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Background: The birth of a premature infant and admission to the NICU is often unexpected and traumatic for families, leading to increased distress and can negatively impact parental-infant attachment. Appropriate interventions can help to lessen the negative impact of a NICU admission on families, improving parental mental health, reducing distress, enhancing parent- infant relationships, and improving the long-term physical, cognitive, emotional, and social development of the infant. Aims: The purpose of this study is to examine and evaluate research evidence on the effectiveness of current interventions for improving parental distress in the NICU. Methods: A rapid review was conducted utilizing a protocol based on the Virginia Commonwealth University guidance. Keyword searches were conducted on CINAHL, MEDLINE, and PsychINFO, and studies were selected according to pre-defined eligibility criteria, published between January 2015 and January 2020. The literature search included primary studies of interventions with parental stress and/or anxiety reduction as outcomes. Results: A total of 14 articles were included, evaluating the effectiveness of 13 different interventions, including narrative writing, art therapy, structured nursing interventions, anxiety counselling, spiritual care, organizational change, music therapy, relaxation, and mindfulness techniques. With the Pexception of three, all the studies found significant results in the reduction of stress and/or anxiety levels of the subjects, with mothers having overall higher levels of stress indicated by higher stress scores on standardized measurement tools. Conclusion: There is a need for ongoing assessment of parental distress and integration of appropriate interventions within the NICU settings. In this review, both individualized and group interventions including narrative writing, art therapy, music therapy, spiritual care, activity-based group therapy, music therapy, audio-assisted relaxation techniques, mindfulness based neurodevelopmental care, cognitive behavioral based counselling, family nurture intervention and a structured nursing intervention were shown to be effective in reducing parental stress and/or anxiety in the NICU. The small scale of the studies included in this review impact generalizability to a broader audience and emphasizes the need for larger scope, multi-center studies at an international level to build on and broaden our level of knowledge on how to better support families and reduce parental distress in the NICU.

Weight estimation is critical in paediatric resuscitation, as stopping to weigh a child could influence their survival. Weight estimation methods used in New Zealand (NZ) are not accurate for the population, increasing the complexity of prescribing medication and selecting equipment.Develop regression equations (RE) to predict the weight of NZ children based on height, sex, age and ethnicity to be deployed in a mobile application (Weight Estimation Without Waiting).The RE was derived from retrospective regression modelling of a large existing dataset. Data were presented using descriptive statistics and calculation of means, limits of agreement and the proportion of weight estimates within a percentage of actual weight.The RE developed in this study outperformed existing age-based weight estimation methods while providing a method to ensure that weight estimation techniques evolve with NZ children.

Objective:To compare the Nutrition Information Panel (NIP) content, serving size and package size of children’s ready-to-eat breakfast cereals (RTEC) available in five different Western countries.Design:NIP label information was collected from RTEC available for purchase in major supermarket chains. Kruskal–Wallis, Mann–WhitneyUandχ2tests were applied to detect differences between countries on manufacturer-declared serving size, total energy (kJ), total protein, fat, saturated fat, carbohydrate, total sugar, Na and fibre content. The Nutrient Profiling Scoring Criterion (NPSC) was used to evaluate the number of products deemed to be ‘unhealthy’.Setting:Supermarkets in Australia, Canada, New Zealand, the UK and the USA.Participants:Children’s breakfast cereals (n636), including those with and without promotional characters.Results:The majority of children’s RTEC contained substantial levels of total sugar and differences were apparent between countries. Median sugar content per serving was higher in US cereals than all other countries (10·0v. 7·7–9·1 g;P< 0·0001). Median fat and saturated fat content were lowest in Australia and New Zealand RTEC, while the Na content of RTEC was 60–120 % higher in the USA and Canada than in Australia and the UK (allP≤ 0·01).Conclusions:Across all countries, there was a high proportion of RTEC marketed for children that had an unhealthy nutrient profile. Strategies and policies are needed to improve the nutrient value of RTEC for children, so they provide a breakfast food that meets nutrition guidelines.

