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Aim: The aim of this study was to assess whether obese patients undergoing primary total hip replacement (THR) via a posterior approach had superior revision rates and Oxford Hip Scores (OHS) compared to those via a lateral approach. Patients and methods: This is a retrospective cohort study using prospective data from the New Zealand Joint Registry applying STROBE and RECORD guidelines. Patients undergoing THR since 2010 were stratified by body mass index (BMI) into obese (BMI 30–39 kg/m2), and morbidly obese (BMI ⩾40 kg/m2) groups. All-cause revision rates, and 6-month OHS post-surgery were compared between groups. Multivariate analysis was performed. Results: 12,109 unilateral THRs in obese patients were identified. The mean follow-up was 2.8 years (range 0.01–6.95 years). Univariate analysis in the BMI ⩾ 40 group showed the posterior approach had a significantly lower all-cause revision rate (0.99/100 observed component years (ocys); 95% CI, 0.65–1.44/100 ocys) than the lateral approach (1.71/100 ocys (95% CI, 0.98–2.77/100 ocys), p < 0.05). There was no significant difference in dislocation rates between the surgical approaches. OHS was statistically higher in the posterior approach group in BMI 30–39 patients (p < 0.001) but not clinically significant. Multivariate analysis showed femoral head size significantly influenced all-cause revision rates and mitigated against the increased risk associated with the surgical approach. Conclusion: The choice of surgical approach in obese patients conveys no advantage in overall revision rates in the short-term. Choosing an appropriate size of femoral head may be of greater importance than choice of surgical approach for obese patients in primary THR. [ABSTRACT FROM AUTHOR]

Aim: Total gastrectomy and Ivor Lewis oesophagectomy procedures are the mainstay of upper gastrointestinal cancer management. Maintenance of adequate nutritional intake is essential for positive patient outcomes. Although numerous nutritional support options exist, clear evidence‐based guidelines on the optimal means and duration of nutritional support are lacking. The aim of this study is to establish preliminary data on the current perioperative nutritional practices of upper gastrointestinal surgeons performing these procedures across Australia and New Zealand. It is hoped this will help provide the platform for future research towards establishing evidence‐based guidelines in upper gastrointestinal surgery. Methods: A questionnaire exploring the nutritional practices and considerations of surgeons was developed and emailed to the members of the Australia & New Zealand Gastric & Oesophageal Surgery Association. Results: A total of 27.4% of Australia & New Zealand Gastric & Oesophageal Surgery Association members completed the questionnaire. Surgeons reported inserting a jejunostomy feeding tube intraoperatively in Ivor Lewis oesophagectomy procedures 80–100% of the time, compared to only 20–39% of the time in total gastrectomy procedures. For both procedures, surgeons often refer their patients to a dietitian preoperatively, and always postoperatively. Preoperative immune‐enhancing nutrition is rarely administered. Patient age and BMI are deemed to be of low importance when determining the means of nutritional support. Conclusions: This study has demonstrated the current nutritional practices employed in Australia and New Zealand for patients undergoing major upper gastrointestinal surgery. Questions remain regarding the noted differences between procedures as well as the optimal means and duration of perioperative nutritional support. [ABSTRACT FROM AUTHOR]

