Pacific families navigating responsiveness and children's sleep in Aotearoa New Zealand.

The stakes for understanding sleep practices are rising as health inequalities related to sleep become more apparent. Pacific peoples in Aotearoa New Zealand face disproportionate challenges around poverty and health and sleep is one growing area of importance in addressing health inequalities. Through a qualitative study of 17 Pacific families in Aotearoa New Zealand, we provide a rare and valuable glimpse into the familial, cultural, social and economic context of sleep for Pacific families and children in New Zealand.

Weiqu, structural injustice and caring for sick older people in rural Chinese families: An empirical ethical study.

This paper examines caregiving for sick older family members in the context of socio-economic transformations in rural China, combining empirical investigation with normative inquiry. The empirical part of this paper is based on a case study, taken from fieldwork in a rural Chinese hospital, of a son who took care of his hospitalized mother. This empirical study highlighted family members' weiqu (sense of unfairness)-a mental status from experiencing mistreatment and oppression in family care, yet with constrained power to explicitly protest or make care-related choices.

Gendered caregiving and structural constraints: An empirical ethical study.

Background: The pressing issue of aged care has made gendered caregiving a growing subject of feminist bioethical enquiry. However, the impact of feminism on empirical studies in the area of gendered care in Chinese sociocultural contexts has been less influential.

Objectives: To examine female members' lived experiences of gendered care in rural China and offer proper normative evaluation based on their experiences.

"Unworthy of Care and Treatment": Cultural Devaluation and Structural Constraints to Healthcare-Seeking for Older People in Rural China.

This paper examines the experiences of seeking healthcare for rural Chinese older people, a population who experiences the multiple threats of socio-economic deprivation, marginalization, and lack of access to medical care, yet have been relatively overlooked within the existing scholarly literature. Based on ethnographical data collected from six-month fieldwork conducted in a rural primary hospital in Southern China, this paper identifies a widespread discouraging, dispiriting attitude regarding healthcare-seeking for rural older members despite the ongoing efforts of institutional reforms with a particular focus on addressing access to health services amongst rural populations. Such an attitude was expressed by older people's families as well as the public in their narratives by devaluing older members' health care demands as "unworthy of care and treatment" ("" in Chinese).

Excluding indigenous bioethical concerns when regulating frozen embryo storage: An Aotearoa New Zealand case study.

This article undertakes a close reading of the parliamentary debates associated with the topic of embryo cryopreservation in Aotearoa New Zealand. From our critical readings, we argue that there is a lack of transparency over the ethical reasons for enforcing a maximum storage limit. We demonstrate that arguments for the retention of this limit are associated (in New Zealand) with arguments based upon 'build-up avoidance' and 'conflict avoidance' as social goods based on Pākehā [New Zealander of European descent] cultural world views rather than identifiable universal ethical principles.

Connecting the East and the West, the Local and the Universal: The Methodological Elements of a Transcultural Approach to Bioethics.

From the outset, cross-cultural and transglobal bioethics has constituted a potent arena for a dynamic public discourse and academic debate alike. But prominent bioethical debates on such issues as the notion of common morality and a distinctive "Asian" bioethics in contrast to a "Western" one reveal some deeply rooted and still popular but seriously problematic methodological habits in approaching cultural differences, most notably, radically dichotomizing the East and the West, the local and the universal. In this paper, a "transcultural" approach to bioethics and cultural studies is proposed.

Complete tooth loss as status passage.

The aim of this article is to add to the literature on the sociology of oral health and dentistry by presenting the relevance of status passage to the study of complete tooth loss. The article reports on an analysis of data taken from participants residing in the Nelson region of New Zealand. In total the data include interviews from 20 participants, all of whom had their remaining natural teeth removed before 1960.

Valuing embryos as both commodities and singularities.

