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Play is the context for acquiring social skills. While it is logical to suspect that the difficulties associated with ADHD would affect play, there is surprisingly little work in that area. Further, there is almost no previous research describing the playmates of children with ADHD. This study involved children with ADHD ( n = 112) playing with a usual playmate ( n = 112), and pairs of age-, ethnicity-, and sex-matched children ( n = 126) playing together. In this paper, the authors interpret the data from the perspective of the playmates. The overall finding was that the play behavior of the playmates closely resembled that of the children with ADHD; it was characterized by low levels of empathy. A primary purpose of this paper is to explore possible explanations for this surprising finding. Two possible explanations are explored. First, children with ADHD are demanding playmates so that children who play with them mirror their negative behaviors. Second, although the playmates did not have ADHD, their play behaviors might reflect the known risk of negative behaviors reported amongst siblings and peers of children with ADHD. Evidence to support both explanations is presented and new lines of research are proposed to examine each possibility. [ABSTRACT FROM AUTHOR]

This paper suggests that India will be the next important tourist generating country to emerge after the People's Republic of China, and seeks to provide some information on a key segment of future overseas tourists, the well educated. The paper reports the results of a study of over 1,000 Indian students at four Indian universities. The study uses the Leisure Motivation Scale of Beard and Ragheb (1983) and replicates a finding of four dimensions, albeit with a modification relating to the intellectual and challenge factors. The destination used for the study was New Zealand for a number of reasons. At the time of the study the New Zealand Prime Minister had recently visited India, Tourism New Zealand had opened offices in Mumbai and a, then current, popular Bollywood film had been produced in New Zealand. Attitudes toward New Zealand were found to be positive, and some evidence is provided for the possible development of more urban based tourism in New Zealand to avoid the environmentally damaging aspects associated with more traditional adventure tourists in that country. The paper ends with various recommendations and comments. [ABSTRACT FROM AUTHOR]

This paper examines age-related differences in voice quality between 15 young and 15 old speakers, using electroglottographic (EGG) recordings of three elicitation types: sustained vowels, hVd word lists, and readings of the Rainbow Passage. For each elicitation type, fundamental frequency (F0), contact quotient (Qx), and their standard deviations are analysed. Results found, for all three elicitations, that Qx was significantly lower for older speakers. F0 was higher for the older speakers, but this was only significant for the hVd word lists. Sustained vowels were used to examine the effect of target pitch and loudness on F0 and Qx. Both Qx and F0 were raised with increased target loudness. The hVd word lists were used to examine the phonetic effects of different vowels. Lip rounded vowels had higher Qx than non-lip rounded vowels. Readings of the Rainbow Passage encompassed prosodic and phonetic variations in F0 and Qx, in addition to voice quality. F0 and Qx contours of the hVd word lists and the vowel/ei/taken from the Rainbow Passage were analysed using the discrete cosine transform. The hVd frame produced coarticulation effects on the Qx contour, but no such effects were evident for the vowel /ei/. The study concluded that using multiple elicitation types is beneficial in the study of the effect of age on the voice, and that analysing contour tracks for F0 and Qx will allow further examination of how prosodic and phonetic effects interact with age-related changes in voice quality. [ABSTRACT FROM PUBLISHER]

Spirituality is increasingly understood to be important in healthcare provision, as seen in policy, guidelines and practice across many Western healthcare systems. Definitions of spirituality remain controversial, despite their importance for consistency in research and practice. This paper reports on the definition findings of a nation-wide New Zealand (NZ) study (2006–2008) that examined understandings, experiences and ways to improve spiritual care, primarily focused in hospices. A mixed methods approach included 52 semi-structured interviews and a survey of 642 patients, family members and staff from 25 (78%) of NZ's hospices. A generic qualitative design and analysis was used to capture the experiences and understandings of participants' spirituality and spiritual care and a cross-sectional survey gave sample-based information about the study's questions. Across both studies the majority view held that spirituality is a useful, important, inclusive and broadly defined concept. NZ is a secular country, yet there is clear evidence that spirituality is important at the end of life. These findings add weight to the international trend for spirituality to be further investigated and attended to in healthcare. [ABSTRACT FROM AUTHOR]

The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]

