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Objective: To identify factors associated with death secondary to haemorrhage following major trauma. Methods: A retrospective case–control study was conducted on data from adult major trauma patients attending Christchurch Hospital ED between 1 June 2016 and 1 June 2020. Cases (those who died due to haemorrhage or multiple organ failure [MOF]), were matched to controls (those who survived) in a 1:5 ratio from the Canterbury District Health Board major trauma database. A multivariate analysis was used to identify potential risk factors for death due to haemorrhage. Results: One thousand, five hundred and forty major trauma patients were admitted to Christchurch Hospital or died in ED during the study period. Of them, 140 (9.1%) died from any cause, most attributed to a central nervous system cause of death; 19 (1.2%) died from haemorrhage or MOF. After controlling for age and injury severity, having a lower temperature on arrival in ED was a significant modifiable risk factor for death. Additionally, intubation prior to hospital, increased base deficit, lower initial haemoglobin and lower Glasgow Coma Scale were risk factors associated with death. Conclusions: The present study reaffirms previous literature that lower body temperature on presentation to hospital is a significant potentially modifiable variable in predicting death following major trauma. Further studies should investigate whether all pre‐hospital services have key performance indicators (KPIs) for temperature management, and causes for failure to reach these. Our findings should promote development and tracking of such KPIs where they do not already exist. [ABSTRACT FROM AUTHOR]

Existing research highlights adaptive applications of spiritual intelligence, specifically its relationship to positive well-being and quality of life. Limited studies have examined its applicability within secular Western contexts. Two-hundred and fourteen New Zealand university students completed a questionnaire measuring their spiritual intelligence, resilience, and several aspects of wellbeing. Results revealed that spiritual intelligence was significantly associated with increased resilience and reduced feelings of depression and stress, but not anxiety. However, the relationship between spiritual intelligence scores and combined depression, anxiety, and stress scores was fully mediated by resilience scores, suggesting that spiritual intelligence per se may not directly affect wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: Cardiopulmonary bypass (CPB) machines have oxygenators with integrated filters and unique biocompatible coatings to combat systemic inflammatory response syndrome (SIRS) and mitigate coagulopathy. Contemporary oxygenators have undergone comparative studies; however, our study aimed to identify the most appropriate oxygenator for our regional Cardiothoracic unit in Australasia. Methods: A prospective audit consecutively recruited one-hundred and fifty patients undergoing cardiac surgery at Waikato Hospital, New Zealand between the periods of 29th January 2018 and 31st July 2018. Fifty patients were recruited for each oxygenator arm: Sorin INSPIRE' (Group-S); Terumo CAPIOX'FX (Group-T); and Medtronic Affinity Fusion' (Group-M). The clinical outcomes were transfusions, chest drain output, reoperation and length of hospital stay (LOHS). Routine blood testing protocol included: haemoglobin, protein, albumin, white cell count (WCC), C-reactive protein (CRP), platelet count and coagulations tests including international normalized ratio (INR). Results: Comparing Groups S, T and M there was no statistical difference in chest drain output (650 vs. 500 vs. 595 ml respectively, p = 0.45), transfusions (61 vs. 117 vs. 70 units, p = 0.67), reoperation (6 vs. 8 vs. 12%, p = 0.99) and LOHS (median 7.4 vs. 7.6 vs. 9.5 days, p = 0.42). Group-T had fewer SIRS cases but similar increase in CRP (p = 0.12) and WCC (p = 0.35). Group-M had a significant rise in post-op INR (p = 0.005) but no associated increase in chest drain output (p = 0.62). Group-S and -M required more 4%-albumin and Group-T had more transfusions. Only fresh frozen plasma (FFP) and red blood cell (RBC) transfusion had a significant relationship with LOHS (p < 0.05). Conclusion: Biochemically, there was slight difference among the oxygenators which did not translate into clinical difference in outcomes. The oxygenator design and perfusionist choice aided in our decision-making process. [ABSTRACT FROM AUTHOR]

Background: Owing to the disappointing regenerative ability of osteochondral tissue, without treatment an osteochondral defect would progress to osteoarthritis. This situation motivates the need for new strategies to enhance the regeneration of osteochondral defects. Purpose: To develop a tissue-engineering scaffold by tethering bone morphogenetic protein 2 (BMP2) and transforming growth factor beta 3 (TGFβ3) in a layer-specific manner on a slotted decellularized osteochondral matrix (SDOM) and to evaluate the efficacy of this scaffold for osteochondral regeneration. Study Design: Controlled laboratory study. Methods: Normal osteochondral tissue from the rabbit patellofemoral groove was sectioned into a slot shape and decellularized for fabricating an SDOM. The collagen-binding domain (CBD) was fused into the N-terminus of BMP2 or TGFβ3 to synthesize 2 recombinant growth factors (GFs) (CBD-BMP2 or CBD-TGFβ3), which were tethered to the bone layer and cartilage layer, respectively, of the SDOM to prepare a tissue-engineering scaffold (namely, CBD-GFs/SDOM). After examining the influence of the CBD-GFs/SDOM on the viability and layer-specific differentiation of bone marrow mesenchymal stem cells in vitro, we determined the regeneration potential of the CBD-GFs/SDOM on osteochondral regeneration in a rabbit model. A total of 72 New Zealand White rabbits with a cylindrical osteochondral defect in the patellofemoral groove were randomly assigned to 3 groups: defect only (control [CTL] group), defect patched with an SDOM (SDOM group), and defect patched with the CBD-GFs/SDOM (CBD-GFs/SDOM group). At 6 or 12 weeks postoperatively, the rabbits were euthanized to harvest the knee joint, which was then evaluated via gross observation, micro–computed tomography, histological staining, and mechanical testing. Results: In vitro, the CBD-GFs/SDOM was noncytotoxic, showed high biomimetics with normal osteochondral tissue, was suitable for cell adhesion and growth, and had good layer-specific ability in inducing stem cell differentiation. Macroscopic images showed that the CBD-GFs/SDOM group had significantly better osteochondral regeneration than the CTL and SDOM groups had. Micro–computed tomography demonstrated that much more bony tissue was formed at the defect sites in the CBD-GFs/SDOM group compared with the defect sites in the CTL or SDOM group. Histological analysis showed that the CBD-GFs/SDOM group had a significant enhancement in osteochondral regeneration at 6 and 12 weeks postoperatively in comparison with the CTL or SDOM group. At 12 weeks postoperatively, the mechanical properties of reparative tissue were significantly better in the CBD-GFs/SDOM group than in the other groups. Conclusion: The CBD-GFs/SDOM is a promising scaffold for osteochondral regeneration. Clinical Relevance: The findings of this study indicated that the CBD-GFs/SDOM is an excellent candidate for reconstructing osteochondral defects, which may be translated for clinical use in the future. [ABSTRACT FROM AUTHOR]

New Zealand blackcurrant (NZBC) extract is a rich source of anthocyanins and in order to exert physiological effects, the anthocyanin-derived metabolites need to be bioavailable in vivo. We examined the plasma uptake of selected phenolic acids following NZBC extract supplementation alongside maintaining a habitual diet (i.e. not restricting habitual polyphenol intake). Twenty healthy volunteers (nine females, age: 28 ± 7 years, height 1.73 ± 0.09 m, body mass 73 ± 11 kg) consumed a 300 mg NZBC extract capsule (CurraNZ®; anthocyanin content 105 mg) following an overnight fast. Venous blood samples were taken pre and 1, 1.5, 2, 3, 4, 5, and 6 h post-ingestion of the capsule. Reversed-phase high-performance liquid chromatography (HPLC) was used for analysis of two dihydroxybenzoic acids [i.e. vanillic acid (VA) and protocatechuic acid (PCA)] and one trihydroxybenzoic acid [i.e. gallic acid (GA)] in plasma following NZBC extract supplementation. Habitual anthocyanin intake was 168 (95%CI:68–404) mg⋅day−1 and no associations were observed between this and VA, PCA, and GA plasma uptake by the NZBC extract intake. Plasma time-concentration curves revealed that GA, and PCA were most abundant at 4, and 1.5 h post-ingestion, representing a 261% and 320% increase above baseline, respectively, with VA remaining unchanged. This is the first study to demonstrate that an NZBC extract supplement increases the plasma uptake of phenolic acids GA, and PCA even when a habitual diet is followed in the days preceding the experimental trial, although inter-individual variability is apparent. [ABSTRACT FROM AUTHOR]

