ORCID Profile
0000-0001-5425-6018
Current Organisations
The University of Auckland
,
University of Adelaide
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Publisher: Oxford University Press (OUP)
Date: 22-10-2010
Abstract: Utility cycling provides substantial health, environmental and economic benefits. Despite a favourable trend in leisure-time cycling, cycling is infrequently used for everyday travel needs in New Zealand. This study investigated cyclists' attitudes toward environmental and policy measures that would encourage them to cycle more, particularly for a trip to work. A cross-sectional analysis was undertaken using baseline data obtained from the Taupo Bicycle Study, a web-based longitudinal study. The study population comprised 2469 cyclists, aged 16 years or over, who had enrolled in the 2006 Wattyl Lake Taupo Cycle Challenge. The majority (88%) reported the provision of bicycle lanes as an important factor that would encourage them to cycle more often, followed by bicycle paths (76%), better bicycle security (64%), reduced motor vehicle speed (55%) and bike friendly public transport (38%). Of those who reported travelling to work at least once a week (N = 2223), varying proportions reported shower facilities at work (61%), fewer difficult intersections (43%), rising fuel costs (41%), fewer car parks (27%), bike designed to commute (26%) and rising cost of car parking (25%) as important factors that would encourage them to cycle to work more often. There were important differences in these perceived influences defined by the participants' socio-demographic characteristics and current cycling habits.
Publisher: Springer Science and Business Media LLC
Date: 04-06-2014
Publisher: Informa UK Limited
Date: 16-04-2023
Publisher: Elsevier BV
Date: 12-2001
DOI: 10.1016/S0277-9536(00)00438-X
Abstract: This paper aims to describe and explain the development of third sector primary care organisations in New Zealand. The third sector is the non-government, non-profit sector. International literature suggests that this sector fulfils an important role in democratic societies with market-based economies, providing services otherwise neglected by the government and private for-profit sectors. Third sector organisations provided a range of social services throughout New Zealand's colonial history. However, it was not until the 1980s that third sector organisations providing comprehensive primary medical and related services started having a significant presence in New Zealand. In 1994 a range of union health centres, tribally based Mäori health providers, and community-based primary care providers established a formal network -- Health Care Aotearoa. While not representing all third sector primary care providers in New Zealand, Health Care Aotearoa was the best-developed ex le of a grouping of third sector primary care organisations. Member organisations served populations that were largely non-European and lived in deprived areas, and tended to adopt population approaches to funding and provision of services. The development of Health Care Aotearoa has been consistent with international experience of third sector involvement -- there were perceived "failures" in government policies for funding primary care and private sector responses to these policies, resulting in lack of universal funding and provision of primary care and continuing patient co-payments. The principal policy implication concerns the role of the third sector in providing primary care services for vulnerable populations as a partial alternative to universal funding and provision of primary care. Such an alternative may be convenient for proponents of reduced state involvement in funding and provision of health care, but may not be desirable from the point of view of equity and social cohesion insofar as the role of the welfare state is diminished.
Publisher: Elsevier BV
Date: 2019
Publisher: Wiley
Date: 05-02-2010
Publisher: Elsevier BV
Date: 05-2016
Publisher: Elsevier BV
Date: 10-1984
DOI: 10.1016/S0140-6736(84)90694-9
Abstract: The syntheses of new chiral cyclic 1,2-diacetals from (2R, 3R)-( )-tartaric acid are described. C(2)-symmetrical diamines were prepared via direct amidation of the tartrate or from the corresponding bismesylate via reaction with sodium azide. For C1-symmetrical compounds, the Appel reaction was used to form the key intermediate, a monochlorocarbinol, from the diol. Some of the new chiral compounds, produced in good to high yields, may be potentially useful as asymmetric organocatalysts or as nitrogen and sulfur chelating ligands for asymmetric metal catalyzed reactions. Thus, a bis-N-methyl-methanamine derivative, used in substoichiometric amounts, was found to catalyze the enantioselective addition of cyclohexanone to (E)-beta-nitrostyrene with high diastereoselectivity (syn / anti = 92:8), albeit giving moderate optical purity (syn: 30 %).
Publisher: Elsevier BV
Date: 09-2002
Publisher: BMJ
Date: 09-2004
Publisher: Oxford University Press (OUP)
Date: 09-10-2019
DOI: 10.1002/BJS.11326
Abstract: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12 P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent P & 0·001). NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
Publisher: Springer Science and Business Media LLC
Date: 07-1991
DOI: 10.1007/BF00052136
Publisher: Wiley
Date: 12-02-2010
Publisher: Informa UK Limited
Date: 06-12-2018
Publisher: SAGE Publications, Inc.
Date: 2004
Publisher: Informa UK Limited
Date: 06-1999
Publisher: Informa UK Limited
Date: 17-08-2023
Publisher: BMJ
Date: 11-12-2014
Publisher: Oxford University Press (OUP)
Date: 11-07-2008
Publisher: Oxford University Press
Date: 02-2015
Publisher: Informa UK Limited
Date: 29-06-2023
Publisher: Elsevier BV
Date: 05-1983
DOI: 10.1016/S0033-3506(83)80086-9
Abstract: There has been an increasing interest in the identification of genetic variants causing in idual differences in human behavior. Psychiatrists have contributed to the genetics field by defining the most important behavioral characteristics and by studying the association between genetic variants and behavioral differences within phenotypically well-characterized s les in which detailed assessments have been collected (e.g. neuroimaging). These s les are typically limited in size and are therefore not suitable for a genome-wide association analysis. Instead, gene association studies conducted in such s les typically focus on a few genes of interest, allowing smaller s le sizes. However, the selection of high-priority genes is not always straightforward and psychiatrists will usually have a limited background in genetics. We aim to fill this gap by (i) providing a basic introduction to genetics (ii) showing how the selection of genes of interest can be optimized by the use of two web tools: Polysearch and Gene Prospector (iii) illustrating how statistical power analyses can be performed and discussing the importance of sufficiently powered studies. This guide can help psychiatrists with limited experience in genetics in designing genetic studies that allow identification of specific behavioral, cognitive, or neural correlates of genetic risk variants, while avoiding common pitfalls. Copyright © 2015 John Wiley & Sons, Ltd.
Publisher: Elsevier BV
Date: 12-2009
Publisher: BMJ
Date: 02-2008
Abstract: To describe the methods, characteristics of participants, and report on the preliminary findings of a longitudinal study of cyclists. Web-based survey to establish a cohort of cyclists. Participants in the largest mass-participation bicycle event in New Zealand, the Wattyl Lake Taupo Cycle Challenge. 2469 riders who had enrolled online in the 2006 Wattyl Lake Taupo Cycle Challenge. Self-reported crashes in preceding 12 months. Of 5653 eligible riders, 2469 (44%) completed the study questionnaire. Mean age was 44 years, 73% were male, and the average number of kilometers cycled per week in the preceding 12 months was 130. The annual incidence of crashes leading to injury that disrupted usual daily activities for at least 24 h was 0.5 per cyclist/year. About one-third of these crashes resulted in presentation to a health professional. The mean number of days absent from work attributable to bicycle crashes was 0.39 per cyclist/year. After adjustment for potential confounders and exposure (kilometers cycled per year), the rate of days off work from bicycle crash injury was substantially lower among riders who reported always wearing fluorescent colors (multivariate incidence rate ratio 0.23, 95% CI 0.09 to 0.59). Low cyclist conspicuity may increase the risk of crash-related injury and subsequent time off work. Increased use of high-visibility clothing is a simple intervention that may have a large impact on the safety of cycling.