New Zealand blackcurrant (NZBC) extract is a rich source of anthocyanins and in order to exert physiological effects, the anthocyanin-derived metabolites need to be bioavailable in vivo. We examined the plasma uptake of selected phenolic acids following NZBC extract supplementation alongside maintaining a habitual diet (i.e. not restricting habitual polyphenol intake). Twenty healthy volunteers (nine females, age: 28 ± 7 years, height 1.73 ± 0.09 m, body mass 73 ± 11 kg) consumed a 300 mg NZBC extract capsule (CurraNZ®; anthocyanin content 105 mg) following an overnight fast. Venous blood samples were taken pre and 1, 1.5, 2, 3, 4, 5, and 6 h post-ingestion of the capsule. Reversed-phase high-performance liquid chromatography (HPLC) was used for analysis of two dihydroxybenzoic acids [i.e. vanillic acid (VA) and protocatechuic acid (PCA)] and one trihydroxybenzoic acid [i.e. gallic acid (GA)] in plasma following NZBC extract supplementation. Habitual anthocyanin intake was 168 (95%CI:68–404) mg⋅day−1 and no associations were observed between this and VA, PCA, and GA plasma uptake by the NZBC extract intake. Plasma time-concentration curves revealed that GA, and PCA were most abundant at 4, and 1.5 h post-ingestion, representing a 261% and 320% increase above baseline, respectively, with VA remaining unchanged. This is the first study to demonstrate that an NZBC extract supplement increases the plasma uptake of phenolic acids GA, and PCA even when a habitual diet is followed in the days preceding the experimental trial, although inter-individual variability is apparent. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to explore the intersection between mild traumatic brain injury (MTBI) recovery experiences and injury understandings, using both quantitative and qualitative methods. Materials and Methods: The quantitative component was a descriptive case–control study comparing participants (n = 76) who had recovered or not recovered after an MTBI, across demographic and psychological variables. A subset of participants (n = 10) participated in a semi-structured interview to explore experiences of recovery in more detail. We followed threads across the datasets to integrate findings from component methods. Results: The quantitative analyses revealed differences between the two groups in terms of injury recovery understandings and expectations. The qualitative analyses suggested that achieving consistency across information sources was important. By tracing threads back and forth between the component datasets, we identified a super-ordinate meta-theme that captured participants' experiences of wrestling with uncertainty about their recovery and the impacts in terms of heightened anxiety, confusion, and feelings of invalidation. Conclusion: The effectiveness of psychoeducation and reassurance after MTBI may be optimized when content is tailored to the individual. Clinicians are urged to attend both to the subjective interpretations patients make of information gained from formal and informal, internal and external sources, and where information across these sources conflicts and creates uncertainty. Effectiveness of psychoeducation and reassurance after injury may be optimized when content is tailored to the individual rather than being generic. Effectiveness of such interventions may also be optimized by understanding the subjective interpretations individuals make of injury knowledge gleaned from formal and informal, internal and external sources. Conflicting information from such multiple sources may create uncertainty with associated increased distress as an individual negotiates their recovery from injury. Attending to this uncertainty may be a helpful target for treatment. [ABSTRACT FROM AUTHOR]

Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18–80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder. [ABSTRACT FROM AUTHOR]

Background: Satisfaction with life is a complex interplay of older people's perspectives on life achievements. Satisfaction with life, alongside health and functional ability contribute to successful ageing. Aim: To explore the impact of increasing age on older people's perceptions of their health, functional ability and life satisfaction. Methods: A cross-sectional survey of non-institutionalised older people (65+) was conducted (n = 542). The Short Form-12 Health Survey measured perceived physical and mental health, the Groningen Activity Restriction Scale measured functional ability and the Satisfaction With Life Scale measured life satisfaction. Results: Significant group differences were found; while participants' perceptions of health and function decreased with age, perceptions of life satisfaction increased. Unexpectedly, the youngest groups reported low levels of life satisfaction while the oldest reported very high levels. Conclusions: Further study should consider factors that might influence the perception of health, functional ability and particularly life satisfaction across older age groups. [ABSTRACT FROM AUTHOR]

Objective: To develop and assess use, acceptability and feasibility of an ecological hearing conservation programme for workplaces.Design: A school-based public health hearing preservation education programme (Dangerous Decibels®) was adapted for workplaces using the Multi-level Approach to Community Health (MATCH) Model. The programme was delivered in small manufacturing companies and evaluated using a questionnaire before the training and at one week and two-months after training.Study sample: Workers (n = 56) from five small manufacturing companies were recruited.Results: There was a significant improvement in knowledge, attitudes and behaviour of workers at the intrapersonal level; in behaviour motivation and safety culture at the interpersonal and organisational levels; and an overall improvement in hearing-health behaviour after two months post-intervention.Conclusions: The developed programme offers a simple, interactive and theory-based intervention that is well accepted and effective in promoting positive hearing-health behaviour in workplaces. [ABSTRACT FROM PUBLISHER]

Objectives: (1) To examine whether the willingness of people to socialize with adolescents with brain injury is influenced by gender, visibility of injury and/or knowing how to interact with people with brain injury; and (2) To consider two models: the responsibility model (attributions about the cause of a condition) and the danger appraisal model (perceptions of dangerousness due to anger/aggression) for their effect on willingness to socialize and to understand how these perceptions lead to avoidant behaviour. Method and procedures: Participants were recruited either by personal approach or via Facebook advertising and completed a survey after reading a brief vignette and seeing a photo of an adolescent male or female, with or without a head scar. Vignettes for some participants were varied to represent perceptions of responsibility and dangerousness Main outcomes and results: ANOVAs and structural equation modelling revealed that participants were more willing to socialize with the adolescents with a scar than with no scar. Knowledge about how to interact with survivors impacted willingness to socialize, but familiarity did not. The full danger appraisal model was supported, but only some aspects of the responsibility model were supported. Conclusion: The results provide useful information for rehabilitation health professionals working with survivors of brain injury. The implications of these findings are discussed with regards to assisting adolescents’ re-entry into society post-injury. [ABSTRACT FROM PUBLISHER]

