title: Discordance in perceptions of barriers to diabetes care between patients and primary care and secondary care

authors: Simmons, David

subjects: DAWN

abstract: OBJECTIVE—We sought to compare perceived barriers to diabetes care between people with diabetes and different health professional groups. 
RESEARCH DESIGN AND METHODS—This was a cross-sectional, postal, open-questionnaire survey conducted in the Waikato district, New Zealand. A total of 3,890 individuals with diabetes participated, as well as 436 primary and secondary health professionals. 
RESULTS—Barriers were reported in 69.7% of patients. Psychological barriers were most important (55.5%), followed by systems barriers (25.7%), and then knowledge as least important (15.3%). Psychological barriers were ranked first among general practitioners (91.0%), but systems barriers were ranked first by other health professionals (38.8–100%). General practitioner and patient barrier group rankings were similar (rT = 0.976, P < 0.05). Of specific barriers among individuals with diabetes, strictness of treatment regimen was the most frequently reported (42.3 vs. 0.1–16.8%) (P < 0.001) and 2.5 (95% CI 2.4–2.7)- to 3.4 (3.2–3.7)-fold more than the 2nd through 4th ranked barriers. Motivation was the most common specific barrier reported by general practitioners (86%), practice nurses (31.5%), and the diabetes team (85.7%). Practice and hospital nurse/dietitian rankings were most comparable with patients (rT = 0.457 and 0.466, respectively, both P < 0.05). A major area of patient–health professional discordance was the influence of other health problems, which was ranked 2nd among patients but 10th–18th among health professionals. 
CONCLUSIONS—The most important barriers to diabetes care perceived by patients are psychological and particularly relate to the strictness of the regimen. Discordance between patients and different health professionals exists in the perception of the importance of different barriers to diabetes care.

text: Discordance in perceptions of barriers to diabetes care between patients and primary care and secondary care OBJECTIVE—We sought to compare perceived barriers to diabetes care between people with diabetes and different health professional groups. 
RESEARCH DESIGN AND METHODS—This was a cross-sectional, postal, open-questionnaire survey conducted in the Waikato district, New Zealand. A total of 3,890 individuals with diabetes participated, as well as 436 primary and secondary health professionals. 
RESULTS—Barriers were reported in 69.7% of patients. Psychological barriers were most important (55.5%), followed by systems barriers (25.7%), and then knowledge as least important (15.3%). Psychological barriers were ranked first among general practitioners (91.0%), but systems barriers were ranked first by other health professionals (38.8–100%). General practitioner and patient barrier group rankings were similar (rT = 0.976, P < 0.05). Of specific barriers among individuals with diabetes, strictness of treatment regimen was the most frequently reported (42.3 vs. 0.1–16.8%) (P < 0.001) and 2.5 (95% CI 2.4–2.7)- to 3.4 (3.2–3.7)-fold more than the 2nd through 4th ranked barriers. Motivation was the most common specific barrier reported by general practitioners (86%), practice nurses (31.5%), and the diabetes team (85.7%). Practice and hospital nurse/dietitian rankings were most comparable with patients (rT = 0.457 and 0.466, respectively, both P < 0.05). A major area of patient–health professional discordance was the influence of other health problems, which was ranked 2nd among patients but 10th–18th among health professionals. 
CONCLUSIONS—The most important barriers to diabetes care perceived by patients are psychological and particularly relate to the strictness of the regimen. Discordance between patients and different health professionals exists in the perception of the importance of different barriers to diabetes care.

year: 2007

title: Extreme southern locations for moss sporophytes in Antarctica

authors: Seppelt, Rodney D.

subjects: bryophyte

abstract: Abundant immature sporophytes of the moss Pottia heimii are reported from the Lower Taylor Valley, McMurdo Dry Valleys and from Cape Chocolate, Victoria Land. These finds extend the reported southern limit for the occurrence of abundant moss sporophytes to 77° 55′S.

text: Extreme southern locations for moss sporophytes in Antarctica Abundant immature sporophytes of the moss Pottia heimii are reported from the Lower Taylor Valley, McMurdo Dry Valleys and from Cape Chocolate, Victoria Land. These finds extend the reported southern limit for the occurrence of abundant moss sporophytes to 77° 55′S.

year: 1992

title: Providing space for indigenous knowledge

authors: Tangihaere, Tracey Mininoa

subjects: indigenous knowledge

abstract: Colonial influences have generally failed to respect indigenous knowledge, languages, and cultures. Determination to reclaim First Nations identity is visible in many jurisdictions. First Nations Peoples continue to call on governments to facilitate changes needed to revitalize their economic, social, cultural, and spiritual well-being. This article is a reflective article generated from our response to the situation of Mäori, the indigenous peoples of New Zealand. It provides a background on the historical attempts to weaken Mäori leadership and the resilience of Mäori in their resistance to such undermining. Using a description of a physical space, the Marae (the meetinghouse), the authors provide a glimpse into a distinctive Mäori psychology connected to Marae encounters and into Mäori ways of thinking, feeling, and behaving. Three examples of organizational practice at the incorporation of such values are provided. Four implications for management education are posited as relevant not only to the education of managers in Aotearoa but wherever engagement with indigenous people occurs.

text: Providing space for indigenous knowledge Colonial influences have generally failed to respect indigenous knowledge, languages, and cultures. Determination to reclaim First Nations identity is visible in many jurisdictions. First Nations Peoples continue to call on governments to facilitate changes needed to revitalize their economic, social, cultural, and spiritual well-being. This article is a reflective article generated from our response to the situation of Mäori, the indigenous peoples of New Zealand. It provides a background on the historical attempts to weaken Mäori leadership and the resilience of Mäori in their resistance to such undermining. Using a description of a physical space, the Marae (the meetinghouse), the authors provide a glimpse into a distinctive Mäori psychology connected to Marae encounters and into Mäori ways of thinking, feeling, and behaving. Three examples of organizational practice at the incorporation of such values are provided. Four implications for management education are posited as relevant not only to the education of managers in Aotearoa but wherever engagement with indigenous people occurs.

year: 2011