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The aim of this study was to investigate the impact of the COVID-19 pandemic on falls rates in long-term care residents with cognitive impairment. An observational study using routinely collected national interRAI data. Participants were from long-term care residents (age ≥60 years) who received an interRAI Long Term Care Facility assessment anywhere in New Zealand between August 17, 2018, and August 16, 2022. The primary outcome was "At least 1 fall in the last 30 days." Based on the Cognitive Performance Scale (CPS), cognitive impairment was categorized into 3 levels: intact or borderline intact (0-1), mild to moderate impairment (2-3), and moderately to very severe impairment (4-6). The COVID-19 pandemic was divided into 3 periods (First wave: March 21, 2020, to June 8, 2020; Varying level of community outbreaks: June 9, 2020 to August 16, 2021; and Delta-Omicron wave: August 17, 2021, to August 16, 2021) and compared to a pre-COVID-19 period (August 17, 2018, to March 20, 2020). Cox regression modeling was used to study falls and interactions between CPS and COVID-19 pandemic periods, along with other established falls risk factors in the literature. A total of 282,518 interRAI-LTCF assessments from 75,132 unique residents were included. Interactions between CPS and COVID-19 pandemic periods found that cognitive impairment was associated with a higher hazard ratio (ranged from 1.22 to 1.37) in each of the 3 COVID-19 pandemic periods. We also found unstable health, unsteady gait, wandering, and moderate to severe ADL dependency were the strongest risk factors for falls. Cognitively impaired long-term care residents had an increased risk for falls during the COVID-19 pandemic. This risk was influenced by several factors. In future pandemic or infection control related isolation, residents who are most at risk can be identified for targeted falls prevention programs. [ABSTRACT FROM AUTHOR]

Objective: Older Chinese people in New Zealand underutilise mental health services. Lack of recognition of mental health issues and awareness of available treatment is a potential barrier to accessing care. This study investigated depression literacy in older Chinese people. Method: A convenience sample of 67 older Chinese people were presented a depression vignette and completed a depression literacy questionnaire. Results: There was a good rate (71.6%) of depression recognition, but no participant chose taking medication as the best method of help. There was a notable level of stigma among participants. Conclusion: Older Chinese people would benefit from information regarding mental health conditions and their interventions. Strategies to deliver this information and de-stigmatise mental illness in the Chinese community which incorporate cultural values may be beneficial. [ABSTRACT FROM AUTHOR]

Enterococcus faecalis, a Gram‐positive bacterium, is known to be a key player in several chronic infections as well as nosocomial, heart valve, urinary tract, surgical wound, and dental root canal infections. The capability to sense different transition metal levels and tune its response accordingly endows it with the potential to thrive and cause infections in several host niches. Over the past decade, our knowledge of how transition metals play a critical role in maintaining homeostasis of E. faecalis has improved significantly. The aim of this review is to elucidate the roles of metals such as iron, manganese, zinc, and copper in the physiology, metabolism, and pathogenicity of E. faecalis. These essential micronutrients contribute to energy production, redox stress response, expression of virulence determinants, and cooperation in polymicrobial communities. The review also highlights metal homeostasis systems in E. faecalis, which respond to fluctuations in extracellular metal levels, and regulate the intracellular metal content. Regulation of intracellular metallome secures the tolerance of E. faecalis to oxidative stress and host‐mediated metal sequestration strategies. Therapeutic interventions which deprive E. faecalis of its essential metal requirements or disrupt its homeostatic control have been proposed to combat E. faecalis infections. [ABSTRACT FROM AUTHOR]

Objective: To collect mental health and addiction service providers' opinions about priorities for an e-Mental Health (eMH) research agenda focused on delivering culturally safe eMH in Aotearoa New Zealand. Method: Service providers were recruited to participate in an anonymous online survey, which asked participants to rate the importance of potential research domains and items on a continuous scale from 1 to 10. The mean values of each item were normalised to develop a priority index. Results: 48 participants rated at least one of the listed research items. The highest-rated items were (i) identifying strategies to improve access; co-developing eMH with the community (ii) a set of competencies required for delivering culturally safe care, (iii) a set of meaningful clinical outcomes that can be achieved via eMH, (iv) guidelines for the delivery of eMH services and (v) investigating the extent to which eMH could meet the mental health needs of these communities. 'Standards and guidelines' was the domain with the highest priority index. Conclusions: Mental health and addiction service providers in Aotearoa New Zealand prioritised an eMH research agenda that is focused on pro-equity outcomes and incorporating the voices and experiences of the communities they seek to serve. [ABSTRACT FROM AUTHOR]

The authors talk about the role of psychiatrists in Australia and New Zealand in dealing with voluntary assisted dying (VAD). They discuss the role of psychiatrists in VAD legislation in Australia and New Zealand, psychological effects of VAD on health practitioners, and VAD research opportunities in New Zealand.

This qualitative study explores the meanings of frailty held by Chinese New Zealanders and Chinese health care professionals with the aim of identifying commonalities as well as potential differences. Two guided focus groups with Mandarin and Cantonese speaking older adults (n = 10), one individual interview with a English speaking older Chinese, and one focus group with Chinese New Zealand health care professionals (n = 7) were held to obtain views on frailty in older adults, followed by transcribing and a thematic qualitative analysis. Three main themes emerged: (1) Frailty is marked by ill-health, multiple chronic and unstable medical comorbidities, and is a linked with polypharmacy; (2) Frailty can involve physical weakness, decline in physical function such as reduced mobility or poor balance, and declining cognitive function; and (3) Frailty is associated with psychological and social health including depression, reduced motivation, social isolation, and loss of confidence. The perspectives of frailty that emerged are congruent with a multi-dimensional concept of frailty that has been described in both Chinese and non-Chinese medical research literature. [ABSTRACT FROM AUTHOR]

