title: Cultural justice, ethics and teaching

authors: Nairn, Ray

subjects: Maori

abstract: Te Tiriti o Waitangi provides both a basis for cultural justice in this society and an explication of the term; each of the articles identifying a significant aspect of cultural justice. First, there is the guarantee to the Maori signatories that the Crown would protect their independence - tino rangatiratanga, (also read as authority, autonomy or self-determination) [Article II]. In Article III Maori are promised that they will also have the “Rights and Privileges of British subjects”. Finally, in Article I, Maori cede to the Crown the right to govern, to make laws to protect all peoples from the evil consequences of lawlessness. The 1835 Declaration of Independence located legislative authority in the Wakaminenga (the gathered rangatira meeting in Congress); and in 1840, in the context of the Crown promises, Maori authorised the Crown to exercise that authority. For Maori Te Tiriti specifies cultural justice for interactions between Maori and settlers in the new society. Maori are guaranteed the right to self-determination (and the economic and social resources to make that practical) in their relations with New Zealand society. They are also entitled to the same opportunities as other citizens. The latter rights, embodied in local legislation and international covenants to which we are signatory, are not alternatives to the prior right of Maori people to their (cultural) autonomy. The exercise of legislative and organisational authority must be exercised in a manner consistent with the promises which clearly requires consultation and negotiation with Maori.

text: Cultural justice, ethics and teaching Te Tiriti o Waitangi provides both a basis for cultural justice in this society and an explication of the term; each of the articles identifying a significant aspect of cultural justice. First, there is the guarantee to the Maori signatories that the Crown would protect their independence - tino rangatiratanga, (also read as authority, autonomy or self-determination) [Article II]. In Article III Maori are promised that they will also have the “Rights and Privileges of British subjects”. Finally, in Article I, Maori cede to the Crown the right to govern, to make laws to protect all peoples from the evil consequences of lawlessness. The 1835 Declaration of Independence located legislative authority in the Wakaminenga (the gathered rangatira meeting in Congress); and in 1840, in the context of the Crown promises, Maori authorised the Crown to exercise that authority. For Maori Te Tiriti specifies cultural justice for interactions between Maori and settlers in the new society. Maori are guaranteed the right to self-determination (and the economic and social resources to make that practical) in their relations with New Zealand society. They are also entitled to the same opportunities as other citizens. The latter rights, embodied in local legislation and international covenants to which we are signatory, are not alternatives to the prior right of Maori people to their (cultural) autonomy. The exercise of legislative and organisational authority must be exercised in a manner consistent with the promises which clearly requires consultation and negotiation with Maori.

year: 1993

title: Desirable attributes for medical graduates: The health aspirations and needs of Maaori living in Te Rohe Pootae

authors: Maikuku, Victoria Louisa Wikitoria

abstract: Health disparities for Maaori, the tangata whenua of Aotearoa New Zealand, are prevalent when compared to the health of European New Zealanders, and even more so in remote and rural communities where access to health-care services is limited. Moreover, Maaori are underrepresented in the medical workforce in which there is a serious and escalating shortage of doctors and nurses.

In the context of the University of Waikato’s proposal to establish a Graduate Entry Medical School, Te Huataki Waiora School of Health has identified the need for a collaborative approach to ‘growing’ a fit-for-purpose health workforce with the skills and commitment to care for and work with Maaori (and Pacific peoples) living in remote and rural communities. This study thus explores the health perspectives, needs, and aspirations of Maaori living in and around the King Country rural service towns of Te Kuiti and OOtorohanga. Conducted by a Ngaati Maniapoto tribal member, the location for the study is known by Maaori as Te Rohe Pootae - the lands of Rereahu/Maniapoto, to which the Waikato people sort refuge after the invasion and confiscation of their lands in the 1860s. The perspectives, needs, and aspirations of Pacific peoples living in these communities have been explored in a ‘sister’ Masters study conducted by Janina Galewski.

The present exploratory study incorporates a co-design research process underpinned by an Indigenous health framework with Kaupapa Maaori values. Kanohi ki te kanohi (face to face) semi-structured interviews were conducted with 30 community members, 11 males and 19 females aged 18 years and over. The data analysis included a combination of values, verses and holistic, and provisional coding methods (focused, thematic, descriptive) (Saldana, 2021).

The findings reveal that these community members view themselves as either rural or remote based on distance, access to services, and geographic isolation, but not population numbers. In terms of services, they want a mobile health workforce including clinics, carers, doctors, nurses; mental health workers who are equipped with the resources and time needed to reach and serve their patients; and better access to dialysis and related services. The research also identifies three healthcare strategies. When ill or injured, one-third of the group go directly to their GP; one-third try other things before seeking medical assistance, including going home to their parents and/or to their marae for comfort and advice, ‘going bush’ to (re)connect with nature, and forms of pure (cleansing rituals); and although the remaining third are registered with medical centres they do everything they can to avoid seeing a doctor at all. Instead, they rely on rongoaa and other ‘complementary and alternative’ treatments such as physiotherapists, chiropractors, osteopaths, and other healers. 

