18 results for Abbott, M

  • Lotteries literature review: final report

    Bellringer, M; Abbott, M (2011-09-07)

    Report
    Auckland University of Technology

    This report provides an overview of available literature relating to lotteries products, based on five specific question areas of focus: • To what extent do lotteries products in general and New Zealand lotteries products in particular appeal to problem and under-age gamblers? Do someproducts appeal more than others and, if so, can this be described? • What policies, programmes, codes of practice and corporate social responsibility guidelines have other lotteries adopted and is there any evidence about the impact these have had on problem and under-age gamblers? • What other lotteries have made existing or new products available on the internet or via electronic media and what impact, if any, have these had on problem and under-age gambling? • What is the role of lotteries marketing in shaping people’s views on participating in lotteries and about gambling in general? • What education programmes or materials have been developed to educate gamblers about responsible gambling and are there examples of ‘good practice’ in this area? The review was commissioned by the New Zealand Lotteries Commission in order that research gaps could be identified and recommendations made for research that the New Zealand Lotteries Commission could potentially contract. The review consisted of an extensive search of library and other electronic databases, personal specialist collections and grey literature. Professional and personal networks were also drawn on to locate unpublished reports and more especially, organisational documents relating to social responsibility and/or educational programmes and materials that might otherwise not have been easily accessible via the public domain. Relevant documentation was accessed and critically reviewed. Background and contextual information is provided in Chapter 1. Chapter 2 outlines the methodology used. The literature review (Chapter 3) comprises the main body of the report and is followed by the conclusion (Chapter 4), identified research gaps (Chapter 5) and recommendations for research (Chapter 6). Key points from the review follow, grouped under the five questions areas of focus.

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  • Exploration of the impact of gambling and problem gambling on Pacific families and communities in New Zealand

    Bellringer, M; Fa'amatuainu, B; Taylor, S; Coombes, R; Poon, Z; Abbott, M (2013-12-04)

    Report
    Auckland University of Technology

    No abstract.

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  • Maternal gambling associated with families' food, shelter and safety needs: findings from the Pacific Island Families study

    Schluter, PJ; Bellringer, M; Abbott, M (2011-09-07)

    Journal article
    Auckland University of Technology

    From a cohort study of Pacific families with children resident in Auckland (n = 983) we examine the association between maternal gambling over the previous 12 months and families' food, shelter, and safety needs. Overall, 666 (68%) mothers reported no gambling, 267 (27%) reported gambling but receiving no criticism, and 50 (5%) reported both gambling and receiving criticism. Compared to those with nongambling mothers, households with gambling mothers were more likely to have both food and housing issues related to a lack of money but no excess in physical intimate partner violence.

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  • Problem gambling assessment and screening instruments: phase one final report

    Bellringer, M; Abbott, M; Volberg, R; Garrett, N; Coombes, R (2011-09-07)

    Report
    Auckland University of Technology

    Objectives: This project was commissioned by the Problem Gambling Committee (PGC); subsequently the Ministry of Health assumed responsibility from the PGC. The primary objectives of the project were to: 1. Review the assessment and screening instruments currently used in New Zealand and internationally for the assessment of problem gamblers at the clinical level including by the telephone helpline 2. Following the review, to recommend a full set of screening and assessment instruments to be used in the clinical treatment of problem gamblers; selected instruments will be able to be used to monitor client progress in follow-up assessments currently undertaken at six monthly intervals 3. To pilot the recommended screening and assessment instruments in order to test the application of these screens in the New Zealand setting The research was divided into two phases. There was a particular focus on the screening instruments currently mandated for use by Ministry of Health funded problem gambling service providers, namely the South Oaks Gambling Screen - Three Month time frame (SOGS-3M), DSM-IV gambling criteria, Dollars Lost assessment and Control over Gambling assessment. Other screening tools used by the service providers were also considered. Additionally, the family/whanau checklist was reviewed.