Objective: With longer life expectancies, cardiovascular diseases are increasingly common among older adults, which also leads to functional changes that severely impact their quality of life. This study aimed to identify the predictors of health‐related quality of life (HRQOL) among older New Zealanders with cardiovascular health problems. Methods: A cross‐sectional data analysis of the 2015/16 New Zealand Health Survey was performed. In total, 2203 older New Zealanders with cardiovascular health problems were identified and included in the final analyses. The association between demographics, physical activity, health measurements, and HRQOL was examined using a multiple linear regression model. Results: Significant differences in HRQOL were identified between the demographics and cardiovascular risk factors. Predictors of higher HRQOL among older New Zealanders with cardiovascular conditions were increased physical activity (β = 0.218), age (β = −0.067), employed (β = 0.137), lower waist circumference (β = −0.261), male (β = 0.127), and being without a history of diabetes (β = −0.071). Conclusions: Physical activity is the strongest predictor of HRQOL in older adults with cardiovascular problems. Older female New Zealanders with cardiovascular health problems have lower perceptions of their health status. These predictors should be considered while designing and developing intervention and health education that aims to improve the HRQOL of older adults. [ABSTRACT FROM AUTHOR]

Men with prostate cancer experience many side effects and symptoms that may be improved by a physically active lifestyle. It was hypothesized that older men with prostate cancer who were physically active would report significantly higher levels of quality of life (QOL) as assessed by the WHOQOL-BREF and the WHOQOL-OLD. Of the 348 prostate cancer survivors who were invited to participate in the present postal survey, 137 men returned the questionnaires. Those who were physically active had significantly lower prostate specific antigen (PSA) scores and higher social participation than those insufficiently active. These findings offer some support for the benefits of physical activity (PA) within the prostate cancer population in managing the adverse side effects of their treatments on aspects of their QOL. Future research should more closely examine what types of PA best promote improvements in varying aspects of QOL and psychological well-being for prostate cancer survivors. [ABSTRACT FROM AUTHOR]

Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. Sixteen autistic children aged 6–10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 – quiet standing before step initiation, phase 2 – transit, and phase 3 - quiet standing until measurement completion. The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021). • Autistic children show postural control deficits before and after step initiation. • Autistic children take longer to complete a step than typically developing peers. • Posturography can be used to assess postural control in autistic children. [ABSTRACT FROM AUTHOR]

Purpose: To examine potential indicators of health need for primary care in spatial equity research, and evidence of the Inverse Care Law in the Waikato region of New Zealand. Methods: A cross‐sectional analysis of 7 health need indicators (ambulatory sensitive hospitalizations; cancer rate; mortality rate; New Zealand index of multiple deprivation‐health domain; age; New Zealand index of deprivation; smoking rate) that were identified through a systematic review was carried out. Values of indicators were mapped and analyzed using geographic information systems (GIS). Spearman's correlations were calculated between indicators, and clusters of high need were identified through spatial autocorrelation. The impact of incorporating indicator‐based weightings into an accessibility model was tested using analysis of variance and Spearman's correlations. General practice service spatial equity was assessed by comparing clusters of high access versus need, and quantified through the Gini coefficient. Findings: Ambulatory sensitive hospitalization (ASH) rates were significantly correlated with all indicators. Health needs were significantly clustered, but incorporating indicator weightings into the spatial accessibility analysis did not impact accessibility scores. A misalignment of access and need, and a Gini coefficient of 0.281 suggest that services are not equitably distributed. Conclusion: ASH rates seem a robust indicator of health need. However, data access issues may restrict their use. Area‐level socioeconomic deprivation measures incorporate some social determinants of health, and they have potential for wider use. High need clusters vary spatially according to the indicator used. GIS techniques can identify "hot‐spots" of need, but these can be masked in accessibility models. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Diabetes mellitus is common in primary care, yet little has been reported of its primary care prevalence or the clinical characteristics of patients with Type 2 diabetes mellitus (T2DM). AIM: To determine the prevalence of diabetes mellitus and clinical characteristics of diabetes patients in primary care in the Waikato region. METHODS: Primary care data were extracted from the electronic records of 15 general practices for patients aged >20 years with current diabetes mellitus at 20 June 2017. Diabetes mellitus was defined as having a glycated haemoglobin (HbA1c) of ≥50 mmol/mol (6.7%) or having being dispensed two or more anti-diabetic medications in the previous 12 months. Additional data collected included patients' ethnicity, age, sex and years since diagnosis. RESULTS: The overall prevalence of diabetes mellitus was 5.7% and was higher for Māori (8.6%), Asian (7.0%) and Pacific peoples (9.1%) than Europeans (5.0%; all P < 0.001). For patients with T2DM for whom current diabetes annual review data were available (n = 2227) the mean body mass index (BMI) was 32.8 ± 0.2 kg/m2, but BMI was higher in Māori, younger patients, females and patients diagnosed <2 years previously (all P < 0.001). Similarly, HbA1c levels were highest in Māori and younger patients (both P < 0.001), with 40% of patients overall having a HbA1c of ≤53 mmol/mol (7.0%). Approximately 70% of all patients had at least one measure of hypertension (systolic ≥130 or diastolic ≥80 mmHg), or dyslipidaemia. More than 85% of patients had completed a recent retinal screen and foot check. DISCUSSION: We found that management of T2DM was suboptimal, with measures for many patients not meeting clinical targets. Support should be provided to improve weight and glycaemic management, particularly for Māori, females and younger patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to ascertain whether a high carbohydrate diet in the days before movement patterns simulating a squash match would increase carbohydrate oxidation during the match, and alter physical performance. Nine New Zealand level squash players were recruited to complete a simulated squash match on two occasions: 1) following a 48-hr high carbohydrate (11.1g·kg-1); and 2) following a calorie-matched low carbohydrate (2.1 g·kg-1) diet. The interventions were assigned in a randomized, single-blind, cross-over design. The match simulation was designed to mimic a five-game match lasting approximately 1 hr. Performance was measured as time to complete each game. Expired respiratory gases and heart rate were continuously collected throughout the trial using a portable gas analysis system. Capillary blood glucose and lactate samples were obtained during a 90 s rest period between each game. Rating of perceived exertion was also recorded after each set. Respiratory exchange ratio was significantly higher during exercise following the high CHO diet (0.80 vs. 0.76) p < .001) and this was associated with significantly faster time to complete the games (2340 ± 189 s vs. 2416 ± 128 s, p = .036). Blood glucose and lactate concentrations were also significantly higher in the high carbohydrate condition (p = .038 and p = .021 respectively). These results suggest that ingestion of a diet high in carbohydrate (>10 g/kg body weight) preceding simulated competitive squash produces increased rates of carbohydrate oxidation and maintains higher blood glucose concentrations. These metabolic effects were associated with improved physical performance. [ABSTRACT FROM AUTHOR]

Purpose: While several studies have documented isokinetic knee strength in junior and senior rugby league players, investigations of isokinetic knee and hip strength in professional rugby union players are limited. The purpose of this study was to provide lower-extremity strength profiles and compare isokinetic knee and hip strength of professional rugby league and rugby union players. Participants: 32 professional rugby league and 25 professional rugby union players. Methods: Cross-sectional analysis. Isokinetic dynamometry was used to evaluate peak torque and strength ratios of the dominant and nondominant legs during seated knee-extension/ flexion and supine hip-extension/flexion actions at 60°/s. Results: Forwards from both codes were taller and heavier and had a higher body-mass index than the backs of each code. Rugby union forwards produced significantly (P < .05) greater peak torque during knee flexion in the dominant and nondominant legs (ES = 1.81 and 2.02) compared with rugby league forwards. Rugby league backs produced significantly greater hip-extension peak torque in the dominant and nondominant legs (ES = 0.83 and 0.77) compared with rugby union backs. There were no significant differences in hamstring-to-quadriceps ratios between code, position, or leg. Rugby union forwards and backs produced significantly greater knee-flexion-to-hip-extension ratios in the dominant and nondominant legs (ES = 1.49-2.26) than rugby union players. Conclusions: It seems that the joint torque profiles of players from rugby league and union codes differ, which may be attributed to the different demands of each code. [ABSTRACT FROM AUTHOR]