Background There are no critical care nurse training programs in Malawi despite the high burden of diseases which culminate in critical illness. This paper presents contextual issues that influence preparedness of nurses for critical care nursing practice in Malawi. The qualitative findings presented are part of a larger mixed methods study which explored learning needs of critical care nurses as a way of informing the development of a training program for the critical care nurses in Malawi. Methods Interpretive descriptive design was used. Data were gathered through 10 key informant interviews with nurse leaders (n=8) and anaesthetists (n=2); and two focus group discussions with registered nurses and nurse midwife technicians working in intensive care and adult high dependency units at two tertiary hospitals. Transcribed data were analyzed manually and through the use of NVivo data management software utilizing Thorne’s steps of analysis1. Results Being unprepared to work in intensive care and high dependency units was a dominant theme. Factors that contributed to this sense of unpreparedness were lack of educational preparation, organisational factors and workforce issues. The consequences of nurses’ perceptions of being unprepared were fearfulness, a change of nurses’ attitudes and elevation of risk to patients. The nurses managed unpreparedness by relying on other health professionals and learning on the job. Conclusion The findings illuminated contextual issues to be considered when developing programs for upskilling nurses in hospitals within Malawi and contributes to the developing body of knowledge related to nursing education and practice development within developing countries.

Aim Fruit and vegetables are strongly promoted because of the nutrients they provide; many processed products contain added sugar and sodium. The present study aims to quantify the sugar and sodium content of pre-packaged fruit and vegetable-based products that are available in New Zealand supermarkets. Methods Nutrition Information Panel data were collected from non-frozen, processed fruit and vegetable products in New Zealand supermarkets (including soups, sauces, jams and spreads, pickles, chutneys and dips, and canned/bottled fruit and vegetables) where fruit and/or vegetables were the majority ingredient(s). Results With the exception of canned/bottled vegetables, more than 60% of products contained added sugar. Per serve, the median sugar content was highest in canned/bottled fruit (17.8 g). More than 75% of soups, vegetable-based sauces, pickles/chutneys and canned/bottled vegetables contained added sodium, with soups (722 mg) recording the highest median values per serve. Conclusions Consumers need to be aware that although they are encouraged to eat a diet high in fruit and vegetables, there may be large quantities of added sugar and sodium in manufactured fruit and vegetable products that can have significant negative impacts on their health. Government health promotion campaigns encouraging the consumption of fruit and vegetables should be careful to target fresh, frozen and home-prepared foods, and work on educating the public about the lower nutritional quality associated with most processed fruit and vegetable products.

In New Zealand, the incidence of type 2 diabetes (T2D) is increasing in Pacific youth. [...]

Background: The variety, quality and quantity of foods consumed and eating patterns influencethe development of non-communicable diseases [...]

Background Patterns of knowing in nursing are the epistemological foundation of the discipline and are necessary for achieving nursing competence. Although knowing in nursing has received critical attention in developed countries, the notion has not been explored in developing countries like Malawi where the context is different to that studied by other researchers. The aim of the study reported in this paper was to identify nurses’ perceived ways of knowing and their learning needs in the critical care environment. The study was part of a larger body of research on the planning, development and evaluation of a training programme for critical care nurses in Malawi. Methods Thorne’s interpretive descriptive design was used to analyse the qualitative data collected using two focus groups with nurses (n = 13), and one-on-one interviews with nurse leaders (n = 8) and anaesthetists (n = 2) in critical care units (CCU) at two tertiary hospitals in Malawi. Results The dimensions of knowing which are expected to be demonstrated by an effective nurse are theoretical knowing, practical knowing, managerial knowing, ethical and professional knowing, and ability to interpret and act. Critical care nurses who demonstrate these dimensions of knowing are confident with delivering the required standard of care for critically ill patients and in managing the complexities of working in the critical care units. Conclusion The findings illustrate the need to be cognizant of patterns of knowing in resource limited settings and the importance of incorporating these into the development of training programmes.

