87 results for Ameratunga, Shanthi

  • 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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  • 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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  • 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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  • Initiation and maintenance of cardiovascular medications following cardiovascular risk assessment in a large primary care cohort: PREDICT CVD-16.

    Mehta, Suneela; Wells, Linda; Grey, Corina; Riddell, Tania; Kerr, Andrew; Marshall, Roger; Ameratunga, Shanthi; Harrison, Jeffrey; Kenealy, Timothy; Bramley, D; Chan, WC; Thornley, Simon; McDonald-Sundborn, Gerhard; Jackson, Rodney (2014-02)

    Journal article
    The University of Auckland Library

    AIM: To examine whether use of a standardized cardiovascular disease (CVD) risk assessment recommended by national guidelines is associated with appropriate initiation and maintenance of medication in a large primary care cohort. METHODS AND DESIGN: A total of 90,631 people aged 30-80 years were followed for up to 3 years after a formal CVD risk assessment was undertaken between January 2006 and October 2009, during routine primary care visits in New Zealand. Patients either had prior CVD or had their CVD risk estimated using a modified Framingham prediction equation for fatal or non-fatal CVD events. The individual risk profiles were anonymously linked to national dispensing data for blood-pressure-lowering and lipid-lowering medications in the 6-month period before and in consecutive 6-month blocks after the baseline CVD risk assessment. RESULTS: At baseline, a combination of blood-pressure-lowering and lipid-lowering therapy was already being used by about two-thirds of patients with prior CVD, one-quarter with a 5-year CVD risk greater than 10% (approximately 20% 10-year risk), and one-tenth with CVD risk below this level. Among these previously treated patients, dispensing rates for blood-pressure-lowering, lipid-lowering, or both medications together declined by only 4???16% up to 3 years after baseline assessment, irrespective of risk category. Among patients untreated at baseline, combination therapy was initiated within 6 months for 21% with prior CVD, 16% with 5-year CVD risk greater than 15% (approximately 30% 10-year risk and the national drug-treatment threshold), 10% with 5-year CVD risk between 10 and 14% (approximately 20???29% 10-year risk), and 3% in the lowest risk category. Across the study population, patients with prior CVD had the highest dispensing rates for each category of medication, and incrementally higher dispensing rates were noted as CVD risk group increased. CONCLUSIONS: In this primary care cohort, most patients already using CVD medications at the time of the baseline CVD risk assessment maintained treatment over a maximum of 3 years follow up, irrespective of their estimated baseline risk. Among patients untreated at baseline, subsequent dispensing rates were strongly related to estimated CVD risk group. Around 15???20% of untreated patients meeting national drug-treatment criteria commenced combination pharmacotherapy within 6 months of CVD risk assessment.

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  • Bicycle travel, injury risk and conspicuity: Findings from a PhD project in New Zealand

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2015-08)

    Journal article
    The University of Auckland Library

    Regular cycling provides health, environmental and economic benefits but is rarely part of everyday travel for many people. The real and perceived risk of injury is commonly cited as a significant deterrent to engaging in such activity and motor vehicles are regarded as a particular threat. Bicycle-motor vehicle collisions often result from the driver's failure to detect the cyclist in time, suggesting that conspicuity may be a contributing factor. This paper provides an overview of bicycle travel, injury risk and conspicuity in New Zealand, based on the findings of a PhD research project conducted in 2008-14. The findings of the Taupo Bicycle Study, a prospective cohort study involving 2,590 adult cyclists, were used in conjunction with aggregate or de-identified data from routinely collected national databases.

