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Background/Aims We aimed to assess differences in patient management, and outcomes, of Australian and New Zealand patients admitted with a suspected or confirmed acute coronary syndrome ( ACS). Methods We used comprehensive data from the binational Australia and New Zealand ACS ' SNAPSHOT' audit, acquired on individual patients admitted between 00.00 h on 14 May 2012 to 24.00 h on 27 May 2012. Results There were 4387 patient admissions, 3381 (77%) in Australia and 1006 (23%) in New Zealand; Australian patients were slightly younger (67 vs 69 years, P = 0.0044). Of the 2356 patients with confirmed ACS, Australian patients were at a lower cardiovascular risk with a lower median Global Registry Acute Coronary Events score (147 vs 154 P = 0.0008), but as likely to receive an invasive coronary angiogram (58% vs 54%, P = 0.082), or revascularisation with percutaneous coronary intervention (32% vs 31%, P = 0.92) or coronary artery bypass graft surgery (7.0% vs 5.6%, P = 0.32). Of the 1937 non-segment elevation myocardial infarction/unstable angina pectoris ( NSTEMI/ UAP) patients, Australian patients had a shorter time to angiography (46 h vs 67 h, P < 0.0001). However, at discharge, Australian NSTEMI/ UAP survivors were less likely to receive aspirin (84% vs 89%, P = 0.0079, a second anti-platelet agent (57% vs 63%, P = 0.050) or a beta blocker (67% vs 77%, P = 0.0002). In-hospital death rates were not different (2.7% vs 3.2%, P = 0.55) between Australia and New Zealand. Conclusions Overall more similarities were seen, than differences, in the management of suspected or confirmed ACS patients between Australia and New Zealand. However, in several management areas, both countries could improve the service delivery to this high-risk patient group. [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]

Compared with the wealth of research accumulated on face-to-face social interactions, relatively little research has examined race talk within anonymous Web 2.0 mediums. We investigated online threaded comments on YouTube video clips of two race-related incidents involving New Zealand television presenter Paul Henry. Through thematic content analysis, thematic analysis, and discourse analysis, it was found that characteristics unique to Web 2.0 were associated with the appearance of old-fashioned racism and high-levels of obscenity (together with modern racism/symbolic racism). The hyper-low context of communication led to interpretive ambiguity; conversation sequences failed to follow Gricean maxims for cooperative communication, with most comments attracting no replies and the modal sequence being two turns. There was almost never resolution to a disagreement online: rather there was points-scoring against opposing opinions and a tangential style of dialogue influenced by the asynchronous and anonymous nature of communication. The YouTube medium shaped but did not determine the message, as obscenity and racist content in the target video from the eliciting public figure influenced the subsequent degree of obscenity and hostility in the responses. A third corpus that examined responses to our own research on race talk presented on a news website (stuff.co.nz) underlined this point by engendering a dramatically different response to the same subject, retaining the tangential style of communication, but with little to no obscenity. A framework to understand race talk as a function of both medium and context effects is proposed. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. Methods: We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. Results: The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. Conclusions: In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses. [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]

Objective: Personality has been associated with a variety of outcomes in adulthood. Most of the literature related to mental state disorder and personality is cross sectional. Methods: Data from more than 900 participants of the Christchurch Health and Development Study (CHDS) were examined. Extroversion and neuroticism were measured at 14 years old and social outcomes at age 30. The presence of mental state disorder between 18-30 years old was identified. Multiple potential confounders in childhood were included in the analysis. Results: Neuroticism at fourteen was significantly correlated with multiple environmental exposures whereas extroversion had relatively few associations. Regression analysis found that neuroticism at 14 predicted depression, anxiety, suicidality and overall mental health problems at 30 as well as poor self-esteem but not relationship quality or wellbeing. Extroversion at 14 predicted alcohol and drug dependence and overall mental health problems, but also predicted improved social wellbeing, self-esteem and relationship quality at 30. Conclusions: In this analysis extroversion interacts with significantly fewer environmental factors than neuroticism in predicting adult outcomes. Neuroticism at 14 years predicts poorer mental health outcomes in adulthood. Extroversion in childhood may be a protective factor in the development of mental disorder other than alcohol use disorders. Extroverted adolescents have more positive social outcomes at 30 years. [ABSTRACT FROM AUTHOR]