Purpose: Language sample analysis is a powerful clinical tool for identifying and describing the oral language difficulties of children with language impairment. In response to a lack of existing Australian normative data, the current study collected spoken language samples from 127 children attending the first 3 years of schooling (YOS). This dataset was compared with the New Zealand (NZ) database of language samples to determine whether clinicians can use overseas databases for appraising language performance of Australian children. Method: Children participated in several oral language tasks: conversation, personal narratives, story retelling and exposition (YOS3 only). Result: Analyses of the spoken language samples revealed a developmental trend of increasing syntactic complexity, semantic diversity and verbal productivity. Discourse genre had a significant impact on children's language production, with the expository task yielding the syntactically most complex language from the YOS 3 children. Comparisons between the Australian and NZ datasets revealed some differences in performance, with the Australian children showing better syntactic complexity. Conclusion: The Australian dataset of language samples provides clinicians with useful information regarding young school-age children's performance on a range of discourse tasks deemed important for classroom participation. Care should be taken when using the NZ database for diagnostic purposes. [ABSTRACT FROM AUTHOR]

Objective: The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury. Method: Adults (>15 years) with mild TBI (n = 260) completed neuropsychological (CNS-Vital Signs, Behavioural Dyscontrol Scale), mood (Hospital Anxiety Depression Scale) and behavioural assessments (Cognitive Failures Questionnaire, Rivermead Post-Concussion Questionnaire) at baseline, 1-, 6- and 12-months post-injury. Results: Over the 12-months post-injury self-reported cognition (p = 0.027), post-concussion symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001) and dyscontrol (p = 0.025) improved significantly. Assessments of memory, processing speed, executive function, psychomotor speed/reaction time, complex attention and flexibility also improved significantly. At baseline >20% of individuals produced very low scores on executive ability, complex attention and cognitive flexibility. At 1- and 6-month follow-ups >20% of participants were very low for complex attention, with 16.3% remaining so at 12-months. Executive abilities and speed were related to post-concussion symptoms, mood and self-reported cognition at 12-months. Conclusions: Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods. [ABSTRACT FROM PUBLISHER]

Objectives:Behavioral and psychological symptoms of dementia (BPSD) cause significant stress and distress to both aged-care residents and staff. This study evaluated a training program to assist staff to manage BPSD in residential care. Method:A randomised controlled trial (RCT) was employed. The study was included in the Australian and New Zealand Clinical Trial Register residential care facilities. Staff (n= 204) and residents (n= 187) were from 16 residential care facilities. Facilities were recruited and randomly assigned to four staff training conditions: (1) training in the use of a BPSD-structured clinical protocol, plus external clinical support, (2) a workshop on BPSD, plus external clinical support, (3) training in the use of the structured clinical protocol alone, and (4) care as usual. Staff and resident outcome measures were obtained pre-intervention, three months and six months post-intervention. The primary outcome was changes in BPSD, measured using the Cohen-Mansfield Agitation Inventory (CMAI) as well as frequency and duration of challenging behaviors. Secondary outcomes were changes in staff adjustment. Results:There were improvements in challenging behaviors for both intervention conditions that included training in the BPSD instrument, but these were not maintained in the condition without clinical support. The training/support condition resulted in sustained improvements in both staff and resident variables, whereas the other conditions only led to improvement in some of the measured variables. Conclusion:These results demonstrate the effectiveness of the BPSD protocol in reducing BPSD and improving staff self-efficacy and stress. [ABSTRACT FROM AUTHOR]

The purpose of this study was to quantify the inter-session reliability of force–velocity–power profiling and estimated maximal strength in youth. Thirty-six males (11–15 years old) performed a ballistic supine leg press test at five randomized loads (80%, 100%, 120%, 140%, and 160% body mass) on three separate occasions. Peak and mean force, power, velocity, and peak displacement were collected with a linear position transducer attached to the weight stack. Mean values at each load were used to calculate different regression lines and estimate maximal strength, force, velocity, and power. All variables were found reliable (change in the mean [CIM] = − 1 to 14%; coefficient of variation [CV] = 3–18%; intraclass correlation coefficient [ICC] = 0.74–0.99), but were likely to benefit from a familiarization, apart from the unreliable maximal force/velocity ratio (CIM = 0–3%; CV = 23–25%; ICC = 0.35–0.54) and load at maximal power (CIM = − 1 to 2%; CV = 10–13%; ICC = 0.26–0.61). Isoinertial force–velocity–power profiling and maximal strength in youth can be assessed after a familiarization session. Such profiling may provide valuable insight into neuromuscular capabilities during growth and maturation and may be used to monitor specific training adaptations. [ABSTRACT FROM PUBLISHER]