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  • Effect of the Shorter Stays in Emergency Departments time target policy on key indicators of quality of care

    Jones, Peter; Le Fevre, J; Harper, A; Wells, Linda; Stewart, Joanna; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi (2017-05-12)

    Journal article
    The University of Auckland Library

    To determine whether implementation of a national health target called Shorter Stays in Emergency Departments impacted on clinical markers of quality of care.A retrospective pre- and post-intervention study from 2006 to 2012 examined quality of care metrics for five different indicators at different sites in relation to the implementation of the target using a general linear model for times to treatment. Explanatory variables included period (pre- or post-target), ethnicity, age, deprivation and severity of condition. Back transformed least square means were used to describe the outcomes.The times to treatment for ST elevation myocardial infarction; 36.9 (28-49) vs 47.6 (36-63) minutes p=0.14, antibiotics for severe sepsis; 105.9 (73-153) vs 104.3 (70-155) minutes p=0.93, analgesia for moderate or severe pain; 48 (31-75) vs 46 (32-66) minutes p =0.77, theatre for fractured neck of femur; 35.4 (32.1-39.1) vs 32.4 (29.2-36.1) hours, and to theatre for appendicitis; 14.1 (12-17) vs 16.4 (14-20) hours were unchanged after implementation of the target. Treatment adequacy was also unchanged for these indicators.Introduction of the Shorter Stays in Emergency Departments target was not associated with any clinically important or statistically significant changes in the time to treatment and adequacy of care for five different clinical indicators of quality of care in Aotearoa New Zealand. For those indicators measured at one site only, it is unknown whether these results can be generalised to other sites.

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  • National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study

    Jones, P; Than, M; Dalziel, S; Larkin, GL; Yates, K; MacLean, A; Cheri, T; Munro, A; Brainard, Andrew; Joseph, TR; Tauranga, M; Quigley, P; Peckler, B; Makower, R; Harvey, M; Watts, M; Fleischer, D; Ellis, C; Macgregor, C; Henry, J; Schimanski, K; Gutenstein, M; Colligan, M; Sawtell, F; Mitchell, N; Wailing, J; Hussey, M; Mcleay, A; Cresswell, C; Moore, D; Sage, D; Ardagh, M; Fevre, JL; McKee, D; Harper, A; Wells, Linda; Stewart, Joanna; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi; Lagas, A; Nienaber, A; Shahpuri, B; Lambie, B; McCaffrey, C; Fish, D; Ragaban, F; Martin, I; Taplin, K; Pickering, J; Lucas, J; Pass, K; Reid, R; Austin, K; Hattaway, M; Shasha, M; Welfare, O; Mills, R; Shasha, R; Subritzky, R; Farrar, R; Tan, W; Jairam, S; Davies, T (2017-04)

    Journal article
    The University of Auckland Library

    Objective: Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. Methods: The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006???2012) from 26 New Zealand public hospital EDs. Results: Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30???134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45???57%); however, there was some variation between hospitals for both outcomes. Conclusion: Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator.

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  • Time to cranial computerised tomography for acute traumatic brain injury in paediatric patients: Effect of the shorter stays in emergency departments target in New Zealand

    Jones, Peter; Kool, Bridget; Dalziel, S; Shepherd, M; Le Fevre, J; Harper, A; Wells, Linda; Stewart, Joanna; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi (2017-07)

    Journal article
    The University of Auckland Library

    Aim Timely access to computerised tomography (CT) for acute traumatic brain injuries (TBIs) facilitates rapid diagnosis and surgical intervention. In 2009, New Zealand introduced a mandatory target for emergency department (ED) stay such that 95% of patients should leave ED within 6???h of arrival. This study investigated whether this target influenced the timeliness of cranial CT scanning in children who presented to ED with acute TBI. Methods We retrospectively reviewed a random sample of charts of children <15???years with acute TBI from 2006 to 2012. Cases were identified using International Classification of Disease 10 codes consistent with TBI. General linear models investigated changes in time to CT and other indicators before and after the shorter stays in???ED target was introduced in 2009. Results Among the 190 cases eligible for study (n???=???91 pre-target and n???=???99 post-target), no significant difference was found in time to CT scan pre- and post-target: least squares mean (LSM) with 95% confidence interval???=???68 (56???81) versus 65 (53???78) min, respectively, P???=???0.66. Time to neurosurgery (LSM 8.7 (5???15) vs. 5.1 (2.6???9.9) h, P???=???0.19, or hospital length of stay (LSM: 4.9 (3.9???6.3) vs. 5.2 (4.1???6.7) days, P???=???0.69) did not change significantly. However, ED length of stay decreased by 45 min in the post-target period (LSM???=???211 (187???238) vs. 166 (98???160) min, P???=???0.006). Conclusion Implementation of the shorter stays in???ED target was not associated with a change in the time to CT for children presenting with acute TBI, but an overall reduction in the time spent in ED was apparent.