Objectives: The determinants of health and mortality inequalities in New Zealand and Australia have been subjected to research, with the influence of a range of socio-economic and demographic influences (deprivation, social class, ethnicity) receiving notable attention. Both countries are considered privileged, positioned amongst the world leaders in rankings of mortality and life expectancy. This paper reports on observed rates of mortality and views how the countries have fared over time with respect to one another. Study design, observational, methods: This study derives comparable rates of mortality for both New Zealand and Australia, disaggregated by age and sex for the time period 1948-2008. The age-standardised rates are visualised using the Lexis mapping software program, showing the relative differences between the countries over time whilst simultaneously highlighting age, period and cohort effects. Results: Relative to Australia, New Zealand had advantageous rates of mortality across almost all age groups between the years 1948 and 1980 (approximately). For both sexes, a dramatic reversal of fortunes in New Zealand has followed relative to Australia. For example, for younger males in New Zealand, the reversal is startling. Over the time period observed, males aged 10-20 years in New Zealand have moved from an advantageous position of having a mortality rate 20% lower than Australia to a relative position of 50% higher. Conclusions: The social and economic forces in both New Zealand and Australia which may have driven the divergence require further scrutiny. It is argued here, that the changing fortunes of the populations are linked to the process of selective migration and the largescale population movements between the countries facilitated by the Trans-Tasman Travel Arrangement. These findings have important implications for policy formation and service planning, if the inequality in mortality between the areas of study is to be addressed. [ABSTRACT FROM AUTHOR]

Introduction Palliative care delivery has become integral to the role of healthcare staff in residential aged care (RAC) internationally. Challenges within this work environment (e.g. workload, staffing levels, resources) may impact on healthcare staffs' willingness to undertake formal palliative care education. The study described herein explored factors (socioenvironmental and psychological) that influence staff willingness to engage in palliative care education. Methods The predictors of palliative care education uptake for healthcare staff (n = 431) from 52 New Zealand RAC facilities in one large urban District Health Board were assessed. Logistic regression was used to explore willingness to engage in education. Results Higher scores for burnout predicted a decreased likelihood of engaging in palliative care education (odds ratio (OR) 0.41, P = 0.01). The identified predictor of willingness to engage in education was previous palliative care experience (OR 1.59, P = 0.027). Discussion These results can inform the design and delivery of future palliative care education programmes within RAC. [ABSTRACT FROM AUTHOR]

Heterogeneity in the expression of schizotypy may arise from underlying dimensional processes or a taxonic population structure. In a 2-phase study, we tested the taxonicity of self-reported schizotypy within a general psychiatric sample (n = 109) and examined taxon validity by testing its association with clinical schizotaxia in follow-up subsamples. Taxometric analyses indicated a taxonic structure (schizotypy prevalence = 38.8%) provided the best description of the underlying population distribution. After a year, schizotypal (n = 14) and nonschizotypal (n = 14) subsamples returned for diagnosis of clinical schizotaxia by assessment of executive functioning, attention, memory, and negative symptoms. Seven patients met diagnostic criteria, all members of the schizotypy class. Schizotypy was associated with impaired attention and memory, more negative symptoms, poorer global functioning, and more extensive psychiatric histories. We reconcile inconsistencies in the literature by discussing threats to the validity of this and similar research on Meehl's taxonomic model of schizotypy, including conceptual limitations of the lexical hypothesis and conventions of factor analysis. Scrutiny of Meehl's model should involve disambiguation and better measurement of the schizotaxia-schizotypy phenotype. [ABSTRACT FROM AUTHOR]

Objectives: Physician-assisted dying (PAD) is legal in several countries in Europe and some states of the United States. Despite regular societal debate in New Zealand about assisted dying, little is known about what the New Zealand public think about this issue. The present study was the first to examine New Zealanders' attitudes toward assisted dying in the context of various parameters of patient suffering, and as a public policy issue. Methods: Stratified random sampling techniques were used to elicit 677 participants from the electoral roll. They completed an anonymous questionnaire asking about the most appropriate medical response to patients who explicitly request assistance in dying, as well as their opinions around legalization of PAD. Results: Overall, 78% felt PAD was the most appropriate response in certain situations while 82% felt it should be legalized. When the patient was suffering from loss of dignity, PAD was considered the most appropriate response to patients' requests for assistance in dying by 75% of respondents; when the patient was suffering from intractable pain, 65% of respondents considered PAD the most appropriate response. Almost 65% of those who wanted PAD to be legalized felt it should only be accessible to those suffering unbearably with little hope of recovery, and 46% felt that the presence of mental illness should be an exclusionary factor. Conclusions: The results have highlighted the high value respondents place on patient autonomy with regards to end-of-life choices; however the choice to hasten death is not a 'right' that should be available to all. Results have clearly shown that New Zealanders believe regulation will play a key role in maintaining compliance with any assisted dying legislation, and in restricting access, so that only patients who are suffering intolerably and hopelessly are able to legally gain medical assistance to end their life. [ABSTRACT FROM AUTHOR]

