John Parsons

Genomics‐informed cancer care is central to precision oncology; however, integrating genomic competencies into routine practice remains challenging. Despite the development of competency frameworks, limited clarity exists regarding how these competencies are operationalised within oncology settings. Aim: To synthesise and critically examine how genomic competencies are conceptualised across the literature, identify areas of convergence and gaps and examine implications for clinical implementation and cancer nursing workforce development. Design: Scoping review. Methods: The review followed Joanna Briggs Institute (JBI) methodology and was reported in accordance with PRISMA‐ScR guidelines. Data Sources: CINAHL, Embase, PubMed, Google Scholar and grey literature sources were searched (2010–2026). Evidence describing genomic competencies for healthcare professionals was included. Data were extracted and analysed using inductive thematic analysis. Results: Forty‐one sources were included. One overarching theme (holistic patient‐centred care), two major themes (genomic knowledge and genomic literacy) and seven interconnected competency domains were identified: social, ethical and legal considerations, communication, assessment, care planning, collaboration, professional practice and systems and process. Although these domains were consistently described across the literature, competencies were frequently articulated at a high level with limited specificity regarding their application within genomics‐informed cancer care and oncology workflows. Conclusion: Genomic competencies are well described across healthcare frameworks; however, a significant gap exists between their conceptualisation and translation into cancer care practice. While educational initiatives support genomic knowledge development, integration requires sustained workforce and implementation approaches that enable competencies to be enacted through clinically embedded oncology roles, pathways and service models. Implications for Practice: Existing genomic competencies provide a foundation for education and practice; however, their application within cancer care requires contextualisation within oncology workflows and roles. Aligning competencies with cancer nursing practice may support development of clinically relevant pathways and workforce models for genomics‐informed care. Impact: This review highlights the need for workforce and service‐level approaches, including clinically embedded nursing roles, to support the integration of genomics into cancer care. What Problem Did the Study Address?: Global healthcare systems are working to integrate genomic testing into routine cancer care; however, there is limited clarity on how existing genomic competency frameworks translate into clinical practice. This review addresses the gap between the conceptualisation of genomic competencies and their operationalisation within oncology settings, particularly in relation to cancer nursing roles. What Were the Main Findings?: Genomic competencies are consistently described across the literature but are often articulated at a high level and lack specificity for application in cancer care. While these competencies align with established nursing capabilities, education alone is insufficient to support their implementation, highlighting a gap between competency frameworks and clinical practice. Where and on Whom Will the Research Have an Impact?: This review demonstrates that the challenge is no longer defining genomic competencies, but creating the clinical, educational and organisational conditions that enable genomic competencies to be enacted within routine cancer care. Reporting Method: Inductive thematic analysis with findings descriptively summarised and narratively reported according to JBI methodology and PRISMA‐ScR guidelines. Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct or reporting.

Telerehabilitation adoption in low-middle income countries (LMICs) accelerated during COVID-19 pandemic, promoting a surge in telehealth initiatives, many of which remain unexplored. This scoping review aims to assess the current state of telerehabilitation services in LMICs across Asia and Africa using Arksey and O’Malley’s five-stage framework with PRISMA-ScR guidelines. Two reviews were conducted: one covering from 2012 to 2022 and another from 2023 to January 2025, yielding a total of 87 relevant articles. The key themes that emerged from the collected literature include current telerehabilitation status, pandemic utilization, implementation challenges, user understanding of telerehabilitation along with their perceptions and practices, and feasibility together with legal-ethical aspects and acceptability. Despite limited ICT skills and infrastructure challenges, users reported positive experiences, primarily using mobile phones and video conferences. However, privacy concerns along with digital literacy issues remain. Although many nations adopted WHO guidelines and donor support, formal policies and sustainable implementation strategies are still lacking. The findings underscore the need for context specific and sustainable frameworks to strengthen telerehabilitation in LMICs.

