15 results for Anderson, C

  • 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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  • ASPIRE: Assessment of services promoting independence and recovery in elders

    Parsons, M; Anderson, C; Senior, H; Chen, X; Kerse, N; Jorgensen, D; Brown, P; Jacobs, Stephen; Vanderhoorn, S; Kilpatrick, J (2006)

    Report
    The University of Auckland Library

    The Assessment of Services Promoting Independence and Recovery in Elders (ASPIRE) was a prospective meta-analysis 1 of three initiatives designed to promote independence and continued living in the community for elderly people (ageing-in-place). The three initiatives are: • The Community Flexible Integrated Restorative Support Team (Community FIRST) initiative in Hamilton; a restorative home support model of care; • The Promoting Independence Programme (PIP) in Lower Hutt; a rehabilitation services model of care; and • The Coordinator of Services for Elderly (COSE) initiative in Christchurch; an individual case-management model of care. This report presents the results of a cost effectiveness analysis of each of the three ageing-in-place initiatives to assess their cost effectiveness relative to the elderly receiving conventional health care services (usual care) in each region. The study design was based around 3 randomised controlled trials with a total sample size for analysis of 564 older people assessed as having high or very high needs, across the 3 centres; Christchurch had a much larger sample size with 350 participants compared with 111 in Hamilton and 103 in Lower Hutt.

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  • ASPIRE: Assessment of services promoting independence and recovery in elders

    Parsons, Matthew; Anderson, C; Senior, H; Chen, X; Kerse, N; Jorgensen, D; Brown, P; Jacobs, S; Vanderhoorn, S; Kilpatrick, J (2006)

    Report
    The University of Auckland Library

    The Assessment of Services Promoting Independence and Recovery in Elders (ASPIRE) was a prospective meta-analysis 1 of three initiatives designed to promote independence and continued living in the community for elderly people (ageing-in-place). The three initiatives are: • The Community Flexible Integrated Restorative Support Team (Community FIRST) initiative in Hamilton; a restorative home support model of care; • The Promoting Independence Programme (PIP) in Lower Hutt; a rehabilitation services model of care; and • The Coordinator of Services for Elderly (COSE) initiative in Christchurch; an individual case-management model of care. This report presents the results of a cost effectiveness analysis of each of the three ageing-in-place initiatives to assess their cost effectiveness relative to the elderly receiving conventional health care services (usual care) in each region. The study design was based around 3 randomised controlled trials with a total sample size for analysis of 564 older people assessed as having high or very high needs, across the 3 centres; Christchurch had a much larger sample size with 350 participants compared with 111 in Hamilton and 103 in Lower Hutt.

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  • An investigation into the teaching of extemporaneous compounding skills to pharmacy students in schools of pharmacy in Australia, Canada, New Zealand, South Africa and the United Kingdom

    Aspden, Trudi; Rew, A; Anderson, C; Tan, J; Woodrow, R; Zheng, Y (2011)

    Conference poster
    The University of Auckland Library

    Background: Many countries require that registered pharmacists are competent to extemporaneously compound. In general, however, there is a lack of opportunity for interns and new pharmacists to practice extemporaneous compounding due to the reduction in demand for extemporaneously compounded products in community pharmacy. Thus it falls to schools of pharmacy to prepare future pharmacist for this role. Objectives: With respect to extemporaneous compounding to pharmacy undergraduates- to determine what is taught, how it is taught, how it is assessed and the time allocated to teaching in the different schools of pharmacy in the five countries. Methodology: Thirty eight course coordinators involved in the teaching of extemporaneous compounding from 32 schools of pharmacy in Australia, Canada, New Zealand, South Africa and the United Kingdom were invited to complete an online survey using Survey MonkeyTM. Results: Twenty four responses were obtained from participants in all five countries (response rate 63.2%). Extemporaneous compounding was a compulsory component of all the BPharm programmes. However, there was a wide inter and intra-country variation in the teaching of the subject including the number of hours dedicated to its teaching, the dosage forms included and the teaching methods used. Many schools used extemporaneous compounding teaching to introduce transferrable skills, such as the ability to accurately calculate. A strong desire to retain the teaching of extemporaneous compounding was expressed by the course coordinators. Discussion: Our results highlight differences in the extemporaneous compounding teaching of the BPharm programmes in the five countries surveyed, but also uncover its use in developing related skills.

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  • Ethnicity and functional outcome after stroke.