• A systematic review of dementia diagnosis using deep learning is presented. • The systematic review was conducted using the PRISMA 2020 protocol. • Repositories of related datasets, features, and algorithms are provided. • Performances of deep learning-based systems for diagnosing dementia are reported. • Research focus areas, gaps, and recommendations for future research are presented. Dementia is a progressive neurodegenerative disease that burdens the person living with the disease, their families, and medical and social services. Timely diagnosis of dementia could be followed by introducing interventions that may slow down its progression or reduce its burdens. However, the diagnostic process of dementia is often complex and resource intensive. Access to diagnostic services is also an issue in low and middle-income countries. The abundance and easy accessibility of speech and language data have created new possibilities for utilizing Deep Learning (DL) technologies to be part of the dementia diagnostic process. This systematic review included studies published between 2012–2022 that utilized such technologies to aid in diagnosing dementia. We identified 72 studies using the PRISMA 2020 protocol, extracted and analyzed data from these studies and reported the related DL technologies. We found these technologies effectively differentiated between healthy individuals and those with a dementia diagnosis, highlighting their potential in the diagnosis of dementia. This systematic review provides insights into the contributions of DL-based speech and language techniques to support the dementia diagnostic process. It also offers an understanding of the advancements made in this field thus far and highlights some challenges that still need to be addressed. [ABSTRACT FROM AUTHOR]

Background: Many countries around the world have adopted social distancing as one of the public health measures to reduce COVID-19 transmissions in the community. Such measures could have negative effects on the mental health of the population. The aims of this study are to (1) track the impact of COVID-19 on self-reported mood, self-rated health, other health and psychosocial indicators, and health services utilization of people who have an interRAI assessment during the first year of COVID-19; (2) compare these indicators with the same indicators in people who had an interRAI assessment in the year before COVID-19; and (3) report these indicators publicly as soon as data analysis is completed every 3 months.Methods: interRAI COVID-19 Study (iCoS) is an observational study on routinely collected national data using the interRAI Home Care and Contact Assessment, which are standardized geriatric assessment tools mandated for all people assessed for publicly funded home support services and aged residential care in New Zealand. Based on the 2018/19 figures, we estimated there are 36,000 interRAI assessments per annum. We will compare the four post-lockdown quarters (from 25th March 2020) with the respective pre-lockdown quarters. The primary outcomes are self-reported mood (feeling sad, depressed or hopeless: 0 = no, 1 = yes) and self-rated health (0 = excellent, 1 = good, 2 = fair, 3 = poor). We will also analyze sociodemographics, other secondary health and psychosocial indicators, and health services utilization. Descriptive statistics will be conducted for primary outcomes and other indicators for each of the eight quarters. We will compare the quarters using regression models adjusted for demographic characteristics using weights or additional variables. Key health and psychosocial indicators will be reported publicly as soon as data analysis is completed for each quarter in the 12-month post-lockdown period by using a data visualization tool.Discussion: This rapid translation of routinely collected national interRAI data will provide a means to monitor the health and psychosocial well-being of vulnerable older New Zealanders. Insights from this study can be shared with other countries that use interRAI and prepare health and social services for similar epidemics/pandemics in the future. [ABSTRACT FROM AUTHOR]

Objective: The number of Asian New Zealanders with dementia is growing. The objective of this study was to explore with a group of Asian health care professionals about public attitudes towards dementia in Asian communities in New Zealand, the stigma of dementia, and how best to develop culturally appropriate services for Asian people and families living with dementia.Methods: A focus group was conducted with a group of bilingual Asian health care professionals. A topic guide was developed based on the discussion at a prior meeting with the Cross Cultural Interest Group. The data were independently analysed by three researchers using the thematic qualitative methodology.Results: Eleven overseas-born Asian health care professionals (Chinese: n = 9, 82%) participated in the focus group. Four main themes emerged from the data: (a) cultural interpretations of dementia; (b) stigma; (c) filial piety; and (d) inequity in the availability of resources.Conclusion: Our findings suggest that much work is needed to destigmatise dementia in New Zealand Asian communities, through psychoeducation, public awareness, and the availability of readily accessible services that can meet their cultural and language needs. [ABSTRACT FROM AUTHOR]

There is general agreement that frailty is common and important in later life, but there is less agreement about what frailty is. Little is known about the extent to which practicing health professionals and older people hold a mutual understanding of frailty. Focus groups were held to engage older people and health professionals in discussion about what made them think that someone was frail. Eighteen older people took part across three focus groups, and se'venteen health professionals took part across another three focus groups. Both the health professionals and the older people talked about the experience of frailty as an interplay of physical, psychological, and social dimensions. Older people with frailty were seen as needing help and being vulnerable to adverse outcomes, but accepting help was positioned by older people as an adaptive choice. The experience of frailty was described as being mediated by the individual's psychological mindset, highlighting the importance of approaches that recognise strengths and resilience. A broader and more balanced understanding of frailty may help create more rounded and appropriate approaches to assessment and management. [ABSTRACT FROM AUTHOR]

Objective: Cognitive stimulation therapy (CST) is a psychosocial group treatment for people with dementia. The aims of this project were to (a) evaluate the effectiveness of a one-day training workshop; (b) measure the uptake of CST following the workshops; and (c) explore the barriers of implementing CST.Method: Ten workshops were conducted. Attendees completed a self-evaluation at the end of the training day and were later invited to complete an online survey enquiring about implementation.Results: Two hundred and fourteen workshop attendees completed the self-evaluation. The mean self-rated knowledge and skills for conducting and facilitating CST (1 = No skills, 5 = Very good skills) was 2.3 (SD = 1.2) and 4.3 (SD = 0.7) before and after the workshop, respectively (p = 0.000). The mean self-rated confidence for applying learning to conducting and facilitating CST was 4.2 (SD = 0.7) (1 = Not confident, 5 = Very confident). There were 11 CST programmes started after the workshops and another 10 sites were in the process of starting CST programmes. The main barriers of implementation were lack of staff time/funding and problems of finding suitable participants with dementia.Conclusions: The one-day training workshop is an effective method to disseminate CST. Addressing the barriers identified could improve the adoption of CST in practice. [ABSTRACT FROM AUTHOR]