Fruit and vegetables are strongly promoted because of the nutrients they provide; many processed products contain added sugar and sodium. The present study aims to quantify the sugar and sodium content of pre-packaged fruit and vegetable-based products that are available in New Zealand supermarkets.Nutrition Information Panel data were collected from non-frozen, processed fruit and vegetable products in New Zealand supermarkets (including soups, sauces, jams and spreads, pickles, chutneys and dips, and canned/bottled fruit and vegetables) where fruit and/or vegetables were the majority ingredient(s).With the exception of canned/bottled vegetables, more than 60% of products contained added sugar. Per serve, the median sugar content was highest in canned/bottled fruit (17.8 g). More than 75% of soups, vegetable-based sauces, pickles/chutneys and canned/bottled vegetables contained added sodium, with soups (722 mg) recording the highest median values per serve.Consumers need to be aware that although they are encouraged to eat a diet high in fruit and vegetables, there may be large quantities of added sugar and sodium in manufactured fruit and vegetable products that can have significant negative impacts on their health. Government health promotion campaigns encouraging the consumption of fruit and vegetables should be careful to target fresh, frozen and home-prepared foods, and work on educating the public about the lower nutritional quality associated with most processed fruit and vegetable products.

ObjectiveTo compare the nutritional content, serving size and taxation potential of supermarket beverages from four different Western countries.DesignCross-sectional analysis. Multivariate regression analysis and χ2 comparisons were used to detect differences between countries.SettingSupermarkets in New Zealand (NZ), Australia, Canada and the UK.SubjectsSupermarket beverages in the following categories: fruit juices, fruit-based drinks, carbonated soda, waters and sports/energy drinks.ResultsA total of 4157 products were analysed, including 749 from NZ, 1738 from Australia, 740 from Canada and 930 from the UK. NZ had the highest percentage of beverages with sugar added to them (52 %), while the UK had the lowest (9 %, P8 % sugar) categories.ConclusionsThere is substantial difference between countries in the mean energy, serving size and proportion of products eligible for fiscal sugar taxation. Current self-regulatory approaches used in these countries may not be effective to reduce the availability, marketing and consumption of sugar-sweetened beverages and subsequent intake of free sugars.

ObjectiveTo compare the nutritional quality of New Zealand breakfast cereals in 2013 and 2017.DesignNutrition Information Panel data were collected from all cereals available from two large supermarket chains in 2017 and compared with earlier published data collected in 2013.SettingUrban New Zealand supermarkets.SubjectsThe nutritional content of breakfast cereals (‘biscuits and bites’, ‘brans’, ‘bubbles, flakes and puffs’, ‘children’s cereals’, ‘muesli’ and ‘oats’) was analysed for total energy, protein, fat (total and saturated), carbohydrate, sugar, fibre and Na. The Nutrient Profile Scoring Criterion (NPSC) for each cereal was calculated to determine the proportion of ‘less healthy’ cereals (NPSC≥4) in each product category.ResultsThe energy and fat content of bubbles, flakes and puffs, muesli and oats were significantly higher in 2017 compared with 2013 (all P≤0·01). However, there was a small reduction in Na overall in 2017 (PConclusionsThe nutrient profile of breakfast cereals has not improved since 2013, suggesting that industry self-regulation of the nutritional composition of cereals in New Zealand is not working and needs urgent reconsideration.

Background: The published literature suggests that RNs are more overweight and obese than the general population. This research investigates associations between nutrition literacy, anthropometry measures, and nutritional biomarkers in an undergraduate nursing student population. Method: Year-one nursing students from two tertiary education institutions in New Zealand were invited to participate in an observational, convenience sample study. Data collection from participants ( N = 103) included a nutrition literacy questionnaire, anthropometry measures, and blood lipid, glucose, and HbA1c concentrations. Results: Approximately 51% of participants were either overweight or obese, which is a similar prevalence to the New Zealand demographic-matched population. Mean body mass index was 26.7 ± 6.3 kg/m 2 and body fat was 29% ± 8.3%. The mean literacy score was 56.7% ± 13.2%. The literacy score was inversely associated with anthropometry measures and total cholesterol/high-density lipoprotein cholesterol ratio and positively associated with high-density lipoprotein cholesterol. Conclusions: Nutrition literacy had a statistically significant influence on anthropometry and lipid measures. [ J Nurs Educ. 2017;56(1):43–48.]