Background: Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (rotational acceleration or strain) have been postulated as the 2 major mechanisms of head-related injuries such as concussion. Although data are accumulating for soccer and American football, there are no published data for nonhelmeted collision sports such as rugby union. Purpose: To quantify head impacts via instrumented mouthguard acceleration analyses for rugby union players over a season of matches. Study Design: Descriptive epidemiology study. Methods: Data on impact magnitude and frequency were collected with molded instrumented mouthguards worn by 38 premier amateur senior rugby players participating in the 2013 domestic season of matches. Results: A total of 20,687 impacts >10g (range, 10.0-164.9g) were recorded over the duration of the study. The mean ± SD number of impacts per player over the duration of the season of matches was 564 ± 618, resulting in a mean ± SD of 95 ± 133 impacts to the head per player, per match over the duration of the season of matches. The impact magnitudes for linear accelerations were skewed to the lower values (Sp = 3.7 ± 0.02; P<.001), with a mean linear acceleration of 22.2 ± 16.2g. Rotational accelerations were also skewed to the lower values (Sp = 2.0 ± 0.02; P < .001), with a mean rotational acceleration of 3902.9 ± 3948.8 rad/s2. Conclusion: The acceleration magnitudes and number of head impacts in amateur rugby union players over a season of matches, measured via instrumented mouthguard accelerations, were higher than for most sports previously reported. Mean linear acceleration measured over a season of matches was similar to the mean linear accelerations previously reported for youth, high school, and collegiate American football players but lower than that for female youth soccer players. Mean rotational acceleration measured over a season of matches was similar to mean rotational accelerations for youth, high school, and collegiate American football players but less than those for female youth soccer players, concussed American collegiate players, collegiate American football players, and professional American football players. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners perform a diagnostic role previously delivered by doctors. Multiple studies demonstrate nurse practitioners are as effective as doctors when managing chronic conditions and minor illnesses and injuries. No studies have focused on how nurse practitioners compare to doctors in their management of complex cases presenting for the first time. Objective: This study assessed how nurse practitioners’ diagnostic reasoning abilities when managing a complex case compared to those of doctors’? Design: A comparative research design. Participants: Purposeful sampling recruited 30 nurse practitioners and 16 doctors working in multiple specialties in New Zealand. All doctors were completing postgraduate specialist training programmes. Specialties included older adults, emergency care, primary health care/general practice, cardiology, respiratory and palliative care. Methods: A complex case scenario assessed by an expert panel and think aloud protocol was used to assess diagnostic reasoning abilities. The ability of 30 nurse practitioners to determine diagnoses, identify the problem, and propose actions was compared to that of 16 doctors. Correct responses were determined by an expert panel. Data gained from the case scenario using think aloud protocol were quantified for analysis. Results: 61.9% of doctors identified the correct diagnoses, 56.3% the problem and 34.4% the actions as determined by the expert panel. This compares to 54.7% of nurse practitioners identifying the correct diagnoses, 53.3% the problem and 35.8% the actions. Analysis revealed no difference between these groups (diagnoses 95% CI: 1.76 to 0.32, p = 0.17, problem χ2 = 0.00, p = 1.0, or actions 95% CI: 1.23 to 1.58, p = 0.80). Conclusion: Nurse practitioners’ diagnostic reasoning abilities compared favourably to those of doctors in terms of diagnoses made, problems identified and action plans proposed from a complex case scenario. In times of global economic restraints this adds further support to alternative models of care. [ABSTRACT FROM AUTHOR]

Postnatal psychological well-being is a complex issue characterized by major changes in physical, social, and emotional health. In response to addressing limitations of previous research this study aimed to: (i) quantify psychological distress, depression, anxiety, and stress in a large sample of Australian and New Zealand mothers and to compare to Australian norm data; and (ii) identify any significant differences in psychological distress, depression, anxiety, and stress of the mothers when grouped according to their self-reported exercise incidence. Self-reported short-form version Depression Anxiety Stress Scale data were collected from 3601 Australia and New Zealand mothers with at least one child under the age of 5 years. Results demonstrated that this sample of mothers had significantly poorer psychological well-being than the general Australian population. Furthermore, with the exception of anxiety, psychological well-being of mothers who reported exercising three to four times per week was significantly and meaningfully more positive compared to those mothers that reported not to exercise. [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]