Publisher: Oxford University Press (OUP)
Date: 15-05-2013
DOI: 10.1093/NTR/NTS127
Abstract: Few studies have measured the effect of tobacco bans on secondhand smoke (SHS) exposure in prisons. From June 1, 2011, the sale of tobacco was prohibited in New Zealand prisons. One month later, the possession of tobacco was banned. We studied the indoor air quality before and after this policy was enforced. We measured indoor-fine-particulate (PM(2.5)) concentrations using a TSI SidePak photometer. The instrument was placed in a staff base of a New Zealand maximum-security prison, adjacent to four 12-cell wings. Measurements were made before the sales restriction, during this period, and after the ban. Data were summarized using daily geometric means and generalized least squares regression. A total of 7,107 observations were recorded at 5-min intervals, on 14 days before and 15 days after implementation, between 24 May and 5 August. Before the policy was implemented, the geometric mean was 6.58 μg/m(3) (95% CI = 6.29-6.58), which declined to 5.17 μg/m(3) (95% CI = 4.93-5.41) during the sales ban, and fell to 2.44 μg/m(3) (95% CI = 2.37-2.52) after the smoking ban. Regression analyses revealed an average 57% (95% CI = 42-68) decline in PM(2.5) concentrations, comparing the before and after periods. Our study showed a rapid and substantial improvement in indoor air quality after tobacco was banned at a prison. We conclude that prisoners have reduced their smoking in line with the ban, and that a significant health hazard has been reduced for staff and prisoners alike.
Publisher: BMJ
Date: 05-1994
DOI: 10.1136/BJO.78.5.344
Abstract: Data on the prevalence and causes of blindness and visual impairment in Polynesians are not readily available nor are they population based. This survey was designed to obtain an accurate estimate of blindness and its causes in Tonga. A s le of 4056 persons, aged 20 years and over, was selected by stratified cluster s ling. Participants received a screening, visual acuity examination, and, if visually impaired, were referred for detailed ophthalmic examination to determine the cause. The prevalence of bilateral blindness in the study population was 0.47% and all affected were aged over 50 years. It is estimated that the national prevalence of bilateral blindness, adjusted for the s le weight applied in the selection procedure, is 0.56% (95% confidence interval 0-1.13). Monocular blindness was three times more frequent. Cataract was responsible for 68.4% of bilateral and 30.3% of monocular blindness. Risk factors for life time experience of cataract included age and diabetes (self-reported). Neither smoking nor the presence of pterygium were independently associated with cataract. Increasing years of education were protective against cataract for women, but not men. Corneal opacity from infection or trauma, and diabetes were responsible for most of the remaining visual impairment. While these results do not represent a significant public health problem by world standards they do provide a basis for planning blindness prevention programmes in the region.
Publisher: Wiley
Date: 26-03-2010
DOI: 10.1111/J.1753-6405.1987.TB00512.X
Abstract: We report that intraoperative NIM-2 monitoring devices can interfere with bispectral index monitoring. A 45-year-old male with chronic otits media underwent tympanolasty under general anesthesia with NIM-2 monitoring and bispectral index monitoring at our institution. And then, bispectral index monitoring was severely interrupted by facial nerve monitoring.
Publisher: Elsevier BV
Date: 11-1991
DOI: 10.1016/0277-5379(91)90034-B
Abstract: The apparent effect of passive smoking on cancer risk has become an important social and political issue. For this reason alone the strength of the epidemiological evidence warrants close examination. The research published to date indicates a positive association of passive smoking with lung cancer, but there is no consistent evidence of associations with cancer at other sites. We have summarised the epidemiological evidence, and examined the major criticisms raised against these studies. These criticisms include alleged bias arising from misclassification of exposure to environmental tobacco smoke (ETS) or of personal smoking history, and from differential publication of positive findings. In their strongest form, these critiques challenge the ability of epidemiology to establish causation on any issue. We argue that epidemiology is not inherently different from other branches of science--in each of which scientific "proof" of cause and effect involves judgement based on measurement and logical interference. We also describe the application of epidemiological data to establishing proof, in courts of law, of the lung cancer risk of passive smoking.
Publisher: BMJ
Date: 10-01-2014
DOI: 10.1136/BMJ.F7713
Publisher: Public Library of Science (PLoS)
Date: 29-01-2014
Publisher: Springer Science and Business Media LLC
Date: 08-09-2014
Publisher: Elsevier BV
Date: 06-2010
Publisher: Springer Science and Business Media LLC
Date: 21-01-2015
Publisher: Elsevier BV
Date: 03-2002
Publisher: Elsevier BV
Date: 09-2014
Publisher: Springer Science and Business Media LLC
Date: 2009
Publisher: Oxford University Press (OUP)
Date: 24-01-2020
DOI: 10.1002/BJS.11422
Abstract: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P & 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46 P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent major 3·3 versus 3·4 per cent P = 0·110). Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2008
Publisher: BMJ
Date: 12-2004
Publisher: JSTOR
Date: 02-1999
DOI: 10.2307/3434364
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.SCITOTENV.2014.05.024
Abstract: Tibet of China, with an average altitude of over 4000 m, has experienced noticeable changes in its climate over the last 50 years. The association between temperature and morbidity (most commonly represented by hospital admissions) has been documented mainly in developed countries. Little is known about patterns in China nor have the health effects of temperature variations been closely studied in highland areas, worldwide. We investigated the temperature-morbidity association in Lhasa, the capital city of Tibet, using sex- and age-specific hospitalizations, excluding those due to external causes. A distributed lag non-linear model (DLNM) was applied to assess the nonlinear and delayed effects of temperature on morbidity (including total emergency room visits, total and cause-specific hospital admissions, sex- and age-specific non-external admissions). High temperatures are associated with increases in morbidity, to a greater extent than low temperatures. Lag effects of high and low temperatures were cause-specific. The relative risks (RR) of high temperature for total emergency room visits and non-external hospitalizations were 1.162 (95% CI: 1.002-1.349) and 1.161 (95% CI: 1.007-1.339) respectively, for lag 0-14 days. The strongest cumulative effect of heat for lag 0-27 days was on admissions for infectious diseases (RR: 2.067, 95% CI: 1.026-4.027). Acute heat effects at lag 0 were related with increases of renal (RR: 1.478, 95% CI: 1.005-2.174) and respiratory diseases (RR: 1.119, 95% CI: 1.010-1.240), whereas immediate cold effects increased admission for digestive diseases (RR: 1.132, 95% CI: 1.002-1.282). Those ≥65 years of age and males were more vulnerable to high temperatures. We provide a first look at the temperature-morbidity relationship in Tibet. Exposure to both hot and cold temperatures resulted in increased admissions to hospital, but the immediate causes varied. We suggest that initiatives should be taken to reduce the adverse effects of temperature extremes in Tibet.
Publisher: BMJ
Date: 11-12-2008
DOI: 10.1136/BMJ.A2806
Publisher: Oxford University Press (OUP)
Date: 1994
DOI: 10.1093/IJE/23.4.818
Abstract: This study sought explanations for the proneness to respiratory events in young Australian children. Prospective respiratory symptom diaries on 836 children collected data on respiratory symptoms and episodes. Questionnaires to mothers and birth and pregnancy records provided 56 known and possible predictors which were tested against two summary respiratory outcomes in each of the first and second years of life. The two summary respiratory variables recorded for first and second year of life give four outcome variables. In fitting multivariate regression models to predict outcomes, use of child care in early childhood and mothers' experience of respiratory illness in the 12 months before birth were significant predictors for all four outcomes. Number of siblings was a predictor for three of the four outcomes. Sleep difficulty during pregnancy in the mother, and respiratory hospitalization of the infant in the first year, were significant predictors for both first-year outcomes. Unexpected and unexplained findings emerged for alcohol intake during pregnancy, passive smoking and breastfeeding in relation to the second year respiratory outcomes. Less than 9% of variance in outcome scores was explained in any of the four multiple regression models but this rose to between 24% and 31% when a corresponding score from the other year was added to the model. Proneness to respiratory illness is an important entity its determinants are largely unknown and events in pregnancy or the perinatal period explain only a small proportion of the between-infant variability.
