67 results for Ameratunga, Shanthi

  • The Spectrum Captured: A Methodological Approach to Studying Incidence and Outcomes of Traumatic Brain Injury on a Population Level

    Theadom, Alice; Barker-Collo, Suzanne; Feigin, Valery L.; Starkey, Nicola J.; Jones, Kelly; Jones, Amy; Ameratunga, Shanthi; Barber, P. Alan (2012)

    Journal article
    University of Waikato

    Objective: Drawing on the experience of conducting the Brain Injury Incidence and Outcomes New Zealand in the Community study, this article aims to identify the issues arising from the implementation of proposed guidelines for population-based studies of incidence and outcomes in traumatic brain injury (TBI). Study Design and Setting: All new cases of TBI (all ages and severities) were ascertained over a 1-year period, using overlapping prospective and retrospective sources of case ascertainment in New Zealand. All eligible TBI cases were invited to participate in a comprehensive assessment at baseline and at 1-month follow-up. Results: Our experience to date has revealed the feasibility of case ascertainment methods. Consultation with community health services and professionals resulted in feasible referral pathways to support the identification of TBI cases. ‘Hot pursuit’ methods of recruitment were essential to ensure complete case ascertainment for this population with few additional cases of TBI identified through cross-checks. Conclusion: This review of proposed guidelines in relation to practical study methodology provides a framework for future comparable population-based epidemiological studies of TBI incidence and outcomes in developed countries.

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  • Cycling and walking to work in New Zealand, 1991-2006: regional and individual differences, and pointers to effective interventions.

    Tin Tin, S; Woodward, Alistair; Thornley, Simon; Ameratunga, Shanthi (2009)

    Journal article
    The University of Auckland Library

    BACKGROUND: Active commuting increases levels of physical activity and is more likely to be adopted and sustained than exercise programmes. Despite the potential health, environmental, social and economic benefits, cycling and walking are increasingly marginal modes of transport in many countries. This paper investigated regional and individual differences in cycling and walking to work in New Zealand over the 15-year period (1991-2006). METHODS: New Zealand Census data (collected every five years) were accessed to analyse self-reported information on the "main means of travel to work" from individuals aged 15 years and over who are usually resident and employed in New Zealand. This analysis investigated differences in patterns of active commuting to work stratified by region, age, gender and personal income. RESULTS: In 2006, over four-fifths of New Zealanders used a private vehicle, one in fourteen walked and one in forty cycled to work. Increased car use from 1991 to 2006 occurred at the expense of active means of travel as trends in public transport use remained unchanged during that period. Of the 16 regions defined at meshblock and area unit level, Auckland had the lowest prevalence of cycling and walking. In contrast to other regions, walking to work increased in Wellington and Nelson, two regions which have made substantial investments in local infrastructure to promote active transport. Nationally, cycling prevalence declined with age whereas a U-shaped trend was observed for walking. The numbers of younger people cycling to work and older people walking to work declined substantially from 1991 to 2006. Higher proportions of men compared with women cycled to work. The opposite was true for walking with an increasing trend observed in women aged under 30 years. Walking to work was less prevalent among people with higher income. CONCLUSION: We observed a steady decline in cycling and walking to work from 1991 to 2006, with two regional exceptions. This together with the important differences in travel patterns by age, gender and personal income highlights opportunities to target and modify transport policies in order to promote active commuting.

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  • Acute poisoning fatalities and hospitalisations among children and youth in New Zealand

    Peiris-John, Roshini; Kool, Bridget; Ameratunga, Shanthi (2012)

