Background Aotearoa/New Zealand has a population that is ageing and there are challenges to health and social outcomes related to related to key life transitions (e.g., retirement, change in health conditions, loss of spouse). Further, there are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. The purpose of this study was to test the impacts and cost effectiveness of a tuakana/teina (peer education) intervention on kaumātua (elders) receiving the intervention. This study was framed by a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation). Methods This study was grounded in principles of Kaupapa Māori and community-based participatory research to bring together a diverse group of stakeholders to co-develop and co-evaluate the intervention. The intervention had tuakana (peer educators) having conversations with up to six teina (recipients) and providing information related to health and social services. The research design was a pre- and post-test, clustered staggered design. Participants completed a baseline assessment of health and mana motuhake measures consistent with Māori worldviews along with two follow-up assessments (one after the first intervention group completed its activities and a second after the second intervention group completed its activities). Additionally, five focus groups and open-ended questions on the assessments were used to provide qualitative evaluation. Findings A total of 180 kaumātua were recruited to the intervention with 121 completing it. The analysis revealed improvements over time in the expected direction on most of the variables. However, only three of the variables had statistically significant intervention effects: received support, tribal identity, and trouble paying bills. Qualitative results supported impacts of the intervention on mana motuhake, social connectedness, and tangible/information support related to services. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times gross domestic product per capita. Conclusions The findings support the relevancy and importance of kaumātua knowledge to create a strengths-based approach to improve health and social outcomes. This study demonstrates that a contextually based and culturally safe age-friendly environments can facilitate engagement and participation by kaumātua for kaumātua. Trial registry Australia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373733&isClinicalTrial=False
The purpose of this study is to explore the cultural practices and communication tensions perceived among Māori kaumātua (elders) and their whānaunga (extended family) during the end-of-life journey. Further, the study aims to explore the manner in which the tensions are managed. The study was framed by relational dialectics theory and included interviews with 21 kaumātua and focus groups with 39 whānau members. The study identified three cultural practices (dying at home, prayer, and song) that helped to build connection among the family members and also helped to connect the dying person to the spiritual world. Further, four communication tensions were noted: (a) autonomy and connection; (b) conflict and connection; (c) isolation and connection; and (d) balancing the needs of self and other. To manage these tensions, the following strategies were used: (a) coordination conversations; (b) inclusion in decision-making conversations; (c) emotional support within the whānau; and (d) passing on lessons to the next generation.
We review the available life history information on green sturgeon and develop a simple population model to inform interpretations of status and threats in the Sacramento River and throughout their range. A review of general life history information provides a context for interpretation of model results that are based on population parameters specific to the Sacrament River and inferences from other populations where Sacramento data were lacking. The simple life table model consisted of an age-specific schedule of demographic parameters including average length, weight, natural mortality, fishing mortality, sex ratio, and maturity that are used to project age-specific population size, biomass, fecundity, harvest, and yield for any given level of recruitment. While model assumptions of constant recruitment, population equilibrium, stable size and age structure, and a lack of density dependence are rarely met, the model provided useful descriptions of a hypothetical green sturgeon population based on current estimates of demographic parameters. The data available for Sacramento green sturgeon included young-ofyear from juvenile salmon migrant traps in the river, pump salvage samples of juveniles from the Sacramento-San Joaquin delta, San Pablo Bay trammel net samples dominated by subadults, and Columbia River commercial fishery landings of subadults and adults. Life table results indicate that green sturgeon are vulnerable to salvage pumps for one or two years of age and that fishery slot limits of 117 cm to 183 cm included 14 years of vulnerability on average. Subadults that rear primarily in bay and ocean habitats would comprise the majority (63%) of an equilibrium population with adults only 12% of average numbers and only a fraction of adults spawning each year. Population fecundity, which is the total number of eggs based on female number, size, and individual fecundity, peaks around age 24 when all females have matured. The sensitivity of sturgeon to increasing mortality is highlighted by abrupt declines in numbers, reproductive potential, and potential yield in hypothetical life table analyses. This review and modeling exercise identified significant research needs for green sturgeon and supports a precautionary approach in conservation and management in the face of uncertain assessments of status and risk.
A B ST R A C T The retirement village sector 1 is one part of the increasingly marketized 'aged-care' services in New Zealand and in many other parts of the industrialized world. While critical researchers have examined organizational and residents' representations of aging, retirement, and retirement communities in the context of 'the market', there is no research that examines communication related to residents' enactment of participation within these settings with respect to these processes of marketization. We aim to refine, complicate, and extend what we might call 'the marketization thesis' through this study that examines resident participation within retirement communities. This essay is based on a comparative examination of two major New Zealand retirement community organizations. The rhetorical and critical discourse analysis reveals the complexity of what 'participation' means for the residents within the context of an institution that is in transition from a medicalized to a marketized model of service delivery. Through a close examination of these meanings, we offer new insights into issues of individual action and freedom within the frame of a market-driven and avowedly 'customer-centred' organization and consequently suggest a reconsideration of participation in organizations in which clients are also 'insiders'.
Background The Aotearoa New Zealand population is ageing accompanied by health and social challenges including significant inequities that exist between Māori and non-Māori around poor ageing and health. Although historically kaumātua (elder Māori) faced a dominant society that failed to realise their full potential as they age, Māori culture has remained steadfast in upholding elders as cultural/community anchors. Yet, many of today’s kaumātua have experienced ‘cultural dissonance’ as the result of a hegemonic dominant culture subjugating an Indigenous culture, leading to generations of Indigenous peoples compelled or forced to dissociate with their culture. The present research project, Kaumātua Mana Motuhake Pōī (KMMP) comprises two interrelated projects that foreground dimensions of wellbeing within a holistic Te Ao Māori (Māori epistemology) view of wellbeing. Project 1 involves a tuakana-teina/peer educator model approach focused on increasing service access and utilisation to support kaumātua with the greatest health and social needs. Project 2 focuses on physical activity and cultural knowledge exchange (including te reo Māori--Māori language) through intergenerational models of learning. Methods Both projects have a consistent research design and common set of methods that coalesce around the emphasis on kaupapa kaumatua; research projects led by kaumātua and kaumātua providers that advance better life outcomes for kaumātua and their communities. The research design for each project is a mixed-methods, pre-test and two post-test, staggered design with 2–3 providers receiving the approach first and then 2–3 receiving it on a delayed basis. A pre-test (baseline) of all participants will be completed. The approach will then be implemented with the first providers. There will then be a follow-up data collection for all participants (post-test 1). The second providers will then implement the approach, which will be followed by a final data collection for all participants (post-test 2). Discussion Two specific outcomes are anticipated from this research; firstly, it is hoped that the research methodology provides a framework for how government agencies, researchers and relevant sector stakeholders can work with Māori communities. Secondly, the two individual projects will each produce a tangible approach that, it is anticipated, will be cost effective in enhancing kaumātua hauora and mana motuhake. Trial registration Australia New Zealand Clinical Trial Registry (ACTRN12620000316909). Registered 6 March 2020.
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