INTRODUCTION: Several methods of reducing the cost barrier to primary health care have been implemented in New Zealand, but research about free primary health care and the patients who use such services is scarce. AIM: To compare the characteristics of patients at Dunedin's free clinic with those at a traditional general practice clinic. METHODS: A written survey was distributed to waiting room patients at the Free Clinic and a fee-charging clinic in close proximity. Patient records were accessed to determine health services utilisation rates at both clinics and the discounting rate at the traditional clinic. RESULTS: There were 126 patient surveys returned at the Traditional Clinic and 65 at the Free Clinic. There was a significantly greater proportion of Maori respondents at the Free Clinic than at the Traditional Clinic (24.1% versus 9.2%, p=0.011). The difference in deprivation profiles of Free Clinic and Traditional Clinic respondents was more marked for the individual deprivation measure (five or more NZiDep deprivation characteristics: 65.5% versus 13.3%, p<0.001) than for residential area deprivation (NZDep2006 quintile 5: 41.4% versus 15.8%, p<0.001). Emergency department presentation rates were high for Free Clinic patients, despite free primary care access and high general practitioner consultation rates. Among Traditional Clinic respondents, 31.7% reported deferring health care because of cost in the previous 12 months. The equivalent figure for Free Clinic respondents was 63.8%. DISCUSSION: This survey suggests that Dunedin's Free Clinic serves a vulnerable population, in whom levels of unmet health need and health service usage are high. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Obesity and low levels of physical activity are increasing among Pacific and Maori adolescents in New Zealand. AIM: To assess the feasibility of an after-school exercise and lifestyle programme to improve cardio-respiratory fitness, health and usual activity in less-active Pacific and Maori adolescents over six weeks. METHODS: Eighteen less-active secondary school students participated. The six-week programme included 3 x 1.5 hour exercise and healthy lifestyle sessions per week. Outcomes included estimated cardiorespiratory fitness (VO2max), insulin resistance (Homeostasis Model Assessment), physical activity, glycated haemoglobin (HbA1c), fasting plasma glucose, blood pressure, waist circumference and fasting lipids, measured at baseline and six weeks. Programme attendance and qualitative comments were also recorded. Student's f-tests were used. RESULTS: Of the 18 students enrolled, 16(89%) completed six-week follow-up, 14(78%) were female, 13 (72%) were Pacific ethnicity and 5 (28%) were Māori. At baseline, mean age was 16.3 (standard deviation [SD] 1.0) years, body mass index (BMI) 35.2 (SD 6.7) kg/m², VO2 max 31.5 (SD4.3) mL/kg/min, systolic blood pressure 125.0 (SD 12.9) mm Hg, HbA1c 39.9 (SD 3.8) mmol/mol, fasting serum insulin 28.3 (SD 27.8) µU/mL. At follow-up, improvements had occurred in VO2max (3.2 mL/kg/min; p = 0.02), systolic blood pressure (-10.6 mm Hg; p = 0.003), HbA1c (-1.1 mmol/mol; p = 0.03) and weekly vigorous (4 hours, p = 0.002) and moderate (2 hours, p = 0.006) physical activity, although waist circumference increased (p = 0.005). Programme attendance was over 50%. Comments were mostly positive. DISCUSSION: The after-school exercise and lifestyle programme and study methods were feasible. Such programmes have the potential to improve health outcomes for Pacific and Maori adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. AIM: To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. METHODS: Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. RESULTS: Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (p<0.05), generally being highest for specialist nurses and lowest for district nurses. DISCUSSION: Most practice and specialist nurses could access patients' weight and HbA1c levels and focused their clinical management on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The Medicines (Standing Order) Amendment Regulations 2011 allow medicines to be supplied or administered to a patient by a nurse in the absence of a medical practitioner and without a prescription. Regulations have been in place since 2002, but no substantive research has occurred in New Zealand concerning their use. AIM: This paper reports a survey of registered nurses (RNs) who work in primary health care (PHC) settings and explores aspects of their practice relating to their use of standing orders. METHODS: A self-reported survey using a non-probability sample of RNs working in PHC who use standing orders in their practice (n=231). Data were analysed descriptively. RESULTS: The sample were experienced RNs (mean 24 years since registration) and 53% have a post-graduate qualification. Some nurses' understanding of a standing order included provision of a prescription to a patient. Standing orders were used frequently (42% reported use 1 to >5 times/day) for a wide variety of conditions. There is a significant relationship between undertaking the stated professional development requirements and confidence in the clinical decisions made (p=0.025). Over half (52%) would like to use standing orders more often. DISCUSSION: Standing orders are used extensively in PHC settings. The conditions nurses are involved in treating are usually already differentiated or have a high degree of diagnostic certainty. Nurses can effectively provide medicines under standing orders when doctors support their use, issue evidence-based orders, and have confidence in nurses with advanced skills. Doctors need to meet their responsibilities under the Regulations. [ABSTRACT FROM AUTHOR]