Nurse educators across the globe are exploring different simulation methodologies and tools to prepare nursing students for the challenges of the real clinical environment. There has been an expansion of virtual reality and wearable technology-based simulation tools in contemporary nursing education pedagogies, particularly through the COVID-19 pandemic. This descriptive qualitative study explored the perceptions and experiences of nursing educators and undergraduate nursing students (Year 2 Bachelor of Nursing) using a mixed reality wearable holographic device as a simulation tool. The remote simulation experience was live-streamed by a nurse educator, using the mixed reality headset, to the students’ mobile camera devices. Prebriefing and debriefing took place online via the Zoom meeting platform. The research was undertaken at a tertiary educational institute in Aotearoa New Zealand during the COVID-19 pandemic. Five students and four nurse educators participated in two separate focus groups, with and one further interview with one student, to explore their experiences of the simulation. Three key themes emerged after thematic analysis of the transcribed qualitative data: 1) benefits of the simulation experience; 2) the associated challenges; and 3) recommendations for further improvements. Despite the restrictions on face-to-face learning at the time, students valued the remote online simulation learning experience, which provided engaging, visual, and realistic simulation to develop clinical reasoning skills in a safe environment. Provision of robust training to both educators and students was found to be key to addressing the technological barriers. The simulation technology was considered to be most beneficial when leveraged as a complementary tool to traditional pedagogies and provides opportunity for distance learners. There is room for collaboration between nursing faculty and technology developers to advance the interactive features of simulation devices and programmes, and tailor the simulation scenarios to the Aotearoa New Zealand context. Te reo Māori translation: Te Akoranga Whaihanga mā te Whakamahi i Tētahi Pūrere Ao Mariko Hanumi Ngā Whakaaro o ngā Kaiwhakaako Tapuhi me ngā Ākonga Tapuhi Paetahi: Ngā Ariā Matua Kei te tūhura ngā kaiwhakaako tapuhi puta noa i te ao i ētahi tikanga me ētahi taputapu whaihanga huhua hei whakangungu i ngā ākonga tapuhi mō ngā wero o te ao tiaki tūroro tūturu. Kua puāwai te puta mai o ētahi taputapu ao mariko, taputapu hangarau, ka taea hoki te whakamau hei kākahu, i roto i ngā tikanga whakaako tapuhi, otirā i roto i te mate urutā o COVID-19 i horapa ēnei mahi i te ao. Nā tēnei mātai inekounga whakaahua i tūhura ngā whakaaro me ngā wheako o ngā kaiwhakaako tapuhi me ngā ākonga tapuhi paetahi (Tau 2, Tohu Paetahi mō Te Tapuhitanga) mā te whakamahi i tētahi taputapu ata kōroto ka taea te whakamau hei taputapu whaihanga. I pāho mataoratia tēnei wheako whaihanga mamao e tētahi kaiwhakaako tapuhi, mā te whakamahi pokiupoko ao mariko hanumi ki ngā pūrere kāmera pūkoro a ngā ākonga. I haere ētahi tohutohu i mua, tohutohu i muri hoki mā te ipurangi, mā te pūhara hui o Zoom. I kawea ngā rangahau ki tētahi whare akoranga mātauranga matua ki Aotearoa i roto i te mate urutā o COVID-19. E rima ngā ākonga, e whā hoki ngā kaiwhakaako tapuhi i wahi wāhi ki ētahi rōpū arotahi e rua motuhake, me tētahi atu uiuinga ki te ākonga kotahi, hei tūhura i ō rātou wheako mō te whaihanga. E toru ngā tāhuhu matua i puta i muri i te tātaritanga tāhuhu o ngā raraunga inekounga kua tuhia: 1) ngā painga o te wheako whaihanga; 2) ngā pīkauranga i te taha; me 3) ngā tohutohu mō ngā whakatikatika e hiahiatia ana. Ahakoa ngā here mō te wā ako ā-kanohi i taua wā, he rawe ki ngā ākonga te wheako akoranga whaihanga tuihono mamao, nā te mea nā konā i uru ki tētahi taruna whakahihiko, ā-kanohi, hāngai ki te ao tūturu, ki a rātou, hei whakapakari i ō rātou pūkenga whiriwhiri tikanga tiaki tūroro i tētahi horopaki haumaru. I kitea ko te whakangungu hōhonu mā tēnei mea te kaiwhakaako me te ākonga anō tētahi mea taketake mō te kake i ngā maioro hangarau. I whakaarotia i whai painga nui rawa ngā hangarau whaihanga me i haere tahi hei taputapu āpiti mō ngā tikanga whakaako tuku iho, ā, he whāinga wāhi tēnei mō te hunga ako mamao. Ka taea te kawe whakamua i ngā tikanga tauwhitiwhiti o ngā pūrere me ngā hōtaka whaihanga mā ngā tari whakaako tapuhi me ngā kaiwaihanga hangarau, kia whakahāngaitia ngā kitenga whaihanga ki te horopaki o Aotearoa. Ngā Ariā Matua te akoranga tapuhi; te akoranga tuihono; te akoranga paetahi; inekounga; whaihanga; ao mariko

Background: Across countries, most dementia carers report a lack of adequate information about dementia and local services. To address this issue, the World Health Organization developed the iSupport programme to provide information and support to dementia carers. The iSupport online programme was found to be feasible and acceptable by dementia carers. However, the potential of using the iSupport manual (iSupport) specifically for Chinese dementia carers in New Zealand remains unknown. Objective: This study aimed to (1) identify refinements to adapt iSupport by eliciting the perspectives of Chinese dementia carers; and (2) explore the educational needs of Chinese dementia carers, which can inform the development of support programmes tailored to their specific requirements. Design: This was a qualitative descriptive study using semistructured interviews. The data were analysed using thematic analysis. Results: Twelve Chinese dementia carers were interviewed (mean age 58.0 years, 100% female, and mean caring experience of 2.2 years). Emerging themes were identified within three domains: (1) usefulness, (2) complexities of using iSupport, and (3) suggestions for improvement. Conclusions: The findings suggest that Chinese dementia carers generally found iSupport to be valuable, providing valuable insights into how to tailor and enhance support for this population. However, further research is required to empirically validate the effectiveness of the adapted iSupport for Chinese dementia carers in New Zealand. These findings have implications for the development of future interventions that can more effectively address the specific needs of Chinese dementia carers.