Introduction: Indigenous peoples, and racial and ethnic minorities around the world experience significant mental health inequities. Telepsychiatry can contribute to addressing these inequities among these populations. However, it is first crucial to ensure the cultural safety of this tool as a critical step toward health equity. This review aimed to collate evidence regarding cultural adaptations, barriers, opportunities, and facilitators for telepsychiatry services supporting minority groups. Method: Using the PRISMA extension for scoping reviews (PRISMA-ScR) guideline, we conducted a systematic scoping review and thematic analysis. Six databases were searched using the PICO framework, i.e., population, intervention, comparison, and outcomes.. Additional literature was identified through reference lists screening. We developed a table for data extraction, and the extracted data were further analyzed following Braun and Clarke's approach for thematic analysis. Results: A total of 1514 citations were screened with a final total of 58 articles included in the review. The themes related to telepsychiatry cultural adaptations emphasize the crucial role of community involvement and quality service delivery. Identified barriers were associated with service and infrastructure, and service users' socioeconomic and cultural contexts. Opportunities and facilitators for telepsychiatry were enhanced access and rapport, and multi-organizational collaborations and partnerships. Discussion: This review identified factors that can guide the adaptation of telepsychiatry evidence-based interventions to meet the needs of Indigenous peoples and racial and ethnic minorities. Telepsychiatry programs must be specifically designed for the population they seek to serve, and this review offers emerging insights into critical factors to consider in their development. [ABSTRACT FROM AUTHOR]

An editorial is presented on the challenges to dementia care during COVID-19 innovations in remote delivery of group Cognitive Stimulation Therapy. Topics include the people are required to avoid face-to-face social contact and to stay home, the drastic measures can have many direct and indirect effects on the health and psychosocial well-being of older adults, and the older adults who were previously mobile but are housebound are at risk of developing frailty.

Objective: To explore trainee perception of what facilitates or delays completion of the RANZCP Scholarly Project (SP).Method: Of 182 currently registered New Zealand trainees, 33 (18%) completed an online questionnaire and three open-ended questions.Results: Most trainees agreed or strongly agreed that having protected time for research (87.5%) and access to an appropriate supervisor (87.9%) would facilitate the completion of their SP. Other college requirements were identified by most trainees (87.9%) as a factor delaying completion.Conclusions: Identifying and protecting research time and ensuring adequate supervision appear essential to improve the uptake and completion of this training requirement. [ABSTRACT FROM AUTHOR]

Objective: To survey the Psychiatry of Old Age (POA) services and workforce in New Zealand (NZ).Methods: The NZ branch of Faculty of POA contacted the POA lead clinician and/or service manager of the 20 district health boards (DHBs) and completed a survey based on variables used in two similar previous national surveys.Results: Seventeen services responded. We found acute inpatient beds and clinical staff time are funded differently across DHBs. Although there has been an increase in non-medical clinical staff time in the community teams, most DHBs are not planning to increase their medical staff time in the next 3 years. Specialist services for people with intellectual disabilities and young-onset dementia, and older people with substance use disorder are generally not provided within POA services.Conclusions: A wider POA and non-POA services mapping is required to determine the level of services for clinical populations that have high and complex clinical needs. DHB funders should review the expected population growth in people aged 65+ and consider increasing the funding for these under-served clinical populations. [ABSTRACT FROM AUTHOR]

Objective: Suicide rates increase in late life. There is, however, a gap in understanding suicide in the very old. We aimed to underscore the evidence for high rates of death by suicide in the oldest-old men (age 85+) in New Zealand and to provide a conjectural discussion about factors driving these rates.Method: Provisional suicide data were obtained from the New Zealand Coronial Services website for the period 2011-2019. Yearly suicide rates for those aged 85+ were plotted over time. Mean suicide rates were calculated for three youth and young adult male cohorts, identified by the Coroner as having very high rates, and compared with the 85+ age cohort.Results: Between 2011 and 2019, rates of death by suicide of older males remained consistently high never overlapping female suicide rates. Mean suicide deaths/100,000 population for all four age cohorts were comparable; 15-19 years: 23.5; 20-24 years: 29.0; 25-29 years: 27.0; 85+ years: 27.9.Conclusions: Deaths by suicide are very high for older males. In addition to established risk factors, psychosocial adversity as reflected by loneliness, poverty and shift to residential care may be major reasons for the high suicide rates. Research to inform about this vulnerable population and prevention are urgently needed. [ABSTRACT FROM AUTHOR]

Objectives: Scholarly projects (SPs) are a compulsory component of psychiatry training in Australasia. This article outlines the role of a research supervisor in supporting a trainee to complete an SP.Methods: A total of 10 old age and forensic psychiatry SPs were reviewed with regard to aims, methodology, supervisor input, trainee tasks and additional resources.Results: The main supervisor tasks are described and discussed. They include practical advice on study design, ethics applications, critical appraisal, data analysis, academic writing and publication.Conclusions: Supervising SPs can bring significant rewards in awakening a trainee's interest in research. Key competencies for research supervision are discussed and further recommendations for supervisor support and training are provided. [ABSTRACT FROM AUTHOR]