Publisher: BMJ
Date: 09-10-2013
DOI: 10.1136/TOBACCOCONTROL-2012-050698
Abstract: About a third of the world's population is exposed to secondhand smoke (SHS), despite reductions in smoking prevalence in many countries. Accurate, cost-effective measures of exposure are needed in investigations of the health risks associated with SHS, and in studies of interventions to extend smoke-free environments. There have been important developments in the use of questionnaires, air quality monitoring and biomarkers, but still, there is no single, gold standard assessment of exposure to SHS. Choice of measure depends on circumstances, including cost, scale and time window.
Publisher: Wiley
Date: 12-02-2010
DOI: 10.1111/J.1753-6405.1984.TB00463.X
Abstract: The objectives of this study were to delineate the clinical-epidemiological profile of patients with neuropathic pain (NP) in the groups of SCD patients, from each of the three questionnaires used DN-4, painDETECT - PDQ, LANSS and to compare these three questionnaires in NP evaluation in SCD carriers. This cross-sectional study evaluated 83 patients with symptomatic SCD, aged 14 years or older. Clinical and laboratory data were extracted from the patients' charts and from information obtained from the patients during the interview before the application of the questionnaire. The calculations were performed using the statistical software Epi InfoTM 7. Pearson's correlation coefficient was used to compare the neuropathic pain evaluation scales with the software BioEstat 5.3. The use of two or more questionnaires may increase the suspicion of NP in patients with SCD and, with a confirmed diagnosis, adequate treatments will benefit patients.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-1995
DOI: 10.1097/00001648-199505000-00012
Abstract: We examined the relation between the speed of passenger cars and risk of involvement in a severe crash, in an urban setting, using a case-control study. "Cases" were 45 vehicles involved in severe crashes in the Adelaide metropolitan area we determined their pre-crash speeds using accident reconstruction techniques. For each case, we measured the speeds of 10 controls using an hometer controls were cars not involved in crashes that passed through the crash location at the same time of day, day of week, and season. We found that the risk of involvement in a severe crash increased as vehicle speed increased. In particular, within 60 km per hour zones, compared with vehicles traveling at about the posted limit, vehicles traveling at 75-84 km per hour had an odds ratio of 7.8 [95% confidence interval (CI) = 1.4-38.8] for a severe crash, whereas vehicles with speeds in excess of 84 km per hour had an odds ratio of 39.0 (95% CI = 9.3-170.5).
Publisher: BMJ
Date: 07-2001
DOI: 10.1136/EWJM.175.1.6
Publisher: Wiley
Date: 26-03-2010
Publisher: BMJ
Date: 10-2008
Abstract: The aim of this study was to examine the effect of household income on unintentional injury mortality in children and to model the potential impact of eradicating income poverty as an injury prevention strategy. A national retrospective cohort study linking census to mortality records carried out in New Zealand during a 3-year period following the 1991 census and including children aged 0-14 years on census night. The main outcome measures are odds ratios (ORs) for unintentional injury death by equivalised household income category and proportional reductions (population-attributable risk) in unintentional injury mortality from modelled scenarios of nil poverty. One-third of children lived in households earning less than 60% of the national median household income. Age-adjusted odds of death from unintentional injury were higher for children from any income category compared with the highest, and were most elevated for children from households earning less than 40% of the national median income (OR 2.81, 95% CI 1.73 to 4.55). Adjusting for ethnicity, household education, family status and labour force status halved the effect size (OR 1.83, 1.02 to 3.28). Thirty per cent of injury mortality was attributable to low or middle household income using the highest income category as reference. Altering the income distribution to eradicate poverty, defined by a threshold of 50% or 60% of the national median income, reduced injury mortality in this model by a magnitude of 3.3% to 6.6%. Household income is related to a child's risk of death from unintentional injury independent of measured confounders. Most deaths attributable to low income occur among households that are not defined as "in poverty". The elimination of poverty may reduce childhood unintentional injury mortality by 3.3% to 6.6%.
Publisher: Elsevier BV
Date: 02-2015
Publisher: The Royal Society
Date: 29-07-2001
Publisher: Elsevier BV
Date: 12-2011
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.637
Publisher: Springer Science and Business Media LLC
Date: 27-02-2013
DOI: 10.1007/S10552-013-0171-7
Abstract: A history of allergy has been inversely associated with several types of cancer although the evidence is not entirely consistent. We examined the association between allergy history and risk of glioma, meningioma, acoustic neuroma, and parotid gland tumors using data on a large number of cases and controls from five INTERPHONE study countries (Australia, Canada, France, Israel, New Zealand), to better understand potential sources of bias in brain tumor case-control studies and to examine associations between allergy and tumor sites where few studies exist. A total of 793 glioma, 832 meningioma, 394 acoustic neuroma, and 84 parotid gland tumor cases were analyzed with 2,520 controls recruited during 2000-2004. Conditional logistic regression models were used to obtain odds ratios (ORs) and 95 % confidence intervals (CIs) for associations between self-reported allergy and tumor risk. A significant inverse association was observed between a history of any allergy and glioma (OR = 0.73, 95 % CI 0.60-0.88), meningioma (OR = 0.77, 95 % CI 0.63-0.93), and acoustic neuroma (OR = 0.64, 95 % CI 0.49-0.83). Inverse associations were also observed with specific allergic conditions. However, inverse associations with asthma and hay fever strengthened with increasing age of allergy onset and weakened with longer time since onset. No overall association was observed for parotid gland tumors (OR = 1.21, 95 % CI 0.73-2.02). While allergy history might influence glioma, meningioma, and acoustic neuroma risk, the observed associations could be due to information or selection bias or reverse causality.
Publisher: Elsevier BV
Date: 12-2009
Publisher: Wiley
Date: 11-2019
DOI: 10.1111/ANS.15562
Abstract: We know very well what causes climate change, and in general terms, what the dangers are. This is a new kind of environmental problem, it is not like taking lead out of petrol, and it is important to understand why responding to climate change is so challenging. But that is no reason to give up: in fact there are many opportunities to intervene, including actions that can be taken by surgeons and other health professionals.
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: BMJ
Date: 03-09-2014
DOI: 10.1136/TOBACCOCONTROL-2012-050944
Abstract: Improving social circumstances (e.g., an increase in income, finding a job or moving into a good neighbourhood) may reduce tobacco use, but robust evidence on the effects of such improvements is scarce. Accordingly we investigated the link between changing social circumstances and changing tobacco smoking using repeated measures data. 15 000 adults with at least two observations over three waves (each 2 years apart) of a panel study had data on smoking status, family, labour force, income and deprivation (both neighbourhood and in idual). Fixed effects regression modelling was used. The odds of smoking increased 1.42-fold (95% CI 1.16 to 1.74) for a one log-unit increase in personal income among 15-24-year-olds, but there was no association of increased smoking with an increase in income among 25+ year olds. Moving out of a family nucleus, increasing neighbourhood deprivation (e.g., 1.83-fold (95% CI 1.18 to 2.83) increased odds of smoking for moving from least to most deprived quintile of neighbourhoods), increasing personal deprivation and moving into employment were all associated with increased odds of smoking. The number of cigarettes smoked a day changed little with changing social circumstances. Worsening social circumstances over the short run are generally associated with higher smoking risk. However, there were counter ex les: for instance, decreasing personal income among young people was associated with decreased odds of smoking, a finding consistent with income elasticity of demand (the less one's income, the less one can consume). This paper suggests that improving social circumstances is not always pro-health over the short run a more nuanced approach to the social determinants of health is required.