    Conference item
    The University of Auckland Library

    Background Globally, poisoning accounts for a significant proportion of deaths among children and young people aged 0–24 years. However, few studies have examined changes in the epidemiologic characteristics across this age group and explored the particular features that could inform targeted intervention strategies. Aim To determine demographic patterns and substances related to acute poisoning fatalities and hospital admissions among children (0–14 years) and youth (15–24 years) in New Zealand. Methods Using the national mortality (1999–2008) and morbidity (2000–2009) databases compiled by the New Zealand Ministry of Health, ICD external cause data corresponding to relevant poisoning events were extracted and analysed. Results During the 10-year period, 286 fatalities and 15 626 primary hospital admissions accounted for mean annual rates of 2.0 and 108.6/100 000 young people aged 0–24 years, respectively. Over half of the deaths and hospitalisations were due to intentional poisoning which occurred mainly among youth aged 15–24 years. Most unintentional poisoning hospitalisations were among children aged less than 5 years. In general, young people of European and Maori ethnicities and those residing in socio-economically deprived neighbourhoods were over-represented among poisoning events. While most deaths were due to carbon monoxide toxicity, most hospitalisations for poisonings were due to pharmacological drugs. Significance The burden of poisoning among young people in New Zealand is substantial with important differences in related demographic and injury characteristics. Age-specific prevention strategies targeting exposure to carbon monoxide and pharmacological drugs and suicide prevention strategies more generally require particular attention. The leading cause of infant and under 5-years' child burn mortality was contact with hot drinks and foods (31.6%, 45.6%) in 2009. According to the study report of Mongolia, the median age of child death of burn was 3.0. Therefore child burn is the public health priority issues that need comprehensive policies and measures in order to reduce the incidence of child burn in Mongolia. The aim of the study was to determine the incidence of child burn among Ulaanbaatar. The study involved a total number of 793 children of 711 families from the Ulaanbaatar, randomly. The age range was 0–5, of which 50.7% were boys. A total of 51.3% attend in daycare centres. 17.9% of the total surveyed children were injured within the last year, of which 8.1% were resulted from burns. A total of 83.3% of burned children were at home when accidents happened. Only 41.7% of the surveyed family members stated that the children burned themselves. The family members were asked during the survey: ‘what to do when your child gets burned’. Out of the total, 38.7% indicated that they would treat it by soap, 49.1% by sugar, 39.6% by blood of dogs, and of which 51% would treat by raw meat. This study identified that almost all of these burn incidents occurred in environment among the children under 5 years old. This study concludes that the family members have inadequate knowledge about child accident prevention programme and the first-aid treatment.

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  • Taking a risk perceptions approach to improving beach swimming safety

    McCool, Judith; Moran, Kevin; Ameratunga, Shanthi; Robinson, Elizabeth (2009)

    Conference item
    The University of Auckland Library

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  • Being in Trouble with the Police and Associations with Mental Health Outcomes Amongst Alternative Education Students in New Zealand

    Clark, Terryann; Robinson, Elizabeth; Fleming, Theresa; Smith, J; Denny, S; Jackson, C; Raphael, Deborah; Ameratunga, Shanthi (2011)

    Conference item
    The University of Auckland Library

    Students who are excluded from mainstream education are vulnerable to negative health, social and educational outcomes. The purpose of this analysis to is to explore whether being in trouble with the Police is associated with mental health problems such as depressive symptoms, conduct problems, hyperactivity-inattention symptoms, marijuana use and binge drinking for students attending Alternative Education (AE) in New Zealand.

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  • Hand-held internet tablets for school-based data collection

    Denny, Simon; Milfont, Taciano; Utter, Jennifer; Robinson, Elizabeth; Ameratunga, Shanthi; Merry, Sally; Fleming, Theresa; Watson, Peter (2008)

    Journal article
    The University of Auckland Library

    An open access copy of this article is available and complies with the copyright holder/publisher conditions. BACKGROUND:In the last 20 years, researchers have been using computer self-administered questionnaires to gather data on a wide range of adolescent health related behaviours. More recently, researchers collecting data in schools have started to use smaller hand-held computers for their ease of use and portability. The aim of this study is to describe a new technology with wi-fi enabled hand-held internet tablets and to compare adolescent preferences of laptop computers or hand-held internet tablets in administering a youth health and well-being questionnaire in a school setting.METHODS:A total of 177 students took part in a pilot study of a national youth health and wellbeing survey. Students were randomly assigned to internet tablets or laptops at the start of the survey and were changed to the alternate mode of administration about half-way through the questionnaire. Students at the end of the questionnaire were asked which of the two modes of administration (1) they preferred, (2) was easier to use, (3) was more private and confidential, and (4) was easier to answer truthfully.RESULTS:Many students expressed no preference between laptop computers or internet tablets. However, among the students who expressed a preference between laptop computers or internet tablets, the majority of students found the internet tablets more private and confidential (p < 0.001) and easier to answer questions truthfully (p < 0.001) compared to laptop computers.CONCLUSION:This study demonstrates that using wi-fi enabled hand-held internet tablets is a feasible methodology for school-based surveys especially when asking about sensitive information.

