School of Clinical Sciences - Te Kura Mātai Haumanu

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https://hdl.handle.net/10292/1241

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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2023 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, TM
The 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.
2023 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; Education, Implementation, and Teams; and First Aid Task Forces
(Elsevier BV, 2023-11-09) 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; Bittencourt Couto, T; 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; Fernanda de Almeida, M; 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; Daripa Kawakami, M; 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; John Madar, R; Malta Hansen, C; 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, TM
The 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.
30-year trends in stroke rates and outcome in Auckland, New Zealand (1981-2012): a multi-ethnic population-based series of studies
(PLoS One, 2015) Feigin, VL; Krishnamurthi, RV; Barker-Collo, S; McPherson, KM; Barber, PA; Parag, V; Arroll, B; Bennett, DA; Tobias, M; Jones, A; Witt, E; Brown, P; Abbott, M; Bhattacharjee, R; Rush, E; Suh, FM; Theadom, A; Rathnasabapathy, Y; Te Ao, B; Parmar, PG; Anderson, C; Bonita, R; ARCOS IV Group
Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years.
A Case Series on the Effectiveness of the ReAktiv PDE Orthosis Following High-Energy Ankle Trauma
(Auckland University of Technology (AUT) Library, 2022-11-17) Gardner, Sarah
In this presentation I aim to highlight the effectiveness of the ReAktiv PDE orthosis to improve physical function in people who have sustained lower extremity injuries during high-energy trauma (HET). These injuries often require complex surgery and extensive rehabilitation, resulting in long-term problems such as pain, loss of function and limitations in physical activity. There is limited evidence in the literature on the success of passive-dynamic ankle-foot-orthosis being used for unloading traumatic ankle injuries and improving physical function in general populations as previous studies have predominantly been conducted on military personnel. For this study, a case series was used to evaluate the effect the ReAktiv PDE Orthosis and a six-week rehabilitation program had on physical function in people with a HET injury. Measures of physical function were recorded pre- and post-fitting of the orthosis in three people who had sustained a HET injury to the lower limb. Physical function was assessed using the Lower Extremity Functional Score (LEFS), Two-minute walk test (2MWT), Single-Leg Balance (SLB), Timed stair ascent (TSA), and the Four-square step test (FSST). Following wearing of the orthosis and the completion of the rehabilitation programme, lower limb function improved in two of the participants. These improvements in physical function were seen as indicated by the change in scores seen in the 2MWT, FSST, TSA and the SLB test at the commencement and conclusion of the rehabilitation programme. The ReAktiv PDE orthosis shows potential as a treatment option to improve walking performance in people who have sustained a lower extremity HET injury. In addition to the use of the orthosis, the use of a six-week physiotherapy-led rehabilitation programme, recorded further improvements in physical function specifically walking performance, physical mobility, and balance.
A Comparative Analysis of Global Optimization Algorithms for Surface Electromyographic Signal Onset Detection
(Elsevier BV, 2023-09-01) Alam, S; Zhao, X; Niazi, IK; Ayub, MS; Khan, MA
Surface Electromyography (sEMG) is a technique for measuring muscle activity by recording electrical signals from the surface of the body. It is widely used in fields such as medical diagnosis, human–computer interaction, and sports injury rehabilitation. The detection of the onset and offset of muscle activation is a longstanding challenge in sEMG analysis. This study pioneers the implementation, configuration, and evaluation of Particle Swarm Optimization (PSO) against other optimization algorithms for sEMG signal detection, including Genetic algorithms (GA), Simulated Annealing (SA), Ant Colony Optimization (ACO), and Tabu Search (TS). The results show that the PSO algorithm achieves the highest median accuracy and F1-Score and is the fastest among the selected algorithms but has lower stability compared to Genetic algorithms and Ant colony optimization. The design and value of the cost function had a significant impact on the results, with optimal results obtained when the cost value was between 0.1203 and 0.1384. The use of these algorithms improved detection efficiency and reduced the need for manual parameter adjustment. To the best of our knowledge, no published studies have utilized Simulated Annealing, Ant colony optimization, and Tabu search meta-heuristic algorithms to detect sEMG signal onsets.
