11 results for Ameratunga, S

  • Traumatic brain injury within Pacific people of New Zealand

    Lagolago, W; Theadom, A; Fairbairn Dunlop, P; Ameratunga, S; Dowell, A; McPherson, KM; Te Ao, B; Starkey, NJ; Feigin, VL; on behalf of the BIONIC Research Group

    Journal article
    Auckland University of Technology

    Aims Previous research has suggested there are ethnic disparities in the incidence of traumatic brain injury (TBI). This study aimed to: identify the incidence of TBI for Pacific people; describe the injury profile in this population; and determine if there were disparities in healthcare service use. Methods All TBI cases that occurred within a 1-year period in the Hamilton and Waikato regions of New Zealand were identified using multiple case ascertainment methods as part of a population-based incidence study. Demographic and injury data from people who self-identified as a Pacific person (N=76) were extracted and compared to New Zealand (NZ) Europeans (N=794). Differences in injury severity, mechanism of injury and acute healthcare service use were explored between the two ethnic groups. Results The total crude incidence of TBI in Pacific people was 1242 cases per 100,000 person-years, significantly higher than NZ Europeans (842 per 100,000). Peaks in incidence for Pacific people and NZ Europeans were observed between 0–4 and 15–24 years of age, with males at greater risk of injury than females. There were no statistically significant differences in TBI severity, mechanism of injury and acute healthcare use between the two groups. Conclusion Pacific people are at a significantly higher risk of experiencing a TBI than NZ Europeans and targeted prevention efforts are needed.

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  • Reliable Individual Change in Post Concussive Symptoms in the Year Following Mild Traumatic Brain Injury: Data From the Longitudinal, Population-based Brain Injury Incidence and Outcomes New Zealand in the Community (Bionic) Study

    Barker-Collo, S; Theadom, A; Jones, K; Ameratunga, S; Feigin, V; Starkey, N; Dudley, M; Kahan, M

    Journal article
    Auckland University of Technology

    Objective: Post concussive syndromes (PCS) is common after mild-TBI, yet are not well studied on a population level. This study examined PCS symptoms, including reliable change over time in a population-based sample up to one year post-TBI. Methods: Prospective follow-up of 527 adults (≥16 years) with mild TBI (mTBI) and assessment data (Rivermead Post concussion Questionnaire; RPQ) at baseline, 1, 6, and/or 12-months post-TBI. Change in mean scores and clinically significant change across RPQ items for each person was calculated between assessment time points using a reliable change index (RCI). Results: While prevalence of all symptoms reduced over time, >30% of participants reported fatigue, slowed thinking, and forgetfulness 12-months postinjury. Using the RCI, <12% of individuals improved from baseline to 1-month, 50% from 1 to 6-months, and 4.2% from 6 to 12-months. Conclusions: Improvements in PCS post-mTBI were most obvious between 1 and 6-months, suggesting lengthy recovery trajectory. A third of patients experience residual cognitive problems 12-months following a mTBI, and while many individuals improve post-TBI, a large proportion remain stable or worsen.

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  • Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of available assistive devices and technologies

    Davies, TC; Mudge, S; Stott, NS; Ameratunga, S (2013-05-21)

    Journal article
    Auckland University of Technology

    Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements. Results  Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV. Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance.

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  • A multimedia mobile phone based programme to prevent depression in adolescents.

    Whittaker, Robyn; Merry, S; McDowell, H; Stasiak, K; Shepherd, M; Doherty, I; Dorey, E; Ameratunga, S (2011)

    Conference item
    The University of Auckland Library

    Background: Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations. Objective: To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants’ self-reported satisfaction with the intervention. Methods: The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011. Results: A total of 1348 students (13–17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)—significantly higher than proportions in the control group. Conclusions: Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage.

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  • Noise Induced Hearing Loss: Epidemiology and Noise Exposure

    Thorne, Peter; Welch, D; Grynevych, A; John, G; Ameratunga, S; Stewart, J; Dirks, K; Williams, W; Dodd, G; Purdy, SC; Long, G; Black, D

    Report
    The University of Auckland Library

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  • Risk and Protective Factors for Suicide Attempt Among Indigenous Māori Youth in New Zealand: The Role of Family Connection

    Clark, Terryann; Robinson, E; Crengle, S; Fleming, T; Ameratunga, S; Denny, S; Bearinger, LH; Sieving, R; Saewyc, E (2011)

