title: Maori children and death: Views from parents

authors: Jacob, Juanita

subjects: Maori

abstract: Research about Maori children's experiences and perceptions of death and tangi (Maori death rituals) is sparse. What is available tends to be generalised and stems from Western paradigms of knowledge. In this study we explore Maori children's experiences of death and tangi through the eyes of Maori parents. Through semi-structured interviews with 17 Maori parents, five areas were explored: a) the childhood experiences of parents and how they learned about death and an afterlife; b) what their adult beliefs about these matters are; c) how they have communicated the death concept to their children; and d) whether their children are likely to do the same in the future. From this study we learn that death was not hidden from children, that parents talked with their children in very open and age relevant ways, and considered their children's participation in tangi an important way to grieve and ensure continuity with kinship networks and support. This study suggests that the challenge now is to ensure that these practices continue to persist between parents and their children, and future generations.

text: Maori children and death: Views from parents Research about Maori children's experiences and perceptions of death and tangi (Maori death rituals) is sparse. What is available tends to be generalised and stems from Western paradigms of knowledge. In this study we explore Maori children's experiences of death and tangi through the eyes of Maori parents. Through semi-structured interviews with 17 Maori parents, five areas were explored: a) the childhood experiences of parents and how they learned about death and an afterlife; b) what their adult beliefs about these matters are; c) how they have communicated the death concept to their children; and d) whether their children are likely to do the same in the future. From this study we learn that death was not hidden from children, that parents talked with their children in very open and age relevant ways, and considered their children's participation in tangi an important way to grieve and ensure continuity with kinship networks and support. This study suggests that the challenge now is to ensure that these practices continue to persist between parents and their children, and future generations.

year: 2011-12

title: Rising demand for health care: The sustainability of community general practice in the Waikato

authors: Amey, Janet Heather

subjects: General practice

abstract: Community general practice is the cornerstone of New Zealand’s health system, providing first contact health care, care coordination and acting as gatekeeper to expensive hospital services. An ageing population now brings increasing demand for the care provided in general practice, with chronic conditions a major contributing factor. This rising demand, alongside limited workforce capacity will seriously test general practice sustainability. 

These evolving and multifaceted challenges are within the context of long-standing health access and outcome inequalities, particularly for Māori (and more recently the Pacific population) compared with Pākehā. The pursuit of equity is inherent in all health sector strategies, but any meaningful improvement will necessitate wide-ranging reform of current planning, funding and service delivery pathways across traditional sector boundaries.

The sustainability of general practice is about the sustainability and efficiency of the entire health system. To better measure the contribution of general practice care to the system, and improve demand projections, an expanded service use measure was developed, combining services of a general practice nature from Emergency Department and Accident & Medical settings with services delivered in community general practice.

Drawing on approaches from demography, epidemiology and health services research, linked demographic and health administrative data were used to undertake a retrospective, observational study of service use for 235,666 people enrolled with the Pinnacle Midlands Health Network in 2013/14. Using the new expanded measure, service use levels at a locality level were established by age, gender, ethnic group, chronic condition status, practice funding model, high needs status, income and geography of residence.

Significant variation was found in annual average consults (1.0 to 13.4 consults in 2013/14). Statistical analysis identified age, chronic conditions and gender as the key demand drivers responsible for such variation, with regional level results masking significant spatial variation. Where the cost of care was lower, people used a higher level of services in the enrolled practice setting and a lower level outside of it, suggesting the importance of affordable care. Māori and Pacific used significantly fewer services than Pākehā although there was substantial sub-regional variation. Using the expanded measure, the vast majority of care was delivered in the enrolled setting, including for those with chronic conditions.

Demand projections, based on the expanded measure of general practice, out to 2038 show the uneven geography of future demand due to disordered cohort flows and sub-regional population contexts. Overall, demand for services is projected to rise by 34 per cent to almost two million consults across the Waikato District Health Board catchment, with this driven predominantly by services for those aged 65+ years (or 45+ years in Hamilton City, Waikato and Waipa Districts).

Models of care are being transformed as general practices and Primary Health Organisations look to the future. Reorganisation of work roles, improved use of health information and use of emerging health technologies will be required to re-configure general practice in preparation for an ageing future, and to eliminate recalcitrant health inequalities. Real and inclusive collaboration across traditional system boundaries is perhaps the greatest challenge to general practice sustainability.

text: Rising demand for health care: The sustainability of community general practice in the Waikato Community general practice is the cornerstone of New Zealand’s health system, providing first contact health care, care coordination and acting as gatekeeper to expensive hospital services. An ageing population now brings increasing demand for the care provided in general practice, with chronic conditions a major contributing factor. This rising demand, alongside limited workforce capacity will seriously test general practice sustainability. 

