title: The determinants of GP visits in New Zealand

authors: Cumming, Jacqueline

subjects: General practitioner

abstract: Objective: To identify the characteristics of New Zealanders who utilised primary healthcare services prior to the implementation of the New Zealand Primary Healthcare Strategy (PHCS).
Methods: This paper uses data from the 1996/97 and 2002/03 waves of the nationally representative New Zealand Health Survey to examine the relationship between individual, household and community characteristics and the utilisation of healthcare services by New Zealanders. Multivariate regression models are used to examine the correlation between particular characteristics and whether an individual visited a GP in the previous 12 months, the number of visits made to a GP in the previous 12 months, whether they reported needing to see a GP in the previous 12 months, but failed to do so, and whether they visited a secondary practitioner in the previous 12 months.
Results: Gender, age, and ethnicity are all found to be significantly related to healthcare utilisation, even when controlling for a fairly comprehensive set of characteristics. On the other hand, education, marital status, household composition, household income and community deprivation are found to be unrelated to healthcare utilisation. A strong relationship is found between employment status, health status and healthcare utilisation.
Conclusions and implications: We do not find any evidence of a relationship between socioeconomic status and healthcare utilisation after controlling for other measures of need. This and other findings suggest that the government subsidies in place prior to the implementation of the 2001 Primary Healthcare Strategy helped to ensure that user charges did not limit service utilisation in New Zealand for groups with lower socioeconomic status.

text: The determinants of GP visits in New Zealand Objective: To identify the characteristics of New Zealanders who utilised primary healthcare services prior to the implementation of the New Zealand Primary Healthcare Strategy (PHCS).
Methods: This paper uses data from the 1996/97 and 2002/03 waves of the nationally representative New Zealand Health Survey to examine the relationship between individual, household and community characteristics and the utilisation of healthcare services by New Zealanders. Multivariate regression models are used to examine the correlation between particular characteristics and whether an individual visited a GP in the previous 12 months, the number of visits made to a GP in the previous 12 months, whether they reported needing to see a GP in the previous 12 months, but failed to do so, and whether they visited a secondary practitioner in the previous 12 months.
Results: Gender, age, and ethnicity are all found to be significantly related to healthcare utilisation, even when controlling for a fairly comprehensive set of characteristics. On the other hand, education, marital status, household composition, household income and community deprivation are found to be unrelated to healthcare utilisation. A strong relationship is found between employment status, health status and healthcare utilisation.
Conclusions and implications: We do not find any evidence of a relationship between socioeconomic status and healthcare utilisation after controlling for other measures of need. This and other findings suggest that the government subsidies in place prior to the implementation of the 2001 Primary Healthcare Strategy helped to ensure that user charges did not limit service utilisation in New Zealand for groups with lower socioeconomic status.

year: 2010

title: Dominant words rise to the top by positive frequency-dependent selection.

authors: Pagel, Mark

subjects: approximate Bayesian computation

abstract: A puzzle of language is how speakers come to use the same words for particular meanings, given that there are often many competing alternatives (e.g., "sofa," "couch," "settee"), and there is seldom a necessary connection between a word and its meaning. The well-known process of random drift-roughly corresponding in this context to "say what you hear"-can cause the frequencies of alternative words to fluctuate over time, and it is even possible for one of the words to replace all others, without any form of selection being involved. However, is drift alone an adequate explanation of a shared vocabulary? Darwin thought not. Here, we apply models of neutral drift, directional selection, and positive frequency-dependent selection to explain over 417,000 word-use choices for 418 meanings in two natural populations of speakers. We find that neutral drift does not in general explain word use. Instead, some form of selection governs word choice in over 91% of the meanings we studied. In cases where one word dominates all others for a particular meaning-such as is typical of the words in the core lexicon of a language-word choice is guided by positive frequency-dependent selection-a bias that makes speakers disproportionately likely to use the words that most others use. This bias grants an increasing advantage to the common form as it becomes more popular and provides a mechanism to explain how a shared vocabulary can spontaneously self-organize and then be maintained for centuries or even millennia, despite new words continually entering the lexicon.

text: Dominant words rise to the top by positive frequency-dependent selection. A puzzle of language is how speakers come to use the same words for particular meanings, given that there are often many competing alternatives (e.g., "sofa," "couch," "settee"), and there is seldom a necessary connection between a word and its meaning. The well-known process of random drift-roughly corresponding in this context to "say what you hear"-can cause the frequencies of alternative words to fluctuate over time, and it is even possible for one of the words to replace all others, without any form of selection being involved. However, is drift alone an adequate explanation of a shared vocabulary? Darwin thought not. Here, we apply models of neutral drift, directional selection, and positive frequency-dependent selection to explain over 417,000 word-use choices for 418 meanings in two natural populations of speakers. We find that neutral drift does not in general explain word use. Instead, some form of selection governs word choice in over 91% of the meanings we studied. In cases where one word dominates all others for a particular meaning-such as is typical of the words in the core lexicon of a language-word choice is guided by positive frequency-dependent selection-a bias that makes speakers disproportionately likely to use the words that most others use. This bias grants an increasing advantage to the common form as it becomes more popular and provides a mechanism to explain how a shared vocabulary can spontaneously self-organize and then be maintained for centuries or even millennia, despite new words continually entering the lexicon.

year: 2019

title: Aro mai aro atu: Raising Māori-medium students' academic oral language proficiency

authors: Shandley, Rosina Mary

subjects: Māori-medium

abstract: From the early 1860s, colonial governments worked systematically to eradicate the language and culture of the indigenous people of Aotearoa / New Zealand, and, by the late 1960s, the death of the Māori language was being predicted by leading linguists. Māori leaders responded in the 1980s with language regeneration initiatives that included the birth of Māori-medium education. Today, this uniquely indigenous education system is a significant site of language learning for new generations of Māori children. In Māori-medium education, children are nurtured, educated, and loved as Māori, and they are more likely to attain educational qualifications than their Māori peers who attend English-medium schools. 