Primary objective: This study investigated psychological disorders for patients receiving traumatic brain injury (TBI) rehabilitation within a community-based TBI service in New Zealand. Research design: Cross-sectional study involving retrospective review of clinical notes for all referrals received in a 6-month period. This methodology was selected to gain a sample of individuals reflective of the range of patients seen in TBI rehabilitation services in New Zealand. Methods and procedures: The clinical records for 279 patients were reviewed for formal psychiatric diagnoses and references to moderate or severe psychological symptoms. Main outcomes and results: Of the clinical records, 57.7% noted significant psychological problems post-injury ( n = 161) and 8.6% had a psychiatric diagnosis recorded, with 10.8% reporting psychological disorders pre-injury. In comparison, 15.1% had input from a clinical psychologist and 2.2% had involvement from a mental health team. Conclusions: The rate of psychological symptoms was significantly higher post-TBI than pre-TBI and few of the patients reporting significant psychological symptoms were receiving intervention from mental health professionals. Further research is needed regarding the ability of TBI rehabilitation professionals in New Zealand to identify and respond to the psychological implications of TBI and on the ability of TBI and mental health teams to liaise effectively. [ABSTRACT FROM AUTHOR]

Interventions that identify and develop character strengths have been shown to benefit well-being, academic engagement and achievement. Strengths research within positive psychology has focused primarily on individual outcomes with less attention on group or relationships effects. This study (N = 193) examined the effect of a classroom-based strengths intervention on class cohesion and friction, relatedness, engagement, well-being and strengths use. A six-session programme was trialled with 9–12-year-old students. Students learned to recognise strengths and practised strengths-related goal setting. At three-months post-test, multi-level modelling indicated that intervention group participants scored significantly higher on class cohesion and relatedness need satisfaction, and lower on class friction than the non-randomised control group. Programme participants also reported higher levels of positive affect, classroom engagement, autonomy need satisfaction and strengths use. School-based strengths interventions may influence individual perceptions of class climate, engagement and student relatedness in addition to individual well-being. [ABSTRACT FROM PUBLISHER]

The screening and monitoring of phonological awareness (PA) in the classroom is of great importance to the early identification and prevention of reading disorder. This study investigated whether a time-efficient computer-based PA screening and monitoring assessment (Com-PASMA) could accurately predict end-of-year reading outcomes for 5-year-old children in the first year of schooling. A longitudinal design was employed where the Com-PASMA was used to measure the PA ability of 95 5-year-old children at the start, middle, and end of the first year of school. Of this group, 21 children presented with spoken language impairment. Reading outcomes were formally measured after 1 year of schooling. School-entry measures of PA using the Com-PASMA (p < .001), in conjunction with language ability (p = .004), accounted for 68.9% of the variance in end-of-year word decoding ability. Sensitivity and specificity calculations demonstrated that the Com-PASMA was 92% accurate at school-entry, and 94% accurate by the middle of the school year in predicting reading outcomes at 6-years of age. Results suggest that a time-efficient computer-based method of screening and monitoring PA can support the early identification of reading difficulties in the first year of schooling. [ABSTRACT FROM AUTHOR]

Primary objective: The occurrence of facial affect recognition difficulties in a sample of people accessing traumatic brain injury (TBI) rehabilitation services was examined. It was hypothesized that between 13-39% of participants would demonstrate clinically significant impairment in facial affect recognition. Research design: Cross-sectional sample of eligible participants who were current clients of eight brain injury services were invited to participate. Methods and procedures: Forty-five participants with mild-to-severe TBI were assessed for facial affect recognition difficulties using the facial affect discrimination, naming, selection and matching sub-tests of the Florida Affect Battery. Main outcomes and results: Fifty-one per cent of participants had at least moderate difficulties with facial affect recognition. Conclusions: The current sample was not a random selection from the population of people with TBI, so the results do not establish a formal estimate of prevalence. Nonetheless, the data indicate that when assessing typical clients with severe brain injuries presenting to neurorehabilitation services, there is likely to be a high frequency of occurrence of facial affect recognition difficulties. Rehabilitation outcomes may be improved by screening for and treating facial affect recognition difficulties following TBI. Further examination and development of treatment options is warranted. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the spoken expository discourse skills of children and adolescents elicited in generation and retelling conditions. There were three groups of participants: young school-age children (M = 7.0 years; n = 64); intermediate-school-age children (M = 11.3 years; n = 18) and high-school-age students (M = 17.6 years; n = 18). Participants were asked to generate expository discourse using the favourite game or sport (FGS) task and to retell an expository passage about the game of curling. All samples were transcribed and analysed on measures of verbal productivity (number of utterances), syntactic complexity (mean length of utterance in T-units [MLU] and clausal density) and verbal fluency (percent maze words). Results indicated that although all age groups produced longer samples in the generation condition, MLU was significantly longer in the retelling condition. The results suggest that the expository retelling task may be a clinically useful addition to a language assessment battery for children and adolescents. [ABSTRACT FROM AUTHOR]

