Shedding Light on Falls: The Effect of Lighting Levels on Fall Risk in Long-Term Residential Care Facilities.

To compare lighting levels in care facilities with local recommendations and determine their cross-sectional association with fall rate, we recruited residents ( = 126) from 12 long-term care facilities (mean ± SD age 85.1 ± 7.9 years; 64.

Effects of an Exercise Program to Reduce Falls in Older People Living in Long-Term Care: A Randomized Controlled Trial.

Objectives: 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.

Process evaluation of the Safer Prescribing and Care for the Elderly (SPACE) cluster randomised controlled trial in New Zealand general practice.

Introduction The Safer Prescribing and Care for the Elderly (SPACE) cluster randomised controlled trial in 39 general practices found that a search of the practice database to identify and generate for each general practitioner (GP) a list of patients with high-risk prescribing, pharmacist-delivered one-on-one feedback to GPs, and electronic tick-box for GPs to select action for each patient (Patient letter; No letter but possible medication review when patient next in; No action), prompted safer prescribing at 6 months but not at 1 year. Aim This process evaluation explores research participation, intervention uptake and effect on GPs. Methods Mixed methods were used including quantitative data (log of practice recruitment, demographic data, intervention delivery and GP responses including tick-box selections) and qualitative data (trial pharmacist reflective journal).

Safer Prescribing and Care for the Elderly (SPACE): a cluster randomised controlled trial in general practice.

Background: Safer prescribing in general practice may help to decrease preventable adverse drug events (ADE) and related hospitalisations.

Aim: To test the effect of the Safer Prescribing and Care for the Elderly (SPACE) intervention on high-risk prescribing of non-steroidal anti-inflammatory drugs (NSAIDs) and/or antiplatelet medicines and related hospitalisations.

Design & Setting: A pragmatic cluster randomised controlled trial in general practice.

Costs of inpatient hospitalisations in the last year of life in older New Zealanders: a cohort study.

Background: Rapidly ageing populations means that many people now die in advanced age. This paper investigated public hospital and long-term care home costs in the 12 months before death in Māori and non-Māori of advanced age in New Zealand.

Methods: Data from an existing longitudinal study (LiLACS NZ) was used, in which 937 older New Zealanders were enrolled in 2010.

Association between dietary protein intake and change in grip strength over time among adults of advanced age: Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ).

Objective: To determine the association between dietary protein intake and change in grip strength (GS) over time among Māori and non-Māori of advanced age.

Methods: Protein intake was estimated from 2×24h multiple pass recall (MPR) in 554 participants, and GS was measured yearly over five years. Anthropometric, physical activity and health data were collected.

Modifiable Risk Factors and Change in Cognition of Māori and Non-Māori in Advanced Age: LiLACS NZ.

Objective: This study investigated whether previously identified modifiable risk factors for dementia were associated with cognitive change in Māori (indigenous people of New Zealand) and non-Māori octogenarians of LiLACS NZ (Life and Living in Advanced Age; a Cohort Study in New Zealand), a longitudinal study.

Method: Multivariable repeated-measure mixed effect regression models were used to assess the association between modifiable risk factors and sociodemographic variables at baseline, and cognitive change over 6 years, with values of <.05 regarded as statistically significant.

Dietary Protein Intake and Determinants in Māori and Non-Māori Octogenarians. Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu: Life and Living in Advanced Age: A Cohort Study in New Zealand.

Protein intake, food sources and distribution are important in preventing age-related loss of muscle mass and strength. The prevalence and determinants of low protein intake, food sources and mealtime distribution were examined in 214 Māori and 360 non-Māori of advanced age using two 24 h multiple pass recalls. The contribution of food groups to protein intake was assessed.

Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the 'oldest old'.

Background: Potentially inappropriate prescribing (PIP) is associated with negative health outcomes, including hospitalisation and mortality. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is a longitudinal study of Māori (the indigenous population of New Zealand) and non-Māori octogenarians. Health disparities between indigenous and non-indigenous populations are prevalent internationally and engagement of indigenous populations in health research is necessary to understand and address these disparities.

The Association Between Drug Burden Index (DBI) and Health-Related Outcomes: A Longitudinal Study of the 'Oldest Old' (LiLACS NZ).

Background: The prescribing of medications with anticholinergic and/or sedative properties is considered potentially inappropriate in older people (due to their side-effect profile), and the Drug Burden Index (DBI) is an evidence-based tool which measures exposure to these medications. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is an ongoing longitudinal study investigating the determinants of healthy ageing. Using data from LiLACS NZ, this study aimed to determine whether a higher DBI was associated with poorer outcomes (hospitalisation, falls, mortality and cognitive function and functional status) over 36 months follow-up.

Evaluating the effects of an exercise program (Staying UpRight) for older adults in long-term care on rates of falls: study protocol for a randomised controlled trial.

Background: Falls are two to four times more frequent amongst older adults living in long-term care (LTC) than community-dwelling older adults and have deleterious consequences. It is hypothesised that a progressive exercise program targeting balance and strength will reduce fall rates when compared to a seated exercise program and do so cost effectively.

Methods/design: This is a single blind, parallel-group, randomised controlled trial with blinded assessment of outcome and intention-to-treat analysis.

