Fatigue After Stroke Educational Recovery Program: A Prospective, Phase III, Randomized Controlled Trial.

Background: Poststroke fatigue affects ≈50% of patients with stroke, causing significant personal, societal, and economic burden. In the FASTER (Fatigue After Stroke Educational Recovery) study, we assessed a group-based educational intervention for poststroke fatigue.

Methods And Results: Two hundred patients with clinically significant fatigue were included and randomized to either a general stroke education control or fatigue management group (FMG) intervention and assessed at baseline, 6 weeks, and 3 months.

IFOMPT's Educational Standards and International Monitoring: A member survey and review.

Background: The International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT) membership requires accreditation of countries postgraduate musculoskeletal physiotherapy programmes to meet IFOMPT's Educational Standards through International Monitoring. The Educational Standards and International Monitoring are both being reviewed.

Objectives: To seek insight and feedback from IFOMPT's membership on the Educational Standards and International Monitoring to inform the current review.

Long-term accuracy of the National Emergency Laparotomy Audit risk score: Analysis of the impact of comorbidities on mortality 5 years after emergency laparotomy.

Background: The National Emergency Laparotomy Audit (NELA) risk prediction tool has demonstrated superiority in predicting 30-day mortality after emergency laparotomy (EL). The aim of our study was to evaluate the accuracy of NELA in calculating long-term (5 year) mortality and determine factors predicting long-term risk of death after EL.

Methods: This retrospective cohort study included consecutive patients who underwent EL for any indication other than trauma between May 2012 and June 2017 at a large tertiary and academic teaching center.

Home-based EEG Neurofeedback for the Treatment of Chronic Pain: A Randomized Controlled Clinical Trial.

This parallel, 2-arm, blinded, randomized controlled superiority trial examined whether, when added to usual care, active-electroencephalography neurofeedback (EEG NFB) was safe and more effective than sham control-EEG NFB for chronic pain. In total, 116 participants with chronic pain were randomly assigned (1:1) to usual care plus ≥32 sessions of active-EEG NFB upregulating relative alpha power over C4 or usual care plus ≥32 sessions of sham control-EEG NFB. Per-protocol analyses revealed no significant between-group differences in the primary outcome, Brief Pain Inventory average pain (mean difference [95% confidence interval]: -.

Tracking the 3-year trajectory of referrals to an early psychosis intervention service.

Aim: To review the baseline and clinical characteristics of patients referred to a New Zealand Early Psychosis Intervention (EPI) service across a 4-year timeframe.

Method: We compared two cohorts, and identified variables associated with being accepted or declined, and reasons for decline, by an EPI service between 2013 and 2017.

Results: There were 576 people with suspected psychosis referred to the EPI service for assessment: 300 (52%) were accepted, 221 (38%) declined and 55 (10%) were not processed.

Environmental Influences on the Behavioural and Emotional Outcomes of Children: A Network Analysis.

Background: Intellectual developmental disorders are a serious source of health morbidity with negative consequences for adults as well as children. However, there is limited evidence on the environmental, trace element, behavioural, and emotional outcomes in children. Here, we investigated whether there is any association between child behaviour and emotional outcomes and micronutrients using network analysis.

A Secondary-Primary Mental Health Integrated Care Model for Communities with Diverse Population and Complex Health Needs - a Case Study with Health Care Utilization Evaluation.

Unlabelled: Integrated care is expected to improve patient experience, patient outcomes and assist with the increasing demand on health services from those with long term conditions including mental disorder. Few studies have evaluated health care utilization as a consequence of increased integration of mental health care. This study considers the factors known to influence secondary health service utilization and investigated the impact of a locality based mental health integrated model of care (ILoC) providing specialist consultation and liaison advice to primary care, to support early diagnosis and treatment.

Sputum procalcitonin: a potential biomarker in stable bronchiectasis.

Sputum procalcitonin is elevated in exacerbations of bronchiectasis. The primary aim of this study was to investigate whether sputum procalcitonin levels are higher in patients with stable bronchiectasis than in healthy controls. We also assessed differences in procalcitonin levels in spontaneously expectorated and induced sputum samples and their repeatability 1 week later.

Evaluating and improving current risk prediction tools in emergency laparotomy.

Purpose: Emergency laparotomy (EL) encompasses a high-risk group of operations, which are increasingly performed on a heterogeneous population of patients, making preoperative risk assessment potentially difficult. The UK National Emergency Laparotomy Audit (NELA) recently produced a risk predictive tool for EL that has not yet been externally validated. We aimed to externally validate and potentially improve the NELA tool for mortality prediction after EL.

Documenting psychiatric risk: more than ticking boxes.

Objective: The purpose of this study was to audit the completion of risk assessment documentation by staff working within an acute adult mental health setting.

Method: Fifty risk assessment forms in a district health board's acute adult mental health service were audited for completion. Clinicians provided verbal feedback on the audit results.

Diagnostic accuracy of procalcitonin for the early diagnosis of anastomotic leakage after colorectal surgery: a meta-analysis.

Background: Anastomotic leakage (AL) is a dreaded complication following colorectal surgery. Procalcitonin is one of many biomarkers studied and research has suggested that it has improved accuracy for the diagnosis of AL compared with other inflammatory biomarkers such as C-reactive protein. This meta-analysis was conducted to evaluate the accuracy of procalcitonin in the early diagnosis of AL following colorectal surgery.