    Journal article
    The University of Auckland Library

    The purpose of this study was to (1) describe risk and protective factors associated with a suicide attempt for Māori youth and (2) explore whether family connection moderates the relationship between depressive symptoms and suicide attempts for Māori youth. Secondary analysis was conducted with 1702 Māori young people aged 12–18 years from an anonymous representative national school-based survey of New Zealand (NZ) youth in 2001. A logistic regression and a multivariable model were developed to identify risk and protective factors associated with suicide attempt. An interaction term was used to identify whether family connection acts as a moderator between depressive symptoms and a suicide attempt. Risk factors from the logistic regression for a suicide attempt in the past year were depressive symptoms (OR = 4.3, p < 0.0001), having a close friend or family member commit suicide (OR = 4.2, p < 0.0001), being 12–15 years old (reference group: 16–18 years) (OR = 2.7, p < 0.0001), having anxiety symptoms (OR = 2.3, p = 0.0073), witnessing an adult hit another adult or a child in the home (OR = 1.8, p = 0.001), and being uncomfortable in NZ European social surroundings (OR = 1.7, p = 0.0040). Family connection was associated with fewer suicide attempts (OR = 0.9, p = 0.0002), but this factor did not moderate the relationship between depressive symptoms and suicide attempt (χ2 = 2.84, df = 1, p = 0.09). Family connection acts as a compensatory mechanism to reduce the risk of suicide attempts for Māori students with depressive symptoms, not as a moderating variable.

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  • Youth’07: The health and wellbeing of secondary school students in New Zealand: Results for Chinese, Indian and other Asian Students

    Parackal, Sherly; Ameratunga, S; Tin Tin, S; Wong, S (2011)

    Report
    The University of Auckland Library

    This report presents findings from Youth’07, the second national survey of the health and wellbeing of secondary school students in New Zealand, for the 1310 students who identified with an Asian ethnic group. It must be noted that ‘Asian’ is not a single ethnic category but a broad range of ethnic groups encompassing a wide range of cultural, language, and migration experiences. In this report we highlight the term ‘Asian’ to remind readers of the particular meaning placed on it and its shortcomings as a single ethnic category. For the same reason, the results for the two largest Asian ethnic groups in the survey – Chinese and Indian – are presented as two separate, specific reports, comparing the findings for each group with those for New Zealand European students, and with the corresponding findings from the previous survey conducted in 2001. This is followed by an overview report on the ‘Asian’ group as a whole, with the caution that these results, averaged across the combined ‘Asian’ group, may mask different experiences relating to specific ethnic groups. Overall, the majority of ‘Asian’ students reported positive family, home and school environments, and positive relationships with adults at home and school. However, Chinese and Indian students were more likely than NZ European students to experience family adversity or hardships (eg, changing homes more often, overcrowding and unemployment among parents). Compared to NZ European students, Chinese and Indian students were more likely to report positive feelings about school. Several school safety indicators have improved since the previous survey in 2001, but a small proportion of Chinese and Indian students continue to report being bullied weekly or more often, many reporting the bullying to be related to their ethnicity. In the 2007 survey, about three-quarters of ‘Asian’ students did not meet the current national guidelines for daily intake of fruit and vegetables, and 91% did not meet the current national guidelines of one or more hours of physical activity per day. Indian students reported similar levels of physical activity to NZ European students while Chinese students reported lower levels of physical activity. The vast majority of ‘Asian’ students reported good health in 2007. However, when health care was needed, many ‘Asian’ students faced barriers to accessing it, including a lack of knowledge of the healthcare system, cost of care and lack of transport. Mental health problems were of particular concern in this population, especially among female students. Among Chinese and Indian students 18% of females and 7-8% of males showed significant depressive symptoms – proportions unchanged since the 2001 survey. The prevalence of smoking, measured both in terms of ever smoking a cigarette and of smoking weekly or more often, had substantially decreased among Chinese students since the 2001 survey. In contrast, among Indian students these indicators showed little change over the same period. Drinking alcohol was less prevalent among Chinese and Indian students than among NZ European students: 35% of Chinese students and 34% of Indian students were current drinkers compared to 66% of NZ European students. While Indian and Chinese students were less likely than NZ European students to be binge drinkers, about 16% reported binge drinking on at least one occasion in the previous 4 weeks. Compared with the 2001 survey, marijuana use had declined among Chinese students but not among Indian students. Chinese and Indian students were more likely than NZ European students to report not using contraception. While the proportion of Chinese students using contraception has remained unchanged since the 2001 survey, the equivalent proportion among Indian students had declined. The majority of ‘Asian’ students reported positive and rewarding friendships, 41% reported spiritual beliefs as important, and a similar proportion attended a place of worship regularly. These proportions had not changed since 2001.