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  • The Stroke Riskometer(TM) App: validation of a data collection tool and stroke risk predictor

    Parmar, P; Krishnamurthi, R; Ikram, MA; Hofman, A; Mirza, SS; Varakin, Y; Kravchenko, M; Piradov, M; Thrift, AG; Norrving, B; Wang, W; Mandal, DK; Barker-Collo, S; Sahathevan, R; Davis, S; Saposnik, G; Kivipelto, M; Sindi, S; Bornstein, NM; Giroud, M; Béjot, Y; Brainin, M; Poulton, R; Narayan, KM; Correia, M; Freire, A; Kokubo, Y; Wiebers, D; Mensah, G; BinDhim, NF; Barber, PA; Pandian, JD; Hankey, GJ; Mehndiratta, MM; Azhagammal, S; Ibrahim, NM; Abbott, M; Rush, E; Hume, P; Hussein, T; Bhattacharjee, R; Purohit, M; Feigin, VL; Stroke RiskometerTM Collaboration Writing Group

    Journal article
    Auckland University of Technology

    The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the 'mass' approach), the 'high risk' approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer(TM) , has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods.

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  • Formative investigation into the effectiveness of gambling venue exclusion processes in New Zealand

    Bellringer, M; Coombes, R; Pulford, J; Abbott, M (2011-09-07)

    Report
    Auckland University of Technology

    Exclusion of patrons from gambling venues is potentially an effective early intervention for minimising harm from excessive gambling since it may contribute to the treatment and/or recovery of people with developing and established gambling problems. Internationally, some jurisdictional regulations mandate „imposed exclusion‟ programmes, where gamblers with problems are identified by venue staff (usually casinos) and barred from gambling at those venues. In other jurisdictions, „self-exclusion‟ programmes are in place, where gamblers may request that they be banned from the venue, removed from its mailing list and potentially face legal consequences if they re-enter the premises. Traditionally, such self-exclusion programmes have been operated by casinos but increasingly are being required for clubs and pubs where electronic gaming machines are located. In New Zealand, The Gambling Act 2003 stipulates that both imposed- and self- exclusion measures should be operated. The Act refers to these exclusion measures as an "order‟ but colloquial use of the term "contract‟ has been used throughout this report due to the word usage amongst participants in this research and in the literature. However, there is a paucity of research regarding the effectiveness of gambling venue exclusion processes per se and even less information outside the casino environment. In addition, the effectiveness of the particular processes in force in New Zealand has not been evaluated. Currently, different processes are operated by different venues, for example with variations in minimum and maximum exclusion periods, and different requirements for re-entering the gambling venue when an exclusion contract comes to an end. Given that exclusion programmes consume private and public resources and are a legislated requirement, it is important that their effectiveness be ascertained. This will have substantial implications in terms of the potential to improve existing processes to ensure maximum minimisation of harms from gambling. In August 2008, the Gambling and Addictions Research Centre at Auckland University of Technology was commissioned by the Ministry of Health to conduct the research project Formative investigation into the effectiveness of gambling venue exclusion processes in New Zealand. The purpose of this project was two-fold: a) to ascertain the most suitable methodology and processes for researching venue excluders in order to robustly evaluate the effectiveness of current venue exclusion processes, and b) to gain some initial insight into the effectiveness of gambling (particularly electronic gaming machine and casino) venue exclusion processes in New Zealand.

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  • Evaluation of problem gambling intervention services: stage three final report

    Bellringer, M; Coombes, R; Pulford, J; Garrett, N; Abbott, M (2011-09-07)