    McNaughton, H; Feigin, V; Kerse, Ngaire; Barber, Peter; Weatherall, M; Bennett, D; Carter, K; Hackett, M; Anderson, C; Auckland Regional Community Stroke Study Group (2011-04)

    Journal article
    The University of Auckland Library

    There is limited information on the influence of ethnicity on functional outcome after stroke. We examined functional outcomes among European New Zealanders, Māori, Pacific, and Asian people 6 months after stroke in a population-based context.

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  • Relationship between QRS duration and left ventricular mass and volume in patients at high cardiovascular risk

    Stewart, RA; Young, AA; Anderson, C; Teo, KK; Jennings, G; Cowan, Brett (2011)

    Journal article
    The University of Auckland Library

    Objective Longer QRS duration on the ECG is associated with increased cardiovascular (CV) mortality. To evaluate potential mechanisms, we examined in this study the relationship between QRS duration and left ventricular (LV) mass and LV end systolic and end diastolic volume in patients with known CV disease or high-risk diabetes. Methods In a substudy of the ONTARGET/TRANSCEND (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) clinical trials, 368 patients had a cardiac magnetic resonance scan to measure LV mass, LV end systolic volume, LV end diastolic volume and LV ejection fraction at baseline and after 2 years of follow-up. Relationships between QRS duration on the 12-lead ECG and LV mass and volumes were evaluated at both assessments. Results Each 10-ms increase in QRS duration both within and above the normal reference range was associated with an 8.3% (95% CI 6.7% to 9.9%) increase in LV mass, a 9.2% (95% CI 7.4% to 10%) increase in LV end diastolic volume and a 7.8% (95% CI 6.4% to 9.3%) increase in LV end systolic volume. QRS duration increased with body size, but associations with LV mass and volumes remained strong after indexing measurements to height2.7 (p<0.001 for all) and were similar for subjects with an otherwise normal and abnormal ECG. Conclusion A longer QRS duration both within and above the normal reference range is associated with a greater LV mass and larger LV end systolic and end diastolic volumes. This may explain the known association of longer QRS duration with increased CV mortality.

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  • Relationship between QRS duration and left ventricular mass and volume in patients at high cardiovascular risk

    Stewart, RA; Young, Alistair; Anderson, C; Teo, KK; Jennings, G; Cowan, Brett (2011-08-11)

    Journal article
    The University of Auckland Library

    Objective Longer QRS duration on the ECG is associated with increased cardiovascular (CV) mortality. To evaluate potential mechanisms, we examined in this study the relationship between QRS duration and left ventricular (LV) mass and LV end systolic and end diastolic volume in patients with known CV disease or high-risk diabetes. Methods In a substudy of the ONTARGET/TRANSCEND (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) clinical trials, 368 patients had a cardiac magnetic resonance scan to measure LV mass, LV end systolic volume, LV end diastolic volume and LV ejection fraction at baseline and after 2 years of follow-up. Relationships between QRS duration on the 12-lead ECG and LV mass and volumes were evaluated at both assessments. Results Each 10-ms increase in QRS duration both within and above the normal reference range was associated with an 8.3% (95% CI 6.7% to 9.9%) increase in LV mass, a 9.2% (95% CI 7.4% to 10%) increase in LV end diastolic volume and a 7.8% (95% CI 6.4% to 9.3%) increase in LV end systolic volume. QRS duration increased with body size, but associations with LV mass and volumes remained strong after indexing measurements to height(2.7) (p<0.001 for all) and were similar for subjects with an otherwise normal and abnormal ECG. Conclusion A longer QRS duration both within and above the normal reference range is associated with a greater LV mass and larger LV end systolic and end diastolic volumes. This may explain the known association of longer QRS duration with increased CV mortality.

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  • Trends in stroke incidence in Auckland, New Zealand, during 1981 to 2003.

    Anderson, C; Carter, KN; Hackett, ML; Feigin, V; Barber, Peter; Broad, Joanna; Bonita, R (2005)

    Journal article
    The University of Auckland Library

    Background and Purpose—Long-term trends in stroke incidence in different populations have not been well characterized, largely as a result of the complexities associated with population-based stroke surveillance. Methods—We assessed temporal trends in stroke incidence using standard diagnostic criteria and community-wide surveillance procedures in the population ( 1 million) of Auckland, New Zealand, over 12-month calendar periods in 1981–1982, 1991–1992, and 2002–2003. Age-adjusted first-ever (incident) and total (attack) rates, and temporal trends, were reported with 95% confidence intervals (CIs). Rates were analyzed by sex and major age groups. Results—From 1981 to 1982, stroke rates were stable in 1991–1992 and then declined in 2002–2003, to produce overall modest declines in standardized incidence (11%; 95% CI, 1 to 19%) and attack rates (9%; 95% CI, 0 to 16%) between the first and last study periods. Some favorable downward trends in vascular risk factors such as cigarette smoking were counterbalanced by increasing age and body mass index, and frequency of diabetes, in patients with stroke. Conclusions—There has been a modest decline in stroke incidence in Auckland over the last 2 decades, mainly during 1991 to 2003, in association with divergent trends in major risk factors