ObjectiveTo compare the nutritional content, serving size and taxation potential of supermarket beverages from four different Western countries.DesignCross-sectional analysis. Multivariate regression analysis and χ2 comparisons were used to detect differences between countries.SettingSupermarkets in New Zealand (NZ), Australia, Canada and the UK.SubjectsSupermarket beverages in the following categories: fruit juices, fruit-based drinks, carbonated soda, waters and sports/energy drinks.ResultsA total of 4157 products were analysed, including 749 from NZ, 1738 from Australia, 740 from Canada and 930 from the UK. NZ had the highest percentage of beverages with sugar added to them (52 %), while the UK had the lowest (9 %, P 8 % sugar) categories.ConclusionsThere is substantial difference between countries in the mean energy, serving size and proportion of products eligible for fiscal sugar taxation. Current self-regulatory approaches used in these countries may not be effective to reduce the availability, marketing and consumption of sugar-sweetened beverages and subsequent intake of free sugars.

Background: Obesity is prevalent in health care workers, but it is unknown whether a lack of nutritional knowledge contributes to this. This study measured the nutrition knowledge of undergraduate nursing students to identify knowledge gaps that could be addressed through nutrition teaching in an updated undergraduate nursing curriculum. Method: Undergraduate nursing students ( N = 197) completed a nutrition knowledge survey with questions on demographics, body composition, nutrition labels, food packaging claims, and healthy food-purchasing choices. Results: Mean overall nutritional knowledge scores were low, but overall scores were higher for students who had received nutrition teaching (60.5% versus 52.5%; F [1, 187] = 7.2, p < 0.001). Improvements in nutrition knowledge were consistent across all ethnic groups, and no effects of age were observed. Conclusion: To sufficiently prepare nurses for their public health role in obesity prevention, more nutrition education is needed in undergraduate nursing education programs, with emphasis on ethnic-specific educational requirements. [ J Nurs Educ. 2015;54(9, Suppl.):S103–S106.]

To examine the effectiveness, acceptability and sustainability of interventions to reduce vitamin B12 (B12) deficiency in South Asian women before conception.A 6-month randomised controlled trial conducted in Auckland, New Zealand. Participants (62 South Asian women, 18-50 years old) were stratified by dietary practices, then randomised to three treatment groups: B12 Supplement (oral cyanocobalamin 6 μg/day) (n=21), Placebo (n=21), or B12 Dietary Advice (n=20). Primary outcome measures were changes in B12 biomarkers (serum B12 and holotranscobalamin (holoTC)) at 6 months. Dietary B12 intake was estimated from a B12 food-specific frequency questionnaire (B12FFQ). Intention-to-treat analysis was applied using 'last observation carried forward' method. Changes in B12 biomarkers by treatment were compared using analysis of variance. Pearson's correlations tested relationships between dietary B12 intake and B12 biomarkers.At baseline, 48% of women tested as insufficient or deficient in serum B12 (222 pmol/l) and 51% as insufficient or deficient in holoTC (45 pmol/l). B12 status was moderately correlated with dietary B12 intake (r=0.5, 95% confidence interval (CI) (0.3-0.7)) and 44% of women reported insufficient dietary intake (2.4 μg/day). B12 Supplement was the only treatment group to record a significant increase in B12 biomarkers over 6 months: serum B12 by 30% (95% CI (11-48%)) and holoTC by 42% (12-72%).The prevalence of B12 insufficiency among Auckland South Asian women is high and moderately correlated with inadequate intake of foods that contain B12. Cyanocobalamin supplementation (6 μg/day) was associated with improved B12 biomarkers, with a potential to improve preconception B12 status in South Asian women.