This study investigated the response to class-wide phonological awareness and oral language teaching for 40 children who entered school with speech and language difficulties. A stepped wedge research design was adopted to compare the immediate impact of the 10-week teacher-led instruction. The progress of the children with speech and language difficulties was monitored over the first school year and compared with 110 children with language difficulties alone and 95 children with typical development. Children with speech and language needs showed a strong intervention response in phoneme awareness and vocabulary learning but needed more support to transfer skills to word decoding and spelling. Implementing the approach earlier in the school year resulted in stronger literacy performance at the year-end for all three groups. The importance of positive speech–language pathologist and teacher collaborations to support a systematic approach to evidence-based foundational literacy teaching is discussed. [ABSTRACT FROM AUTHOR]

This study examined whether perceived barriers, benefits, and motives for physical activity differed based on allocation to 2 different types of primary-care activity-prescription programs (pedometer-based vs. time-based Green Prescription). Eighty participants from the Healthy Steps study completed a questionnaire that assessed their perceived barriers, benefits, and motives for physical activity. Factor analysis was carried out to identify common themes of barriers, benefits, and motives for physical activity. Factor scores were then used to explore between groups differences for perceived barriers, benefits, and motives based on group allocation and demographic variables. No significant differences were found in factor scores based on allocation. Demographic variables relating to the existence of chronic health conditions, weight status, and older age were found to significantly influence perceived barriers, benefits, and motives for physical activity. Findings suggest that the addition of a pedometer to the standard Green Prescription does not appear to increase perceived motives or benefits or decrease perceived barriers for physical activity in low-active older adults. [ABSTRACT FROM AUTHOR]

Objective: To use finite element analysis to investigate the influence of insertion torque on the stress distribution around an immediately placed oral implant. Method and Materials: Finite element software was used to model a mandibular molar extraction socket. The properties of surrounding cancellous bone and thickness of cortical bone were modified to give four 3D finite element models (I, II, III, and IV). A wide-diameter tapered oral implant was modeled and inserted into the socket. Final insertion torques of 32, 50, and 70 Ncm were applied, and the stress profile in each model was evaluated. The maximum von Mises stresses along the buccal cortical bone adjacent to the implant neck were statistically analyzed to compare the three torque values and four bone models. Results: At the level of the cortical bone, the greatest von Mises stress levels were generated in model IV and diminished as the bone quality increased. Significant increase in stress values at the crestal bone level was observed in all models after using 70 Ncm compared with 32 Ncm. The maximum von Mises stresses at the cancellous bone were higher in model I and reduced with lower level of bone quality (model IV). Conclusion: The use of 70 Ncm or more insertion torque during placement of an immediately placed wide-diameter implant substantially increases stresses on the crestal bone. The development of a modified surgical protocol involving moderate insertion torque value (32 to 50 Ncm) may contribute to minimizing the risk of early implant failure in extraction sockets. [ABSTRACT FROM AUTHOR]

This study aimed to examine the normative data for the SARTS rugby tests in elite and schoolboy rugby players. A second aim was to examine differences between level of sport and position of play in the SARTS rugby tests. Elite (N = 57) and Schoolboy (N = 63) rugby players performed the SARTS tests relevant to rugby players each for 1 min, with 1–2 min rest between each test. A 2×2 factorial ANOVA was used to assess for the main effect of player position and player level of play. Results showed that elite players performed more Ball Abduction External Rotation (BABER) (dominant and non-dominant), Side Hold Rotations (dominant and non-dominant), Ball Taps (dominant and non-dominant), and Overhead Snatch than schoolboy players. Heavier players performed fewer Push-up Claps. Injured rugby players should perform at least the mean value of the repetitions of the SARTS tests before returning to contact training after an injury. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to explore the intersection between mild traumatic brain injury (MTBI) recovery experiences and injury understandings, using both quantitative and qualitative methods. Materials and Methods: The quantitative component was a descriptive case–control study comparing participants (n = 76) who had recovered or not recovered after an MTBI, across demographic and psychological variables. A subset of participants (n = 10) participated in a semi-structured interview to explore experiences of recovery in more detail. We followed threads across the datasets to integrate findings from component methods. Results: The quantitative analyses revealed differences between the two groups in terms of injury recovery understandings and expectations. The qualitative analyses suggested that achieving consistency across information sources was important. By tracing threads back and forth between the component datasets, we identified a super-ordinate meta-theme that captured participants' experiences of wrestling with uncertainty about their recovery and the impacts in terms of heightened anxiety, confusion, and feelings of invalidation. Conclusion: The effectiveness of psychoeducation and reassurance after MTBI may be optimized when content is tailored to the individual. Clinicians are urged to attend both to the subjective interpretations patients make of information gained from formal and informal, internal and external sources, and where information across these sources conflicts and creates uncertainty. Effectiveness of psychoeducation and reassurance after injury may be optimized when content is tailored to the individual rather than being generic. Effectiveness of such interventions may also be optimized by understanding the subjective interpretations individuals make of injury knowledge gleaned from formal and informal, internal and external sources. Conflicting information from such multiple sources may create uncertainty with associated increased distress as an individual negotiates their recovery from injury. Attending to this uncertainty may be a helpful target for treatment. [ABSTRACT FROM AUTHOR]

Background: Microfracture or bone marrow stimulation (BMS) is often the first choice for clinical treatment of cartilage injuries; however, fibrocartilage, not pure hyaline cartilage, has been reported because of the development of fibrosis in the repair tissue. Transforming growth factor β1 (TGF-β1), which can promote fibrosis, can be inhibited by losartan and potentially be used to reduce fibrocartilage. Hypothesis: Blocking TGF-β1 would improve cartilage healing in a rabbit knee BMS model via decreasing the amount of fibrocartilage and increasing hyaline-like cartilage formation. Study Design: Controlled laboratory study. Methods: An osteochondral defect was made in the patellar groove of 48 New Zealand White rabbits. The rabbits were divided into 3 groups: a defect group (defect only), a BMS group (osteochondral defect + BMS), and a BMS + losartan group (osteochondral defect + BMS + losartan). For the rabbits in the BMS + losartan group, losartan was administrated orally from the day after surgery through the day of euthanasia. Rabbits were sacrificed 6 or 12 weeks postoperatively. Macroscopic appearance, microcomputed tomography, histological assessment, and TGF-β1 signaling pathway were evaluated at 6 and 12 weeks postoperatively. Results: The macroscopic assessment of the repair revealed that the BMS + losartan group was superior to the other groups tested. Microcomputed tomography showed superior healing of the bony defect in the BMS + losartan group in comparison with the other groups. Histologically, fibrosis in the repair tissue of the BMS + losartan group was significantly reduced when compared with the other groups. Results obtained with the modified O'Driscoll International Cartilage Repair Society grading system yielded significantly superior scores in the BMS + losartan group as compared with both the defect group and the BMS group (F value: 15.8, P <.001, P =.012, respectively). TGF-β1 signaling and TGF-β-activated kinase 1 of the BMS + losartan group were significantly suppressed in the synovial tissues. Conclusion: By blocking TGF-β1 with losartan, the repair cartilage tissue after BMS was superior to the other groups and consisted primarily of hyaline cartilage. These results should be easily translated to the clinic because losartan is a Food and Drug Administration–approved drug and it can be combined with the BMS technique for optimal repair of chondral defects. Clinical Relevance: Biologically regulated marrow stimulation by blocking TGF-β1 (oral intake of losartan) provides superior repair via decreasing fibrocartilage formation and resulting in hyaline-like cartilage as compared with outcomes from BMS only. [ABSTRACT FROM AUTHOR]