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  • Impact of a national time target for ED length of stay on patient outcomes

    Jones, Peter; Wells, Linda; Harper, A; Le Fevre, J; Stewart, Joanna; Curtis, Elana; Reid, Mary-Jane; Ameratunga, Shanthi (2017-05-12)

    Journal article
    The University of Auckland Library

    The impact of national targets for emergency department (ED) length of stay (LOS) on patient care is unclear. This study aimed to determine the effect of New Zealand's six-hour time target (95% of ED patients discharged or admitted to hospital within six hours) on a range of quality indicators.A nationwide observational study from 2006 to 2012 modelled differences in changes over time before and after target introduction in 2009. The observed model estimates in 2012 were compared to those predicted if pre-target trends had continued. Differences are absolute values except for morality, which is presented as a relative change.There were 5,793,767 ED presentations and 2,082,374 elective admissions from 18 out of a possible 20 district health boards included in the study. There were clinically important reductions in hospital LOS (-0.29 days), EDLOS (-1.1 hours), admitted patients EDLOS (-2.9 hours), ED crowding (-26.8%), ED mortality (-57.8%), elective inpatient mortality (-42.2%) and the proportion not waiting for assessment (-2.8%). Small changes were seen in time to assessment in the ED (-3.4 minutes), re-presentation to ED within 48 hours of the index ED discharge (-0.7%), re-presentation to ED within 48 hours from ward discharge (+0.4%) and acute admissions (+3.9%). An increase was observed in re-admission to a ward within 30 days of discharge (1.0%). These changes were all statistically significant (p<0.001).Most outcomes we investigated either improved or were unchanged after the introduction of the time target policy in New Zealand. However, attention is required to ensure that reductions in hospital length of stay are not at the expense of subsequent re-admissions.

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  • 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, 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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  • Use of health care by young Asian New Zealanders: findings from a national youth health survey

    Ameratunga, Shanthi; Tin Tin, S; Rasanathan, Kumanan; Robinson, Elizabeth; Watson, Peter (2008)

    Journal article
    The University of Auckland Library

    Aim: To examine the use of health services and perceived barriers to accessing health care among young Asian New Zealanders. Methods: Secondary analysis of data from Youth2000, a cross-sectional survey of secondary school students in New Zealand (NZ) conducted in 2001. Of the 9567 survey participants (aged 12???18 years), this study was restricted to students who identified with an ???Asian??? ethnic category (n = 922). Results: Chinese and Indian students (the largest Asian ethnic groups in NZ) reported levels of overall health comparable to NZ European (NZE) students. However, relative to NZE students, Chinese students were more likely to report (i) not having a usual location for health care (adjusted OR 3.28; 95% CI: 2.51???4.43); and (ii) having problems getting health care when they needed it (adjusted OR 1.61; 95% CI: 1.32???1.96). Asian students who had been in NZ for 5 years or less (compared with NZ-born students), as well as those who did not speak English at home (compared with those who did) were less likely to report having a usual source of health care, even after adjusting for their overall health (adjusted OR 2.13, 95% CI: 1.27???3.56; and adjusted OR 1.69, 95% CI: 1.11???2.56, respectively). Conclusion: Young Asian New Zealanders are less likely to access health care than their NZE counterparts. The perceived barriers require explicit attention within the broader platforms of health-care quality, and professional and cultural competence of health-care services.

