School of Clinical Sciences
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The School of Clinical Sciences plays an important role in specialist teaching and research conducted by its academic staff and postgraduate students. This places AUT students at the forefront of much of the ground-breaking research undertaken in New Zealand, especially in the fields of Midwifery, Nursing, Occupational Therapy, Oral Health, Paramedicine, Physiotherapy, Podiatry.
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Browsing School of Clinical Sciences by Subject "1103 Clinical Sciences"
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- Item2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Educati(Ovid Technologies (Wolters Kluwer Health), 2023-12-12) Berg, KM; Bray, JE; Ng, KC; Liley, HG; Greif, R; Carlson, JN; Morley, PT; Drennan, IR; Smyth, M; Scholefield, BR; Weiner, GM; Cheng, A; Djärv, T; Abelairas-Gómez, C; Acworth, J; Andersen, LW; Atkins, DL; Berry, DC; Bhanji, F; Bierens, J; Couto, TB; Borra, V; Böttiger, BW; Bradley, RN; Breckwoldt, J; Cassan, P; Chang, WT; Charlton, NP; Chung, SP; Considine, J; Costa-Nobre, DT; Couper, K; Dainty, KN; Dassanayake, V; Davis, PG; Dawson, JA; de Almeida, MF; De Caen, AR; Deakin, CD; Dicker, B; Douma, MJ; Eastwood, K; El-Naggar, W; Fabres, JG; Fawke, J; Fijacko, N; Finn, JC; Flores, GE; Foglia, EE; Folke, F; Gilfoyle, E; Goolsby, CA; Granfeldt, A; Guerguerian, AM; Guinsburg, R; Hatanaka, T; Hirsch, KG; Holmberg, MJ; Hosono, S; Hsieh, MJ; Hsu, CH; Ikeyama, T; Isayama, T; Johnson, NJ; Kapadia, VS; Kawakami, MD; Kim, HS; Kleinman, ME; Kloeck, DA; Kudenchuk, P; Kule, A; Kurosawa, H; Lagina, AT; Lauridsen, KG; Lavonas, EJ; Lee, HC; Lin, Y; Lockey, AS; Macneil, F; Maconochie, IK; Madar, RJ; Hansen, CM; Masterson, S; Matsuyama, T; McKinlay, CJD; Meyran, D; Monnelly, V; Nadkarni, V; Nakwa, FL; Nation, KJ; Nehme, Z; Nemeth, M; Neumar, RW; Nicholson, T; Nikolaou, N; Nishiyama, C; Norii, T; Nuthall, GA; Ohshimo, S; Olasveengen, TMThe International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
- ItemA Six-Month Telerehabilitation Programme Delivered via Readily Accessible Technology Is Acceptable to People Following Stroke: A Qualitative Study(Elsevier BV, 2023-05-19) Saywell, Nicola L; Mudge, Suzie; Kayes, Nicola M; Stavric, Verna; Taylor, DeniseObjective To explore the experiences of participants during a six-month, post-stroke telerehabilitation programme. Design A qualitative descriptive study to investigate participant experiences of ACTIV (Augmented Community Telerehabilitation Intervention), a six-month tailored exercise programme delivered by physiotherapists primarily using readily accessible telecommunication technology. Semi-structured, in-depth interviews were used to collect data, which were analysed using thematic analysis. Setting Interviews conducted in participants’ homes or a community facility. Participants Participants were eligible if they had a stroke in the previous 18 months and had participated in ACTIV. Results Twenty-one participants were interviewed. Four key themes were constructed from the data: 1. ‘ACTIV was not what I call physio’ (it differed from participants’ expectations of physiotherapy, but they reported many positive aspects to the programme). 2. ‘There’s somebody there’ (ongoing support from the physiotherapists helped participants find strategies to continue improving). 3. ‘Making progress’ (in the face of barriers, small improvements were valued). 4. ‘What I really want’ (participant goals were frequently more general than therapy goals and involved progress towards getting back to ‘normal’). Conclusions Although ACTIV was not what participants expected from physiotherapy, the majority found contact from a physiotherapist reduced the feeling of being left to struggle alone. Most participants found a programme with minimal face-to-face contact augmented by phone calls and encouraging text messages to be helpful and acceptable.
