Interpreting & practicing kaupapa Māori research in a community setting: The in’s and out’s

Pou Tuia Rangahau is a unique community based research unit based within a kaupapa Māori organisation. Kaupapa Māori methodologies are utilised, with the importance of these methodologies being that Māori are defining the process, doing the research for and about Māori, with the eventual outcome being meaningful to Māori. This paper is placed within this wider context of Kaupapa Māori and how it applies to the practice of research in particular. We discuss how we interpret and practice Kaupapa Māori Research (KMR) within an urban community based organisation by highlighting a particular piece of research that was undertaken by Pou Tuia Rangahau, the Research Unit of Te Runanga O Kirikiriroa Trust Inc

Māori whānau experiences of a neonatal intensive care unit: Waikato hospital

This thesis topic emerged from my personal experience of having a premature baby in the Neonatal Intensive Care Unit (NICU) at Waikato hospital. My whānau and I felt like aliens; culturally inept, and totally alone during our time in the NICU. It was not until I spoke to other Māori mothers that I realised our stories were similar. I sought to understand how other Māori whānau members made sense of their own experiences, how they coped/adjusted to the experience of having a premature baby in an NICU and at home, and the sources of support they utilised. This study did not seek to delineate parents' experiences but attempted to allow whānau members to share their stories and explore their experiences of having a premature or special-care baby in an NICU. The event of childbirth and the placing of a natural event into a pathological illness model through necessity has repercussions for the ways in which women experience and make sense of the event. Knowing this, six whānau stories were collected comprising of four individual interviews with the mothers and two whānau hui (focus groups). My use of a narrative methodology and kaupapa Māori approach enabled all the participants the opportunity to share their stories on how they make sense of their own experiences without the frame of pathological illness. The findings present each whānau story autonomously, to highlight the key events that occur once the birth of a premature/special-care infant is admitted into an NICU. The participants' narratives followed their transitions through an NICU and return home. The narrative analysis and discussion confirmed that this research had been successful in creating a space for the mothers and their whānau members to share their stories. The discussion combined their narratives to reveal that the effective coping strategies did not remove the sources of stress but rather lessened the impact of the stresses. In situations where sources of stress were unable to be removed or reduced, participants perceptions of ineffective coping translated into narratives of negative perceptions of the NICU, and birthing experience. The importance of positive relationships within an NICU, and in particular, the role of the nurse as a key facilitator, highlighted that efficacious communication resulted in positive experiences for Māori whānau. Whānau support was identified as one of the most important coping strategies for mothers in the NICU. Those participants who were encouraged to maintain connections with whānau members reported more positive experiences overall. Three levels of implications were identified in this research. Firstly, that the participants'narratives provided a range of coping strategies for future Māori parents and their whānau who enter an NICU. Secondly, there are implications for NICU policy, and best practice particularly when supporting Māori in an NICU environment. Lastly, the narratives provided meaningful insights that contribute to gaps in local, national, and international literature. Overall, I realised that just like me, these mothers, and other whānau members, constructed narratives that are meaningful accounts to be shared with others

Evaluation of the whanau carers training programme delivered by LIFE Unlimited

In response to the needs of Maori informal carers, a training programme was developed for whanau carers in the Waikato region. It was delivered by LIFE Unlimited. It is a unique training programme in that it is community driven and focuses on informal caregivers who are Maori. The overarching aim of the whanau carers training programme is to provide increased training and support of informal carers. This report aimed to evaluate the effectiveness of the whanau carers training programme, including: the unique nature of the programme, the critical success factors, the barriers to success if any, and suggested improvements. The report concludes the programme has had a positive and definite impact upon the whanau carers. The evaluation team observed that the overall programme works very well and fulfils its stated obligations to the Ministry of Health. The programmes are delivered well, and are well received by the client group

Te Rau Puawai 2002-2004: An evaluation

Established in 1999 as a joint workforce initiative between the former Health Funding Authority and Massey University, Te Rau Puawai aimed to support 100 Maori students to graduate with mental health qualifications within a five year period. The goal of Te Rau Puawai is to contribute to the building of capacity for Maori in the mental health workforce. The programme exceeded its performance expectations in the first two years (1999-2001) with 56 bursars completing their qualifications. Bursars achieved an 80% pass rate compared with 65% for all students at Massey University as a whole. In 2004, this pass rate has continued, a significant achievement in light of increasing numbers of bursars being accepted and many without previously studying at the tertiary level. In 2001 the Maori & Psychology Research Unit (MPRU) at the University of Waikato undertook an evaluation of Te Rau Puawai reporting on the programme's success and identifying any barriers the programme needed to address. The 2002 evaluation report outlines critical success factors and recommendations for improvement. In 2003 Te Rau Puawai negotiated further funding from the Mental Health Directorate (MeHD) of the Ministry of Health under the Mental Health Workforce Development Strategy (2002). Workforce development is critical in building capacity and capability in the mental health workforce to increase appropriately skilled workers required to meet the mental health needs of Maori communities. In 2004 the Ministry of Health requested a follow-up evaluation to provide a descriptive record of programme activities and progress from April 2002 to December 2004. This report provides an overview of Te Rau Puawai activities between 2002 and 2004; the progress and contributions made by bursars to the mental health workforce; and a reassessment of the programme's critical success factors

Creating whanaungatanga: Kaupapa Maori support in the Psychology Department at the University of Waikato