A description of the methodology used in an overview of reviews to evaluate evidence on the treatment, harms, diagnosis/ classification, prognosis and outcomes used in the management of neck pain
(Bentham Open, 2013) Santaguida, L; Keshavarz, H; Carlesso, L; Lomoton, M; Gross, A; MacDermid, J; Walton, D; Reid, Duncan Arthur
Background: Neck Pain (NP) is a common musculoskeletal disorder and the literature provides conflicting evidence about its management. Objective: To describe the methodology used to conduct an overview of reviews (OvR) and to characterize the distribution and risk of bias profiles across the evidence for all areas of NP management. Methods: Standard systematic review (SR) methodology was employed. MEDLINE, CINAHL, EMBASE, ILC, Cochrane CENTRAL, and LILACS were searched from 2000 to March 2012; Narrative and SR and clinical practice guidelines (CPG) evaluating the efficacy of treatment (benefits and harms), diagnosis/classification, prognosis, and outcomes were eligible. For treatment, articles were limited to SRs from 2005 forward. Risk of bias of SR was assessed with the AMSTAR; the AGREE II was used to critically appraise the CPGs. Results: From 2476 articles, 508 were eligible for full text screening. A total of 341 articles were included. Treatment (n=117) had the greatest yield. Other clinical areas had less literature (diagnosis=54, prognosis=16, outcomes=27, harms=16). There were no SR for classification and narrative reviews were problematic for this topic. There was great overlap across different databases within each clinical area except for those for outcome measures. Risk of bias assessment using the AMSTAR of eligible SRs showed a similar trend across different clinical areas. Conclusion: A summary of methods used to review the literature in five clinical areas of NP management have been described. The challenges of selecting and synthesizing eligible articles in an OvR required customized solutions across different areas of clinical focus.
A Heideggerian Analysis of Good Care in an Acute Hospital Setting: Insights from Healthcare Workers, Patients and Families.
(Wiley, 2023-05-17) Dewar, Jan; Cook, Catherine; Smythe, Elizabeth; Spence, Deborah
This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research investigated accounts of good care provided by nursing, medical, allied and auxiliary staff. The Heideggerian phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, communicative nature of care. The study involved interviews with 17 participants: 3 previous patients, 3 family members and 11 staff. Data were analysed iteratively, dwelling with stories and writing and rewriting to surface the phenomenality of good care. The data set highlighted the following essential constituents: authentic care: caring encompassing solicitude (fürsorge); impromptu care: caring beyond role category; sustained care: caring beyond specialist parameters; attuned care: caring encompassing family and culture; and insightful care: caring beyond assessment and diagnosis. The findings are clinically significant because they indicate the importance of nurse leaders and educators harnessing the potential capacity of all healthcare workers to participate in good care. Healthcare workers reported that participating in or witnessing good care was uplifting and added meaning to their work, contributing to a sense of shared humanity.
A Historical Narrative of the Development of Midwifery Education in Indonesia
(Elsevier, 2022-06-20) Adnani, Qorinah Estiningtyas Sakilah; Gilkison, Andrea; McAra-Couper, Judith
AIM: To describe the history of midwifery education, present the current education programmes and explore the ways that have been undertaken to advance the midwifery profession in Indonesia. METHODS: Historical and contemporary government documents were reviewed. FINDINGS: The history of midwifery education in Indonesia shows a complex picture during and since colonisation with government, education institutes and association proposing different ways in which midwives were to be educated. Advocacy from the midwifery profession in Indonesia meant increasingly it is midwives who are determining how midwifery education is provided. Recent initiatives have resulted in a diploma, advanced diploma, bachelor's degree, and a master's degree in midwifery. The work of the midwifery profession advocating for midwifery education culminated in the Midwifery Act 2019. These changes in this Act will ensure that midwifery education meets the needs of women and their families but also lead to competent midwives who have the knowledge and skills to provide midwifery services at all levels of health provision. The history of midwifery in Indonesia illustrates the importance of the ICM pillars of association, regulation, and education. CONCLUSION: The history of midwifery education in Indonesia shows that for too long midwifery education was decided, determined and even regulated by authorities and disciplines other than midwifery. However, when the midwifery association and regulation inform and regulate midwifery education then there is an opportunity to provide care that will make a difference in outcomes for women and their families. The historical analysis of the story of Indonesia midwifery gives insight into what is required for quality education.
