title: Life after Stroke: A Comparative Study

authors: Thomson, Kirstin Marie

subjects: Stroke

abstract: Stroke is a chronic illness and is the leading cause of disability globally in the adult population. The effects of stroke are wide ranging and impact on the stroke survivor’s daily functioning and quality of life. To date, most research has focused on short-term outcomes in a clinical setting, rather than examining the longer term consequences of stroke in those who live in the community. To address this, the current study explored daily functioning and participation in a community based stroke sample aged 55-85 years (>2 years post-stroke), compared to a control sample of the same sex and age. Participants completed a battery of questionnaires, (modified Rankin Scale, Barthel Index, Hospital Anxiety and Depression Scale, EuroQol-5 Dimension, and the Short Form-36), and two brief cognitive screening tests (Mini Mental State Examination and the Montreal Cognitive Assessment ). A semi-structure interview was also conducted with participants, and a qualitative data analysis was carried out and findings integrated with the quantitative results.

Stroke survivors reported greater disability and reduced health related quality of life across all measures, and they also demonstrated higher rates of anxiety and depression. In addition, they showed higher levels of cognitive impairment. Findings from the qualitative interview revealed that stroke survivor participated in fewer activities both inside and outside the home, and activities were less physically demanding.
The results obtained from this study demonstrated the long term effects of stroke present challenges for stroke survivors which impact on their HRQoL, significantly more than difficulties experienced from the ageing process. Finally, the MoCA is more sensitive and detecting cognitive impairment in both a stroke and non-stroke population. Implications of the research are discussed.

text: Life after Stroke: A Comparative Study Stroke is a chronic illness and is the leading cause of disability globally in the adult population. The effects of stroke are wide ranging and impact on the stroke survivor’s daily functioning and quality of life. To date, most research has focused on short-term outcomes in a clinical setting, rather than examining the longer term consequences of stroke in those who live in the community. To address this, the current study explored daily functioning and participation in a community based stroke sample aged 55-85 years (>2 years post-stroke), compared to a control sample of the same sex and age. Participants completed a battery of questionnaires, (modified Rankin Scale, Barthel Index, Hospital Anxiety and Depression Scale, EuroQol-5 Dimension, and the Short Form-36), and two brief cognitive screening tests (Mini Mental State Examination and the Montreal Cognitive Assessment ). A semi-structure interview was also conducted with participants, and a qualitative data analysis was carried out and findings integrated with the quantitative results.

Stroke survivors reported greater disability and reduced health related quality of life across all measures, and they also demonstrated higher rates of anxiety and depression. In addition, they showed higher levels of cognitive impairment. Findings from the qualitative interview revealed that stroke survivor participated in fewer activities both inside and outside the home, and activities were less physically demanding.
The results obtained from this study demonstrated the long term effects of stroke present challenges for stroke survivors which impact on their HRQoL, significantly more than difficulties experienced from the ageing process. Finally, the MoCA is more sensitive and detecting cognitive impairment in both a stroke and non-stroke population. Implications of the research are discussed.

year: 2012

title: The Identification of Recidivism Indicators in Intellectually Disabled Violent Individuals

authors: Courtney, Jo

subjects: Intellectually Disabled

abstract: The Assessment of Risk and Manageability in Intellectually Disabled IndividuaLs who Offend (ARMIDILO) was developed to address the need for assessment tests specifically designed for intellectually disabled (ID) individuals who offend. This is the first study focusing on the application of the ARMIDILO by using comparative current risk assessment tests to evaluate the ARMIDILO as an effective risk assessment tool.  In this research 16 ID people who have recorded sexual and or violent behaviour offences were evaluated using the Violent Offender Risk Assessment Scale (VORAS), Static-99 and ARMIDILO risk assessment tests. The ARMIDILO, VORAS and Static-99 assessments were completed using individual history files kept within the Regional Forensic Psychiatric Service. The VORAS and Static-99 were adapted to incorporate reported, but not charged or otherwise litigated offences and convictions. The adapted tests were then compared against the ARMIDILO as a risk assessment tool. 
Analysis of the ARMIDILO showed strong validity in assessing ID people who offend. The main strength of the ARMIDILO is in identifying the risk needs of the ID person who offends and may be an effective management test when used in assessing individual needs and program implementation. Risk assessment through the ARMIDILO showed similar results to Static-99 but compared only moderately with the VORAS in measuring the risk of re-offending. Future research with a larger population may further validate the reliability of the ARMIDILO as an assessment tool. Adaptation of the current score sheet for use by non-clinical and correctional staff may prove cost effective.

