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Biomedical subjects

D Sarfati

Publications and source records attributed to D Sarfati.

8 recordsLinked to original sources

The health of lone mothers in New Zealand.

AIMS: To compare the sociodemographic characteristics and the mental and physical health status of lone and couple mothers, and to explore possible contributing factors to any differential health status identified. METHODS: Data from the 1996/97 New Zealand Health Survey were analysed. Lone and couple mothers were compared according to sociodemographic factors, health risk behaviours and three medical conditions. Their self-reported health was measured and compared using the SF-36 questionnaire. Multivariate analyses were performed to explore the possible contributing factors to any health disadvantage identified. RESULTS: Lone mothers (n=721) were more likely to be Maori, to have lower family incomes, lower educational qualifications and to live in more deprived areas. There were no significant differences between lone and couple mothers in their prevalence of probable asthma and diagnosed diabetes mellitus, or in their self-reported physical health status after adjustment for socioeconomic variables. However, lone mothers had higher rates of ever having been on medication for hypertension (OR=2.3; 1.2-4.1), and significantly worse self-reported mental health which persisted after adjustment for differences in socioeconomic and other factors. CONCLUSIONS: These findings suggest that lone mothers are a vulnerable group and special consideration should be given to them if inequalities in health are to be addressed.

Asthma↗

A challenge to the cross-cultural validity of the SF-36 health survey: factor structure in Maori, Pacific and New Zealand European ethnic groups.

This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.

Activities of Daily Living↗

A moment in time: selected results from the 1996-1997 New Zealand health survey.

This article presents key results from the 1996-1997 New Zealand Health Survey, the second of two nationally representative surveys on the health status and health service utilization of New Zealanders. This survey involved a face-to-face interview with 7,862 adults and 1,019 children carried out during the period of a year. The survey had an adult response rate of 73.8%. Using the results of this survey, this article highlights some of the major public health issues facing New Zealanders. These issues include smoking, physical inactivity, alcohol use, asthma, and diabetes. The results presented here show that significant disparities exist between particular demographic and socioeconomic groups in New Zealand in relation to both health risk factors and specific chronic diseases. The policy implications of the results are discussed in relation to existing public health strategies and future initiatives.

Alcohol Drinking↗

SF-36 health survey reliability, validity and norms for New Zealand.

OBJECTIVE: To assess the acceptability, reliability and validity of the SF-36 health survey in the New Zealand population and provide key population norms. METHOD: The SF-36 questionnaire was part of the 1996/97 New Zealand health survey, a cross-sectional, nationally representative survey of 7,862 adults (15 years and over). RESULTS: Overall, in the New Zealand population the questionnaire performed as well as or better than in other national surveys, but there was variability in data completeness across subgroups, and responses were skewed towards the healthy end of the scales. Males scored higher than females on almost all scales; increasing age was associated with decreasing scores (with the exception of the mental health scale); and New Zealand Europeans tended to report better health than the other ethnic groups. CONCLUSIONS: Satisfactory psychometric performance was demonstrated for the SF-36 in the New Zealand population, but researchers need to find ways of increasing data completeness in population groups shown here to have lower completion rates. The questionnaire may be better at discriminating patient rather than population subgroups. The SF-36 normative data confirm in kind, if not in degree, population subgroup disparities in health status observed using objective measures. IMPLICATIONS: Overall, the SF-36 questionnaire appears to be a valid and reliable measure of health-related quality of life for the New Zealand population. However, this paper highlights issues for researchers using the SF-36, such as the skewed nature of responses obstained in a population sample.

Adolescent↗

Is confidence in immunisation declining?

There is no regular immunisation coverage information in New Zealand that is reliable. Immunisation benefit data do provide an indication of trends. The benefit data show a decline in coverage in 1997, after several years of improving coverage. The reasons for the decline are not known, but media reports which dented public and professional confidence in immunisation may have played a role.

Diphtheria-Tetanus-Pertussis Vaccine↗

Does the frame affect the picture? A study into how attitudes to screening for cancer are affected by the way benefits are expressed.

OBJECTIVE: To find out how presenting information about the benefits of screening for cancer in different ways affects an individual's decision to accept or reject screening. METHODS: A telephone survey of the Wellington region, New Zealand was carried out. RESULTS: A response rate of 75.6% was obtained. Respondents were most likely to accept screening when the benefits of screening were presented as a relative risk reduction. They were most likely to reject screening when the benefits were presented as numbers needed to screen to save on life. CONCLUSIONS: An individual's decision about screening for cancer is affected by the way the benefits are framed. Health professionals must choose between framing the benefits of screening in the most positive light, to enhance participation rates, and presenting information in such a way as to reduce framing effects--for example, by expressing the benefits in a variety of forms. Clearly there may be a tension between these approaches; the former is arguably manipulation, and the latter may enhance informed choice, but may also reduce participation rates in screening programmes.

Adolescent↗

Acute gastroenteritis diagnostic practices of New Zealand general practitioners.

AIMS: A sample of New Zealand general practitioners was surveyed to determine the laboratory referral practices of general practitioners for patients with acute gastroenteritis, with particular reference to viral gastroenteritis. METHODS: A mail questionnaire was sent to 209 general practitioners throughout New Zealand. RESULTS: The most important criteria for laboratory referral of a diarrhoeal specimen were prolonged duration of illness, presence of blood in the stool, a recent history of overseas travel, tramping or camping, shellfish consumption, or if the patient worked in the food, child care, or health care industries. Most general practitioners reported that they would refer diarrhoeal specimens from less than 25% of their patients with acute gastroenteritis. Requests for testing for viruses other than rotavirus were rare. CONCLUSION: The viral agents causing acute gastroenteritis were less likely to receive laboratory confirmation than other causes of gastroenteritis. On the basis of current laboratory investigation practices of general practitioners, foodborne viral gastroenteritis outbreaks are unlikely to be identified as such in New Zealand.

Acute Disease↗

[Auditory evoked potentials by electric stimulation of the cochlea].

The recording of auditory brain stem potentials evoked by electrical stimulation of the cochlea is a part of our assessment protocol before pediatric cochlear implantation. It constitutes an objective and reproducible method to estimate the stimulability of the auditory system for candidates to cochlear implant. Ten children, aged from 3 to 12 years, with deep deafness of the 2nd and 3rd group with no response to ABR, undergone electric stimulation of the cochlea. All patients were anesthetized and paralyzed. Electric pulses are delivered by a cochlear stimulator, through a transtympanic needle electrode, placed in the promontory. We record responses on a Medelec "Saphire" computer. One of the main problem we try to solve is the stimulus artefact which occurs during the first ms. The other one is to be sure that the recorded responses are corresponding to the neural activity of the auditory nerve and the brainstem auditory pathway.

Anesthesia, General↗