- ItemA Systematic Review of Fear of Falling and Related Constructs After Hip Fracture: Prevalence, Measurement, Associations with Physical Function, and Interventions(Springer Science and Business Media LLC, 2023-06-23) Gadhvi, Chandini; Bean, Debbie; Rice, DavidBackground Hip fracture is a common and debilitating injury amongst older adults. Fear of falling (FoF) and related constructs (balance confidence and falls efficacy) may impede rehabilitation after hip fracture. An updated systematic review to synthesize existing literature on FoF after hip fracture is needed. This review focussed on four research questions: In the hip fracture population: (1) What is the prevalence of FoF?; (2) What FoF assessment tools are validated? (3) What is the relationship between FoF and physical function?; (4) What interventions are effective for reducing FoF? Methods A systematic search was undertaken in EBSCO Health, Scopus and PsychINFO in January 2021 (and updated December 2022) for articles on FoF after hip fracture. Data in relation to each research question was extracted and analysed. The quality of the studies was appraised using the ‘Risk of Bias Tool for Prevalence Studies’, ‘COSMIN Risk of Bias checklist for Patient-reported outcome measures’, modified version of the ‘Appraisal Tool for Cross-sectional studies’, and the ‘Cochrane Risk of Bias 2’ tools for each research question, respectively. Results 36 studies (37 articles) with 5099 participants were included (mean age 80.2 years and average 78% female). Prevalence rates for FoF after hip fracture ranged between 22.5% and 100%, and prevalence tended to decrease as time progressed post hip fracture. The ‘Falls Efficacy Scale – International’ (FES-I) and ‘Fear of Falling Questionnaire – Revised’ (FFQ-R) were found to be reliable, internally consistent, and valid tools in hip fracture patients. FoF after hip fracture was consistently associated with measures of physical function including balance, gait speed, composite physical performance measures and self-reported function. Ten of 14 intervention studies were considered high risk of bias. Exercise-based interventions with or without a psychological component were not effective in reducing FoF after hip fracture compared to a control condition. Conclusion FoF is prevalent after hip fracture and is consistently associated with poorer physical function. Only two instruments (FES-I and FFQ-R) have been validated for measuring FoF in the hip fracture population. However, there remains a need for larger, higher quality randomised controlled trials targeting FoF after hip fracture in order to guide clinical practice.
- ItemChinese and Indian Interpretations of Pain: A Qualitative Evidence Synthesis To Facilitate Chronic Pain Management(Wiley, 2023-04-18) Lewis, Gwyn; Shaikh, Nusratnaaz; Wang, Grace; Chaudhary, Shikha; Bean, Debbie; Terry, garethObjective People from minority ethnicities often have a greater impact of chronic pain, are underrepresented at pain services, and may not benefit from treatment to the same extent as dominant cultures. The aim of this study was to review Indian and Chinese cultural views of pain and pain management, as a basis for improving management of chronic pain in migrant populations from these ethnicities. Methods A systematic review of qualitative studies addressing pain beliefs and experiences involving Indian and Chinese participants was conducted. Thematic synthesis was used to identify themes across the studies, and the quality of the articles was appraised. Results Twenty-six articles were included, most of which were appraised as high quality. Five themes were identified: Making meaning of pain described the holistic interpretation of the meaning of pain; Pain is disabling and distressing described the marked physical, psychological, and spiritual impact of pain; Pain should be endured described the cultural expectation to suppress responses to pain and not be a burden; Pain brings strength and spiritual growth described the enrichment and empowerment some people experienced through living with pain, and Management of pain goes beyond a traditional or Western approach described the factors that guided people in their use of healthcare. Discussion The review identified a holistic interpretation and impact of pain in Indian and Chinese populations, with pain management guided by multiple factors that transcended a single cultural framework. Several strength-based management strategies are recommended based on preferences for traditional treatments and respect for Western healthcare.