Background: The accurate measurement of daily mobility and travel to destinations beyond the residential neighbourhood has been identified as an important but almost systematically overlooked factor when investigating the relationship between exposure to the built environment and physical activity. The recent development of VERITAS - a web-based application nested within a computer-assisted personal interview - allows researchers to assess daily mobility, travel to regular destinations, and perceived neighbourhood boundaries using interactive mapping technology. The aims of this pilot study were to (1) demonstrate the feasibility and functionality of using VERITAS in an adolescent sample, and (2) compare urban form characteristics and geometric features of the perceived neighbourhood with traditional neighbourhood delimitations. Methods: Data were collected and analysed for twenty-eight participants (14 male, 15.9 ± 1.48 years) in 2013. Participants underwent anthropometric assessment before completing a custom-designed VERITAS protocol under the supervision of trained interview technicians. Regularly visited destinations, school travel routes, transportation modes, travel companions, and perceived neighbourhood boundaries were assessed. Data were imported into ArcGIS and street network distances between the home and each geolocated destination were generated. Convex hull activity spaces were derived from destinations. Urban form variables and geometric characteristics were compared between the perceived neighbourhood, existing meshblocks, 1 mile Euclidean buffers, and 1 km network buffers. Results: In total, 529 destinations were geolocated, 58% of which were outside the perceived neighbourhood boundary. Active travel was inversely associated with distance to destinations (r = −.43, p < .05) and traveling with adults (r = −.68, p < .01). Urban form and geometric characteristics of the perceived neighbourhood were different from those in other neighbourhood delimitations. Conclusions: This study demonstrates the feasibility of using VERITAS to assess mobility within adolescent populations. Our results also illustrate the potential novelty and use of user-defined spaces, and highlight the limitations of relying on restricted definitions of place (i.e., administrative or residential-focused neighbourhoods) when assessing environmental exposure. [ABSTRACT FROM AUTHOR]

The article discusses the use of Social Judgment Theory method for occupational therapy in Great Britain, Australia and New Zealand. It highlights the importance of automobile driving as an instrumental activity of daily living for community mobility of many individuals. It cites the integration of occupational therapy to the drivers with acquired illness or disability that deteriorate health condition.

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]

Background: Estimates of the variability that athletes show from competition to competition provide information about the relative contributions of environmental and other factors affecting competitive performance. Smallest and other important thresholds for assessing changes in performance in competitions and field or laboratory tests can also be derived from estimates of variability. Objectives: To systematically review estimates of within-athlete variability of competitive performance in various sports. Methods: We searched SPORTDiscus and Google Scholar for studies providing estimates of within-athlete variability between competitions. Estimates are reported here as coefficients of variation (CV) only for the best athletes. Some studies also combined within-athlete variability with between-athlete differences into a measure of predictability expressed as an intraclass correlation coefficient, reported here for the full field of competition. Results: Skeleton and 1,000-m speed-skating times have the lowest within-athlete variability (CV of 0.15 % and 0.4 %, respectively), apparently because of the effect of the initial phase of the race on race dynamics. Times in sprint and endurance sports also have relatively low variability (0.6-1.4 %), reflecting the predominant contribution of mean power output to performance. The power-velocity relationship tends to make CV for time smaller in sports performed against water or wind resistance, but this effect is offset by variability in the effects of wind and water on individual athletes. Sports requiring explosive power in a single effort, such as field events and weightlifting, have larger CVs for their performance measures (1.4-3.3 %), likely reflecting substantial contributions of skill. Sports with the greatest within-athlete variability (~50 %) were those with subjective scores (e.g. surfing). Predictability correlations ranged from 0.17 (half-pipe snowboarding) to 0.93 (cross-country skiing). There was little difference in variability or predictability between men and women. Application of power-velocity and power-duration relationships allows transformation of the estimates of within-athlete variability of competitive performance into thresholds for smallest and other important changes in performance in laboratory and field tests of power output. Conclusion: Understanding the contributions of race dynamics, power output, environment, skill, and subjective scoring to the variability of athletic performance should help identify and evaluate strategies for performance enhancement. [ABSTRACT FROM AUTHOR]

Aim To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. Background As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Design Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. Methods A cohort of all nurses aged ≥50 years on the register and practising in 2006 ( n = 12,606) was tracked until 2011. Results After 5 years, a quarter ( n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. Conclusions To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. [ABSTRACT FROM AUTHOR]

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]