Do community-dwelling Māori and Pacific peoples present with dementia at a younger age and at a later stage compared with NZ Europeans?

Objective: Ethnicity may affect presentation to clinical services in people with dementia; however, no studies have examined this in Māori or Pacific peoples in New Zealand (NZ). Our objective was to examine the routinely collected clinical data from a memory assessment service in South Auckland to examine the presentation of dementia in the major NZ ethnic groups.

Methods: A total of 360 patients presenting to a memory service with a new diagnosis of dementia were included in this study.

The reliability of the Epworth Sleepiness Score in a sleep clinic population.

Despite the Epworth Sleepiness Score being widely used, there are limited studies of its reliability in clinical practice. The aim of this study was to assess the reliability of the Epworth Sleepiness Score in a clinical population. The study included patients referred to Middlemore Hospital sleep service between October and November 2014, aged over 17 years, with at least two Epworth Sleepiness Score measurements at up to three different points on the diagnostic pathway: on General Practitioner referral (GP Epworth Sleepiness Score); at overnight oximetry assessment (Oximetry Epworth Sleepiness Score); and at a specialist clinic (Specialist Epworth Sleepiness Score).

Review of Statistical Learning Methods in Integrated Omics Studies (An Integrated Information Science).

Integrated omics is becoming a new channel for investigating the complex molecular system in modern biological science and sets a foundation for systematic learning for precision medicine. The statistical/machine learning methods that have emerged in the past decade for integrated omics are not only innovative but also multidisciplinary with integrated knowledge in biology, medicine, statistics, machine learning, and artificial intelligence. Here, we review the nontrivial classes of learning methods from the statistical aspects and streamline these learning methods within the statistical learning framework.

Clinical characteristics affecting length of stay in patients with cellulitis.

Background: This study aimed to profile the clinical characteristics of patients presenting to Middlemore Hospital with cellulitis in order to identify factors that are associated with an increased length of stay (LOS).

Methods: Retrospective clinical data were collected for all patients aged 18 and above who were admitted with cellulitis to Middlemore Hospital General Surgical Department between 1 January and 31 March 2014. Comorbidities, laboratory results and medical conditions were included in the investigation.

Status and interrelationship of toenail elements in Pacific children.

Objective: Elemental deficiencies or in excess effects growth and development. Pacific population are at a disadvantage due to food insecurity as compared to New Zealand European households. This study aims to evaluate the status and interrelationship of elements (essential, non-essential and toxic) in nine-year-old Pacific children who were part of the Pacific Island Families Study living in New Zealand.

Comparison of four methods of endotracheal tube passage in simulated airways: There is room for improved techniques.

Objective: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective.

Methods: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie.

Validation of the assessment of risk tool: patient prioritisation technology for clinical pharmacist interventions.

Background: Adverse drug events (ADEs) pose a heavy burden on health systems worldwide. The assessment of risk tool (ART) was developed to help prioritise hospitalised patients for interventions such as medication reconciliation (MR) and review, and to reduce potential ADEs from unintentional medication discrepancies and prescribing errors.

Aim: To validate ART, and to determine which of the selected 25 flags were significantly associated with risk of unintentional medication discrepancies and prescribing errors.

Periprosthetic Joint Infection Is the Main Cause of Failure for Modern Knee Arthroplasty: An Analysis of 11,134 Knees.

Background: Although large series from national joint registries may accurately reflect indications for revision TKAs, they may lack the granularity to detect the true incidence and relative importance of such indications, especially periprosthetic joint infections (PJI).

Questions/purposes: Using a combination of individual chart review supplemented with New Zealand Joint Registry data, we asked: (1) What is the cumulative incidence of revision TKA? (2) What are the common indications for revising a contemporary primary TKA? (3) Do revision TKA indications differ at various followup times after primary TKA?

Methods: We identified 11,134 primary TKAs performed between 2000 and 2015 in three tertiary referral hospitals. The New Zealand Joint Registry and individual patient chart review were used to identify 357 patients undergoing subsequent revision surgery or any reoperation for PJI.

Derivation and validation of the APPEND score: an acute appendicitis clinical prediction rule.

Background: Although many clinical prediction rules (CPRs) for appendicitis exist, none have been developed for a New Zealand population presenting with right iliac fossa (RIF) pain. The aim of this study was to derive and validate an appendicitis CPR for our population.

Method: This is a retrospective review of all patients from December 2010 to February 2012 of at least 15 years of age presenting to the general surgery service with RIF pain.

Definition determines weight regain outcomes after sleeve gastrectomy.

Background: Sleeve gastrectomy (SG) is one of the most commonly undertaken bariatric procedures. Weight regain after bariatric surgery, when significant, may be associated with recurrence of diabetes and deterioration in quality of life. Furthermore, it may be more common after SG than bypass procedures.

Burnout, quality of life, motivation, and academic achievement among medical students: A person-oriented approach.

Background: The aim of this study was to identify burnout and quality of life profiles of medical students and determine their associations with academic motivation and achievement on progress tests using a person-oriented approach.

Methods: Medical students (n = 670) in Year 3 to Year 5 at the University of Auckland were classified into three different profiles as derived from a two-step cluster analysis using World Health Organization Quality of Life-BREF scores and Copenhagen Burnout Inventory scores. The profiles were used as independent variables to assess differences in academic motivation and achievement on progress tests using a multivariate analysis of co-variance and repeated measures analysis of co-variance methods.