    Report
    Auckland University of Technology

    The Ministry of Health is responsible for the funding and coordination of problem gambling services and activities in New Zealand. This includes the funding of a national telephone helpline, two national face-to-face counselling services and several regional treatment providers which include Maori and Pacific specific services (Asian specific services are provided as a division of one of the national face-to-face treatment providers) (Ministry of Health, 2008a). From 2008, the Ministry of Health funded face-to-face problem gambling treatment providers have received specific training around the Ministry of Health expectations for service practice requirements (e.g. the types of intervention that will be funded and the processes expected within those interventions as well as for referrals for co-existing issues), and expectations around data collection, management and information submission to the Ministry of Health. The Ministry of Health has also identified specific sets of screening instruments to be used with clients, which vary depending on whether the client is receiving a Brief or Full-length intervention, or is a problem gambler or family/whanau member („significant other‟) of a gambler. These screening instruments came into use in 2008, with different sets of instruments having been used previously. At the present time, the effectiveness of the current problem gambling treatment services is largely unknown, as is the optimal intervention process for different types of client. Whilst this sort of information can ultimately only be ascertained through rigorously conducted effectiveness studies (randomised controlled trials) (Westphal & Abbott, 2006), an evaluation (process, impact and outcome) of services could provide indications as to optimal treatment pathways and approaches for problem gamblers and affected others, as well as identifying successful strategies currently in existence nationally and internationally and areas for improvement in current service provision. In September 2008, the Gambling and Addictions Research Centre at Auckland University of Technology was commissioned by the Ministry of Health to conduct the research project Evaluation of problem gambling intervention services. This project was to focus on four priority areas: 1.) Review and analysis of national service statistics and client data to inform workforce development, evaluation of the Ministry of Health systems and processes, and other related aspects 2.) Process and outcome1 evaluation of the effect of different pathways to problem gambling services on client outcomes and delivery 3.) Process and outcome1 evaluation of distinct intervention services 4.) Process and outcome1 evaluation of the roll-out and implementation of Facilitation Services2

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  • Two years on: gambling amongst Pacific mothers living in New Zealand

    Perese, LM; Bellringer, M; Williams, MM; Abbott, M (2011-09-07)

    Journal article
    Auckland University of Technology

    Research investigating the prevalence and correlates of Pacific peoples gambling within a New Zealand context is limited. This paper provides data about gambling activity from the two-year data collection point for a cohort of mothers within the longitudinal Pacific Islands Families study. The results indicate a number of consistencies and discrepancies between data collected at this time point and two years previously (six-week baseline data collection point). For example, at baseline, Samoans were the least likely to gamble and spent less money on gambling activities. Two years later, Samoans remained the least likely to gamble, but those who did gamble, were more likely to spend more money than other ethnicities. This article highlights the importance of this type of prospective study in examining the development of the risk and protective factors in relation to the development of problem gambling.

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  • Problem gambling assessment and screening instruments: phase two final report

    Bellringer, M; Abbott, M; Coombes, R; Garrett, N; Volberg, R (2011-09-07)

    Report
    Auckland University of Technology

    Objectives: This project was commissioned by the Problem Gambling Committee (PGC); subsequently the Ministry of Health assumed responsibility from the PGC. The primary objectives of the project were to: 1. Review the assessment and screening instruments currently used in New Zealand and internationally for the assessment of problem gamblers at the clinical level including by the telephone helpline 2. Following the review, to recommend a full set of screening and assessment instruments to be used in the clinical treatment of problem gamblers; selected instruments should be able to be used to monitor client progress in follow-up assessments currently undertaken at various set intervals 3. To pilot the recommended screening and assessment instruments in order to test the application of these screens in the New Zealand setting The research was divided into two phases. There was a particular focus on the screening instruments currently mandated for use by Ministry of Health funded problem gambling service providers, namely the South Oaks Gambling Screen - Three Month time frame (SOGS-3M), DSM-IV gambling criteria, Dollars Lost assessment and Control over Gambling assessment. Other screening tools used by the service providers were also considered. Additionally, the family/whanau checklist for use with ‘significant others’ was reviewed.

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  • Problem gambling - Pacific islands families longitudinal study: final report

    Bellringer, M; Abbott, M; Williams, M; Gao, W (2011-09-07)