Aim: To establish the prevalence of nutrition risk and associated risk factors among adults of advanced age newly admitted to hospital. Methods: A cross‐sectional study was undertaken in adults aged over 85 years admitted to one of two hospital wards in Auckland within the previous 5 days. An interviewer‐administered questionnaire was used to establish participant's socio‐demographic and health characteristics. Markers of body composition and muscle strength were collected. Nutrition risk was assessed using the Mini Nutritional Assessment‐Short Form (MNA‐SF), dysphagia risk using the 10‐Item Eating Assessment Tool (EAT‐10) and level of cognition using the Montreal Cognitive Assessment. Results: A total of 88 participants with a mean age of 90.0 ± 3.7 years completed the assessments. A third (28.4%) of the participants were categorised by the MNA‐SF as malnourished and 43.2% were classified at risk of malnutrition. A third (29.5%) were at risk of dysphagia as assessed by EAT‐10. Malnourished participants were more likely to be at risk of dysphagia (P = 0.015). The MNA‐SF score was positively correlated with body mass index (r = 0.484, P < 0.001) and grip strength (r = 0.250, P = 0.026) and negatively correlated with risk of dysphagia (r = −0.383, P < 0.001). Conclusions: Among newly hospitalised adults of advanced age, over two thirds were malnourished or at risk of malnutrition, and a third were at risk of dysphagia. Nutrition risk was positively correlated with low BMI and grip strength and negatively correlated with dysphagia risk. Findings highlight the importance of screening for dysphagia risk, especially in those identified to be malnourished or at nutrition risk. [ABSTRACT FROM AUTHOR]

Introduction To evaluate the effectiveness of the levonorgestrel intrauterine system ( LNG- IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. Methods Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding ( HMB) who agreed to treatment with the LNG- IUS and had a body mass index ( BMI) of >30 kg/m2 were recruited between May and December 2014. The women completed two validated tools (Menstrual Impact Questionnaire and the Pictorial Bleeding Assessment Chart) at recruitment, 6 and 12 months follow-up. Demographic, medical and laboratory variables were obtained from the relevant CMH databases. Data on side effects and satisfaction were obtained from the women at 12 months. Results The median age (range) and BMI of the 20 women were 40.5 years (27-52 years) and 40.6 kg/m2 (30-68), respectively. Three LNG- IUS were removed due to infection and pain and these women were subsequently booked for a hysterectomy. The reduction in menstrual loss was estimated at 19.7% per month (95% CI (12.5%, 26.2%); P < 0.001), which translates to 73.2% per period of 6 months (95% CI (55.3%, 83.9%)) and 92.8% per period of 12 months (95% CI (80.0%, 97.4%)). The six items in the quality of life measure improved significantly in 14 women but only 12 women were satisfied with the treatment. Conclusion The LNG- IUS was an effective treatment for 67% of obese women with heavy menstrual bleeding over a 12-month period, as assessed by the reduction in menstrual bleeding and the improvement in the quality of life measures. [ABSTRACT FROM AUTHOR]

Purpose: To measure the iodine status and iodine intake of New Zealand adults 18-64 years of age following mandatory fortification of bread with iodine. Methods: A cross-sectional survey of NZ adults living in Dunedin and Wellington during February-November 2012. Three hundred and one men and women aged 18-64 years randomly selected from the New Zealand Electoral Roll completed a 24-h urine collection, a demographic and iodine-specific food frequency questionnaire (FFQ), and had height and weight measured. Urine collections were analysed for iodine and reported as median urinary iodine concentration (UIC) µg/L and median urinary iodine excretion (UIE) µg/day. The FFQ was used to estimate iodine intake with and without discretionary iodised salt use. Results: The median UIC for all adults was 73 µg/L, indicative of mild iodine deficiency. The mean urinary volume was 2.0 L. As an estimate of iodine intake, the median UIE was 127 µg/day. Estimated iodine intake, using the FFQ which included discretionary iodised salt use, was 132 µg/day. Iodine intakes were associated with UIC ( P = 0.040) and UIE ( P = 0.003), but not with bread iodine intake and iodised salt use. Conclusion: Using the WHO/UNICEF/ICCIDD target for iodine sufficiency (a UIC of >100 µg/L) based on school-aged children with a mean urinary volume of 1.0 L, the iodine status of NZ adults does not reach adequate levels (73 µg/L). A more realistic parameter in a population with a higher urinary volume excretion (2.0 L) is the UIE. A median UIE of 127 µg/day suggests that the iodine status of NZ adults is now likely to be adequate. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). METHODS Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from 96 randomly selected schools participated. School-level measures were created by aggregating students' reports within schools. Analyses were conducted using multilevel modeling, accounting for student-level characteristics. RESULTS There was a positive association between the school nutrition climate and students' consumption of fruits and vegetables. This relationship was statistically significant after controlling for the background characteristics of students. There were no associations between the school nutrition climate and students' junk food consumption or BMI. CONCLUSIONS The school nutrition climate appears to have a positive influence on adolescents' healthy eating behaviors (fruit and vegetable intake), but a limited effect on unhealthy eating behaviors and ultimately body weight. This may reflect the pervasiveness of junk food in the environments of adolescents outside of school and the difficulty in limiting its consumption. [ABSTRACT FROM AUTHOR]

