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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]

Background: The effect of natural disasters internationally is linked to intensity and duration and the impact of these events for tertiary level professional students is not clearly understood. Following a 7.1 magnitude earthquake in New Zealand in 2010 (with aftershocks lasting 27 months) a number of tertiary nursing students experienced significant disruption to their studies. Aim: To compare the psychological health, resilience and the impact on learning for three cohorts of students engaged in tertiary nursing education during this time. Method: A cross-sectional survey design and convenience sampling was used for three cohorts of learners. An online survey was completed (n = 290) and included: Depression Anxiety and Stress Scale; PTSD Checklist; Work and Social Adjustment Scale; Connor-Davidson Resilience Scale. Results: Statistically significant differences were found across the psychometric scales with regard to relationship status. Whilst an increase in self-reported physical and mental health issues prior to and following the earthquakes were noted, mitigating factors were also identified. Conclusions: In order to support psychological health amongst nursing students, tertiary education systems need to plan for sustainable learning. The importance of facilitating future orientation within organisations is necessary to develop resilience amongst staff and students, which, in turn, will enable on-going education during significant disaster events. [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]

Objective Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. Methods The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs. Results Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30-134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45-57%); however, there was some variation between hospitals for both outcomes. Conclusion Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator. [ABSTRACT FROM AUTHOR]

Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. [ABSTRACT FROM AUTHOR]

Objective: To explore validity of an assessment tool under development-the Emotional Inferencing from Stories Test (EIST). This measure is being designed to assess the ability of people with traumatic brain injury (TBI) to make inferences about the emotional state of others solely from contextual cues. Methods and procedures: Study 1: 25 stories were presented to 40 healthy young adults. From this data, two versions of the EIST (EIST-1; EIST-2) were created. Study 2: Each version was administered to a group of participants with moderate-to-severe TBI-EIST 1 group: 77 participants; EIST-2 group: 126 participants. Participants also completed a facial affect recognition (DANVA2-AF) test. Participants with facial affect recognition impairment returned 2 weeks later and were re-administered both tests. Main outcomes: Participants with TBI scored significantly lower than the healthy group mean for EIST-1, F(1,114) = 68.49, p < 0.001, and EIST-2, F(1,163) = 177.39, p < 0.001. EIST scores in the EIST-2 group were significantly lower than the EIST-1 group, t = 4.47, p < 0.001. DANVA2-AF scores significantly correlated with EIST scores, EIST-1: r = 0.50, p < 0.001; EIST-2: r = 0.31, p < 0.001. Test-re-test reliability scores for the EIST were adequate. Conclusions: Both versions of the EIST were found to be sensitive to deficits in emotional inferencing. After further development, the EIST may provide clinicians valuable information for intervention planning. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether individuals with a history of traumatic brain injury (TBI) experience a greater number of adverse life events (ALE) compared to controls, to identify significant predictors of experiencing ALE and whether the severity of childhood TBI negatively influences adult life outcomes. Design: A total of 167 individuals, injured prior to age 18, 5 or more years post-injury and 18 or more years of age, were recruited in the Canterbury region of New Zealand, with 124 having sustained childhood TBI (62 mild, 62 moderate/severe) and 43 orthopaedic injury controls. Participants were asked about ALE they had experienced and other adult life outcomes. Results: Individuals with a history of TBI experienced more ALE compared to controls. The number of ALE experienced by an individual was associated with more visits to the doctor, lower education level and lower satisfaction with material standard of living. Conclusions: Childhood TBI is associated with an increased number of ALE and adult negative life outcomes. Understanding factors that contribute to negative outcomes following childhood TBI will provide an avenue for rehabilitation and support to reduce any problems in adulthood. [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]

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]

STUDY DESIGN: Feasibility randomized controlled trial. OBJECTIVES: To assess the feasibility of a trial to investigate the effectiveness of a lumbopelvic monitor as a feedback device for modifying postural behavior during daily work-related activities, BACKGROUND: Frequent or sustained flexed postures play a role in the development or maintenance of nonspecific low back pain. The provision of postural feedback could help individuals with or at risk of nonspecific low back pain improve their postural awareness and avoid hazardous or pain-provoking postures. METHODS: Sixty-two participants employed in a health care organization were randomly allocated into 1 of 3 groups: a control group, an intermittent feedback group, and a constant feedback group. Adherence and follow-up rates were assessed. Differences in postural pattern between baseline and follow-up measurements were used to assess the effectiveness of the lumbopelvic monitor as a postural feedback device, RESULTS: Adherence was approximately 75%. With the exception of 1 center, the follow-up overall rates exceeded the a priori desired threshold of 80%. Within-group comparisons revealed no significant differences in postural pattern for the control group and intermittent feedback group. The constant feedback group showed a significant reduction in flexed posture at the follow-up period compared with the baseline period. Differences between groups did not reach statistical significance; however, the constant feedback group, compared with the control group, demonstrated an effect size (d) of 0.60. CONCLUSION: The provision of constant postural feedback seems promising for promoting changes in postural behavior. This feasibility trial identified adherence and follow-up rates and sample-size estimates important to the conduct of a fully powered efficacy trial. LEVEL OF EVIDENCE: Therapy, level 2b-. [ABSTRACT FROM AUTHOR]