Background: Tracheostomy management is considered an area of advanced practice for speech–language therapists (SLTs) internationally. Infrequent exposure and limited access to specialist SLTs are barriers to competency development. Aims: To evaluate the benefits of postgraduate tracheostomy education programme for SLTs working with children and adults. Methods & Procedures: A total of 35 SLTs participated in the programme, which included a 1‐day tracheostomy simulation‐based workshop. Before the workshop, SLTs took an online knowledge quiz and then completed a theory package. The workshop consisted of part‐task skill learning and simulated scenarios. Scenarios were video recorded for delayed independent appraisal of participant performance. Manual skills were judged as (1) completed successfully, (2) completed inadequately/needed assistance or (3) lost opportunity. Core non‐medical skills required when managing a crisis situation and overall performance were scored using an adapted Ottawa Global Rating Scale (GRS). Feedback from participants was collected and self‐perceived confidence rated prior, immediately post and 4 months post‐workshop. Outcomes & Results: SLTs successfully performed 94% of manual tasks. Most SLTs (29 of 35) scored > 5 of 7 on all elements of the adapted Ottawa GRS. Workshop feedback was positive with significant increases in confidence ratings post‐workshop and maintained at 4 months. Conclusions & Implications: Postgraduate tracheostomy education, using a flipped‐classroom approach and low‐ and high‐fidelity simulation, is an effective way to increase knowledge, confidence and manual skill performance in SLTs across patient populations. Simulation is a well‐received method of learning. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates whether an acute bout of whole body vibration (WBV): (i) improves measures of central hemodynamics and (ii) can be completed without inducing orthostatic intolerance in frail older adults. Methods: Nine rest home residents participated in a cross-over design incorporating WBV and non-vibrational control conditions (CON) on 2 separate testing days. The order of the two testing conditions was randomized. Participants completed 10 sets of 60 seconds of WBV training or CON with an inter-set rest period of 60 seconds. Results: During training, no interaction or between-condition effects were observed for any variable. Following training, there was an interaction effect reported for augmentation index (AIx) (P < 0.019) and a significant large increase in AIx for WBV (P = 0.020, Eta = 0.202). Three participants exhibited one-off notable decreases in either central systolic or diastolic blood pressure. Conclusion: An acute bout of WBV is a safe training method for frail older adults. [ABSTRACT FROM AUTHOR]

Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18–80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder. [ABSTRACT FROM AUTHOR]

Healthcare support workers face challenging situations in their day‐to‐day work but may have minimal training on how to deal with such incidents. Although staff training is often recommended as an essential part of any comprehensive approach for preventing and managing workplace violence, there is paucity of evidence on the content and effectiveness of such training. This study aimed to evaluate the effect of an intervention (communication skills training) to reduce the experience of aggression for healthcare support workers. A two arm, cluster randomised, single‐blinded, controlled trial among healthcare support workers in nongovernmental organisations (NGOs) and District Health Boards (DHBs) in New Zealand was conducted. The trial was conducted across 14 NGOs and DHB in Otago, Southland, and Auckland regions of New Zealand. One hundred and twenty‐seven participants were randomised to one of two groups. Both the intervention (communication skills) and control condition (mindfulness) were group‐based, fully scripted, and structured training interventions that consisted of four once weekly workshops that were facilitated by one of two nonclinical facilitators. Measurements of perceived aggression, psychological well‐being, and distress and communication competence were taken pre‐, post‐, 3 months' post‐, and 6 months' postintervention. There was a significant drop in the rate of aggression over time with a mean score and standard deviation of 10.37 (9.169) at baseline dropping to 6.07 (6.923) for the Perception of Patient Aggression Scale‐New Zealand across both intervention and control. Equivalent results were noted with increased psychological well‐being and communication competence and decreased distress with both interventions. This was sustained at 6 months' follow‐up. However, the between groups effect did not demonstrate a statistically significant difference between the intervention and control groups. Both mindfulness and communication skills training can reduce the experience of aggression reported by healthcare support workers. [ABSTRACT FROM AUTHOR]

Objective: To evaluate Australian and New Zealand chiropractic students' opinions regarding the identity, role setting, and future of chiropractic practice. Methods: An online, cross-sectional survey was administered to chiropractic students in all chiropractic programs in Australia and New Zealand. The survey explored student viewpoints about the identity, role/scope, setting, and future of chiropractic practice as it relates to chiropractic education and health promotion. Associations between the number of years in the program, highest degree preceding chiropractic education, institution, and opinion summary scores were evaluated by multivariate analysis of variance tests. Results: A total of 347 chiropractic students participated in the study. For identity, most students (51.3%) hold strongly to the traditional chiropractic theory but also agree (94.5%) it is important that chiropractors are educated in evidence-based practice. The main predictor of student viewpoints was a student's chiropractic institution (Pillai's trace = 638, ij/16, 1368] = 16.237, p < .001). Chiropractic institution explained over 50% of the variance around student opinions about role/scope of practice and approximately 25% for identity and future practice. Conclusions: Chiropractic students in Australia and New Zealand seem to hold both traditional and mainstream viewpoints toward chiropractic practice. However, students from different chiropractic institutions have divergent opinions about the identity, role, setting, and future of chiropractic practice, which is most strongly predicted by the institution. Chiropractic education may be a potential determinant of chiropractic professional identity, raising concerns about heterogeneity between chiropractic schools. [ABSTRACT FROM AUTHOR]

Manual therapy (MT) and intermittent pneumatic compression (IPC) are recovery methods used by endurance athletes with little evidence supporting effectiveness. This randomized controlled trial evaluated effectiveness of four daily post-race treatments of a specific MT protocol and IPC compared with supine rest on recovery following an ultramarathon among 56 ultramarathoners. Groups were comparable across all characteristics examined, including post-race plasma creatine kinase concentration. Subject completed timed 400 m runs before the race and on days three, five, seven and 14 post- race, and also provided muscle pain and soreness ratings and fatigue scores immediately before and after treatments, and during the 14 days post- race. Daily subjective measures and 400 m run times were not improved by either treatment, but both treatments reduced (p < .05) muscular fatigue scores acutely after treatment following the race and on post-race day 1, and MT improved (p < .05) muscle pain and soreness acutely following the race. [ABSTRACT FROM AUTHOR]

Background: Classrooms can be noisy and are challenging listening environments for children with auditory processing disorder (APD). This research was undertaken to determine if the Listening Inventory for Education-UK version (LIFE-UK) can differentiate children with listening difficulties and APD from their typically developing peers. Purpose: To investigate reliability and validity of the student and teacher versions LIFE-UK questionnaire for assessing classroom listening difficulties. Research Design: Cross-sectional quantitative study comparing children with listening difficulties with typically developing children. Study Sample: In total, 143 children (7-12 yr) participated; 45 were diagnosed with APD. Fifteen participants with reported listening difficulties who passed the APD test battery were assigned to a ''listening difficulty'' (LiD) group. Eighty three children from nine classrooms formed a Control group. Data Collection and Analysis: Children and teachers completed the LIFE-UK questionnaire student and teacher versions. Factor analysis was undertaken, and item reliability was assessed using Cronbach's alpha. Teacher and student ratings were compared using Spearman correlations. Correlations between LIFE-UK ratings and APD test results were also investigated. Results: Factor analysis revealed three factors accounting for 60% of the variance in the Control group LIFE-UK ratings. After removing six items with low factor loadings, a shortened seven-item version with three factors accounted for 71.8% of the variance for the student questionnaire; Cronbach's alpha indicated good internal reliability for this seven-item version of the student questionnaire. Factors were also derived for the teacher questionnaire. Teacher and student ratings were correlated when participant groups were combined. LIFE-UK ratings correlated weakly with some APD measures, providing some support for the questionnaire validity. Conclusions: The results support the use of either the 13- or 7-item student and the teacher versions of the LIFE-UK to evaluate classroom listening and functional consequences of APD. Factor analysis resulted in groupings of items reflecting differences in listening demands in quiet versus noise for the student questionnaire and attentional versus class participation demands for the teacher questionnaire. Further research is needed to confirm the robustness of these factors in other populations. [ABSTRACT FROM AUTHOR]