INTRODUCTION: Māori are overrepresented in cardiovascular disease (CVD) mortality and morbidity statistics in New Zealand (NZ). AIM: To examine cardiovascular risk (CVR) assessment and management for Māori, utilising Caring Does Matter (CDM) initiative data. METHODS: Using 16 general practices' electronic medical records--which include ethnicity data--the rate o f CVR screening, CVD medication treatment and adherence levels, and physiological measures for Māori patients at high CVR (≥15% five-year risk o f a cardiovascular event) were compared to findings for Pacific and non-Māori/non-Pacific patients. RESULTS: Records for 72 351 adults (10 358 Māori; 14%) showed that Māori patients have a poorer CVR assessment rate (46% at guideline-indicated age) than Pacific and non-Māori/non-Pacific groups; when assessed, a greater proportion o f Māori patients (38%) were at high CVR. The proportion o f high-CVR Māori patients being treated with oral antidiabetic medication (42%) was lower than for Pacific patients but higher than for non-Māori/non-Pacific patients. Lower rates o f antihypertensive adherence were found for high-CVR Māori patients than for non-Māori/non-Pacific patients (although higher than for Pacific patients). The high-CVR Māori patients who adhered to CVD medications had lower blood pressure, total- to-HDL cholesterol ratio and HbA1c than non-adherers. DISCUSSION: The association between higher medication adherence and better control o f risk factors suggests that adherence should be further promoted by clinicians. More active CVR assessment, treatment and support o f medication adherence in Māori attending general practices is justified, given their high mortality rate from CVD in comparison to the overall NZ population. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Older people tend to take more medicines and prescription medicine costs may influence medicine adherence. AIM: The aim of this pilot study was to identify older people's perceptions of prescription medicine costs and related costs in four major cities across New Zealand. METHODS: A questionnaire was administered to people aged 65 years and older visiting pharmacies in Auckland, Wellington, Christchurch, and Dunedin to identify their perceptions of costs relating to prescription medicines and related pharmacy and general practice services. Data were compared between cities and examined for associations between participants' views on costs and age, sex, income, ethnicity, number of medicines, and monthly cost. RESULTS: Participants (N=107) received a median of five prescription medicines (range 1-15), at a median cost of NZ$8.00 (range 0-55.30). Median part-charges for medicines only partly funded by the government were NZ$6.25 (range 0.60-100.00), and GP consultations ranged from NZ$0-60.00. Of the participants, 89 (83.2%) thought medicine costs and 63 (58.9%) thought GP consultation costs were reasonable. Participants with median monthly medicine costs of NZ$8.33-87.00 more commonly perceived medicines as expensive or very expensive (p= 0.001, Fisher's exact test). DISCUSSION: Older people in this study mostly viewed their prescription medicines and related costs as reasonable; however, 17% and 41%, respectively, found medicines costs and GP consultation costs expensive. Larger, in-depth studies across New Zealand are needed to determine the sections of the population that find these costs expensive, and to explore how this might affect medicine adherence. [ABSTRACT FROM AUTHOR]

Background and Objective The role of two recently identified and closely related T-helper cell subsets - regulatory T-cells [Tregs; forkhead box P3-positive ( FOXP3+)] and Th17 cells [interleukin-17-positive ( IL-17+)] - in periodontal disease is yet to be determined. Tregs are essential in maintaining peripheral tolerance and regulating the immune response. Th17 cells play a critical role in several autoimmune diseases, inflammation and host defence. The aim of this study was to determine the presence of FOXP3+ Tregs and IL-17+ cells, and their possible spatial interaction, in diseased periodontal tissues. Material and Methods Twenty-nine archival tissues with nonspecific gingival inflammation were grouped based on the intensity (minimally or intensely inflamed) and nature (T-cell predominant or B- and plasma-cell predominant) of the inflammatory infiltrate. Using double-labelling immunohistochemistry, the concomitant presence of FOXP3+ and IL-17+ cells was determined and their spatial relationship was established. In addition, the proportions of FOXP3+ and IL-17+ cells were compared between the groups. Results Of the 29 gingival specimens investigated, 17 were intensely inflamed (≥ 1000 inflammatory cells per 0.12 mm2) and 12 were minimally inflamed (≤ 600 cells per 0.12 mm2). Based on the percentage of CD19+ B-cells and plasma cells collectively and CD3+ T-cells, gingival tissues were also grouped into B- and plasma-cell-predominant gingival tissues ( n = 21; 50.7% total B- and plasma cells vs. 19.1% T cells; p < 0.001) and T-cell-predominant gingival tissues ( n = 8; 61.0% T-cells vs. 15.2% B- and plasma cells; p = 0.007). More FOXP3+ cells than IL-17+ cells were observed in all archival gingival tissues examined. A trend towards an increased number of FOXP3+ cells was observed for intensely inflamed gingival tissues (6.7%) and for B- and plasma-cell-predominant tissues (6.4%) compared with minimally inflamed gingival tissues (4.6%) and T-cell-predominant gingival tissues (4.5%). However, no statistically significant difference in the mean percentage of FOXP3+ cells between the groups was observed. Interestingly, FOXP3+ cells were significantly correlated with the B- and plasma-cell/T-cell ratio in B- and plasma-cell-predominant tissues ( r = 0.713, p < 0.001). Overall, there were very few IL-17+ cells (< 1%). All IL-17+ cells identified in this study had an ovoid/plasmacytoid morphology and were larger in size compared with adjacent inflammatory cells. IL-17+ and FOXP3+ cells were not adjacent to each other in any of the areas examined, suggesting that FOXP3+ Tregs do not directly interact with IL-17+ cells in diseased gingival tissues. IL-17+/ FOXP3+ cells were not detected in the tissues examined. Conclusion These results show that FOXP3+ cells are more prominent than IL-17+ cells in periodontal disease processes, which may suggest a predominant role for FOXP3+cells in periodontal disease. Further studies are required to characterize these cells more precisely and to understand, in more detail, their roles in the pathophysiology of periodontal disease. [ABSTRACT FROM AUTHOR]