- ItemCritical Physiotherapy: A Ten-Year Retrospective(Informa UK Limited, 2023-09-09) Nicholls, DA; Ahlsen, B; Bjorbækmo, W; Dahl-Michelsen, T; Höppner, H; Rajala, AI; Richter, R; Hansen, LS; Sudmann, T; Sviland, R; Maric, FCritical physiotherapy has been a rapidly expanding field over the last decade and could now justifiably be called a professional sub-discipline. In this paper we define three different but somewhat interconnected critical positions that have emerged over the last decade that share a critique of physiotherapy’s historical approach to health and illness, while also diverging in the possibilities for new forms of practice and thinking. These three positions broadly align with three distinctive philosophies: approaches that emphasize lived experience, social theory, and a range of philosophies increasingly referred to as the “posts”. In this paper we discuss the origins of these approaches, exploring the ways they critique contemporary physiotherapy thinking and practice. We offer an overview of the key principles of each approach and, for each in turn, suggest readings from key authors. We conclude each section by discussing the limits of these various approaches, but also indicate ways in which they might inform future thinking and practice. We end the paper by arguing that the various approaches that now fall under the rubric of critical physiotherapy represent some of the most exciting and opportune ways we might (re)think the future for the physiotherapy profession and the physical therapies more generally.
- ItemDid Lockdown Influence Bystanders’ Willingness To Perform Cardiopulmonary Resuscitation? A Worldwide Registry-Based Perspective(Elsevier BV, 2023-03-17) Tjelmeland, Ingvild BM; Wnent, Jan; Masterson, Siobhan; Kramer-Johansen, Jo; Eng Hock Ong, Marcus; Smith, Karen; Skogvoll, Eirik; Lefering, Rolf; Lynn Lim, Shir; Liu, Nan; Dicker, Bridget; Swain, Andrew; Ball, Stephen; Gräsner, Jan-Thorsten; Lockdown, bystander CPR groupAIM: Bystander cardiopulmonary resuscitation (CPR) significantly increases the survival rate after out-of-hospital cardiac arrest. Using population-based registries, we investigated the impact of lockdown due to Covid-19 on the provision of bystander CPR, taking background changes over time into consideration. METHODS: Using a registry network, we invited all registries capable of delivering data from 1. January 2017 to 31. December 2020 to participate in this study. We used negative binominal regression for the analysis of the overall results. We also calculated the rates for bystander CPR. For every participating registry, we analysed the incidence per 100000 inhabitants of bystander CPR and EMS-treated patients using Poisson regression, including time trends. RESULTS: Twenty-six established OHCA registries reported 742 923 cardiac arrest patients over a four-year period covering 1.3 billion person-years. We found large variations in the reported incidence between and within continents. There was an increase in the incidence of bystander CPR of almost 5% per year. The lockdown in March/April 2020 did not impact this trend. The increase in the rate of bystander CPR was also seen when analysing data on a continental level. We found large variations in incidence of bystander CPR before and after lockdown when analysing data on a registry level. CONCLUSION: There was a steady increase in bystander CPR from 2017 to 2020, not associated with an increase in the number of ambulance-treated cardiac arrest patients. We did not find an association between lockdown and bystanders' willingness to start CPR before ambulance arrival, but we found inconsistent patterns of changes between registries.
- ItemDoes Physiotherapy Research in South Korea Match International Best-practice Osteoarthritis Guidelines? A Narrative Review(New Zealand Journal of Physiotherapy, 2024-03-28) La Park, ML; Magni, N; O’brien, DWThe aim of this study was to explore physiotherapy-based osteoarthritis (OA) research conducted in South Korea, focusing on the utilisation of non-surgical management and its alignment with international clinical practice guidelines (CPGs). Databases (MEDLINE, EMBASE, CINAHL and SPORTDiscus – accessed via EBSCOhost) and Google Scholar were searched to identify clinical articles and trials focused on research related to OA management in physiotherapy conducted in South Korea. A total of 11 studies met the inclusion criteria – nine were randomised controlled trials, one utilised a prospective design and one adopted a quasi-experimental approach. These studies employed various interventions such as kinesiology tape, electrotherapies, and exercise. None of the studies implemented education, self-management, and weight control as management. There is a discrepancy between research-based physiotherapy for OA management in South Korea and international CPGs. These findings may be explained by factors such as education, healthcare systems, and cultural differences.