text: The Identification of Recidivism Indicators in Intellectually Disabled Violent Individuals The Assessment of Risk and Manageability in Intellectually Disabled IndividuaLs who Offend (ARMIDILO) was developed to address the need for assessment tests specifically designed for intellectually disabled (ID) individuals who offend. This is the first study focusing on the application of the ARMIDILO by using comparative current risk assessment tests to evaluate the ARMIDILO as an effective risk assessment tool.  In this research 16 ID people who have recorded sexual and or violent behaviour offences were evaluated using the Violent Offender Risk Assessment Scale (VORAS), Static-99 and ARMIDILO risk assessment tests. The ARMIDILO, VORAS and Static-99 assessments were completed using individual history files kept within the Regional Forensic Psychiatric Service. The VORAS and Static-99 were adapted to incorporate reported, but not charged or otherwise litigated offences and convictions. The adapted tests were then compared against the ARMIDILO as a risk assessment tool. 
Analysis of the ARMIDILO showed strong validity in assessing ID people who offend. The main strength of the ARMIDILO is in identifying the risk needs of the ID person who offends and may be an effective management test when used in assessing individual needs and program implementation. Risk assessment through the ARMIDILO showed similar results to Static-99 but compared only moderately with the VORAS in measuring the risk of re-offending. Future research with a larger population may further validate the reliability of the ARMIDILO as an assessment tool. Adaptation of the current score sheet for use by non-clinical and correctional staff may prove cost effective.

year: 2008

title: Contextualising Māori writing: a study of prose fiction written in English by Witi Ihimaera, Patricia Grace, Keri Hulme and Alan Duff

authors: Calvert, Julia Helen

abstract: All prose fiction written in English by Māori is political on one level or another. The authors considered in this thesis, Witi Ihimaera, Patricia Grace, Keri Hulme and Alan Duff, choose to identify as Māori, but for each writer exactly what this entails implies something different. The diverse range of Māori characters represented in their work illustrates the heterogeneity of contemporary Māori identity. Whilst bearing in mind that there is no fixed Māori identity, this thesis proposes that all fiction written in English by Māori is motivated by a belief that Māori are a disadvantaged group within New Zealand society. 

Three of the four writers, Ihimaera, Grace and Hulme, write against a background of colonisation. Their fiction confronts grievances based on perceived injustices committed against Māori in the past by European colonists and is concerned with the restoration of Māori rights pertaining to land, language, identity and political voice. While all three engage with these issues in their fiction, this thesis specifically considers the way in which Ihimaera treats the theme of land, Grace focuses on issues of education and Hulme explores Māori mythology.

Alan Duff stands apart from the other three writers in his belief that colonisation is not to blame for contemporary Māori disadvantage. Rather, Duff considers the situation to be the result of inherent flaws within Māori society. Through his often didactic writing he proposes that improved Māori socioeconomic levels can only be achieved through a radical structural and economic re-evaluation of Māori culture.

This thesis contextualises the work of the four authors and explores the ways in which their fiction engages with historical and contemporary issues of “race relations” and cultural identity in New Zealand. A sociological approach has been applied to the texts. This approach derives from the Māori writers’ own insistent reading of contemporary Māori identity as the product of historical encounter between Māori and Pākehā. The authors work in a dialectical relationship to previous Pākehā representations of Māori in literature, are historically revisionist, and are frequently adversarial. 

Despite the differences in personal and political perspectives held by the authors, their fictions share a common goal in their search for Māori pathways to empowerment. This thesis argues that prose fiction written in English by Māori writers contributes to the political activism of the Māori people and helps to foster an environment in which new perspectives on Māori culture and bicultural relations can be articulated.

text: Contextualising Māori writing: a study of prose fiction written in English by Witi Ihimaera, Patricia Grace, Keri Hulme and Alan Duff All prose fiction written in English by Māori is political on one level or another. The authors considered in this thesis, Witi Ihimaera, Patricia Grace, Keri Hulme and Alan Duff, choose to identify as Māori, but for each writer exactly what this entails implies something different. The diverse range of Māori characters represented in their work illustrates the heterogeneity of contemporary Māori identity. Whilst bearing in mind that there is no fixed Māori identity, this thesis proposes that all fiction written in English by Māori is motivated by a belief that Māori are a disadvantaged group within New Zealand society. 

Three of the four writers, Ihimaera, Grace and Hulme, write against a background of colonisation. Their fiction confronts grievances based on perceived injustices committed against Māori in the past by European colonists and is concerned with the restoration of Māori rights pertaining to land, language, identity and political voice. While all three engage with these issues in their fiction, this thesis specifically considers the way in which Ihimaera treats the theme of land, Grace focuses on issues of education and Hulme explores Māori mythology.

Alan Duff stands apart from the other three writers in his belief that colonisation is not to blame for contemporary Māori disadvantage. Rather, Duff considers the situation to be the result of inherent flaws within Māori society. Through his often didactic writing he proposes that improved Māori socioeconomic levels can only be achieved through a radical structural and economic re-evaluation of Māori culture.

This thesis contextualises the work of the four authors and explores the ways in which their fiction engages with historical and contemporary issues of “race relations” and cultural identity in New Zealand. A sociological approach has been applied to the texts. This approach derives from the Māori writers’ own insistent reading of contemporary Māori identity as the product of historical encounter between Māori and Pākehā. The authors work in a dialectical relationship to previous Pākehā representations of Māori in literature, are historically revisionist, and are frequently adversarial. 

Despite the differences in personal and political perspectives held by the authors, their fictions share a common goal in their search for Māori pathways to empowerment. This thesis argues that prose fiction written in English by Māori writers contributes to the political activism of the Māori people and helps to foster an environment in which new perspectives on Māori culture and bicultural relations can be articulated.

year: 2002