Search

Mental health inpatient units can provide a sanctuary for people to recover from mental illness. To support a therapeutic environment, the safety and well‐being of service users and staff need protection through reduced conflict and containment rates. The Safewards model identifies 10 interventions to prevent conflict and containment. This paper aims to present barriers and enablers to implementing Safewards by analysing current literature on the Safewards model. It will also compare the Safewards model to New Zealand's Six Core Strategies. In a systematic search of 12 electronic databases following the PRISMA flow chart, 22 primary studies were included in this analysis. JBI tools were used for quality appraisal and deductive content analysis was used to organize and interpret data. Four categories were identified: (a) designing the Safewards interventions and implementation; (b) staff participation and perception of Safewards; (c) healthcare system influences on Safewards implementation; (d) service user participation and perception of Safewards. To support successful Safewards implementation in future practice, this review recommends that Safewards implementation is enabled through robust design of the Safewards interventions and implementation methods; staff participation and positive perception of the Safewards model; a resourced healthcare system that prioritizes Safewards implementation; service user awareness and participation in Safewards interventions. Interactionist perspectives may support the implementation of Safewards. This analysis is limited by research settings mostly being inpatient adult services and inadequate capturing of the service user voice. An ongoing review of barriers and enablers is important for supporting future Safewards implementation. [ABSTRACT FROM AUTHOR]

Aim: To synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti‐racist praxis to inform nursing in Aotearoa New Zealand. Design: An integrative literature review was undertaken, integrating Indigenous Kaupapa Māori methodologies to ensure a cultural and philosophical lens. Methods: Peer‐reviewed literature published, between January 2011 and July 2023 were sourced. Of 1296 articles, 16 met the inclusion criteria and 4 were identified via citation chaining. In total, 20 articles were included. The Johns Hopkins Research Evidence Tool was applied, findings extracted, and thematic analysis completed utilising Indigenous Kaupapa Māori principles. Data Sources: Databases, including CINAHL, Scopus, PubMed and Aus/NZ Reference Centre, were searched in July 2023. Results: Two key themes were identified: (1) colonial active resistance to change; and (2) transformational, visionary, and proactive nursing. Conclusion: Nurses are well‐positioned to confront the structures that maintain racism in health and education systems but are often actors in maintaining status quo. Anti‐racist praxis can be a mechanism for nurses to reimagine, redefine and transform nursing care, leadership, and nursing education to begin to eradicate racism. Reporting Method: This integrative review adhered to the 2020 Preferred Reporting for Systematic Reviews and Meta‐Analyses (PRISMA) method. Patient or Public Contribution: No patient or public contribution. Implications for the Profession: Racism remains prevalent in nursing and the healthcare system. It is necessary to implement anti‐racist praxis and policies that resist, deconstruct, and dismantle power and racism while validating Indigenous values, beliefs and practices. This is vital to deliver equitable health care. Impact: This integrative review presents lived realities and knowledge of Indigenous and racially minoritised nurses and scholars, alongside nursing allies to inform anti‐racist praxis. This evidence signifies that it is time to walk the walk to challenge the colonising systems and processes that hold racism in place. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. Background: Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide‐ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. Evaluation: A scoping review, guided by Arksey and O′Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. Key issues: Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. Conclusions: Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. Implications for nursing management: Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero‐tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

Introduction. The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middleincome countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim. This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods. The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results. Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion. This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems. [ABSTRACT FROM AUTHOR]