    Report
    Auckland University of Technology

    Background The Pacific Islands Families (PIF) study has been following a cohort of Pacific children since the year 2000. The purpose of this prospective study is to determine the pathways leading to optimal health, development and social outcomes for Pacific children and their families. Pacific peoples are at high risk for developing problem gambling (the highest risk of the ethnicities living in New Zealand) and have shown heterogeneous differences between the different Pacific cultures in relation to gambling. This highlights the need for significant further study in this area. The longitudinal cohort PIF study has offered a valuable and unique opportunity to study gambling and problem gambling within a Pacific family and child development context, allowing for sub-analyses of the major ethnic Pacific groups and the potential to begin identifying risk and protective factors in the development of problem gambling. In April 2006, the Gambling Research Centre at Auckland University of Technology was commissioned by the Ministry of Health to conduct the research project Problem Gambling - Pacific Islands Families Longitudinal Study. The purpose of this project was to enhance and add value to the existing PIF study by incorporating a substantial gambling component in the six-year data collection phase. Methodology A range of gambling-related questions was incorporated into the interview questionnaire protocols for mothers and fathers of the cohort children at the six-year data collection phase. The questions related to gambling participation and to having problems because of someone else’s gambling, and included problem gambling screens (Problem Gambling Severity Index [PGSI] for mothers and fathers, and South Oaks Gambling Screen - Revised [SOGS-R] for fathers only). All cohort parents (mothers and fathers) were invited to participate in the PIF study six-year assessment. In keeping with previous procedures, all participants were visited in their homes by gender- and ethnically-matched interviewers to complete the structured assessments. Results and discussion This study has significantly increased the knowledge around Pacific peoples’ gambling since the nature of the general population cohort has allowed for analyses to be performed by different Pacific ethnicities and other cultural and demographic variables, which is not usually possible in general population studies due to small Pacific participant sample sizes. Whilst the data in this report represent a cross-section in time, at the six-year data collection point for the cohort, the potential exists for gambling to continue to be a significant part of future data collection phases. This will allow for longitudinal analyses to explore the links between parental gambling and child development of gambling behaviours, as well as risk and protective factors for problem gambling amongst not only adults but also children as they progress through teenage years and into adulthood. It will also allow for exploration of changes over time in regard to gambling participation and problem gambling risk and protective factors. Gambling participation was lower amongst the participants in the cohort than would be expected though a bimodal distribution of gambling (low numbers of people gambling with those who do gamble reporting higher than average expenditure on gambling) was apparent, as was expected from previous national prevalence surveys. Thirty-six percent of all mothers and 30% of all fathers reported that they had gambled in the previous 12 months. Of the mothers and fathers who had gambled, Lotto was the form of gambling most played (89% mothers, 88% fathers) with much lower levels of participation in other forms of gambling. Gender differences were apparent for non-Lotto forms of gambling with mothers participating in Housie and Instant Kiwi gambling (both at 11%) and fathers participating in casino electronic gaming machine (20%), non-casino electronic gaming machine (15%) and Instant Kiwi (14%) gambling. The most preferred forms of gambling were Lotto (80% of gamblers) followed by Housie (9%) for mothers and Lotto (78%) followed by horse/dog race betting (6%) and sports betting at the TAB (5%) for fathers. Amongst those who gambled, four percent of mothers and 16% of fathers were classified as moderate risk or problem gamblers using the PGSI. Using the SOGS-R, 10% of fathers were classified as problem or probable pathological gamblers. Ethnicity appeared to be a key factor in mothers’ gambling but not for fathers. Tongan mothers were less likely to gamble than Samoan mothers; however, those who gambled were 2.4 times more likely to be classified as at risk/problem gamblers, indicating that Tongan mothers are at higher risk for developing problem gambling. Cultural orientation appeared to be related to gambling (in some cases, less gambling) both for mothers and fathers, though different orientations were associated with gambling for the different genders. Fathers who were in the higher total net weekly household income brackets (>$500) were more likely to gamble than fathers in the lower income bracket (<$501), whilst mothers with post-school qualifications were less likely to gamble (0.7 times) than mothers with no formal qualifications. Further gender differences were noted in terms of associations between gambling and health. For fathers both gambling and at risk/problem gambling were associated with psychological distress. Fathers who gambled were more likely to be perpetrators as well as victims of verbal aggression than fathers who did not gamble, with at risk/problem gambling also being associated with physical violence. These findings were not noted amongst mothers whereby at risk/problem gamblers were significantly less likely to perpetrate violence than non-problem gamblers. Not unexpectedly, smoking and alcohol consumption (particularly at higher/harmful levels) were associated with gambling (though not with at risk/problem gambling) both for mothers and fathers. In addition, mothers who drank alcohol were also more likely to have a weekly gambling expenditure in the upper quartile (≥$20) than mothers who did not drink, with increased frequency and amount of consumption associated with increased risk of higher gambling expenditure; this finding was not noted amongst fathers. In addition, a clear association was noted between higher (upper quartile) expenditure on gambling and being classified (PGSI) as a low risk/moderate risk/problem gambler with at risk/problem gambler classified mothers three times more likely, and at risk/problem gambler classified fathers six times more likely to spend in the upper quartile on gambling than non-problem gamblers. The problem gambling screens used (PGSI for mothers and fathers and SOGS-R for fathers only) showed very good internal consistency (reliability). There was good agreement between the PGSI and SOGS-R with 94% of fathers identified as problem gamblers by the SOGS-R also being classified as at risk/problem gamblers by the PGSI. In addition, questions related to lying about gambling and betting more than intended also associated well with the PGSI and SOGS-R within this Pacific cohort. The results suggest that the use of any of these problem gambling screens may be valid for use within a general Pacific population, though this would need to be further tested. Four percent of mothers and ten percent of fathers reported that they had experienced problems because of someone else’s gambling. The findings detailed in this report indicate that different gender and ethnic differences exist amongst Pacific people who should, therefore, not be considered as a homogeneous group. This has implications for service provision by organisations providing services for Pacific people as well as social marketing campaigns around gambling and problem gambling.