Caring for people living with dementia during the novel coronavirus disease 2019 (COVID-19) pandemic significantly impacted the emotional, physical, and social well-being of carers. However, no study has focused on the well-being of Chinese carers of people living with dementia in New Zealand during the pandemic. This study aimed to explore the support needs of Chinese carers of people living with dementia in New Zealand during the COVID-19 pandemic. Semi-structured interviews were conducted by two bilingual and bicultural researchers. Thematic analysis was used to explore the resilience resources for Chinese carers. Twelve Chinese carers were recruited from four community organizations in New Zealand. Four themes were identified: (1) social isolation, (2) emotional loneliness, (3) ambivalent feelings of being a carer, and (4) a variety of unmet needs. The findings of our study provide new insights into the multiple support needs of Chinese carers of people living with dementia during the COVID-19 pandemic. Implications for practice include the establishment of culturally appropriate care support services and the development of tailored resilience-building interventions to address the unmet needs of Chinese carers of people living with dementia.

This study examines the impact of Islamic beliefs on the caregiving practices of individuals diagnosed with Parkinson's disease in Indonesia and New Zealand. The study sample comprised seventeen caregivers who participated in semi-structured interviews which were analysed using the method of inductive thematic analysis. The study delineated three overarching themes: value-driven caregiving, comprehensive care and caregivers strengthened by faith and practice. This study examined the practical applications of the Quran, Hadith and Muslim beliefs in caregiver experiences. Further research is necessary to enhance the support systems for Muslim caregivers in various circumstances, facilitating the advancement of solutions to contemporary social problems.

AIM: To investigate the knowledge and practice of health professionals when advising persons on driving restrictions after a transient ischaemic attack (TIA) or stroke in a tertiary hospital in New Zealand. METHODS: Health professionals working in the area of stroke care across the acute and rehabilitation services in a large tertiary hospital were invited to complete an electronic survey around knowledge of driving restrictions based on the New Zealand Transport Agency (NZTA) guidelines. Knowledge was assessed for both private and commercial vehicle use. The other information gathered included participant profession, level of seniority and experience working in stroke care, previous education around medical-related driving restrictions and how and what driving recommendations were discussed with patients. Knowledge of driving restrictions was established by the number and percentage of correct responses for each condition (single TIA, multiple TIA and stroke with full recovery) relating to the recommended restrictions in both private and commercial vehicle use. RESULTS: Forty-nine participants' surveys were analysed with representation from across all the health professions (24.5% (12/49) doctors, 38.8% (19/49) nurses and 36.7% (18/49) allied health). Only 38.8% reported having had received training around post-stroke driving restrictions. Knowledge around driving restrictions was highest for a single episode TIA for private vehicle use (73.5% (36/49)). For ail other categories, fewer than 50% of participants answered correctly, with knowledge of commercial vehicle restrictions being the least accurate. CONCLUSIONS: Many health professionals have discussions with people about driving restrictions following a TIA or stroke. However, there appears to be limited knowledge of all the restrictions for each condition as they relate to either private or commercial vehicle use. Insufficient training and education for clinicians might explain this gap.

AIM: Previous generation contrast agents were associated with high rates of nausea, vomiting and risk of aspiration leading to recommendations to fast prior to the procedure. However, modern contrast agents are well tolerated with a low risk of aspiration. Our current guidelines recommend fasting four to six hours before elective and semi-urgent cardiac catheterisation despite a lack of evidence to support this. We sought to determine the duration and effects of fasting at our centre. METHODS: A single-centre prospective observational study in patients undergoing elective cardiac catheterisation over a six-month period between 7 August 2017 to 7 February 2018 at Auckland City Hospital, New Zealand. RESULTS: One thousand and thirty patients with a mean age of 66 +/- 12 years underwent catheterisation. Sixty-seven percent were male, 26% had diabetes, 72% had hypertension and 23% had stage 3 or worse chronic kidney disease. The mean duration of fasting was 11.6 +/- 4.9 hours with 80% fasting longer than recommended. One hundred and eight (48%) patients with documented chronic kidney disease did not receive recommended pre-hydration. The most common symptoms related to fasting were hunger (47 %), nausea (3.9%) and vomiting (0.8%). Hypertension (4.1%) and hyperglycaemia (0.8%) occurred due to missed medication. There were no reports of aspiration. CONCLUSION: Most patients were fasted for significantly longer than recommended and pre-hydration was underutilised in patients at high risk of contrast-induced nephropathy. There were no episodes of aspiration with modern contrast agents. Further studies are required to evaluate the need for fasting prior to non-emergency cardiac catheterisation.