This study compared the effects of six warm-up modalities on peak power output (PPO) during the high-pull exercise. Nine resistance-trained males completed six trials using different warm-ups: highpull specific (HPS), cycle, whole body vibration (WBV), cycle+HPS, WBV+HPS and a control. Intramuscular temperature (Tm) was increased by 2°C using WBV or cycling. PPO, Tm and electromyography (EMG) were recorded during each trial. Two high-pulls were performed prior to and 3 min after participants completed the warm-up. The greatest increase in PPO occurred with HPS (232.8 ± 89.7 W, P < 0.001); however, this was not different to combined warm-ups (cycle+HPS 158.6 ± 121.1 W; WBV +HPS 177.3 ± 93.3 W, P = 1.00). These modalities increased PPO to a greater extent than those that did not involve HPS (all P < 0.05). HPS took the shortest time to complete, compared to the other conditions (P < 0.05). EMG did not differ from pre to post warm-up or between modalities in any of the muscles investigated. No change in Tm occurred in warm-ups that did not include cycling or WBV. These results suggest that a movement-specific warm-up improves performance more than temperature- related warm-ups. Therefore, mechanisms other than increased muscle temperature and activation may be important for improving short-term PPO. [ABSTRACT FROM AUTHOR]

Background: Chronic tinnitus (phantom perception of sound) significantly disrupts quality of life in 15-20% of those who experience it. Understanding how certain personality traits impact tinnitus perception and distress can be beneficial for the development of interventions to improve the lives of tinnitus sufferers. Purpose: Four key self-reported personality traits (social closeness, stress reaction, alienation, and self-control) were identified from previous research as being associated with tinnitus. These were compared between tinnitus and age-, gender-, and hearing level-matched nontinnitus controls to see whether underlying profile differences exist, and if personality traits levels correlate with various tinnitus characteristics assessed in typical clinical questionnaires. Research Design: A Web-based personality survey was administered comprising of self-control, stress reaction, alienation, and social closeness subscale questions of the Multidimensional Personality Questionnaire, the Hearing Handicap Inventory-Screening Version, TFI, and the Tinnitus Case History Questionnaire. Study Sample: A total of 154 participants with tinnitus (81 males, 73 females, mean age = 62.6 yr) and 61 control (32 males, 29 females, mean age = 59.62 yr) participants were recruited via e-mail invitations to a tinnitus research clinic database, poster, and social media Web site advertising. Data Collection and Analysis: Statistical analysis was conducted using parametric statistics and IBM SPSS® Version 22 software. Results: Tinnitus sufferers displayed higher levels of stress reaction, lower social closeness, lower self-control, and higher alienation than the control group (p < 0.05). Alienation was related to tinnitus pitch and self-reported hyperacusis measured using the Tinnitus Case History Questionnaire (p < 0.05). Stress reaction correlated with self-reported hyperacusis, whether tinnitus sufferers had sought other treatments, and whether loud sounds make the tinnitus worse (p < 0.05). Conclusions: The four personality traits examined in this study exhibited a consistent association with tinnitus perception and distress, and differentiated tinnitus sufferers from nontinnitus control. Some of the traits also correlated significantly with certain characteristics measured in tinnitus history questionnaires. Personality traits are described in relation to "maladaptive" residuals under the Adaptation Level Theory model of tinnitus. The results of the study suggest that certain personality traits correlate with the clinical presentation of tinnitus. [ABSTRACT FROM AUTHOR]

In this study, we assessed the quality of publicly available cancer-related physical activity ( PA) information appearing on reputable sites from Canada and other English-speaking countries. A cross-sectional Internet search was conducted on select countries (Canada, USA, Australia, New Zealand, UK) using Google to generate top 50 results per country for the keywords ''physical activity' AND 'cancer''. Top results were assessed for quality of PA information based on a coding frame. Additional searches were performed for Canadian-based sites to produce an exhaustive list. Results found that many sites offered cancer-related PA information (94.5%), but rarely defined PA (25.2%). Top 50 results from each country did not differ on any indicator examined. The exhaustive list of Canadian sites found that many sites gave information about PA for survivorship (78.3%) and prevention (70.0%), but rarely defined (6.7%) or referenced PA guidelines (28.3%). Cancer-related PA information is plentiful on the Internet but the quality needs improvement. Sites should do more than mention PA; they should provide definitions, examples and guidelines. With improvements, these websites would enable healthcare providers to effectively educate their patients about PA, and serve as a valuable resource to the general public who may be seeking cancer-related PA information. [ABSTRACT FROM AUTHOR]

Objectives The tendency to generate overgeneral past or future events is characteristic of individuals with a history of depression. Although much research has investigated the contribution of rumination and avoidance to the reduced specificity of past events, comparatively little research has examined (1) whether the specificity of future events is differentially reduced in depression and (2) the role of executive functions in this phenomenon. Our study aimed to redress this imbalance. Methods Participants with either current or past experience of depressive symptoms ('depressive group'; N = 24) and matched controls ('control group'; N = 24) completed tests of avoidance, rumination, and executive functions. A modified Autobiographical Memory Test was administered to assess the specificity of past and future events. Results The depressive group were more ruminative and avoidant than controls, but did not exhibit deficits in executive function. Although overall the depressive group generated significantly fewer specific events than controls, this reduction was driven by a significant group difference in future event specificity. Strategic retrieval processes were correlated with both past and future specificity, and predictive of the future specificity, whereas avoidance and rumination were not. Conclusions Our findings demonstrate that future simulation appears to be particularly vulnerable to disruption in individuals with current or past experience of depressive symptoms, consistent with the notion that future simulation is more cognitively demanding than autobiographical memory retrieval. Moreover, our findings suggest that even subtle changes in executive functions such as strategic processes may impact the ability to imagine specific future events. Practitioner points Future simulation may be particularly vulnerable to executive dysfunction in individuals with current/previous depressive symptoms, with evidence of a differential reduction in the specificity of future events., Strategic retrieval abilities were associated with the degree of future event specificity whereas levels of rumination and avoidance were not., Given that the ability to generate specific simulations of the future is associated with enhanced psychological wellbeing, problem solving and coping behaviours, understanding how to increase the specificity of future simulations in depression is an important direction for future research and clinical practice., Interventions focusing on improving the ability to engage strategic processes may be a fruitful avenue for increasing the ability to imagine specific future events in depression., The autobiographical event tasks have somewhat limited ecological validity as they do not account for the many social and environmental cues present in everyday life; the development of more clinically-relevant tasks may be of benefit to this area of study. [ABSTRACT FROM AUTHOR]

There is a growing body of evidence suggesting that altered brain connectivity may be a defining feature of disorders such as autism spectrum disorder (ASD), anxiety, and ADHD. This study investigated whether resting state functional connectivity, measured by 128-channel EEG oscillation coherence, differs between developmental disorders. Analyses were conducted separately on groups with and without comorbid conditions. Analyses revealed increased coherence across central electrodes over the primary motor cortex and decreased coherence in the frontal lobe networks in those with ASD compared to neurotypical controls. There was increased coherence in occipital lobe networks in the ADHD group compared to other groups. Symptoms of generalised anxiety were positively correlated with both frontal-occipital intrahemispheric (alpha only) coherence and occipital interhemispheric coherence (alpha, approaching theta band). The patterns of coherence in the ASD pure group were different when comorbid conditions were included in the analyses, suggesting that aberrant coherence in the frontal and central areas of the brain is specifically associated with ASD. Our findings support the idea that comorbid conditions are additive, rather than being symptoms of the same disorder. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the relationship between self-efficacy for hearing aids (HAs) and satisfaction with HAs in a group of adult HA owners. Method: Forty-seven adults acquiring HAs (new and experienced owners) completed a demographic questionnaire, the Hearing Handicap Questionnaire (Gatehouse & Noble, 2004), and received an audiometric evaluation prior to HA fitting. Twelve weeks following the completion of the HA fitting, they completed the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (Smith & West, 2006) and the Satisfaction with Amplification in Daily Life (Cox & Alexander, 1999) questionnaires. Results: There were no significant differences between experienced and new HA owners in terms of self-efficacy or HA satisfaction. The majority of participants had adequate self-efficacy for basic HA handling and adjustment to HAs. Fewer participants had adequate self-efficacy for aided listening and advanced handling of HAs. HA selfefficacy was related to HA satisfaction in three domains: positive effect and negative features of HAs and service and cost. Conclusion: Many HA owners do not have adequate self-efficacy in important HA-related domains. Clinical intervention to improve self-efficacy for HAs may help improve HA satisfaction. [ABSTRACT FROM AUTHOR]