Rural medical education is known as one of the most effective strategies in improving rural recruitment and retention. The aim was to identify modes of delivery to improve access to rural postgraduate medical education. Arksey and O'Malley's methodological framework was used for conducting scoping reviews. CINAHL, Google Scholar, ERIC, PsycINFO, Medline and PubMed were searched to identify peer‐reviewed English‐language literature published between 2000 and 2019 focusing on postgraduate rural and regional medical education. A total of 102 articles were identified, with 51 included in the final analysis after applying inclusion and exclusion criteria. Outcome measures included: article type; research methodology; date of publication; country of origin; and study population. Through iterative reading, common themes were identified. A typology of 6 content themes emerged as follows: rural curriculum; procedural skills; rurally based learning; service delivery; workforce; and distance learning. The majority of articles focused on rural curriculum, and rurally based learning, with half originating from Australia or New Zealand. Although results strongly emphasised context and curriculum in rural environments, lack of specific and pragmatic approaches was noted. Surprisingly, few articles focused on rural distance learning utilising information and communication technology. Pathways to improve rural education access include recognition of the unique rural context in curriculums; development of rural educational faculty; and creation of opportunities for rural specialist training. Emphasis should be given for education provided through rural centres rather than urban facilities. Use of information technology could be increased, for example in remote trainee supervision programs. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Dietetic intervention is effective in the management of nutrition-related conditions and their comorbidities. New Zealand has an increasing need for primary and preventive health care to reduce the burden of non-communicable disease. AIM: To review the recent evidence of effectiveness of dietetic intervention in primary health care on health and wider economic outcomes. Health benefits and cost benefits of employing dietitians to perform nutrition intervention in the primary health care setting are evaluated in the areas of obesity in conjunction with diabetes and cardiovascular disease, and malnutrition in older adults. METHODS: An electronic literature search of four scientific databases, websites of major dietetic associations and high-impact nutrition and dietetic journals was conducted. Randomised controlled trials and non-randomised studies conducted from 2000 to 2014 were included. RESULTS: Dietetic intervention demonstrates statistically and clinically significant impacts on health outcomes in the areas of obesity, cardiovascular disease, diabetes, and malnutrition in older adults, when compared to usual care. Dietitians working in primary health care can also have significant economic benefits, potentially saving the health care system NZ$5.50-$99 for every NZ$1 spent on dietetic intervention. DISCUSSION: New Zealand must look to new models of health care provision that are not only patient-centred but are also cost-effective. This review demonstrates that dietitians in primary health care can improve patients'health and quality of life. Increasing the number of dietitians working in primary health care has the potential to make quality nutrition care accessible and affordable for more New Zealanders. [ABSTRACT FROM AUTHOR]

The researchers aim in this synthesis is to interpret the cultural constructions of menopause in Indigenous women and apply these interpretations to the context of Māori women in Aotearoa/New Zealand. There is a lack of research about Indigenous women's interpretations of health, and how culture mediates understandings and experiences of menopause. There is even less research regarding Māori women's understandings and experiences of menopause, as the discourse is dominated by Western ideology. Using meta ethnography methodology, the researchers selected eight studies, that provided the foundations to enable the interpretation of the cultural constructions of menopause in Indigenous women. The findings were then translated into four metaphors- natural, cultural protection, freedom and idiomatic and then were subsequently translated to Māori concepts mana wahine, Mātauranga Māori, tikanga and pepeha. We suggest that broader mainstream understandings of the cultural constructions of menopause for Indigenous women are necessary to provide equitable health outcomes for Māori and other Indigenous women. The researchers further developed a model that can be used to represent the foundations of Māori women's conscious understandings and experience of menopause. [ABSTRACT FROM AUTHOR]

Research on the value of interprofessional education (IPE), collaboration and practice in the health sector at both a pre- and post-registration level has increased in recent years. A scoping review of Australian and New Zealand studies was conducted on the value of IPE to interprofessional practice in allied health professionals from 2013 to 2019. A scoping review framework was used to identify 109 studies. Twenty-one articles met the eligibility criteria. The studies were grouped into undergraduate students in academic and WIL settings, allied health professionals and clinical educators. Results suggest that IPE is necessary for the maintenance of interprofessional practice and that it is strongly connected to the development of successful communication within the interprofessional environment. Authentic IPE experience and socialization opportunities appear to be major facilitators of interprofessional practice but no consensus regarding the ideal length of time or timing of IPE was found. The studies also provided an insight into facilitators and barriers to successful implementation of IPE and interprofessional practice in rural environments. As IPE has been shown to contribute to improved interprofessional practice and patient outcomes, future research should explore how to create IPE opportunities for implementation within rural communities where adequate resourcing is most challenged. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly's hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples' experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas. [ABSTRACT FROM AUTHOR]