Attendance at university has been recognized by some as a competitive environment that does not cater for the co-operative philosophy followed by many Maori. Within the Psychology Department at the University of Waikato there have been efforts since the Departments early days to place emphasis on the Maori cultural experience, but there were few Maori students and no Maori staff back then. Now, in 2004, the Department has a team of Maori staff and courses with Maori content at both undergraduate and graduate levels. Yet the environment that the students move in is still competitive. Grades are based on individual assessment through undergraduate level. At graduate level the emphasis on group dynamics comes to the fore. The availability and accessibility of Maori staff at different levels in a Kaupapa Maori programme provides one of the strategies of support for maori students at Waikato. This paper discusses the issues around managing, delivering and providing opportunities so that Maori students studying psychology feel supported for the duration of their time at Waikato University

African American Adults’ Experiences with the Health Care System: In Their Own Words

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and attitudes, and (5) improving health care experiences. These findings indicate that perceptions of discrimination and racism were prevalent among African Americans in this study, and that the expectation of a negative interaction is a barrier to seeking care. Authors discuss prevention and public health implications of these findings and make recommendations for health care practitioners

Failure of Working Memory Training to Enhance Cognition or Intelligence

Fluid intelligence is important for successful functioning in the modern world, but much evidence suggests that fluid intelligence is largely immutable after childhood. Recently, however, researchers have reported gains in fluid intelligence after multiple sessions of adaptive working memory training in adults. The current study attempted to replicate and expand those results by administering a broad assessment of cognitive abilities and personality traits to young adults who underwent 20 sessions of an adaptive dual n-back working memory training program and comparing their post-training performance on those tests to a matched set of young adults who underwent 20 sessions of an adaptive attentional tracking program. Pre- and post-training measurements of fluid intelligence, standardized intelligence tests, speed of processing, reading skills, and other tests of working memory were assessed. Both training groups exhibited substantial and specific improvements on the trained tasks that persisted for at least 6 months post-training, but no transfer of improvement was observed to any of the non-trained measurements when compared to a third untrained group serving as a passive control. These findings fail to support the idea that adaptive working memory training in healthy young adults enhances working memory capacity in non-trained tasks, fluid intelligence, or other measures of cognitive abilities.</p

Evaluation of a novel nutrition education intervention for medical students from across England

Objectives: Problems such as hospital malnutrition (∼40% prevalence in the UK) may be managed better by improving the nutrition education of 'tomorrow's doctors'. The Need for Nutrition Education Programme aimed to measure the effectiveness and acceptability of an educational intervention on nutrition for medical students in the clinical phase of their training. Design: An educational needs analysis was followed by a consultative process to gain consensus on a suitable educational intervention. This was followed by two identical 2-day educational interventions with before and after analyses of Knowledge, Attitudes and Practices (KAP). The 2-day training incorporated six key learning outcomes. Setting: Two constituent colleges of Cambridge University used to deliver the above educational interventions. Participants: An intervention group of 100 clinical medical students from 15 medical schools across England were recruited to attend one of two identical intensive weekend workshops. Primary and secondary outcome measures: The primary outcome measure consisted of change in KAP scores following intervention using a clinical nutrition questionnaire. Secondary outcome measures included change in KAP scores 3 months after the intervention as well as a student-led semiqualitative evaluation of the educational intervention. Results: Statistically significant changes in KAP scores were seen immediately after the intervention, and this was sustained for 3 months. Mean differences and 95% CIs after intervention were Knowledge 0.86 (0.43 to 1.28); Attitude 1.68 (1.47 to 1.89); Practice 1.76 (1.11 to 2.40); KAP 4.28 (3.49 to 5.06). Ninety-seven per cent of the participants rated the overall intervention and its delivery as 'very good to excellent', reporting that they would recommend this educational intervention to colleagues. Conclusion: Need for Nutrition Education Programme has highlighted the need for curricular innovation in the area of clinical health nutrition in medical schools. This project also demonstrates the effectiveness and acceptability of such a curriculum intervention for 'tomorrow's doctors'. Doctors, dietitians and nutritionists worked well in an effective interdisciplinary partnership when teaching medical students, providing a good model for further work in a healthcare setting

Skunk River Review Fall 2003, vol 15

https://openspace.dmacc.edu/skunkriver/1011/thumbnail.jp

Preliminary Assessment of Celecoxib and Microdiode Pulse Laser Treatment of Diabetic Macular Edema

Purpose: Inflammation may play an important role in the pathogenesis of diabetic macular edema, a major cause of vision loss in persons with diabetes. The purpose of this study was to evaluate combined antiinflammatory therapy and laser approaches for treating patients with diabetic macular edema. Methods: In this prospective, factorial, randomized, multicenter trial, we compared cyclo-oxygenase-2 inhibitor (celecoxib) with placebo and diode grid laser with standard Early Treatment Diabetic Retinopathy Study focal laser treatment in 86 participants with diabetic macular edema. The primary outcome is change in visual acuity of ≥15 letters from baseline, and the secondary outcomes include a 50% reduction in the retinal thickening of diabetic macular edema measured by optical coherence tomography and a 50% reduction in leakage severity on fluorescein angiography. Results: Visual acuity and retinal thickening data from >2 years of follow-up did not show evidence of differences between the medical and laser treatments. However, participants assigned to the celecoxib group were more likely to have a reduction in fluorescein leakage when compared with the placebo group (odds ratio = 3.6; P < 0.01). Conclusion: This short-term study did not find large visual function benefits of treatment with celecoxib or diode laser compared with those of standard laser treatment. A suggestive effect of celecoxib in reducing fluorescein leakage was observed