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Understanding experiences of diabetes care among patients with diabetic kidney disease
No full textThis research aimed to explore and understand the experiences and perceptions of diabetes care among patients with diabetic kidney disease and is driven by my research question “what are the experiences of diabetes care among patients with diabetic kidney disease?”. In order to achieve this I interviewed ten patients individually from the Hawke’s Bay area and guided by semi-structured questions, I asked them to describe their experiences about the diabetes care they have received since their diagnosis of diabetes.
The literature review demonstrated that diabetes and diabetic kidney disease is increasing in prevalance in New Zealand and that diabetic kidney disease is preventable. The literature also revealed that there is very little evidence of evaluated models of diabetes care in New Zealand and that currently diabetes care is fragmented in its delivery, not only in geographical location but also in general practice. There are several international studies examining patients’ experience of care involving various models of integrated care in diabetes and one international study exploring patients’ perspectives on health care with diabetes and chronic kidney disease. However, there is no literature in New Zealand specifically exploring patients’ with diabetic kidney disease and their experience of their diabetes care.
This thesis used a qualitative approach by way of semi-structured questions to gain deep insight and rich data from patients’ regarding their experiences of their diabetes care. To analyse the data, a clearly defined method of thematic analysis guided by the general inductive approach was used. The validity of the research was strengthened by applying method triangulation.
This thesis is the first known research in New Zealand to specifically understand patients’ with diabetic kidney disease experience of their diabetes care. The research highlighted the importance of the value of knowledge for patients with diabetes in order to self-manage and improve the quality of their lives. The research also revealed that continuity of care can provide patients with trust and rapport in their health provider which in turn will improve patient outcomes. Coping with a diagnosis of diabetes, including emotional factors such as denial, regret and self-blame were described by participants, as was the importance of whanau involvement in diabetes care.
The findings of this research have implications for the role of healthcare delivery in New Zealand, as well as the future development of nursing roles in primary and specialist nursing care. With the knowledge of diabetic kidney disease numbers on the rise, the recommendations for improving diabetes education, implementing integrated models of diabetes care, addressing the psycho-social needs of patients and health provider recognition and utilisation of Maori models of care, may provide a way forward in the prevention of diabetic kidney disease in New Zealand
Limbo : acknowledging value
No full textRESEARCH QUESTION:
How can the inherited qualities of a derelict place be retained in its rehabilitation?
The Mittagong Maltings is located in the Southern Highlands region of New South Wales, Australia. Established in 1899, the Maltings at its peak seamlessly worked three functioning Malthouses into a successful brewing operation. A series of crippling fires, financial issues and ageing technology led to its demise in 1980. Four decades of limbo would ensue. During its dormancy, the Maltings became (and still is) culturally significant to a distinct feral demographic. Such environments exude characteristics that can be considered conducive to fostering creativity. It is unfortunate that, so often, these characteristics are under-valued. Fortunately, however, contemporary conservation practice has moved beyond simply conserving the built fabric, to also take careful account of the intangible realm.
This research project is a response to the Mittagong Maltings’ limbo state. Limbo is not traditionally used to describe the state of affairs of a derelict building but is befitting for any environment with an uncertain future. A place in a state of limbo will, over time, acquire several inimitable qualities which, for the most part, are perceived negatively. It is not uncommon for individuals or groups to find value in what others may consider worthless, odd and imperfect.
The Maltings is deteriorating fast, and in a recent turn of events, it has been purchased by a deep-pocketed property developer eager to restore it and sell off the land. Its reintegration process has begun.
Several adaptive re-use precedents have influenced design decisions, as have the design informants of Wabi-Sabi, Kintsugi and the broader theory of beauty in imperfection. The Australia ICOMOS Burra Charter and “The Potential Role of the Physical Environment in Fostering Creativity” journal were influential texts
Managing company responsibility for mental health in the New Zealand construction industry
No full textHealth and safety in the construction industry has traditionally had a strong emphasis on safety, with the health aspect receiving little attention beyond high profile issues related to asbestos and silica. More recently, however, studies and initiatives in several countries have identified the mental health of construction workers as an area that warrants greater attention. In New Zealand, new legislation on workplace health and safety which was implemented in 2016 explicitly includes non-physical harms in its scope, so employers are required to consider the mental health of their workers as part of providing a safe workplace. This paper provides a cross-case comparison of mental health awareness and initiatives in two New Zealand construction companies. The first company is a Tier 1 management only main contractor, while the second is a Tier 2 company which is involved in full construction activities and operates both as a main contractor and sub-contractor. The health and safety policies and procedures of both companies were analyzed, and a range of company representatives were interviewed including human resources managers, health and safety managers, office and site staff. Managers and staff at both case study companies expressed varying degrees of understanding of company obligations under the legislation and considered it difficult to take practical steps to fulfil their responsibilities. The Tier 2 company in particular struggled with identifying and managing the needs of the wide range of employees represented. The shared responsibility between human resources and health and safety representatives was seen as a complicating factor for both companies. Despite the challenges, the case studies offered insights into potential best practice in the area, and recommendations are provided for improving performance in workplace mental health in construction
Open spaces in the developing city
No full textRESEARCH QUESTION:
How can open spaces in a developing city be preserved and enhanced?