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  • 30-year trends in stroke rates and outcome in Auckland, New Zealand (1981-2012): a multi-ethnic population-based series of studies

    Feigin, VL; Krishnamurthi, RV; Barker-Collo, S; McPherson, KM; Barber, PA; Parag, V; Arroll, B; Bennett, DA; Tobias, M; Jones, A; Witt, E; Brown, P; Abbott, M; Bhattacharjee, R; Rush, E; Suh, FM; Theadom, A; Rathnasabapathy, Y; Te Ao, B; Parmar, PG; Anderson, C; Bonita, R; ARCOS IV Group

    Journal article
    Auckland University of Technology

    Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years.

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  • Evaluation of problem gambling intervention services: stages one and two final report

    Bellringer, M; Coombes, R; Garrett, N; Nahi, P; Pulford, J; Abbott, M (2011-09-07)

    Report
    Auckland University of Technology

    Background The Ministry of Health is responsible for the funding and coordination of problem gambling services and activities in New Zealand. This includes the funding of a national telephone helpline, two national face-to-face counselling services and several regional treatment providers which include Maori and Pacific specific services (Asian specific services are provided as a division of one of the national face-to-face treatment providers) (Ministry of Health, 2008a). From 2008, Ministry funded face-to-face problem gambling treatment providers have received specific training around Ministry expectations for service practice requirements (e.g. the types of intervention that will be funded and the processes expected within those interventions as well as for referrals for co-existing issues), and expectations around data collection, management and information submission to the Ministry. The Ministry has also identified specific sets of screening instruments to be used with clients, which vary depending on whether the client is receiving a brief or full-length intervention, or is a problem gambler or family/whanau member (‘significant other’) of a gambler. These screening instruments came into use in 2008, with different sets of instruments having been used previously. At the present time, the effectiveness of the current problem gambling treatment services is largely unknown, as is the optimal intervention process for different types of client. Whilst this sort of information can ultimately only be ascertained through rigorously conducted effectiveness studies (randomised controlled trials) (Westphal & Abbott, 2006), an evaluation (process, impact and outcome) of services could provide indications as to optimal treatment pathways and approaches for problem gamblers and affected others, as well as identifying successful strategies currently in existence and areas for improvement in current service provision. In September 2008, the Gambling and Addictions Research Centre at Auckland University of Technology was commissioned by the Ministry of Health to conduct the research project Problem gambling: Evaluation of problem gambling intervention services. This project focused on four priority areas: 1.) Review and analysis of national service statistics and client data to inform workforce development, evaluation of Ministry systems and processes, and other related aspects 2.) Process and outcome evaluation of the effect of different pathways to problem gambling services on client outcomes and delivery 3.) Process and outcome evaluation of distinct intervention services 4.) Process and outcome evaluation of the roll-out and implementation of Facilitation Services