- ItemDonor-Linking Provisions in New Zealand: Counselling Roles, Concerns and Needs.(Informa UK Limited, 2024-04-25) Goedeke, Sonja; Gamble, HeatherDonor-linking where those genetically related through donor conception (e.g. donor-conceived persons (DCP), donors and siblings), or recipient parents, search for and connect with each other, is increasingly common, both in identity-release jurisdictions where donors' identifying information may be released to DCP, usually when they become adults - and in anonymous jurisdictions, e.g. as a result of direct-to-consumer DNA testing. In this paper, we explore New Zealand fertility clinic counsellors' views regarding their donor-linking roles and their concerns and needs in relation to current and anticipated service provision. Counsellors believed that fertility service providers had a longer-term responsibility to offer donor-linking services to ensure the wellbeing of all parties affected by donor conception. They perceived their role as complex and multifaceted, encompassing psychoeducation, mediation, advocacy, facilitation, relationship counselling, and therapeutic intervention. They identified significant service provision challenges however, including inadequate staffing, training, time and prioritisation of donor-linking, and inadequate legislative provisions to support practice. Counsellors called for clarity in legislation addressing different contexts of donation and providing measures to ensure the recording of and access to identifying information. They expressed a need for comprehensive, funded donor-linking services, therefore facilitating choice, and services staffed by professionally trained and supported staff.
- ItemEffects of an Exercise Program to Reduce Falls in Older People Living in Long-Term Care: A Randomized Controlled Trial(Elsevier BV, 2023-11-29) Taylor, LM; Parsons, J; Moyes, SA; Binns, E; Cavadino, A; Taylor, D; Lord, S; Del Din, S; Klenk, J; Rochester, L; Kerse, NObjectives: To investigate the effect of an exercise program on falls in intermediate and high-level long-term care (LTC) residents and to determine whether adherence, physical capacity, and cognition modified outcomes. Design: Randomized controlled trial. Setting and Participants: Residents (n = 520, aged 84 ± 8 years) from 25 LTC facilities in New Zealand. Methods: Individually randomized to Staying UpRight, a physical therapist–led, balance and strength group exercise program delivered for 1 hour, twice weekly over 12 months. The control arm was dose-matched and used seated activities with no resistance. Falls were collected using routinely collected incident reports. Results: Baseline fall rates were 4.1 and 3.3 falls per person-year (ppy) for intervention and control groups. Fall rates over the trial period were 4.1 and 4.3 falls ppy respectively [P = .89, incidence rate ratio (IRR) 0.98, 95% CI 0.76, 1.27]. Over the 12-month trial period, 74% fell, with 63% of intervention and 61% of the control group falling more than once. Risk of falls (P = .56, hazard ratio 1.08, 95% CI 0.85, 1.36) and repeat falling or fallers sustaining an injury at trial completion were similar between groups. Fall rates per 100 hours walked did not differ between groups (P = .42, IRR 1.15, 95% CI 0.81, 1.63). Program delivery was suspended several times because of COVID-19, reducing average attendance to 26 hours over 12 months. Subgroup analyses of falls outcomes for those with the highest attendance (≥50% of classes), better physical capacity (Short Physical Performance Battery scores ≥8/12), or cognition (Montreal Cognitive Assessment scores ≥ 18/30) showed no significant impact of the program. Conclusions/Implications: In intermediate and high-level care residents, the Staying UpRight program did not reduce fall rates or risk compared with a control activity, independent of age, sex, or care level. Inadequate exercise dose because of COVID-19–related interruptions to intervention delivery likely contributed to the null result.