Objective: The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury. Method: Adults (>15 years) with mild TBI (n = 260) completed neuropsychological (CNS-Vital Signs, Behavioural Dyscontrol Scale), mood (Hospital Anxiety Depression Scale) and behavioural assessments (Cognitive Failures Questionnaire, Rivermead Post-Concussion Questionnaire) at baseline, 1-, 6- and 12-months post-injury. Results: Over the 12-months post-injury self-reported cognition (p = 0.027), post-concussion symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001) and dyscontrol (p = 0.025) improved significantly. Assessments of memory, processing speed, executive function, psychomotor speed/reaction time, complex attention and flexibility also improved significantly. At baseline >20% of individuals produced very low scores on executive ability, complex attention and cognitive flexibility. At 1- and 6-month follow-ups >20% of participants were very low for complex attention, with 16.3% remaining so at 12-months. Executive abilities and speed were related to post-concussion symptoms, mood and self-reported cognition at 12-months. Conclusions: Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods. [ABSTRACT FROM PUBLISHER]

Structured abstract: Introduction: This article explores the rate and degree of loneliness in community-dwelling older visually impaired people, and is the first study to investigate the unique contribution that social and emotional loneliness makes to perceived quality of life (PQOL) in this population. Methods: The study constituted a secondary analysis of postal survey data from the second wave (2012) of the nationally representative New Zealand Longitudinal Study of Ageing, a longitudinal study of older New Zealanders. A total of 2,683 participants completed both the visual status screening question and all 11 loneliness items to meet the criteria for inclusion in this study. Results: Those designated as being visually impaired (n = 315) were found to be more likely to experience loneliness (53% vs. 36%) than their sighted peers (n = 2,368). Increased loneliness among those who are visually impaired was found to be associated with decreased economic well-being, mental health, satisfaction with activities of daily living, satisfaction with life, and PQOL. Social loneliness, but not emotional loneliness, was found to make a unique contribution to the prediction of variance in the PQOL of older visually impaired people over and above the impact of other predictors. Discussion: Loneliness is much more prevalent in, and occurs with greater severity among, people who are visually impaired than with those who are not. Social loneliness made a unique contribution to PQOL over and above the contribution of variables that previous research has shown are central to PQOL in this population. Implications for practitioners: Loneliness is not often addressed in vision rehabilitation programs designed for older adults, yet it is apparent from these findings that rates of loneliness may be high in this population. Its effect, even at moderate levels, is detrimental to the PQOL of older people with visual impairments. [ABSTRACT FROM AUTHOR]

Objectives: To measure the postprandial plasma amino acid appearance in younger and older adults following a high protein mixed meal. Design: Cross-sectional study. Setting: Clinical research setting. Participants: Healthy men and women aged 60-75 (n=15) years, and young controls aged 20-25 years (n=15) matched for body mass index and insulin sensitivity based on the homeostatic model assessment of insulin resistance. Intervention: High protein mixed meal of complete food products. Measurements: Circulating amino acid concentrations were determined hourly before and for 5 hours after meal ingestion. Results: There was no difference between cohorts in postprandial appearance of non-essential amino acids, or area under the curve of any individual amino acid or amino acid class. However, older adults had higher baseline concentrations of aspartic acid, glutamic acid, glycine, ornithine, threonine and tyrosine and lower baseline concentrations of hydroxyproline, isoleucine, leucine, methionine and valine compared to younger adults. Younger adults showed peak essential (EAA) and branched-chain amino acid (BCAA) concentrations at 1 hour post meal while older adults' peak EAA and BCAA concentration was at 3 hours. Similarly, peak total amino acid concentrations were at 3 hours in older adults. Conclusion: Older adults digested and absorbed the protein within a mixed meal more slowly than younger adults. Delayed absorption of AA following a mixed meal of complete food products may suppress or delay protein synthesis in senescent muscle. [ABSTRACT FROM AUTHOR]

Background: Obesity is prevalent in health care workers, but it is unknown whether a lack of nutritional knowledge contributes to this. This study measured the nutrition knowledge of undergraduate nursing students to identify knowledge gaps that could be addressed through nutrition teaching in an updated undergraduate nursing curriculum. Method: Undergraduate nursing students (N = 197) completed a nutrition knowledge survey with questions on demographics, body composition, nutrition labels, food packaging claims, and healthy food-purchasing choices. Results: Mean overall nutritional knowledge scores were low, but overall scores were higher for students who had received nutrition teaching (60.5% versus 52.5%; F[1,187] = 7.2, p < 0.001). Improvements in nutrition knowledge were consistent across all ethnic groups, and no effects of age were observed. Conclusion: To sufficiently prepare nurses for their public health role in obesity prevention, more nutrition education is needed in undergraduate nursing education programs, with emphasis on ethnic-specific educational requirements. [ABSTRACT FROM AUTHOR]

Objectives:Behavioral and psychological symptoms of dementia (BPSD) cause significant stress and distress to both aged-care residents and staff. This study evaluated a training program to assist staff to manage BPSD in residential care. Method:A randomised controlled trial (RCT) was employed. The study was included in the Australian and New Zealand Clinical Trial Register residential care facilities. Staff (n= 204) and residents (n= 187) were from 16 residential care facilities. Facilities were recruited and randomly assigned to four staff training conditions: (1) training in the use of a BPSD-structured clinical protocol, plus external clinical support, (2) a workshop on BPSD, plus external clinical support, (3) training in the use of the structured clinical protocol alone, and (4) care as usual. Staff and resident outcome measures were obtained pre-intervention, three months and six months post-intervention. The primary outcome was changes in BPSD, measured using the Cohen-Mansfield Agitation Inventory (CMAI) as well as frequency and duration of challenging behaviors. Secondary outcomes were changes in staff adjustment. Results:There were improvements in challenging behaviors for both intervention conditions that included training in the BPSD instrument, but these were not maintained in the condition without clinical support. The training/support condition resulted in sustained improvements in both staff and resident variables, whereas the other conditions only led to improvement in some of the measured variables. Conclusion:These results demonstrate the effectiveness of the BPSD protocol in reducing BPSD and improving staff self-efficacy and stress. [ABSTRACT FROM AUTHOR]

Peloruside A is a microtubule-stabilizing agent that is currently under investigation as a potential anticancer agent. Peloruside A binds to a site on β-tubulin that is distinct to that of the taxanes (paclitaxel and docetaxel) and the epothilones. An attractive clinical quality of microtubule-stabilizing agents is their ability to target multiple mechanisms of tumour growth. In addition to inducing tumour cell apoptosis by arresting cells in mitosis, microtubule-stabilizing agents also inhibit angiogenesis, a process needed by tumor cells for growth and metastasis. In this study, the effects of peloruside A on endothelial cell processes important for angiogenesis were assessed in comparison to docetaxel. Both peloruside A and docetaxel potently inhibited the proliferation of human umbilical vein endothelial cells, with IC values of 1.4 and 1.7 nM, respectively. Peloruside also potently blocked endothelial cell migration during wound closure and the three-dimensional organization of the endothelial cells into capillary-like tubes. In the wound scratch assay, peloruside A inhibited wound recovery with an IC of 6.3 nM after 18 h. Docetaxel was approximately 3-fold more potent than peloruside A. The number of capillary-like tubes that formed after 16 h culture in Matrigel™ was also inhibited in a dose-dependent manner with an IC of 4.5 nM. Docetaxel was about 2-fold more potent than peloruside A in preventing tube formation. This inhibition of endothelial cell function occurred at relatively non-cytotoxic concentrations over the 16-18 h incubations for both stabilizing agents, suggesting that anti-angiogenic effects are likely to occur before therapeutically relevant doses begin to inhibit tumor growth or adverse side effects develop. [ABSTRACT FROM AUTHOR]