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  • Left Ventricular Mass and Volume with Telmisartan, Ramipril, or Combination in Patients with Previous Atherosclerotic Events or with Diabetes Mellitus (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial [ONTARGET])

    Cowan, Brett; Young, Alistair; Anderson, C; Doughty, Robert; Krittayaphong, R; Lonn, E; Marwick, Thomas; Reid, CM; Sanderson, JE; Schmieder, RE; Teo, K; Wadham, Angela; Worthley, SG; Yu, CM; Yusuf, S; Jennings, GL (2009)

    Journal article
    The University of Auckland Library

    The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) showed that the angiotensin receptor blocker telmisartan 80 mg was not inferior to the angiotensin-converting enzyme inhibitor ramipril 10 mg, and the combination no more effective than ramipril alone, in decreasing morbidity and mortality in patients with cardiovascular disease or high-risk diabetes. Although therapy targeting angiotensin II is known to decrease left ventricular (LV) mass and volume, the relative influence of angiotensin-converting enzyme inhibitor inhibitors and angiotensin receptor blocker, and their combination, on the heart remains unclear in this population. Magnetic resonance imaging was performed in 287 patients enrolled in ONTARGET, across 8 centers in 6 countries, at randomization and after 2-year treatment (90, 100, and 97 patients in the ramipril, telmisartan, and combination therapy groups, respectively). Baseline patient characteristics showed higher frequencies of coronary artery disease, Asian ethnicity, and use of statins and β blockers than the main ONTARGET trial. LV mass decreased in all groups (p <0.0001). In conclusion, telmisartan and ramipril had similar effects on LV mass and volume, and combination therapy was not more effective, in high-risk patients with cardiovascular disease. These results are consistent with the major outcome findings of the main ONTARGET study.

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  • Ethnic disparities in incidence of stroke subtypes: Auckland Regional Community Stroke Study, 2002–2003

    Feigin, V; Carter, K; Hackett, M; Barber, Peter; McNaughton, H; Dyall, Lorna; Chen, M; Anderson, C (2006)

    Journal article
    The University of Auckland Library

    Limited population-based data exist on differences in the incidence of major pathological stroke types and ischaemic stroke subtypes across ethnic groups. We aimed to provide such data within the large multi-ethnic population of Auckland, New Zealand.

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  • Should care managers for older adults be located in primary care? A randomized controlled trial.

    Parsons, Matthew; Senior, H; Kerse, Ngaire; Chen, MH; Jacobs, Stephen; Vanderhoorn, S; Anderson, C (2012)

    Journal article
    The University of Auckland Library

    To determine the effect of a primary care-based care management initiative on residential care placement and death in a population of frail older adults referred for needs assessment in New Zealand.

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  • The cardiac MRI substudy to ongoing telmisartan alone and in combination with ramipril global endpoint trial/ telmisartan randomized assessment study in ACE-intolerant subjects with cardiovascular disease: analysis protocol

    Cowan, Brett; Young, Alistair; Anderson, C; Doughty, Robert; Krittayaphong, R; Lonn, E; Marwick, Thomas; Reid, CM; Sanderson, JE; Schmieder, RE; Teo, K; Wadham, Angela; Worthley, SG; Yu, CM; Yusuf, S; Jennings, GL (2009)

