title: Length of Hospital Stay for Osteoarthritic Primary Hip and Knee Replacement Surgeries in New Zealand

authors: Lao, Chunhuan

abstract: This study aims to explore the length of stay (LOS) of publicly funded osteoarthritic primary hip and knee replacement surgeries in New Zealand. Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgery in 2005–2017 were included. We have identified 53,439 osteoarthritic primary hip replacements and 50,072 osteoarthritic primary knee replacements. LOS has been reduced by almost 40% over the last 13 years. Logistic regression showed that women, Māori, Pacific and Asian patients, older patients, people with more comorbidities and those having opiates on discharge and patients in earlier years were more likely to have extended LOS following hip replacements and knee replacements. Regional differences were noted in LOS between the Waitemata District Health Board (DHB) compared to Tairāwhiti DHB where patients were the most likely to have a LOS of more than 5 days after hip and knee replacements. LOS after hip and knee replacements has been reduced dramatically. Women, Māori, Pacific and Asian patients, older patients and people with more comorbidities are more likely to have extended LOS. Patients dispensed opiates on discharge had a longer LOS. There are great geographical variations in LOS for primary hip and knee surgeries in New Zealand.

text: Length of Hospital Stay for Osteoarthritic Primary Hip and Knee Replacement Surgeries in New Zealand This study aims to explore the length of stay (LOS) of publicly funded osteoarthritic primary hip and knee replacement surgeries in New Zealand. Patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgery in 2005–2017 were included. We have identified 53,439 osteoarthritic primary hip replacements and 50,072 osteoarthritic primary knee replacements. LOS has been reduced by almost 40% over the last 13 years. Logistic regression showed that women, Māori, Pacific and Asian patients, older patients, people with more comorbidities and those having opiates on discharge and patients in earlier years were more likely to have extended LOS following hip replacements and knee replacements. Regional differences were noted in LOS between the Waitemata District Health Board (DHB) compared to Tairāwhiti DHB where patients were the most likely to have a LOS of more than 5 days after hip and knee replacements. LOS after hip and knee replacements has been reduced dramatically. Women, Māori, Pacific and Asian patients, older patients and people with more comorbidities are more likely to have extended LOS. Patients dispensed opiates on discharge had a longer LOS. There are great geographical variations in LOS for primary hip and knee surgeries in New Zealand.

year: 2019

title: Institutional responses to mental deficiency in New Zealand, 1911-1935: Tokanui Mental Hospital

authors: Hoult, Adrienne

subjects: mental deficiency

abstract: This thesis considers the response of one New Zealand institution, Tokanui Mental Hospital, to legislation and policies for 'mental deficiency' introduced during the first half of the twentieth century. Institutional reactions to these policies have been under examined in New Zealand. While psychiatric or mentally ill patients have been the subject of a number of New Zealand histories of the asylum, 'mental defectives' have often been overlooked. Yet during the early-twentieth century, 'mental defectives' were thought to be a source of a number of social problems, and the New Zealand government considered a range of measures aimed at limiting the spread and effect of mental deficiency in society. Policies for 'mental deficiency' were influenced by contemporary anxieties about crime, sexuality and hereditarism. As a policy of segregation was formally prescribed, more 'mental defectives' were committed to mental hospitals and other institutions than ever before. An understanding of the responses to this perceived problem also provides an insight into wider social policies in New Zealand in the first half of the twentieth century. This thesis argues that gender was a significant factor in the decision to commit mental defectives to Tokanui. Subsequent categorisation and treatment within Tokanui was also affected by gender. Official reports inform us about the policies that were in place, and historical materials from Tokanui show how these worked in practice. Most of the archives of Tokanui Mental Hospital have been unexamined by historians before now, and close analysis of patient cases also reveals more about institutional practices. The connection between Tokanui and neighbouring Waikeria Prison is also explored, in the context of contemporary fears surrounding 
mental deficiency and crime.

text: Institutional responses to mental deficiency in New Zealand, 1911-1935: Tokanui Mental Hospital This thesis considers the response of one New Zealand institution, Tokanui Mental Hospital, to legislation and policies for 'mental deficiency' introduced during the first half of the twentieth century. Institutional reactions to these policies have been under examined in New Zealand. While psychiatric or mentally ill patients have been the subject of a number of New Zealand histories of the asylum, 'mental defectives' have often been overlooked. Yet during the early-twentieth century, 'mental defectives' were thought to be a source of a number of social problems, and the New Zealand government considered a range of measures aimed at limiting the spread and effect of mental deficiency in society. Policies for 'mental deficiency' were influenced by contemporary anxieties about crime, sexuality and hereditarism. As a policy of segregation was formally prescribed, more 'mental defectives' were committed to mental hospitals and other institutions than ever before. An understanding of the responses to this perceived problem also provides an insight into wider social policies in New Zealand in the first half of the twentieth century. This thesis argues that gender was a significant factor in the decision to commit mental defectives to Tokanui. Subsequent categorisation and treatment within Tokanui was also affected by gender. Official reports inform us about the policies that were in place, and historical materials from Tokanui show how these worked in practice. Most of the archives of Tokanui Mental Hospital have been unexamined by historians before now, and close analysis of patient cases also reveals more about institutional practices. The connection between Tokanui and neighbouring Waikeria Prison is also explored, in the context of contemporary fears surrounding 
mental deficiency and crime.

year: 2007

title: Taking Taniwha seriously

authors: Kingsbury, Justine

subjects: intercultural understanding

abstract: Taniwha are powerful water creatures in te ao Māori (the Māori world/worldview). Taniwha sometimes afect public works in Aotearoa New Zealand: for example, consultation between government agencies and tangata whenua (the people of the land) about proposed roading developments sometimes results in the route being moved to avoid the dwelling place of a taniwha. Mainstream media responses have tended to be hostile or mocking, as you might expect, since on the face of it the dominant western scientifc worldview has no place for beings like taniwha. However, in the 2020s, there appears to be an increased willingness to engage with te ao Māori. In this spirit, this paper proposes a way for non-Māori to begin to take taniwha more seriously, taking as its starting point the work of Dan Hikuroa on the practical usefulness of taniwha pūrākau (traditional narratives) in encoding information about natural hazards. The focus of this paper is narrow, but aspects of the strategy it proposes may be generalisable both to other aspects of te ao Māori and to other bicultural and multicultural contexts.

text: Taking Taniwha seriously Taniwha are powerful water creatures in te ao Māori (the Māori world/worldview). Taniwha sometimes afect public works in Aotearoa New Zealand: for example, consultation between government agencies and tangata whenua (the people of the land) about proposed roading developments sometimes results in the route being moved to avoid the dwelling place of a taniwha. Mainstream media responses have tended to be hostile or mocking, as you might expect, since on the face of it the dominant western scientifc worldview has no place for beings like taniwha. However, in the 2020s, there appears to be an increased willingness to engage with te ao Māori. In this spirit, this paper proposes a way for non-Māori to begin to take taniwha more seriously, taking as its starting point the work of Dan Hikuroa on the practical usefulness of taniwha pūrākau (traditional narratives) in encoding information about natural hazards. The focus of this paper is narrow, but aspects of the strategy it proposes may be generalisable both to other aspects of te ao Māori and to other bicultural and multicultural contexts.

year: 2022-11-10