Background: There is a dearth of qualitative research on resuscitation preferences of older New Zealanders. The aim of this study was to investigate the resuscitation preferences of older New Zealanders in a retirement village or residential care setting, as well as the reasons for these preferences. Methods: This study had 37 participants from two retirement villages in Auckland, New Zealand. Participants were interviewed about a hypothetical case vignette about cardiopulmonary resuscitation, and then they completed a semi‐structured interview. Interviews were subsequently transcribed and analyzed by two independent researchers using thematic qualitative methodology. Results: The majority of the participants (n = 25, 67.6%) decided against resuscitation, 10 (27.0%) wanted resuscitation, and 2 (5.4%) were ambivalent about their resuscitation preferences. Three main themes emerged during the data analysis regarding participants’ reasons for deciding against resuscitation: (i) the wish for a natural death; (ii) advanced age; and (iii) a realistic awareness about the consequences of resuscitation. Responses related to the third these had three subthemes: (i) reduced quality of life; (ii) loss of personal integrity and sense of existence; and (iii) concern that resuscitation could result in unnecessary costs or a burden on others. Among participants who preferred resuscitation, two main themes emerged regarding their reasons for wanting resuscitation: (i) the wish to prolong a good quality of life; and (ii) unrealistic expectations of resuscitation. Conclusions: Older people in this study were able to make reasoned decisions about resuscitation based on balancing their subjective estimations of quality of life and the presumed consequences of resuscitation. It is important therefore to educate older adults about the potential outcomes of resuscitation and explore (and document) their reasoning when discussing resuscitation preferences so their wishes can be respected. [ABSTRACT FROM AUTHOR]

Objective: Death wishes in older people are common and may progress to suicidal ideation and attempts. This study used routinely collected data from the interRAI Home Care assessment to examine the prevalence and clinical predictors of death wishes in older New Zealanders assessed for home support and long-term aged residential care.Methods: Data were collected from 35 734 people aged over 65 during 2012-2014. Chi-squared analyses were used to determine significant relationships between the presence of death wishes and demographic factors, health and functional status, and emotional and psychosocial well-being. A three-step hierarchical logistic regression model was used to determine the predictive variables of death wishes, and odds ratios were calculated.Results: Death wishes were present in 9.5% of the sample. The following factors were significantly associated with death wishes: physical health (poor self-reported health, recurrent falls, severe fatigue and inadequate pain control), psychological factors (depression, major stressors and anxiety), social factors (loneliness and decline in social activities) and impaired cognition. Depression (odds ratio = 2.54, 95% confidence interval = 2.29-2.81), loneliness (odds ratio = 2.40, 95% confidence interval = 2.20-2.63) and poor self-reported health (odds ratio = 2.34, 95% confidence interval = 1.78-3.07) had the greatest odds ratios in the full model.Conclusions: Clinically significant depression alone cannot fully account for the development of death wishes in the elderly, and several factors are independently associated with death wishes. This knowledge can help clinicians caring for older persons to identify people who are most at risk of developing death wishes. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Context: Previous studies have reported significantly elevated standardized mortality rates in older people with cancer. Terminally ill people represent a unique group where suicide may be considered as rational.Objectives: The aims of this study are to compare the sociodemographic and clinical characteristics of older people with and without terminal cancer who died by suicide and analyze the suicide motives of those with terminal cancer to determine whether they represent rational suicide.Methods: The New Zealand Coronial Services provided records of all older people (aged 65 years and older) who died by suicide between July 2007 and December 2012. Sociodemographic and clinical data were extracted from the records. Using the characteristics for defining rational suicide, we determined whether the motives in terminal cancer cases represented rational suicide.Results: Of the 214 suicide cases, 23 (10.7%) older people were diagnosed with a terminal cancer. Univariate analysis found that older people with terminal cancer who died by suicide were less likely to have a diagnosis of depression (8.7% vs. 46.6%; P = 0.001) or previous contact with mental health services (4.5% vs. 35.0%; P = 0.004) than those without terminal cancer. About 82.6% of the terminal cancer cases had a motivational basis that would be understandable to uninvolved observers.Conclusion: A high proportion of those with terminal cancer had motives suggestive of rational suicide. Future studies are needed to clarify whether the low rate of depression is secondary to underdiagnosis of depression or people with terminal cancer choosing to end their life as a rational act to alleviate suffering. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore psychiatrists' perspectives on how clinical teaching and supervision can be improved in postgraduate psychiatric training.Method: All New Zealand members of the Royal Australian and New Zealand College of Psychiatrists (fellows: n=367; affiliates: n=167) were invited to participate in an online survey that collected responses to two open-ended questions. The responses were then analysed qualitatively.Results: A total of 27% psychiatrists responded. Two major themes emerged: supervisor competencies and the workplace educational environment, with subthemes of supervisor training, feedback and culture change.Conclusions: Suggestions to improve clinical teaching and supervision included defining supervisor teaching competencies, instituting evidence-based faculty development, a feedback structure and strengthening leadership support for workplace-based education. [ABSTRACT FROM AUTHOR]

Objective: The primary objective was to survey the Psychiatry of Old Age (POA) service resources in New Zealand: number of psychiatrists, inpatient beds, and community psychogeriatric beds. A secondary objective was to compare the POA service resources reported by frontline clinicians with official government data. Methods: The New Zealand Branch of Faculty of POA collected information from a POA representative in each of the 20 districts, along with official government data. Results: Information from 17 services were obtained. POA service resources varied greatly between districts. There were discrepancies between the New Zealand Branch of Faculty of POA and official government data. The number of old age psychiatrist FTEs per 10,000 older adults ranged from 0.3 to 1.1 (mean = 0.7). The number of inpatient beds per 10,000 older adults ranged from 0.0 to 4.1 (mean = 1.6); and the number of psychogeriatric beds per 10,000 older adults ranged from 0.0 to 22.7 (mean = 12.6). Conclusions: There is an urgent need to address the official government data discrepancies and POA service resource inequalities. This can ensure the "postcode" system that determines psychiatric care for older adults can be effectively eliminated. We also found the number of POA inpatient beds is below the internationally recommended level. [ABSTRACT FROM AUTHOR]