    Journal article
    The University of Auckland Library

    BACKGROUND: The ONTARGET and TRANSCEND clinical trials were designed to investigate the cardioprotective effects of telmisartan 80 mg and ramipril 10 mg, alone and in combination, in patients at high risk of cardiovascular disease. Cardiac MRI enables investigation of mechanistic effects of these agents on cardiac structural and functional variables. Here, we report the design, analysis protocol, reproducibility and relevant quality control procedures, and baseline patient characteristics of the ONTARGET/TRANSCEND cardiac MRI substudy. MRI was undertaken in 330 subjects enrolled in ONTARGET, and 38 subjects in TRANSCEND, across eight centers in six countries. Analyses were performed by two independent analysts using guide-point modeling. Cases with discrepancies in LV mass (LVM) of >5% were independently reanalyzed. Cases with discrepancies in end-diastolic volume (EDV) of >5%, or end-systolic volume (ESV) of >12%, were then reconciled by consensus. RESULTS: Baseline characteristics were broadly similar to the main ONTARGET/TRANSCEND trials, except for a higher frequency of coronary artery disease and Asian ethnicity in the substudy. Reproducibility of MRI analyses (mean +/- SD) were 2.8 +/- 3.7 ml in EDV, -0.3 +/- 3.6 ml in ESV, 3.1 +/- 3.3 ml in SV, 1.1 +/- 1.8% in EF, and 0.4 +/- 4.5 g in LVM. Subgroup analyses revealed increased ESV and LVM, and reduced EF, in subjects with a history of either coronary artery disease or myocardial infarction. CONCLUSIONS: The ONTARGET/TRANSCEND cardiac MRI substudy protocol provides for a reliable assessment of the effects of telmisartan and ramipril, alone and in combination, on cardiac structural and functional parameters over a 2-year follow-up period.

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  • Effects of omega-3 fish oil on cardiovascular risk factors and mood after ischemic stroke: a randomized controlled trial

    Poppitt, Sally; Howe, Colin; Lithander, FE; Silvers, KM; Lin, RB; Croft, J; Ratnasabapathy, Y; Gibson, RA; Anderson, C (2009)

    Journal article
    The University of Auckland Library

    Background and Purpose— Fish-derived omega-3 fatty acids have long been associated with cardiovascular protection. In this trial, we assessed whether treatment with a guideline-recommended moderate-dose fish oil supplement could improve cardiovascular biomarkers, mood- and health-related quality of life in patients with ischemic stroke. Methods— Patients with CT-confirmed stroke were randomized to 3 g/day encapsulated fish oil containing approximately 1.2 g total omega-3 (0.7 g docosahexaenoic acid; 0.3 g eicosapentaenoic acid) or placebo oil (combination palm and soy) taken daily over 12 weeks. Serum triglycerides, total cholesterol and associated lipoproteins, selected inflammatory and hemostatic markers, mood, and health-related quality of life were assessed at baseline and follow-up. The primary outcome was change in triglycerides. Compliance was assessed by capsule count and serum phospholipid omega-3 levels (Australian Clinical Trials Registration: ACTRN12605000207617). Results— One hundred two patients were randomized to fish oil or placebo. Intention-to-treat and per-protocol (>85% compliance) analyses showed no significant effect of fish oil treatment on any lipid, inflammatory, hemostatic, or composite mood parameters measured. Adherence to treatment based on pill count was good (89%) reflected by increased serum docosahexanoic acid (P<0.001) and eicosapentaenoic acid (P=0.0006) in the fish oil group. Analysis of oil composition, however, showed some degradation and potentially adverse oxidation products at the end of the study. Conclusions— There was no effect of 12 weeks of treatment with moderate-dose fish oil supplements on cardiovascular biomarkers or mood in patients with ischemic stroke. It is possible that insufficient dose, short duration of treatment, and/or oxidation of the fish oils may have influenced these outcomes.

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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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  • Diurnal, weekly, and seasonal variations in stroke occurrence in a population-based study in Auckland, New Zealand

    Anderson, Neil; Feigin, Valery; Bennett, D; Broad, Joanna; Pledger, M; Anderson, C; Bonita, R (2004-09-24)

    Journal article
    The University of Auckland Library

    Aims: To determine (via a population-based study in Auckland, New Zealand) if there are diurnal, weekly, or seasonal variations in the occurrence of stroke. Methods: All new stroke events in Auckland residents were traced. Time of onset of the stroke was defined as the time when neurological symptoms were first noticed. The day of the week and month of onset were analysed for all strokes. Results: 1711 patients were registered over 1 year. The rate ratios for the onset of stroke in each 6-hourly interval compared with reference interval (1800-2359 hours) were 0.74 (95% CI: 0.61-1.10) for 0000-0559 hours, 2.88 (95% CI: 2.48-3.34) for 0600-1159 hours and 1.74 (95% CI: 1.49-2.05) for 1200-1759 hours. Rate ratios of the seasonal occurrence of stroke compared with spring were 0.75 (95% CI: 0.65-0.86) for summer, 0.83 (95% CI: 0.73-0.95) for autumn and 1.08 (95% CI: 0.96-1.23) for winter. No weekly pattern of stroke occurrence was observed. Conclusions: Strokes were less likely to occur during the summer and autumn than in the winter or spring. There was an increase in the occurrence of stroke in the late morning. The results have implications for the provision of acute stroke services in the community and in hospital.

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