ABSTRACT:
Open spaces in urban areas provide multiple and diverse functions such as the contribution to the preservation of biodiversity, the reconciliation of people and nature, as well as promoting the health and well-being of the population (Joana de Sa, October 2013). The presence of an open space can improve a view and provide a venue for active or passive recreation. Urban restoration and new developments without vision for an open space could destroy this unique relationship. Locating open space carefully in relation to buildings, can reduce the apparent density of urban clusters.
“Auckland is one of the most liveable cities in the world, with its unique urban-nature relationship and high-quality lifestyle. Auckland is facing the challenges of increasing population and ongoing urban growth”. (Auckland Tourism Events and Economic Development, 2014) A suggestion to develop Unitec campus is an example of the pressure being created by future population growth. The Unitec campus at Mt Albert is proposing a mix of residential, business, tertiary education and activities on the Wairaka precinct.
This research project aims to investigate and design the open spaces in what was a proposed redevelopment of the Unitec campus by Wairaka Land Company.
9.1. Final Site Design 112
9.2. Building 1 Heritage Open Space 113
9.3. Open Space Above Mason Clinic 114
9.4. Sanctuary Garden- Mahi Whenua 115
9.5. Heritage Cultural Precinct 117
9.6. Open Space in Front of the Main Unitec Buildin
Visible learning : health and physical education. A collaborative secondary/tertiary partnership supported by the Teacher-led Innovation Fund (TLIF)
No full textStory hui
Workshop learning outcome
A partnership
The purpose of feedback is to close the gap in learning
A visible learner
Our project
Our findings & results
VL strategies
Evaluating the strategies
Challenges encountered
Station: story hu
Assessing the earthquake performance of existing buildings of various material types and configurations in New Zealand
No full textThe Initial Evaluation Procedure, conducted as part of Initial Seismic Assessment, is the main topic of this paper. An overview is provided of the eight key steps which define this procedure, and how they are used to determine ratio of New Building Standard (NBS). The key steps are encapsulated in a programmed EXCEL worksheet (developed and current used in New Zealand) which takes into account various parameters and applies an algorithm to arrive at a preliminary assessed value. Actual examples of various buildings assessed using this procedure in recent years by authors are presented, and the results and some areas of interest are discussed
SETTING UP THE UPSETTER : a vertical studio for architecture
No full textContemporary education systems tend to subdivide learning groups into horizontal slices of similar age or similar levels of experience or skill. Architectural education programmes in most western countries generally follow this pattern and work in a horizontally stratified manner. Similarly, architecture and design practices tend to ossify in patterns around specialisations in work processes. To maintain all the qualities required of creative practice there is a need to shake up these patterns, to destabilize the obvious in order to constantly reinvigorate practice. As design educators and practitioners, we have long recognised a need for what we have called upsetter projects. In 2017 a Vertical Studio experiment involving final year BAS and first year MARCP students was initiated to try and shake things up and generate a stronger peer learning/ peer assessment culture. The first half of the paper describes and analyses that original Vertical Studio and discusses the insights gained. The second half makes use of a matrix derived from that analysis and proposes two upsetter projects each using a different method of generation. The paper concludes that there is potential for further use of these methods in the development of upsetter projects designed to enrich both pedagogy and practice
Particulate matter in residential buildings in New Zealand : Part I. Variability of particle transport into unoccupied spaces with mechanical ventilation
No full textAir pollution measured as particulate matter (PM) has been shown to be detrimental to human health and can lead to increased mortality rates. There are four main indoor sources of episodic PM emissions: smoking, cooking, cleaning and resuspension. This study has eliminated all human activity and provides data on the variability of the contribution from external sources via mechanical ventilation. The transportation of PM from an external to internal environment by mechanical ventilation is investigated in the same room in two, similar timber-framed houses, constructed identically apart from details affecting their airtightness.