Publisher: Elsevier BV
Date: 06-2010
Publisher: Oxford University Press (OUP)
Date: 1990
DOI: 10.1093/IJE/19.4.937
Abstract: In a community-based study we investigated the relationships between maternal stress, maternal social supports, family functioning and proneness to acute respiratory illness (AR1) in childhood. 'Prone' and 'not prone' children were identified from the responses to a mail questionnaire sent to the addresses of a randomly selected group of Adelaide children who had been born in 1983. 'Prone' children (n = 255) were defined by a respiratory score (based on frequency and severity of reported symptoms in the preceding 12 months) in the top quintile of the distribution, while 'not prone' children (n = 227) were defined by a score in the bottom 20% of the range. Further information was obtained from a questionnaire administered at a home visit. Maternal stress levels were determined from a combination of major life events, minor life events and psychological distress. Maternal stress was significantly associated with respiratory proneness in a stepwise multiple logistic regression (adjusted odds ratio/high versus low = 3.8 95% confidence interval 2.0-7.2 p = 0.000), while controlling for the effects of maternal smoking, group child care, early chest illness, number of siblings, breastfeeding, occupation, sex, age, home heating, birthweight and parental history of respiratory illness. Family dysfunction was associated with respiratory proneness in bivariate analyses but not after adjustment for the effects of other psychosocial factors in multivariate analyses. Lack of maternal social support was not associated with having a child who was prone to respiratory illness. These findings raise a number of questions about the nature and direction of the relationship between parental psychological status and child health.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.ENVPOL.2018.09.056
Abstract: The linkage between ambient air pollution exposure and occurrence of diabetes mellitus is not well defined. This study examined the association between exposure to fine particles (PM
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.638
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.ANNEPIDEM.2008.10.006
Abstract: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56% cases, 50%) than by those who completed the full interview (controls, 69% cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.
Publisher: Elsevier BV
Date: 05-2005
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.639
Abstract: Pediatric otolaryngology clinics have tremendous access to children with allergic conditions, yet no research has evaluated in this setting environmental tobacco smoke and the occurrence of atopic diseases. Caregivers or parents of 201 consecutive patients in a Hungarian pediatric otolaryngology clinic were queried on otolaryngologic conditions self-reported diagnoses of atopic diseases and tobacco smoke exposure. A history of asthma was reported in 10.3% of children 38.7% had at least one parent who smoked. Fifteen out of the 20 children with asthma (75.0%) had at least one parent who smoked. Having a diagnosis of hay fever and having a parent who smoked greatly increased the odds of having a diagnosis of asthma. Second hand smoke exposure among children in an otolaryngology clinic was common, and was associated with co-existing atopic conditions. Pediatric otolaryngologists have an important opportunity to address parental smoking as part their care of children.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Elsevier BV
Date: 11-2015
Publisher: BMJ
Date: 04-2006
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.SOCSCIMED.2005.02.011
Abstract: The aim of this paper is to determine the extent of undercounting of Mäori and Pacific deaths in New Zealand during the 1980s and 1990s, and to calculate corrected ethnic mortality and life expectancy trends. We calculated adjustment ratios for undercounting of Mäori and Pacific deaths (and over-counting of non-Mäori non-Pacific (nMnP) deaths) using the linked census-mortality data. These ratios were then used to calculate corrected mortality rates and life expectancies. Mäori deaths were underestimated by a quarter, and Pacific deaths by a third, during the 1980s and early 1990s. Undercounting was minor in the late 1990s following alignment of ethnicity collection on mortality data to approximate the census. Corrected mortality rates demonstrated 30% (males) and 26% (females) decreases among nMnP from 1980-84 to 1996-99, smaller decreases among Mäori (8% and 7%) and no clear change among Pacific people (9% decrease for males, 4% increase for females). The gap in life expectancy increased from an average of 7.7 years in 1980-84 to 10.8 years in 1996-99 for Mäori, and from 3.3 to 7.7 years for Pacific people, in comparison to nMnP people. Deaths among 45-64 and 65 plus year olds, and cardiovascular disease and cancer deaths, were the main contributors to these disparities. The economic reforms in New Zealand during the 1980s and early 1990s impacted harder upon Mäori and Pacific people in terms of unemployment and income, and are a likely explanation for the erging mortality trends in this period. Both behavioural factors and health services probably also play a role, but in the absence of trend data by ethnicity, their contribution to erging mortality trends is unknown. Internationally, our study demonstrates marked undercounting of Mäori and Pacific deaths. We strongly encourage researchers and custodians of vital statistics in other countries to investigate the possibility of undercounting of deaths by ethnicity.
Publisher: Oxford University Press (OUP)
Date: 07-06-1995
Abstract: Radioactive radon is an inert gas that can migrate from soils and rocks and accumulate in enclosed areas, such as homes and underground mines. Studies of miners show that exposure to radon decay products causes lung cancer. Consequently, it is of public health interest to estimate accurately the consequences of daily, low-level exposure in homes to this known carcinogen. Epidemiologic studies of residential radon exposure are burdened by an inability to estimate exposure accurately, low total exposure, and subsequent small excess risks. As a result, the studies have been inconclusive to date. Estimates of the hazard posed by residential radon have been based on analyses of data on miners, with recent estimates based on a pooling of four occupational cohort studies of miners, including 360 lung cancer deaths. To more fully describe the lung cancer risk in radon-exposed miners, we pooled original data from 11 studies of radon-exposed underground miners, conducted a comprehensive analysis, and developed models for estimating radon-associated lung cancer risk. We pooled original data from 11 cohort studies of radon-exposed underground miners, including 65,000 men and more than 2700 lung cancer deaths, and fit various relative risk (RR) regression models. The RR relationship for cumulative radon progeny exposure was consistently linear in the range of miner exposures, suggesting that exposures at lower levels, such as in homes, would carry some risk. The exposure-response trend for never-smokers was threefold the trend for smokers, indicating a greater RR for exposure in never-smokers. The RR from exposure diminished with time since the exposure occurred. For equal total exposure, exposures of long duration (and low rate) were more harmful than exposures of short duration (and high rate). In the miners, about 40% of all lung cancer deaths may be due to radon progeny exposure, 70% of lung cancer deaths in never-smokers, and 39% of lung cancer deaths in smokers. In the United States, 10% of all lung cancer deaths might be due to indoor radon exposure, 11% of lung cancer deaths in smokers, and 30% of lung cancer deaths in never-smokers. This risk model estimates that reducing radon in all homes exceeding the U. S. Environmental Protection Agency's recommended action level may reduce lung cancer deaths about 2%-4%. These estimates should be interpreted with caution, because concomitant exposures of miners to agents such as arsenic or diesel exhaust may modify the radon effect and, when considered together with other differences between homes and mines, might reduce the generalizability of findings in miners.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2003
DOI: 10.1097/01.JOM.0000069242.06498.86
Abstract: The purpose of this work was to assess the relation between exposure to secondhand smoke (SHS) at work and reported respiratory and sensory symptoms. A cross-sectional telephone survey of 382 nonsmoking indoor workers in Victoria, Australia was used. After controlling for potential confounders, exposure to SHS at work for part of the day was significantly associated with an increased risk of wheeze (OR = 4.26), frequent cough (OR = 2.26), sore eyes (OR = 3.77), and sore throat (OR = 2.70). Among workers who had not experienced a cold in the past 4 weeks, we found strong dose-response relationships between increasing levels of exposure to SHS at work and morning cough, frequent cough, sore eyes and sore throat, and a positive relationship for wheeze. These findings provide compelling evidence that nonsmoking indoor workers are adversely affected by exposure to SHS at work and underline the importance of workplace smoke-free policies in protecting the health of workers.