Purpose: The cultures and service needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) minority groups are relevant to speech-language pathologists (SLPs). In particular, transgender individuals seeking communication services from SLPs in order to improve quality of life require culturally and clinically competent clinicians. Knowledge and attitudes regarding a population are foundational stages toward cultural competency (Turner, Wilson, & Shirah, 2006). The purpose of this research is to assess LGBTQ knowledge and attitudes among aspiring and practicing SLPs. Method: An online survey was completed by 279 SLPs from 4 countries. Results: Mean accuracy scores on LGBTQ culture questions were near 50%. Self-ratings indicated more comfort than knowledge, with generally positive feelings toward LGBTQ subgroups. Transgender communication is within SLPs' scope of practice, yet 47% indicated such services were not addressed in their master's curriculum, and 51% did not know how to describe transgender communication therapy. When respondents were asked to indicate priority of 10 LGBTQ topics for a continuing education seminar, communication masculinization/ feminization best practice and case examples had the highest mean priority scores. Conclusion: There is a need to promote LGBTQ cultural competence within speech-language pathology. This study provides direction for improving LGBTQ cultural competence among SLPs. [ABSTRACT FROM AUTHOR]

Background High on-treatment platelet reactivity has been associated with poor outcomes following acute coronary syndromes ( ACS). Both the loss of function CYP 2 C 19*2 allele and the gain of function CYP 2 C 19*17 allele along with a range of clinical characteristics have been associated with variation in the response to clopidogrel. Aim The study aims to examine the frequency of CYP2 C19 variants and understand the factors associated with on-treatment platelet reactivity in a New Zealand ACS population. Methods We prospectively enrolled 312 ACS patients. We collected clinical characteristics and measured on-treatment platelet reactivity using two validated point-of-care assays, VerifyNow and Multiplate. DNA was extracted and CYP 2 C 19*2 and *17 alleles were identified using real-time polymerase chain reaction. Results CYP 2 C 19*2 or CYP 2 C 19*17 alleles were observed in 101 (32%) and 106 (34%) of patients, respectively, with significant differences in distribution by ethnicity. In Maori and Pacific Island patients, 47% (confidence interval ( CI) 31-63%) had CYP 2 C 19*2 and 11% ( CI 4-19%) CYP 2 C 19*17 compared with 26% ( CI 19-32%) and 41% ( CI 32-49%) in white people. Carriage of CYP 2 C 19*2 alleles was associated with higher levels of platelet reactivity measured by either assay, but we observed no relationship between platelet reactivity and CYP 2 C 19*17. In multivariate analysis diabetes, clopidogrel dose and CYP 2 C 19*2 status were all significant independent predictors of platelet reactivity. Conclusions Both CYP 2 C 19*2 and *17 were common in a New Zealand ACS population, with CYP 2 C 19*2 observed in almost half the Maori and Pacific Island patients. CYP 2 C 19*2, diabetes and clopidogrel dose were independent contributors to on-treatment platelet reactivity. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the muscle activity and onset time of hip extensors during a closed kinetic chain exercise (deadlift) at sub-maximal loads of 30%, 40%, 50%, and 75% of one repetition maximum (1RM). Twelve healthy males with at least three years of resistance training experience volunteered for the study. Biceps femoris (BF) and gluteus maximus (GM) muscle activity, onset time, peak and mean power were measured during the concentric phase of the deadlift. There was no main effect (p > 0.05) or no interaction effect for the onset time in BF and GM and for each load BF and GM had similar muscle activity. Increasing the external load during deadlift had no adverse effect on the relative onset time and it did not promote BF onset to occur before GM onset, thus both muscles were simultaneously activated, which should not compromise a delay in GM. [ABSTRACT FROM AUTHOR]

Objectives: Outcomes after mild traumatic brain injury (MTBI) vary, with slow or incomplete recovery for a significant minority. This study examines whether groups of cases with shared psychological factors but with different injury outcomes could be identified using cluster analysis. Method: This is a prospective observational study following 147 adults presenting to a hospital-based emergency department or concussion services in Christchurch, New Zealand. This study examined associations between baseline demographic, clinical, psychological variables (distress, injury beliefs and symptom burden) and outcome 6 months later. A two-step approach to cluster analysis was applied (Ward's method to identify clusters, K-means to refine results). Results: Three meaningful clusters emerged (high-adapters, medium-adapters, low-adapters). Baseline cluster-group membership was significantly associated with outcomes over time. High-adapters appeared recovered by 6-weeks and medium-adapters revealed improvements by 6-months. The low-adapters continued to endorse many symptoms, negative recovery expectations and distress, being significantly at risk for poor outcome more than 6-months after injury (OR (good outcome) = 0.12; CI = 0.03-0.53; p < 0.01). Conclusions: Cluster analysis supported the notion that groups could be identified early post-injury based on psychological factors, with group membership associated with differing outcomes over time. Implications for clinical care providers regarding therapy targets and cases that may benefit from different intensities of intervention are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to quantify the inter-session reliability of force–velocity–power profiling and estimated maximal strength in youth. Thirty-six males (11–15 years old) performed a ballistic supine leg press test at five randomized loads (80%, 100%, 120%, 140%, and 160% body mass) on three separate occasions. Peak and mean force, power, velocity, and peak displacement were collected with a linear position transducer attached to the weight stack. Mean values at each load were used to calculate different regression lines and estimate maximal strength, force, velocity, and power. All variables were found reliable (change in the mean [CIM] = − 1 to 14%; coefficient of variation [CV] = 3–18%; intraclass correlation coefficient [ICC] = 0.74–0.99), but were likely to benefit from a familiarization, apart from the unreliable maximal force/velocity ratio (CIM = 0–3%; CV = 23–25%; ICC = 0.35–0.54) and load at maximal power (CIM = − 1 to 2%; CV = 10–13%; ICC = 0.26–0.61). Isoinertial force–velocity–power profiling and maximal strength in youth can be assessed after a familiarization session. Such profiling may provide valuable insight into neuromuscular capabilities during growth and maturation and may be used to monitor specific training adaptations. [ABSTRACT FROM PUBLISHER]

Aims To examine the effects of two factors on the transmission of clinical information at nursing handover. These factors were: (i) an affective statement expressing concern about the information; and (ii) verbal reference to a written summary of the information. Background Quality of communication at patient handover is inconsistent, compromising patient safety. Little is known about the nuances of communication that lead to effective handovers. Furthermore, effective information transmission during handovers is seldom evaluated using experimental research designs. Design A randomized, single-blind, controlled experiment. Methods Postanaesthesia care unit or surgical ward nurses and final-year nursing students were randomly assigned to watch one of four versions of a video-recorded handover. In each version, one piece of information was presented as either a simple statement (control), with an affective qualifier, with a written summary of the information, or with both an affective qualifier and a written summary. Primary outcome was assessed by questionnaire following a task directing attention away from the handover. Data were collected July-October, 2013 and analysed using 2 × 2 anova. Results A total of 157 nurses participated. Successful transmission of the clinical information did not significantly differ across the experimental conditions. Subgroup analysis revealed significantly higher transmission success among more experienced nurses when the affective statement was present compared to when it was absent (Kruskal-Wallis P = 0·002). Conclusions Expressing concern about information or directing attention to written notes may not improve information transfer at handover. However, affective qualifiers may have differential receiver-specific influences on information retention. [ABSTRACT FROM AUTHOR]

Interventions that identify and develop character strengths have been shown to benefit well-being, academic engagement and achievement. Strengths research within positive psychology has focused primarily on individual outcomes with less attention on group or relationships effects. This study (N = 193) examined the effect of a classroom-based strengths intervention on class cohesion and friction, relatedness, engagement, well-being and strengths use. A six-session programme was trialled with 9–12-year-old students. Students learned to recognise strengths and practised strengths-related goal setting. At three-months post-test, multi-level modelling indicated that intervention group participants scored significantly higher on class cohesion and relatedness need satisfaction, and lower on class friction than the non-randomised control group. Programme participants also reported higher levels of positive affect, classroom engagement, autonomy need satisfaction and strengths use. School-based strengths interventions may influence individual perceptions of class climate, engagement and student relatedness in addition to individual well-being. [ABSTRACT FROM PUBLISHER]

