title: Effect of multimorbidity on health service utilisation and health care experiences

authors: Millar, Elinor

subjects: Multimorbidity

abstract: Introduction: Multimorbidity, the co-existence of two or more long-term conditions, is associated with poor quality of life, high health care costs and contributes to ethnic health inequality in New Zealand (NZ). Health care delivery remains largely focused on management of single diseases, creating major challenges for patients and clinicians. 
Aim: To understand the experiences of people with multimorbidity in the NZ health care system.
Methods: A questionnaire was sent to 758 people with multimorbidity from two primary health care organisations (PHOs). Outcomes were compared to general population estimates from the NZ Health Survey. 
RESULTS Participants (n = 234, 31% response rate) reported that their general practitioners (GPs) respected their opinions, involved them in decision-making and knew their medical history well. The main barriers to effective care were short GP appointments, availability and affordability of primary and secondary health care, and poor communication between clinicians. Access issues were higher than for the general population. 
DISCUSSION Participants generally had very positive opinions of primary care and their GP, but encountered structural issues with the health system that created barriers to effective care. These results support the value of ongoing changes to primary care models, with a focus on patient-centred care to address access and care coordination.

text: Effect of multimorbidity on health service utilisation and health care experiences Introduction: Multimorbidity, the co-existence of two or more long-term conditions, is associated with poor quality of life, high health care costs and contributes to ethnic health inequality in New Zealand (NZ). Health care delivery remains largely focused on management of single diseases, creating major challenges for patients and clinicians. 
Aim: To understand the experiences of people with multimorbidity in the NZ health care system.
Methods: A questionnaire was sent to 758 people with multimorbidity from two primary health care organisations (PHOs). Outcomes were compared to general population estimates from the NZ Health Survey. 
RESULTS Participants (n = 234, 31% response rate) reported that their general practitioners (GPs) respected their opinions, involved them in decision-making and knew their medical history well. The main barriers to effective care were short GP appointments, availability and affordability of primary and secondary health care, and poor communication between clinicians. Access issues were higher than for the general population. 
DISCUSSION Participants generally had very positive opinions of primary care and their GP, but encountered structural issues with the health system that created barriers to effective care. These results support the value of ongoing changes to primary care models, with a focus on patient-centred care to address access and care coordination.

year: 2018

title: Microstructure and Mechanical Properties of Ti-6Al-4V Produced by Selective Laser Sintering of Pre-alloyed Powders

authors: Abd Aziz, Izhar

subjects: Titanium

abstract: The purpose of this research is to investigate the microstructure and mechanical properties of Ti6Al4V pre-alloyed powders producing by direct metal laser sintering technique. Through this research, the direct fabrication of Ti6Al4V metal parts by selective laser sintering machine has been carried out using EOS GmbH M270 equipment. Employing intricate thermo-mechanical interaction between the laser beam and the metallic powders, the machine consolidates predefined cross sections and binds the particles together to form solid parts which correspond to CAD data.The geometrical feasibility of the parts, including process accuracy were statistically analysed by simple benchmark studies. The intricate correlation between powder materials and process parameters were thoroughly investigated via fractography, metallography and standard physical testing.It was found that, SLS technologies are capable of directly producing near to full density metal parts with good mechanical properties.Ti6Al4V produced by laser sintering has very fine α+  microstructure. This fine and stable microstructure demonstrated a high yield stress and UTS with low elongation at break.  The fracture surface has a dimple features typical of a ductile structure. Dimensional analyses were performed on the customised benchmark showing process accuracy below 50 m. Designated heat treatments modified the microstructure which influences the mechanical behaviour of the parts.

text: Microstructure and Mechanical Properties of Ti-6Al-4V Produced by Selective Laser Sintering of Pre-alloyed Powders The purpose of this research is to investigate the microstructure and mechanical properties of Ti6Al4V pre-alloyed powders producing by direct metal laser sintering technique. Through this research, the direct fabrication of Ti6Al4V metal parts by selective laser sintering machine has been carried out using EOS GmbH M270 equipment. Employing intricate thermo-mechanical interaction between the laser beam and the metallic powders, the machine consolidates predefined cross sections and binds the particles together to form solid parts which correspond to CAD data.The geometrical feasibility of the parts, including process accuracy were statistically analysed by simple benchmark studies. The intricate correlation between powder materials and process parameters were thoroughly investigated via fractography, metallography and standard physical testing.It was found that, SLS technologies are capable of directly producing near to full density metal parts with good mechanical properties.Ti6Al4V produced by laser sintering has very fine α+  microstructure. This fine and stable microstructure demonstrated a high yield stress and UTS with low elongation at break.  The fracture surface has a dimple features typical of a ductile structure. Dimensional analyses were performed on the customised benchmark showing process accuracy below 50 m. Designated heat treatments modified the microstructure which influences the mechanical behaviour of the parts.

year: 2010

title: Bilingual Education in Aotearoa/New Zealand

authors: Hill, Richard Kenneth

subjects: Maori medium

abstract: Bilingual education in the context of New Zealand is now over 30 years old. The two largest linguistic minority groups involved in this type of education – the Indigenous Māori and Pasifika peoples of Samoan, Tongan, Cook Islands and Niuean and Tokelauan backgrounds – have made many gains but have struggled in a national context where minority languages have low status. Māori bilingual programs are well established and have made a significant contribution towards reducing Māori language shift that in the 1970s looked to be beyond regeneration. Pasifika bilingual education by contrast is not widely available and not well resourced by the New Zealand government. Both forms continue to need support and a renewed focus at local and national levels.

This chapter provides an overview of past development of Māori and Pasifika bilingual education and present progress. For Māori, the issues relate primarily to how to boost language regeneration, particularly between the generations. Gaining greater support for immersion programs and further strengthening bilingual education pedagogies, particularly relating to achieving biliteracy objectives, are key. In the context of Pasifika, extending government and local support would not only safeguard the languages but has the potential to counteract long-established patterns of low Pasifika student achievement in mainstream/English-medium schooling contexts. Finally, the future of both forms of bilingual education can be safeguarded if they are encompassed within a national languages policy that ensures minority language development in the predominantly English monolingual national context of New Zealand.

text: Bilingual Education in Aotearoa/New Zealand Bilingual education in the context of New Zealand is now over 30 years old. The two largest linguistic minority groups involved in this type of education – the Indigenous Māori and Pasifika peoples of Samoan, Tongan, Cook Islands and Niuean and Tokelauan backgrounds – have made many gains but have struggled in a national context where minority languages have low status. Māori bilingual programs are well established and have made a significant contribution towards reducing Māori language shift that in the 1970s looked to be beyond regeneration. Pasifika bilingual education by contrast is not widely available and not well resourced by the New Zealand government. Both forms continue to need support and a renewed focus at local and national levels.

This chapter provides an overview of past development of Māori and Pasifika bilingual education and present progress. For Māori, the issues relate primarily to how to boost language regeneration, particularly between the generations. Gaining greater support for immersion programs and further strengthening bilingual education pedagogies, particularly relating to achieving biliteracy objectives, are key. In the context of Pasifika, extending government and local support would not only safeguard the languages but has the potential to counteract long-established patterns of low Pasifika student achievement in mainstream/English-medium schooling contexts. Finally, the future of both forms of bilingual education can be safeguarded if they are encompassed within a national languages policy that ensures minority language development in the predominantly English monolingual national context of New Zealand.

year: 2017