Adopting and adapting a table created by Woolley et al. (2013), the findings also revealed three sets of desirable attributes for medical graduates (and other healthcare professionals): Skill-based attributes include quality care and communication skills, knowledge-based attributes include medical knowledge and culturally appropriate knowledge, while attitude-based attributes include personality and community engagement. This framework can be used to inform a medical education curriculum, with a specific emphasis on the health needs and aspirations of Maaori living in rural and remote communities.

text: Desirable attributes for medical graduates: The health aspirations and needs of Maaori living in Te Rohe Pootae Health disparities for Maaori, the tangata whenua of Aotearoa New Zealand, are prevalent when compared to the health of European New Zealanders, and even more so in remote and rural communities where access to health-care services is limited. Moreover, Maaori are underrepresented in the medical workforce in which there is a serious and escalating shortage of doctors and nurses.

In the context of the University of Waikato’s proposal to establish a Graduate Entry Medical School, Te Huataki Waiora School of Health has identified the need for a collaborative approach to ‘growing’ a fit-for-purpose health workforce with the skills and commitment to care for and work with Maaori (and Pacific peoples) living in remote and rural communities. This study thus explores the health perspectives, needs, and aspirations of Maaori living in and around the King Country rural service towns of Te Kuiti and OOtorohanga. Conducted by a Ngaati Maniapoto tribal member, the location for the study is known by Maaori as Te Rohe Pootae - the lands of Rereahu/Maniapoto, to which the Waikato people sort refuge after the invasion and confiscation of their lands in the 1860s. The perspectives, needs, and aspirations of Pacific peoples living in these communities have been explored in a ‘sister’ Masters study conducted by Janina Galewski.

The present exploratory study incorporates a co-design research process underpinned by an Indigenous health framework with Kaupapa Maaori values. Kanohi ki te kanohi (face to face) semi-structured interviews were conducted with 30 community members, 11 males and 19 females aged 18 years and over. The data analysis included a combination of values, verses and holistic, and provisional coding methods (focused, thematic, descriptive) (Saldana, 2021).

The findings reveal that these community members view themselves as either rural or remote based on distance, access to services, and geographic isolation, but not population numbers. In terms of services, they want a mobile health workforce including clinics, carers, doctors, nurses; mental health workers who are equipped with the resources and time needed to reach and serve their patients; and better access to dialysis and related services. The research also identifies three healthcare strategies. When ill or injured, one-third of the group go directly to their GP; one-third try other things before seeking medical assistance, including going home to their parents and/or to their marae for comfort and advice, ‘going bush’ to (re)connect with nature, and forms of pure (cleansing rituals); and although the remaining third are registered with medical centres they do everything they can to avoid seeing a doctor at all. Instead, they rely on rongoaa and other ‘complementary and alternative’ treatments such as physiotherapists, chiropractors, osteopaths, and other healers. 

Adopting and adapting a table created by Woolley et al. (2013), the findings also revealed three sets of desirable attributes for medical graduates (and other healthcare professionals): Skill-based attributes include quality care and communication skills, knowledge-based attributes include medical knowledge and culturally appropriate knowledge, while attitude-based attributes include personality and community engagement. This framework can be used to inform a medical education curriculum, with a specific emphasis on the health needs and aspirations of Maaori living in rural and remote communities.

year: 2022

title: Calcium modeling and TMS variability

authors: Wilson, Marcus T.

subjects: Modeling

abstract: • We have modelled Calcium-dependent plasticity with a Neural Field scheme
• Developed the approach further to modelling MEPs
• Modelling can reproduce MEP ranges from submillivolt to ~10 mV
• Modelling can reproduce both potentiation and depression following cTBS and iTBS
• In terms of variability of MEPs, the following are important:
• TMS-to-e coupling strength (parameter μ)
• Excitatory-to-excitatory coupling strength wee
• Number of pulses / time since stimulation
• Include reporting of actual thresholds when %RMT is used

text: Calcium modeling and TMS variability • We have modelled Calcium-dependent plasticity with a Neural Field scheme
• Developed the approach further to modelling MEPs
• Modelling can reproduce MEP ranges from submillivolt to ~10 mV
• Modelling can reproduce both potentiation and depression following cTBS and iTBS
• In terms of variability of MEPs, the following are important:
• TMS-to-e coupling strength (parameter μ)
• Excitatory-to-excitatory coupling strength wee
• Number of pulses / time since stimulation
• Include reporting of actual thresholds when %RMT is used

year: 2023