Background/Study Context: Research largely shows no performance differences between older and younger employees, or that older workers even outperform younger employees, yet negative attitudes towards older workers can underpin discrimination. Unfortunately, traditional “explicit” techniques for assessing attitudes (i.e., self-report measures) have serious drawbacks. Therefore, using an approach that is novel to organizational contexts, the authors supplemented explicit with implicit (indirect) measures of attitudes towards older workers, and examined the malleability of both. Methods: This research consists of two studies. The authors measured self-report (explicit) attitudes towards older and younger workers with a survey, and implicit attitudes with a reaction-time-based measure of implicit associations. In addition, to test whether attitudes were malleable, the authors measured attitudes before and after a mental imagery intervention, where the authors asked participants in the experimental group to imagine respected and valued older workers from their surroundings. Results: Negative, stable implicit attitudes towards older workers emerged in two studies. Conversely, explicit attitudes showed no age bias and were more susceptible to change intervention, such that attitudes became more positive towards older workers following the experimental manipulation. Conclusion: This research demonstrates the unconscious nature of bias against older workers, and highlights the utility of implicit attitude measures in the context of the workplace. In the current era of aging workforce and skill shortages, implicit measures may be necessary to illuminate hidden workplace ageism. [ABSTRACT FROM PUBLISHER]

Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13–18 presenting to an adolescent outpatient mental health service. At the time of the interview, 37.6% were smokers according to the study definition, with 25.8% scoring high or very high on the Fagerstrom Test for Nicotine Dependence. Smoking was more likely if patients had conduct disorder or cannabis/alcohol dependence or abuse, but no difference was detected between smokers and nonsmokers in relation to attention-deficit/hyperactivity disorder, depression, or anxiety disorders. Only 15.1% of patients were given a chart diagnosis of nicotine dependence. [ABSTRACT FROM AUTHOR]

Primary objective: To determine how visible markers of brain injury interact with people's knowledge about brain injury to influence people's attributions for undesirable behaviours of a person with brain injury. Research design, method and procedures: Scenarios in Experiment 1 ( n = 98) and Experiment 2 ( n = 148) described an adolescent pictured with or without a head scar, who showed four behavioural changes. Participants rated two causal attributions for each behaviour: brain injury and adolescence. Experiment 1 varied information that the adolescent had a brain injury and Experiment 2 assessed participants' familiarity with brain injury. Main outcomes and results: The presence of a head scar increased attributions to brain injury. In Experiment 1, participants not informed about the brain injury attributed the behaviours more to adolescence than to brain injury than informed participants. In Experiment 2, in the 'no scar' condition participants familiar with brain injury attributed the behaviours more to brain injury than those who were not. Conclusion: Markers of brain injury interact with people's knowledge about brain injury in shaping people's attributions for the behaviour of persons with brain injury. When people attribute sequelae of the brain injury to other causes, this may hinder appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Clinical decisions require insight and foresight. When these are lacking, overconfidence and error can occur. Aims: Multiple choice questions (MCQ) responses were used to estimate insight, as determined by confidence in responses, and foresight, as determined by the safety of incorrect responses. Methods: An MCQ response system was developed which reflected confidence in, and safeness of, responses. An optional examination incorporating this system was offered to medical students at one university. Results: A total of 372 students completed the study. There was evidence of insight. The proportion of responses that were correct rose from 32% for low confidence to 77% for high confidence. The proportion that was incorrect and not unsafe fell from 34% for low confidence to 7% for high confidence. There was less evidence of foresight. Of the responses that were incorrect, the proportion that was unsafe increased from 52% for low confidence to 68% for high confidence. Measures of insight and foresight increased with experience. Students with poorer knowledge chose more unsafe responses, but with lower confidence. Five students gave multiple highly unsafe responses held with high confidence. Conclusions: Students had insight but less foresight. Experience and knowledge altered measures of both. This response system identified students who appeared to lack both. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine stuttering behavior in German-English bilingual people who stutter (PWS), with particular reference to the frequency of stuttering on content and function words. Fifteen bilingual PWS were sampled who spoke German as the first language (L1) and English as a second language (L2). Conversational speech was sampled in each language and analyzed for the percentage of overall stuttering-like disfluencies and distribution of stuttering on content and function words. Significantly more stuttering was found to occur in L2 compared to L1. Stuttering occurred significantly more often on content words compared to function words in L1. No significant difference between stuttering on function and content words was observed in L2. Examination across L1 and L2 found a significantly greater percentage of stuttering on function words in L2 compared to L1, and a significantly lower percentage of stuttering on content words in L2 compared to L1. The characteristics of stuttering in L2 could not be differentiated on the basis of an L2 proficiency measure. The differences observed in the amount of stuttering between L1 and L2 suggest that stuttering in bilingual speakers is closely related to language dominance, with features of stuttering in L2 indicative of a less developed language system. [ABSTRACT FROM AUTHOR]

