title: Understanding accountability in an ever-changing New Zealand health system

authors: Zainal Abidin, Nor Azizah Binti

subjects: accountability

abstract: The purpose of this research was to understand how the constant adoption of reforms affected accountability understanding and its practices in the New Zealand public health system. 

This study adopted a qualitative methodology and took a critical hermeneutics approach in order to explore the reasons for, and formats of, public health reform, and the experience of health policy implementers in dealing with reforms, policy changes, and accountability. To develop new insights about accountability and its practices, this study reviewed a range of policy documents and relevant publications, and interviewed senior health managers who were experienced in dealing with reforms. 

The research evidence is presented in line with Ricoeur’s stages of understanding; these are: preunderstanding, understanding, and finally, comprehensive understanding. The preunderstanding was developed from study of secondary sources, while the understanding was achieved through interviews. A comprehensive understanding results from both review of and reflection on preunderstanding and understanding. 

The findings are that reform can be described as a ‘means without ends’ because it was continually implemented in a political loop, in which, demand and supply for change were determined by the government’s political interests. Postreform accountability was full of frustrations because of its complexity in practice. Surprisingly, despite that fact, the health managers still believe that accountability per se is essential. This study proposes that postreform accountability can be understood as two sides of the same coin: accountability means being accountable, in a normative sense, and not being able to be accountable, in practice.
The adoption of constant reforms has increased the level of organisational complexity. This has affected the notion of accountability and its practices because accountability rests in the organisational structures. This study suggests that accountability cannot be detached from its normative and mechanism perspectives. No matter how much the policy has changed or will change in the future, the possibility of policy implementers facing similar challenges and the same feelings is high because reform produces two identical outcomes for accountability: i.e., hopes and frustrations. 

The study contributes in three ways to an understanding of accountability in the context of reform. First, it offers valuable insights into the ongoing developments in the public health system and the issues of accountability. Second, it contributes to the wider understanding of the effects reform have on the notion of accountability and its practices. Third, it advances understanding relating to recent discussions on postreform accountability.

text: Understanding accountability in an ever-changing New Zealand health system The purpose of this research was to understand how the constant adoption of reforms affected accountability understanding and its practices in the New Zealand public health system. 

This study adopted a qualitative methodology and took a critical hermeneutics approach in order to explore the reasons for, and formats of, public health reform, and the experience of health policy implementers in dealing with reforms, policy changes, and accountability. To develop new insights about accountability and its practices, this study reviewed a range of policy documents and relevant publications, and interviewed senior health managers who were experienced in dealing with reforms. 

The research evidence is presented in line with Ricoeur’s stages of understanding; these are: preunderstanding, understanding, and finally, comprehensive understanding. The preunderstanding was developed from study of secondary sources, while the understanding was achieved through interviews. A comprehensive understanding results from both review of and reflection on preunderstanding and understanding. 

The findings are that reform can be described as a ‘means without ends’ because it was continually implemented in a political loop, in which, demand and supply for change were determined by the government’s political interests. Postreform accountability was full of frustrations because of its complexity in practice. Surprisingly, despite that fact, the health managers still believe that accountability per se is essential. This study proposes that postreform accountability can be understood as two sides of the same coin: accountability means being accountable, in a normative sense, and not being able to be accountable, in practice.
The adoption of constant reforms has increased the level of organisational complexity. This has affected the notion of accountability and its practices because accountability rests in the organisational structures. This study suggests that accountability cannot be detached from its normative and mechanism perspectives. No matter how much the policy has changed or will change in the future, the possibility of policy implementers facing similar challenges and the same feelings is high because reform produces two identical outcomes for accountability: i.e., hopes and frustrations. 

The study contributes in three ways to an understanding of accountability in the context of reform. First, it offers valuable insights into the ongoing developments in the public health system and the issues of accountability. Second, it contributes to the wider understanding of the effects reform have on the notion of accountability and its practices. Third, it advances understanding relating to recent discussions on postreform accountability.