Caloric restriction occurs when athletes attempt to reduce body fat or make weight. There is evidence that protein needs increase when athletes restrict calories or have low body fat. Purpose: The aims of this review were to evaluate the effects of dietary protein on body composition in energy-restricted resistance-trained athletes and to provide protein recommendations for these athletes. Methods: Database searches were performed from earliest record to July 2013 using the terms protein, and intake, or diet, and weight, or train, or restrict, or energy, or strength, and athlete. Studies (N = 6) needed to use adult (≥ 18 yrs), energy-restricted, resistance-trained (> 6 months) humans of lower body fat (males ≤ 23% and females ≤ 35%) performing resistance training. Protein intake, fat free mass (FFM) and body fat had to be reported. Results: Body fat percentage decreased (0.5-6.6%) in all study groups (N = 13) and FFM decreased (0.3-2.7kg) in nine of 13. Six groups gained, did not lose, or lost nonsignificant amounts of FFM. Five out of these six groups were among the highest in body fat, lowest in caloric restriction, or underwent novel resistance training stimuli. However, the one group that was not high in body fat that underwent substantial caloric restriction, without novel training stimuli, consumed the highest protein intake out of all the groups in this review (2.5-2.6g/kg). Conclusions: Protein needs for energy-restricted resistance-trained athletes are likely 2.3-3.1g/kg of FFM scaled upwards with severity of caloric restriction and leanness. [ABSTRACT FROM AUTHOR]

Background: In New Zealand, health equity is a pressing concern and reaching disadvantaged populations has become the goal to close the inequity gap. Building and strengthening health systems is one way to secure better outcomes. However, the discourse to date has predominately focussed on inequities in health outcomes for Māori. This study has interest in the African ethnic minority community in New Zealand. It undertakes a narrative review of the New Zealand health system which aims to identify literature around the attainment of health equity of African minority by: (i) providing a critical overview of the healthcare delivery system using World Health Organization's six inter-related building blocks of health system strengthening; (ii) developing a summary and discussions of the research results and; (iii) identifying priorities and recommendations for future research. Method: A narrative review of 27 articles published between January 2010 and June 2019 were selected from CINAHL, PubMed, Scopus, Google Scholar. Grey literature also informed the review. Articles excluded studies: (i) non-related to New Zealand; (ii) with no focus on equity on ethnic minority in the delivering of healthcare; (iii) had no full text available. Findings: Literature on Africans health outcomes were scarce regarding the six building blocks. However, findings show inequities in accessibility of health services, a non-ethnic inclusive health workforce, a leadership and governance which lack political will on migrant health and resultantly an under-performing health information system which influences resource allocation. Recommendation and conclusion: An improvement and well-functioning health information system is pivotal to capture the unmet needs of the African population. There is a need for research and political will to invest in African minority health and diverse workforce that understands the background of the African population; and action to address structural and institutional racism and white privilege to address root causes of inadequate access and care processes for ethnic minorities. [ABSTRACT FROM AUTHOR]

Background: There are currently various methods of delivery that can improve adherence on under-five childhood immunization schedule. The methods differ significantly and there is the conventional method of providing a health education module, reminders and recalls to improve adherence and some other non-conventional methods to improve adherence. A systematic review was conducted on the effectiveness of methods of delivery and reminder of health education module to improve adherence on childhood immunization schedule. Materials and Methods: The systematic review performed utilized searched on available electronic databases and bibliographies of studies and also previous reviews. The databases were broad search and began with the use of generic terms to identify search terms that were relevant. The PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) by Moher et al (2009) was used. Databases including PubMed, Science Direct, Medline and CINAHL were utilized for this systematic review. Results: The studies in the review conducted was conducted in various countries with the United States of America (USA) contributing 7 studies, followed by the United Kingdom and Pakistan with 3 studies each and Kenya, Australia, New Zealand and India with 1 study respectively. The lowest number of respondents was 12 while the most was 9213 respondents. All studies were Randomized Control Trial’s (RCT’s) and 1 Quasi Experimental study. Conclusion: The studies showed multiple factor and effective methods of delivery with reminders for health education. Utilizing technology showed to be one of the most effective methods. [ABSTRACT FROM AUTHOR]