A Mixed-Methods Study Protocol on Factors Contributing to Suicide Clusters Among Native American Youth in a Northern Plains Reservation
(Frontiers Media SA, 2024-01-08) Brockie, T; Kahn-John, M; Mata Lopez, L; Bell, E; Brockie, T; Brockie, T; Decker, E; Glass, N; Has Eagle, H; Helgeson, K; Main, NJ; Kazemi, M; Perez-Monteau, R; Myrick, A; Nelson, KE; Ricker, A; Rider, T; Roberts, T; Wilson, DH; Yazzie, K; Perrin, N
Introduction: Suicide and suicide clusters within Native American Reservation communities are devastating to the entire community and increase individuals’ risk for suicide over the lifespan. The objective of this paper is to describe the Indigenous community-based participatory research protocol implemented in partnership with the Fort Belknap Indian Community in Montana, United States. The study protocol was developed to understand suicide risk and protective factors, and community-derived solutions, in a reservation community with history of a suicide cluster and high rates of youth suicide. Methods: In this mixed-methods study, qualitative data from youth, adults, and service providers and quantitative data from 200 adolescents and young adults (aged 14–24 years) were collected in Fort Belknap, Montana from May – December of 2022. Qualitative data were collected first via in-depth interviews and focus groups. Survey questions included validated and pre-tested measures of factors youth experience across socio-ecological levels. Thematic analysis was applied to the qualitative data; and logistic regression models were used to examine relationships within the quantitative data. Discussion: This study will add a multi-dimensional perspective to our current understanding of (1) risk and protective factors for suicide, community-derived postvention solutions, and insights on community assets, and (2) the current health and psychosocial status of youth in the Fort Belknap community. This study may serve as an exemplar of co-created, culturally safe solutions designed to address mental health resource gaps. Next steps include development of a suicide crisis response tool kit and a culturally aligned postvention intervention that will enhance individual, family, and community survivance.
A new paradigm for primary prevention strategy in people with elevated risk of stroke
(International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization, 2014-07) Feigin, VL; Norrving, B
Existing methods of primary stroke prevention are not sufficiently effective. Based on the recently developed Stroke Riskometer app, a new 'mass-elevated risk stroke/cardiovascular disease prevention' approach as an addition to the currently adopted absolute risk stroke/cardiovascular disease prevention approach is being advocated. We believe this approach is far more appealing to the individuals concerned and could be as efficient as the conventional population-based approach because it allows identification and engagement in prevention of all individuals who are at an increased (even slightly increased) risk of stroke and cardiovascular disease. The key novelty of this approach is twofold. First, it utilizes modern far-reaching mobile technologies, allowing individuals to calculate their absolute risk of stroke within the next 5 to 10 years and to compare their risk with those of the same age and gender without risk factors. Second, it employs self-management strategies to engage the person concerned in stroke/cardiovascular disease prevention, which is tailored to the person's individual risk profile. Preventative strategies similar to the Stroke Riskometer could be developed for other non-communicable disorders for which reliable predictive models and preventative recommendations exist. This would help reduce the burden of non-communicable disorders worldwide.
A phenomenological study of occupational engagement in recovery from mental illness
(SAGE, 2012) Sutton, D; Hocking, C; Smythe, L
This study aimed to uncover the meaning of occupation for 13 people who self identified as being in recovery from mental illness. Recovery narratives were collected from the participants in a series of open ended conversational interviews that were recorded and transcribed. The interview transcripts were analysed using phenomenological and hermeneutic approaches, with a focus on participants’ descriptions of engagement in everyday occupations. A range of experiences were evident, from complete disengagement to complete absorption in occupations. Participants described significant shifts in their experience of time, space, body and other people while in different modes of occupation and these were captured under the themes of ‘non-doing’, ‘half-doing’, ‘engaged doing’ and ‘absorbed doing’. Each mode had the potential to support recovery by creating opportunities for participants to reconnect with aspects of their being-in-the-world. The findings highlight the dynamics at play in different modes of occupation and suggest that all forms of engagement, including disengagement, can be significant in the recovery process. A greater understanding of the dynamics of occupation for people experiencing mental illness will enable carers and mental health services to more effectively support people in their recovery.