- ItemEmpowering Pacific Patients on the Weight Loss Surgery Pathway: A Co-designed Evaluation Study(Springer, 2024-02-12) Taylor, Tamasin; Beban, Grant; Yi, Elaine; Veukiso, Michael; Sang-Yum, Genevieve; Dewes, Ofa; Wrapson, Wendy; Taufa, Nalei; Campbell, Andrew RT; Siegert, Richard; Shepherd, PeterPurpose: Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. In collaboration with the Auckland City Hospital bariatric surgery team, a Pacific-led preoperative weight loss surgery program was co-designed, delivered, and evaluated between 2020 and 2023. Materials and Methods: This was a single-arm, prospective co-designed evaluation study that took place at Auckland City Hospital in Aotearoa New Zealand. Participants were Pacific patients (n = 14) referred to the weight loss surgery program. Survey and video diaries were analyzed to determine if the program had the potential to increase Pacific patient retention through the preoperative stage of weight loss surgery, increase surgery completion rates, and improve the quality of treatment experiences. Results: Nine out of 14 participants attended all preoperative sessions. Six participants subsequently underwent weight loss surgery. Program components that had positive impacts on patient success and satisfaction were accessibility, information quality, having Pacific role models, cultural safety, and the group support system. The patients found the program to be culturally anchored and there was support for the implementation of the program going forward. Conclusion: This study demonstrated how a culturally anchored intervention can increase patient retention for those patients who may not respond to mainstream treatment. Adjusting existing preoperative weight loss surgery programs to integrate Pacific-led models of healthcare has the potential to increase Pacific patient resiliency to follow through with surgery. Graphical Abstract: (Figure presented.)
- ItemEnvironmental Physiotherapy and the Case for Multispecies Justice in Planetary Health(Taylor & Francis, ) Maric, F; Nicholls, DABackground: Global environmental change is fundamentally altering the composition and functioning of our planetary ecosystem. Effectively presenting the largest threat to the health of present and future generations, these changes and their health impacts are forcing us to think and practice healthcare in much broader terms than ever before. Objective: In this article, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy developed through a succession of carefully developed arguments. Discussion: We show how an underpinning belief in human exceptionalism has engendered an exploitative relationship with our natural planetary environment that has both shaped Western science and healthcare and led to our current environmental health crisis. Building on the dependence of human health on our planetary ecosystem, approaches like planetary health hold great promise for a corresponding, paradigmatic turn in healthcare. They fall short of this however, where they perpetuate anthropocentric interests and interventionist practices that have underpinned healthcare to date. Drawing on ethical and post-human philosophies we argue against human exceptionalism and for a solidarity that includes other-than-humans as the primary characteristic of planetary existence. Conclusion: Building on this foundation, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy, grounded in ecological awareness, multispecies justice, and a range of consonant practices of passivity and accompaniment, conceived as an alternative to the commonplace interventionism of healthcare.
- ItemEthnic Differences of the Care Pathway Following an Out-of-Hospital Cardiac Event: A Systematic Review(Elsevier, 2023-10-27) Newport, Rochelle; Grey, Corina; Dicker, Bridget; Ameratunga, Shanthi; Harwood, MatireAIM: This systematic review aimed to determine to what extent and why the care pathways for acute cardiac events in the community might differ for minoritised ethnic populations compared to non-minoritised populations. It also sought to identify the barriers and enablers that could influence variations in access to care for minoritised populations. METHODS: A multi-database search was conducted for articles published between 1 January 2000 and 1 January 2023. A combination of MeSH terms and keywords was used. Inclusion criteria for papers were published in English, adult population, the primary health condition was an acute cardiac event, and the primary outcomes were disaggregated by ethnicity or race. A narrative review of extracted data was performed, and findings were reported according to the PRISMA 2020 guidelines. RESULTS: Of the 3552 articles identified using the search strategy, 40 were deemed eligible for the review. Studies identified a range of variables in the care pathway that differed by ethnicity or race. These could be grouped as time to care, transportation, event related-variables, EMS interactions and symptoms. A meta-analysis was not performed due to heterogeneity across the studies. CONCLUSION: The extent and reasons for differences in cardiac care pathways are considerable. There are several remediable barriers and enablers that require attention to achieve equitable access to care for minoritised populations.