Publisher: Elsevier BV
Date: 15-10-2000
Publisher: BMJ
Date: 11-2007
Publisher: Elsevier BV
Date: 06-1987
DOI: 10.1016/0001-4575(87)90002-9
Abstract: In the past, evaluation of helmet efficacy has been based on laboratory tests of limited relevance to real crashes. In the present study 894 South Australian bicycling enthusiasts returned mail questionnaires about their most recent bicycle crash and their helmet use at the time. 197 bicyclists reported a crash within the past five years in which they had struck their head or helmet. Helmet status at the time of the crash was reported as: no helmet used (n = 75), hairnet-style helmet (n = 69), hard-shell with soft or no liner (n = 37), or hard-shell helmet with stiff liner (n = 16). Analysis of the crude, unadjusted data showed a statistically significant association between helmet use and reduced severity of head injury. The association persisted after adjustment for age and sex of rider, and severity of crash forces. Using an unpublished method developed by Somers, it was estimated that the risk of death from head injury was considerably reduced for helmeted relative to unhelmeted bicyclists, depending on helmet type.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2016
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.640
Publisher: SAGE Publications
Date: 17-12-2011
Publisher: Elsevier BV
Date: 12-1999
Publisher: Informa UK Limited
Date: 06-02-2023
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.SCITOTENV.2014.02.094
Abstract: Tibet, with an average altitude of more than 4,000 meters, is warming faster than anywhere else in China. However, there have been no studies in Tibet of the relation between ambient temperature and mortality. We examined mean temperature and daily mortality in three Tibetan counties (Chengguan, Jiangzi and Naidong) using a distributed lag non-linear model (DLNM) based on 5,610 deaths that occurred in 2008-2012. We separately investigated hot and cold effects on non-accidental deaths, cardiovascular deaths, out-of-hospital deaths and vulnerability factors including age, sex and education. In all three counties, the effect of heat tended to be immediate, while the impact of cold lasted longer. The effects were consistent but modest in size and not statistically significant except for cumulative cold effects in Jiangzi (lag=0-14, RR=2.251, 95% CI=1.054-4.849). Those who were more vulnerable to temperature extremes tended to be men, the elderly (over 65 years) and illiterate persons. We found stronger temperature effects on cardiovascular deaths than on all-cause mortality, and we also observed an increase in out-of-hospital mortality in one county. This is the first study to investigate the temperature-mortality relationship in Tibet, and the findings may guide public health programs and other interventions to protect the population against extreme temperatures in a developing Tibet.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2010
Abstract: The risk of injury is one of the major barriers to engaging in cycling. We investigated exposure-based rates and profiles of traffic injuries sustained by pedal cyclists that resulted in death or hospital inpatient treatment in New Zealand, one of the most car dependent countries. Pedal cyclist traffic injuries were identified from the Mortality Collection and the National Minimum Dataset. Total time spent cycling was used as the measure of exposure and computed from National Household Travel Surveys. Analyses were undertaken for the periods 1988-91, 1996-99 and 2003-07 in relation to other major road users and by age, gender and body region affected. A modified Barell matrix was used to characterise the profiles of pedal cyclist injuries by body region affected and nature of injury. Cyclists had the second highest rate of traffic injuries compared to other major road user categories and the rate increased from 1996-99 to 2003-07. During 2003-07, 31 injuries occurred per million hours spent cycling. Non-collision crashes (40%) and collisions with a car, pick-up truck or van (26%) accounted for two thirds of the cycling injuries. Children and adolescents aged under 15 years were at the highest risk, particularly of non-collision crashes. The rate of traumatic brain injuries fell from 1988-91 to 1996-99 however, injuries to other body parts increased steadily. Traumatic brain injuries were most common in collision cases whereas upper extremity fractures were most common in other crashes. The burden of fatal and hospitalised injuries among pedal cyclists is considerable and has been increasing over the last decade. This underscores the development of road safety and injury prevention programmes for cyclists alongside the cycling promotion strategies.
Publisher: Springer Science and Business Media LLC
Date: 06-08-2013
Publisher: Oxford University Press (OUP)
Date: 08-2015
Publisher: Informa UK Limited
Date: 12-1991
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.643
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.644
Abstract: Psychological treatments for obsessive-compulsive disorder (OCD) are increasingly aimed at improving outcomes by directly incorporating family members to address family disruption, dysfunction, or symptom accommodation. Much remains to be learned about the pooled effects of "family inclusive treatment" (FIT) for OCD and factors that may explain variation in response. Random-effects meta-analytic procedures were conducted to empirically evaluate the overall effect of FITs on OCD, and treatment moderators. Study search criteria yielded 29 studies examining FIT response in 1,366 OCD patients. Outcome variables included OCD symptoms and global functioning. Examined moderators included age group, gender, minority status, treatment length and format, and inclusion of specific family focused treatment elements. FITs for OCD demonstrated a large overall effect on OCD symptoms (pooled d = 1.68, SE = 0.14) and global functioning (pooled d = 0.98, SE = 0.14). Moderator analyses found that in idual family treatments (vs. group) and FITs targeting family accommodation of symptoms (vs. those that did not target accommodation) were associated with greater improvements in patient functioning. Results indicate a robust overall response to FITs for OCD and clarify key moderators that inform optimal circumstances for effective treatment. Findings underscore the need for continued momentum in the development, evaluation, and dissemination of FITs for OCD.
Publisher: Elsevier BV
Date: 12-2014
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.641
Publisher: Oxford University Press (OUP)
Date: 1985
DOI: 10.1093/IJE/14.4.642
Publisher: Human Kinetics
Date: 10-2023
Abstract: Background : Surveillance of domain-specific physical activity (PA) helps to target interventions to promote PA. We examined the sociodemographic correlates of domain-specific PA in New Zealand adults. Methods : A nationally representative s le of 13,887 adults completed the International PA Questionnaire–long form in 2019/20. Three measures of total and domain-specific (leisure, travel, home, and work) PA were calculated: (1) weekly participation, (2) mean weekly metabolic energy equivalent minutes (MET-min), and (3) median weekly MET-min among those who undertook PA. Results were weighted to the New Zealand adult population. Results : The average contribution of domain-specific activity to total PA was 37.5% for work activities (participation = 43.6% median participating MET-min = 2790), 31.9% for home activities (participation = 82.2% median participating MET-min = 1185), 19.4% for leisure activities (participation = 64.7% median participating MET-min = 933), and 11.2% for travel activities (participation = 64.0% median MET-min among participants = 495). Women accumulated more home PA and less work PA than men. Total PA was higher in middle-aged adults, with erse patterns by age within domains. Māori accumulated less leisure PA than New Zealand Europeans but higher total PA. Asian groups reported lower PA across all domains. Higher area deprivation was negatively associated with leisure PA. Sociodemographic patterns varied by measure. For ex le, gender was not associated with total PA participation, but men accumulated higher MET-min when taking part in PA than women. Conclusions : Inequalities in PA varied by domain and sociodemographic group. These results should be used to inform interventions to improve PA.
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1111/J.1753-6405.2010.00621.X
Abstract: To estimate the effects on health, air pollution and greenhouse gas emissions if short trips (≤7 km) were undertaken by bicycle rather than motor car. Existing data sources were used to model effects, in the urban setting in New Zealand, of varying the proportion of vehicle kilometres travelled by bicycle instead of light motor vehicle. Shifting 5% of vehicle kilometres to cycling would reduce vehicle travel by approximately 223 million kilometres each year, save about 22 million litres of fuel and reduce transport-related greenhouse emissions by 0.4%. The health effects would include about 116 deaths avoided annually as a result of increased physical activity, six fewer deaths due to local air pollution from vehicle emissions, and an additional five cyclist fatalities from road crashes. In economic terms, including only fatalities and using the NZ Ministry of Transport Value of a Statistical Life, the health effects of a 5% shift represent net savings of about $200 million per year. The health benefits of moving from cars to bikes heavily outweigh the costs of injury from road crashes. Transport policies that encourage bicycle use will help to reduce air pollution and greenhouse emissions and improve public health.
