Dying to research: An autoethnographic exploration of researching Māori and whānau experiences of end-of-life care

The authors critically reflect on the autoethnographic process involved in navigating a smooth pathway towards investigating dying, death and bereavement for Māori whānau (families) in a way that supports and gives voice to their experience. This study, based in the Māori & Psychology Research Unit at The University of Waikato, is supported by a Health Research Council Erihapeti Rehu-Murchie Career Development Award. It explores the “end-of-life” journeys of Māori and their whānau in South Auckland and Waikato, through the dying process and subsequent challenges of bereavement. The researcher’s journey from novice to someone fully enmeshed in the struggles and triumphs of conducting research with Māori is examined. There is reflection on the challenges and issues that have emerged since settling on this research topic. These include ethical concerns, and the processes and outcomes associated with negotiating tensions between a shifting academic objectivity and the development of a methodology requiring subjective reflexivity

Professional interventions with parents at the time of the sudden death of a child

The sudden death of a child is likely the most traumatizing event a parent can experience. Traumatic death, and particularly the death of a child, increases the risk of a complicated grieving process in mourners. Little has been written with respect to the interventions of professionals with parents at the time of a sudden death of a child. The present study examines the experiences of parents with a variety of professionals from the time of death notification through the funeral. Twenty parents who were involved in Bereaved Families of Ontario participated in this study. The purpose was to examine the impact of professional interventions on the grieving process of the parents. Qualitative inquiry was utilized with the heuristic aspect of the phenomenological approach using semi-structured, open-ended interviews. Thematic analysis was completed at two levels. The first identified three key themes in helping: the provision of instrumental assistance, compassion and information. The themes in grieving were the reconstruction of the death scene, issues of control and the assumptive world, saying goodbye, making sense of the death, and carrying the deceased child forward in a new world. The integration of these themes produced concrete ways of helping parents through the trauma, and facilitating a healthy grieving process. The conclusion of the study outlines the clinical implications of these significant findings

Tangihanga: The ultimate form of Māori cultural expression - overview of a research programme

Death, observed through the process of tangihanga (time set aside to grieve and mourn, rites for the dead) or tangi (to grieve and mourn), is the ultimate form of Māori cultural expression. It is also the topic least studied by Māori or understood by outsiders, even after televised funeral rites of Māori leaders and intrusive media engagements with more humble family crises. It has prevailed as a cultural priority since earliest European contact, despite missionary and colonial impact and interference, and macabre Victorian fascination. Change is speculative rather than confirmed. Tangi and death rituals have yet to be rigorously examined in the Māori oral canon, or in the archival and historic record that may be discarded or reinforced by current practice. As researchers we are committed to studying tangi, conscious of the belief that such work carries the inherent risk of karanga aituā (inviting misfortune or even death itself) by drawing attention to it. Contemporary Aotearoa New Zealand is constantly touched by aspects of tangi practice through popular media and personal exposure. This volatile subject nevertheless demands careful and comprehensive scrutiny in order to extend and enrich the knowledge base, reveal the logic that guides ritual, inform the wider New Zealand community and, more importantly, support the cultural, social, ritual, economic and decision making processes of bereaved whānau (family, including extended family), people affiliated with marae (communal meeting complex) and iwi (tribe, tribal). This paper provides an overview of a research programme that began in July 2009, based at The University of Waikato. The programme is funded by Ngā Pae o te Māramatanga, the Marsden Fund of New Zealand and the Health Research Council of New Zealand

Beyond pain management: A primer for providing quality end-of-life care

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient\u27s emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the support available to the patient, the family, and you, the primary care physician. In the end, there is much that we have to offer a dying patient. Efforts should not stop because the illness cannot be cured. So much can happen to someone in the window of time between terminal diagnosis and death. Making this period one in which a person is as mentally clear, physically comfortable, and symptom free for as long as possible is a goal that is worthy of our efforts