This investigation examined the relationship between teachers’ beliefs and their preferences for classroom interventions for behaviours consistent with attention-deficit/hyperactivity disorder (ADHD). Teacher ratings of intervention acceptability, effectiveness, and rate of change were compared across United States and New Zealand samples. Beliefs examined were personal teaching efficacy, general teaching efficacy, and pupil control ideology (PCI). Samples were compared regarding their preferences for the daily report card, response cost technique, classroom lottery, and medication as classroom strategies for managing ADHD-related behavioural concerns. Data were analysed using general linear modelling techniques, and an interaction was demonstrated between ADHD intervention x PCI x nationality. Differences were observed for ADHD interventions across samples based upon pupil control orientations. Implications for educators and their classroom practices are discussed. [ABSTRACT FROM PUBLISHER]

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: To explore how contraindications to the use of acupuncture during pregnancy are managed in clinical practice. Design: Acupuncturists' views on their management of threatened miscarriage were sought by using a mixed-methods design involving a self-completed questionnaire and semi-structured interviews. An online survey was distributed through the Australian and New Zealand acupuncture associations requesting practitioners' to access an online link to a questionnaire hosted by Survey Monkey. This questionnaire examined acupuncturist's views on safety and the use of Traditional Chinese Medicine treatment modalities. Descriptive and bivariate statistics were used to analyze data. Thirteen participants were purposefully selected from the survey responses to further explore treatment management. These interviews were recorded via Skype, transcribed, and analyzed by using thematic analysis. Results: Of 370 respondents, 214 (58%) had treated women for threatened miscarriage within the previous year. Approximately half (58%) had treated four or fewer women, while a minority (14%) had treated 15 or more. The use of abdominal and blood invigorating points reflected diverse treatment strategies within acupuncture textbooks. While the majority avoided acupuncture points traditionally cautioned against in pregnancy, 13% would use LI 4, 22% would use SP 6, and 31% would use BL 32. Two safety themes emerged: 'Well I'm safe because...justifying diverse approaches' and 'A limited knowledge base-sorting it out for yourself,' illustrating how practitioners justified safe practice and had difficulty obtaining trustworthy treatment knowledge. Conclusion: Practitioners demonstrated interest in treating threatened miscarriage. All practitioners saw themselves as providing safe treatment. Those using historically contraindicated points justified their use on the basis of personal opinion, advice from trusted others, and clinical experience with a small number of women. In treating at-risk pregnancies, these justifications may be inadequate. Further research exploring the views of practitioners who are experienced in this specialized area would inform clinical practice for this common complication of early pregnancy. [ABSTRACT FROM AUTHOR]

This study investigated ‘healthy’ participants’ perceptions of types 1 and 2 diabetes using mixed methods. A total of 38 participants were asked about their perceptions of both types of diabetes using video-based vignettes of four cases. Participants answered standardised questionnaires while thinking aloud and could expand during semi-structured interview sections. Four themes were identified: knowledge of diabetes, power to influence diabetes, limitations of responsibility or blame for diabetes and feelings about individuals with diabetes. Perceived controllability of causes and perceptions of illness management informs understanding of stigma and risk and emphasises the importance of comparing perceptions of both types of diabetes. [ABSTRACT FROM PUBLISHER]

