title: Reclaiming Kaitiakitanga : An intergenerational perspective of Kaitiakitanga within Te Parawhau

authors: Walker, Erana

subjects: Kaitiakitanga

abstract: Kaitiakitanga is a concept that is utilised widely throughout the Māori world for the protection and preservation of cultural aspects to Māori. Through years of application by westernised mainstream processes the value has largely been restricted to the realms of environmental protection. This restriction has often been the result of misinterpretation of Kaitiakitanga and its relevance as a concept to Māori. The purpose of the thesis is to question how the perspective of Kaitiakitanga is constructed in the minds of representatives from the hapū of Te Parawhau. To test for variance, the research spans across two generations of hapū members. Using Whakawhiti Kōrero for data collection as well as Kaupapa Māori methodology as guidance, the thesis explores perspectives of two generations of Te Parawhau descendants around Kaitiakitanga and how it can be developed to aid in the growth and prosperity of the hapū. Key themes highlighted by the analysis encompass ideas of connectedness as well as spiritual, physical, environmental and human elements of responsibility and obligation. The thesis introduces a distinct Te Parawhau analytical framework for its analysis of rich kōrero by hapū members in relation to Kaitiakitanga. Through this framework the value of Kaitiakitanga is tested for relevance to Te Parawhau and its future development. The world view of Te Parawhau has formed the basis of participant perspectives around Kaitiakitanga and leads the researcher to consider that such knowledge is important to the future functionality of Māori value’s. The thesis concludes to show that there are indeed differences in application and perspectives of Kaitiakitanga within the hapū of Te Parawhau.

text: Reclaiming Kaitiakitanga : An intergenerational perspective of Kaitiakitanga within Te Parawhau Kaitiakitanga is a concept that is utilised widely throughout the Māori world for the protection and preservation of cultural aspects to Māori. Through years of application by westernised mainstream processes the value has largely been restricted to the realms of environmental protection. This restriction has often been the result of misinterpretation of Kaitiakitanga and its relevance as a concept to Māori. The purpose of the thesis is to question how the perspective of Kaitiakitanga is constructed in the minds of representatives from the hapū of Te Parawhau. To test for variance, the research spans across two generations of hapū members. Using Whakawhiti Kōrero for data collection as well as Kaupapa Māori methodology as guidance, the thesis explores perspectives of two generations of Te Parawhau descendants around Kaitiakitanga and how it can be developed to aid in the growth and prosperity of the hapū. Key themes highlighted by the analysis encompass ideas of connectedness as well as spiritual, physical, environmental and human elements of responsibility and obligation. The thesis introduces a distinct Te Parawhau analytical framework for its analysis of rich kōrero by hapū members in relation to Kaitiakitanga. Through this framework the value of Kaitiakitanga is tested for relevance to Te Parawhau and its future development. The world view of Te Parawhau has formed the basis of participant perspectives around Kaitiakitanga and leads the researcher to consider that such knowledge is important to the future functionality of Māori value’s. The thesis concludes to show that there are indeed differences in application and perspectives of Kaitiakitanga within the hapū of Te Parawhau.

year: 2016

title: Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand

authors: Oliphant, Jeannie

abstract: Internationally and within New Zealand there has been a substantial increase in the demand for gender affirming healthcare over the past decade. The Youth’12 secondary school survey, estimated that approximately 1.2% of adolescents in New Zealand identify as transgender.¹ It is likely that this level of referrals to health services will continue in the foreseeable future. 
This guideline has been developed following the recognition that New Zealand’s previous good practice guide, Gender Reassignment Health Services for Trans People within New Zealand,² which was based heavily on the World Professional Association of Transgender Health, Standards of Care, version 6 (WPATH SOC v6),³ requires updating to be in step with current practice and international guidelines.
Transgender healthcare is a rapidly evolving area of medicine. WPATH is the international body responsible for producing standards of care. WPATH SOC v7,⁴ was published soon after New Zealand’s good practice guide and version 8 is currently in development. This guideline is not intended to replace the WPATH SOC but to present additional guidance for the provision of gender affirming healthcare in Aotearoa, New Zealand. We hope that this guide will be used to support the development of health services providing gender affirming healthcare around the country and provide guidance to District Health Boards (DHBs).
We use Sir Mason Durie’s health framework to inform the kaupapa or approach of these guidelines. WPATH SOC v7 encourages culturally appropriate approaches which are contextually based.⁴ Durie’s model for health promotion development, Te Pae Māhutonga (the Southern Cross), has two guiding principles which correspond to the pointer stars of the constellation, Te Mana Whakahaere and Ngā Manukura.⁵

text: Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand Internationally and within New Zealand there has been a substantial increase in the demand for gender affirming healthcare over the past decade. The Youth’12 secondary school survey, estimated that approximately 1.2% of adolescents in New Zealand identify as transgender.¹ It is likely that this level of referrals to health services will continue in the foreseeable future. 
This guideline has been developed following the recognition that New Zealand’s previous good practice guide, Gender Reassignment Health Services for Trans People within New Zealand,² which was based heavily on the World Professional Association of Transgender Health, Standards of Care, version 6 (WPATH SOC v6),³ requires updating to be in step with current practice and international guidelines.
Transgender healthcare is a rapidly evolving area of medicine. WPATH is the international body responsible for producing standards of care. WPATH SOC v7,⁴ was published soon after New Zealand’s good practice guide and version 8 is currently in development. This guideline is not intended to replace the WPATH SOC but to present additional guidance for the provision of gender affirming healthcare in Aotearoa, New Zealand. We hope that this guide will be used to support the development of health services providing gender affirming healthcare around the country and provide guidance to District Health Boards (DHBs).
We use Sir Mason Durie’s health framework to inform the kaupapa or approach of these guidelines. WPATH SOC v7 encourages culturally appropriate approaches which are contextually based.⁴ Durie’s model for health promotion development, Te Pae Māhutonga (the Southern Cross), has two guiding principles which correspond to the pointer stars of the constellation, Te Mana Whakahaere and Ngā Manukura.⁵

year: 2018

title: A typology of longitudinal integrated clerkships.

authors: Worley, Paul

subjects: Australia

abstract: CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

text: A typology of longitudinal integrated clerkships. CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

year: 2016