The article presents research which examined the occurrence of childhood trauma in children with bipolar disorder. Topics covered include the impact of stress on the treatment course for the children and the rate of childhood trauma in patients with the condition. Also mentioned is the use of the Childhood Trauma Questionnaire in the study.

The aim of the study was to validate the self-report Multimedia Activity Recall for Children and Adolescents (MARCA) against accelerometry for the assessment of physical activity in New Zealand children. Participants (n = 716, 10–18 years) recalled 3–4 days of activity using the MARCA and underwent a partially overlapping 7-day accelerometry protocol during a national survey. Spearman correlation coefficients (ρ) assessed the association between accelerometer-derived counts per minute and MARCA-derived physical activity level and time in locomotion. Both data sources estimated time spent in light and moderate–vigorous physical activity. Association and agreement between methods for light physical activity and moderate–vigorous physical activity was assessed using correlations and Bland–Altman plots respectively, and pairedt-tests conducted. Accelerometer-derived activity counts were moderately correlated with both MARCA-derived physical activity level and locomotion (ρ = 0.38,P < 0.0001). The correlation between methods was –0.14 for light physical activity and 0.28 for moderate–vigorous physical activity (P < 0.0001). The MARCA overestimated moderate–vigorous physical activity compared with accelerometry (120 min,P < 0.0001), which increased as moderate–vigorous physical activity time increased. Some sex and ethnicity (Māori [indigenous] versus non-Māori) differences were observed. Overall, the MARCA indicated moderate validity for assessment of physical activity level, locomotion and moderate–vigorous physical activity and poor validity for assessment of light physical activity. This was comparable to other self-report tools. The MARCA has utility for future large-scale research. [ABSTRACT FROM PUBLISHER]

Aim and objective. To investigate health differences between nurses who report meeting the daily physical activity recommendations in or away from the workplace. Background. Adhering to the national physical activity recommendations has known health benefits. Whilst often considered a workplace active profession, data are emerging of poor health amongst nurses. However, health differences between workplace or leisure-time physically active nurses are understudied. Design. The investigation is an observation study of Australian and New Zealand nurses. Data were generated from the longitudinal, population-based, observational e-Cohort nursing survey. Methods. Data were informed and groups defined by the self-reported minutes per day of moderate physical activity collected from a large international survey of practicing nurses ( n = 2264). Groups were: Group (G) 1 - high workplace (≥30 minutes/day)/high leisure (≥30 minutes/day), G2 - high workplace/low leisure (<30 minutes/day), G3 - low workplace/low leisure (<30 minutes/day) and G4 - low workplace/high leisure. Results. G2 had a high BMI and were younger than G4. G4 were significantly more active away from work and more likely to report cycling to work than G2. In contrast, G2 were most likely to have taken sick days because of their health (χ2 = 19·101), have difficulty sleeping most of the time and have a medical history of diagnosed anxiety and depression. Conclusions. This study shows that improved well-being can be achieved in nursing cohort through leisure-time physical activity. Relevance to clinical practice. This research shows that nurse should consider leisure-time physical activity necessary to maintain and prolong health and that workplace activity is not a sufficient stimulus. This has important implications for workforce planners and administrators. [ABSTRACT FROM AUTHOR]