In My Household, There Are (NOW) Many Colors

Book revie

Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction

Objective To measure the short term impact on hospital admissions for myocardial infarction of the introduction of smoke-free legislation in England on 1 July 2007

What women know: Perceptions of seven female superintendents

An anomalous concentration of female superintendents in mostly rural South Texas prompted this inquiry. South Texas faces critical shortages in personnel due to impending retirement and turnover of existing school administrators and superintendents (Wesson & Marshall, 2012). It is difficult to recruit and retain the best talent necessary to solve tough school improvement challenges—high dropout rates, high poverty, low student achievement, and complex multi-cultural issues—in high needs, Hispanic majority, primarily rural school districts (Trevino Jr., Braley, Brown, & Slate, 2008; Wesson & Marshall, 2012). Krüger (2008) stated women are stronger educational leaders than men. Females seek and obtain leadership credentials for the express purpose of impacting education for students (Young & McLeod, 2001). Schools of all sizes and levels with female administrators achieved higher student success than schools with male administrators, according to a 7000 campus Texas study, in the 2006-2007 academic year (Roser, Brown, & Kelsey, 2009). In every ethnic group, women earn more doctoral degrees in education than men; women earn bachelors and masters degrees in education in proportion to their representation in the field; and women have more years of teaching experience than men (Shakeshaft, Brown, Irby, Grogan, & Ballenger, 2007). Women also outnumber men in education administration preparation programs (Petrie & Lindauer, 2001). Yet women are not ascending to the superintendency in proportion to their representation in the education profession (Shakeshaft et al., 2007). This naturalistic study of seven female superintendents in South Texas, including leaders in large and small rural districts, illuminated perceptions and experiences of female school leadership through portraiture and lent insight into common themes of aspiration and motivation

Engaging midwifery students in academic integrity through a multi-faceted, integrated approach

As part of an Australian Government funded Office of Learning and Teaching (OLT) project, a Midwifery Program Coordinator and an Academic Language and Learning (ALL) adviser worked together to integrate academic integrity into the discipline content in a first year subject in the Graduate Diploma of Midwifery. The Program Manager and ALL adviser shared responsibility for developing and assessing academic integrity activities. The activities formed a scaffolded approach, beginning with a workshop to explicitly engage students with the concepts, followed by an assignment where students could test out their knowledge of paraphrasing, in-text referencing and synthesising from refereed journals in their discipline. Both summative and substantial formative feedback was provided, designed to assist students in identifying what they did well and any issues that needed to be addressed before they engaged with their literature review assignment. The rubric for the literature review was changed to give greater emphasis to academic integrity. Results showed that students developed a deep understanding of how to achieve academic integrity, and focus group feedback on the activities was positive. We argue that this multi-faceted, scaffolded, integrated approach is the most effective way to engage students in academic literacy skills such as academic integrity

Myostatin negatively regulates satellite cell activation and self-renewal

Satellite cells are quiescent muscle stem cells that promote postnatal muscle growth and repair. Here we show that myostatin, a TGF-β member, signals satellite cell quiescence and also negatively regulates satellite cell self-renewal. BrdU labeling in vivo revealed that, among the Myostatin-deficient satellite cells, higher numbers of satellite cells are activated as compared with wild type. In contrast, addition of Myostatin to myofiber explant cultures inhibits satellite cell activation. Cell cycle analysis confirms that Myostatin up-regulated p21, a Cdk inhibitor, and decreased the levels and activity of Cdk2 protein in satellite cells. Hence, Myostatin negatively regulates the G1 to S progression and thus maintains the quiescent status of satellite cells. Immunohistochemical analysis with CD34 antibodies indicates that there is an increased number of satellite cells per unit length of freshly isolated Mstn−/− muscle fibers. Determination of proliferation rate suggests that this elevation in satellite cell number could be due to increased self-renewal and delayed expression of the differentiation gene (myogenin) in Mstn−/− adult myoblasts. Taken together, these results suggest that Myostatin is a potent negative regulator of satellite cell activation and thus signals the quiescence of satellite cells