The effectiveness of expansion as a technique for facilitating children's language and conversational skills is well known (Scherer and Olswang, 1984). Expansion, however, can appear alone or in combination with other techniques. Using a repeated measures design, this study aimed to compare the effects of expansion alone (EA); expansion combined with wh-questions (EQ); and expansion followed by a cloze procedure (EC) on the conversational skills of eight preschool children with conversational difficulties. Results showed that while there were no significant differences in child verbal topic maintaining responses across all techniques, EA elicited a significantly higher number of topic extensions, more non-verbal topic maintaining responses and fewer 'non-relevant responses' from the children, than either EQ or EC. The positive effects of each technique on the pragmatic appropriateness in conversations suggest that they could be used strategically in language intervention to ensure greater therapeutic effect. [ABSTRACT FROM AUTHOR]

Abstract Objective: This study aimed to investigate occupational stress amongst audiologists, along with quantification of their professional quality of life: Burnout, compassion fatigue, and compassion satisfaction. Design: A cross-sectional postal survey research design using an audiology occupational stress questionnaire (AOSQ), and the professional quality of life (ProQOL) instrument. Study sample: The sample consisted of members of the New Zealand Audiological Society. One hundred and forty-five questionnaires were mailed, 82 responses were received. Results: The main findings suggest that six stress factors dominate clinical audiology: (1) time demand, (2) audiological management, (3) patient contact, (4) clinical protocol, (5) patient accountability, and (6) administration or equipment. A significant relationship was found between increasing age of the audiologist and risk of acquiring burnout (chi-square (1) == 6.119, p < 0.05). Pearson's correlation's revealed time demand was the strongest predictor of low compassion satisfaction (r == 0.327) and burnout (r == 0.463), while stress associated with patient contact was the strongest predictor of compassion fatigue (r == 0.352). Conclusions: This study identifies sources of stress for clinical audiologists and different factors that contribute to professional quality of life. [ABSTRACT FROM AUTHOR]

Conclusion: Whilst objective testing on music perception showed no individual differences between cochlear implant (CI) devices, subjective music perception was found to be superior with the MED-EL device in the majority of cases evaluated. Objective: To compare speech and music perception through two different CI systems in the same individuals. Methods: Six post-lingually deaf patients, who had been implanted with a Cochlear™ Nucleus® device in one ear and a MED-EL SONATATI100 on the contralateral side were evaluated. One subject was excluded from group analysis because of significant differences in performance between ears. Subjects completed a questionnaire designed to assess implant users' listening habits. Subjective assessments of each subject were made for comparison of speech and music perception with each system and preferences of system. The subjects consecutively used each system with the contralateral device turned off, and were objectively assessed for specific musical skills. Speech perception in quiet and in noise was tested. Results: For all objective tests of music discrimination and speech perception in noise, there were no statistically significant differences between MED-EL and Cochlear CI systems. Subjectively, four subjects thought their MED-EL device was better than their Cochlear device for music appreciation. Four thought that music sounded more natural, less tinny and more reverberant with their MED-EL CI than with their Cochlear CI. One subject rated all these to be equal. [ABSTRACT FROM AUTHOR]

This study documents the lifetime and 12-month prevalence and overlap of psychological/emotional, physical, and sexual intimate partner violence (IPV) reported by a representative sample of New Zealand women. Use of controlling behaviors by women's current or most recent intimate partner was also explored. The results indicated that 55% of ever-partnered women had experienced any IPV in their lifetime: 33% had experienced more than one type of IPV (usually psychological/emotional violence and physical and/or sexual violence), and 22% had experienced one type of IPV. Use of controlling behaviors by the woman's current or most recent partner was associated with partner's use of physical or sexual violence. Implications are discussed at the population level, for service providers, and for future studies. [ABSTRACT FROM AUTHOR]