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  • Injury risk behaviours among young Asian New Zealanders: a national survey of secondary school students

    Rasanathan, Kumanan; Ameratunga, Shanthi; Tin Tin, Sandar; Robinson, Elizabeth; Chen, J; Young, W; Watson, Peter (2008)

    Journal article
    The University of Auckland Library

    Objective: To investigate injury risk behaviours among young Asian New Zealanders. Method: Secondary analysis of data from Youth2000, a nationwide cross-sectional youth health survey conducted in 2001 in a random sample of New Zealand (NZ) secondary schools using a multimedia, computer-assisted, self-administered interview. Of the 9,567 survey participants (aged 12 to 18 years), this study was restricted to students who identified with an ???Asian??? ethnic category (n=922). Results: Many young Asian New Zealanders report engaging in injury risk behaviours, including: not using helmets when cycling; dangerous drink and drug driving; and being intentionally physically harmed by others. NZ-born Asian students are more likely than overseas-born Asian students to report most of these risky behaviours. Chinese and Indian students are less likely to engage in most of these behaviours than their NZ European peers. Conclusion: While young Asian New Zealanders are a relatively healthy population, many engage in well-recognised injury risk behaviours. The lower levels of these risky behaviours in Indian and Chinese students compared with NZ European students, and the positive dose-response effect seen in relation to duration of residence in NZ, are likely to be due to the effect of acculturation. Implications: Injury prevention strategies for young people in NZ need to specifically consider the diversity, context and specific risk profiles of young Asian New Zealanders. Health promotion efforts for this group should target the use of safety equipment and risky driving behaviours and consider traditional cultural practices that may be protective.

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  • Riding in a motor vehicle with a driver under the influence of alcohol and drinking patterns: findings from a national survey of New Zealand youth

    Tin Tin, Sandar; Ameratunga, Shanthi; Watson, Peter (2008)

    Journal article
    The University of Auckland Library

    Objective. To investigate the relationships between the risks of riding in a motor vehicle with a driver under the influence of alcohol and young people's drinking patterns and usual drinking locations. Methods. A secondary analysis was undertaken of Youth2000 data - the first nationally representative youth health survey conducted in 2001. The study base comprised all secondary schools with more than 50 students enrolled in years 9 to 13 (ages 12 to 18 years). An anonymous multi-media computer-assisted interview survey collected information on drinking patterns, locations, and if the respondent had ridden in a motor vehicle with a driver who was under the influence of alcohol during the previous 30 days. Results. Of the 9,567 respondents, 27.8% reported riding with a driver who had been drinking alcohol and 27.4% reported riding with a driver who had consumed more than two glasses of alcohol in the two hours before travel (36.4% responded 'yes' to one or other item). After adjusting for age and gender, binge drinking, drinking in cars, at parties and outdoors, and drinking in the company of friends were associated with a significantly increased risk of riding in a motor vehicle driven by a driver under the influence of alcohol. This risk was not apparent among adolescents who usually consumed alcohol at home and those who usually drank with family. Conclusions. The findings indicate the need to consider how and where adolescents drink to inform effective public policies that can reduce alcohol-related harm and road traffic injury.

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  • Incidence, risk, and protective factors of bicycle crashes: findings from a prospective cohort study in New Zealand

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2013-09)

    Journal article
    The University of Auckland Library

    OBJECTIVE: To estimate the incidence and risk of medically or police attended bicycle crashes in a prospective cohort study in New Zealand. METHOD: The Taupo Bicycle Study involved 2590 adult cyclists recruited from the country's largest cycling event in 2006 and followed over a median period of 4.6 years through linkage to four administrative databases. Incidence rates with Poisson distribution confidence intervals were computed and Cox regression modelling for repeated events was performed. RESULTS: The 66 on-road crashes and 10 collisions per 1000 person-years corresponded to 240 crashes and 38 collisions per million hours spent road cycling. The risk increased by 6% and 8% respectively for an extra cycling hour each week. There were 50 off-road crashes per 1000 person-years. Residing in urban areas and in Auckland (region with the lowest level of cycling), riding in a bunch, using a road bike and experiencing a previous crash predicted a higher risk. Habitual use of conspicuity aids appeared to lower the risk. CONCLUSION: The risk is higher in urban areas and where cycling is less common, and increased by bunch riding and previous crashes. These findings alongside the possible protective effect of conspicuity aids suggest promising approaches to improving cycle safety.