Background: Knee injuries are prevalent among a variety of competitive sports and can impact an athlete's ability to continue to participate in their sport or, in the worst case, end an athlete's career. Objective: The aim was to evaluate biomechanics associated with both patellofemoral pain syndrome (PFPS) and anterior cruciate ligament (ACL) injuries (in sports involving landing, change in direction, or rapid deceleration) across the three time points frequently reported in the literature: pre-injury, at the time of injury, and following injury. Methods: A search of the literature was conducted for research evaluating biomechanics associated with ACL injury and PFPS. The Web of Science, SPORTDiscus, EBSCO, PubMed, and CINAHL databases, to March 2015, were searched, and journal articles focused on ACL injuries and PFPS in sports that met the inclusion criteria were reviewed. The search methodology was created with the intent of extracting case-control, case, and cohort studies of knee injury in athletic populations. The search strategy was restricted to only full-text articles published in English. These articles were included in the review if they met all of the required selection criteria. The following inclusion criteria were used: (1) The study must report lower extremity biomechanics in one of the following settings: (a) a comparison of currently injured and uninjured participants, (b) a prospective study evaluating risk factors for injury, or (c) a study reporting on the injury event itself. (2) The study must include only currently active participants who were similar at baseline (i.e. healthy, high school level basketball players currently in-season) and include biomechanical analysis of either landing, change in direction, or rapid deceleration. (3) The study must include currently injured participants. The studies were graded on the basis of quality, which served as an indication of risk of bias. An adapted version of the 'Strengthening the Reporting of Observational Studies in Epidemiology' (STROBE) guidelines was used to rate observational research. Results: Fifteen journal articles focusing on ACL injuries and PFPS in sports met the inclusion criteria. These included three associated with both ACL injuries and PFPS across multiple time points. There was limited evidence for an association between ankle biomechanics and knee injury, with only one ACL injury study identifying decreased plantar flexion in association with injury. Limitations: Only prospective studies can determine biomechanical risk factors associated with ACL injuries and PFPS. Case studies and case-control studies do not allow for the determination of risk factors associated with both ACL injuries and PFPS as there is no certainty regarding the presence of the observed biomechanics prior to the onset of injury. Further, each study design has its own set of limitations. Lastly, the majority of the studies included in this review had adult female participants. Conclusion: By evaluating several different study designs looking at knee injuries during high-risk manoeuvres, we were able to obtain a holistic perspective of biomechanics associated with PFPS and ACL injuries. Looking at different biomechanical research approaches allowed us to assess not only the mechanism of injury, but also to look for commonalities in biomechanics (in particular, altered frontal plane mechanics at the knee and altered sagittal plane mechanics at the knee and hip) between injured and uninjured participants pre-injury, at the time of injury, and following injury, to better understand potential causes of PFPS and ACL injury. Development of injury prevention programmes should focus on correcting these mechanics observed across the three time points during high-risk manoeuvres as this may help decrease the prevalence of ACL injury and PFPS. Programmes focusing not only on neuromuscular training, but also skill-specific training focused on correcting mechanics during these high-risk manoeuvres may be of greatest benefit regarding prevention. Future research should consider the impact of cumulative loading on knee injury risk. Additionally, better techniques for assessing mechanics in-game are needed in order to facilitate injury prevention and screening strategies. [ABSTRACT FROM AUTHOR]

The article presents a review of evidences in literature related to the contribution of transnational family arrangement and migration to the mental health of Korean transnational mothers. Findings reveal the key factors that are associated to their mental health, including life difficulties and psychological and emotional conditions. It suggests the vulnerability of these mothers to mental disorders and the need of more research to determine risk factors.

Background: Knee joint mechanics during sidestepping are associated with anterior cruciate ligament injury. Unplanned sidestepping more closely emulates game scenarios when compared with planned sidestepping by limiting decision time, increasing knee loading and challenging the integrity of soft-tissue structures in the knee. It is important to quantify the loads that may challenge the integrity of the knee during planned and unplanned sidestepping. Objective: Our objective was to review literature on knee mechanics during planned and unplanned phases of sidestepping. Data sources: PubMed, CINAHL, MEDLINE (EBSCO), SPORTDiscus and Web of Science were searched using the terms knee mechanics OR knee kine*, AND plan*, unplan*, anticipat*, unanticipat*, side*, cut* or chang*. Study selection: A systematic approach was used to evaluate 4,629 records. Records were excluded when not available in English, only available in abstract of conference proceedings, not involving a change-of-direction sidestep, not comparing planned and unplanned or maintaining a running velocity greater than 2 m s. Data extraction: Included studies were evaluated independently by two authors using a custom-designed methodological quality assessment derived from the Physiotherapy Evidence Database (PEDro) scale and then confirmed by a third author. Data synthesis: Only six studies met the inclusion criteria and were retained for meta-analysis. Magnitude-based inferences were used to assess the standardised effect of the differences between planned and unplanned sidestepping. Knee angles and knee moments were extracted and reported for flexion/extension, abduction/adduction and internal/external rotation for initial contact, weight acceptance, peak push-off and final push-off phases of sidestepping. Results: For kinematic variables, unplanned sidestepping produced a wide range of small to large increases in knee extension angles, small and moderate increases in knee abduction angles and a small increase in internal rotation angle relative to planned sidestepping during the sidestepping manoeuvre. For kinetic variables, unplanned sidestepping produced mostly small (small to large) increases in knee flexor moments, small to moderate increases in knee abductor moments and mostly moderate (small to large) increases in internal rotator moments relative to planned sidestepping. Limitations: Approach velocity constraints during the sidestepping manoeuvre were lifted due to the low number of eligible studies. The varying approach velocities included (ranging from 3.0 to 5.5 m s) may impact the kinematic and kinetic variables examined in this review. Conclusions: Differences in knee mechanics between planned and unplanned sidestepping exist. The most substantial effects occurred during the weight acceptance phase of sidestepping. It seems that biomechanical factors commonly associated with anterior cruciate ligament injury risk are affected the most during the loading phase compared with peak push-off; made evident in the coronal (abductor) and transverse (internal rotator) knee kinetic data presented in this review. The authors of this review propose a rationale for the incorporation of unplanned sport tasks in the development of anterior cruciate ligament injury screening and in prophylactic training programmes. [ABSTRACT FROM AUTHOR]