Physiotherapists are primary care practitioners, and are often the first health professional to consult with patients presenting with acute sprains or strains, and such patients may ask for advice regarding medications. Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are readily available without a prescription and are commonly used by patients. The aim of this study was to investigate New Zealand physiotherapists' knowledge regarding the comparative safety, effectiveness, and appropriate timing of paracetamol and NSAIDs for acute musculoskeletal sprains and strains. A questionnaire was mailed to all members of the New Zealand Society of Physiotherapists currently practicing in the field of musculoskeletal physiotherapy ( n == 948). Of 278 respondents (29.3%%), just over half (52%%) thought that NSAIDs were more effective than paracetamol in the treatment of sprains and strains. Almost half (45%%) believed that NSAIDs should be withheld because of the potential for interrupting the beneficial role of inflammation in healing and that NSAIDs could increase bleeding into the injured tissue. In contrast, the majority of respondents (81%%) recognised that there was no need to withhold paracetamol in the initial postinjury period. Knowledge regarding safety, effectiveness, and risks of paracetamol and NSAIDs may assist physiotherapists to recommend appropriate management of acute musculoskeletal injuries, within regulatory boundaries. [ABSTRACT FROM AUTHOR]

Background: More than 15 years ago, the International Conference on Population and Development (ICPD) identified men’s involvement with reproductive and contraceptive tasks as vital for improving women’s reproductive health worldwide. The uptake of vasectomy provides one measure of men’s involvement in reproductive and contraceptive actions, but uptake requires the negotiation of a complex set of social and psychological meanings related to masculinity, sexuality and contraceptive involvement. The limited research in this area paints a largely negative picture around vasectomy, emphasising fears, side effects, and men being pressured into having the operation, but it is not the only account of vasectomy. Objectives: The aim of this research was to examine the accounts of New Zealand men who had undergone vasectomy. Method: Interviews with 28 men who had opted to have a vasectomy (16 had children; 12 did not) based in New Zealand, a country with a high rate of vasectomy, offer a more positive portrayal of the meanings and experiences of vasectomy. Results: Men referred to vasectomy as a positive reflection of their identities, and their choice to have it as exemplifying personal characteristics they valued. Such accounts disrupt the common-sense story of vasectomy as negative or difficult for men, and allow it to be positioned as a positive choice for heterosexual male reproductive involvement and responsibility [ABSTRACT FROM PUBLISHER]

Background There is a paucity of studies which explore palliative care patients' involvement in research. The involvement of patients with a life-limiting illness in research raises numerous ethical concerns for researchers keen to take account of their views and experiences of service provision. Assumptions are readily made about whether participation is appropriate for this patient group due to their perceived vulnerability. Aim To explore the views of hospice users regarding their motivations for taking part in a study, designed to inform the delivery of care, and ensure ongoing service improvement. Methods Based on a larger pilot study to examine patients' satisfaction with hospice care, and using a qualitative interview approach, twenty-one patients under the care of three hospices in the Auckland region of New Zealand took part. Interviews were recorded and transcribed verbatim. Data were analysed using a thematic analysis technique. Results The involvement of hospice users in research is important and has the capacity to produce a diverse, but significant impact on those involved. Not only does their involvement demonstrate the potential to shape service provision, it also reveals the therapeutic benefits to individuals with a life-limiting illness of simply taking part. Of particular importance is the view that participation enables a sense of personhood to be maintained circumventing the potential of a 'social death'. Unless they are unable to consent, palliative care patients should be regarded as autonomous individuals and given the opportunity to participate in research. [ABSTRACT FROM AUTHOR]

Conclusion: There was no evidence of a mean raised vasopressin level in 80 subjects suffering from definite Meniere's disease with positive electrocochleographic findings. There was no correlation with stress. The only group with a mildly raised level comprised those who had had a vertigo attack within a day. The most likely cause is nausea, which is the most potent trigger for vasopressin release. Objective: It has been claimed that patients with Meniere's disease have raised vasopressin levels. This has been linked with a long-standing notion that that there is a link between stress and Meniere's disease, so that an increase in vasopressin could trigger a vertigo attack. Methods: Serum vasopressin concentrations were measured in 80 patients with Meniere's disease whose diagnosis was based on conventional symptom criteria plus electrocochleographic evidence of endolymphatic hydrops. Results: The community mean for vasopressin is 2.2 pmol/L (SD == 2.4). For all 80 Meniere's patients the mean vasopressin concentration was 2.1 pmol/L (SD == 1.6), and 2.8 pmol/L (SD == 0.9) when the last attack was within a day. [ABSTRACT FROM AUTHOR]

Internationally the recruitment and retention of Indigenous and minority peoples into nursing is a persistent challenge, despite their participation being essential in reducing health disparities and improving health service quality for Indigenous and minority users. We aimed to identify Māori (Indigenous to New Zealand) nursing students' experiences of undertaking a nursing degree program. A non-experimental cross-sectional survey was undertaken with undergraduate nursing students identifying as Māori. The surveys were analyzed using descriptive and inferential statistics. One hundred and eight students responded, with a career, stable income, and desire to make a difference in Māori health outcomes motivating most to embark on a nursing program. They reported numerous obstacles that compromised their academic advancement. However, affirming students' identities; providing academic support; accessing Indigenous role models, mentors and relevant clinical experiences; and, having supportive teaching and learning environments and the inclusion of Indigenous content in curricula; were identified as strategies that promoted retention in nursing programs. [ABSTRACT FROM AUTHOR]