An argument put forward against gamete and embryo donation, sale and research, is that to do so would treat the gametes or embryos as objects with no intrinsic value as human. Instead, gametes and embryos created and used for donation, sale or research, can be considered more like a commodity created and traded for economic exchange--something that is valuable only for the amount of money or other goods and services that others are willing to exchange. While Kant asserts that humans have dignity rather than object worth, the provision of human gametes and embryos are progressively becoming utilities for resolving childlessness and for certain research investigations.

Choice, Rights, and Virtue: Prenatal Testing and Styles of Moral Reasoning in Aotearoa/New Zealand.

Using a Foucauldian biopower analytic, this article combines insights from several ethnographic research projects around the moral reasoning styles underpinning debates over selective reproductive technologies in Aotearoa/New Zealand. We show that divergent or shared public, private, state, individual, and community moral reasoning styles become highly politicized truth discourses that have the potential to, and at times do, affect one another, modifying a dominant, state-supported, principal-based bioethics framework. The styles of moral reasoning that we identify pivot on an aspirational cultural ideal of the provision of choice to citizens, which is taken as an appropriate position from which to regulate selective reproductive technologies.

Ethics of mitochondrial therapy for deafness.

Mitochondrial therapy may provide the relief to many families with inherited mitochondrial diseases. However, it also has the potential for use in non-fatal disorders such as inherited mitochondrial deafness, providing an option for correction of the deafness using assisted reproductive technology. In this paper we discuss the potential for use in correcting mitochondrial deafness and consider some of the issues for the deaf community.

Numerical identity: the creation of tri-parental embryos to correct inherited mitochondrial disease.

Inherited mitochondrial disorders affect between 1 in 5000 to 1 in 8000 people. These are a heterogeneous group of maternally-inherited disorders, with an array of outcomes such as heart and liver failure, defects in energy metabolism, blindness, deafness, loss of motor skills and premature death. Recently the Human Fertilisation and Embryology Authority provided advice to the UK Government to permit the use of enucleated donated oocytes with normal (wild-type) mitochondria (a currently prohibited IVF technique) to be used as recipients of nuclear DNA from intending mothers to overcome transmission of mitochondrial disorders.

The embodied liminalities of occupational overuse syndrome: Medical anthropology quarterly.

Drawing on interviews with sufferers of OOS (occupational overuse syndrome) in Aoteraoa/New Zealand, this article explores the liminalities associated with OOS and the ways in which this liminality is embodied. While successful rehabilitation could lead back to employment, the respondents' fragility while living with OOS and its accompanying social stigma render such rehabilitation both literally and symbolically "out of reach". Their situations reveal social isolation, loss of identities, pain, and functional disability that have been incorporated into renegotiated identities and biographies in which respondents have become exquisitely self-absorbed, exercising constant bodily surveillance and discipline in order to manage their symptoms.

Occupational overuse syndrome: moral ambiguities of New Zealand health professionals.

In this article we examine the moral ambiguities expressed by New Zealand health professionals regarding their clients and patients who have occupational overuse syndrome (OOS). Workers with OOS were described as being hard working and dedicated, but also undisciplined in their work and personal lives. The goal of rehabilitation in such cases is a return to full work duties and to this end, health professionals represent the disciplinary and normalizing technologies of the neoliberal state which, in New Zealand, provides financial support and treatment for injured workers.

Embodying occupational overuse syndrome.

This article explores the ways in which embodiedness has become problematic for New Zealand sufferers of occupational overuse syndrome (OOS). While successful rehabilitation could lead back to employment, this was based on the biographical continuity of a bodily hexus that ignored persistent pain. The reality of OOS involved a liminal fragility associated with social isolation, loss of identities, pain and functional disability that was incorporated into re-negotiated identities and biographies with the result that respondents became exquisitely self-absorbed, exercising constant bodily surveillance and discipline in order to manage their symptoms.

'Going-to-have-cancerness': a study of living with increased risk of BRCA1 and BRCA2 mutations for six South Island women.