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  • Formative investigation of the links between gambling (including problem gambling) and crime in New Zealand

    Bellringer, M; Abbott, M; Coombes, R; Brown, R; McKenna, B; Dyall, L; Rossen, F (2011-09-07)

    Report
    Auckland University of Technology

    Crime (illegal behaviours) constitutes a continuum ranging from undetected, unreported, and unprosecuted crimes through to prosecuted, convicted and sentenced crimes; any of these may be associated with gambling/problem gambling. There may also be behaviours considered marginally illegal, for example welfare beneficiaries obtaining additional benefit and not disclosing that benefit money has been used for gambling, or business owners using business cash for gambling and not declaring cash as income for tax purposes. These behaviours are difficult to detect and even if detected may be considered morally socially unacceptable but not necessarily criminal and thus not reported to police. There may also be other behaviours, for example embezzlement of employer funds or stealing from family that are clearly criminal and may be detected, but are not likely to be reported to save embarrassment of either the victim or the perpetrator, or even to protect the perpetrator. In some instances, these crimes are not readily linked to gambling. Additionally, there are financial crimes to support gambling, situational crimes associated with gambling venues, violence associated with gambling and family/whanau crime associated with gambling. In November 2006, the Gambling and Addictions Research Centre at Auckland University of Technology, in collaboration with the Centre for Gambling Studies at the University of Auckland, was commissioned by the Ministry of Health to conduct the research project Problem gambling – Formative investigation of the links between gambling (including problem gambling) and crime in New Zealand. The purpose of this project was to develop a better understanding of the nature of the links between gambling and crime, with particular reference to unreported crime and the nature of the resulting harms experienced by individuals, families/whanau and communities.

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  • Problem gambling - barriers to help-seeking behaviours (final report)

    Bellringer, M; Pulford, J; Abbott, M; DeSouza, R; Clarke, D (2011-09-07)

    Report
    Auckland University of Technology

    Background: In New Zealand, as elsewhere, only a small proportion of problem gamblers seek formal help for their gambling problems. In particular, Pacific peoples appear to be significantly underrepresented relative to general population prevalence estimates from the 1999 national survey (Abbott & Volberg, 2000). There also appears to be male under-representation, especially in the case of new Maori clients, and an over-representation of females and Pakeha/Europeans seeking help for someone else’s gambling (Ministry of Health, 2006). Thus, increased understanding of the motivations and barriers for help-seeking behaviours is required. In March 2006, the Gambling Research Centre at Auckland University of Technology was commissioned by the Ministry of Health to conduct the research project Problem gambling - Barriers to help seeking behaviours. The aim of the project was to describe and understand barriers and enablers to help-seeking, and the experiences when seeking help, of people experiencing gambling harm and of their families/whanau.

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  • Gender, age, ethnic and occupational associations with pathological gambling in a New Zealand urban sample

    Clarke, D; Abbott, M; Tse, S; Townsend, S; Kingi, P; Manaia, W

    Journal article
    Massey University

    Published

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  • 30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012): A Multi-Ethnic Population-Based Series of Studies

    Feigin, VL; Krishnamurthi, RV; Barker-Collo, Suzanne; McPherson, KM; Barber, Peter; Parag, V; Arroll, Bruce; Bennett, DA; Tobias, M; Jones, A; Witt, E; Brown, P; Abbott, M; Bhattacharjee, R; Rush, E; Suh, FM; Theadom, A; Rathnasabapathy, Y; Te Ao, B; Parmar, PG; Anderson, C; Bonita, R (2015-01)

    Journal article
    The University of Auckland Library

    BACKGROUND: Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ) over 30-years. METHODS: Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years) of Auckland NZ in 1981-1982, 1991-1992, 2002-2003 and 2011-2012. All used standard World Health Organization (WHO) diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard) annual incidence and mortality with corresponding 95% confidence intervals (CI) were calculated per 100,000 people, assuming a Poisson distribution. RESULTS: 5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31%) and 62% (95% CI 36%-86%), respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively) compared with NZ/Europeans (mean age 75 years). There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17%) across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in frequency of current smoking among stroke patients. CONCLUSIONS: In this unique temporal series of studies spanning 30 years, stroke incidence, early case-fatality and 1-year mortality have declined, but ethnic disparities in risk and outcome for stroke persisted suggesting that primary stroke prevention remains crucial to reducing the burden of this disease.