A postoperative shoulder exercise program improves function and decreases pain following open thoracotomy: a randomised trial
(Australian Physiotherapy Association, 2010) Reeve, J; Stiller, K; Nicol, K; McPherson, KM; Birch, P; Gordon, IR; Denehy, L
QUESTION: Does a postoperative physiotherapy exercise program incorporating shoulder exercises improve shoulder function, pain, range of motion, muscle strength, and health-related quality of life in patients undergoing elective pulmonary resection via open thoracotomy? DESIGN: Randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: 76 patients who underwent pulmonary resection via open thoracotomy. INTERVENTION: All participants received standard medical and nursing care involving a clinical pathway. The experimental group also received physiotherapy interventions that included daily supervised, progressive exercises until discharge and a postoperative exercise booklet on discharge. OUTCOME MEASURES: Preoperatively and up to 3 months postoperatively pain was measured with a numerical rating scale, shoulder function with the Shoulder Pain and Disability Index, and quality of life with the Short Form-36. Shoulder range of motion and muscle strength were measured in a subgroup. RESULTS: The experimental group had 1.3 units (95% CI 0.3 to 2.2) less shoulder pain (scored /10) and 2.2 units (95% CI 0.2 to 4.3) less total pain (scored /30) at discharge, and 7.6% (95% CI 1.7 to 13.6) better function at 3 months. The Short Form-36 physical component score was 4.8 points (95% CI -0.3 to 10.0) better for the experimental group than the control group at 3 months. Differences between groups in all range of motion and strength measures were small and statistically non-significant. CONCLUSION: A physiotherapist-directed postoperative exercise program resulted in significant benefits in pain and shoulder function over usual care for patients following open thoracotomy.
A Process for Assessing the Reliability and Validity of Questions for Use in Online Surveys: Exploring How Communication Technology Is Used Between Lead Maternity Carer Midwives and Pregnant People in Aotearoa New Zealand
(SAGE Publishing, 2023-01-22) Wakelin, KJ; McAra-Couper, J; Fleming, T; Erlam, GD
There is growing use of communication technology in Aotearoa New Zealand. How it is used between midwives and pregnant people is unknown. Surveys are ideal for gathering information when there is little known of a phenomenon. Aligning questions to a midwifery informed framework provides an innovate approach to explore this issue. To assess reliability and validity of questions for two online surveys using a tool created for an expert advisory group of midwives with experience in survey design and midwifery practice. An innovative approach is taken to validate questions for two online surveys using an expert advisory group of seven midwifery academic researchers with experience in both quantitative and qualitative research designs, and midwifery practice. The group were asked to rate items using a 4-point rating scale ranging from strongly agree to strongly disagree. Analysis of the scoring was undertaken using Content Validity Index, Cronbach’s alpha coefficient and review of comments by the group. Quantitative scoring of both survey instruments were valid and reliable. The overall Content Validity Index score was 0.92 (midwives) and 0.93 (pregnant people). The overall Cronbach’s alpha coefficient score was.78 (midwives) and.83 (pregnant people). Qualitative comments reinforced the validity and reliability of survey questions. An innovative approach was taken in assessing the reliability and validity of two online surveys using a midwifery expert advisory group and a midwifery framework to situate the surveys within a midwifery body of expertise and knowledge. The comments made by midwifery experts provided an extra layer in the validation of survey instruments using Content Validity Index and Cronbach’s alpha coefficient scoring. Creating a tool for validating questions developed by midwives for an expert group of midwives recognises the potential patriarchal roots of knowledge production and dissemination and enables marginalised voices to be heard.