Introduction: Mutations in the BRCA (breast cancer) 1 and 2 genes are thought to lead to 5-10% of breast cancers.

Aim: A qualitative study to explore six New Zealand women's experiences of living with increased risk for a genetic susceptibility to breast cancer.

Methods: Six women were interviewed using semi-structured interviews, to explore their experiences of living at high risk for developing breast cancer due to familial and/or individual genetic susceptibilities.

The lived political economy of occupational overuse syndrome among New Zealand workers.

In New Zealand, as in other industrialised nations, rates of work-related gradual onset injuries increased during the 1980s and 1990s. The perspectives and experiences of workers suffering what became known as occupational overuse injuries in New Zealand offer insights into local lived political economies. Here, we explore the dominant metaphor, 'battling', in participants' narratives.

Understanding the 'epidemic' of complete tooth loss among older New Zealanders.

Objective: The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand's historic 'epidemic of edentulism' and how they operated.

Method: In-depth, semi-structured interviews with 31 older New Zealanders were analysed using applied grounded theory.

Results: Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a 'sub-optimal' natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction-based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to 'calcium theory' and dental caries were fundamental in decisions relating to the transition to edentulism.

An alternative consideration in drug testing in elite athletes.

As vigilance increases for drug abuse in sport there is an increasing awareness of new technologies creating new possibilities of performance enhancement. One such example is the recent consideration of 'gene doping', which may enhance athletic performance. In this article we consider an alternative strategy not yet considered; the potential for a pharmacogenomics approach and the utility of information at the level of the protein rather than the gene.

Rural nurse specialists: clinical practice and the politics of care.

Doctor flight from rural areas is an international phenomenon that places great pressure on primary health care delivery. In New Zealand, the response to these empty doctors' surgeries has been the introduction of nurse-led rural health clinics that have attracted controversy both in the media and from urban-based doctors over whether such nurse-led care is a direct substitution of medical care. This article analyzes the reflections of nurses working in some of these clinics who suggest that their situation is more complex than a direct substitution of labor.

Risky knowledges: the sociocultural impacts of personal genetics in a knowledge-driven economy.

The rapid developments in modern genetics are changing the way disease and wellness may be considered. New concepts are emerging such as predictive genetic testing and forecasting future disease, as well as internet genetic analysis available to the public. In this short communication we consider some of the implications relating to predictive genetic testing in the public domain.

Phenylketonuria--the lived experience.

Aim: This study explored the lived experience of phenylketonuria (PKU) for the New Zealand adult and its relevance for issues of treatment adherence.

Method: In-depth qualitative interviews were conducted with eight New Zealand adults with early-treated PKU regarding their experiences of living with PKU. The interviews were transcribed, and then analysed using grounded theory.

Cytogeneticists' stories around the ethics and social consequences of their work: a New Zealand case study.

This paper is based on anthropological research in three New Zealand cytogenetics laboratories involving participant observation carried out over three months and interviews with sixteen cytogeneticists in order to elucidate the distinctive characteristics of their views on the social consequences of their work in prenatal genetic testing. The discourses employed by cytogeneticists to describe their work are placed against other discourses in the contemporary debate surrounding prenatal genetic testing, i.e.

An exploratory qualitative study of Otago adolescents' views of oral health and oral health care.

Objectives: To investigate Otago adolescents' views of oral health and oral health care, in order to increase understanding of the influences on their use or non-use of free care.

Design: The study employed a qualitative approach, using focus groups and grounded theory analysis.

Participants: Participants ranged in age from 13 to 18, and included both genders and a variety of educational attainments, ethnicities and family incomes.

The New Zealand health reforms: dividing the labour of care.

This paper examines the concept of care as it was practised and conceptualised within one hospital group in southern New Zealand during the health reforms. The paper argues that these reforms brought about a division in the labour of care between the broad group of managers, computer analysts, administration officers, and the clinical staff. Aspects of these two empirically derived categories of care are elaborated, as well as the problems associated with each style.