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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  • 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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  • 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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  • 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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  • Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders

    Peiris-John, Roshini; Wong, A; Sobrun-Maharaj, A; Ameratunga, Shanthi (2016-03-31)

    Journal article
    The University of Auckland Library

    In New Zealand, while the term ‘Asians’ in popular discourse means East and South-east Asian peoples, Statistics New Zealand’s definition includes people of many nationalities from East, South and South-east Asia, all with quite different cultural norms, taboos and degrees of conservatism. In a context where ‘Asian’ youth data are typically presented in aggregate form, there are notable gaps in knowledge regarding the contextual determinants of health in this highly heterogeneous group. This qualitative study explored key stakeholder views on issues that would be most useful to explore on the health and wellbeing of Asian youth and processes that would foster engagement of Asian youth in health research. METHODS: Interviews were conducted with six key stakeholders whose professional activities were largely focused on the wellbeing of Asian people. The general inductive approach was used to identify and analyse themes in the qualitative text data. FINDINGS: Six broad themes were identified from the key stakeholder interviews framed as priority areas that need further exploration: cultural identity, integration and acculturation; barriers to help-seeking; aspects to consider when engaging Asian youth in research (youth voice, empowerment and participatory approach to research); parental influence and involvement in health research; confidentiality and anonymity; and capacity building and informing policy. CONCLUSION: With stakeholders strongly advocating the engagement of Asian youth in the health research agenda this study highlights the importance of engaging youth alongside service providers to collaborate on research and co-design responsive primary health care services in a multicultural setting.

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  • Epidemiology of fatal and hospitalised injuries among youth in Fiji (TRIP 15)

    Herman, Josephine; Peiris-John, Roshini; Wainiqolo, I; Kafoa, B; Laginikoro, P; McCaig, E; Ameratunga, Shanthi (2016-11)

    Journal article
    The University of Auckland Library

    Aim: To determine the burden and characteristics of fatal and hospitalised injuries among youth in Fiji. Methods: We conducted a cross-sectional analysis of the Fiji Injury Surveillance in Hospitals database – a prospective population-based trauma registry – to examine the incidence and epidemiological characteristics associated with injury-related deaths and hospital admissions among youth aged 15–24 years. The study base was Viti Levu, Fiji, during the 12-month period concluding on 30 September 2006. Results: One in four injuries in the Fiji Injury Surveillance in Hospitals database occurred among youth (n = 515, incidence rate 400/100 000). Injury rates were higher among men, those aged 20–24 years compared with 15- to 19-year-olds, and indigenous Fijians (iTaukei) compared with Indians. The leading causes among indigenous Fijians were being hit by a person/object (men) and falls (women), whereas for Indians, it was road traffic injuries (men) and intentional poisoning (women). Most injuries occurred at home (39%) or on the road (22%). Of the 63 fatal events, 57% were intentional injuries, and most deaths (73%) occurred prior to hospitalisation. Homicide rates were four times higher among indigenous Fijians than Indians, whereas suicide rates were five times higher among Indians compared with indigenous Fijians. Conclusions: Important ethnic-specific differences in the epidemiology of fatal and serious non-fatal injuries are apparent among youth in Fiji. Efforts to prevent the avoidable burden of injury among Fiji youth thus requires inter-sectoral cooperation that takes account of important sociocultural, environmental and health system factors such as unmet mental healthcare needs and effective pre-hospital trauma services.

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  • Adolescents with disability report higher rates of injury but lower rates of receiving care: findings from a national school-based survey in New Zealand

    Peiris-John, Roshini; Ameratunga, Shanthi; Lee, Arier; Al-Ani, H; Fleming, Theresa; Clark, Terryann (2016-02)

    Journal article
    The University of Auckland Library

    This study investigates the associations between living with a disabling condition and experiencing clinically attended injuries, risk behaviours and difficulties accessing healthcare for injury among adolescents attending secondary (high) schools in New Zealand.A nationally representative cross-sectional self-report survey conducted in 2012 captured health and well-being data from 8500 secondary school students using a multimedia computer-assisted interview. Respondents reporting a disability or a long-term condition with functional limitations were defined as adolescents with a disabling condition (index group of interest). The association between experience of disability (or not) and injuries, related risk factors and access to healthcare was investigated using logistic regression models.One in six students (n=1268, 14.9%) reported a disabling condition. Compared with their peers, these students had significantly increased odds of needing treatment in the previous 12 months for an injury related to an RTC (OR 1.53; 95% CI 1.11 to 2.10), fall (OR 1.30; 95% CI 1.08 to 1.57), near drowning (OR 2.50; 95% CI 1.40 to 4.48), assault (OR 2.13; 95% CI 1.50 to 3.02) and self-harm (OR 4.25; 95% CI 3.03 to 5.96). Students with disabilities were also at increased odds of reporting they had problems accessing healthcare for injury (OR 1.51; 95% CI 1.27 to 1.81). Adolescents with disability were more likely than their peers to have been a passenger in a vehicle where the driver was under the influence of drugs (OR 1.29; 95% CI 1.03 to 1.62) or was driving dangerously (OR 1.40; 95% CI 1.21 to 1.62).Acknowledging the likely underestimation of effects in a mainstream school survey, adolescents with disability face elevated odds of injury and yet have poorer access to healthcare. Environmental and systemic causes of these disparities require greater attention with implementation of effective interventions.