Background: Research into the nature of overuse Achilles tendon injuries is extensive, yet uncertainty remains around how to identify athletes susceptible to Achilles tendon injury. Objective: To identify the strength of evidence for biomechanical risk factors associated with Achilles tendon injuries. Research Methods: SPORTDiscus, CINAHL, Web of Science and PubMed were searched for Achilles tendon injury risk factors and biomechanical measures which are altered in runners with Achilles tendon injuries, excluding ruptures. Fifteen articles were included in the analysis. Results: Two variables, high vertical forces and high arch, showed strong evidence for reduced injury risk. High propulsive forces and running on stiffer surfaces may also be protective. Only one biomechanical variable, high braking force, showed clear evidence for increasing Achilles injury risk. Discussion: Gait retraining to direct the centre of mass further forward to reduce high braking force could be useful in decreasing the risk of Achilles injury. The majority of biomechanical risk factors examined showed unclear results, which is likely due to the multifactorial nature of Achilles overuse injuries. Many risk factors are related to how the athlete's body interacts with the environment during gait, including ground reaction forces, muscle activity both prior to landing and immediately post ground contact, and joint motion throughout stance. Conclusion: Multiple risk factors have been associated with the development of Achilles tendon injuries in running athletes but most effects remain unclear. Advice for athletes recovering from Achilles tendon injuries could include avoiding soft surfaces and reducing the pace of recovery runs. Orthotic intervention could assist athletes with low arches but modification of pronation should be viewed with caution. Strength training and gait retraining could be beneficial for reducing injury risk. [ABSTRACT FROM AUTHOR]

Objectives: To present the results of a systematic review of studies on acupuncture patients' health beliefs and treatment experiences. Search strategy: The search was conducted using CINAHL, PubMed, Ovid MEDLINE, ISI Web of Science, and PsychINFO for qualitative and mixed-methods studies expressing the voice of acupuncture patients. Reference lists of relevant articles were also searched. The review was restricted to studies published in English. Data collection and analysis: Study selection, quality appraisal, and data extraction were performed sequentially. Quality was appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument, and the Dedoose mixed methods tool was used in data management and analysis. Results: Four overarching themes were identified: reasons for using acupuncture, treatment experiences, treatment outcomes, and therapeutic model. Conclusions: Patients' reasons for using acupuncture are diverse and include dissatisfaction with conventional medicine and attraction to holistic and empowering models of healthcare. Treatment is thought to relieve symptoms of the presenting concern and a range of other effects that improve well-being. This review highlights the need to improve understanding of patients' health-seeking behaviors and how individually meaningful treatment outcomes may be understood and assessed, particularly within complementary and alternative medicine. [ABSTRACT FROM AUTHOR]

Aim: The availability of high-quality, validated food frequency questionnaires is useful for the conduct of robust population dietary iron-related research. This review aimed to evaluate the validation quality of recently validated food frequency questionnaires that measure iron intakes in Australian or New Zealand adults. Methods: Articles validating food frequency questionnaires that measured iron intakes in Australian or New Zealand adults, published from 1995, were sourced from a range of databases using standard search terms. Eligible validation studies were assessed for validation quality using recommendations from international reviews of food frequency questionnaire validation studies, and a quality score was calculated. Results: Nine studies validating food frequency questionnaires were located. Seven of the nine studies had achieved at least an acceptable quality validation score. More than half of the international validation recommendations were met in at least half of the eligible studies. Studies generally did not report or consider nutrient supplementation, did not validate the food frequency questionnaire against a biomarker, nor measured survey repeatability. Conclusions: The majority of food frequency questionnaire validation studies had achieved at least an acceptable quality validation score; however, some food frequency questionnaires had undergone a higher quality validation process than others. Applying the international validation recommendations to future validation studies may improve the quality of the food frequency questionnaire validation process and, potentially, population dietary iron-related research. [ABSTRACT FROM AUTHOR]