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  • The role of multilevel factors in geographic differences in bicycle crash risk: a prospective cohort study

    Tin Tin, Sandar; Woodward, Alistair; Ameratunga, Shanthi (2013-12)

    Journal article
    The University of Auckland Library

    BACKGROUND: Regular cycling plays an important role in increasing physical activity levels but raises safety concerns for many people. While cyclists bear a higher risk of injury than most other types of road users, the risk differs geographically. Auckland, New Zealand's largest urban region, has a higher injury risk than the rest of the country. This paper identified underlying factors at individual, neighbourhood and environmental levels and assessed their relative contribution to this risk differential. METHODS: The Taupo Bicycle Study involved 2590 adult cyclists recruited in 2006 and followed over a median period of 4.6 years through linkage to four national databases. The Auckland participants were compared with others in terms of baseline characteristics, crash outcomes and perceptions about environmental determinants of cycling. Cox regression modelling for repeated events was performed with multivariate adjustments. RESULTS: Of the 2554 participants whose addresses could be mapped, 919 (36%) resided in Auckland. The Auckland participants were less likely to be M??ori but more likely to be socioeconomically advantaged and reside in an urban area. They were less likely to cycle for commuting and off-road but more likely to cycle in the dark and in a bunch, use a road bike and use lights in the dark. They had a higher risk of on-road crashes (hazard ratio: 1.47; 95% CI: 1.22, 1.76), of which 53% (95% CI: 20%, 72%) was explained by baseline differences, particularly related to cycling off-road, in the dark and in a bunch and residing in urban areas. They were more concerned about traffic volume, speed and drivers' behaviour. CONCLUSIONS: The excess crash risk in Auckland was explained by cycling patterns, urban residence and factors associated with the region's car-dominated transport environment.

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  • Drink driving and the patterns and context of drinking among New Zealand adolescents

    Tin Tin, Sandar; Ameratunga, Shanthi; Robinson, Elizabeth; Crengle, Suzanne; Schaaf, David; Watson, Peter (2008)

    Journal article
    The University of Auckland Library

    Aim: To examine the association between drink driving and the patterns and locations of usual drinking among New Zealand adolescents. Methods: This is a secondary analysis of data from a nationally representative youth health survey, the sampling frame for which was all New Zealand secondary schools with more than 50 students enrolled in years 9 to 13 (ages 12 to 18 years) in 2001. The analysis was restricted to the 3408 survey respondents aged 15 years or older who were current drinkers and drivers. Results: In total, 17.3% of participants reported drink driving in the previous month. Drink driving was significantly associated with frequent (at least weekly) alcohol use, binge drinking and usually drinking away from home, that is in cars, outdoors, at bars or nightclubs, at parties, at school and at work. Students' perception that parents and schools care about them, parental monitoring, and high academic achievement was associated with a reduced risk of drink driving while having friends who drink alcohol increased this risk. These associations were similar among boys and girls. Conclusion: The findings support calls to address how and where young people drink, and indicate the potential gains to be made with family- and school-based interventions.

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  • Uneven reductions in high school students??? alcohol use from 2007 to 2012 by age, sex and socio-economic strata

    Jackson, N; Denny, Simon; Sheridan, Jane; Fleming, Theresa; Clark, Terryann; Peiris-John, Roshini; Ameratunga, Shanthi (2016)

    Journal article
    The University of Auckland Library

    Background: Many Western countries have reported declines in adolescent alcohol use. This study examined changes in adolescent alcohol use in New Zealand between 2007 and 2012 and explored variations across sociodemographic strata. Methods: Data from 2 nationally representative, cross-sectional high school surveys conducted in 2007 (n = 7709) and 2012 (n = 7266) were examined. Changes in the prevalence of drinking in the past 4 weeks were examined among the total sample, as well as the frequency of drinking in the past 4 weeks and typical drinking-occasion quantity among drinkers. Only students residing in urban areas were included. Variation in changes was investigated across 4 demographic groups characterized by age (<16 years) showed significantly reduced typical drinking-occasion quantities. Among young females, significant interactions revealed a shift towards increasing typical drinking-occasion quantities among those of low household and neighborhood SEP, whereas their more advantaged counterparts showed no significant change over time. Conclusions: Fewer drinking occasions characterized the major declines in adolescent drinking between 2007 and 2012. Whereas young males showed reductions in the typical quantity consumed, young females of low household and neighborhood SEP progressed towards higher typical quantities. To address the uneven distribution of alcohol-related harm and improve the targeting of harm reduction initiatives, it remains imperative to examine changes in both the overall shift and shape of the distribution curve.