Publisher: Elsevier BV
Date: 12-1995
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 05-2005
Publisher: JSTOR
Date: 10-1999
DOI: 10.2307/3454579
Publisher: MDPI AG
Date: 14-05-2014
Publisher: BMJ
Date: 04-2014
Publisher: Elsevier BV
Date: 10-2012
Publisher: Wiley
Date: 12-02-1995
Publisher: Wiley
Date: 29-07-2015
DOI: 10.1111/ADD.13024
Publisher: BMJ
Date: 12-2000
Abstract: It is well known that social, cultural and economic factors cause substantial inequalities in health. Should we strive to achieve a more even share of good health, beyond improving the average health status of the population? We examine four arguments for the reduction of health inequalities.1 Inequalities are unfair. Inequalities in health are undesirable to the extent that they are unfair, or unjust. Distinguishing between health inequalities and health inequities can be contentious. Our view is that inequalities become "unfair" when poor health is itself the consequence of an unjust distribution of the underlying social determinants of health (for ex le, unequal opportunities in education or employment).2 Inequalities affect everyone. Conditions that lead to marked health disparities are detrimental to all members of society. Some types of health inequalities have obvious spillover effects on the rest of society, for ex le, the spread of infectious diseases, the consequences of alcohol and drug misuse, or the occurrence of violence and crime.3 Inequalities are avoidable. Disparities in health are avoidable to the extent that they stem from identifiable policy options exercised by governments, such as tax policy, regulation of business and labour, welfare benefits and health care funding. It follows that health inequalities are, in principle, amenable to policy interventions. A government that cares about improving the health of the population ought therefore to incorporate considerations of the health impact of alternative options in its policy setting process.3 Interventions to reduce health inequalities are cost effective. Public health programmes that reduce health inequalities can also be cost effective. The case can be made to give priority to such programmes (for ex le, improving access to cervical cancer screening in low income women) on efficiency grounds. On the other hand, few programmes designed to reduce health inequalities have been formally evaluated using cost effectiveness analysis. We conclude that fairness is likely to be the most influential argument in favour of acting to reduce disparities in health, but the concept of equity is contested and susceptible to different interpretations. There is persuasive evidence for some outcomes that reducing inequalities will diminish "spill over" effects on the health of society at large. In principle, you would expect that differences in health status that are not biologically determined are avoidable. However, the mechanisms giving rise to inequalities are still imperfectly understood, and evidence remains to be gathered on the effectiveness of interventions to reduce such inequalities.
Publisher: Elsevier BV
Date: 04-2014
Publisher: Elsevier BV
Date: 04-2014
Publisher: Elsevier BV
Date: 2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2010
Publisher: Oxford University Press (OUP)
Date: 05-12-2007
DOI: 10.1093/AJE/KWK043
Abstract: Evidence is growing that secondhand smoke can cause death from several diseases. The association between household exposure to secondhand smoke and disease-specific mortality was examined in two New Zealand cohorts of lifelong nonsmokers ("never smokers") aged 45-77 years. In idual census records from 1981 and 1996 were anonymously and probabilistically linked with mortality records from the 3 years that followed each census. Age- and ethnicity-standardized mortality rates were compared for never smokers with and without home exposure to secondhand smoke (based on the reported smoking behavior of other household members). Relative risk estimates adjusted for age, ethnicity, marital status, and socioeconomic position showed a significantly greater mortality risk for never smokers living in households with smokers, with excess mortality attributed to tobacco-related diseases, particularly ischemic heart disease and cerebrovascular disease, but not lung cancer. Adjusted relative risk estimates for all cardiovascular diseases were 1.19 (95% confidence interval: 1.04, 1.38) for men and 1.01 (95% confidence interval: 0.88, 1.16) for women from the 1981-1984 cohort, and 1.25 (95% confidence interval: 1.06, 1.47) for men and 1.35 (95% confidence interval: 1.11, 1.64) for women from the 1996-1999 cohort. Passive smokers also had nonsignificantly increased mortality from respiratory disease. Sensitivity analyses indicate that these findings are not due to misclassification bias.
Publisher: BMJ
Date: 2002
DOI: 10.1136/JECH.56.1.66
Abstract: The aim of this study was to compare the two biomarkers of exposure to environmental tobacco smoke (ETS) urine cotinine and hair nicotine, using questionnaires as the standard. A cross sectional study of children consecutively admitted to hospital for lower respiratory illnesses during the period of the study. Three regional hospitals in the larger Wellington area, New Zealand. Children aged 3-27 months and admitted to the above hospitals during August 1997 to October 1998. A total of 322 children provided 297 hair s les and 158 urine s les. Hair nicotine levels were better able to discriminate the groups of children according to their household's smoking habits at home (no smokers, smoke only outside the home, smoke inside the house) than urine cotinine (Kruskall-Wallis chi(2)=142.14, and chi(2)=49.5, respectively (p<0.0001)). Furthermore, hair nicotine levels were more strongly correlated with number of smokers in the house, and the number of cigarettes smoked by parents and other members of the child's households. Hair nicotine was better related to the questionnaire variables of smoking in a multivariate regression model (r(2)=0.55) than urine cotinine (r(2)=0.31). In this group of young children, hair nicotine was a more precise biomarker of exposure to ETS than urine cotinine levels, using questionnaire reports as the reference. Both biomarkers indicate that smoking outside the house limits ETS exposure of children but does not eliminate it.
Publisher: Elsevier BV
Date: 12-2009
Publisher: The Electrochemical Society
Date: 2010
DOI: 10.1149/1.3327913
Publisher: Springer Science and Business Media LLC
Date: 18-07-2007
DOI: 10.1007/S10654-007-9152-Z
Abstract: The very rapid worldwide increase in mobile phone use in the last decade has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. A multinational case-control study, INTERPHONE, was set-up to investigate whether mobile phone use increases the risk of cancer and, more specifically, whether the RF fields emitted by mobile phones are carcinogenic. The study focused on tumours arising in the tissues most exposed to RF fields from mobile phones: glioma, meningioma, acoustic neurinoma and parotid gland tumours. In addition to a detailed history of mobile phone use, information was collected on a number of known and potential risk factors for these tumours. The study was conducted in 13 countries. Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK using a common core protocol. This paper describes the study design and methods and the main characteristics of the study population. INTERPHONE is the largest case-control study to date investigating risks related to mobile phone use and to other potential risk factors for the tumours of interest and includes 2,765 glioma, 2,425 meningioma, 1,121 acoustic neurinoma, 109 malignant parotid gland tumour cases and 7,658 controls. Particular attention was paid to estimating the amount and direction of potential recall and participation biases and their impact on the study results.
Publisher: Oxford University Press (OUP)
Date: 03-1995
Publisher: Informa UK Limited
Date: 03-1999
Publisher: Elsevier BV
Date: 11-2003
Publisher: BMJ
Date: 26-02-2007
Publisher: Public Library of Science (PLoS)
Date: 18-02-2015
Publisher: Elsevier BV
Date: 10-2012
Publisher: Elsevier BV
Date: 12-2018
Publisher: BMJ
Date: 21-05-2009
Abstract: The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure for epidemiological studies, we assessed determinants of mobile phone output power in a multinational study. More than 500 volunteers in 12 countries used Global System for Mobile communications software-modified phones (GSM SMPs) for approximately 1 month each. The SMPs recorded date, time, and duration of each call, and the frequency band and output power at fixed s ling intervals throughout each call. Questionnaires provided information on the typical circumstances of an in idual's phone use. Linear regression models were used to analyse the influence of possible explanatory variables on the average output power and the percentage call time at maximum power for each call. Measurements of over 60,000 phone calls showed that the average output power was approximately 50% of the maximum, and that output power varied by a factor of up to 2 to 3 between study centres and network operators. Maximum power was used during a considerable proportion of call time (39% on average). Output power decreased with increasing call duration, but showed little variation in relation to reported frequency of use while in a moving vehicle or inside buildings. Higher output powers for rural compared with urban use of the SMP were observed principally in Sweden where the study covered very sparsely populated areas. Average power levels are substantially higher than the minimum levels theoretically achievable in GSM networks. Exposure indices could be improved by accounting for average power levels of different telecommunications systems. There appears to be little value in gathering information on circumstances of phone use other than use in very sparsely populated regions.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.ENVPOL.2018.05.011
Abstract: To date, greenhouse gas (GHG) emissions, mitigation strategies and the accompanying health co-benefits in different economic sectors have not been fully investigated. The purpose of this paper is to review comprehensively the evidence on GHG mitigation measures and the related health co-benefits, identify knowledge gaps, and provide recommendations to promote further development and implementation of climate change response policies. Evidence on GHG emissions, abatement measures and related health co-benefits has been observed at regional, national and global levels, involving both low- and high-income societies. GHG mitigation actions have mainly been taken in five sectors: energy generation, transport, food and agriculture, household and industry, consistent with the main sources of GHG emissions. GHGs and air pollutants to a large extent stem from the same sources and are inseparable in terms of their atmospheric evolution and effects on ecosystem thus, GHG reductions are usually, although not always, estimated to have cost effective co-benefits for public health. Some integrated mitigation strategies involving multiple sectors, which tend to create greater health benefits. The pros and cons of different mitigation measures, issues with existing knowledge, priorities for research, and potential policy implications were also discussed. Findings from this study can play a role not only in motivating large GHG emitters to make decisive changes in GHG emissions, but also in facilitating cooperation at international, national and regional levels, to promote GHG mitigation policies that protect public health from climate change and air pollution simultaneously.
