Reconnecting whānau: Pathways to recovery for Māori with bipolar disorder

While Māori are known to experience a higher burden of mental health and addiction problems compared to non-Māori (Baxter, 2008), little exploratory research has been conducted into Māori experiences of bipolar affective disorder. Bipolar disorder is at times regarded as a “life sentence”, with little hope of recovery. The recovery- focused mental health literature, however, argues wellness is achievable for even the most intractable conditions (Lapsley, Nikora, & Black, 2002; Mental Health Commission, 2001). The aim of this research was to gather information about the experiences of Māori who were diagnosed with bipolar affective disorder. Interviews were conducted with 22 Māori wāhine (women) and tāne (men), and using thematic analyses, themes relevant to their life stories were uncovered. This research sought to contribute to the realisation of Māori potential by explicitly shifting from deficit- focused frameworks to a focus on systemic factors that influenced Māori wellbeing. Highlights were that whānau (participants) who were connected with friends, partners and family were motivated to achieve wellness and to stay well

Wāhine Whaiora: Māori Women's Experiences of Bipolar Disorder and their Pathways to Recovery

This research examines the unique, lived experiences of wāhine Māori (Māori women) who have been diagnosed with bipolar affective disorder and who are currently living ‘well’. Recent literature indicates that Māori present at higher rates than non-Māori with bipolar disorder. However, there is little qualitative information about the nature of their experiences, as well as sparse detail of the impacts that bipolar has on their everyday living. The purpose of this research is to highlight Māori women’s experiences of bipolar disorder from initial presentation and assessment through to diagnosis, treatment and recovery. It focuses on the impact bipolar disorder has on women’s relationships with their tamariki (children), whānau (family), and partners, while also exploring social and personal impacts, help-seeking patterns, and stories of recovery. This research heard the stories of 11 wāhine Māori using a narrative-storying technique to allow wāhine to share their unique experiences as they recalled them. A thematic analysis was then used to identify key themes that depicted their journeys of: • Illness and symptom presentation; • Consequences and impacts of bipolar disorder; • Support and help-seeking; and • Wellness and recovery. The intent of this research is to create an awareness of the nature of bipolar disorder as it affects wāhine Māori. It endeavours to expose the experiences they have encountered and their aspirations to be better supported by whānau, and community organisations in their attempts to live active and well lives

An investigation by LA-ICP-MS of possum tooth enamel as a model for identifying childhood geographical locations of historical and archaeological human from New Zealand

LA -IC P-MS (laser ablation-inductively coupled plasma-mass spectrometry) has been used to analyse enamel from the teeth of brushtail possum (Trichosurus vulpecula) in order to model a method for identifying the childhood geographical origin of human remains within New Zealand. The model application of the method is promising for establishing locations of historical and archaeological human remains, including preserved heads, upoko tuhi

Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data

BACKGROUND: The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. OBJECTIVE: To determine whether primary care access is associated with the route of emergency admission-via a GP versus via an A and E department. METHODS: Retrospective analysis of national administrative data from English hospitals for 2011-2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access-the percentage of patients able to get a general practice appointment on their last attempt-was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. RESULTS: The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. CONCLUSIONS: Among hospital inpatients admitted as an emergency, patients registered to more accessible general practices were more likely to have been admitted via a GP (vs an A and E department). This furthers evidence suggesting that access to general practice is related to use of emergency hospital services in England. The relative merits of the two admission routes remain unclear

A European Turn in Early American History? A Discussion of Evan Haefeli's Accidental Pluralism: America and the Religious Politics of English Expansion, 1497-1662

From the nineteenth century onwards, Americans have naturalized their colonial origins into a consensual nationalist history, emphasizing America’s perceived role as a refuge for the persecuted, while smoothing out a myriad of complexities in the process. Evan Haefeli attempts to overturn the assumptions underpinning this narrative and is convinced that many important aspects of early America need to be understood within a broader European context. In Accidental Pluralism, he argues that the collapse of religious unity in England lies at the root of the emergence of pluralism in colonial America, in which he includes Canada and the Caribbean. Relationships among states, churches, and publics were contested from the earliest decades of colonization and created a pluralistic religious landscape that no one had anticipated. The four reviewers are fulsome in their praise, calling it an impressive, important, powerful, and sweeping book that few scholars could have written. The reviewers also raise questions, for instance by problematizing the incorporation of the colonial American dimension into early British history, criticizing the validity of the chosen end date, and questioning his definitions of diversity, pluralism, and religious toleration. In his response Evan Haefeli takes the opportunity to reflect on what drove him to write the book and to organize it in this way. He acknowledges that connecting early American history with its broader European context was more difficult than it should have been, as the dominant questions in the two historiographies are an ocean apart. While the argument of the book is aimed at early Americanists, Haefeli is grateful that the reviewers situate the story he tells within the broader early modern European history of toleration