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  • Auckland beachgoer's perception of drowning risk and water safety behaviours

    McCool, Judith; Moran, Kevin; Ameratunga, Shanthi (2006)

    Report
    The University of Auckland Library

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  • The role of conspicuity in bicycle crashes involving a motor vehicle

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2014-10-30)

    Conference poster
    The University of Auckland Library

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  • Self-reported pregnancy and access to primary health care among sexually experienced New Zealand high school students.

    Copland, RJ; Denny, Simon; Robinson, Elizabeth; Crengle, Suzanne; Ameratunga, Shanthi; Dixon, Robyn (2011)

    Journal article
    The University of Auckland Library

    To determine the prevalence of self-reported pregnancy among sexually experienced high school students, and the association between teenage pregnancy and access to primary health care.

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  • Under-utilisation of preventive medication in patients with cardiovascular disease is greatest in younger age groups (PREDICT-CVD 15).

    Mehta, Suneela; Wells, Linda; Riddell, Tania; Kerr, A; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Chan, WC; Thornley, Simon; Crengle, Suzanne; Harrison, Jeffrey; Drury, P; Elley, Carolyn; Bell, F; Jackson, Rodney (2011-06)

    Journal article
    The University of Auckland Library

    Blood pressure-lowering (BPL) and lipid-lowering (LL) medications together reduce estimated absolute five-year cardiovascular disease (CVD) risk by >40%. International studies indicate that the proportion of people with CVD receiving pharmacotherapy increases with advancing age.

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  • Why is the risk of bicycle crash injury higher in the Auckland region?: Findings from the Taupo Bicycle Study.

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2014-10-06)

    Conference item
    The University of Auckland Library

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  • What influences the association between previous and future crashes among cyclists.

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2014-10-09)

    Conference poster
    The University of Auckland Library

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  • Organisational travel plans for improving health (Protocol for Cochrane review)

    Hosking, James; Macmillan, Alexandra; Ameratunga, Shanthi; Bullen, Christopher; Connor, Jennie (2010)

    Journal article
    The University of Auckland Library

    Travel plans are programmes that aim to change travel behaviour. If successful they are likely to change health related outcomes, with the possibility of risks as well as benefits. It is not currently clear how travel plans will affect health, and this systematic review aims to assess the effects of organisational travel plans on a variety of health outcomes.

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  • Cost of traumatic brain injury in New Zealand: Evidence from a population-based study.

    Te Ao, Braden; Brown, Paul; Tobias, Martin; Ameratunga, Shanthi; Barker-Collo, Suzanne; Theadom, Alice; McPherson, Kathryn; Starkey, Nicola J.; Dowell, Anthony; Jones, Kelly; Feigin, Valery L. (2014-09)

    Journal article
    University of Waikato

    OBJECTIVE: We aimed to estimate from a societal perspective the 1-year and lifetime direct and indirect costs of traumatic brain injury (TBI) for New Zealand (NZ) in 2010 projected to 2020. METHODS: An incidence-based cost of illness model was developed using data from the Brain Injury Outcomes New Zealand in the Community Study. Details of TBI-related resource use during the first 12 months after injury were obtained for 725 cases using resource utilization information from participant surveys and medical records. Total costs are presented in US dollars year 2010 value. RESULTS: In 2010, 11,301 first-ever TBI cases were estimated to have occurred in NZ; total first-year cost of all new TBI cases was estimated to be US $47.9 million with total prevalence costs of US $101.4 million. The average cost per new TBI case during the first 12 months and over a lifetime was US $5,922 (95% confidence interval [CI] $4,777-$7,858), varying from US $4,636 (95% CI $3,756-$5,561) for mild cases to US $36,648 (95% CI $16,348-$65,350) for moderate/severe cases. Because of the unexpectedly large number of mild TBI cases (95% of all TBI cases), the total cost of treating these cases is nearly 3 times that of moderate/severe. The total lifetime cost of all TBI survivors in 2010 was US $146.5 million and is expected to increase to US $177.1 million in 2020. CONCLUSION: The results suggest that there is an urgent need to develop effective interventions to prevent both mild and moderate/severe TBI.