A Randomized Controlled Trial Comparing Different Sites of High-Velocity Low Amplitude Thrust on Sensorimotor Integration Parameters
(Springer Science and Business Media LLC, 2024-01-12) Niazi, IK; Navid, MS; Merkle, C; Amjad, I; Kumari, N; Trager, RJ; Holt, K; Haavik, H
Increasing evidence suggests that a high-velocity, low-amplitude (HVLA) thrust directed at a dysfunctional vertebral segment in people with subclinical spinal pain alters various neurophysiological measures, including somatosensory evoked potentials (SEPs). We hypothesized that an HVLA thrust applied to a clinician chosen vertebral segment based on clinical indicators of vertebral dysfunction, in short, segment considered as “relevant” would significantly reduce the N30 amplitude compared to an HVLA thrust applied to a predetermined vertebral segment not based on clinical indicators of vertebral dysfunction or segment considered as “non-relevant”. In this double-blinded, active-controlled, parallel-design study, 96 adults with recurrent mild neck pain, ache, or stiffness were randomly allocated to receiving a single thrust directed at either a segment considered as “relevant” or a segment considered as “non-relevant" in their upper cervical spine. SEPs of median nerve stimulation were recorded before and immediately after a single HVLA application delivered using an adjusting instrument (Activator). A linear mixed model was used to assess changes in the N30 amplitude. A significant interaction between the site of thrust delivery and session was found (F1,840 = 9.89, p < 0.002). Pairwise comparisons showed a significant immediate decrease in the N30 complex amplitude after the application of HVLA thrust to a segment considered “relevant” (− 16.76 ± 28.32%, p = 0.005). In contrast, no significant change was observed in the group that received HVLA thrust over a segment considered “non-relevant” (p = 0.757). Cervical HVLA thrust applied to the segment considered as “relevant” altered sensorimotor parameters, while cervical HVLA thrust over the segment considered as “non-relevant” did not. This finding supports the hypothesis that spinal site targeting of HVLA interventions is important when measuring neurophysiological responses. Further studies are needed to explore the potential clinical relevance of these findings.
A service delivery model of Constraint-Induced Movement Therapy utilising clinical education
(World Confederation for Physical Therapy, 2011) Binns, E; Taylor, D
Purpose: To use a unique method of service delivery for Constraint-Induced Movement Therapy Relevance: Despite strong evidence of effectiveness Constraint-Induced Movement Therapy is not a readily available treatment option in New Zealand post-stroke. There is no hard evidence to provide a rationale for the lack of this treatment option however, anecdotally the amount of therapist time required and therefore the amount of human resource consumed deems this treatment financially prohibitive. Participants: A self-selected group of chronic stroke patients (n=6, time since stroke ranged from 22 to 84 months). Methods: A Constraint-Induced Movement Therapy programme was delivered five hours a day for five days a week for 2 two weeks. as per the original protocol described by Wolf and colleagues
A 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, Denise
Objective 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.
A Smartphone App Effectively Facilitates Mothers’ Mind-Mindedness: A Randomized Controlled Trial
(Wiley, 2023-11-15) Larkin, Fionnuala; Oostenbroek, Janine; Lee, Yujin; Hayward, Emily; Fernandez, Amy; Wang, Ying; Mitchell, Alex; Li, Lydia Y; Meins, Elizabeth
The efficacy of a smartphone app intervention (BabyMind©) in facilitating mind‐mindedness was investigated in a randomized controlled trial, assigning mothers and their 6‐month‐olds (N = 152; 72 girls, 146 White) to intervention or active control conditions. Mothers who had received the BabyMind© app intervention scored higher for appropriate (d = .61, 95% CI .28, .94) and lower for non‐attuned (d = −.55, 95% CI −.92, −.18) mind‐related comments at follow‐up (age 12 months), compared with their control group counterparts. Adjusting for missing data did not alter this pattern of findings. Mothers' baseline parental reflective functioning did not moderate these relations. Results are discussed in terms of the benefits of early intervention and exploring the efficacy of the app in more diverse populations.