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  • The effect of the Shorter Stays in Emergency Departments health target on the quality of ED discharge summaries

    Harper, A; Jones, P; Wimsett, J; Stewart, Joanna; Le Fevre, James; Wells, Linda; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi (2016-12)

    Journal article
    The University of Auckland Library

    Time targets for ED stays are used as a policy instrument to reduce ED crowding. There is debate whether such policies are helpful or harmful, as focus on a process target may divert attention from clinical care. The objective of this study is to investigate whether the Shorter Stays in Emergency Departments target in New Zealand was associated with a change in the quality of ED discharge information provided to primary care providers.The quality of discharge summaries was assessed retrospectively over time using chart review. Logistic regression was used to account for secular trends with adequate or not as the dependent variable. Explanatory variables were: age, ethnicity, deprivation, triage category, year, the step at target introduction (2009) and the change in slope before and after the target.Of 500 randomly selected discharge summaries, 491 (98.2%) were included in the analysis. There was evidence of a decrease over time in the proportion of adequate discharge summaries before the introduction of the target (slope estimate (SE) -0.43 (0.20), p=0.02). A step at the target introduction could not be shown (p=0.47). There was evidence of an improvement over time from pre-target to post-target: slope afterwards 0.33, estimate of change in slope (SE) 0.76 (0.27), p=0.006.There was no reduction in the quality of discharge summaries following the introduction of the shorter stays in ED target and trends in quality improved. These findings deserve replication in other hospitals which may experience different challenges.

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  • Incidence of traumatic brain injury in New Zealand: A population-based study

    Feigin, Valery L.; Theadom, Alice; Barker-Collo, Suzanne; Starkey, Nicola J.; McPherson, Kathryn; Kahan, Michael; Dowell, Anthony; Brown, Paul; Parag, Varsha; Kydd, Robert; Jones, Kelly; Jones, Amy; Ameratunga, Shanthi (2013)

    Journal article
    University of Waikato

    Background Traumatic brain injury (TBI) is the leading cause of long-term disability in children and young adults worldwide. However, accurate information about its incidence does not exist. We aimed to estimate the burden of TBI in rural and urban populations in New Zealand across all ages and TBI severities. Methods We did a population-based incidence study in an urban (Hamilton) and rural (Waikato District) population in New Zealand. We registered all cases of TB! (admitted to hospital or not, fatal or non-fatal) that occurred in the population between March 1, 2010, and Feb 28, 2011, using multiple overlapping sources of information. We calculated incidence per 100 000 person-years with 95% CIs using a Poisson distribution. We calculated rate ratios [RRs] to compare the age-standardised rates between sex, ethnicity, and residency (urban, rural) groups. We used direct standardisation to age-standardise the rates to the world population. Results The total incidence of TBI per 100 000 person-years was 790 cases (95% CI 749-832); incidence per 100 000 person-years of mild TBI was 749 cases (709-790) and of moderate to severe TBI was 41 cases (31-51). Children (aged 0-14 years) and adolescents and young adults (aged 15-34 years) constituted almost 70% of all TBI cases. TBI affected boys and men more than women and girls (RR 1.77,95% CI 1.58-1.97). Most TBI cases were due to falls (38% [516 of 1369]), mechanical forces (21% [288 of 1369]), transport accidents (20% [277 of 1369]), and assaults (17% [228 of 1369]). Compared with people of European origin, Maori people had a greater risk of mild TBI (RR 1.23, 95% CI 1.08-1.39). Incidence of moderate to severe TBI in the rural population (73 per 100 000 person-years [95% CI 50-107]) was almost 2.5 times greater than in the urban population (31 per 100 000 person-years [23-42]). Interpretation Our findings suggest that the incidence of TBI, especially mild TBI, in New Zealand is far greater than would be estimated from the findings of previous studies done in other high-income countries. Our age-specific and residency-specific data for TBI incidence overall and by mechanism of injury should be considered when planning prevention and TBI care services.

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

    Cunningham, Alice; Barker-Collo, Suzanne; Feigin, V; Starkey, N; Jones, K; Jones, A; Ameratunga, Shanthi; Barber, Peter (2012)

    Journal article
    The University of Auckland Library

    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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  • 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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  • 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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  • 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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  • Hospitalisations and deaths due to unintentional falls at home among working-aged New Zealanders.