Publisher: Springer Science and Business Media LLC
Date: 08-03-2012
Publisher: BMJ
Date: 08-2007
Publisher: JMIR Publications Inc.
Date: 19-12-2016
DOI: 10.2196/MHEALTH.5931
Publisher: Wiley
Date: 29-08-2001
DOI: 10.1002/AJIM.1097
Abstract: A previous investigation showed an increased risk of testicular cancer among fire fighters in Wellington City, New Zealand, during the 1980s. Other studies of fire fighters had not identified testicular cancer as an occupational disease. This was an historical cohort study of mortality and cancer incidence in all paid New Zealand fire fighters, from 1977 to 1995. The only cancer for which this study provided evidence of an increased risk was testicular cancer, even after excluding cases from the previous investigation. The standardized incidence ratio for 1990-96 was 3.0 (95% confidence interval: 1.3-5.90). There was no evidence that fire fighters were at increased risk from any particular cause of death. This study confirmed that New Zealand fire fighters are at increased risk of testicular cancer, although the reason is unknown. Other incidence studies of cancer in fire fighters are needed to confirm this finding.
Publisher: Springer Science and Business Media LLC
Date: 06-2004
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.SCITOTENV.2020.136678
Abstract: The 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs) represent a historic global linking of health, equity and environmental sustainability. Accumulated evidence suggests that improving urban neighbourhoods to make them safer and more attractive for walking and cycling can accelerate progress towards the SDGs. The pathways to change are complex, non-linear and involve multiple pathways and multiple SDG outcomes, yet the SDG goals are often considered in isolation. Further, there have been few studies of environmental interventions for healthier transport that foreground equity. The aim of this paper is to describe and demonstrate practically how integrated interventions for placemaking and active transport can contribute to a wide range of SDG targets. First, we take an evidence-based approach to describing how such interventions are connected to targets within the SDGs. Second, we propose a complex causal theory of the pathways to change and the inter-relationships between SDGs. Third, we show, with concrete ex les, how a case study project in Auckland, New Zealand illustrates these pathways, contributing to achieving the SDG targets, including barriers and challenges. We find that by addressing Goal 11 in particular ways that focus on equity (Goal 10), eight of the other goals can also be advanced. Our causal theory describes one balancing and 12 reinforcing patterns of behaviour that link interventions improvements to neighbourhoods with ten of the SDGs in a complex system. Our case study demonstrates that it is possible to successfully put this causal theory into practice through interventions, but these require strong partnerships between researchers, public health practitioners, policy-makers and communities, long-term evaluation and addressing both physical and social environments.
Publisher: JSTOR
Date: 02-1997
DOI: 10.2307/3579412
Publisher: BMJ
Date: 06-2015
Abstract: There is increased interest in the effectiveness and co-benefits of measures to promote walking and cycling, including health gains from increased physical activity and reductions in fossil fuel use and vehicle emissions. This paper analyses the changes in walking and cycling in two New Zealand cities that accompanied public investment in infrastructure married with programmes to encourage active travel. Using a quasi-experimental two-group pre-post study design, we estimated changes in travel behaviour from baseline in 2011 to mid-programme in 2012, and postprogramme in 2013. The intervention and control cities were matched in terms of sociodemographic variables and baseline levels of walking and cycling. A face-to-face survey obtained information on walking and cycling. We also drew from the New Zealand Travel Survey, a national ongoing survey of travel behaviour, which was conducted in the study areas. Estimates from the two surveys were combined using meta-analysis techniques. The trips and physical activity were evaluated. Relative to the control cities, the odds of trips being by active modes (walking or cycling) increased by 37% (95% CI 8% to 73%) in the intervention cities between baseline and postintervention. The net proportion of trips made by active modes increased by about 30%. In terms of physical activity levels, there was little evidence of an overall change. Comparing the intervention cities with the matched controls, we found substantial changes in walking and cycling, and conclude that the improvements in infrastructure and associated programmes appear to have successfully arrested the general decline in active mode use evident in recent years.
Publisher: Elsevier BV
Date: 04-2008
Publisher: Walter de Gruyter GmbH
Date: 1997
DOI: 10.1515/REVEH.1997.12.3.191
Abstract: The potential health impacts of climate change are wide-ranging, from direct impacts at familiar local scales, through indirect effects occurring at the regional or ecosystem level, to long term effects on the sustainability of global systems. To assess these potential impacts, there is a need to broaden the scope of health impact assessment. Eco-epidemiology is emerging as a response to this need. Eco-epidemiology entails a shift in focus: from direct (toxicological) to indirect (ecological) mechanisms and from effects occurring at 'human' temporal and geographical scales to those at regional and geophysical scales. We discuss the potential health impacts of climate change on each scale. At the global scale, interactions and feedbacks between systems are critical determinants of long term outcomes. From an eco-epidemiological perspective, the study of climate change becomes inseparable from the study of global change more generally.
Publisher: Elsevier BV
Date: 12-2005
DOI: 10.1016/J.SOCSCIMED.2005.04.049
Abstract: This paper describes the purpose and methods of a single-blinded, clustered and randomised trial of the health impacts of insulating existing houses. The key research question was whether this intervention increased the indoor temperature and lowered the relative humidity, energy consumption and mould growth in the houses, as well as improved the health and well-being of the occupants and thereby lowered their utilisation of health care. Households in which at least one person had symptoms of respiratory disease were recruited from seven predominantly low-income communities in New Zealand. These households were then randomised within communities to receive retrofitted insulation either during or after the study. Measures at baseline (2001) and follow-up (2002) included subjective measures of health, comfort and well-being and objective measures of house condition, temperature, relative humidity, mould (speciation and mass), endotoxin, beta glucans, house dust mite allergens, general practitioner and hospital visits, and energy or fuel usage. All measurements referred to the three coldest winter months, June, July and August. From the 1352 households that were initially recruited, baseline information was obtained from 1310 households and 4413 people. At follow-up, 3312 people and 1110 households remained, an 84% household retention rate and a 75% in idual retention rate. Final outcome results will be reported in a subsequent paper. The study showed that large trials of complex environmental interventions can be conducted in a robust manner with high participation rates. Critical success factors are effective community involvement and an intervention that is valued by the participants.