Aim: To undertake a systematic literature review to examine the effect of food cost on diet quality and risk factors for chronic disease, specifically focusing on diet-related lifestyle diseases affecting the Australian population. Methods: A search of six databases resulted in the inclusion of one systematic review, three cohort studies, 41 cross-sectional studies and four modelling studies in this review. Results: Between 2000 and 2006, the price of healthy foods has increased more than the price of less healthy foods. Healthy Food Access Basket surveys show that a healthy diet may often be unaffordable for low- and average-income households. Diets of higher energy density were associated with lower diet cost, whereas diets of higher nutrient density and nutritional quality were associated with higher diet cost. Recent studies report an inverse association between food price and food consumption. Consequently, an increase in food cost was associated with a significant reduction in weight, waist circumference, body mass index, obesity and insulin resistance. Conclusions: Manipulation of food cost may alter food consumption and therefore risk factors for chronic disease. Further longitudinal studies investigating the impact of pricing strategies on diet quality and disease risk are needed. [ABSTRACT FROM AUTHOR]

Objective: This narrative review aimed to identify and categorize the barriers and facilitators to the provision of brief intervention and behavioral change programs that target several risk behaviors among the Indigenous populations of Australia, Canada, and New Zealand. Methods: A systematic database search was conducted of six databases including PubMeD, Embase, CINAHL, HealthStar, PsycINFO, and Web of Science. Thematic analysis was utilized to analyze qualitative data extracted from the included studies, and a narrative approach was employed to synthesize the common themes that emerged. The quality of studies was assessed in accordance with the Joanna Briggs Institute's guidelines and using the software SUMARI – The System for the Unified Management, Assessment and Review of Information. Results: Nine studies were included. The studies were classified at three intervention levels: (1) individual-based brief interventions, (2) family-based interventions, and (3) community-based-interventions. Across the studies, selection of the intervention level was associated with Indigenous priorities and preferences, and approaches with Indigenous collaboration were supported. Barriers and facilitators were grouped under four major categories representing the common themes: (1) characteristics of design, development, and delivery, (2) patient/provider relationship, (3) environmental factors, and (4) organizational capacity and workplace-related factors. Several sub-themes also emerged under the above-mentioned categories including level of intervention, Indigenous leadership and participation, cultural appropriateness, social and economic barriers, and design elements. Conclusion: To improve the effectiveness of multiple health behavior change interventions among Indigenous populations, collaborative approaches that target different intervention levels are beneficial. Further research to bridge the knowledge gap in this topic will help to improve the quality of preventive health strategies to achieve better outcomes at all levels, and will improve intervention implementation from development and delivery fidelity, to acceptability and sustainability. [ABSTRACT FROM AUTHOR]

Background: The purpose of this review was to examine the literature for themes of underlying social contributors to inequity in maternal health outcomes and experiences in the high resource setting of Aotearoa New Zealand. These 'causes of the causes' were explored and compared with the international context to identify similarities and New Zealand-specific differences. Method: A structured integrative review methodology was employed to enable a complex cross disciplinary analysis of data from a variety of published sources. This method enabled incorporation of diverse research methodologies and theoretical approaches found in the literature to form a unified overall of the topic. Results: Six integrated factors – Physical Access, Political Context, Maternity Care System, Acceptability, Colonialism, and Cultural factors – were identified as barriers to equitable maternal health in Aotearoa New Zealand. The structure of the maternal health system in New Zealand, which includes free maternity care and a woman centred continuity of care structure, should help to ameliorate inequity in maternal health and yet does not appear to. A complex set of underlying structural and systemic factors, such as institutionalised racism, serve to act as barriers to equitable maternity outcomes and experiences. Initiatives that appear to be working are adapted to the local context and involve self-determination in research, clinical outreach and community programmes. Conclusions: The combination of six social determinants identified in this review that contribute to maternal health inequity is specific to New Zealand, although individually these factors can be identified elsewhere; this creates a unique set of challenges in addressing inequity. Due to the specific social determinants in Aotearoa New Zealand, localised solutions have potential to further maternal health equity. [ABSTRACT FROM AUTHOR]