- ItemExercise Therapy for Knee Osteoarthritis Pain: How Does It Work? A Study Protocol for a Randomised Controlled Trial(BMJ, 2024-01-10) Beckwée, D; Nijs, J; Bierma-Zeinstra, SMA; Leemans, L; Leysen, L; Puts, S; Rice, D; Schiphof, D; Bautmans, IINTRODUCTION: Muscle strengthening training (MST) and behavioural graded activity (BGA) show comparable effects on knee osteoarthritic (KOA) pain, but the mechanisms of action remain unclear. Both exercise-induced anti-inflammation and central sensitisation are promising pathways for pain relief in response to exercise therapy in patients with KOA: MST has the potential to decrease inflammation and BGA has the potential to decrease central sensitisation. Hence, this study aims to examine inflammation and central sensitisation as mediators for the effect of MST and/or BGA on pain in patients with KOA. METHODS AND ANALYSIS: The Knee OsteoArthritis PAIN trial started on 10 January 2020 (anticipated end: April 2024). The three-arm clinical trial aims to recruit 90 KOA patients who will be randomly allocated to 12 weeks of (1) MST, (2) BGA or (3) care as usual. Assessments will be performed at baseline, 13 and 52 weeks after finishing the intervention. Outcomes, including pain (Knee injury and Osteoarthritis Outcome Score), were chosen in line with the OARSI recommendations for clinical trials of rehabilitation interventions for OA and the IMMPACT/OMERACT recommendations for the assessment of physical function in chronic pain clinical trials. Inflammation as well as features of central sensitisation (including conditioned pain modulation, offset analgesia, temporal summation of pain and event-related potentials following electrical stimulation), will be considered as treatment mediators. A multiple mediators model will be estimated with a path-analysis using structural equation models. In July 2023, all 90 KOA patients have been included and 42 participants already finished the study. ETHICS AND DISSEMINATION: This study obtained ethics approval (B.U.N. 143201941843). Unravelling the mechanisms of action of exercise therapy in KOA will not only be extremely valuable for researchers, but also for exercise immunology and pain scientists and clinicians. TRIAL REGISTRATION NUMBER: NCT04362618.
- ItemExperiences of Participating in a Group-Based Sensory Modulation Intervention for Mental Health Service Users(Informa UK Limited, 2023-12-19) Forsberg, Klara; Sutton, Daniel; Stjernswärd, Sigrid; Bejerholm, Ulrika; Argentzell, ElisabethBackground People with mental health issues often experience difficulties with sensory modulation affecting occupational engagement. Research conducted in inpatient units has shown positive effects of individual sensory modulation interventions, however, research on experiences of group-based interventions in outpatient units is limited. Hence, a group-based sensory modulation intervention was adapted and tested within Swedish mental health outpatient units. Aim To explore the experiences of participating in a group-based sensory modulation intervention for service users in mental health outpatient units. Material and methods This qualitative study involved interviews with 25 informants who had participated in the intervention. The interview data were analysed using reflexive thematic analysis. Results Synthesis of the interviews resulted in one overarching theme of ‘Embodied awareness facilitates improved coping and sense of self’ organised into four themes: (1) ‘Developing embodied awareness and strategies’, (2) ‘Taking control of everyday life’, (3) ‘Creating a stronger sense of self’, and (4) ‘From alienation to belonging’. Conclusion and significance The informants experienced the intervention to provide new embodied coping strategies that had previously been neglected. This understanding may enrich occupational therapy practice in new ways to support service users’ engagement in occupations.
- ItemExtended Families? Contact Expectations and Experiences of Egg Donors Donating to Previously Unknown Recipients(Informa UK Limited, 2023-12-13) Goedeke, S; Gamble, H; Thurlow, RIn New Zealand egg donation is identity-release, and donors may be known to recipients, e.g. family members/friends, or previously unknown e.g. clinic-recruited or sourced through advertising. In the case of unknown donors, New Zealand practice allows donors and recipients to meet face-to-face prior to donation in a joint counselling meeting. While contact details may not necessarily be exchanged in counselling, information-exchange and contact expectations are usually addressed. In previous papers, we explored donors’ motivations and experiences of donation. In this paper, we explore donors’ ideas around their role in relation to the donor-conceived person (DCP) and their expectations and experiences of information-exchange and contact. While donors did not see themselves as parents and were aware of appropriate boundaries, they described a sense of ongoing connection to DCP, often framing this in extended family terms. They desired to be kept informed about DCP, considered themselves ‘on standby’ for information requests or in-person contact and valued the opportunity for connection between their children and DCP. Donors were, however, cognisant of the limits to their ability to ensure information-exchange and contact and sometimes struggled with their perceived disempowered position. Meeting prior to donation may both clarify and reinforce expectations of information-exchange and contact.