We sought to determine the incidence of ‘true’ VO2 max confirmation with the verification procedure across different protocols. 12 active participants (men n = 6, women n = 6) performed in random order 4 different maximal graded exercises tests (GXT) and verification bout protocols on 4 separate days. Conditions for the rest period and verification bout intensity were: A – 105 % intensity, 20 min rest; B – 105 % intensity, 60 min rest; C – 115 % intensity, 20 min rest; D – 115 % intensity, 60 min rest. VO2 max confirmation (difference between peak VO2 GXT and verification trial < ± 3 %) using the verification trial was 12/12 (100 %), 12/12 (100 %), 8/12 (66.70 %), and 7/12 (58.33 %) for protocols A, B, C, and D. There was a significant (p < 0.05) effect of verification intensity on VO2 max confirmation across all exercise test conditions (intensity effect within recovery 20 min (x2 (1) = 4.800, p < 0.05), intensity effect within recovery 60 min (x2 (1) = 6.316, p < 0.05)). No significant effect was found for incidence of VO2 max confirmation with different rest periods. We recommend the use of 105 % of the maximal GXT workload and 20 min rest periods when using verification trials to confirm VO2 max in normally active populations. [ABSTRACT FROM AUTHOR]

Objectives. The aims of this study were to establish whether, in patients with gout, MPO is released from neutrophils and urate is oxidized to allantoin and if these effects are attenuated by allopurinol.Methods. MPO, urate, allantoin and oxypurinol were measured in plasma from 54 patients with gout and 27 healthy controls. Twenty-three patients had acute gout, 13 of whom were receiving allopurinol, and 31 had intercritical gout, 20 of whom were receiving allopurinol. Ten additional gout patients had samples collected before and after 4 weeks of allopurinol.Results. Plasma MPO and its specific activity were higher (P < 0.05) in patients with acute gout not receiving allopurinol compared with controls. MPO protein in patients’ plasma was related to urate concentration (r = 0.5, P < 0.001). Plasma allantoin was higher (P < 0.001) in all patient groups compared with controls. In controls and patients not receiving allopurinol, allantoin was associated with plasma urate (r = 0.62, P < 0.001) and MPO activity (r = 0.45, P < 0.002). When 10 patients were treated with allopurinol, it lowered their plasma urate and allantoin (P = 0.002). In all patients receiving allopurinol, plasma allantoin was related to oxypurinol (r = 0.65, P < 0.0001). Oxypurinol was a substrate for purified MPO that enhanced the oxidation of urate.Conclusion. Increased concentrations of urate in gout lead to the release of MPO from neutrophils and the oxidation of urate. Products of MPO and reactive metabolites of urate may contribute to the pathology of gout and hyperuricaemia. At low concentrations, oxypurinol should reduce inflammation, but high concentrations may contribute to oxidative stress. [ABSTRACT FROM PUBLISHER]

Objective. Gout is strongly associated with obesity. The aim of this study was to determine if obesity altered the inflammatory phenotype of non-adipose tissue-resident macrophages in response to the gout-causing agent monosodium urate (MSU) crystals.Methods. C57BL/6J mice were fed a high-fat diet for 12 weeks. Resident peritoneal macrophages were stimulated ex vivo with MSU crystals (200 µg/ml for 18 h) and the supernatants were collected. Mice were challenged with MSU crystals in vivo (3 mg, intraperitonal) and the peritoneal lavage fluid was collected (8 and 16 h). Cytokine and chemokine levels were analysed by multiplex bead array and peritoneal cell populations were analysed by flow cytometry.Results. Peritoneal macrophages from obese mice produced elevated background levels of IL-6, monocyte chemoattractant protein 1 (MCP-1) and keratinocyte-derived cytokine (KC) that decreased following MSU crystal stimulation ex vivo. MSU-induced IL-1β production was higher for macrophages from obese mice compared with controls. High background levels of IL-6, MCP-1, KC and GM-CSF, but not IL-1β, were measured in the peritoneal fluid of unchallenged obese mice. MSU crystal challenge in vivo raised IL-1β levels equally in both control and obese mice, whereas elevated background levels of IL-6, MCP-1, KC and GM-CSF levels dropped in obese mice. There was a consistent trend towards lower numbers of naive peritoneal resident macrophages and MSU-recruited monocytes and neutrophils in obese mice.Conclusion. Obesity induces a background pro-inflammatory environment orchestrated by non-adipose tissue-resident macrophages. However, this may not automatically translate into exacerbation of MSU crystal-induced inflammation in gout. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to compare the effectiveness of either continuous moderate intensity exercise training (CMIET) alone vs. CMIET combined with a single weekly bout of high intensity interval training (HIIT) on cardiorespiratory fitness. Twenty nine sedentary participants (36.3 ± 6.9 yrs) at moderate risk of cardiovascular disease were recruited for 12 weeks of exercise training on a treadmill and cycle ergometer. Participants were randomised into three groups: CMIET + HIIT (n = 7; 8-12 x 60 sec at 100% VO2max, 150 sec active recovery), CMIET (n = 6; 30 min at 45-60% oxygen consumption reserve (VO2R)) and a sedentary control group (n = 7). Participants in the CMIET + HIIT group performed a single weekly bout of HIIT and four weekly sessions of CMIET, whilst the CMIET group performed five weekly CMIET sessions. Probabilistic magnitude-based inferences were determined to assess the likelihood that the true value of the effect represents substantial change. Relative VO2max increased by 10.1% (benefit possible relative to control) in in the CMIET + HIIT group (32.7 ± 9.2 to 36.0 ± 11.5 mL•kg- 1•min-1) and 3.9% (benefit possible relative to control) in the CMIET group (33.2 ± 4.0 to 34.5 ± 6.1 mL•kg-1•min-1), whilst there was a 5.7% decrease in the control group (30.0 ± 4.6 to 28.3 ± 6.5 mL•kg-1•min-1). It was ‘unclear’ if a clinically significant difference existed between the effect of CMIET + HIIT and CMIET on the change in VO2max. Both exercising groups showed clinically meaningful improvements in VO2max. Nevertheless, it remains ‘unclear’ whether one type of exercise training regimen elicits a superior improvement in cardiorespiratory fitness relative to its counterpart. [ABSTRACT FROM AUTHOR]

Purpose: To determine how increased vocal loudness and reduced speech rate affect listeners’ cognitive–perceptual processing of hypokinetic dysarthric speech associated with Parkinson’s disease. Method: Fifty-one healthy listener participants completed a speech perception experiment. Listeners repeated phrases produced by 5 individuals with dysarthria across habitual, loud, and slow speaking modes. Listeners were allocated to habitual (n = 17), loud (n = 17), or slow (n = 17) experimental conditions. Transcripts derived from the phrase repetition task were coded for overall accuracy (i.e., intelligibility), and perceptual error analyses examined how these conditions affected listeners’ phonemic mapping (i.e., syllable resemblance) and lexical segmentation (i.e., lexical boundary error analysis). Results: Both speech conditions provided obvious perceptual benefits to listeners. Overall, transcript accuracy was highest in the slow condition. In the loud condition, however, improvement was evidenced across the experiment. An error analysis suggested that listeners in the loud condition prioritized acoustic–phonetic cues in their attempts to resolve the degraded signal, whereas those in the slow condition appeared to preferentially weight lexical stress cues. Conclusions: Increased loudness and reduced rate exhibited differential effects on listeners’ perceptual processing of dysarthric speech. The current study highlights the insights that may be gained from a cognitive–perceptual approach. [ABSTRACT FROM AUTHOR]

The article presents research which examined the use of electroconvulsive therapy in Otago, New Zealand. Topics covered include the global variations in the adoption of the treatment approach, and the participation of 199 patients with affective disorders in the study. Also mentioned is the prevalence of the method in other countries including the U.S. and Australia.