Objective: We aimed to explore psychiatry trainees' perspectives on clinical teaching and supervision as well as how this might be improved.Method: New Zealand trainees ( n=51) completed online the Maastricht Clinical Teaching Questionnaire (MCQT) and three open-ended questions.Results: The majority rated 'agree' or 'strongly agree' to all items of the MCQT. Weaknesses in the feedback process including observation, feedback provision, and formulating learning goals were highlighted. College training requirements and workplace environment were identified as factors impacting on clinical teaching and supervision.Conclusions: A model was proposed to enhance awareness of the various factors involved in the feedback process. [ABSTRACT FROM AUTHOR]

Suicide in older people is a significant public health issue given the aging population and increasing suicide rates with age in many parts of the world. Depression and physical illness are two factors consistently associated with suicidal behavior in older people; however, their inter-relationships are not well understood. We present here a case study based on a newly developed conceptual model illustrating the various medical, psychological, social and resilience factors involved in the progression of physical illness to suicidal behavior. This model provides a framework for clinicians to understand protective factors and address late-life suicide risk. [ABSTRACT FROM PUBLISHER]

Hypersexual behavior is not uncommon in psychiatric presentations. Most available scales that measure hypersexual behavior are self-rated, often containing sexually explicit questions, unsuitable for use in mentally unwell people. Lack of a clinically suitable instrument may have resulted in underdetection and under-researching of hypersexuality in people with mental disorders, with potential to cause significant consequences for themselves and those around them, including family members, coclients, and clinicians. To address this need, we developed the Hypersexuality in Psychiatric Conditions Observer-Rated Scale (HIPCORS), a rater-rated, nonintrusive tool, designed for use in mentally unwell people. It has been shown to be a reliable and valid instrument. [ABSTRACT FROM AUTHOR]

Here, we investigate the morphology, spectral absorption bandwidth and energy transfer in solution-processed, phthalocyanine-based thin films blended with conjugated polymer materials with complementary absorption bands. Unary, binary, and ternary solutions of the solution- processable phthalocyanine derivative 2,3,9,10,16,17,23,24-octakis(octyloxy)-29H,31H-phthalocyanine (Oct-Pc) and the conjugated polymers poly(9,9-dioctylfluorenyl-2,7-diyl) (PFO) and poly(3-hexylthiophene) (P3HT) were used to prepare sub-55-nm-thick unary-phase and blended thin films. Spectroscopic analysis shows that absorption band full-width-at-half-maximum (FWHM) values increase from between 60 nm and 160 nm for the individual materials to greater than 450 nm for the composite ternary-blend thin film due to the complementary bandgap energies and spectral absorption bands of the constituent materials. Additionally, photoluminescence and transient absorption measurements show very efficient transfer of excited-state energy in the wider band-gap materials (donors) to the narrower band-gap material (acceptor). Resonant energy or charge transfer occurs with efficiencies between 90% and 100% for the various blends. Atomic-force microscopy and grazing-incidence, wide-angle X-ray scattering data indicate that P3HT and Oct-Pc exhibit the poorest blending. This correlates with the lowest donor photoluminescence quenching efficiency due to the extended separation of the P3HT chains from Oct-Pc molecules. However, addition of a relatively small fraction of PFO disrupts Oct-Pc crystallinity and enables improved mixing and energy transfer between P3HT and Oct-Pc. [ABSTRACT FROM AUTHOR]

Objectives:To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. Method:Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. Results:Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. Conclusion:Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults. [ABSTRACT FROM AUTHOR]

Homicide‐suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late‐life homicide‐suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late‐life homicide‐suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five‐year period (July 2007–December 2012). Of the 225 suicides, 4 cases of homicide‐suicide were identified (an estimated incidence of 0.12 per 100 000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide‐suicide, and one case as siblicide‐suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide‐suicide. Age‐related biopsychosocial issues were highlighted in this case series of late‐life homicide‐suicide. Additionally, evaluating firearm licences in high‐risk groups may represent a prevention strategy. [ABSTRACT FROM AUTHOR]

Objective: It is often difficult to assess the driving performance of people with mild dementia. The Maze Navigation Test (MNT) was developed in the USA and has been shown to predict driving performance. The aim of this study is to evaluate how the MNT is performed against three commonly used bedside cognitive screening tools and compare our findings with the US population.Methods: A convenience sample of 42 cognitively intact older people (age ≥65) completed the MNT, Mini-Mental State Examination, the revised Addenbrooke's Cognitive Examination and the Trail Making Tests.Results: The mean MNT completion time was 307.6 (SD=85.6) and 444.5 (SD=157.3) for the 65-74 years and 75-84 years age group, respectively. Pearson's product-moment correlations were strongest with the Trail Making Test Part B (r=0.602).Conclusions: The findings of this study were comparable with the initial US data. The MNT is an easy-to-administer bedside cognitive screening tool. Further validation studies using the MNT and driving performance are warranted. [ABSTRACT FROM AUTHOR]