- ItemFactors Which Influence Participation in Telerehabilitation – A Scoping Review of the Literature(Physiotherapy New Zealand, 2023-11-28) Candy, Sarah; Reeve, Julie; Taylor, DenisePulmonary rehabilitation (PR) is a high-value intervention for people living with a chronic respiratory disease. Uptake and completion of PR remains low, and telerehabilitation provides an alternative model for remotely delivering PR, which may improve the reach of this intervention. While telerehabilitation is safe and likely equivalent to centre-based PR, little is known about the barriers to participation in telerehabilitation to date. This scoping review aims to better understand the factors influencing perception of and participation in telerehabilitation for people living with a chronic respiratory disease. Scopus, MEDLINE, and CINAHL were searched between July 27 to November 23, 2022. Articles were screened, and those fulfilling inclusion criteria were extracted to a standard template. Extracted data were analysed using narrative synthesis. Twenty-seven studies met the inclusion criteria. People living with a chronic respiratory disease perceive telerehabilitation to be convenient and flexible, but technically challenging and lacking in contact with clinicians and peer support. The experiences from a small number of people who have participated in these programmes counter this with praise for the therapeutic relationship they developed with their clinician and the social support they received.
- ItemFamily & Bystander Experiences of Emergency Ambulance Services Care: A Scoping Review.(Springer Science and Business Media LLC, 2023-06-14) Satchell, Eillish; Carey, Melissa; Dicker, Bridget; Drake, Haydn; Gott, Merryn; Moeke-Maxwell, Tess; Anderson, NatalieBACKGROUND: Emergency ambulance personnel respond to a variety of incidents in the community, including medical, trauma and obstetric emergencies. Family and bystanders present on scene may provide first aid, reassurance, background information or even act as proxy decision-makers. For most people, involvement in any event requiring an emergency ambulance response is a stressful and salient experience. The aim of this scoping review is to identify and synthesise all published, peer-reviewed research describing family and bystanders' experiences of emergency ambulance care. METHODS: This scoping review included peer-reviewed studies that reported on family or bystander experiences where emergency ambulance services responded. Five databases were searched in May 2022: Medline, CINAHL, Scopus, ProQuest Dissertation & Theses and PsycINFO. After de-duplication and title and abstract screening, 72 articles were reviewed in full by two authors for inclusion. Data analysis was completed using thematic synthesis. RESULTS: Thirty-five articles reporting heterogeneous research designs were included in this review (Qualitative = 21, Quantitative = 2, Mixed methods = 10, Evidence synthesis = 2). Thematic synthesis developed five key themes characterising family member and bystander experiences. In an emergency event, family members and bystanders described chaotic and unreal scenes and emotional extremes of hope and hopelessness. Communication with emergency ambulance personnel played a key role in family member and bystander experience both during and after an emergency event. It is particularly important to family members that they are present during emergencies not just as witnesses but as partners in decision-making. In the event of a death, family and bystanders want access to psychological post-event support. CONCLUSION: By incorporating patient and family-centred care into practice emergency ambulance personnel can influence the experience of family members and bystanders during emergency ambulance responses. More research is needed to explore the needs of diverse populations, particularly regarding differences in cultural and family paradigms as current research reports the experiences of westernised nuclear family experiences.