year: 2015

title: Molecular Studies of House Mice in Southern New Zealand

authors: McCormick, Helen Margaret

subjects: mus musculus

abstract: The house mouse, Mus Musculus, was first introduced into New Zealand in significant numbers in the mid nineteenth century. Earlier research suggests that multiple introductions of the three subspecies of house mouse M. m. domesticus, M. m. musculus and M. m. castaneus occurred at this time. While M. m. domesticus is widely distributed in New Zealand with M. m. musculus somewhat less so, the only extant evidence found to date for M. m. castaneus is in hybrid mice found principally in the southern half of the South Island. In this study, the hybrid population of mice in the South Island was examined in detail using a variety of molecular techniques. The extent of the hybrid zone was first established using a simple polymerase chain reaction (PCR) technique that enabled rapid identification of mitochondrial genomes as being M. m. domesticus, castaneus or musculus in nature. In the second part of the study, four representative mice from the hybrid zone and three M. m. domesticus from north of this zone were subjected to high density (600K) single nucleotide polymorphism (SNP) analyses in order to pinpoint regions of the genomes that differed in a significant manner between the two groups. In a refinement of these analyses, regions of each genome were identified as being domesticus-, castaneus- or musculus-like, using diagnostic SNP alleles for each sub-species. Some 170 mice, principally collected in the Southern South Island, were screened using the rapid PCR technique. In the coastal regions, all mice further south than 44oS had M. m. castaneus mtDNA whereas those north of 43oS had M. m. domesticus mtDNA. Between the two, there is a ‘contact zone’ in which both subspecies were found, sometimes in the same building. The contact zone extends approximately 50km north to south and some 30km inland. Classical tests with three nuclear DNA markers confirmed earlier work, namely, that the nuclear genomes of all mice appeared to be predominantly domesticus-like. Although there is no obvious geographical, ecological or land-use features that characterise this contact zone it may be relevant that there is the distinct change to a wetter colder climate in the south and inland of the contact zone, especially in winter. The inability to identify obvious defining features is not surprising, given that much research over many years worldwide has failed to yield an explanation for distinct mouse hybrid zones. The high density SNP analyses demonstrated that the nuclear genomes of all seven representative mice were very similar and largely (approximately 95%+) domesticus-like in nature. Despite this similarity, clusters of SNPs did reveal differences throughout the genome, often just extending over a few haplotype blocks and often encompassing much less than a million basepairs (Mb). Some of these were of biological interest, for example clusters of vomeronasal receptor genes and also genes believed to be involved in maternal-fetal conflict, which are known to vary markedly between species. The diagnostic SNP analyses confirmed that no marked differences exist between the genomes of the hybrid and M. m. domesticus mice. As stated above, the genomes were predominantly domesticus-like but small regions (~1Mb) of castaneus-like and musculus-like genome were found scattered throughout all mice but, contrary to initial expectations, there was no preponderance of castaneus-like regions in the hybrid mice. The one exception to the largely identical genomic SNP patterns, were those from the mouse collected in Hamilton. This was quite bizarre, in that its genome contains large (up to 10Mb) musculus-like regions that correspond exactly to the same regions in a common laboratory strain of mouse, C57BL/6J. I conclude that if pure M. m. castaneus mice did originally reach New Zealand, extensive ‘backcrossing’ with M. m. domesticus has virtually eliminated the castaneus genome, with just a few remnants remaining that may or may not confer some selective advantage, but could just as likely represent segregation of recognition factors that give rise to assortative mating. Thus, the most obvious and consistent genetic difference between the mice remains the original observation concerning their mitochondrial genomes and these should be examined in more detail. In future research aimed at identifying potential selective advantages that have allowed the hybrid mice to exclusively populate the southern South Island factors that relate to climate should be considered. Specifically, the fact that, in humans, some mitochondrial haplotypes are believed to confer a selective advantage in colder climates immediately suggests that examining variants of key genes involved in energy metabolism such as NADH-dehydrogenase-subunit-3 ( ND3 ) in the hybrid mice could be a profitable line of future research.

text: Molecular Studies of House Mice in Southern New Zealand The house mouse, Mus Musculus, was first introduced into New Zealand in significant numbers in the mid nineteenth century. Earlier research suggests that multiple introductions of the three subspecies of house mouse M. m. domesticus, M. m. musculus and M. m. castaneus occurred at this time. While M. m. domesticus is widely distributed in New Zealand with M. m. musculus somewhat less so, the only extant evidence found to date for M. m. castaneus is in hybrid mice found principally in the southern half of the South Island. In this study, the hybrid population of mice in the South Island was examined in detail using a variety of molecular techniques. The extent of the hybrid zone was first established using a simple polymerase chain reaction (PCR) technique that enabled rapid identification of mitochondrial genomes as being M. m. domesticus, castaneus or musculus in nature. In the second part of the study, four representative mice from the hybrid zone and three M. m. domesticus from north of this zone were subjected to high density (600K) single nucleotide polymorphism (SNP) analyses in order to pinpoint regions of the genomes that differed in a significant manner between the two groups. In a refinement of these analyses, regions of each genome were identified as being domesticus-, castaneus- or musculus-like, using diagnostic SNP alleles for each sub-species. Some 170 mice, principally collected in the Southern South Island, were screened using the rapid PCR technique. In the coastal regions, all mice further south than 44oS had M. m. castaneus mtDNA whereas those north of 43oS had M. m. domesticus mtDNA. Between the two, there is a ‘contact zone’ in which both subspecies were found, sometimes in the same building. The contact zone extends approximately 50km north to south and some 30km inland. Classical tests with three nuclear DNA markers confirmed earlier work, namely, that the nuclear genomes of all mice appeared to be predominantly domesticus-like. Although there is no obvious geographical, ecological or land-use features that characterise this contact zone it may be relevant that there is the distinct change to a wetter colder climate in the south and inland of the contact zone, especially in winter. The inability to identify obvious defining features is not surprising, given that much research over many years worldwide has failed to yield an explanation for distinct mouse hybrid zones. The high density SNP analyses demonstrated that the nuclear genomes of all seven representative mice were very similar and largely (approximately 95%+) domesticus-like in nature. Despite this similarity, clusters of SNPs did reveal differences throughout the genome, often just extending over a few haplotype blocks and often encompassing much less than a million basepairs (Mb). Some of these were of biological interest, for example clusters of vomeronasal receptor genes and also genes believed to be involved in maternal-fetal conflict, which are known to vary markedly between species. The diagnostic SNP analyses confirmed that no marked differences exist between the genomes of the hybrid and M. m. domesticus mice. As stated above, the genomes were predominantly domesticus-like but small regions (~1Mb) of castaneus-like and musculus-like genome were found scattered throughout all mice but, contrary to initial expectations, there was no preponderance of castaneus-like regions in the hybrid mice. The one exception to the largely identical genomic SNP patterns, were those from the mouse collected in Hamilton. This was quite bizarre, in that its genome contains large (up to 10Mb) musculus-like regions that correspond exactly to the same regions in a common laboratory strain of mouse, C57BL/6J. I conclude that if pure M. m. castaneus mice did originally reach New Zealand, extensive ‘backcrossing’ with M. m. domesticus has virtually eliminated the castaneus genome, with just a few remnants remaining that may or may not confer some selective advantage, but could just as likely represent segregation of recognition factors that give rise to assortative mating. Thus, the most obvious and consistent genetic difference between the mice remains the original observation concerning their mitochondrial genomes and these should be examined in more detail. In future research aimed at identifying potential selective advantages that have allowed the hybrid mice to exclusively populate the southern South Island factors that relate to climate should be considered. Specifically, the fact that, in humans, some mitochondrial haplotypes are believed to confer a selective advantage in colder climates immediately suggests that examining variants of key genes involved in energy metabolism such as NADH-dehydrogenase-subunit-3 ( ND3 ) in the hybrid mice could be a profitable line of future research.