Diagnostic accuracy of a global cognitive screen for Māori and non-Māori octogenarians.

Introduction: We assessed the sensitivity and specificity of the Modified Mini-Mental State Examination (3MS) in predicting dementia and cognitive impairment in Māori (indigenous people of New Zealand) and non-Māori octogenarians.

Methods: A subsample of participants from were recruited to determine the 3MS diagnostic accuracy compared with the reference standard.

Results: Seventy-three participants (44% Māori) completed the 3MS and reference standard assessments.

Caregiving, ethnicity and gender in Māori and non-Māori New Zealanders of advanced age: Findings from LiLACS NZ Kaiāwhina (Love and Support) study.

Objective: This study investigates sex and ethnicity in relationships of care using data from Wave 4 of LiLACS NZ, a longitudinal study of Māori and non-Māori New Zealanders of advanced age.

Methods: Informal primary carers for LiLACS NZ participants were interviewed about aspects of caregiving. Data were analysed by gender and ethnic group of the LiLACS NZ participant.

High nutrition risk related to dietary intake is associated with an increased risk of hospitalisation and mortality for older Māori: LiLACS NZ.

Objectives: To investigate the association between domains of nutrition risk with hospitalisations and mortality for New Zealand Māori and non-Māori in advanced age.

Methods: Within LiLACS NZ, 256 Māori and 399 non-Māori octogenarians were assessed for nutrition risk using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN II) questionnaire according to three domains of risk. Sociodemographic and health characteristics were established.

Testosterone in advance age: a New Zealand longitudinal cohort study: Life and Living in Advanced Age (Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu).

Objectives: Serum testosterone (T) levels in men decline with age. Low T levels are associated with sarcopenia and frailty in men aged 80 years. T levels have not previously been directly associated with disability in older men.

What is the relationship between visual impairment and cognitive function in octogenarians?

Aims: To examine direct and indirect pathways between visual and cognitive function in advanced age.

Methods: We analysed cross-sectional baseline data from Life and Living in Advanced Age: A Cohort Study in New Zealand, which recruited equal sample sizes of Māori (n=421) and non-Māori (n=516) octogenarians. The Modified Mini-Mental State Examination assessed cognitive function.

Text messaging between clinicians and patients - Hve we got thngs unda cntrl?

INTRODUCTION Patients are interested in receiving text messages (texts) related to their health care. However, anecdotes are emerging of associated problems and it is possible that many of the potential pitfalls are not recognised. AIM To assess clinicians' attitudes and behaviours towards text messaging (texting) with patients.

Micronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ).

A high prevalence of undernutrition has previously been reported in indigenous Māori (49 %) and non-Māori (38 %) octogenarians and may be associated with risk of micronutrient deficiencies. We examined vitamin and mineral intakes and the contributing food sources among 216 Māori and 362 non-Māori participating in Life and Living to Advanced age a Cohort Study in New Zealand, using a repeat 24-h multiple-pass recall. More than half of the Māori and non-Māori participants had intakes below the estimated average requirement from food alone for Ca, Mg and Se.

Vitamin D status of Māori and non-Māori octogenarians in New Zealand: a Cohort Study (LiLACS NZ).

Background And Objectives: This study assessed vitamin D status and its determinants in a cohort of octogenarians living within New Zealand's Bay of Plenty and Lakes Districts.

Methods And Study Design: Serum 25- hydroxyvitamin D [25(OH)D] concentration was measured in 209 Māori (aged 80-90 years) and 357 non-Māori (85 years), along with demographic, lifestyle, supplement use and other health data.

Results: Mean [95% CI] 25(OH)D concentration was 69 [67 to 72] nmol/L, with 15% >100 nmol/L and 6 individuals >150 nmol/L.

Reliability of Mini-CEX Assessment of Medical Students in General Practice Clinical Attachments.

Background And Objectives: Mini Clinical Evaluation eXercise (mini-CEX) involves observation of routine clinical encounters, initially developed to assess clinical competencies of postgraduate doctors. This study aimed to measure its inter-rater reliability in assessment of medical students in general practice settings.

Methods: General practitioners (GPs) supervising medical students were invited to complete online teaching on how to conduct a mini-CEX.

Socioeconomic correlates of quality of life for non-Māori in advanced age: Te Puāwaitanga o Nga Tapuwae Kia ora Tonu. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ).

Aim: To establish socioeconomic and cultural profiles and correlates of quality of life (QoL) in non-Māori of advanced age.

Method: A cross sectional analysis of the baseline data of a cohort study of 516 non-Māori aged 85 years living in the Bay of Plenty and Rotorua areas of New Zealand. Socioeconomic and cultural characteristics were established by face-to-face interviews in 2010.

Macronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ).

As part of the 12-month follow-up of the longitudinal cohort study, Life and Living in Advanced Age: A Cohort Study in New Zealand, dietary intake was assessed in 216 Māori and 362 non-Māori octogenarians using repeat 24-h multiple pass recalls. Energy and macronutrient intakes were calculated, and food items reported were allocated to food groups used in the New Zealand Adult Nutrition Survey (NZANS). Intakes were compared with the nutrient reference values (NRV) for Australia and New Zealand.

A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

Problem: There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services.

Intervention: Medical students elected peer leaders who underwent training and then provided the intervention.