A Snapshot of the Counselling and Psychotherapy Workforce in Australia in 2020: Underutilised and Poorly Remunerated, yet Highly Qualified and Desperately Needed
(Psychotherapy and Counselling Federation of Australia, 2021-11-01) Bloch-Atefi, Alexandra; Day, Elizabeth; Snell, Tristan; O'Neill, Gina
The aim of the 2020 workforce survey was to profile professionals affiliated with the Psychotherapy and Counselling Federation of Australia (PACFA) to inform future policy and service planning. PACFA is a national peak body for Australian counsellors and psychotherapists, representing 3,500 members across all states and territories. This study builds on previous workforce studies, the first of which was conducted in 2004. An online questionnaire was circulated to PACFA members covering participants’ demographics, qualifications, employment, sources of client referrals, client groups and presentations, along with the impact of the COVID-19 pandemic. Reflecting previous findings, participants predominantly identified as female, as coming from Australian or English backgrounds, and as being located in or around major cities. Notably, a higher proportion of counsellors and psychotherapists than psychologists and psychiatrists (who also have qualifications as counsellors or psychotherapists) were found in regional and rural Australia. The shortage of mental health services in Australia, especially in remote areas, and the desire for more working hours among over one quarter of registered practitioners, mean this workforce needs to be far better utilised to meet public demand and reduce health inequities for people in regional, rural, and remote Australia. Government recognition of registered counsellors and practitioners through Medicare’s Better Access subsidised sessions would significantly remedy the shortage of mental health services.
A Study Protocol for a Cluster-Randomised Controlled Trial of Smartphone-Activated First Responders with Ultraportable Defibrillators in Out-of-Hospital Cardiac Arrest: The First Responder Shock Trial (FIRST)
(Elsevier BV, 2023-09-01) Todd, Verity; Dicker, Bridget; Okyere, Daniel; Smith, Karen; Smith, Tony; Howie, Graham; Stub, Dion; Ray, Michael; Stewart, Ralph; Scott, Tony; Swain, Andy; Heriot, Natalie; Brett, Aroha; Mahony, Emily; Nehme, Ziad
Objective To describe the First Responder Shock Trial (FIRST), which aims to determine whether equipping frequently responding, smartphone-activated (GoodSAM) first responders with an ultraportable AED can increase 30-day survival rates in OHCA. Methods The FIRST trial is an investigator-initiated, bi-national (Victoria, Australia and New Zealand), registry-nested cluster-randomised controlled trial where the unit of randomisation is the smartphone-activated (GoodSAM) first responder. High-frequency GoodSAM responders are randomised 1:1 to receive an ultraportable, single-use AED or standard alert procedures using the GoodSAM app. The primary outcome is survival to 30 days. The secondary outcome measures (shockable rhythm, return of spontaneous circulation, event survival, and time to first shock delivery) are routinely collected by OHCA registries in both regions. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (Registration: ACTRN12622000448741) on 22 March 2022. Results The trial started in November 2022 and the last patient is expected to be enrolled in November 2024. We aim to detect a 7% increase in the proportion of 30-day survivors, from 9% in patients attended by control responders to 16% in patients attended by responders randomised to the ultraportable AED intervention arm. With 80% power, an alpha of 0.05, a cluster size of 1.5 and a coefficient of variation for cluster sizes of 1, the sample size required to detect this difference is 714 (357 per arm). Conclusion The FIRST study will increase our understanding of the potential role of portable AED use by smartphone-activated community responders and their impact on survival outcomes.
A survey of physiotherapy on-call and emergency duty services in New Zealand
(New Zealand Society of Physiotherapists, 2003) Reeve, JC
Physiotherapists working in hospitals are commonly required to undertake emergency on-call duties. Concerns from within the profession about the quality of on-call services have been expressed. The aims of this study were to audit oncall practice in New Zealand, identify variations in service provision and ascertain physiotherapists’ concerns in providing these services. A postal questionnaire was distributed to senior physiotherapists in all New Zealand hospitals expected to provide physiotherapy emergency on-call duties (n = 38). A response rate of 97.4% (n=37) was obtained of which 33 respondents provided on-call physiotherapy. Assessment of competency to undertake on-call duties, agreed standards of practice, the use of protocols, training and support provided were ascertained. Respondents were asked to highlight their most important concerns in the provision of their on-call service. These were found to be maintenance of competency, service provision, training and resource issues. This study demonstrates wide variations in the practice and provision of on-call duties by physiotherapists and highlights common concerns in the provision of these services. Strategies to diminish these concerns require further consideration at both national and local levels.

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