Background: Vitamin C (ascorbate) is likely to be essential for skeletal muscle structure and function via its role as an enzyme cofactor for collagen and carnitine biosynthesis. Vitamin C may also protect these metabolically active cells from oxidative stress. Objective: We investigated the bioavailability of vitamin C to human skeletal muscle in relation to dietary intake and plasma concentrations and compared this relation with ascorbate uptake by leukocytes. Design: Thirty-six nonsmoking men were randomly assigned to receive 6 wk of 0.5 or 2 kiwifruit/d, an outstanding dietary source of vitamin C. Fasting blood samples were drawn weekly, and 24-h urine and leukocyte samples were collected before intervention, after intervention, and after washout. Needle biopsies of skeletal muscle (vastus lateralis) were carried out before and after intervention. Results: Baseline vastus lateralis ascorbate concentrations were ~16 nmol/g tissue. After intervention with 0.5 or 2 kiwifruit/d, these concentrations increased 3.5-fold to 53 and 61 nmol/g, respectively. There was no significant difference between the responses of the 2 groups. Mononuclear cell and neutrophil ascorbate concentrations increased only ~1.5- and ~2-fold, respectively. Muscle ascorbate concentrations were highly correlated (P < 0.001) with dietary intake (R = 0.61) and plasma concentrations (R = 0.75) in the range from 5 to 80 μmol/L. Conclusions: Human skeletal muscle is highly responsive to vitamin C intake and plasma concentrations and exhibits a greater relative uptake of ascorbate than leukocytes. Thus, muscle appears to comprise a relatively labile pool of ascorbate and is likely to be prone to ascorbate depletion with inadequate dietary intake. [ABSTRACT FROM AUTHOR]

The article discusses a study to identify the time course of the retrieval of words from semantic memory. The study contains a test administered to 65 inpatients with major depression and 50 healthy controls. The result showed a shortcoming in the retrieval of words from long-term memory in depressed patients. It is concluded that a generalized impairment in memory retrieval could be a characteristic of major depression.

gilmour j.a., huntington a., broadbent r., strong a. & hawkins m. (2012) Nurses' use of online health information in medical wards. Journal of Advanced Nursing 68(6), 1349-1358. Abstract Aim. This paper is a report of a study of nurses' access, use and evaluation of online health information in medical wards. Background. Online health information is commonly used by patients with chronic illness to support their education needs. Nurses have a critical role in assisting patients to access and use this information. Method. This descriptive cross-sectional survey of a random sample of 540 nurses employed in medical wards was carried out in 2009. The response rate was 58·7% (293). The analytical approach included descriptive statistics and non-parametric tests of correlation and differences between groups. A content analysis was performed on the qualitative data. Results. Most respondents (78·6%) were satisfied with work Internet access and 58·2% believed that the use of online information improved care delivery. Nearly half the group was aware of patient misconceptions about their illness due to incorrect interpretations of online information, but only 24·4% checked if patients used online information. There was a significant association between assessing patients use and awareness of patient misconceptions. Conclusion. The findings of this study highlight that while online resources add to education opportunities, the ongoing nursing assessment required to determine online information needs is not always incorporated into nursing practice. Patient misunderstandings of online material were also identified; developing patient competency in evaluating open access health information should now be recognized as an integral aspect of illness management education. [ABSTRACT FROM AUTHOR]

Objective: To describe in-hospital resuscitation outcomes and factors associated with survival at Auckland City Hospital, New Zealand. Methods: The Utstein template for in-hospital cardiac arrests was used. A retrospective audit of all cardiac arrests 2004-06 determined patient demographics, resuscitation time intervals, interventions, survival and neurological outcome at 12 months. Factors associated with survival to discharge were explored with logistic regression. Results: There were 3470 in-hospital deaths. Resuscitation was attempted in 415 patients (12%), with survival to discharge 27.2%. Survival was higher in first rhythm VT/VF (52.7% vs 13.1%, χ2= 75.3, P < 0.001), when the arrest was 'In-Hours' (41.4% vs 17%, χ2= 30.1, P < 0.001) and with younger age (mean [SD] for survivors 59.4 [7.1] vs 69.1 [14] for non-survivors). These associations were independent predictors of survival after multivariate logistic regression, with OR 6.2 (95% CI 3.6-10.5), 3.1 (95% CI 1.8-5.4) and 1.04 (95% CI 1.02-1.06), respectively (all P < 0.001). Other univariate predictors of survival; cardiac arrest team on site, monitored arrest and time to CPR were not significant after multivariate logistic regression. Time intervals to arrest interventions were short. Twelve month neurological outcome was good (CPC1 or 2) in 97.1% (95% CI 91.6-99.4) of survivors. Conclusions: Survival from cardiac arrest in our hospital compared well to similar centres and good neurological outcome was higher than reported previously. Reduced survival during the 'After-Hours' period is cause for concern, and further research into the factors underlying this is required. [ABSTRACT FROM AUTHOR]