- ItemFragility and Back Pain: Lessons from the Frontiers of Biopsychosocial Practice(Oxford University Press (OUP), 2023-04-20) Nicholls, David A
- ItemGlobal, Regional, and National Burden of Diseases and Injuries for Adults 70 Years and Older: Systematic Analysis for the Global Burden of Disease 2019 Study(BMJ, ) Tyrovolas, S; Stergachis, A; Krish, VS; Chang, AY; Skirbekk, V; Dieleman, JL; Chatterji, S; Abd-Allah, F; Abdollahi, M; Abedi, A; Abolhassani, H; Abosetugn, AE; Abreu, LG; Abrigo, MRM; Abu Haimed, AK; Adabi, M; Adebayo, OM; Adedeji, IA; Adekanmbi, V; Adetokunboh, OO; Adham, D; Advani, SM; Afarideh, M; Agarwal, G; Aghaali, M; Aghamir, SMK; Agrawal, A; Ahmad, S; Ahmad, T; Ahmadi, K; Ahmadi, M; Ahmed, MB; Akinyemi, RO; Al-Aly, Z; Alam, K; Alanezi, FM; Alanzi, TM; Alcalde-Rabanal, JE; Alemu, BW; Al-Hajj, S; Alhassan, RK; Ali, S; Alicandro, G; Alijanzadeh, M; Alipour, V; Aljunid, SM; Alla, F; Almadi, MAH; Almasi-Hashiani, A; Almulhim, AM; Al-Raddadi, RM; Aminorroaya, A; Amiri, F; Amit, AML; Amugsi, DA; Anbesu, EW; Ancuceanu, R; Anderlini, D; Andrei, T; Andrei, CL; Androudi, S; Anjomshoa, M; Ansari, F; Ansari-Moghaddam, A; Antonio, CAT; Antony, B; Anvari, D; Anwer, R; Arabloo, J; Arab-Zozani, M; Ärnlöv, J; Asaad, M; Asadi-Aliabadi, M; Asadi-Pooya, AA; Atout, MMDW; Ausloos, M; Ausloos, F; Ayala Quintanilla, BP; Ayano, G; Ayanore, MA; Aynalem, YA; Azari, S; Azene, ZN; Babaee, E; Badiye, AD; Balachandran, A; Banach, M; Banerjee, SK; Banik, PC; Barker-Collo, SL; Basu, S; Baune, BT; Bayati, M; Baye, BA; Bedi, N; Beghi, E; Béjot, Y; Bell, ML; Bensenor, IM; Bhagavathula, ASObjectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. Setting Participants were aged ≥70 from 204 countries and territories, 1990-2019. Main outcomes measures Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods. Results Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in non-communicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks. Conclusions Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.
- ItemHow Does the Clinical Practice of Aotearoa New Zealand Podiatrists Align with International Guidelines for the Prevention of Diabetes-Related Foot Disease? A Cross-Sectional Survey(2023-08-22) Jepson, Hannah; Lazzarini, Peter A; Garrett, Michele; Carroll, Matthew RBACKGROUND: Given the importance of preventive care for the lower limb in people with diabetes, and the absence of local guidelines in Aotearoa New Zealand (NZ), the aim of this study was to determine the alignment of assessment and management used in the prevention of diabetes-related foot disease by NZ podiatrists to the international prevention guideline recommendations. METHODS: A 37-item web-based survey was developed using a 5-point Likert scale (0 = always; 5 = never) based on the International Working Group of the Diabetic Foot (IWGDF) 2019 prevention guidelines and included domains on participant demographics, sector, caseloads, guidelines, screening, management, education, and referral. The survey was distributed to NZ podiatrists through the NZ podiatry association and social media. Participants completing > 50% of items were included. The Mann-Whitney U test was used to examine differences between sector subgroups. RESULTS: Seventy-seven responses (16.3% of the NZ podiatry workforce) were received, of which 52 completed > 50% of items and were included. Of those 52 podiatrists, 73% were from the private sector. Public sector podiatrists reported higher weekly caseloads of patients with diabetes (p = 0.03) and foot ulcers (p < 0.001). The New Zealand Society for the Study of Diabetes (NZSSD) risk stratification pathway and IWGDF guidelines were the two most frequently utilised guidance documents. Participants reported median scores of at least "often" (< 2) for all items in the assessment and management, inspection, examination, and education provision domains for people with a high-risk foot. More than 50% of respondents reported screening more frequently than guideline recommendations for people with a very low to moderate risk foot. Structured education program was only used by 4 (5%) participants. Public sector podiatrists reported greater provision of custom-made footwear (p = 0.04) and multi-disciplinary team care (p = 0.03). CONCLUSION: NZ podiatrists generally follow international guideline recommendations with respect to screening, self-care education, appropriate footwear, and treatment of risk factors for people at-risk of diabetes-related foot disease. However there may be over-screening of people with very low to medium risk occurring in clinical practice. Increasing access to integrated healthcare, custom-made footwear and structured educational programmes appear to be areas of practice that could be developed in future to help prevent diabetes-related foot disease in NZ.
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