title: Ha ora: Improving access to early diagnosis of lung cancer for Maori and rural communities. Understanding patient experiences in General Practice

authors: Lawrenson, Ross

abstract: There were two main objectives for this report. The first was to identify the barriers to early diagnosis of lung cancer experienced by Māori lung cancer patients and whānau. Second was to co-design a multi-pronged intervention alongside rural Māori communities to improve early diagnosis of lung cancer for whānau in their localities.
The team worked in the Waikato, Lakes, Bay of Plenty and Tairāwhiti districts of the Midland Region. Semi-structured interviews were carried out with 23 Māori lung cancer patients and whānau recruited through respiratory or cancer nurse specialists (CNSs) based at the hospitals of each district. Nine community hui (focus groups) and nine primary healthcare provider hui were carried out in five rural localities: Te Kuiti, Opōtiki, Te Kaha, Rotorua and Gisborne. Community hui included cancer patients, whānau, and other community members. Healthcare provider hui comprised staff members at the local primary healthcare centre, including General Practitioners and nurses. Study data were thematically analysed.
Findings of the study highlight:
1. Barriers in primary care, including symptom ambiguity, accumulating costs, barriers and enablers relating to GP – patient relationships
2. Barriers in secondary care, including a lack of access to diagnostic tests, long waiting times, barriers and enablers relating to communication between HCPs and patients.
3. The importance of whānau as carers and advocates for Māori patients on their lung cancer journey.
The interventions co-designed with each community included a Hā Ora website, a series of lung cancer awareness videos (entitled ‘wharo wharo wharo’), a kaiawhina training programme and a ‘pou pupuru oranga’ (cancer navigator).
We suggest strategies that aim to improve early diagnosis of lung cancer for rural Māori communities. We welcome your feedback to us regarding these recommendations.

text: Ha ora: Improving access to early diagnosis of lung cancer for Maori and rural communities. Understanding patient experiences in General Practice There were two main objectives for this report. The first was to identify the barriers to early diagnosis of lung cancer experienced by Māori lung cancer patients and whānau. Second was to co-design a multi-pronged intervention alongside rural Māori communities to improve early diagnosis of lung cancer for whānau in their localities.
The team worked in the Waikato, Lakes, Bay of Plenty and Tairāwhiti districts of the Midland Region. Semi-structured interviews were carried out with 23 Māori lung cancer patients and whānau recruited through respiratory or cancer nurse specialists (CNSs) based at the hospitals of each district. Nine community hui (focus groups) and nine primary healthcare provider hui were carried out in five rural localities: Te Kuiti, Opōtiki, Te Kaha, Rotorua and Gisborne. Community hui included cancer patients, whānau, and other community members. Healthcare provider hui comprised staff members at the local primary healthcare centre, including General Practitioners and nurses. Study data were thematically analysed.
Findings of the study highlight:
1. Barriers in primary care, including symptom ambiguity, accumulating costs, barriers and enablers relating to GP – patient relationships
2. Barriers in secondary care, including a lack of access to diagnostic tests, long waiting times, barriers and enablers relating to communication between HCPs and patients.
3. The importance of whānau as carers and advocates for Māori patients on their lung cancer journey.
The interventions co-designed with each community included a Hā Ora website, a series of lung cancer awareness videos (entitled ‘wharo wharo wharo’), a kaiawhina training programme and a ‘pou pupuru oranga’ (cancer navigator).
We suggest strategies that aim to improve early diagnosis of lung cancer for rural Māori communities. We welcome your feedback to us regarding these recommendations.

year: 2021

title: Te Kotahitanga: culturally responsive professional development for teachers

authors: Bishop, Russell

subjects: indigenous

abstract: Te Kotahitanga is a research and professional development project that aims to support teachers to raise the achievement of New Zealand's indigenous Māori students in public/mainstream classrooms. An Effective Teaching Profile, developed from the voices of Māori students, their families, principals and some of their teachers, provides direction and focus for both the classroom pedagogy and the professional development. While the authors understand that there are many institutional changes necessary at the school level, this paper focuses on the professional learning opportunities developed for classroom teachers within this project to support the development of more effective classroom relationships and interactions with Māori students. This has resulted in Māori students attending school more regularly, engaging as learners and achieving to levels where they begin to realise their true potential.

text: Te Kotahitanga: culturally responsive professional development for teachers Te Kotahitanga is a research and professional development project that aims to support teachers to raise the achievement of New Zealand's indigenous Māori students in public/mainstream classrooms. An Effective Teaching Profile, developed from the voices of Māori students, their families, principals and some of their teachers, provides direction and focus for both the classroom pedagogy and the professional development. While the authors understand that there are many institutional changes necessary at the school level, this paper focuses on the professional learning opportunities developed for classroom teachers within this project to support the development of more effective classroom relationships and interactions with Māori students. This has resulted in Māori students attending school more regularly, engaging as learners and achieving to levels where they begin to realise their true potential.

year: 2010-05

title: Changing sex ratios in New Zealand: Real change or a statistical problem?

authors: Callister, Paul

abstract: In New Zealand, in all age groups under 20, and in key working age groups, historically there have been more men than women. Life table data suggest that, without migration, the number of males should remain greater than the number of females until around the age of 60 years. However, census data indicate that the number of New Zealand women residents relative to men in the broad 20-49 age group has been increasing since the 1980s. Given that birth ratios for New Zealand residents favour boys in common with international experience, the imbalance of women over men in the 20-49 age group has to come from four possible sources: 1) differential mortality; 2) more New Zealand born men leaving New Zealand; 3) a higher number of female immigrants; or 4) that statistical collections are undercounting men, and this undercounting has become progressively greater over the past 20 years. In this paper we focus on undercount and, through this investigation, raise some doubts about the validity of either a serious ‘man drought’ or a major 'surplus of women' in the population.

text: Changing sex ratios in New Zealand: Real change or a statistical problem? In New Zealand, in all age groups under 20, and in key working age groups, historically there have been more men than women. Life table data suggest that, without migration, the number of males should remain greater than the number of females until around the age of 60 years. However, census data indicate that the number of New Zealand women residents relative to men in the broad 20-49 age group has been increasing since the 1980s. Given that birth ratios for New Zealand residents favour boys in common with international experience, the imbalance of women over men in the 20-49 age group has to come from four possible sources: 1) differential mortality; 2) more New Zealand born men leaving New Zealand; 3) a higher number of female immigrants; or 4) that statistical collections are undercounting men, and this undercounting has become progressively greater over the past 20 years. In this paper we focus on undercount and, through this investigation, raise some doubts about the validity of either a serious ‘man drought’ or a major 'surplus of women' in the population.

year: 2006