Evolution of surname distribution under gender-equality measurements

We consider a model for the evolution of the surnames distribution under a gender-equality measurement presently discussed in the Spanish parliament (the children take the surname of the father or the mother according to alphabetical order). We quantify how this would bias the alphabetical distribution of surnames, and analyze its effect on the present distribution of the surnames in Spain

Best Practices for the Prevention and Management of Diabetes and Obesity-Related Chronic Disease among Indigenous Peoples in Canada: A Review

AbstractObjectivesTo carry out a systematic review of interventions that have aimed at improving screening, treatment, prevention and management of type 2 diabetes and obesity-related chronic disease in Indigenous communities in Canada from 2008 to 2014, with the aim of identifying current best practices.MethodsA comprehensive literature review was carried out through an electronic database search using Medline, EMBASE, PubMED and Google scholar.ResultsWe identified 17 publications, comprising 13 evaluated interventions. Of them, 7 were school-based programs focused on children, 5 focused on adults, and 1 included both adults and children. Most interventions aimed at encouraging behaviour change, especially dietary change, but did little to address the underlying context of systemic marginalization and colonialism experienced in many Indigenous communities. Interventions focused on improving fitness were more effective than those aimed at dietary change. Overall, we found a range of successes among these interventions. Those that met with limited success reported that complex social issues and poverty presented challenges to effective intervention work in these communities. Participatory action research methods and community ownership of the intervention were found to be essential for project success.ConclusionsDiabetes-focused intervention research in Indigenous communities appears to be a low priority for Canadian funders and policymakers. More intervention research is urgently needed in these communities. To be effective, this work must take an approach that is historically deep and sufficiently broad as to enable the ideologic, policy and institutional changes necessary in order to achieve true equity. This will involve addressing colonialism, racism and social exclusion as broader determinants of health

Access to primary care and visits to emergency departments in England: a cross-sectional, population-based study

Background The number of visits to hospital emergency departments (EDs) in England has increased by 20% since 2007-08, placing unsustainable pressure on the National Health Service (NHS). Some patients attend EDs because they are unable to access primary care services. This study examined the association between access to primary care and ED visits in England. Methods A cross-sectional, population-based analysis of patients registered with 7,856 general practices in England was conducted, for the time period April 2010 to March 2011. The outcome measure was the number of self-referred discharged ED visits by the registered population of a general practice. The predictor variables were measures of patient-reported access to general practice services; these were entered into a negative binomial regression model with variables to control for the characteristics of patient populations, supply of general practitioners and travel times to health services. Main Result and Conclusion General practices providing more timely access to primary care had fewer self-referred discharged ED visits per registered patient (for the most accessible quintile of practices, RR = 0.898; P<0.001). Policy makers should consider improving timely access to primary care when developing plans to reduce ED utilisation

Māori experiences of bipolar disorder: pathways to recovery

The findings of this research highlighted pathways into mental illness for Maori that could have been avoided earlier. The pathways to recovery however, showed the critical importance of maintaining connections with significant family members over the lifespan. Exposure to varying levels of childhood adversity, such as sexual and physical violence, parental mental illness, multiple and/or abusive foster care, and abandonment issues led to acute levels of post-traumatic stress, substance abuse, poor relationship choices, depression, anxiety and safety issues

Spin chirality on a two-dimensional frustrated lattice

The collective behavior of interacting magnetic moments can be strongly influenced by the topology of the underlying lattice. In geometrically frustrated spin systems, interesting chiral correlations may develop that are related to the spin arrangement on triangular plaquettes. We report a study of the spin chirality on a two-dimensional geometrically frustrated lattice. Our new chemical synthesis methods allow us to produce large single crystal samples of KFe3(OH)6(SO4)2, an ideal Kagome lattice antiferromagnet. Combined thermodynamic and neutron scattering measurements reveal that the phase transition to the ordered ground-state is unusual. At low temperatures, application of a magnetic field induces a transition between states with different non-trivial spin-textures.Comment: 7 pages, 4 figure