Publisher: No publisher found
Date: 2011
DOI: 10.1289/EHP.1002241
Publisher: Therapeutic Guidelines Limited
Date: 08-2005
Publisher: Environmental Health Perspectives
Date: 07-2023
DOI: 10.1289/EHP12767
Publisher: WHO Press
Date: 11-2014
Publisher: Environmental Health Perspectives
Date: 04-2014
DOI: 10.1289/EHP.1307250
Publisher: Oxford University Press (OUP)
Date: 19-07-2005
DOI: 10.1093/IJE/DYI139
Abstract: The strength of the smoking-mortality association may vary over time and by ethnic group. Cohort studies of 1.6 million (1981-84) and 1.9 million (1996-99) New Zealanders aged 25-74 years were formed by the linkage of census and mortality data. Comparing current smokers with never smokers, standardized rate ratios (RRs) and rate differences (RDs) were calculated for all-cause and ischaemic heart disease (IHD) mortality. Between 1981-84 and 1996-99 the all-cause mortality RR increased from 1.59 (95% CI 1.53-1.66) to 2.05 (1.97-2.14) for men and from 1.49 (1.42-1.56) to 2.01 (1.91-2.12) for women. All-cause RRs were significantly greater among non-Ma-ori non-Pacific than Ma-ori: 2.22 (2.12-2.33) compared with 1.51 (1.35-1.69) in men and 2.20 (2.09-2.33) compared with 1.45 in women (1.27-1.66), respectively, in 1996-99. This RR heterogeneity remained after adjusting for socio-economic factors and was similar for IHD. The RDs demonstrated less heterogeneity. For ex le, in 1996-99 the RDs were 627 per 100,000 (452-802) for Ma-ori compared with 464 (427-502) for non-Ma-ori non-Pacific among men, and 368 (228-509) compared with 340 (311-370) among women. In New Zealand the relative effect of smoking on mortality differs over time and by ethnicity. We expect that such heterogeneity exists in other countries where the background mortality rates vary over time or between social groups. Information on this heterogeneity, including ethnicity-specific data, is needed to accurately determine the mortality burden owing to tobacco. The size of the RR estimates should be interpreted in the context of absolute mortality and effect measures.
Publisher: Elsevier BV
Date: 03-2016
Publisher: Springer Science and Business Media LLC
Date: 05-2013
Publisher: Wiley
Date: 23-02-2011
DOI: 10.1002/WCC.103
Abstract: Adaptation is necessary because climate change has gained considerable momentum. Deep cuts in emissions must be made rapidly to avoid warming of 2° above preindustrial levels but this is most unlikely, given present trends. It is possible that warming may in fact reach 4°C or more by 2100. Risks to health result principally from the effects of climate change on local food production, severity and frequency of storms and floods, threats to water supplies, and the direct effects of heat. The health sector has an important role protecting health in times of climate change. However, other sectors must be involved as well—steps taken in agriculture, urban planning, water and civil defence, for instance, will have implications for prevention of illness and injury. We offer a framework for planning adaptation, taking into account present climate‐sensitive health problems, control options, and constraints. WIREs Clim Change 2011 2 271–282 DOI: 10.1002/wcc.103 This article is categorized under: Vulnerability and Adaptation to Climate Change Learning from Cases and Analogies
Publisher: BMJ
Date: 06-2004
Abstract: To ascertain whether there is an increased risk of cancers of the lung and lymphohaematopoietic tissue in workers employed in the New Zealand meat processing industry, and to identify exposures associated with any increased risks. A cohort of 6647 in iduals assembled from personnel records from three plants was followed from 1988 until 2000. The observed number of deaths and cancer registrations was compared with expected numbers using five year age and gender specific rates for the New Zealand population. Subgroup analyses evaluated the effect of duration of exposure to selected agents, based on job titles and departments. Vital status was determined for 84% of the cohort, and 92% of the total possible person-years. Mortality from all causes and all cancers was increased, and there was a significant excess of lung cancer. There were significant trends of increasing risk of lung and lymphohaematopoietic cancer with increasing duration of exposure to biological material. Excess risks were observed for mortality from all causes, all cancers, and lung cancer. Although the increased risk of lung cancer may be partly due to confounding by smoking, it is unlikely to be entirely due to this cause. Furthermore, the dose-response relation observed for lung cancer suggests the effect is related to exposure to biological material contained in animal urine, faeces, and blood. Although numbers were small, the risk of lymphohaematopoietic cancer was also associated with increasing duration and level of exposure to biological material.
Publisher: BMJ
Date: 05-2000
Abstract: Multi-level research that attempts to describe ecological effects in themselves (for ex le, the effect on in idual health from living in deprived communities), while also including in idual level effects (for ex le, the effect of personal socioeconomic disadvantage), is now prominent in research on the socioeconomic determinants of health and disease. Such research often involves the application of advanced statistical multi-level methods. It is hypothesised that such research is at risk of reaching beyond an epidemiological understanding of what constitutes an ecological effect, and what sources of error may be influencing any observed ecological effect. This paper aims to present such an epidemiological understanding. Three basic types of ecological effect are described: a direct cross level effect (for ex le, living in a deprived community directly affects in idual personal health), cross level effect modification (for ex le, living in a deprived community modifies the effect of in idual socioeconomic status on in idual health), and an indirect cross level effect (for ex le, living in a deprived community increases the risk of smoking, which in turn affects in idual health). Sources of error and weaknesses in study design that may affect estimates of ecological effects include: a lack of variation in the ecological exposure (and health outcome) in the available data not allowing for intraclass correlation selection bias confounding at both the ecological and in idual level misclassification of variables misclassification of units of analysis and assignment of in iduals to those units model mis-specification and multicollinearity. Identification of ecological effects requires the minimisation of these sources of error, and a study design that captures sufficient variation in the ecological exposure of interest.
Publisher: Oxford University Press
Date: 06-09-2009
Publisher: Wiley
Date: 10-1991
Publisher: BMJ
Date: 21-10-2012
Publisher: Springer Science and Business Media LLC
Date: 10-04-2012
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.YPMED.2013.05.001
Abstract: To estimate the incidence and risk of medically or police attended bicycle crashes in a prospective cohort study in New Zealand. 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. 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. 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.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1111/J.1753-6405.2011.00731.X
Abstract: To assess regional variations in rates of traffic injuries to pedal cyclists resulting in death or hospital inpatient treatment, in relation to time spent cycling and time spent travelling in a car. Cycling injuries were identified from the Mortality Collection and the National Minimum Dataset. Time spent cycling and time spent travelling as a driver or passenger in a car/van/ute/SUV were computed from National Household Travel Surveys. There are 16 census regions in New Zealand, some of which were combined for this analysis to ensure an adequate s le size, resulting in eight regional groups. Analyses were undertaken for 1996-99 and 2003-07. Injury rates, per million hours spent cycling, varied widely across regions (11 to 33 injuries during 1996-99 and 12 to 78 injuries during 2003-07). The injury rate increased with decreasing per capita time spent cycling. The rate also increased with increasing per capita time spent travelling in a car. There was an inverse association between the injury rate and the ratio of time spent cycling to time spent travelling in a car. The expected number of cycling injuries increased with increasing total time spent cycling but at a decreasing rate particularly after adjusting for total time spent travelling in a car. The findings indicate a 'risk in scarcity' effect for New Zealand cyclists such that risk profiles of cyclists are likely to deteriorate if fewer people use a bicycle and more use a car. Cooperative efforts to promote cycling and its safety and to restrict car use may reverse the risk in scarcity effect.
Publisher: BMJ
Date: 09-06-2011
Publisher: Springer Science and Business Media LLC
Date: 27-08-2013
Abstract: Tibet, average altitude more than 4,000 meters, is warming faster than anywhere else in China. The increase in temperatures may aggravate existing health problems and lead to the emergence of new risks. However, there are no actions being taken at present to protect population health due to limited understanding about the range and magnitude of health effects of climate change. The study was a cross-sectional survey of 619 respondents from urban Lhasa, Tibet in August 2012 with the aim to investigate public perceptions of risk, heat experiences, and coping resources. Respondents are aware of the warming that has occurred in Lhasa in recent years. Over 78% reported that rising temperature is either a “very” or “somewhat” serious threat to their own health, and nearly 40% reported they had experienced heat-related symptoms. Sex, age, education and income influenced perceived risks, health status, and heat experience. The vast majority of respondents reported that they had altered their behaviour on hot summer days. Bakuo, a sub-district at the city center, is considered especially vulnerable to heat because of sparse vegetation, high population density, poor dwelling conditions and a high proportion of low-income population. However, neighborhood social ties were stronger in Bakuo than other study locations. The study suggests that actions are needed now to minimize downside effects of rapid warming in Tibet, because of increasing human exposure to high temperatures and uneven distribution of the resources needed to cope.
Publisher: Informa UK Limited
Date: 05-12-2023
Publisher: Cambridge University Press
Date: 22-08-2002
No related grants have been discovered for Alistair Woodward.