The success of Māori-medium education is achieved in the face of a raft of ongoing challenges that teachers and students confront on a daily basis. Years of language marginalisation, including the disruption to intergenerational transfer, mean Māori-medium students are required to learn the curriculum through their second and less-developed language. They have limited opportunities to hear or use the Māori language outside of the school, and this places huge pressure on teachers who are often their most significant language models. The challenge is compounded by the limited education that has been made available to teachers in relation to second-language pedagogies specifically designed for Māori-medium classrooms. The resulting situation is that Māori-medium teachers are often left struggling to find ways that they can develop students’ Māori language proficiency at the same time as their curriculum achievement so that one is not sacrificed for the other. 

This study designed and trialled pedagogies to support Māori-medium students to develop their academic oral language proficiency at the same time as their curriculum achievement. It was a mixed methods study grounded in a kaupapa Māori approach, and involved three teachers and 24 students across three separate Māori-medium schools. An Anga Putanga Ako (Curriculum Outcomes Matrix) was developed to support the students to understand what they needed to learn to progress through the writing curriculum. Teachers then learnt to share explicit learning outcomes from the Anga Putanga Ako with students before lessons and to allow them time to discuss their achievement of those outcomes in pairs at the conclusion of those lessons. Linguistic scaffolds were developed to support students’ learning conversations, including the self and peer assessment of the learning outcomes, and decisions about their curriculum achievement levels and next learning steps.

The quantitative and qualitative results of the study revealed that the confluence of the self and peer assessment practices, supported by the Anga Putanga Ako and linguistic scaffolds, improved the students’ academic oral language and accelerated their reading and writing achievement significantly beyond what is usually expected in a Māori-medium classroom in 14 weeks. The study also found that, through implementing the self and peer assessment pedagogies, teachers were able to identify ways they could develop their students’ academic language and curriculum achievement simultaneously and how these approaches could be applied across the curriculum.

It was clear from the research results that pedagogies that support second-language development and curriculum learning, such as the self and peer assessment pedagogies demonstrated in this study, need to be explicitly taught with consistency across initial and in-service teacher education programmes. This development is necessary to help ensure Māori-medium students are supported with the thinking and linguistic skills needed to contribute to the creation of new knowledge, to support or challenge the current social order as they see fit, and to continue to transfer the Māori language to new generations of mokopuna.

text: Aro mai aro atu: Raising Māori-medium students' academic oral language proficiency From the early 1860s, colonial governments worked systematically to eradicate the language and culture of the indigenous people of Aotearoa / New Zealand, and, by the late 1960s, the death of the Māori language was being predicted by leading linguists. Māori leaders responded in the 1980s with language regeneration initiatives that included the birth of Māori-medium education. Today, this uniquely indigenous education system is a significant site of language learning for new generations of Māori children. In Māori-medium education, children are nurtured, educated, and loved as Māori, and they are more likely to attain educational qualifications than their Māori peers who attend English-medium schools. 

The success of Māori-medium education is achieved in the face of a raft of ongoing challenges that teachers and students confront on a daily basis. Years of language marginalisation, including the disruption to intergenerational transfer, mean Māori-medium students are required to learn the curriculum through their second and less-developed language. They have limited opportunities to hear or use the Māori language outside of the school, and this places huge pressure on teachers who are often their most significant language models. The challenge is compounded by the limited education that has been made available to teachers in relation to second-language pedagogies specifically designed for Māori-medium classrooms. The resulting situation is that Māori-medium teachers are often left struggling to find ways that they can develop students’ Māori language proficiency at the same time as their curriculum achievement so that one is not sacrificed for the other. 

This study designed and trialled pedagogies to support Māori-medium students to develop their academic oral language proficiency at the same time as their curriculum achievement. It was a mixed methods study grounded in a kaupapa Māori approach, and involved three teachers and 24 students across three separate Māori-medium schools. An Anga Putanga Ako (Curriculum Outcomes Matrix) was developed to support the students to understand what they needed to learn to progress through the writing curriculum. Teachers then learnt to share explicit learning outcomes from the Anga Putanga Ako with students before lessons and to allow them time to discuss their achievement of those outcomes in pairs at the conclusion of those lessons. Linguistic scaffolds were developed to support students’ learning conversations, including the self and peer assessment of the learning outcomes, and decisions about their curriculum achievement levels and next learning steps.

The quantitative and qualitative results of the study revealed that the confluence of the self and peer assessment practices, supported by the Anga Putanga Ako and linguistic scaffolds, improved the students’ academic oral language and accelerated their reading and writing achievement significantly beyond what is usually expected in a Māori-medium classroom in 14 weeks. The study also found that, through implementing the self and peer assessment pedagogies, teachers were able to identify ways they could develop their students’ academic language and curriculum achievement simultaneously and how these approaches could be applied across the curriculum.

It was clear from the research results that pedagogies that support second-language development and curriculum learning, such as the self and peer assessment pedagogies demonstrated in this study, need to be explicitly taught with consistency across initial and in-service teacher education programmes. This development is necessary to help ensure Māori-medium students are supported with the thinking and linguistic skills needed to contribute to the creation of new knowledge, to support or challenge the current social order as they see fit, and to continue to transfer the Māori language to new generations of mokopuna.

year: 2022