Objectives The aims of this study were: (i) to investigate the proportion of older people writing suicide notes in New Zealand; (ii) to compare the socio-demographic and clinical variables of older suicide note writers and non-note writers; and (iii) to perform a thematic analysis of the content of suicide notes. Methods The Coronial Services provided records of all suicide cases aged 65 years and over ( n =225) between July 2007 and December 2012. We were able to determine whether there was a suicide note written in 212 cases. The content of 39 coroners/medical examiners’ excerpts and 5 suicide notes was available for thematic analysis using a general inductive approach. Findings 88 (41.5%) older people left a suicide note. Logistic regression showed that female gender (OR=2.8, 95% CI=1.4−5.7, p =0.005) and Caucasian ethnicity (OR=13.7, 95% CI=1.7−111.0, p =0.014) are significantly associated with older people writing suicide notes. 33.3% of those who left a suicide note gave health-related reasons for their suicide and a significant proportion (73.3%) of them had underlying medical conditions. Another common theme is around people leaving specific instructions and wishes. Conclusions Apart from gender and ethnicity, suicide note writers are similar to non-writers on broad socio-demographic and clinical factors. Suicide notes indicated free will in and reasons for their suicide and emotional/farewell messages to their loved ones. Many documented poor quality of life or physical illness but the progression of these factors to suicide in older people should be further researched. [ABSTRACT FROM AUTHOR]

Objective Late-life suicide is a growing public health concern in many parts of the world. Understanding the contributory factors to completed suicide is essential to inform the development of effective suicide risk assessment and management. The aim of this study is to synthesise the findings in studies that used coroner or medical examiner records to determine these contributory factors. Methods The databases of Scopus (from 1960), MEDLINE (from 1946) and PsychINFO (from 1806) were searched in August 2013, to identify studies that used coroner or medical examiner records for investigating the epidemiological, sociodemographic characteristics and clinical aspects of late-life suicide. Results In total, 25 studies were identified. There was a lack of standardisation of variables assessed between studies leading to incomplete datasets in some work. However, a diagnosis of depression was found in 33%, and depressive mood/symptoms in 47% of cases. About 55% had a physical health problem. Terminal illness was associated with a smaller proportion (7.1%) of the cases. Older people were more likely to have had contact with primary care rather than mental health services prior to suicide. Conclusions Despite their limitations, coroner and medical examiner records provide an opportunity for examining suicide epidemiology. Targeting primary care providers where late-life depression and physical illness can be detected and treated is a potential strategy to address late-life suicide. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed.Method: An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand.Results: Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s).Conclusions: Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the antibacterial effectiveness of passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser (WTL), and photon-induced photoacoustic streaming (PIPS) using an Er:YAG laser against Enterococcus faecalis biofilms in the apical third of root canals. Methods: Root canals of 70 single-rooted human teeth were instrumented and infected with E. faecalis for 3 weeks to form biofilms. The samples were randomly divided into five groups as follows: (i) PUI + 3% NaOCl (n = 16); (ii) Er,Cr:YSGG laser (n = 16); (iii) PIPS + 3% NaOCl (n = 16); (iv) positive control group (n = 10); and (v) negative control group (n = 10). The bacterial content in the root canal was sampled using (a) the paper-point sampling method before (S1) and after (S2) treatment and (b) pulverising the apical 5 mm of the root. The number of bacteria recovered from each group was counted as colony-forming units (CFUs). The amount of reduction between the groups was compared with the Kruskal–Wallis test and post-test Dunn's multiple comparisons tests. The significance level was set at 5% (p < 0.05). Results: The samples from the paper-point sampling method showed that the amount of bacteria before (S1) and after treatment (S2) was significantly different between PIPS and WTL, as well as between the PUI and WTL groups. In contrast, no significant difference was found between the PIPS and PUI groups. From the pulverised samples, the results indicated no significant difference among all experimental groups in the amount of bacterial reduction in the apical 5 mm of the root. Conclusions: PUI and PIPS showed a significantly greater reduction in bacterial content within the main root canal compared with the WTL. There was no difference among all experimental groups in the apical third of the root. [ABSTRACT FROM AUTHOR]

Cognitive stimulation therapy (CST) is an evidence-based group intervention for people with dementia. In response to the COVID-19 pandemic, many existing CST groups moved virtually and this required carers of people living with dementia to assist with setting up the appropriate technology. This study aimed to explore the roles and experiences of carers in accessing virtual CST (vCST). This qualitative study used semi-structured individual interviews, via telephone or videoconference, to explore the roles and experiences of carers. Interviews were recorded, transcribed verbatim and thematically analysed. Twelve family carers (age: 51–75 years) reported a range of experiences, from novice to expert knowledge in terms of accessing digital devices (mainly laptops and iPads) and connecting to Zoom. Accessing vCST provided carers an immediate application of new knowledge. Carers reported positive responses to vCST that provided their family member living with dementia with social contact and cognitive stimulation during lockdown. Accessing vCST required carers to have an existing adequate level of technological competence in order to learn and use the Zoom platform. Adult learning principles can be used to improve carers' digital literacy required for vCST and other telehealth initiatives. [ABSTRACT FROM AUTHOR]

Abstract: Background: Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult. Method and result: This study is a retrospective review of all patients with Melody valve implantation in a tertiary centre. Between November 2006 and November 2012, 43 procedures were performed in 42 patients (mean age 25years, 6–67years). At a median follow-up of 27months (2–66months), six patients were suspected for IE. However, repeated transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) showed no evidence of IE and the patients were diagnosed as possible cases according to the modified Duke's criteria. Two patients did not respond to antibiotic treatment and underwent intra-cardiac echocardiography (ICE), which clearly demonstrated vegetations. These two cases required surgical explantation, while the other four patients were treated medically without complications. Conclusion: IE after Melody valve implantation is uncommon, but difficult to verify since TTE and TEE often cannot demonstrate vegetations inside the stent. ICE should be considered in suspected cases of IE following PPVR with negative TTE and TEE examinations in order to early tailor the best treatment for the individual patient suspected for IE. [Copyright &y& Elsevier]