To determine the prevalence of household food insecurity in New Zealand (NZ), eight food security statements were included in the 1997 National Nutrition Survey of adults. Rasch model analysis was performed to determine whether each food security statement (addressing a food security attribute) was discrete and could be ranked on a unidimensional scale. The NZ model had marginal ‘household’ reliability (0·60–0·66), good item separation (17·20–17·77) and item infit/outfit values between 0·8 and 1·25. Indices could be ranked by level of severity and represent the experience of household food insecurity in NZ. Categories of food security were assigned and used to predict food choice, and energy and nutrient intakes. Compared with fully secure/almost fully secure households, those that were moderately secure or of low security were less likely to consume the recommended daily servings of fruit and vegetables, and more likely to consume fatty meats. Intake of total fat, saturated, monounsaturated and polyunsaturated fat, cholesterol, lactose and vitamin B12 increased with lower levels of food security. Intakes of glucose, fructose and vitamin C were highest in the fully secure/almost fully secure category. This unique eight-component food security measurement tool has less respondent burden than the US Core Food Security Measure. The relationships between the level of food insecurity and food choice and nutrient intakes illustrate that the most food-insecure households have less healthy diets. This relatively brief population-specific measurement tool is suitable to monitor population food security status, and is a useful marker of nutritional status. [ABSTRACT FROM PUBLISHER]

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

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]

Aim The Canadian Occupational Performance Measure ( COPM) is an outcome measure of clients' self perceptions of performance and satisfaction with occupational performance and is widely used in paediatric research. The aim of this study was to explore how a new outcome measure, the Belief in Goal Self-Competence Scale (Bi GSS), was perceived by paediatric occupational therapists to compliment the COPM as a way of documenting client confidence in goal pursuit. Methods Two hundred and forty-one occupational therapists participated in an online survey through paediatric listserv groups and professional networks. Therapists' views about goal setting and the utility of the Bi GSS were analysed descriptively and open ended questions were analysed thematically. Results Overall, goal setting was viewed as a highly important aspect of therapy ( n = 221, 90.7%) although only 22% ( n = 52) of respondents indicated using formal goal setting tools. For the subset of respondents who frequently used the COPM ( n = 101, 42%) almost all (97.87%) indicated that they would find the Bi GSS to be moderately or highly useful to their current practice. Suggestions for improvement of the measure involved wording and formatting. Conclusion This study supports existing evidence that goal setting is highly valued by occupational therapists, however, formal tools are not always used. There was preliminary support for a measure such as the Bi GSS as a means of documenting children's and families confidence in goal pursuit. [ABSTRACT FROM AUTHOR]

Osteopathy in the cranial field is an approach used by manual and physical therapists. However, there is minimal information in the literature about patient experiences of this treatment. The present study was undertaken to explore patients’ experiences of osteopathy in the cranial field. Patients completed the Patient Perception Measure–Osteopathy in the Cranial Field and identified sensations they experienced during treatment. Additional measures of anxiety, depression, Satisfaction With Life, and Meaningfulness of Daily Activity were completed. The Patient Perception Measure–Osteopathy in the Cranial Field was internally consistent (Cronbach’s α = .85). The most frequently experienced sensations of osteopathy in the cranial field patients were “relaxed,” “releasing,” and “unwinding.” Satisfaction With Life and Meaningfulness of Daily Activity were positively associated with Patient Perception Measure–Osteopathy in the Cranial Field scores. Negative associations were observed between the Patient Perception Measure–Osteopathy in the Cranial Field and depression. Psychometric properties of the Patient Perception Measure–Osteopathy in the Cranial Field require further testing. The observed associations of Satisfaction With Life and depression with patients’ perceptions of osteopathy in the cranial field treatment needs to be tested in larger clinical manual therapy cohorts. [ABSTRACT FROM AUTHOR]

Objective: We investigated the characteristics of loneliness by identifying distinct 'profiles' of loneliness and investigating transitions between those loneliness profiles over two years., Method: We conducted Latent Transition Analyses on two years of data from the New Zealand Attitudes and Values Study (N=15,820) and modelled how people's health and age were associated with changes in profile membership., Results: Four loneliness profiles emerged: 'low-loneliness' (58% of the sample), 'high-loneliness' (5%), 'appreciated outsiders' (28%; perceived acceptance from others but felt like social outsiders), and 'superficially connected' (9%; lacked acceptance from others but felt socially included). Profile membership was relatively stable over time and transitions were most likely from higher to lower loneliness. Younger people and people reporting poorer health were more likely to transition into profiles with greater loneliness indicators., Conclusions: Findings replicated a four-profile pattern of loneliness, supported the theorised 'trait-like' structure of loneliness and identified the possibility that moderate states of loneliness are transitional states into/from low and high loneliness., Implications for Public Health: The stability of loneliness across years reiterates the need for societal interventions, particularly interventions that are adaptive to whether people's loneliness forms as a lack of acceptance/value or a lack of social inclusion., (© 2022 The Authors.)