Research measuring whole-body protein turnover (WBPT) after both exercise and nutrition has generally focused on resistance exercise; however, there is a paucity of data regarding the effect of postaerobic exercise nutrition, especially in older adults. It is not known if postexercise protein feeding has a beneficial effect on protein turnover after low- to moderate-intensity exercise. We investigated whether consuming protein plus carbohydrate (PRO) immediately after an acute bout of aerobic exercise has an additive effect over carbohydrate alone (CHO) on WBPT in older individuals. Twelve healthy older adults (age, 59 ± 4 years) were studied on 2 separate occasions after 1 h of exercise at approximately 50% of maximal rate of oxygen uptake, followed by 4 h of recovery. Immediately following exercise, subjects ingested a CHO (60 g) or an isocaloric PRO beverage (40 g carbohydrate, 20 g whey protein). Whole-body protein metabolism was determined using [1-13C]leucine infusion (60 mg prime; 75 mg·h-1 continuous), and sampling blood and expired breath. Rates of whole-body leucine appearance and oxidation, and nonoxidative leucine disposal during the third and fourth hours of postexercise recovery were higher in the PRO group (2.51 ± 0.55, 0.78 ± 0.37, and 1.71 ± 0.44 µmol·kg-1·min-1, respectively) than in the CHO group (1.81 ± 0.27, 0.33 ± 0.14, and 1.47 ± 0.25 µmol·kg-1·min-1, respectively; p = 0.001). Our results indicate that consumption of a PRO beverage after aerobic exercise increased WBPT to a greater extent than a CHO beverage. Les études s'intéressant à la mesure du renouvellement global des protéines dans l'organisme (WBPT) à la suite d'un exercice physique et d'un apport alimentaire traitent généralement du rôle des exercices de force; néanmoins, il y a peu d'études sur les effets d'un apport alimentaire à la suite d'un exercice aérobie particulièrement chez les personnes âgées. On ne sait pas si un apport protéique après un exercice suscite un effet bénéfique sur le renouvellement protéique consécutif à un exercice d'intensité légère à modérée. Cette étude se propose de vérifier si, comparativement à un apport de sucres seulement (CHO), un apport protéique combiné à des sucres (PRO) immédiatement après un bref effort aérobie apporte des effets additionnels concernant le WBPT chez des personnes âgées. On invite en deux occasions douze adultes en bonne santé et âgés de 59 ± 4 ans à participer à une séance d'exercice d'une durée de 60 min et d'intensité suscitant 50 % du consommation d'oxygene maximale suivie d'une récupération d'une durée de 4 h. Immédiatement après la fin de l'exercice, les sujets consomment soit une boisson contenant des sucres (CHO; 60 g) soit une boisson contenant des sucres et des protéines (PRO; 40 g de sucres et 20 g de protéines lactosériques) totalisant la même quantité d'énergie. On évalue le métabolisme protéique de l'organisme en entier par l'administration de [1-13C] leucine (infusion immédiate de 60 mg suivie d'une perfusion à raison de 75 mg·h-1) et l'analyse des échantillons de sang et des gaz expirés. Les taux corporels d'apparition de la leucine, de son oxydation et de l'élimination de la fraction non oxydée au cours de la 3e et de la 4e heure de la période de récupération postexercice sont plus importants dans la condition PRO (2,51 ± 0,55, 0,78 ± 0,37 et 1,71 ± 0,44 μmol·kg-1·min-1 respectivement) que dans la condition CHO (1,81 ± 0,27, 0,33 ± 0,14 et 1,47 ± 0,25 μmol·kg-1·min-1 respectivement) (p = 0,001). Nos observations révèlent qu'un apport de protéines à la suite d'un exercice aérobie suscite une plus grande augmentation du WBPT que ne le fait un apport de sucres. Un apport protéique à la suite d'un exercice semble favorable à l'amélioration de la qualité des protéines contenues dans l'organisme en entier et pourrait apporter des gains en matière de capacité physique chez les personnes âgées. [ABSTRACT FROM AUTHOR]