There was significant variation in the transportation of PM from an external to internal environment in two similar houses ([PM] Control > [PM] Test (ρ=0.001)) despite both houses operating the same mechanical ventilation system. Mean internal PM10 concentrations=2.4 μgm−3 (Control) and 1.3 μgm−3 (Test) with corresponding mean external PM10 concentrations of 5.4 μgm−3 and 5.2 μgm−3 respectively. Particle removal efficiency between the two houses varied by approximately 20%. These findings indicate that there is considerable variation in filtration efficiencies even when the same mechanical ventilation system is in use in similar homes in the same location.
Control-Test PM10 0.40–0.23) and over time (Control PM10 0.40–0.18) which indicates that relationship between external and internal concentrations of PM is not linear and should therefore be used with caution. This questions simplifying Finf into one factor as there are likely to be multiple contributing factors. For example, the effect of air flow on particle adsorption to internal surfaces, natural variations in filter efficiency and variations in particle loss.
Over the duration of this study, PM concentrations decreased in both bedrooms by 52% (Control) and 37% (Test), which may be due to a number of factors including changes in internal environmental conditions, filter age and the cumulative effect of the use of mechanical ventilation over time reducing the transportation of PM into the houses
The association between pain and sleep and their effects on health-related quality of life, wellbeing and disability in people presenting to healthcare clinics in New Zealand
No full textINTRODUCTION:
There is abundant evidence that sleep and pain are related. Sleep and pain also influence health-related quality of life (HRQOL), wellbeing, and physical disability. This study seeks to build upon existing New Zealand literature investigating pain, sleep, and HRQOL of individuals presenting to an osteopathic teaching clinic.
AIM:
To investigate the associations between sleep and pain and their effects on, health-related quality of life, wellbeing, and physical disability in New Zealand adults.
METHOD:
A composite online questionnaire was administered using SurveyMonkey and advertised online and at community centers/ libraries. Data was collected from adults with pain and/or sleep complaints in New Zealand. Quality of life was assessed using the 12-item Short Form Survey (SF-12v1); general well-being was assessed using the World Health Organisation WHO-5 index questionnaire; sleep quality and interference of pain on sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Pain and Sleep Questionnaire (PSQ-3) respectively; and physical disability was assessed using the Physical Disability Index (PDI).
RESULTS:
A total of 136 participants (age M = 40.53 years, SD = 14.42) were included. Almost all of the participants (94.4%) reported ‘poor’ sleep quality, as measured by the PSQI. Mean sleep duration was less than six hours. The majority (84.6%) of respondents had been affected by moderate pain for more than three months. Mild to moderate disability in physical and mental aspects of health were also reported. There was a significant difference between PSQ-3 scores for respondents affected by no or mild pain and those affected by severe pain and between respondents affected by pain in the timeframe of six weeks to three months and those affected by chronic pain. Poor sleep quality, higher pain intensity, and longer pain duration were associated with significant decreases in HRQOL and wellbeing status- primarily the physical component. Poor sleep quality was also significantly associated with moderate disability and the mental health component of respondents’ HRQOL.
CONCLUSIONS:
The results were consistent with local and wider existing research. Close associations between sleep quality, pain intensity and duration, HRQOL, and wellbeing highlight the importance of future research for multifaceted therapeutic management of pain. Supplementing traditional methods of treatment with sleep interventions and support for daily mental and physical function, where appropriate, may be indicated in future ‘best practice’ pain or sleep management. Further research involving larger populations and longitudinal methodology needs to be undertaken to understand causal relationships between sleep, pain, and HRQOL in a New Zealand population
Stepping back : a look at managed retreat in NZ
No full textIn 1990 the Intergovernmental Panel on Climate Change proposed the adaptation strategies of Protect, Accommodate and Retreat, and these were adopted and incorporated into New Zealand’s national policy. This paper investigates the practice of managed retreat in New Zealand, with the aim to understand how the strategy has been implemented in the coastal environment. Some local councils have faced vociferous opposition from those who are affected by the implementation of ‘managed retreat’ as a preferred coastal hazard management strategy. Coastal property is highly valued, and this financial and social investment in the coastal edge is increasingly being threatened by climate related change. Managed retreat both threatens and aspires to protect the significant role the coast plays in New Zealand’s social identity. The challenges of implementing, even openly discussing these ‘retreat’ strategies in an urban residential context in NZ are yet to be fully realised. The resistance to managed retreat appears to be economic, barely veiled as socio-cultural concerns. Should not socio-ecological resilience take precedence