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  • Unintentional injuries at home: the role of alcohol, recreational drug use, & fatigue in the greater Auckland, Waikato, & Otago regions in people aged 20 to 64 years

    Kool, B; Ameratunga, S; Sharpe, S (2011)

    Report
    The University of Auckland Library

    Unintentional injuries in the home account for a significant burden of injury among all age groups in New Zealand. Falls are the leading cause of injury-related admissions to hospital and one of the three leading causes of injury death in New Zealand. Cutting or piercing injuries are the second leading cause of injury hospitalisation in New Zealand. Home is the most common location for injuries resulting in hospitalisation. The impact of injuries at home among young and middle-age adults may have significant implications for both work productivity and family life. This project was designed to explore modifiable risk factors for unintentional falls and cutting or piecing injuries at home resulting in admission to hospital among young and middle-aged adults (aged 20 to 64 years). The study builds on the Auckland Fall Study previously conducted by the researchers and funded by the Accident Compensation Corporation (ACC). The project involved the following methodologies: a review of the published literature to identify risk factors for unintentional cutting or piercing injury or falls at home among young and middle-aged adults; an analysis of routinely collected national data on hospitalisations and deaths for home injuries; an analysis of trauma registry data for home injuries; and a multi-regional population-based case-control study, with a case-crossover component, to identify modifiable risk factors for unintentional falls and cutting or piercing injures at home among the age group of interest .

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  • Social and Physical Contexts of Schools and Neighborhoods: Associations With Physical Activity Among Young People in New Zealand

    Utter, JA; Denny, S; Robinson, E; Ameratunga, S; Milfont, TL (2011)

    Journal article
    The University of Auckland Library

    Objectives. We sought to determine the association between school- and neighborhood-level characteristics and physical activity among young people. Methods. We collected the data as part of Youth’07, a nationally representative survey of the health and well-being of high school students in New Zealand. In total, 9107 students from 96 schools participated (63% response rate). Students answered questions about their schools (e.g., support for physical activity) and neighborhoods (e.g., community cohesion, disintegration, safety, and recreational facilities). We created school-level measures by aggregating the students’ reports within their schools and we created neighborhood-level measures by aggregating the students’ reports of their neighborhoods to the census area unit of their residential address. We conducted analyses by using cross-classified random-effects models controlling for individual variables, with school and neighborhoods treated as random effects. Results. Schools characterized by high sports team participation and neighborhoods characterized by high social connections were positively associated with student physical activity. We observed few other significant characteristics of school and neighborhood environments. Conclusions. Our findings highlight that opportunity for sports participation and strong social connections in neighborhoods are particularly important for youths’ physical activity.

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  • Kicked out of school and suffering: The health needs of alternative education youth in New Zealand

    Clark, TC; Smith, J; Raphael, D; Jackson, C; Denny, S; Fleming, T; Ameratunga, S; Crengle, S (2010)

    Journal article
    The University of Auckland Library

    Anonymous self-report health and wellbeing surveys were completed by alternative education (AE) students in the Auckland and Northland regions of New Zealand, and 11 semi-structured interviews were conducted with key informants about their perceptions of health issues for AE students. Both groups reported concerning health-risk behaviours among AE students, including drug and alcohol abuse, depressive symptoms and dangerous driving. Health services have consistently failed to engage AE students in effective primary and preventative care that includes their wha"nau/family. Signi!cant changes to the current New Zealand health system are required to provide appropriate and effective health care for students attending AE facilities.

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  • Regional variations in pedal cyclist injuries in New Zealand: safety in numbers or risk in scarcity?

    Tin Tin, Sandar; Woodward, A; Thornley, S; Ameratunga, S (2011-08)

    Journal article
    The University of Auckland Library

    Objective: To assess regional variations in rates of traffic injuries to pedal cyclists resulting in death or hospital inpatient treatment, in relation to time spent cycling and time spent travelling in a car. Methods: Cycling injuries were identified from the Mortality Collection and the National Minimum Dataset. Time spent cycling and time spent travelling as a driver or passenger in a car/van/ute/SUV were computed from National Household Travel Surveys. There are 16 census regions in New Zealand, some of which were combined for this analysis to ensure an adequate sample size, resulting in eight regional groups. Analyses were undertaken for 1996–99 and 2003–07. Results: Injury rates, per million hours spent cycling, varied widely across regions (11 to 33 injuries during 1996–99 and 12 to 78 injuries during 2003–07). The injury rate increased with decreasing per capita time spent cycling. The rate also increased with increasing per capita time spent travelling in a car. There was an inverse association between the injury rate and the ratio of time spent cycling to time spent travelling in a car. The expected number of cycling injuries increased with increasing total time spent cycling but at a decreasing rate particularly after adjusting for total time spent travelling in a car. Conclusions: The findings indicate a ‘risk in scarcity’ effect for New Zealand cyclists such that risk profiles of cyclists are likely to deteriorate if fewer people use a bicycle and more use a car. Implications: Cooperative efforts to promote cycling and its safety and to restrict car use may reverse the risk in scarcity effect.

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