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  • Posttraumatic Stress Among Hospitalized and Nonhospitalized Survivors of Serious Car Crashes: A Population-Based Study

    Ameratunga, Shanthi; Tin Tin, S; Coverdale, JH; Connor, JL; Norton, RN (2009)

    Journal article
    The University of Auckland Library

    Objective: This study investigated the prevalence of posttraumatic stress among survivors of serious injury-producing car crashes. Methods: This population-based prospective cohort study, conducted in New Zealand, recruited hospitalized car occupants (passengers and drivers) as well as nonhospitalized drivers after a crash in which at least one occupant was hospitalized. Fifty-nine hospitalized passengers (62%) and 209 drivers (72%) completed five- and 18-month interviews. The Impact of Event Scale assessed symptoms of posttraumatic stress. Results: At five months 28% of hospitalized passengers, 24% of hospitalized drivers, and 24% of nonhospitalized drivers reported symptoms consistent with posttraumatic stress disorder. At 18 months, 23% of hospitalized passengers, 11% of hospitalized drivers, and 7% of nonhospitalized drivers reported significant levels of stress. Conclusions: Strategies to prevent disabling sequelae of crashes must address the needs of hospitalized and nonhospitalized survivors.

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  • A comparative analysis of the cardiovascular disease risk factor profiles of Pacific peoples and Europeans living in New Zealand assessed in routine primary care: PREDICT CVD-11

    Grey, Corina; Wells, Linda; Riddell, Tania; Kerr, A; Gentles, Dudley; Pylypchuk, Romana; Marshall, Roger; Ameratunga, Shanthi; Drury, P; Elley, Carolyn; Kyle, C; Exeter, Daniel; Jackson, Rodney (2010-02-19)

    Journal article
    The University of Auckland Library

    Aim To investigate the differences in the baseline cardiovascular disease (CVD) risk profiles of Pacific peoples and Europeans assessed in routine primary care practice by PREDICT, a web-based clinical decision support programme for assessing and managing CVD risk. Methods PREDICT has been implemented in primary care practices from nine consenting PHOs in Auckland and Northland. Between 2002 and January 2009, over 70,000 CVD risk assessments were conducted. These analyses compare CVD risk factors for Pacific and European patients. Results Baseline risk assessments were completed for 39,835 Europeans and 10,301 Pacific peoples aged 35-74 years. Over 85% of the Pacific cohort was comprised of the four main Pacific ethnic groups in New Zealand (Samoan, Tongan, Cook Island Maori and Niuean). Fijians (n=1341) were excluded from the analyses because of a likely misclassification error with Indian Fijians. On average, Pacific peoples in the PREDICT cohort were 4 years younger at the time of risk assessment than Europeans, and were overrepresented in areas of high socioeconomic deprivation. At risk assessment, Pacific men were 1.5 times as likely to be current smokers as European men, whereas similar or lower proportions of Pacific women smoked compared with European women. Pacific peoples were approximately three times more likely to have diabetes as Europeans. Pacific peoples had higher diastolic blood pressures and Pacific women had higher total cholesterol/HDL ratios. Both Pacific men and women had a significantly higher predicted risk of CVD in the next 5 years than Europeans, based on the Framingham risk score. Conclusions The PREDICT programme has already generated the largest cohort of Pacific peoples ever to be studied in New Zealand. This comparative analysis of patients who have been screened highlights significant disparities in CVD risk factors for Pacific peoples particularly for diabetes in both sexes and for smoking in men. Targeting these modifiable risk factors will be important in addressing the widening inequalities in CVD outcomes between Pacific peoples and Europeans.

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  • Completeness and accuracy of crash outcome data in a cohort of cyclists: a validation study.

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2013)

    Journal article
    The University of Auckland Library

    Bicycling, despite its health and other benefits, raises safety concerns for many people. However, reliable information on bicycle crash injury is scarce as current statistics rely on a single official database of limited quality. This paper evaluated the completeness and accuracy of crash data collected from multiple sources in a prospective cohort study involving cyclists.