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  • The Stroke RiskometerTM App: Validation of a data collection tool and stroke risk predictor

    Parmar, P; Krishnamurthi, R; Ikram, A; Hofman, A; Mirza, S; Varakin, Y; Kravchenko, M; Piradov, M; Thrift, A; Norrving, B; Wang, W; Mandal, DK; Barker-Collo, Suzanne; Sahathevan, R; Davis, S; Saposnik, G; Kivipelto, M; Sindi, S; Bornstein, NM; Giroud, M; Béjot, Y; Hankey, G; Brainin, M; Poulton, R; Narayan, KMV; Correia, M; Freire, A; Kokubo, Y; Wiebers, D; Mensah, G; Azhagammal, S; Dhim, NB; Barber, Peter; Pandian, JD; Abbott, M; Rus, E; Hume, P; Hussein, T; Bhattacharjee, R; Purohit, M; Feigin, VL (2015)

    Journal article
    The University of Auckland Library

    Background The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke RiskometerTM, has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke RiskometerTM) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke RiskometerTM performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%–77·6%), Stroke RiskometerTM = 74·0(95% CI 71·3%–76·7%) and females [FSRS = 70·3% (95% CI 67·9%–72·8%, Stroke RiskometerTM = 71·5% (95% CI 69·0%–73·9%)], and better than QStroke [males – 59·7% (95% CI 57·3%–62·0%) and comparable to females = 71·1% (95% CI 69·0%–73·1%)]. Discriminative ability of all algorithms was low (C-statistic ranging from 0·51–0·56, D-statistic ranging from 0·01–0·12). Hosmer-Lemeshow illustrated that all of the predicted risk scores were not well calibrated with the observed event data (P < 0·006). Conclusions The Stroke RiskometerTM is comparable in performance for stroke prediction with FSRS and QStroke. All three algorithms performed equally poorly in predicting stroke events. The Stroke RiskometerTM will be continually developed and validated to address the need to improve the current stroke risk scoring systems to more accurately predict stroke, particularly by identifying robust ethnic/race ethnicity group and country specific risk factors.

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  • New strategy to reduce the global burden of stroke.

    Feigin, VL; Krishnamurthi, R; Bhattacharjee, R; Parmar, P; Theadom, A; Hussein, T; Purohit, M; Hume, P; Abbott, M; Rush, E; Kasabov, N; Crezee, I; Frielick, S; Barker-Collo, Suzanne; Barber, Peter; Arroll, Bruce; Poulton, R; Ratnasabathy, Y; Tobias, M; Cabral, N; Martins, SC; Furtado, LE; Lindsay, P; Saposnik, G; Giroud, M; Béjot, Y; Hacke, W; Mehndiratta, MM; Pandian, JD; Gupta, S; Padma, V; Mandal, DK; Kokubo, Y; Ibrahim, NM; Sahathevan, R; Fu, H; Wang, W; Liu, L; Hou, ZG; Goncalves, AF; Correia, M; Varakin, Y; Kravchenko, M; Piradov, M; Saadah, M; Thrift, AG; Cadilhac, D; Davis, S; Donnan, G; Lopez, AD; Hankey, GJ; Maujean, A; Kendall, E; Brainin, M; Abd-Allah, F; Bornstein, NM; Caso, V; Marquez-Romero, JM; Akinyemi, RO; Bin Dhim, NF; Norrving, B; Sindi, S; Kivipelto, M; Mendis, S; Ikram, MA; Hofman, A; Mirza, SS; Rothwell, PM; Sandercock, P; Shakir, R; Sacco, RL; Culebras, A; Roth, GA; Moradi-Lakeh, M; Murray, C; Narayan, KM; Mensah, GA; Wiebers, D; Moran, AE; RIBURST Study Collaboration Writing Group (2015-06)

    Journal article
    The University of Auckland Library

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