Objective: There is a paucity of research on the mental health issues of older Chinese people in New Zealand. This study aimed to describe the profiles of Chinese service users in a community-based old age psychiatry service. Method: There were 22 older Chinese service users at the time of this cross-sectional analysis. Information on their demographics, referral pattern, diagnosis and treatment was obtained from their medical records and compared with a sample of 22 non-Chinese service users. Results: The referral rates for Chinese and non-Chinese were 0.8% and 1.2% respectively. There did not appear to be any differences in the gender ratio, mean age, referral sources, diagnosis and medication use in the Chinese and non-Chinese groups. The largest observed differences were the higher rates of physical aggression at referral, use of Mental Health Act and inpatient treatment in the Chinese group. These observations suggest there might have been a delay in seeking care until psychiatric symptoms became unmanageable. Conclusions: There is a need for further research to improve primary care, mental health service access and responsiveness for older Chinese and other Asian minority groups. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to report the findings from a routine collection of Health of the Nation Outcome Scales for older persons (HoNOS65 + ) in a memory clinic and to explore its clinical utility with clinicians working in old age psychiatric services. Methods: We conducted a retrospective analysis of HoNOS65+ ratings collected during a 12-month period in a newly established memory clinic. Results of this part of the study were presented to 34 clinicians. Results: The mean total HoNOS65+ score was 6.8 and 7.0 for the initial and follow-up episodes respectively. Between 60 and 65% of the clinicians indicated that they 'disagree', 'strongly disagree' or were 'unsure' whether HoNOS65+ (i) can contribute to clinical decision making; (ii) is useful in monitoring progress; (iii) is useful in supporting consumers to assess their progress; and (iv) is assisting in assessing, planning and evaluating service delivery. Conclusions: Service users had timely diagnostic assessment and interventions at the memory clinic. The lack of change on the HoNOS65+ suggests the positive effect of the clinic was not captured by this outcome measure. Although HoNOS65+ is routinely collected, its clinical utility as perceived by clinicians is relatively limited. [ABSTRACT FROM AUTHOR]

Objective: The aim of this survey was to identify all the publicly funded memory clinics in the 21 District Health Boards (DHBs) in New Zealand. Method: Information on the provision of memory clinics was obtained by emailing the old age psychiatrists' group and making telephone contact with clinicians working in old age psychiatry/geriatric services. A brief structured questionnaire was completed by the memory clinic lead clinicians. Results: There are eight memory clinics in New Zealand, funded equally between mental health services and geriatric medicine. However, there is variability in the provision of memory clinics in the medium and smaller sized DHBs and inconsistency in the level of funded staff across DHBs. Conclusions: Acknowledgement of the value of memory clinics within a national service framework is needed, with appropriate benchmarking of funding. This would ensure improved access, including for rural and remote areas of New Zealand. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the low-cycle fatigue (LCF) behaviour of NiTi rotary endodontic instruments in aqueous sodium hypochlorite solution. Methods: Four brands of NiTi rotary instrument (n =179) were subjected to a rotational-bending fatigue test at a rate of 250rpm until fracture, the instrument being immersed in 1.2% sodium hypochlorite solution. The surface strain amplitude, calculated from the curvature (from a pre-test photograph) and diameter of the fracture cross-section (from SEM photomicrograph) was plotted against the total number of revolutions to failure. An apparent fatigue-ductility exponent was determined from a regression line fitted to the LCF lives for each brand of instrument. All detached fragments were examined fractographically for crack initiation and the extent of crack extension into the cross-section. The values were compared using one-way analysis of variance (ANOVA) or χ 2, where appropriate, at α =0.05. Results: A linear strain-life relationship was obtained for all groups; the apparent fatigue-ductility exponent was similar between various brands (ANOVA, P >0.05), but not for the number of crack origins (χ 2, P <0.05). There was an inverse, linear relationship between the square root of the extension of the fatigue-crack and the strain amplitude. Significance: NiTi rotary instruments fatigued in hypochlorite shows a strain-life relationship with low-cycle and high-cycle fatigue regions. The LCF behaviour is not affected by the cross-sectional shape of the instrument. There appears to be a critical extent of crack propagation for various surface strain amplitudes leading to final, catastrophic fracture of the instrument. [Copyright &y& Elsevier]

Abstract: Objective: To assess the incidence of endodontic inter-appointment emergency (EIE) in a dental teaching hospital in China, and to correlate its occurrence with preoperative and treatment parameters. Methods: Three thousand six hundred and ninety six cases were collected at root canal treatment appointments on demographics, presenting symptoms, treatment procedures and periradicular status. The operators consisted of faculty, undergraduate students and advanced trainees. Root canals were conventionally instrumented and then medicated. No systemic medication was prescribed. In cases EIE developed between appointments, an emergency visit was arranged and active treatment was carried out. The data of EIE cases were statistically analyzed using the chi-square test and a multiple logistic regression model. Results: The overall incidence of EIE was 5%, which rate was 5.5% in females and 4.3% in males. Analyses of the potential factors revealed that patient age, tooth location, preoperative percussion pain and pulp status were the most important independent variables. Conclusion: EIE was significantly associated with some host factors (patient age, tooth location) and presenting factors (preoperative percussion pain, pulp status). [Copyright &y& Elsevier]