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  • Social and physical contexts of schools and neighborhoods: Associations with physical activity among young people in New Zealand

    Utter, J; Denny, Simon; Robinson, E; Ameratunga, Shanthi; Milfont, TL (2011-09)

    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. (Am J Public Health. 2011;101:1690-1695. doi:10.2105/AJPH.2011.300171)

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  • Implementing performance improvement in New Zealand emergency departments: the six hour time target policy national research project protocol.

    Jones, P; Chalmers, L; Wells, Linda; Ameratunga, Shanthi; Carswell, P; Ashton, Toni; Curtis, Elana; Reid, Mary-Jane; Stewart, Joanna; Harper, A; Tenbensel, Timothy (2012)

    Journal article
    The University of Auckland Library

    In May 2009, the New Zealand government announced a new policy aimed at improving the quality of Emergency Department care and whole hospital performance. Governments have increasingly looked to time targets as a mechanism for improving hospital performance and from a whole system perspective, using the Emergency Department waiting time as a performance measure has the potential to see improvements in the wider health system. However, the imposition of targets may have significant adverse consequences. There is little empirical work examining how the performance of the wider hospital system is affected by such a target. This project aims to answer the following questions: How has the introduction of the target affected broader hospital performance over time, and what accounts for these changes? Which initiatives and strategies have been successful in moving hospitals towards the target without compromising the quality of other care processes and patient outcomes? Is there a difference in outcomes between different ethnic and age groups? Which initiatives and strategies have the greatest potential to be transferred across organisational contexts?

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  • Performance of Framingham cardiovascular risk scores by ethnic groups in New Zealand: PREDICT CVD-10

    Riddell, Tania; Wells, Linda; Jackson, Rodney; Lee, A-W; Crengle, Suzanne; Bramley, D; Ameratunga, Shanthi; Pylypchuk, Romana; Broad, Joanna; Marshall, Roger; Kerr, A (2010)

    Journal article
    The University of Auckland Library

    Aim To compare the calibration performance of the original Framingham Heart Study risk prediction score for cardiovascular disease and an adjusted version of the Framingham score used in current New Zealand cardiovascular risk management guidelines for high and low risk ethnic groups. Methods Since 2002 cardiovascular risk assessments have been undertaken as part of routine clinical care in many New Zealand primary care practices using PREDICT, a web-based decision support programme for assessing and managing cardiovascular risk. Individual risk profiles from PREDICT were electronically and anonymously linked to national hospital admissions and death registrations in January 2008. Calibration performance was investigated by comparing the observed 5-year cardiovascular event rates (deaths and hospitalisations) with predicted rates from the Framingham and New Zealand adjusted Framingham scores. Calibration was examined in a combined ‘high risk’ ethnic group (Maori, Pacific and Indian) and a European ‘low risk’ ethnic group. There was insufficient person-time follow-up for separate analyses in each ethnic group. The analyses were restricted to PREDICT participants aged 30–74 years with no history of previous cardiovascular disease. Results Of the 59,344 participants followed for a mean of 2.11 years (125,064 person years of follow-up), 1,374 first cardiovascular events occurred. Among the 35,240 European participants, 759 cardiovascular events occurred during follow-up, giving a mean observed 5-year cumulative incidence of 4.5%. There were 582 events among the 21,026 Maori, Pacific and Indian participants, corresponding to a mean 5-year cumulative incidence rate of 7.4%. For Europeans, the original Framingham score overestimated 5-year risk by 0.7 – 3.2% at risk levels below 15% and by about 5% at higher risk levels. In contrast, for Maori, Pacific, and Indian patients combined, the Framingham score underestimated 5-year cardiovascular risk by 1.1–2.2% in participants who scored below 15% 5-year predicted risk (the recommended threshold for drug treatment in New Zealand), and overestimated by 2.4–4.1% the risk in those who scored above the 15% threshold. For both high risk and low risk ethnic groups, the New Zealand adjusted score systematically overestimated the observed 5-year event rate ranging from 0.6–5.3% at predicted risk levels below 15% to 5.4–9.3% at higher risk levels. Conclusion The original Framingham Heart Study risk prediction score overestimates risk for the New Zealand European population but underestimates risk for the combined high risk ethnic populations. However the adjusted Framingham score used in New Zealand clinical guidelines overcompensates for this underestimate, resulting

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