Background: Intrapartum chemoprophylaxis for group B streptococcus (GBS) carriers reduces the risk of early-onset neonatal GBS infection. For women with β-lactam allergy, either erythromycin or clindamycin are administered. Recent reports worldwide suggest that GBS resistance to these antibiotics is increasing. Aims: To compare erythromycin and clindamycin resistance phenotypes in invasive neonatal GBS isolates across New Zealand and Australia over the past two decades and to determine whether regional variation in resistance patterns exist. Method: Invasive neonatal GBS isolates were collected from laboratories across New Zealand ( n = 107) and Australia ( n = 74) over two time periods (1992-1994 and 2002-2004 in New Zealand; 1982-2001 and 2002-2006 in Australia) and subjected to standard antibiotic susceptibility testing. A nested sub-study in New Zealand examined antibiotic susceptibilities of 112 maternal colonising GBS isolates during 2003-2004. Results: Erythromycin resistance among invasive neonatal GBS isolates increased across both countries over the past decade, with similar rates of resistance in New Zealand (9%) and Australia (6%) in recent years. New Zealand erythromycin-resistant GBS isolates commonly displayed cross-resistance to clindamycin. Also, there were significantly higher rates of isolated clindamycin resistance in GBS isolates from New Zealand than Australia ( P = 0.034). Maternal GBS isolates from New Zealand showed similar resistance patterns to neonatal isolates. Conclusion: Erythromycin and clindamycin resistance among invasive neonatal GBS isolates has emerged in both New Zealand and Australia over the past decade and is consistent with global trends in GBS resistance patterns. Although regional variations exist, these findings should be considered when implementing intrapartum GBS prevention strategies. [ABSTRACT FROM AUTHOR]

The article presents the study on the extended joint range of motion of the aquatitan garments without the effect on running performance in New Zealand. It states that the study aims to determine the effects of the titanium-permeated garments on the recovery from high-intensity intermittent exercise. The study was conducted by 14 national and regional male soccer and hockey players in which there sprint time was measured during shuttle test and muscle damage. It notes that wearing of the garment had harmful effects on running velocity. It also mentions that the garments can reduce the stiffness of the muscle-tendon and suggests an enhanced compliance.

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

Vitamin D deficiency has adverse health effects in young children. Our aims were to determine predictors of vitamin D status and then to use these factors to develop a practical tool to predict low 25(OH)D concentrations in preschool New Zealand children. A cross-sectional sample of 1329 children aged 2 to <5 years were enrolled from throughout New Zealand in late-winter to spring 2012. 25-Hydroxyvitamin D (25(OH)D) was measured on dried blood spot (DBS) samples collected using finger-prick sampling. Caregivers completed a questionnaire. Mean (SD) DBS 25(OH)D concentration was 52(19)nmol/L. 25(OH)D < 25 nmol/L was present in 86(7%), 25(OH)D < 50 nmol/L in 642(48%), 25(OH)D 50- < 75 nmol/L in 541(41%) and 25(OH)D > 75 nmol/L in 146(11%) of children. Factors independently associated with the risk of 25(OH)D < 25 nmol/L were female gender (OR 1.92,95%CI 1.17-3.14), other non-European ethnicities (not including Māori or Pacific) (3.51,1.89-6.50), had olive-dark skin colour (4.52,2.22-9.16), did not take vitamin D supplements (2.56,1.06-6.18), had mothers with less than secondary-school qualifications (5.00,2.44-10.21) and lived in more deprived households (1.27,1.06-1.53). Children who drank toddler milk (vitamin D fortified cow's milk formula marketed to young children) had a zero risk of 25(OH)D < 25 nmol/L. The predictive tool identified children at risk of 25(OH)D < 25 nmol/L with sensitivity 42%, specificity 97% and ROC area-under-curve 0.76(95%CI 0.67-0.86, p < 0.001). Predictors of low vitamin D status were consistent with those identified in previous studies of New Zealand children. The tool had insufficient predictive ability for use in clinical situations, and suggests a need to promote safe, inexpensive testing to determine vitamin D status in preschool children. [ABSTRACT FROM AUTHOR]