Abstract: Solar irradiance data on various inclined surfaces at different orientations are important information for active solar-system analyses and passive energy-efficient building designs. In many parts of the world, however, the basic solar irradiance data for the surfaces of interest are not always readily available. Traditionally, different mathematical models have been developed to predict the solar irradiance on various inclined surfaces using “horizontal” data. Alternatively, the diffuse irradiance of a sloping plane can be calculated by integrating the radiance distribution generated with a sky radiance model. This paper presents the evaluation of two slope irradiance models, namely, the Perez point-source model (PEREZSIM) and the Muneer model (MUNEERSIM), and two sky-distribution models, namely, the Perez all-weather model (PEREZSDM) and the Kittler standard-sky model (KITTLERSDM). Three-year (1999–2001) measured average hourly sky radiance and horizontal sky diffuse irradiance data were used for the model assessment. Statistical results showed that all four models can accurately predict the solar irradiance of a 22.3° (latitude angle of Hong Kong) inclined south-oriented surface, indicating the good predictive ability for modelling an inclined surface with a small tilted angle. In general, the KITTLERSDM and PEREZSIM show the best predictions for vertical solar irradiance at this location, followed by the PEREZSDM, then the MUNEERSIM. [Copyright &y& Elsevier]

Abstract: The applications of photovoltaic (PV) systems have become more widespread in both developed and developing countries. The most critical exercise in designing a PV system is the determination of the optimum size of the solar panel and the battery capacity to meet the load demand with acceptable reliability. The amount of power generated by a PV system strongly depends on the availability of solar insolation at the required location. Also, the efficiency of a PV system is influenced considerably by a number of climatic variables, such as solar irradiance availability and ambient temperature. The technical information is provided for standard test conditions that may never occur in practice. Reliable knowledge of the performance of PV systems under actual operating conditions is essential for correct product selection and accurate performance prediction. This paper investigates the operational performance and efficiency characteristic of a small PV system installed at the City University of Hong Kong. The solar data and the power generated by the PV system are systematically recorded and analysed. The findings provide technical data in different months for designers and engineers to assess and size PV systems. [Copyright &y& Elsevier]

Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries. [ABSTRACT FROM AUTHOR]

A Correction to this paper has been published: https://doi.org/10.1007/s10823-021-09429-9 [ABSTRACT FROM AUTHOR]

Objective: To report the development and feedback on a newly created mindfulness-based cognitive therapy (MBCT) informed virtual wellbeing programme for psychiatry trainees. Methods: Thirteen of the 14 trainees participated in the programme provided feedback via an online questionnaire. Qualitative data was analysed using thematic analysis. Results: Thematic analysis revealed three main themes: timing of the intervention in relation to the COVID-19 pandemic; trainees were connected to the facilitator, their peers and within oneself; and trainees were going through a transformative experience. Discussion: Our findings support including an optional MBCT informed wellbeing programme in psychiatry training programmes. Future research could measure efficacy of this online programme by utilising pre- and post-outcome measures of dispositional mindfulness and stress. [ABSTRACT FROM AUTHOR]

Context: The decision to request and proceed with euthanasia or physician-assisted dying is complex, and predictors of such decisions are heterogeneous with regard to physical health, psychological, and social factors. Local research is therefore needed.Objectives: To examine the interplay of demographic, clinical, and psychosocial factors routinely collected by a standardized clinical instrument, the interRAI Resident Assessment Instrument for Palliative Care (interRAI-PC), in people with a prognosis of less than 12 months who wanted to die.Methods: All New Zealanders who had an interRAI-PC in 2018 were included. The outcome variable was the single item Wants to die now. Independent variables included biopsychosocial factors and health index scales generated by interRAI-PC. A binary logistic regression was used to determine the predictive factors of Wants to die now (yes vs. no).Results: There were 771 individuals included (mean age 76.0 years; SD 11.6; female 50.1%); 9.3% of whom reported yes to Wants to die now, 59.8% no, and for 30.9%, the assessor was unable to determine. The factors with the largest odds ratios (ORs) were awareness of terminal prognosis (OR 4.8; 95% CI 2.2-10.3), high level of depression (OR 4.6; 95% CI 1.7-12.6), not finding meaning in day-to-day life (OR 3.8; 95% CI 1.8-8.1), and pain (less than severe: OR 3.7; 95% CI 1.3-10.4 and severe to excruciating: OR 3.5; 95% CI 1.1-10.7).Conclusion: Addressing the significant factors we identified should form part of a multidisciplinary assessment when terminally ill patients express a wish to die, to ensure their physical, psychological, and existential needs are adequately met. [ABSTRACT FROM AUTHOR]

• Data from 51,239 assessments of older adults (mean age: 82.3 years; female: 61%; European: 87.3%) were analysed. • Loneliness was reported in 21%. • The largest odds ratios explaining loneliness were depression, living alone, and financial difficulty. • Predictors of loneliness are multi-factorial. Financial difficulty could be targeted as modifiable risk factor. To investigate the interplay of sociodemographic, health, functional and psychosocial factors in predicting loneliness in community dwelling older adults accessing home support services and long-term aged residential care. Older New Zealanders (age 65+), who had their first interRAI Home Care assessment between July 2014 and June 2016, were included. The outcome variable was the binary interRAI item "Lonely". The predictor variables included sociodemographics, hearing, vision, self-reported health, activities of daily living, social interaction and support, and depression. Data from 51,239 assessments of older adults (mean age: 82.3 years; female: 61%; European: 87.3%) were analysed. Loneliness was reported in 21%. A stepwise logistic regression model explained 12.1% of the variance and was statistically significant (Chi2 = 3501.0.8, df = 22; p < 0.001). The factors with the largest odds ratios (OR > 1.5) were depression, living alone, being Asian, financial difficulty and not in a relationship. Functional impairment was negatively associated with loneliness. Determining the predictors of older adults' loneliness is complex, multi-factorial, with each factor having a small, additive effect on the development of loneliness. Depression, social factors and financial difficulty are the strongest predictors but much of the variance remains unexplained. These factors could be targeted as modifiable risk factors for addressing loneliness in older adults. [ABSTRACT FROM AUTHOR]