year: 2011

title: A local Aotearoa New Zealand investigation of the contribution of Māori cultural knowledges to Pakeha identity and counselling practices

authors: Te Wiata, Joy

subjects: Pakeha identity

abstract: This project investigates the experiences of a small group of social service  practitioners as they consider the question of what it means to be Pakeha in Aotearoa New Zealand in 2004.  Specifically this study considers the contribution  of Māori cultural knowledges to Pakeha identity.  It also explores whether therapeutic practices that participants have available, are relevant to their current  claims of Pakeha identity.   This study highlights the complexity of experience and multiple stories that inform constructions of identity.   In approaching the topic I was aware that many  important stories of people's lived experience are not often told.  People are often silenced due to the difficulty of 'telling'.  In this exploration, space was created  for the telling of stories, which are often not easily told:  stories of struggle and pain; stories of compassionate witnessing; stories of rule-breaking; stories of  stepping into territory beyond binaries and stories of richness and delight.   Knowledges have been produced that indicate the need for carefully crafted space for often very difficult identity conversations to occur and for voices to be heard.   Further, the study has produced knowledges for scaffolding for respectful and honouring conversations .  The stories of this project indicate that the  conversations required, have their foundation through engagement with the value of fairness.  Findings also indicate that forums, where mutual contribution to  identity for both Māori and Pakeha can be acknowledged, are a critical to establishing ongoing honourable relationships between Pakeha and Māori New Zealanders.     Throughout this project participants acknowledge and honour the rich  contribution of Māori knowledges and language to their Pakeha identity.

text: A local Aotearoa New Zealand investigation of the contribution of Māori cultural knowledges to Pakeha identity and counselling practices This project investigates the experiences of a small group of social service  practitioners as they consider the question of what it means to be Pakeha in Aotearoa New Zealand in 2004.  Specifically this study considers the contribution  of Māori cultural knowledges to Pakeha identity.  It also explores whether therapeutic practices that participants have available, are relevant to their current  claims of Pakeha identity.   This study highlights the complexity of experience and multiple stories that inform constructions of identity.   In approaching the topic I was aware that many  important stories of people's lived experience are not often told.  People are often silenced due to the difficulty of 'telling'.  In this exploration, space was created  for the telling of stories, which are often not easily told:  stories of struggle and pain; stories of compassionate witnessing; stories of rule-breaking; stories of  stepping into territory beyond binaries and stories of richness and delight.   Knowledges have been produced that indicate the need for carefully crafted space for often very difficult identity conversations to occur and for voices to be heard.   Further, the study has produced knowledges for scaffolding for respectful and honouring conversations .  The stories of this project indicate that the  conversations required, have their foundation through engagement with the value of fairness.  Findings also indicate that forums, where mutual contribution to  identity for both Māori and Pakeha can be acknowledged, are a critical to establishing ongoing honourable relationships between Pakeha and Māori New Zealanders.     Throughout this project participants acknowledge and honour the rich  contribution of Māori knowledges and language to their Pakeha identity.

year: 2006