Options for the careful use of benzodiazepines in end-of-life care may be limited by several factors, including local availability and experience. Fifty-seven patients treated with midazolam for palliative sedation therapy (PST) in end-of-life care were matched by diagnosis, sex, and age with 57 patients treated with flunitrazepam. Comparisons included the number of PST interventions required, maintenance of consciousness, length of life remaining, and responses for a range of symptoms, using the patient's perspective where possible. Both benzodiazepines improved symptoms in all categories considered, with flunitrazepam appearing to be more effective. Patients on flunitrazepam survived longer after the initiation of PST (P = 0.01), remained conscious for longer (P = 0.019), and required fewer adjuvant treatment interventions (P = 0.008). There is a potential concern that patients may feel trapped by midazolam and not be able to communicate this. [ABSTRACT FROM AUTHOR]

Primary objective: To examine fatigue prevalence, severity, predictors and co-variates over 6 months post-mild traumatic brain injury (MTBI). Research design: Longitudinal prospective study including 263 adults with MTBI. Procedures: Participants completed the Fatigue Severity Scale (FSS), Rivermead Post-concussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence-RPSQ Item 6: severity-FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates. Main outcomes and results: Post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months, respectively. There was a strong effect for time over the first 3 months and moderate-to-high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue; depression, but not anxiety was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases. Conclusions: Post-MTBI fatigue is a persistent post-concussion symptom, exacerbated by depression but not anxiety. It diminishes in the first 3 months and then becomes relatively stable, suggesting the optimum intervention placement is at 3 months or more post-MTBI. [ABSTRACT FROM AUTHOR]

Objective: Factors influencing outcome after mild traumatic brain injury (MTBI) remain poorly understood. In other health conditions patient illness perceptions have been associated with outcome and have provided targets for effective interventions. These have not been systematically explored in MTBI and identifying reliable and valid measures of illness perceptions in MTBI is a first step before such concepts can be explored in clinical and research settings. Method: This study investigated the factor structure and internal consistency reliability of the Illness Perceptions Questionnaire-Revised (IPQ-R) modified for MTBI in a sample of 147 adults recruited within 3 months of injury. Results: The results demonstrated a close replication of the original factor structure although there were notable exceptions likely to be specific to MTBI and potentially other acutely injured populations. Final scales showed good internal consistency although factors relating to causal attribution were less so. Conclusion: The IPQ-R (MTBI) provides an acceptable measure of key components of injury perceptions after MTBI. Minor refinements appear required if this measure is to make a contribution to research and clinical practice in injury-based populations such as MTBI. [ABSTRACT FROM AUTHOR]

Primary objective: This study examined differences in perceived communicative effectiveness between a group of eight participants with chronic dysarthria following TBI and their nominated communication partners (TBIP). The relationship between communicative effectiveness and listener ratings of speech intelligibility was also examined. Research design: Group comparison design. Methods and procedures: The Communicative Effectiveness Survey was completed by the participants with TBI and their communication partner. Speech intelligibility of the eight adults with dysarthria was rated by nine naive listeners using direct magnitude estimation. Main outcomes and results: The participants with TBI tended to rate their communicative effectiveness higher than their TBIP; however, this trend was not significant. No significant differences were noted between the TBI and TBIP groups in ratings of communicative effectiveness in various communication settings. No significant relationship was found between conversation level intelligibility and perceptions of communicative effectiveness, as rated by individuals with TBI and TBIP. Conclusions: The findings of this study highlight the need for collaborative participation in the therapeutic process by all stakeholders. The lack of correlation between speech intelligibility and perceived communicative effectiveness highlights the need for careful examination of activity and participation during assessment and goal-setting. [ABSTRACT FROM AUTHOR]

Background: This article presents findings from a prospective, longitudinal cohort educational study investigating empathy communication in clinical consultations. It reports on changes in students' self-report empathy during medical undergraduate training, investigates how well peers can assess student competence in motivational interviewing/brief interventions (MI/BI) skills and explores the relationship between students' self-report empathy and peer- or tutor-assessments of competence. Methods: 72 medical students completed the Jefferson Scale of Physician Empathy at three time points: at the beginning of their fifth year medical training (Time 1), after a specific MI/BI training session during their fifth year medical training (Time 2) and 1 year later during a revision session in year 6. Competence in BI/MI consultation was assessed using the validated tool Behaviour Change Counselling Index. Results: A significant decline in medical students' empathy scores was observed from year 5 to year 6, consistent with international findings. Peer assessments and tutor ratings of competence in MI/BI skills performance were moderately correlated, but peer assessments were negatively correlated with medical students' self-rated empathy. Senior medical students who self-rated as more empathic received lower competence evaluations of MI/BI skills from their peers. Interventions to further investigate teaching and learning of empathy are discussed. [ABSTRACT FROM AUTHOR]