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  • A Cochrane systematic review of the effectiveness of organisational travel plans: Improving the evidence base for transport decisions

    Macmillan, AK; Hosking, J; L Connor, J; Bullen, Christopher; Ameratunga, Shanthi (2013)

    Journal article
    The University of Auckland Library

    Background: Population dependence on car use has adverse health consequences including road traffic injury, physical inactivity, air pollution and social severance. Widespread car dependence also entrenches lifestyles that require unsustainable levels of energy use. Most transport policies explicitly include goals for public health and sustainability. Transport interventions can therefore be seen as complex public health programmes, and assessing their outcomes against health and sustainability goals is vital. Using organisational travel plans (OTPs) as an example, we demonstrate how best practice epidemiological systematic reviews can be used to assess the existing evidence to inform transport policy. Such a synthesis of the evidence for OTPs has not been undertaken previously. Methods: We undertook a rigorous systematic review in accordance with a peer reviewed protocol to assess the effects of OTPs on individual and population health. We defined OTPs as travel behaviour change programmes conducted in a workplace or education setting. We included published and unpublished randomised controlled trials and controlled before and after studies, where the measured outcomes included change in travel mode or health. Results: 17 studies were included. One study directly measured health outcomes, and all studies measured change in travel mode. The overall methodological validity of studies was poor. The highest quality studies reported mixed effects on travel mode in the school setting. An isolated randomised controlled trial in a workplace suggests that reductions in car use are possible by people already contemplating or preparing for change to active travel. Conclusions: Despite widespread implementation, there is insufficient evidence to determine the effectiveness of organisational travel plans for improving health or changing travel mode. Given the current lack of evidence, new OTP programmes should be implemented in the context of robustly-designed research studies, accounting for potential adverse effects such as child pedestrian injury. Cochrane systematic review methods used in partnerships between public health and transport planners can help achieve transport policy goals. ?? 2012 Elsevier Ltd. All rights reserved.

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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, Andrew; 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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  • Effectiveness of the YourCall??? text message intervention to reduce harmful drinking in patients discharged from trauma wards: protocol for a randomised controlled trial

    Ameratunga, Shanthi; Kool, Bridget; Sharpe, S; Reid, Mary-Jane; Lee, Arier; Civil, Ian; Smith, G; Thornton, V; Walker, M; Whittaker, R (2017-01-09)

    Journal article
    The University of Auckland Library

    Behavioural brief interventions (BI) can support people to reduce harmful drinking but multiple barriers impede the delivery and equitable access to these. To address this challenge, we developed YourCall???, a novel short message service (SMS) text message intervention incorporating BI principles. This protocol describes a trial evaluating the effectiveness of YourCall??? (compared to usual care) in reducing hazardous drinking and alcohol related harm among injured adults who received in-patient care.Participants recruited to this single-blind randomised controlled trial comprised patients aged 16-69 years in three trauma-admitting hospitals in Auckland, New Zealand. Those who screened positive for moderately hazardous drinking were randomly assigned by computer to usual care (control group) or the intervention. The latter comprised 16 informational and motivational text messages delivered using an automated system over the four weeks following discharge. The primary outcome is the difference in mean AUDIT-C score between the intervention and control groups at 3 months, with the maintenance of the effect examined at 6 and 12 months follow-up. Secondary outcomes comprised the health and social impacts of heavy drinking ascertained through a web-survey at 12 months, and further injuries identified through probabilistic linkage to national databases on accident insurance, hospital discharges, and mortality. Research staff evaluating outcomes were blinded to allocation. Intention-to-treat analyses will include assessment of interactions based on ethnicity (M??ori compared with non-M??ori).If found to be effective, this mobile health strategy has the potential to overcome current barriers to implementing equitably accessible interventions that can reduce harmful drinking.

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