    Kool, Bridget; Ameratunga, Shanthi; Jackson, Rodney; Robinson, Elizabeth (2007)

    Journal article
    The University of Auckland Library

    Aims To describe the incidence and characteristics of unintentional fall-related injuries at home resulting in death or hospital inpatient treatment among working-aged New Zealanders. Patients and methods Relevant data on all individuals aged 25–59 years meeting the case definition (using ICD-9-AM E codes E880-886, 888, and ICD-10-AM E codes W00-19) were obtained from the national morbidity (1993–2004) and mortality (1993–2002) databases compiled by the New Zealand Health Information Service. Results Almost one-third of unintentional falls resulting in injury and a subsequent in-patient admission among working-age people were reported to occur at home. This is likely to be an underestimate as the place of occurrence of approximately one-third of falls resulting in a hospital admission was not documented. The average annual mortality rate from unintentional falls at home was 0.41 per 100,000 (95% CI 0.32–0.51) while the primary hospitalisation rate was more than 100-fold greater at 52.0 per 100,000 (95% CI 51.1–53.0). Rates of admission to hospital following a fall at home were three to four-fold greater among people aged 55–59 years compared to those aged 25–29 years. Conclusion A significant proportion of unintentional fall-related injuries among the working-age population occur at home. Until the aetiology of fall-related injury in this age group is better understood, future research should focus on identifying modifiable risk factors that can be targeted to reduce the burden of these injuries and their consequences in a context where the adverse impact on economic productivity is particularly high.

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  • A comparative analysis of cardiovascular disease risk profiles of five Pacific ethnic groups assessed in New Zealand primary care practice: PREDICT CVD-13

    Grey, Corina; Wells, Linda; Riddell, Tania; Pylypchuk, Romana; Marshall, Roger; Drury, P; Elley, Carolyn; Ameratunga, Shanthi; Gentles, Dudley; Erick-Peleti, S; Bell, F; Kerr, A; Jackson, Rodney (2010-11-05)

    Journal article
    The University of Auckland Library

    Background Data on the cardiovascular disease risk profiles of Pacific peoples in New Zealand is usually aggregated and treated as a single entity. Little is known about the comparability or otherwise of cardiovascular disease (CVD) risk between different Pacific groups. Aim To compare CVD risk profiles for the main Pacific ethnic groups assessed in New Zealand primary care practice to determine if it is reasonable to aggregate these data, or if significant differences exist. Methods A web-based clinical decision support system for CVD risk assessment and management (PREDICT) has been implemented in primary care practices in nine PHOs throughout Auckland and Northland since 2002, covering approximately 65% of the population of these regions. Between 2002 and January 2009, baseline CVD risk assessments were carried out on 11,642 patients aged 35–74 years identifying with one or more Pacific ethnic groups (4933 Samoans, 1724 Tongans, 1366 Cook Island Māori, 880 Niueans, 1341 Fijians and 1398 people identified as Other Pacific or Pacific Not Further Defined). Fijians were subsequently excluded from the analyses because of a probable misclassification error that appears to combine Fijian Indians with ethnic Fijians. Prevalences of smoking, diabetes and prior history of CVD, as well as mean total cholesterol/HDL ratio, systolic and diastolic blood pressures, and Framingham 5-year CVD risk were calculated for each Pacific group. Age-adjusted risk ratios and mean differences stratified by gender were calculated using Samoans as the reference group. Results Cook Island women were almost 60% more likely to smoke than Samoan women. While Tongan men had the highest proportion of smoking (29%) among Pacific men, Tongan women had the lowest smoking proportion (10%) among Pacific women. Tongan women and Niuean men and women had a higher burden of diabetes than other Pacific ethnic groups, which were 20–30% higher than their Samoan counterparts. Niuean men and women had lower blood pressure levels than all other Pacific groups while Tongan men and women had the highest total cholesterol to HDL ratios. Tongan men and women had higher absolute 5-year CVD risk scores, as estimated by the Framingham equation, than their Samoan counterparts (Age-adjusted mean differences 0.71% [95% CI 0.36% to 1.06%] for Tongan men and 0.52% [95% CI 0.17% to 0.86%] for Tongan women) although these risk differences were only about 10% higher in relative terms. Conclusion The validity of the analyses depend on the assumption that the selection of participants for CVD risk assessment in primary care is similar between Pacific groups. The ethnic-specific CVD risk profiles presented do not represent estimates of population prevalence. Almost all previous Pacific data has been aggregated with Pacific peoples treated as a single entity because of small sample sizes. We have analysed data from the largest study to date measuring CVD risk factors in Pacific peoples living in New Zealand. Our findings suggest that aggregating Pacific population data appears to be reasonable in terms of assessing absolute CVD risk, however there are differences for specific CVD risk factors between Pacific ethnic groups that may be important for targeting community level interventions.

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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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  • 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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