organisation capability assessment in the construction industry. The result of this thesis provides practical and instrumental knowledge to be used by a project practitioner. Benefits of the current thesis could be categorized in four groups. The first group is the innovation classification model that provides a clear definition for six classified types of innovation with four levels of novelty and specifically defined outcomes and the relationship between the innovation types, novelty and benefit. The second is the ability that is provided for the project practitioner to make the best decision for the right type of innovation at the right phases of a project’s lifecycle. The third is an optimisation that is applied on the SCIRT innovation motivation system that enables the project practitioner to incentivize the right type of innovation with the right level of financial gain. This drives the project teams to develop a more important innovation instead of a simple problemsolving one. Finally, the last and probably more important benefit is the recommended multiple-view innovation model. This is a tool that could be used by a project practitioner in order to empower the project team to support innovation throughout the project.