These evolving and multifaceted challenges are within the context of long-standing health access and outcome inequalities, particularly for Māori (and more recently the Pacific population) compared with Pākehā. The pursuit of equity is inherent in all health sector strategies, but any meaningful improvement will necessitate wide-ranging reform of current planning, funding and service delivery pathways across traditional sector boundaries.

The sustainability of general practice is about the sustainability and efficiency of the entire health system. To better measure the contribution of general practice care to the system, and improve demand projections, an expanded service use measure was developed, combining services of a general practice nature from Emergency Department and Accident & Medical settings with services delivered in community general practice.

Drawing on approaches from demography, epidemiology and health services research, linked demographic and health administrative data were used to undertake a retrospective, observational study of service use for 235,666 people enrolled with the Pinnacle Midlands Health Network in 2013/14. Using the new expanded measure, service use levels at a locality level were established by age, gender, ethnic group, chronic condition status, practice funding model, high needs status, income and geography of residence.

Significant variation was found in annual average consults (1.0 to 13.4 consults in 2013/14). Statistical analysis identified age, chronic conditions and gender as the key demand drivers responsible for such variation, with regional level results masking significant spatial variation. Where the cost of care was lower, people used a higher level of services in the enrolled practice setting and a lower level outside of it, suggesting the importance of affordable care. Māori and Pacific used significantly fewer services than Pākehā although there was substantial sub-regional variation. Using the expanded measure, the vast majority of care was delivered in the enrolled setting, including for those with chronic conditions.

Demand projections, based on the expanded measure of general practice, out to 2038 show the uneven geography of future demand due to disordered cohort flows and sub-regional population contexts. Overall, demand for services is projected to rise by 34 per cent to almost two million consults across the Waikato District Health Board catchment, with this driven predominantly by services for those aged 65+ years (or 45+ years in Hamilton City, Waikato and Waipa Districts).

Models of care are being transformed as general practices and Primary Health Organisations look to the future. Reorganisation of work roles, improved use of health information and use of emerging health technologies will be required to re-configure general practice in preparation for an ageing future, and to eliminate recalcitrant health inequalities. Real and inclusive collaboration across traditional system boundaries is perhaps the greatest challenge to general practice sustainability.

year: 2018

title: Digital learning objects: A need for educational leadership

authors: Falloon, Garry

subjects: educational technology

abstract: Despite increasing interest in technology-assisted education, technology-based instructional design still lacks support from a reliable body of empirical research. This dearth of reliable information hampers its integration into mainstream school systems. In fact, many teachers remain resistant to using technology in the classroom. In order to overcome teacher resistance to technology in the classroom, we have sought to follow a process described by Friesen to evaluate the advantages and disadvantages of the educational use of digital learning objects (DLOs) from the teachers' point of view.
This article explores the opportunities and challenges inherent in using digital learning objects and reports on the impact of DLO use at both the classroom and school levels. By providing research that links students' use of DLOs with the development of key competencies, we hope to sharpen teachers' visions of how DLOs can help them achieve their educational goals, and to encourage DLO uptake for educational purposes. Finally, we envision a DLO that can assist school principals in the facilitation of educational leadership and help transform teachers' attitudes toward technology-based teaching.

text: Digital learning objects: A need for educational leadership Despite increasing interest in technology-assisted education, technology-based instructional design still lacks support from a reliable body of empirical research. This dearth of reliable information hampers its integration into mainstream school systems. In fact, many teachers remain resistant to using technology in the classroom. In order to overcome teacher resistance to technology in the classroom, we have sought to follow a process described by Friesen to evaluate the advantages and disadvantages of the educational use of digital learning objects (DLOs) from the teachers' point of view.
This article explores the opportunities and challenges inherent in using digital learning objects and reports on the impact of DLO use at both the classroom and school levels. By providing research that links students' use of DLOs with the development of key competencies, we hope to sharpen teachers' visions of how DLOs can help them achieve their educational goals, and to encourage DLO uptake for educational purposes. Finally, we envision a DLO that can assist school principals in the facilitation of educational leadership and help transform teachers' attitudes toward technology-based teaching.

year: 2009