Additional file 1: of Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: a feasibility study

Free-text responses from patients to the following post-testing question: â What part of the information [from the pedobarography results] did you find useful?â . (DOCX 17Â kb

Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: a feasibility study

Abstract Background The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography – or plantar pressure measurement – can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients. Methods For the current feasibility study, we embedded pedobarographic measurements into three unique diabetic foot clinic settings in the New Zealand context, and collected pedobarographic data from n = 38 patients with diabetes using a platform-based (Novel Emed) and/or in-shoe-based system (Novel Pedar). Our aim was to assess the feasibility of incorporating pedobarographic testing into the clinical care of diabetic feet in New Zealand. Results and Conclusions We observed a high response rate and positive self-reported experience from participants. As part of our engagement with participants, we observed a high degree of lower-limb morbidity, including current ulceration and chronic foot deformities. The median time for pedobarographic testing (including study introduction and consenting) was 25 min. Despite working with a high-risk population, there were no adverse events in this study. In terms of application of pedobarography as a clinical tool in the New Zealand context, the current feasibility study leads us to believe that there are two avenues that deserve further investigation: a) the use of pedobarography to inform the design and effectiveness of offloading devices among high-risk diabetic patients; and b) the use of pedobarography as a means to increase offloading footwear and/or orthoses compliance among high-risk diabetic patients. Both of these objectives deserve further examination in New Zealand via clinical trial

Perceived barriers and incentives to increased physical activity for Pacific mothers in New Zealand: findings from the Pacific Islands Families Study

Objective: To describe and compare Pacific and non-Pacific mothers' perceived barriers and incentives to physical activity (PA) in New Zealand, and compare perceptions between Pacific mothers. Methods: Three samples were utilised: (i) mothers with children aged 5-15 years living at home from a nationally representative cross-sectional postal survey of adults conducted in 2003 (n=1,070 including 62 Pacific mothers); (ii) a cohort of Pacific mothers with children born in 2000, and interviewed 6-years postpartum (n=934); and (iii) a nested cross-sectional sub-study of (ii) conducted at the 6-years measurement wave (n=240). Participants in samples (i) and (ii) responded to identical questions on perceived barriers (23 items) and incentives (13 items) to PA. Body mass index (BMI) and accelerometer quantified PA was measured in (iii). Results: All barriers but one were significantly more influential for non-Pacific mothers than Pacific mothers and all incentives but one were significantly more likely to succeed for non-Pacific mothers. Pacific mothers' perceptions of barriers and incentives to PA were similar between BMI and accelerometer quantified groupings. Conclusions and implications: Pacific mothers appear not to see PA as an issue of importance. Culturally appropriate approaches aimed at improving PA and health is needed to engage Pacific mothers in New Zealand

New graduate nurses as knowledge brokers in general practice in New Zealand: a constructivist grounded theory

Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country’s two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses’ use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X